Exactly How to Ask Your Doctor for Weight Loss Medication

It’s hard enough to open up to a loved one about wanting to start weight loss medication, let alone a stranger in a sterile exam room. On top of that, discussing potential side effects, high costs, and how struggling to lose weight has affected your mental health can be overwhelming. But I’m here to tell you it doesn’t have to be a distressing experience.

As an obesity-medicine physician with over 15 years of experience helping people achieve their weight loss goals, the first thing I say to new patients is, “Congratulations!” Why? You should be proud of yourself for taking that courageous first step. People often tell me it’s the hardest part of the journey, and I completely understand. 

I’d also tell you that you should never feel nervous or ashamed to meet with an obesity doctor. While I sit with patients in weight loss consultations every day, I know this experience is unfamiliar to you, which is why I want to empower you ahead of your consultation. 

How to Ask Your Doctor for Weight Loss Medication

You’ve done the hard part and scheduled your first appointment. Before you head to the office or log on to your telehealth appointment, there are a few things you can organize in advance to help you show up confident and prepared. 

1. Know your health history

Apart from bringing the essentials (ID, insurance card, and list of current medications), you should know if you or any of your immediate family members have ever struggled with obesity or obesity-related complications such as diabetes, stroke, or heart attack. 

You’ll also need to know if you have a history of any other chronic illnesses or conditions such as cancer, irritable bowel disease (IBD) or irritable bowel syndrome (IBS), thyroid dysfunction, or other issues. That’s because a whole plethora of conditions can affect your candidacy for weight loss medication. 

To save time at the appointment, download records from your annual physicals with your primary care provider (and any other specialist you see) and send them to my office in advance.

Next, you’ll want to be able to explain why you’re considering weight loss medications. You can expect me to ask questions like:

• What is the lowest weight you’ve been in adulthood?
• What is the heaviest weight you’ve been in adulthood?
• What lifestyle changes led to your weight gain?
• What are your current obstacles to losing weight?
• What methods have you tried to lose weight? How long did you use those methods?

I’ll also need to know about your current diet and exercise frequency. For about a week before the appointment, consider jotting notes about the meals you’re eating and how often you exercise. 

It’s important to be honest here, so don’t intentionally leave off that pizza or ice cream you enjoyed a couple of nights ago. Remember, I’m here to help you, not judge you. But I can’t support you unless I fully understand your habits. 

2. Share your goals

Next, we’ll talk about why you’re pursuing weight loss treatment. I know it can be challenging to open up about binge-eating habits, losing a bunch of weight only to regain it, or struggling to maintain a workout regimen. But this information is imperative for me to know so I can create the best treatment plan possible. 

There can be many reasons driving your desire to lose weight. In my experience, the reasons tend to fall into categories I call the three M’s: mobility, metabolism, and mental health. 

Carrying excess weight can make it hard to do activities that are important to you, like having sex with your partner, playing with your kids, driving, or exercising like you want to. By losing weight, you can gain extra mobility—making it easier for you to be active and maintain weight loss. 

If you’re concerned about your risk of developing additional metabolic diseases, such as diabetes, weight loss medications can help support your metabolic health so that you keep the weight off and improve relevant biomarkers.

Finally, mental health plays a bidirectional (and underrated) role in weight loss and maintenance. For example, you might struggle with self-image because of your size and then cope by binge eating, which leads to weight gain. Breaking that cycle can be incredibly difficult, but weight loss medication can help with those mental aspects as well. 

All of these motivations for weight loss are valid in my practice, and I’ll consider your goals when we set a target weight. But before we set a goal weight, we need to make sure you’re a good candidate for these drugs. 

3. Get ready for some tests

After we discuss your health history, goals, and eating and exercise habits, I’ll have you complete two tests in my office. 

The first is a blood panel, which will show your levels of key biomarkers, including thyroid hormone, inflammation, liver, kidney, and lipids.

The next test involves stepping onto a body composition scanner, also frequently called the InBody scan. In case you haven’t heard, many doctors are moving away from using body mass index (BMI) because it doesn’t differentiate between fat and muscle. Instead, your body composition, or your percentage of fat and muscle, is a better indicator of whether or not you have obesity. 

If you’re going the telehealth route, we may consider other measurements, like the circumference of your waist, to prompt a discussion about weight loss medication. (For women the benchmark is usually over 35 inches—and for men, over 40 inches.)

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4. Learn about your treatment options

If tests show that you’re a good candidate, we can get to the fun part: Deciding which weight loss medication is best for you. 

The main factor I consider when prescribing a treatment is affordability because weight loss drugs like Wegovy and Zepbound can run you hundreds of dollars a month without insurance. Depending on your insurance, you may have coverage for only certain medications. If you don’t have insurance at all, there may be coupons or generic versions of weight loss medications available at your pharmacy. I’ll work with you to find the most accessible treatment possible.

I also consider other factors, including other medications you take, chronic illnesses (like cancer or diabetes), family history, how much weight you want to lose, and your preferred mode of taking your medication. (In other words, if you hate needles, there are other effective options.) 

Several weight loss medications can support your efforts. Popular diabetes-turned-weight-loss drugs known as GLP-1 agonists—semaglutide (Ozempic and Wegovy) and tirzepatide (Mounjaro and Zepbound)—reduce your appetite and slow gastric emptying. This can be beneficial if you struggle with reducing calories or are dealing with insulin resistance. Weight loss pills like Contrave block the reward pathways that make it tempting to binge eat, making it a great choice for people with food addiction. 

Unfortunately, there’s no sure-fire way to figure out which weight loss medication is best for you without speaking to a doctor. So if you’re curious about treatment, it’s important to schedule a consultation. 

While your primary care provider can prescribe weight loss medication, I always recommend that people seek out treatment from a board-certified obesity medicine doctor. Your regular doctor can give you a referral, or you can find a provider through resources like the Obesity Medicine Association’s provider directory or your insurance’s list of covered providers. 

If you’re most comfortable discussing your weight loss journey from the comfort of your own home, a telehealth provider like Hone is a great option, too. 

5. Don’t be afraid to ask questions

We’ll cover a lot of ground and throw around a bunch of technical terms during our initial conversation, so it’s understandable if your brain feels like mush afterward. Talking about weight loss can be mentally and emotionally exhausting. 

But this consultation is also your time to grill me about any lingering concerns you may have about kick-starting your weight loss journey. And trust me, I’ve heard it all, so don’t be afraid to hit me with all of your questions. Will my medication make me constipated? and, my bachelor party is next month, can I still drink alcohol during treatment? are both acceptable things to ask.

6. Schedule follow-ups

After you start weight loss medication, I’ll want to meet with you once a month to monitor your progress and titrate, or adjust, your dose as needed.

Most people don’t know that it’s common to start at a low dose of weight loss medication and slowly increase it over the next six to nine months. We do this to keep your weight loss progressing as your body gets used to the current dose and weight loss begins to slow down. 

At your follow-ups, we’ll continue to discuss how lifestyle adjustments are working for you. If you hit any snags, we can easily tweak your program to keep you on track.