The most commonly discussed side effects are nausea, upset stomach, and constipation - especially early on, or when doses are increased too quickly.

In most cases, side effects are less about the medication itself and more about how it’s used. Your body needs time to adapt to GLP-1s as your receptors respond and adjust. When dosing is escalated too rapidly, symptoms are far more likely.

That’s why we use a lowest effective dose approach. Allowing your body to adapt gradually helps most patients experience fewer side effects and better overall tolerance. And if symptoms do arise, you have direct physician access to support you every step of the way!  You're never left to figure it out on your own!  

It can be - if specific, strategic steps to protect muscle mass isn’t a part of the plan.

Rapid weight loss can sometimes come with unintended tradeoffs, whether medication is involved or not.

When GLP-1s are used without a comprehensive strategy, research shows that a meaningful portion of the weight lost - often around 25–40% - can come from lean muscle rather than fat.

The good news is - this isn’t inevitable. With the right approach, muscle loss can be significantly reduced - often closer to ~10% of total weight lost, while supporting strength, energy, and metabolic health.

This is why muscle preservation is a cornerstone of how we approach GLP-1 use.  We focus on helping you lose fat while protecting what keeps your metabolism strong - so the changes you see on the scale are matched by how you feel and function.

This is a valid concern - especially for women in midlife.

Bone density naturally changes with age, and factors like hormonal shifts, chronic dieting, and rapid weight loss can increase risk if bone support prioritized. This is particularly relevant during peri- and post-menopause.

Bone loss isn’t an inevitable side effect of GLP-1 medications.

In this program, bone health is considered alongside muscle, metabolism, and energy - again  not an afterthought. We focus on nutrition and movement strategies that support skeletal strength, ensure adequate fueling, and account for hormonal and metabolic changes as weight loss occurs.

When appropriate, lab data and clinical context help identify increased early risks, so adjustments can be made proactively.

The goal isn’t just weight loss - it’s protecting your strength, independence and long-term health as your body changes.

This is one of the most common - and most overlooked - challenges with GLP-1 use.

Because these medications can suppress appetite so effectively, it’s easy to unintentionally under-eat.

Over time, that can contribute to low energy, muscle loss, slowed metabolism, and stalled progress. Appetite suppression can feel like success at first, but eating too little often works against long-term results.

In the Metabolic Protection Program, the focus is on fueling adequately while using GLP-1s, so you’re still eating enough to support your body's needs while still losing weight in a steady, sustainable way.

This is one of the most common, and understandable fears, especially if you’ve already lost and regained the same weight more than once!

Weight regain is more likely when GLP-1s are used without a plan for nutrition, muscle preservation, and long-term habits. While medication can reduce appetite, it doesn’t automatically create the structure needed to maintain results as life and hunger signals change.

That’s why GLP-1s work best when paired with intentional nutrition and lifestyle strategies that support metabolism and protect muscle.

The medication helps create space (fewer cravings and less food noise) so you can build routines that make weight loss far more likely to last.

The goal isn’t just to lose weight. It’s to maintain your weight loss long-term! 

This is an important question - and one we plan for from the very beginning.

GLP-1s are prescribed with the goal of eventual tapering in mind. We emphasize using the lowest effective dose - enough to reduce hunger and cravings while still allowing you to eat adequately, build sustainable routines, and protect your metabolism.

Some people benefit from longer-term low-dose use, while others are able to taper after several months. On average, patients I work with use GLP1s for months, not indefinitely. When it’s time to reduce or discontinue medication, we do so gradually and intentionally to help minimize rebound hunger and cravings.

The focus is always on building a foundation that supports your body - so progress can continue with or without medication.

Fatigue is a common concern - and when it happens, it’s often a sign that the body isn’t being adequately fueled or supported during weight loss.

Our approach doesn’t prioritize rapid weight loss or pushing through exhaustion. Instead, the focus is on steady progress supported by nutrition strategies that help stabilize energy levels and support how your body responds to food.

Rather than relying on caffeine to get through the day, you’ll learn how to fuel and structure your routine in a way that supports your natural energy - so you can become consistently present in your daily life, without constant fatigue or burnout.

• Monthly Prescription Costs - Included
  • Compounded GLP-1 medication + supplies and shipping - all included in the first 4 months of the program! 
  • After completion of the 16 week program, we can discuss ongoing partnership through monthly medication membership, as needed.

• # 10 - Hour-long Physician Appointments
  
  • 60 Minute Strategy Sessions - not rushed check-ins
  • Personalized, private appointments to fast-track your progress, troubleshoot challenges and refine your strategy based on your evolving needs. 
  • You're not left to figure this out alone!  You'll receive the knowledge, tools and personalized guidance to implement what you learn - every step of the way! 

• Unlimited Physician Messaging Access 
  • Concierge level of support and communication - with direct physician messaging 
  • No middleman, no runaround, just clear, personalized guidance - to eliminate guesswork and unnecessary delays. 
  • Convenient access between appointments to get answers quickly and move forward with clarity and confidence.  

Throughout the program, you will gain a strong foundation in nutrition including insights into food quality, portion sizes and smart shopping strategies.  Most importantly, you’ll master the principles of ideal meal composition, as well as the frequency and timing of meals and snacks.  You’ll be able to confidently plan and prepare balanced meals that nourish and fuel your body in the best way possible.  

• 6 Week Custom Nutrition Plan:
  
  • You will have access to a customized daily meal plan for the first 6 weeks - created specifically for you, based on your body's calorie and macronutrient needs, as well as your food preferences. 
  • It's fully tailored to the type and amount of fuel your body needs to function efficiently, while still supporting weight loss.   
  • No time wasted - just clear direction and early momentum.
    • You start seeing steady progress right away, while gaining the knowledge and confidence to build balanced meals and snacks on your own. 

• Personalized Nutrition Blueprint 
  • You’ll finally know how to fuel your body the right way, with a personalized nutrition blueprint designed to help you lose weight without deprivation or food rules. 
  • Your blueprint outlines exactly how much protein, carbohydrates and fat your body needs - to support metabolism, preserve muscle, and maximize results - especially important if you’re using GLP-1 meds. 

• $400 Credit toward EITHER:
  • Functional Lab Testing - taking an in-depth look at your internal metabolic environment (thyroid, cortisol, insulin regulation, lipids, inflammation markers and female hormone balance) when appropriate.  
    • See the "Why Functional Labs" section to learn why this may be important! 
  • Biometric tracker: Apple watch, Garmin or Fitbit - to monitor key health metrics such as activity levels, heart rate, sleep etc.  

• Complete Weight Loss Course: 
  • Throughout this program, you are given clear, practical resources broken down in a simple, easy-to-apply way.  This helps you to understand not just what to do, but why it works.
    • Your daily decisions shift from blindly following a plan to making confident, informed choices that actively support your results!   
  • Resources include informational video series each week, that Dr. Rafter has hand crafted and recorded, as well as educational handouts and printable resources to help you implement your personalized strategy.  
  • Topics Include:
    • Foundations of Nutrition & Meal and Snack Composition
    • Insulin and Blood Sugar Regulation - a hidden driver of fat loss resistance
    • Chronic Stress and Cortisol Levels - Why you hold on to excess belly fat
    • Exercise for Weight Loss - Which types of movement matter for fat loss and body recompositing - without spending hours in the gym 
    • Metabolism - Understanding the 4 ways our bodies burn calories - and how to maximize your daily calorie burn without slowing metabolism 
    • An Intro to female hormone health - including the connection between weight gain in perimenopause and menopause - as well as topics on inflammation, sleep and recovery, approaching vacations/travel/eating out, and more! 

• 1 Year App Subscription - Nutrition, Exercise and Biometric Tracking  

Food and Biometric Tracking

• • Easily track your food intake (barcode scanner, AI picture functionality) 
  • Weekly food-log review:
    The app connects with our team!  So we can review your nutrition log weekly, fine tune and adjust along the way, helping you build confidence and maximize your results as you learn to compose your daily meals and snacks!

Exercise and resistance training routines built-in to the app!    

• • No need to purchase additional apps, fitness classes or exercise programs. This app has full access to resistance training routines, designed by personal trainers to meet the needs of all fitness levels. 
  • Includes at home workouts, resistance band workouts, and specific routines for those who have access to a gym.