Medical Weight Loss

Weight Loss

5-AMINO 1MQ

Excess weight and obesity can be difficult to reverse or treat effectively. This can be due to changes in metabolism that reduce the ability of the body’s fat stores to break down and become available as a source of energy. As a result, people affected by excess weight and obesity may find it harder to lose weight over time regardless of diets, eating styles or activity patterns.

As fat cells grow larger, they begin to overproduce an enzyme called NNMT. This enzyme acts to slow down fat cell metabolism (fat burning). As a result, it is harder for these cells to burn accumulating fat. As fat tissue grows and more NNMT is produced, greater amounts of hormones and pro-inflammatory signals are produced that are responsible for weight gain and other chronic diseases such as type 2 diabetes and cardiovascular disease.

Researchers found a molecule that blocks this metabolic slowdown in white fat cells caused by excess NNMT. By inhibiting the NNMT enzyme, we can increase fat cell metabolism and reduce the size of white fat deposits and treat the root cause of obesity and related metabolic disease we lose unwanted weight.

Can reverse diet-induced obesity
Can treat related metabolic conditions
Can increase cellular energy regulators
Can prevent lipogenesis (fat accumulation)
Can regulate energy expenditure in fat cells

In many users, 5-Amino 1MQ has a tendency to become less effective if used for more than 8-12 weeks. It is recommended to cycle it twice yearly with an equal amount of time in between use cycles. It must be taken with food to maximize absorption. It is taken orally. You can take it 1-3 times daily. Start at the lower end of the dosing and work your way up to assess individual tolerance.

AOD 9604

AOD-9604 was originally developed by Professor Frank Ng at Monash University in Australia in the 1990s, with the intent of finding an anti-obesity drug that had the fat-burning effects of human growth hormone (HGH) without the muscle-building effect.

AOD-9604 is also has regenerative properties associated with growth hormone. Currently, trials are underway to show the application of AOD-9604 in osteoarthritis, hypercholesterolemia, and bone and cartilage repair.

AOD-9604 is one of the best peptides for weight loss. It also has additional benefits that can help with fat reduction and improved metabolism. AOD-9604 displayed an excellent safety and tolerability profile.

AOD-9604 has been proven to have a strong fat-burning capacity without creating a desire to overeat. It doesn’t affect blood sugar or tissue growth. It activates degradation and fat burning (oxidation) by triggering fat release from the obese fat cells predominantly and works to reduce the accumulation of new fat in fat cells as well as increase fat burning. What is extraordinary about the AOD-9604 is its ability to reduce abdominal fat stores.

Reduces body fat
Triggers fat release from obese fat cells predominantly more than lean ones
Mimics the way natural growth hormone regulates fat metabolism
No adverse effects on blood sugar or growth
Stimulates lipolysis
Inhibits lipogenesis (the transformation of non-fatty foods into body fat)
Favorable cartilage repair and regenerative properties, especially when paired with peptide BPC 157

AOD-9604 alone is very effective. It is taken once daily as a subcutaneous injection of 300 mcg in the AM while fasted, 1 hour before cardio or your first meal. The other option is twice daily subcutaneous injection of 250mcg, once in the AM 1 hour before your first meal and once at bedtime 1-4 hour after your last meal. You can cycle from 6 weeks to 6 months then taking a 1 week break. You can also choose to fast 3-4 hours or longer after your 1st morning injection to see if the fasted state increases the rate of fat loss. Give this protocol at least 3 months to judge how effective it is. Store this in the refrigerator.

MOTS-C

MOTS-C, is a naturally occurring peptide produced by the mitochondria in your cells. It regulates cellular and systemic glucose metabolism and restores insulin sensitivity. Excess calories can overwhelm the mitochondria and cause mitochondrial dysfunction. This has many detrimental effects on metabolism and is strongly associated with weight gain.

MOTS-c regulates metabolic functions throughout the body, including turning glucose into usable energy. MOTS‐c targets skeletal muscle tissue. The skeletal muscle enhances insulin sensitivity and increases glucose uptake in myocytes (muscle cells) by activating the AMPK pathway and at the same time without increasing insulin. It imitates exercise on the body without exercising. Exercise also increases muscle glucose uptake without stimulating insulin.

It doesn’t seem to have much of an effect on people that are already lean.

Helps with weight loss
Promotes fatty acid metabolism in the liver
Helps regulate mitochondrial energy
Protects against age and diet dependent insulin resistance and obesity
Improves exercise capacity and glucose regulation
Promotes cell differentiation to form osteoblasts and helps to prevent osteoporosis

MOTS-C is a subcutaneous injection given in the dosage of 10mg (1 mL) either once weekly or three times weekly.

AMLEXANOX & TTA PEPTIDES

Amlexanox is an anti-inflammatory and anti-allergic compound which has traditionally been used to treat ulcers by reducing healing time and pain, but is also used for weight loss.

It has multiple mechanisms of action, including inhibiting inflammation by inhibiting the release of histamine and leukotrienes. It has been shown to selectively inhibit inflammatory mediators, which produces weight loss and improved insulin sensitivity.

It protects the body from excess fats by clearing fats from the blood to be used by muscle or liver cells. It is a fatty acid that does not get used for fuel by the body, but instead helps to regulate how much fat the body stores by influencing genes that control the metabolism.

TTA can help individuals feel full more quickly while the fatty acid decreases overall hunger and burns fat. In addition to regulating fat metabolism, this fatty acid has LDL lowering, antioxidant, cardioprotective, anti-inflammatory and immunity-enhancing properties.

Amlexanox/TTA is taken orally three times daily.

TESOFENSINE

Tesofensine is classified as a presynaptic serotonin–noradrenaline–dopamine reuptake inhibitor. It was originally developed for the treatment of Alzheimer’s and Parkinson’s but failed to demonstrate efficacy but weight loss was a consistently reported side effect. Tesofensine acts primarily as an appetite suppressant with simultaneous effects on fat oxidation and resting energy expenditure.

Along with diet and lifestyle changes, tesofensine can help reverse blunted dopamine response in obese patients. This combined with exercise (which boosts dopamine) will help with weight loss.

In general, tesofensine is very well tolerated with few adverse effects. When measuring cardiovascular effects, a low but statically significant increase in heart rate was noted but no significant effect on blood pressure at any of the doses tested. Tesofensine has been given FDA approval as an orphan drug.

Potential side effects of tesofensine are similar to other currently approved weight loss medications. In recent clinical trials, side effects such as dry mouth, insomnia, tachycardia, constipation, nausea, diarrhea, high blood pressure and increases in heart rate were reported.

Tesofensine is taken orally once daily. It comes in 250 mcg, 500 mcg and 1mg capsules

SEMAGLUTIDE & TIRZEPATIDE

These medications fall into the GLP-1 agonist class of drugs. GLP-1 stands for Glucagon-like peptide 1. GLP-1 is secreted when we consume carbohydrates and fats. It stimulates the release of insulin, suppression of glucagon, slower gastric emptying, and increased satiety (fullness). Tirzepatide is also known as a glucose-dependent insulinotropic polypeptide (GIP).

Both of those hormones are released when we eat food. Both Semaglutide & Tirzepatide affect these receptors and causes changes to various hormones involved in regulating appetite and body weight: insulin, glucagon, and leptin.

Semaglutide and Tirzepatide help naturally improve your metabolism over time, probably through its effects on leptin levels. Leptin feeds back to your hypothalamus and helps set your body set point – the number of calories your body burns which in terms alters your appetite.

GLP-1 agonists were approved by the FDA for weight loss in late 2014. It’s a newer class of drugs better known for its ability to improve blood-sugar control. These medications were actually designed to treat type II diabetes, but some have also been FDA approved to treat weight loss. Semaglutide is a GLP-1 agonist also commonly known as brand names Ozempic or Wegovy.

Terzepatide is a combination GLP-1 /GIP agonist also used to treat type II diabetes. It works by increasing insulin secretion, decreasing glucagon secretion, increasing insulin sensitivity, and delaying gastric emptying. Because Tirzepatide mimics the effects of 2 hormones, it is found to be more effective than Semaglutide for some people. Tirzepatide is also known as Mounjaro.

Helps to induce weight loss
Helps to slow the rate of food leaving your stomach
Helps to prevent your liver from making too much sugar
Helps the pancreas produce more insulin when your blood sugar levels are high
Helps to control blood glucose
Reduces hyperglycemia, especially after meals
Reduces fasting insulin and fasting glucose
Reduces hemoglobin A1c
Decreases appetite and caloric intake, while inhibiting weight gain
Can lower triglyceride levels and oxidative stress from high LDL
Helps to decrease leptin and increase leptin sensitivity

The use of GLP-1/GIP agonists with calorie restriction significantly enhances weight loss and improves insulin resistance, systolic blood pressure, glucose, and triglyceride concentration in the population at high risk for the development of type 2 diabetes and cardiovascular disease.

Tirzepatide is a subcutaneous injection dosed at 5-15mg once weekly, starting with 2.5mg weekly for 1 month, then 5mg weekly for 1 month. Some individuals need to increase to 7.5mg weekly for 1 month and then 10mg once weekly for 1 month. You can safely increase the dose by 2.5 mg every 4 weeks with a max dose of 15mg once weekly.

Semaglutide is a subcutaneous injection dosed at 0.25mg – 2.4mg once weekly going up from 0.25mg to 0.5mg after 4 weeks, then1mg weekly after 4 weeks, then 1.7mg weekly for 4 weeks, then 2.4mg weekly. If intolerance, delay dose titration for 4 more weeks. If that isn’t helping with tolerance, then titrate down or stop.

The benefits listed above are only achieved at a certain minimum dose and this dose is different for each person. The medications come in a multi-dose vial and are injected into your body daily or weekly depending on which one you take. We will work with you to reach the correct dose.

In clinical trials, the most common side effects observed in patients treated with these medications were nausea, low blood sugar, diarrhea, constipation, vomiting, headache, decreased appetite, upset stomach, fatigue, dizziness, and abdominal pain.

In addition, some patients who took these medications reported other side effects including pancreatitis, gallbladder disease, and renal impairment. You should stop taking it if you notice an increase in your resting heart rate that continues over time.

SETMELANOTIDE

The FDA approved Imcivree (setmelanotide) for chronic weight management in patients with obesity due to 3 genetic conditions:

POMC, PCSK1 or LEPR deficiency affect the melanocortin 4 receptor (MC4R) pathway which is responsible for transmission of signals about when to eat and when to stop eating. Patients with these deficiencies continuously feel hungry and become severely obese. Setmelanotide, the active substance contained in Imcivree, works by activating a pathway in the brain that controls appetite and feeling full. This can help patients eat less and lose weight. It also increases the number of calories that you burn by increasing resting energy.

Adverse effects associated with the use of Setmelanotide may include, but are not limited to, the following:

Setmelanotide is a subcutaneous daily injection starting at 2mg daily for 2 weeks then increase to 3mg daily. Discontinue if weight loss or BMI change is less than 5% after 12-16 weeks.

Slim Shot (Lipotropic MIC/B12)

Self-administered intramuscular injection

Lipotropics are aminos used to aid in transporting fat and removing it from the body.

Rarely: trouble breathing or irregular heartbeat but if this occurs, discontinue use