Are you struggling to achieve your weight loss goals despite your best efforts?
At Pure Medicine, we understand that weight management can be challenging, and we're here to offer comprehensive solutions tailored to your unique needs.
Dr. Pastorek has decades of experience guiding patients through their weight loss journeys. He is excited to introduce you to a range of medical weight loss strategies, which will make a significant difference in your path to a healthier you.
When traditional approaches to weight loss, such as diet and exercise, aren't yielding the desired results, medical weight loss medications can provide a valuable adjunct to your efforts. These medications are designed to support your weight loss journey by targeting specific mechanisms in your body to help regulate your appetite.
Many of our patients use weekly B12 lipotropic injections to help with energy levels and weight loss.
These injections are not required as part of a medical weight loss plan, but they are available for purchase at Pure Medicine and can be given once a week by our staff.
$35 per injection
Phentermine is an appetite suppressant that works by affecting the central nervous system, reducing hunger, and promoting feelings of fullness. It is normally taken once a day, alone or sometimes with other weight loss medication(s).
Like phentermine, phendimetrazine also acts as an appetite suppressant. It stimulates the central nervous system to help you consume fewer calories.
Phendimetrazine is a shorter-acting medication, so unlike phentermine, which is given once daily, phendimetrazine is prescribed to be taken three times daily.
Phendimetrazine is classified by the DEA as a schedule III-controlled medication, meaning there is moderate potential for abuse.
Typically, Dr. Pastorek will sometimes switch patients from phentermine to phendimetrazine after a few months of phentermine therapy if there is a plateau due to building a tolerance to phentermine. The benefit of phendimetrazine is that it is essentially taken before each meal and has a significant appetite-suppressant effect an hour or so after being taken. The downside is that many people have a difficult time remembering to take the midday and/or evening doses, and when doses are missed, appetites return with a vengeance.
Still, phendimetrazine can be a good weight loss medication when fighting for that last few pounds of weight loss towards the end of the diet, when phentermine’s effectiveness wanes.
Side effects / restrictions of phendimetrazine are almost identical to the side effects of phentermine (see above).
Semaglutide is an injectable medication taken once a week that mimics a hormone in the body to regulate blood sugar and decrease appetite. It has gained so much recognition for its potential to promote significant weight loss, that supply-chain issues have developed a few times in the last year.
Mounjaro is only FDA approved for Type 2 Diabetes, however Zepbound (also tirzepatide) is a new medication that is FDA approved for weight loss.
Unlike semaglutide (Wegovy/Ozempic), Mounjaro/Zepbound (tirzepetide) mimics 2 hormones in the body (not 1) to regulate blood sugar and decrease appetite.
Qsymia is a combination medication that contains phentermine and topiramate.
While phentermine suppresses appetite, topiramate helps with reducing food cravings.
Qsymia is often used when patients have a difficult time tolerating the side-effects of phentermine (rapid heart rate/palpitations, insomnia, high blood pressure), as it allows for a lower dose of phentermine (7.5 to 15mg vs 37.5mg).
The topiramate helps augment the lower dose of phentermine to achieve weight loss results like full-dose phentermine but with a much lower side effect profile.
Because Qsymia contains phentermine, it also is classified by the DEA as a schedule IV-controlled medication, meaning there is a low to moderate potential for abuse. While on Qsymia, Dr. Pastorek requires monthly visits (in office or telemedicine) to appropriately monitor vital signs, efficacy, and side effects.
Qsymia can be used slightly longer than phentermine, since the phentermine dose is lower, but it is not a medication that is normally taken indefinitely.
Side effects are like phentermine (see phentermine), though due to the lower dose of phentermine in Qsymia, side effects are much milder.
Cost can be an issue (around $500/month), though the manufacturer does offer prescription assistance, and insurance coverage is often helpful.
Also, dosing can be approximated for the generics, phentermine and topiramate, bringing the cost down under $100/month.
This medication was initially developed as an anti-seizure drug and is also used to treat migraines. It has also been found to aid in weight loss, specifically when combined with other medications like phentermine, by reducing appetite and increasing feelings of fullness (See Qsymia).
Contrave combines bupropion and naltrexone to target the brain's reward system and control cravings. It can be particularly effective for emotional or binge eating.
This medication can be used long term for weight loss and typically results in gradual weight loss over time.
Bupropion is a commonly used antidepressant and is also used under the trade name Zyban to help people quit smoking.
Naltrexone is used to block opiates, so for anyone chronically taking opiates, Contrave is contraindicated, as it will block the effects of opioid pain medication, making them ineffective. By blocking opiate receptors, naltrexone helps dampen dopamine surges from stress eating (you basically won’t get the ’sugar high’ while taking Contrave because of the effects of naltrexone).
Patients with chronic pain, who take opioids, should not take Contrave, as the naltrexone will block the effects of narcotic medicines.
If you develop worsening depression or suicidal thoughts while on Contrave, you should stop the medication and call your doctor.
While every patient is different, and Dr. Pastorek tailors weight loss plans according to each individual patient’s needs, this is what most patients can expect at Pure Medicine.
Dr. Pastorek will get a thorough medical history, which will include ascertaining risks of heart disease/stroke/hypertension as well as talking through weight loss goals.
Basic labs will be ordered, and some patients will need an EKG and/or calcium score and/or blood pressure log before starting phentermine.
Most patients start on phentermine, while waiting for insurance approval/denial of Wegovy/Zepbound (or Ozempic/Mounjaro for those with a diabetes diagnosis). If approved (and assuming there is no delay due to supply chain issues), the Wegovy/Ozempic or Zepbound/Mounjaro is started, and the phentermine is eventually weaned off.
For those who cannot get insurance approval for Wegovy/Ozempic or Zepbound/Mounjaro, Dr. Pastorek recommends compounded semaglutide or compounded tirzepatide, and phentermine is weaned off as compounded semaglutide dosing is titrated up.
While on phentermine, patients are seen monthly in office or via telemedicine visit to discuss progress, side-effects, and to monitor vital signs.
At Pure Medicine, Dr. Pastorek provides personalized care that considers your medical history, lifestyle, and weight loss goals. He understands that every patient is unique, and our team is here to help you navigate the world of medical weight loss. We will work closely with you to determine the most suitable medication, monitor your progress, and make any necessary adjustments to your treatment plan.
Embark on your journey to a healthier weight with the guidance and expertise of Pure Medicine. Contact us today to schedule your consultation and take the first step towards a healthier, happier you.
Your well-being is our priority, and we're committed to supporting you every step of the way.
To request your appointment, please call (469) 414-9660 or contact us online today!
Pure Medicine
4645 Avon Lane, Suite 200
Frisco, TX 75033
Phone: (469) 414-9660
