Medical Weight Loss
Medical weight loss using GLP-1 medications like semaglutide—prescribed and monitored by your primary care physician, not a med spa.
At Three Rivers Medicine, we offer a physician-led GLP-1 weight-loss program that is fully integrated into primary care. This means your weight-loss plan is based on your overall health, medical history, and long-term goals—not just a number on the scale.
Our approach focuses on safety, personalization, and ongoing medical support so you can lose weight in a healthy, sustainable way.
What Is GLP-1 Weight-Loss Therapy?
GLP-1 medications help support weight loss by reducing appetite, helping you feel full sooner, and improving how your body regulates food intake. These medications can be very effective for some people when used appropriately and under medical supervision.
At Three Rivers Medicine, GLP-1 therapy is offered as part of your primary care—not through a standalone or online program. This allows us to monitor your health, manage side effects, and make adjustments based on how your body responds.
Why Physician-Led Care Matters
Weight-loss medications affect more than appetite alone. They can impact digestion, blood sugar, energy levels, and overall health. Having a physician oversee your care helps ensure the treatment is safe, appropriate, and aligned with your broader health needs.
- A medical evaluation before starting medication
- Lab work to establish a safe baseline
- Ongoing follow-ups and dose adjustments
- Monitoring for side effects and overall health changes
This level of care is difficult to achieve through prescription-only or non-medical weight-loss programs.
How the Program Works
Step 1: Complimentary Consultation
We start with a free consultation to learn about your goals, medical history, and questions. This visit helps determine whether GLP-1 therapy may be right for you.
Step 2: Medical Evaluation
If you choose to move forward, we complete a clinical assessment that may include labs and a review of your overall health to ensure treatment is safe.
Step 3: Personalized Care Plan
If GLP-1 medication is appropriate, your physician creates a customized plan that includes medication guidance, follow-up visits, and lifestyle support.
Step 4: Ongoing Monitoring
We continue to monitor your progress, adjust dosing as needed, and support you throughout your weight-loss journey as part of your primary care.
Frequently Asked Questions
What is physician-supervised GLP-1 weight loss?
GLP-1 receptor agonists like semaglutide — FDA-approved for chronic weight management — reduce appetite, increase satiety, and improve metabolic function, and at Three Rivers Concierge Medicine they're prescribed and monitored by Dr. Shoemaker as part of your primary care, not through a med spa or online subscription. This means your weight-loss plan accounts for your full medical history, current medications, and long-term health goals. It's the safest, most personalized approach to medical weight loss available in St. Louis.
How is this different from getting GLP-1s online or at a med spa?
Online prescribers and med spas typically evaluate you through a brief questionnaire, prescribe a standard dose, and provide minimal follow-up — if any. At Three Rivers, Dr. Shoemaker performs a complete medical evaluation, orders baseline labs, monitors your response with regular follow-ups, and adjusts dosing based on how your body actually responds. The medication is the same; the level of medical oversight is not.
What are the side effects of GLP-1 medications?
The most common side effects are gastrointestinal — nausea (reported in roughly 44% of participants in the STEP 1 clinical trial), constipation, and reduced appetite — which are usually manageable and often diminish as your body adjusts. More serious but less common risks include pancreatitis, gallbladder issues, and changes in kidney function, which is why physician monitoring matters. At Three Rivers in Creve Coeur, Dr. Shoemaker tracks labs and symptoms at regular intervals so side effects are caught early and addressed proactively.
How much weight can I lose on GLP-1 therapy?
The landmark STEP 1 trial published in the New England Journal of Medicine showed a mean body weight reduction of 14.9% over 68 weeks with semaglutide 2.4mg, though individual results vary based on starting weight, dosing, adherence, and lifestyle factors. Patients who combine GLP-1 therapy with nutrition guidance and exercise support typically see the best outcomes. Dr. Shoemaker sets realistic expectations and monitors your progress to ensure the approach is working safely and sustainably.
Do I need to be a member to use the weight loss program?
Yes — medical weight loss at Three Rivers is delivered within the concierge membership model, which ensures you receive the ongoing physician oversight, extended visits, and care coordination that safe GLP-1 therapy requires. This isn't a limitation; it's a safeguard. The membership structure is what makes it possible to provide the level of monitoring that standalone weight-loss clinics skip.
Will I gain the weight back if I stop the medication?
Weight regain is common when GLP-1 medications are discontinued without sustainable lifestyle changes in place — which is exactly why Three Rivers integrates nutrition, fitness, and behavioral support into the program alongside medication. Dr. Shoemaker works with you to build habits that maintain results long-term, and any decision to taper or discontinue is made collaboratively based on your progress. The goal is lasting change, not medication dependence.
Is GLP-1 weight loss covered by insurance?
Coverage varies by plan and diagnosis — many insurers cover GLP-1 medications when prescribed for obesity (BMI ≥ 30) or overweight (BMI ≥ 27) with comorbidities such as type 2 diabetes or hypertension, per FDA-approved indications. Dr. Shoemaker's team at Three Rivers in St. Louis can help you navigate your specific coverage before starting treatment. The membership itself covers the physician oversight; medications are billed separately through your insurance or pharmacy.
How do I know if I'm a candidate for GLP-1 therapy?
Start with a complimentary consultation at Three Rivers — or take the online assessment quiz on our website for a quick initial read. Dr. Shoemaker evaluates your medical history, current medications, metabolic health, and weight-loss goals to determine whether GLP-1 therapy is safe and appropriate for you. Not every patient is a candidate, and she'll tell you honestly if a different approach would serve you better.
