Medical Weight Loss
A Medical Approach to Weight Loss and Metabolic Health
At Kass Precision Medicine, we look beyond the number on the scale. considering body composition, metabolic health, nutrition, exercise, sleep, hormones when relevant, and weight-loss medications when appropriate.
LOSE
EXCESS FAT
PRESERVE
MUSCLE
IMPROVE
METABOLIC HEALTH
BUILD A SUSTAINABLE STRATEGY
Schedule a Medical Weight Loss Consultation Today
Why Does Losing Weight Get Harder With Age?
Weight regulation is more complicated than calorie intake alone.
Changes in muscle mass, insulin sensitivity, appetite signaling, sleep, medications, activity, and hormonal health can all influence weight and body composition. The body also adapts to weight loss: hunger may increase while energy expenditure decreases.
Understanding these factors can help inform a more effective and sustainable approach.
Medical Weight Loss at Kass Precision Medicine
We evaluate weight history, body composition, metabolic health, medications, lifestyle, and treatment goals. When appropriate, testing may include glucose regulation, cardiovascular risk markers, thyroid function, sex hormones, and other metabolic or hormonal factors.
Treatment may combine nutrition, resistance and cardiovascular exercise, sleep and behavioral strategies, and prescription medication when medically appropriate.
Modern Weight-Loss Medications
GLP-1–based medications have changed medical weight management by targeting biological pathways involved in hunger, satiety, food intake, and glucose regulation. For appropriate patients, these medications can be highly effective. We view them as one component of a broader strategy for improving body composition and metabolic health.
WEGOVY®
Semaglutide · GLP-1
Available in injectable and oral formulations.
Wegovy has substantial weight-loss data and cardiovascular outcomes evidence in certain
higher-risk patients.
ZEPBOUND®
Tirzepatide · GIP + GLP-1
A once-weekly injection that targets two metabolic hormone pathways. Tirzepatide has produced substantial average weight reductions in clinical trials.
What about newer weight-loss medications?
Research continues into emerging therapies, including investigational medications such as retatrutide.
Weight Loss Shouldn’t Mean Losing Muscle
The number on the scale doesn't tell the whole story. Preserving skeletal muscle is an important part of healthy weight loss, particularly in midlife and beyond.
Higher muscle mass is associated with better health and longevity, while low muscle mass is associated with poorer health outcomes - even after accounting for BMI.
Our approach emphasizes adequate protein, resistance training, and thoughtful medication dosing to lose excess fat while protecting muscle.
Body composition matters. Lower weight does not necessarily mean better health if muscle is lost along the way.
Visceral Fat and Metabolic Health
Where excess fat is stored matters. Visceral fat - fat stored deeper within the abdomen around internal organs - is strongly associated with insulin resistance and cardiometabolic disease, including:
Prediabetes and type 2 diabetes
High blood pressure
Abnormal triglycerides and cholesterol
Cardiovascular disease
Metabolic liver disease
Obstructive sleep apnea
This is why we look beyond BMI alone. Waist circumference, body composition, blood pressure, laboratory markers, and overall metabolic health can provide a more complete picture.
How Does Weight Gain Differ for Women and Men?
The factors that contribute to weight gain overlap considerably, but fat distribution, body composition, hormones, and metabolic risk differ between women and men and change with age.
WOMEN
For women, changes in weight and body composition can accelerate during perimenopause and menopause. Declining estrogen contributes to a shift in fat storage toward the abdomen and an increase in visceral fat, while aging and hormonal changes also contribute to loss of muscle mass.
At the same time, hot flashes, night sweats, and disrupted sleep can make appetite regulation, exercise, and weight management more difficult. A woman may therefore notice a changing waistline or body composition even though she has made no changes to her caloric intake or exercise.
For this reason, we look beyond weight alone - considering visceral fat, muscle mass, insulin sensitivity, sleep, and the hormonal changes of perimenopause and menopause when developing a weight-management strategy.
MEN
In men, weight and body composition tend to change more gradually with age. Muscle mass may decline while visceral fat increases, sometimes without a dramatic change in weight or BMI.
Visceral fat is the deeper fat stored around the abdominal organs. It can create the firm, protruding “belly” seen in some men, rather than the softer fat that can be pinched beneath the skin. This type of fat is more metabolically active and is strongly associated with insulin resistance, type 2 diabetes, cardiovascular disease, heart attack, and stroke.
Declining insulin sensitivity, reduced muscle mass and activity, sleep, alcohol, and hormonal changes can all contribute. For this reason, waist circumference, visceral fat, muscle mass, and metabolic markers can provide a more meaningful picture of health than weight alone.
How Does Menopause Affect Weight and Body Composition?
For many women, weight gain can accelerate during perimenopause and menopause. It is common for women to report gaining a significant amount of weight over just a few years - despite eating more carefully and exercising more than they did before.
As estrogen declines, fat storage shifts toward the abdomen, visceral fat increases, and lean muscle may decline. Sleep disruption, reduced insulin sensitivity, and age-related metabolic changes can compound these effects.
Together, these changes help explain why strategies that worked well in a woman’s 30s or early 40s may become less effective during perimenopause and menopause.
Who Is a Candidate for Medical Weight Loss?
You do not need to have severe obesity to benefit from medical weight management.
People often seek care because of increasing abdominal fat, worsening body composition or metabolic markers, repeated weight regain, prediabetes, sleep apnea, or weight that has become increasingly difficult to manage.
Whether prescription weight-loss medication is appropriate is an individualized medical decision. Treatment should consider overall health, metabolic risk, body composition, weight-related health concerns, goals, and the potential benefits and risks of treatment.
What Happens When You Stop a GLP-1 Medication?
Weight regain after stopping GLP-1–based therapy is common as hunger and other biological signals involved in weight regulation return.
Long-term strategies may include continued therapy, downward-adjusted doses or individualized dosing, a change in medication, or carefully monitored discontinuation.
Planning for weight maintenance should begin before goal weight is reached.
Health Benefits Beyond Weight Loss
GLP-1–based medications were initially developed for type 2 diabetes, but their effects can extend beyond blood sugar and weight. Depending on the medication and patient population, demonstrated benefits include:
Fewer heart attacks and strokes in certain patients at elevated cardiovascular risk
Improved heart failure outcomes in certain patients with obesity-related heart failure
Improved kidney outcomes in certain higher-risk populations
Improved obstructive sleep apnea with tirzepatide in adults with obesity
Improvement in metabolic liver disease with certain GLP-1–based therapies
Potential effects on brain health, neurodegenerative disease, and addictive behaviors are also being studied but remain investigational.
The health implications of these medications can extend well beyond weight loss.
Medical Weight Loss at Kass Precision Medicine
Our approach integrates comprehensive cardiometabolic and hormone lab testing, body composition analysis, medication when appropriate, nutrition for maintaining energy and muscle mass, exercise, muscle preservation monitoring, and regular check ins.
Lose excess fat. Preserve muscle. Improve metabolic health. Build a strategy you can maintain.
Schedule a Medical Weight Loss Consultation Today
Frequently Asked Questions About Medical Weight Loss
What is the best weight-loss medication?
There is no single best medication. Wegovy and Zepbound are among the most effective current options, but selection depends on patient preference and tolerability.
Is Zepbound more effective than Wegovy?
In direct comparative research, tirzepatide (i.e., Zepbound) produced greater average weight loss than semaglutide (i.e., Wegovy). However, weight loss is only one consideration when selecting treatment.
In a direct 72-week comparison:
Zepbound (tirzepatide): 20.2% average body-weight reduction
Wegovy (semaglutide): 13.7% average body-weight reduction
What is retatrutide, and is it available for weight loss?
Retatrutide is an investigational medication that targets GIP, GLP-1, and glucagon receptors. Clinical trials have reported substantial weight loss, but retatrutide is not yet FDA-approved or available from pharmacies for clinical use. Products marketed directly to consumers as retatrutide are not FDA-approved medications.
Do GLP-1 Medications Cause Muscle Loss?
Some loss of lean mass is common with any significant weight loss, including weight loss with GLP-1 medications. Current evidence does not establish that GLP-1 medications directly cause skeletal muscle wasting.
Rather, muscle loss is influenced by the amount and rate of weight loss, reduced calorie and protein intake, age, baseline muscle mass, and physical activity. Adequate protein and resistance training can help preserve muscle while losing fat.
This is why we monitor body composition - not simply body weight - and make muscle preservation an important part of medical weight loss.
Does Menopausal Hormone Therapy Help With Weight or Body Composition?
Menopausal hormone therapy is not a weight-loss treatment; however it may influence body composition and metabolic health.
Declining estrogen during menopause is associated with increasing abdominal and visceral fat and worsening insulin sensitivity. Research suggests that appropriately prescribed menopausal hormone therapy can improve insulin sensitivity and may help blunt some of the shift toward central fat accumulation, although effects vary by formulation and individual patient.
Hormone therapy should therefore be prescribed for appropriate menopausal indications - not simply for weight loss but its effects on body composition and metabolic health can be clinically relevant.
Can Testosterone Improve Body Composition in Men?
In men with testosterone deficiency, testosterone therapy can increase lean muscle mass and may reduce visceral fat. Some studies also show improvements in insulin resistance, particularly in men with obesity, metabolic syndrome, or type 2 diabetes.
Testosterone is not a weight-loss medication, but when deficiency is present, treating it can support healthier body composition, improve response to weight loss efforts, and metabolic function.
Can weight loss help prevent type 2 diabetes?
Yes. Weight loss can substantially improve insulin sensitivity, lower blood glucose and HbA1c, and reduce progression from prediabetes to type 2 diabetes.
In clinical trials, semaglutide produced roughly 14% average weight loss in people with obesity and prediabetes, with 81% returning to normal glucose levels after one year. Tirzepatide produced sustained weight loss of roughly 12% to 20% over three years and reduced progression to type 2 diabetes from 13.3% with placebo to 1.3%.
For people with prediabetes or insulin resistance, reducing excess fat - particularly visceral fat - can meaningfully change long-term metabolic risk.
Do GLP-1 medications have benefits beyond weight loss?
Yes, in certain medications and patient populations. Clinical evidence includes benefits involving cardiovascular health, kidney disease, sleep apnea, heart failure, and metabolic liver disease. Studies around treating addictions and some of the neuroprotective benefits (i.e., dementia) are still under investigation but are potentially promising.
Do I have to be obese to be on a GLP-1?
No. Medical weight management with a GLP-1 medication may be appropriate for people with excess abdominal fat, worsening body composition, prediabetes, other metabolic risk factors, or weight that has become increasingly difficult to manage. GLP-1s are indicated for people with an obese BMI, or an overweight BMI with co-morbidities. GLP-1 medications are prescribed off-label in some cases, but should be instituted only after a thorough risk and benefit conversation with your provider.