What health history does the provider review?
The history comes first because some answers rule GLP-1 medicines out before any lab is drawn. Your provider asks about your weight over the years, what you have tried, how you eat and sleep, and every medicine and supplement you take.
A few questions carry extra weight:
- Medullary thyroid cancer or MEN 2, in you or a close relative. Both semaglutide and tirzepatide carry a boxed warning about thyroid C-cell tumors and are not used with this history.
- Pancreatitis, gallbladder disease or severe stomach emptying problems. These change the risk and may change the plan.
- Insulin or a sulfonylurea. The Zepbound label warns that combining with these raises the risk of low blood sugar, so those doses may need adjusting.
- Kidney disease and diabetic eye disease. MedlinePlus lists both, along with pancreatitis and gallbladder disease, among the conditions to raise before starting semaglutide.
- Upcoming surgery. GLP-1 medicines slow stomach emptying, which matters for anesthesia; our answer on stopping semaglutide before surgery explains the timing question.
Which labs and measurements come first?
Blood is drawn on site the same day at both clinics, with results usually back in 24 to 48 hours. A typical set covers blood sugar (A1c and often fasting insulin), a lipid panel, kidney and liver function and thyroid function. If you have symptoms such as low drive or fatigue, your provider may add testosterone. Our page on lab testing before medical weight loss explains what each result changes.
The measurements matter just as much. Your weight, height, waist, blood pressure and heart rate are recorded, and a body composition analysis splits your weight into fat and lean mass, often with a visceral fat estimate. Those starting numbers are what every later check-in is compared against.
How is the medicine chosen?
Eligibility comes before choice. Weight-management medicines are generally considered at a BMI of 30 or more, or at 27 or more when a weight-related problem such as high blood pressure or type 2 diabetes is present, according to the NIDDK. Our answer on who qualifies for semaglutide goes through the details.
If you qualify, the conversation turns to which medicine and which form. Semaglutide and tirzepatide differ in how they work, their side effects and their labeled uses; tirzepatide’s label also covers obstructive sleep apnea in adults with obesity. Your provider should name the exact product, where it comes from and why it suits you. A compounded version is only on the table when a documented clinical reason applies to you.
How is the starting dose set?
The starting dose is set by the label, not by how much weight you want to lose. The Wegovy label begins at 0.25 mg once a week for four weeks, and the Zepbound label begins at 2.5 mg once a week for four weeks. Both first doses exist to let your stomach adjust, so they are not expected to produce much weight loss on their own.
From there, your provider decides each increase at a check-in, based on how you tolerate the dose and how your weight responds. Before your first dose at home, you learn the injection technique and the warning signs to watch for. Never move up a step on your own.
What should you bring?
Bring a full list of your medicines and supplements with doses, any recent lab reports, and a rough history of your weight and past attempts. Recent results from your primary care doctor may save a repeat draw; our answer on using blood work from your primary doctor explains when that works. A short list of your own questions keeps the visit focused, and our guide to the first medical weight loss visit has a checklist.
How to book your consultation
Ultimate Male sees men for weight loss at San Gabriel (Tuesday, Thursday and Friday, 10 AM to 6 PM) and Downey (by appointment). Start with a free 10-minute phone call at 626-319-5261, take the free online assessment, or go straight to booking. You get a quote before you commit, and the consultation is an evaluation, not a promise of medication. The medical weight loss program page lays out every step.
