229b Main St, second floor, Waterville, ME, USA
Frequently Asked Questions
Please reach us at nicole@advancedpracticesolutions.co if you cannot find an answer to your question.
Nicole Ray, FNP-C Advanced Practice Solutions offers personalized weight loss treatment for patient's with a BMI greater than 27.
NP Ray also offers primary care services to a small patient panel. We are accepting new patients for acute visits to help them access care while they are on wait lists to see a new PCP but currently unable to take over any new primary care patients.
We do not require a referral
We are in the process of credentialling with several insurance companies for our small family practice panel of patients.
We are currently accepting Mainecare for acute telehealth visits.
Most insurance companies do not cover weight loss treatment as they consider it cosmetic (we disagree). Because of this we patient's are responsible for payment in the form of online car payments, cash, check or venmo. If you have a BMI greater than 27 with a covered obesity related condition and you have insurance that does cover, we are happy to provide you with a receipt to submit for reimbursement.
These are medications that works by mimicking a hormone called glucagon-like peptide-1 (GLP-1). Examples of GLP-1s are semaglutide, liraglutide, and tirzepatide. (You may know them by their brand names such as Ozempic, wegovy, victoza and mounjaro). Semaglutide is the most commonly prescribed medication for weight loss. Wegovy (semaglutide) is the only FDA approved medication for weight loss.
Semaglutide can help you leave weight because it:
- Reduces appetite:.Semaglutide stimulates GLP-1 receptors in the brain, which signals to the body that it is full. This reduces hunger and calorie intake.
- Slows gastric emptying:.Semaglutide slows down the rate at which food leaves the stomach, making individuals feel full for longer.
- Increases insulin sensitivity:.Semaglutide improves the body's response to insulin, which helps lower blood sugar levels and reduces fat storage.
- Boosts metabolism:.Studies have shown that semaglutide can increase the body's metabolic rate, meaning it burns more calories at rest.
Sermorelin, a growth hormone-releasing hormone (GHRH) analog, is sometimes used to support weight loss efforts. It works by stimulating the pituitary gland to produce more growth hormone, which can influence metabolism, muscle mass, and fat burning. While it's not a direct weight loss drug like semaglutide, it can be a useful tool within a broader weight management strategy
Weight loss benefits :Increased GH levels can lead to a few positive effects on weight loss:
- Increased metabolism: GH is involved in metabolic processes, potentially helping the body burn more calories.
- Muscle building: GH plays a role in muscle growth, which can increase resting metabolism and contribute to fat loss.
- Fat burning: GH can promote the breakdown of stored fat.
We have partnered with a 503B and 503A compounding pharmacy. We order the medications and have them shipped directly to you. They arrive via overnight refrigerated shipping. Remember the cost of the medication is included in the monthly fee so there is no additional billing to receive the medication.
- There are oral versions of GLP-1s. These are typically more expensive.
- Naltrexone and bupropion (combo drug brand name Contrave): Bupropionis a popular antidepressant medication. Of all antidepressants, Wellbutrin is most likely to cause weight loss as a side effect. By boosting levels of certain brain chemicals, Wellbutrin may have appetite suppressant effects. For some, a modest amount of weight loss may occur. Naltrexone is a μ-opioid receptor antagonist commonly used for treatment of opioid addiction and alcohol dependence [12]. Naltrexone can reduce food consumption through the blockage of β-endorphin action at the μ-opioid receptor as well as preventing autoinhibition of pro-opiomelanocortin neurons
- Metformin: a medication primarily used for type 2 diabetes, is sometimes prescribed off-label for weight loss, particularly in individuals with obesity or prediabetes. While it can lead to modest weight loss, it's not as effective as some other weight loss medications and shouldn't be considered a replacement for lifestyle changes like diet and exercise
- Topiramate: exact mechanisms unknown but suppresses appetite and alters taste in some individual. Also seems to impact the reward mechanism sought for with food which can reduce cravings.
At this time we are not accepting any more patient's for primary care services. We can help with urgent needs such as medication refills when you are between providers or sick visits. However these are currently only being offered via telehealth unless you are already an established primary care patient with the practice.
Who May eligible for GLP-1 treatment through our clinic?
Adults with BMI of 27 WITHOUT the following conditions:
- type 1 diabetes
- a personal or family history of certain types of thyroid cancer, specifically thyroid C-cell tumors such as medullary thyroid carcinoma (MTC), or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2).
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