Medical Weight Loss in Roanoke, VA

You have done the diets. You have done the exercise. You have probably done both at the same time, properly, for months — and the weight either did not move or came straight back.

That is not a discipline problem. For many people, appetite and metabolism work against them in ways willpower does not override.

GLP-1 medications change that. They are prescription medications, they require medical evaluation and monitoring, and they are not appropriate for everyone.

How Our Program Works

1. Free consultation. We start with your history — what you have tried, what happened, your medical background, current medications, and what you are hoping for. There is no fee and no obligation.

2. Laboratory work. We do not prescribe on symptoms alone. Baseline labs typically include a comprehensive metabolic panel, complete blood count and lipid panel, with HbA1c and thyroid testing where indicated. Labs are drawn in our office and processed through Quest Diagnostics.

At our contracted pricing, a full baseline panel usually costs under $35 in total. Insurance typically covers these once a year when medically appropriate. If you have recent labs from your primary care provider, bring them — many patients do.

3. Your plan. We review your results together, discuss which medication is appropriate, and explain what it will cost before anything is prescribed.

4. Follow-up every four weeks. Dosing is adjusted to your response, side effects are managed, and progress is reviewed. These visits are part of the program.

Semaglutide and Tirzepatide

Both are GLP-1 receptor agonists. Both reduce appetite and slow gastric emptying, which is why people eating the same food feel full sooner and stay full longer.

Semaglutide acts on the GLP-1 receptor.

Tirzepatide acts on both GLP-1 and GIP receptors, which is a meaningful difference for some patients.

Which is right for you depends on your medical history, your response and your goals. We will discuss both at your consultation.

Where Our Medication Comes From

This matters more than most people realise, and it is worth understanding before you buy a GLP-1 anywhere.

We use compounded semaglutide and tirzepatide. Not all compounding pharmacies operate the same way, and the difference is significant.

503A compounding pharmacies prepare medications for individual patients based on a prescription. They are primarily regulated by state boards of pharmacy.

503B outsourcing facilities compound larger batches for healthcare facilities. They are registered with and inspected by the FDA, and must follow Current Good Manufacturing Practice (CGMP) requirements.

We order our GLP-1 medications exclusively through a 503B outsourcing facility. If you are comparing providers, this is a question worth asking all of them.

Compounded medications are not FDA-approved products. They are prepared by facilities that are FDA-registered and inspected, which is a different thing, and we would rather explain the distinction than blur it.

Pricing

Consultation — free
Baseline labs — typically under $35 total, often covered by insurance once a year
Semaglutide — $349 per month, all doses
Tirzepatide — from $275 per month, priced by dose

Medication cost is included in the monthly price. Follow-up visits are included. We accept cash, card and HSA. We do not bill insurance for the medication itself.

Tirzepatide is priced according to your dose, and we will confirm your exact monthly cost at your consultation before you commit to anything.

What to Expect

Weight loss with GLP-1 medications is gradual. Most people see change over months rather than weeks, and dosing is usually stepped up over time to manage side effects.

Common side effects include nausea, reduced appetite, constipation or diarrhoea, and fatigue. These are usually most noticeable after a dose increase and often settle as your body adjusts. We manage them with you rather than leaving you to work it out.

Individual results vary. These are prescription medications with risks as well as benefits, and we will discuss both before you start.

Two Things Worth Saying Plainly

Muscle matters. Rapid weight loss costs muscle as well as fat. We will talk about protein intake and resistance training, because losing weight while losing strength is not the outcome you want.

What happens when you stop. The medication’s effects gradually wear off. Appetite and food cravings may increase, and some patients regain weight over time. Long-term results depend on nutrition, physical activity, adequate protein and sustainable habits. For some patients, ongoing maintenance therapy is appropriate. We discuss this before you start, not afterwards.

If you reach your goal and want to come off, most patients titrate down to the lowest dose, and some move to dosing every ten to fourteen days rather than weekly. There is no single protocol — it is whatever works for you.

Who This Is Not For

GLP-1 medications are not appropriate for everyone. We will not prescribe if you have:

A personal or family history of medullary thyroid carcinoma (MTC)
Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
A previous serious allergic reaction to the medication or its ingredients
Pregnancy

Additional evaluation may be needed if you have a history of pancreatitis, gallbladder disease, severe gastrointestinal disease or gastroparesis, kidney problems, or certain diabetic eye conditions.

We review your full medical history at your consultation. If this is not right for you, we will say so.

Why a Nurse Practitioner

Erin Alouf is a board-certified Family Nurse Practitioner. In Virginia that means full clinical evaluation, ordering and interpreting labs, prescribing, and ongoing management — one provider, start to finish.

This matters more here than in most treatments. GLP-1 medications are widely available online from services that prescribe on a questionnaire and never see you again. That is not the same thing.

Frequently Asked Questions

Is the consultation really free?
Yes. There is no fee and no obligation.

Do I need lab work first?
Yes. We do not prescribe without baseline labs. If you have recent results from your primary care provider, bring them.

How much will the labs cost?
Usually under $35 in total at our contracted pricing. Insurance typically covers them once a year when medically appropriate.

Do I have to inject myself?
That is up to you. Most patients self-administer at home after instruction. If you are not comfortable doing that, Erin will give the weekly injection in the office.

How much weight will I lose?
Individual results vary considerably. We will discuss realistic expectations based on your history and starting point rather than quoting a number.

Is this covered by insurance?
We do not bill insurance for the medication. We accept cash, card and HSA. Laboratory testing may be covered when medically appropriate.

Can I combine this with other treatments?
Often, yes. Weight management, hormone therapy, IV therapy and B-12 can work well together, though it depends on your individual needs. We will discuss what makes sense for you.