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Alcohol preferentially becomes the primary fuel source when present, shutting down fat oxidation pathways regardless of peptide signaling

One such option is Endoscopic Sleeve Gastroplasty, often called ESG

Important considerations before combining these medications include: Absolute contraindications : The combination should be avoided in patients with cardiovascular disease, uncontrolled hypertension, hyperthyroidism, glaucoma, during or within 14 days of MAOI use, personal/family history of MTC or MEN2, pregnancy, breastfeeding, or severe gastrointestinal disease Cardiovascular risk assessment : Phentermine increases heart rate and blood pressure, which requires careful monitoring with baseline and follow-up measurements of vital signs and possibly EKG if cardiac history exists Gastrointestinal tolerability : Tirzepatide commonly causes nausea, vomiting, and diarrhea, which may be compounded by phentermine's effects Medication interactions : Tirzepatide may reduce the effectiveness of oral contraceptives during initiation and dose escalation

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Body composition is tracked using InBody analysis, allowing us to monitor not just weight, but muscle mass and overall balance