Weight Loss Questions & Answers (FAQ)
Many patients report feeling less hungry once they reach ketosis. Healthy fats and adequate protein can help increase satiety, making it easier to reduce calorie intake without constantly feeling deprived. Individual experiences vary, especially during the first week of the program.
Weight regain is common after GLP-1 therapy is stopped, which is why maintenance should be planned before goal weight is reached. The best long-term strategy varies. It may involve continued medication, dose or interval adjustments when medically appropriate, nutrition and activity changes, or another maintenance approach. Dr. Lipman develops the maintenance plan around the patient’s response, health, and risk of regain.
The answer depends on the specific medication. FDA-approved semaglutide and tirzepatide products are contraindicated in people with a personal or family history of medullary thyroid carcinoma or MEN 2, and they should not be used during pregnancy for weight loss. Other gastrointestinal, gallbladder, pancreatic, kidney, diabetes, and medication issues may require additional caution or a different treatment plan. A medical evaluation is essential.
The most common side effects are gastrointestinal, including nausea, vomiting, diarrhea, constipation, abdominal discomfort, and reflux. They are often most noticeable when treatment begins or the dose increases. More serious problems can occur, so persistent vomiting, severe abdominal pain, dehydration, or other concerning symptoms should be discussed with a physician promptly.
You do not need a fad diet, but food choices still matter. Because GLP-1 medications reduce appetite, it becomes especially important to get enough protein, fluids, fiber, vitamins, and minerals from a smaller amount of food. Dr. Lipman’s approach emphasizes adequate protein and practical calorie control to support fat loss while helping preserve lean muscle and healthy nutrient balance.
Some patients notice reduced hunger and begin losing weight within the first few weeks, but GLP-1 treatment is designed to work over months, not days. Doses are usually increased gradually to improve tolerability. Weight loss commonly continues as treatment is adjusted, then slows as the body approaches a new weight. A slowdown does not automatically mean the medication has stopped working.
Yes. Wegovy is now available as an FDA-approved daily oral semaglutide tablet as well as a weekly injection. Foundayo (orforglipron) was also FDA-approved in 2026 as an oral GLP-1 receptor agonist for chronic weight management in qualifying adults. Oral treatment can be useful for patients who prefer not to use injections, although the medications have different dosing instructions and clinical considerations.
Tirzepatide has generally produced greater average weight loss than semaglutide in obesity trials at the doses studied, but that does not mean it is the best choice for every patient. Medical history, diabetes status, side effects, previous response, cost, access, and treatment goals all matter. Dr. Lipman selects treatment based on the individual rather than choosing a medication from weight-loss percentages alone.
Results vary by medication and by patient. In major obesity trials, semaglutide 2.4 mg produced average weight loss of about 15% at 68 weeks, while tirzepatide produced average losses up to about 21% at 72 weeks. In a longer tirzepatide maintenance trial, participants who continued treatment averaged about 25% total weight loss at 88 weeks. These are study averages, not guarantees.
GLP-1 receptor agonists mimic a hormone involved in appetite, digestion, and blood-sugar regulation. They act on appetite centers in the brain, increase feelings of fullness, and can slow gastric emptying. Tirzepatide is slightly different because it activates both GIP and GLP-1 receptors. These effects can make it much easier to eat less without the persistent hunger and food noise that often make weight loss difficult.
The best way to determine whether Keto is appropriate is through a medical evaluation. Dr. Lipman reviews your health history, medications, weight-loss goals, and metabolic risk factors before recommending a personalized treatment plan designed specifically for you.
Although many patients choose Keto for weight loss, the diet may also support improvements in appetite control, blood sugar regulation, triglyceride levels, insulin resistance, and other aspects of metabolic health. Individual results vary, and treatment recommendations should always be personalized.
Many people enter ketosis within two to seven days of consistently limiting carbohydrate intake, although the exact timeframe varies depending on metabolism, activity level, and previous eating habits. Following your meal plan carefully can help you reach ketosis more efficiently.
Some people with diabetes may benefit from a medically supervised ketogenic diet, but medication adjustments are often necessary. Because carbohydrate intake can significantly affect blood sugar levels, patients with diabetes should never begin a Keto Diet without consulting their physician.
Yes. Most patients can continue exercising while following the Keto Diet, although energy levels may temporarily change during the first few weeks of adaptation. Dr. Lipman can recommend appropriate activity levels based on your medical history, fitness level, and weight-loss goals.
Ketosis is a natural metabolic state that occurs when carbohydrate intake is low enough that the body begins producing ketones from stored fat to use as an alternative energy source. This shift allows many people to burn body fat more efficiently while following a properly designed ketogenic diet.
Having treated more than 40,000 people with weight problems in his Miami, Florida office over the past 40 years, Dr. Lipman realizes that every dieter has different reasons for his/her weight gain. Each person needs a personalized weight loss plan to lose and then maintain their weight loss. This includes different food changes, eating plans and medications when needed.
A. The personalized weight loss plan is first accomplished by reviewing your past and present medical/medication history and obtaining current laboratory testing to determine if there are any metabolic problems or medications causing or contributing to your weight.
B. After determining any metabolic causes for your weight gain, you and Dr. Lipman discover together the 3 most important causes of your weight gain from a food diary you provide.
C. You and Dr. Lipman construct a personalized food plan based on what you like to eat without excluding any food group. Usually the food plan is low in high glycemic index carbs (bread, rice, pasta, potatoes) and high in lean proteins. You can chose one of the 6 diet systems based on your likes and dislikes.
Some new patients can make a few key changes in their food or beverage intake and lose all the weight they need, while others may require the assistance of weight loss medications.
Many people struggle with Keto because they unknowingly consume too many carbohydrates, fail to maintain proper nutrition, or do not adjust medications appropriately. A medically supervised program provides individualized meal planning, monitoring, education, and accountability, helping patients avoid common mistakes and achieve more consistent results.
For many healthy adults, the Keto Diet can be a safe and effective way to lose weight. However, certain medical conditions and medications require careful supervision. Dr. Lipman evaluates your medical history, laboratory results, and medications before recommending the program to ensure it is appropriate for you.
A healthy Keto Diet emphasizes foods such as meat, poultry, seafood, eggs, healthy oils, avocados, nuts, seeds, and low-carbohydrate vegetables. Sugary foods, bread, pasta, rice, potatoes, and most processed carbohydrates are limited. Every patient receives an easy-to-follow meal plan and guidance on making appropriate food choices.
Weight loss varies depending on your starting weight, metabolism, activity level, and adherence to the program. Many patients lose weight rapidly during the first few weeks as carbohydrate stores are depleted, followed by a steady, sustainable rate of fat loss. Dr. Lipman develops individualized plans designed to maximize results while protecting your overall health.
The Keto Diet is a very low-carbohydrate, moderate-protein, high-fat eating plan designed to shift your body into ketosis. In ketosis, your body burns stored fat for energy instead of relying primarily on carbohydrates. Under Dr. Lipman’s supervision, the program combines a personalized meal plan, medical monitoring, and ongoing support to help patients lose weight safely and effectively.
You are free to return every week to the office for a weigh-in at no charge. You will be seen by Dr. Lipman every two weeks after the first visit.
Dr. Lipman offers 6 different weight loss food plans. He has published 4 eBooks on these diet plans. Each dieter can chose the plan that he or she likes best. None of the diets have special recipes, preparations, shopping or counting calories, points, carbs or anything else. All plans use unique and interactive illustrated food menus which show choices, portions, and preparations with colored images.
Dr. Lipman has designed all the food choices in pocket size, colorful meal menus – one for each meal and one for snacks. They show you numerous choices, portions and preparations. Brand and product suggestions are presented on other cards.
HCG is the hormone produced by pregnant women that mobilizes the fat to feed the fetus. Like insulin, this hormone has been produced artificially and when given to overweight men and women it produces large amounts of weight loss without hunger. It has NO side effects, so it is perfect for people with heart disease, a history of strokes, etc. It also comes with a special, option-rich food plan so you can achieve optimal weight loss. Dr. Lipman’s 800 Calorie HCG diet uses HCG injections or HCG sublingual drops.
My diet plans can work for the whole family, including spouses, children (as young as 6 years old) and teens. If other members of your family need to lose weight, you are encouraged to bring them in with you on the second visit. This free family consultation will include taking an eating history, discovering their diet secrets, and providing a food plan tailored to their individual needs.
Some dieters can lose and keep their weight off by following one of Dr. Lipman’s weight loss plans – others need the help of FDA approved medications. Dr. Lipman uses many different weight loss medications depending upon the need and requirement of the dieter.
Over the past 40 years, he has treated tens of thousands of patients with the older FDA approved appetite suppressors such as Adipex, (phentermine), phendimetrazine, and Tenuate (diethylpropion). He has also treated hundreds of overweight people with the new weight loss drugs Qsymia, , Contrave, and Lomaira.
Most recently, Dr. Lipman has been prescribing the breakthrough drugs Semaglutide (Ozempic, Wegovy, Rybelsus) and Tirzepatide (Mounjaro). His patients have been experiencing dramatic, sustained weight loss on this amazing new class of medications.
When considering a weight loss medication, Dr. Lipman first reviews your weight, medical profile, medications, laboratory tests and weight goals. He will discusses with you the efficacy and potential side effects. Safe and effective weight loss involves selecting the right medication for the right patient.
Dr. Lipman is a board certified internist and endocrinologist (the medical specialty of metabolism, thyroid and the glands) who has helped hundreds of people lose weight safely and healthily. By examining your medical history, eating habits, and blood tests, Dr. Lipman can develop a weight loss plan that fits your biological profile and supports a healthy lifestyle.
Absolutely! I have treated children as young as 6 years old all the way to men and women over 90 years old. It’s never too early or too late to achieve a healthy weight.
Of course! These are the people who need it most, but also NEED the greatest supervision. That’s why you need a board certified physician with a lot of experience. As an endocrinologist I treat diabetics, hypertensives and people with high cholesterol every day – both thin and overweight.
Most insurance does not pay for weight loss plans, therefore we do not accept or bill your insurance. We will supply you a receipt with a diagnosis in order to help you get reimbursed by your insurance. You may be able to obtain some of the laboratory tests through your insurance. If you have had an EKG and/or blood tests including a CBC, chem profile and/or a thyroid profile in the last 3 months, bring them with you and you will receive a credit. Ask about these services when making an appointment.
