Yes, we require appointments for evaluation and management visits. All Seguin Weight Loss Clinic appointments are completely separate from PCP clinical appointments and care provided by Family Medical Center of Seguin. Your initial appointment must be in the clinic for clinical evaluation and your plan of care. Some appointments may be available via telehealth communications by arrangement, while others may require an office appointment. We hope that you will be the active participant in your weight loss/weight management health journey through the HEALTHY START and STAY HEALTHY Programs offered. Calorie/activity/weight loss tracking apps are encouraged and can be used to help us guide you both remotely and during clinic visits. Weight loss and management are a lifelong health goal. "If it is feasible, then it is possible."

The Healthy Start Program is a 10-week, initial, medically directed weight-loss program to help patients that are medically overweight redirect their eating and habits to improve health, diet knowledge, and weight loss efforts. The Healthy Start Program is not a Primary Care medical offering. Health risks may be discussed, but will not be treated with the Healthy Start Program. The Healthy Start Program is separate from any PCP/Family Medicine care scheduled or provided by Family Medical Center of Seguin. Program and Fees: Visit #1: New Client Evaluation Visit: $300-350* - for your initial evaluation and new client visit. This fee is due and payable at your first visit if care is initiated and is only refundable if our care will not be possible, or if intolerable side effects arise after the first injection. The fee includes medication costs for ten, weekly injections of the starting dose of semaglutide (0.25mg) if appropriate*. A targeted history and physical evaluation will be be completed at the first visit to consider care. If care with dietary recommendations and prescribing of semaglutide compound is appropriate, we can administer the first dose of 10U of semaglutide/B12 compound at the end of the visit. Laboratory testing may be offered during this visit to better understand your clinical health and metabolic risks. Laboratory testing fees are not included in the Health Start Program, but are often covered by your healthcare insurance. *If you are a current patient of Family Medical Center of Seguin, this fee may be reduced to $300 due to reduced administrative effort. Weekly Visit #2-4: Care Evaluations Visits: (no fees) Each week thereafter - for three more weeks -you will be encouraged to log your weekly experience, come to the clinic, or book a Telehealth visit for a brief evaluation of effects and side effects of the prior injections. You can submit your weight online, or be weighed and measured to evaluate progress. Dietary discussions and guidance can be refined. If there are no clinical problems, injections of 10U will continue. Week #10 : STAY HEALTHY Visit: $125 At the end of your injections, medication use, effects, weight loss, side effects, and dosing will be discussed and reconsidered. Dosing adjustments may be made if medication care is to be continued. If you choose to continue medically directed care and prescribing you can book and appointment with our STAY HEALTHY PROGRAM. The fee must be paid and a prescription for semaglutide compound dosing will be sent to the compounding pharmacy for ongoing medical care. The prescription and dosing for semaglutide compound is sent to a specialty pharmacy pharmacy in Schertz where you can pick the medication up, or they can have it sent to you. Ongoing medication costs after the first ten injections are not included. The price of the GLP-1 compound medications varies based on the compound and dose used for each injections. Weekly costs for semaglutide injections currently range from $7 - $50/injection depending on the dose and GLP1 medication. The prescription semaglutide medication is sold in a multi-dose vial.

The cost of the Healthy Start Program is $350.00* Habits and food are powerful. In order to make lasting changes in diet and lifestyle mismatches, it takes commitment. Likely the largest 'cost' to you will be the challenge of changing your dietary choices, purchasing patterns, and redirection your cravings that seem so difficult to avoid. Our professional fees are charged separately from clinical care so that we can lend ongoing focus to your goals. An accessible and reasonable financial commitment to your health is required to maintain your commitment by placing financial value to continue to motivate your changes. This fee includes professional and office fees for your initial evaluation visit. Additionally, it covers the medicine and administration costs of 10 weekly clinic injections of the starting dose of semaglutide (0.25mg) compound in order to evaluate the effects and possible undesirable side effects of the medication. Along the way, diet evaluation and counseling will be offered. The 10-week Program is priced at $350*. Visits, administrations and scheduled payments can be somewhat flexible. Our ongoing care is offered at a price that encourages quality, safety and ongoing participation to reach your health goals. Intake: $350 - Initial evaluation, medication consideration and administration if appropriate. *This fee may be reduced by$50 if you are a current Family Medical Center patient. Day 7 - online weight logging, quick-visit for evaluation of effect/side effects and Q&A, administration of second dose. We will check with you occasionally to evaluate the effects of this first dose. Day 14 - online weight logging and/or quick visit for ongoing evaluation and teaching, administration of the third dose. We will continue to check in via text to see if there are problems, and will monitor your weekly logging of weight and effects/side effects. Day 30 - If you wish, you can set up a Clinic visit for evaluation of the effects, and any undesirable side effects after the first month of medication and diet changes. Fourth dose injected, dose continuation, diet review, intake assessment and recommendations. Be aware that even with a drop in appetite, you still have to maintain diet focus. You still have to balance your protein, fats, and continue to minimize unhealthy carbohydrates. We encourage you to plan your meals. Even with semaglutide, you will feel hungry at times. 8 Weeks - Weight loss trend and review, diet review, activity assessment. Medication titration consideration if you believe that you need more appetite reduction support. After the 10 starting-dose vial injections are completed, medication cost is no longer included. Upon tolerability and final assessment, we encourage you to stay with your diet changes and the supportive medication with our ongoing STAY HEALTHY PROGRAM. If you wish to continue the prescription and clinical dietary support, you will be asked to schedule a STAY HEALTHY PROGRAM appointment. a prescription can be sent for ongoing care and dose escalation if appropriate or desired. The price of semaglutide compound, and other GLP-1 medications, is dependent on the dose. Current pricing ranges from $7-10/weekly injection up to >$50/injection depending on the dose and medication. Ongoing Costs: **Estimated to be ~$120/month for care and medication costs. Seguin Medical Weight Loss is not a subscription weight loss clinic requiring an ongoing, monthly subscription fee, charge or auto-debit. Once the 10-week Healthy Start Program is completed, we offer ongoing support, guidance, and prescribing through the STAY HEALTHY PROGRAM. Every three months, an appointment will be required for ongoing prescribing. During the 3-month STAY HEALTHY / Seguin Medical Weight Loss appointment, we offer ongoing dietary recommendations and request intermittent submissions/updates of your progress to goal. We request immediate contact if clinical problems should arise during the STAY HEALTHY intervals of 3 months. Our ongoing weight loss care is centered around guidance and possible dose escalation after completing the Healthy Start Program. These visits are separate from any healthcare clinic visits to Family Medical Center of Seguin. If your ongoing medication dosage is appropriate and you remain on your journey toward your healthy-weight goals, Clinician Visits will be required four times per year (every 3 months) for evaluation and refills. * *Costs may be more depending on dosing and medication

Medical care and prescriptions are not typically or currently covered by most insurance plans. It is possible that the services and costs may be covered by Health Savings Accounts and/or Flex Savings accounts. For Family Medical Center's Weigh Loss Clinic, charges are professional fees and are not billed to your insurance. Should you have a medical condition that we are treating related to weight or obesity risk factors, your insurance may cover clinical services but not likely cover prescription costs. We will work with you after the initial three month weight loss program to identify metabolic, cardiovascular, and functional issues.

No. Family Medical Center's Weight Loss Clinic does not require insurance, and we will not bill your insurance for our Getting Started Program. Care is provided as a clinical program with fixed costs for professional services guided by Dr. Zincone or Dan Thull PA-C. The costs are due and payable upon care. You may be able to seek reimbursement or payment(s) for care through your insurance, FSA, or HSA.

In your initial evaluation, we will collect necessary clinical information for appropriate care and prescribing of weight loss medications. We will need to be aware of and clinically consider medications you are currently taking, so please bring all of your current medicines to your initial visit.

At your Initial Visit, we will ask for a targeted medical, surgical, and prescription care history. If you have recent laboratory results (completed within the past 6 months), please bring them with you for review. If you have taken diet medications/injections in the past, please provide that information as well.

Lab testing and your clinical history may be important parts of your current and/or ongoing weight loss goals. Appropriate lab testing that has been completed within the past several months is adequate in most cases. At other times we will request or recommend lab testing. Please feel free to bring any recent lab testing you've had done for review. If you had your lab testing at CPL, Quest, LabCorp, or any of the local hospitals, the results of those labs are likely available to you via their 'results portal'. Please contact them, or the links below may be useful: CPL: https://www.cpllabs.com/patients/test-results/access-your-test-results-sonicmyaccess-portal/ Quest: https://www.questdiagnostics.com/log-in LabCorp: https://www.labcorp.com/patients/results GRMC: https://patientportal.grmedcenter.com/Phm-PhmHome.HomePage.WR.mthr?hcis=GVAWEB.LIVEF&application=PHM

We are able to evaluate your current goals, prescriptions, and issues in your care to see if Seguin Medical Weight Loss is a good fit for your ongoing weight loss care. Costs for care will be evaluated on a case by case basis as medications and dosing vary.

Our hours are currently limited as we balance new patient and ongoing patient volume. We are located and are a part of Family Medical Center of Seguin / Dean Zincone, MD and Dan Thull, PA-C. The office hours for Medical Weight Loss are scheduled after our daily Family Medicine Clinic on Wednesdays, Thursdays, and Fridays. Additional hours and telehealth visits are being considered and developed.

For weight loss only: If you are currently prescribed weight loss medications, we can most often accept and continue that prescribing and dosing for your ongoing weight management care. Continued care will be according to our professional fees and office policies. Please contact us using the contact email, chat, or text on this site for further consideration. For Primary Care: If you would like to become a patient of Family Medical Care for your primary care health needs, please contact our office at: 830-401-4401 or see www.seguinfamilypractice.com.

Health savings account (HSA) can be used to pay for a weight loss program if it's part of a treatment plan for a specific disease diagnosed by a physician, such as obesity, heart disease, or hypertension. Weight loss programs that may be eligible for reimbursement include those like the Health Start Program that include ongoing feedback and monitoring, and slow and steady weight loss goals. Each HSA Plan Administrator has different requirements, so check with them for specifics.

After completing the Healthy Start Program, we encourage you to continue toward your metabolic health goals. Care for ongoing visits and prescribing will not be covered by your insurance in most cases. Professional fees for clinical visits, that can be estimated to be scheduled every three months, are currently billed at $125/visit. The fees for ongoing medication / prescriptions are variable based on medication(s) and dosing.

There are a variety of traditional and non-traditional appetite suppressant and combination products that may be considered. Until recently, few were successful long-term or had undesirable side effects. While GLP-1 medications have been available and used clinically for more than 15 years, only recently have they been studied and utilized effectively for medical weight loss. New medications like Ozempic, Wegovy, Mounjaro -- and their peptide/compound equivalents -- will be followed by many new candidates currently being studied. Our program is experienced and capable with all of the current medications to help you meet your goals. We will remain up to date with current advances in weight loss and related clinical care.

Currently, many traditional weight loss medications are available broadly. Supply chain problems, costs, and insurance coverage currently restrain use of the several branded GLP-1 medications. We have qualified and utilize a local, certified compounding pharmacy in Schertz that ensures stringent quality control, sterility, and dispensing. All compounding and dispensing is through licensed pharmacy business practices and the professional licensing of the pharmacists.

Refills for medications must be authorized by Family Medical Center. While you may contact the pharmacy for a refill, ongoing care and refills must be authorized by our Providers.

Family Medical Center has been a private Family Medicine practice in Seguin for more than 30 years. Since obesity is endemic in the adult population and viable solutions for safe and effective medical weight loss are recently available we now offer more focused treatment. However, insurance companies are reluctant to cover or pay for our services and/or your weight-loss prescriptions. So we often must separate professional fees for the weight loss and obesity care offered. If you do not currently have a primary care office, Family Medical Center has openings for new patients. If you are an established patient of our practice, other medications you might take for your health will be refilled according to office policies and practice. If you only allow us to help you with your weight loss journey, you'll have to contact your primary or other prescribing doctor's office for refills of other medications. We view medical weight loss as a critical component of overall health for those that are obese.

Drugs and Supplements - from mayoclinic.org Semaglutide (Subcutaneous Route) Descriptions Semaglutide injection is used to treat type 2 diabetes. It is used together with diet and exercise to help control your blood sugar. This medicine is also used to lower the risk of heart attack, stroke, or death in patients with type 2 diabetes, obesity, and heart or blood vessel disease. Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist. Semaglutide injection is also used together with diet and exercise to help lose weight and keep the weight off in patients with at least one weight-related medical condition. This medicine is available only with your doctor's prescription. Before Using In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. Allergies Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Geriatric Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of semaglutide injection in the elderly. However, elderly patients are more sensitive to the effects of this medicine than younger adults. Breastfeeding There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Drug Interactions Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Other Interactions Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco. Other Medical Problems The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially: Depression, history of or Diabetic retinopathy, history of or Digestion problems or Kidney disease or Type 2 diabetes (for patients using semaglutide®)—Use with caution. May make these conditions worse. Diabetic ketoacidosis (ketones in the blood) or Type 1 diabetes—Should not be used in patients with these conditions. Insulin is needed to control these conditions. Multiple endocrine neoplasia syndrome type 2 (MEN 2) or Thyroid cancer, history of—Should not be used in patients with these conditions. Pancreatitis (inflammation of the pancreas), history of—It is not known if this medicine will be safe in patients with this condition. Proper Use When you start using this medicine, it is very important that you check your blood sugar often, especially before and after meals and at bedtime. This will help lower the chance of having very low blood sugar. Carefully follow the special meal plan your doctor gave you. This is the most important part of controlling your diabetes, and is necessary if the medicine is to work properly. Also, exercise regularly and test for sugar in your blood or urine as directed. This medicine comes with a Medication Guide and patient instructions. Read and follow these instructions carefully. Ask your doctor if you have any questions. If you will be using semaglutide at home, your doctor will teach you how the injections will be given. Be sure you understand exactly how the medicine is to be injected. This medicine is given as a shot under the skin of your stomach, thighs, or upper arm. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas. If you use this medicine with insulin, do not mix them into the same syringe. It is acceptable to inject these in the same body area, but the shots should not be right next to each other. Check the liquid in the pen. it should be clear and colorless. Do not use it if it is cloudy, discolored, or has particles in it. Use a new needle each time you inject your medicine. Never share medicine pens with others under any circumstances. It is not safe for one pen to be used for more than one person. Sharing needles or pens can result in transmission of infection. Use this medicine on the same day each week, at any time of the day, with or without meals. Dosing The dose of this medicine will be different for different patients. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless you’re told to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each month, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. For weight management and lowering the risk of heart attack or stroke: For injection dosage form (semaglutide solution): Adults—At first, 0.25 milligrams (mg) injected under the skin once a week for 4 weeks. Your doctor may increase your dose every 4 weeks. However the dose is usually not more than 2.4 mg once a week. Missed Dose If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. If you miss a dose of semaglutide, use it as soon as possible within 5 days after your missed dose. If you miss a dose for more than 5 days, skip the missed dose and go back to your regular dosing schedule. If you miss a dose of semaglutide, and the next scheduled dose is more than 2 days away, use it as soon as possible. If you miss a dose, and the next scheduled dose is less than 2 days away, skip the missed dose and go back to your regular dosing schedule. If you miss a dose of this medicine for more than 2 weeks, use it on the next scheduled dose. Ask your doctor about how to restart your treatment. Storage Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed. Ask your healthcare professional how you should dispose of any medicine you do not use. Store in the refrigerator. Do not freeze. Store your new, unopened medicine bottle in its original carton in the refrigerator. Do not freeze. Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets. Precautions It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects. Do not use this medicine for at least 2 months before you plan to become pregnant. This medicine may increase the risk of having thyroid tumors. Contact the medical office if you have a lump or swelling in your neck or throat, trouble swallowing or breathing, or if your voice gets hoarse. Pancreatitis (swelling of the pancreas) may occur while you are using this medicine. Contact the medical office if you have sudden and severe stomach pain, chills, constipation, nausea, vomiting, fever, or lightheadedness. Contact us right away if you have gaseous stomach pain, indigestion, recurrent fever, severe nausea or vomiting, stomach fullness, or yellow eyes or skin. These may be symptoms of gallbladder problems (eg, cholelithiasis, cholecystitis). This medicine may cause diabetic retinopathy. Contact us if you have blurred vision or any other changes in vision. This medicine does not cause hypoglycemia (low blood sugar). However, low blood sugar can occur when you use semaglutide with other medicines, including insulin or sulfonylurea diabetes medications, that can lower blood sugar. Low blood sugar also can occur if you delay or miss a meal or snack, exercise more than usual, drink alcohol, or cannot eat because of nausea or vomiting. Symptoms of low blood sugar include anxiety, behavior change similar to being drunk, blurred vision, cold sweats, confusion, cool, pale skin, difficulty with thinking, drowsiness, excessive hunger, fast heartbeat, headache (continuing), nausea, nervousness, nightmares, restless sleep, shakiness, slurred speech, or unusual tiredness or weakness. If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes, or drink fruit juice, non-diet soft drink, or sugar dissolved in water to relieve the symptoms. Also, check your blood for low blood sugar. Glucagon is used in emergency situations when severe symptoms including seizures or unconsciousness occur. Have a glucagon kit available, along with a syringe and needle, and know how to use it. Members of your family should also know how to use it. This medicine may cause serious allergic reactions, including anaphylaxis and angioedema, which can be life-threatening and require immediate medical attention.Contact us right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, mouth, or throat while you are using this medicine. This medicine may cause acute kidney injury.Contact us right away if you have a bloody urine, decreased urine output, muscle twitching, nausea, rapid weight gain, seizures, stupor, swelling of the face, ankles, or hands, or unusual tiredness or weakness. This medicine may increase your heart rate while you are at rest.Contact us right away if you have a noticeably fast or pounding heart beat. Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your antidiabetic medicine, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual. Symptoms of high blood sugar include blurred vision, drowsiness, dry mouth, flushed, dry skin, fruit-like breath odor, increased urination (frequency and amount), ketones in the urine, loss of appetite, stomachache, nausea or vomiting, tiredness, trouble breathing (rapid and deep), unconsciousness, or unusual thirst. If symptoms of high blood sugar occur, check your blood sugar level and then call your doctor for instructions. This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Also. contact us if you have sudden or strong feelings, including feeling nervous, angry, restless, violent, or scared. If you or your caregiver notice any of these side effects, tell your doctor right away. Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. Side Effects Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Contact us immediately if any of the following side effects occur: Less common Belching bloated, full feeling excess air or gas in the stomach or intestines gaseous stomach pain heartburn passing gas recurrent fever stomach discomfort, fullness, or pain yellow eyes or skin Rare Burning feeling in the chest or stomach indigestion stomach upset tenderness in the stomach area Incidence not known Anxiety blurred vision chest tightness chills cold sweats confusion cool, pale skin cough darkened urine difficulty swallowing discouragement dizziness fast heartbeat feeling sad or empty headache hives, itching increased heart rate increased hunger irritability lack of appetite large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs loss of consciousness loss of interest or pleasure nausea nightmares pains in stomach, side, or abdomen, possibly radiating to the back puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue redness of the skin seizures shakiness skin rash slurred speech tiredness trouble breathing trouble concentrating trouble sleeping unusual tiredness or weakness vomiting Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: More common Diarrhea Less common Constipation hair loss Rare Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site change in taste loss of taste Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Achieving weight loss through conventional diet and exercise can be an uphill battle when it comes to reducing and controlling unwanted fat long-term. Semaglutide therapy provides a significant advantage, as patients can experience a 15% to 20% reduction in body weight. Historically, traditional diet and exercise methods typically yield a mere 2 to 3 percent decrease - that is often short term. The effectiveness of semaglutide stems from its ability to slow down gastric emptying, resulting in reduced appetite. By delaying the release of glucose from consumed food, this mechanism prompts individuals to consume less, leading to more substantial weight loss.