Thank you for choosing Washington University Metabolic Weight Management. We are looking forward to meeting you and helping you improve your health and quality of life through weight loss and a healthy lifestyle.


Medication information

Many of our patients are interested in using weight-loss medications to assist in achieving their health goals. Please review these notes about the use of weight-loss medications in our practice:

  • Weight-loss medications may be appropriate for patients with a Body Mass Index (BMI) above 30 kg/m2, or those with a BMI above 27 who also have a related health condition such as diabetes or hypertension. Medication may be appropriate for some patients with a BMI 25-30 without associated medical problems, but insurance coverage is likely to be limited.
  • Medications are only one of the tools used in the management of the chronic illness of obesity. They are not effective without lifestyle modifications. In all studies looking at the effectiveness of weight loss medications, the medications are added to a plan of healthy eating and physical activity.
  • Medications are typically not prescribed at an initial appointment, as we need to gather and review information in order to make the best recommendations.
  • Medications such as Wegovy, Saxenda, and Zepbound (also called GLP drugs or weight-loss shots) have been receiving a lot of attention in the media and are very effective. However, these are not the only options. The sites below have additional information about the currently available, FDA-approved weight-loss medications.
  • Medications for other conditions may help with weight loss. These may be an option for patients who do not have insurance coverage for or meet criteria for weight-loss drugs. This includes the injected diabetes medications Ozempic and Mounjaro. But please be aware that it has been getting harder to get these medications approved for patients who do not have type 2 diabetes.
  • Many insurance plans do not cover medications indicated and approved only for obesity or weight loss. While we and many others are working to improve this bias in the system, it remains a limiting factor in treatment.
    If you are interested in weight-loss drugs, it is helpful if you are able to check prior to your appointment whether these medications are covered by your insurance plan and, in particular, if Wegovy and/or Saxenda are on formulary or are exclusions.
  • We will work with you to try to get the best, most appropriate treatment; however, sometimes when a medication is denied, there is not anything we can do.

More information on weight loss medications:
National Institute of Diabetes and Digestive and Kidney Diseases | Prescription Medications to Treat Overweight & Obesity
Mayo Clinic | Prescription Weight-Loss Drugs

Due to the high demand for weight loss medications, please review the following information:
  • Many, but not all, patients in our practice use weight loss medications to assist them in achieving their health goals.
  • Overweight and obesity are usually diagnosed using a calculated value called the “Body Mass Index (BMI)” which reflects your weight relative to your height. Insurance coverage for weight loss medications is often based on your BMI value.
  • Weight loss medications may be appropriate for patients with a BMI of 30 or greater (which is a person who is at least 30-40 lbs. above ideal body weight), or those with a BMI of 27-30 who also have a related health condition, such as diabetes or high blood pressure.
  • Medications are only one of the tools used in the management of the chronic illness of obesity. Medications are more effective when used together with lifestyle modifications that include healthy eating and increased physical activity.
  • Overweight and obesity are chronic medical problems and, in most cases, long-term use of medications is anticipated. Weight regain is typical after stopping any weight loss medication.
  • Medications are typically not prescribed at an initial appointment because we need to gather and review your medical information in order to make the best recommendations.
  • Medications such as Wegovy, Saxenda and Zepbound (also called GLP-1 drugs or weight loss shots) have been receiving a lot of attention in the media and are very effective. However, these are not our only options! The sites below have additional information about the currently available, FDA-approved weight loss medications.
  • Medications indicated for conditions other than obesity may also help people lose weight and are sometime used “off-label.” (They are not FDA-approved for weight loss but have studies supporting their use.) These include diabetes medications such as Ozempic, Trulcity and Mounjaro; it is, however, difficult to get these medications approved for patients who do not have type 2 diabetes.
  • Many insurance plans do not cover weight loss medications that are approved only for obesity.
    It will be helpful if you are able to check whether weight loss drugs are covered by your insurance plan before your appointment. (In particular, ask or look online to see whether Wegovy, Saxenda and Zepbound are on formulary or are plan exclusions.)
  • We will work with you to try to get the best, most-appropriate treatment. However, sometimes when a medication is denied there is not anything we can do to enable you to obtain it.
What to expect at your initial Metabolic Weight Management appointment:

A completed new patient information packet is required at the time of your first appointment. This allows your provider to spend your appointment time focused on weight management.

The initial visit is largely devoted to information gathering; in many cases this will be scheduled with our Nurse Practitioner.

Your provider will review your past medical history with you and will discuss your weight history in detail. You will have a complete physical exam (excluding GYN/genitourinary).

Blood tests to evaluate conditions that can contribute to or be caused by overweight/obesity will be ordered if they have not been completed recently, and a baseline EKG may be required.

A calorie deficit (taking in fewer calories than you burn) is necessary to lose weight. Your provider will calculate your estimated energy requirements and recommend a calorie intake level. He or she will discuss dietary macronutrients (protein, carbohydrate, and fat) as appropriate. You will be asked to keep a food record to review at your follow-up visit. An “after visit summary” including the provider’s recommendations will be printed at the end of your appointment (or will be available through My Chart for virtual appointments).

In general, you will not be given a specific, detailed menu or meal plan. A referral to a dietitian who can assist with this may be considered. A list of resources which provide additional information will be provided.

Overweight and obesity are complex chronic medical conditions. There is no one approach towards weight loss that is best for everybody; many factors go into determining the most appropriate plan. A weight loss of 1-2 lbs per week is considered successful. Rather than being told what your weight “should be” or necessarily targeting a “normal” weight, the focus is on health benefits. An initial goal is 5% weight loss which is associated with significant risk reductions.

You will be scheduled for a follow-up appointment approximately one month after your initial visit. If you have seen the Nurse Practioner for your initial appointment, this follow-up will be scheduled with Dr. Reeds. More specific recommendations will be made at the second visit after review of labs, EKG if applicable, food record, and additional discussion of related factors including hunger, cravings, etc. While medications are appropriate for many patients, discussion of this is generally deferred until the 2nd visit.

A copy of your provider’s note and of any testing done will be sent to your PCP. Your Medical Weight Management provider may recommend or make changes to medications for conditions that are associated with obesity and/or can be affected by weight loss, such as diabetes or hypertension.

It may be recommended that you follow up with a therapist or counselor to assist with behavior change.

We look forward to working with you!