Weight loss programs, five kinds compared.
Most weight loss programs fall into one of five kinds. They differ in who runs them, what the first visit looks like, and whether medication is part of the plan. Each kind below answers the same six questions in the same order, so you can compare them.
A GLP-1 receptor agonist is a medicine that acts on the receptor for glucagon-like peptide-1, a gut hormone that signals fullness. Semaglutide, sold as Wegovy, is one. Tirzepatide, sold as Zepbound, acts on that receptor and a second one, GIP. Titration is the planned step-up from a low starting dose over several weeks, set by the prescriber.
To see what a GLP-1 medication could do for your weight before you pick a program, try the weight-loss calculator. It projects a range from clinical-trial data.
| Program type | Run by | Medication | Where to find one |
|---|---|---|---|
| In-clinic medical programs | Physician, nurse practitioner, or physician assistant | Prescribed when the label fits | Weight loss clinics near you → |
| Telehealth GLP-1 programs | Licensed clinician, by video or message | Central to the program | GLP-1 doctors near you → |
| Skinny shot clinics | Varies, from physician practices to med spas | Lipotropic or B12 shots, or a prescription GLP-1 | Skinny shot providers by state → |
| Dietitian-led programs | Registered dietitian | None prescribed by the dietitian | Weight loss clinics near you → |
| Bariatric surgery referral | Bariatric surgeon and a care team | A separate treatment, teams differ | Find a doctor for a referral → |
In-clinic medical programs
- What it is
- A medical office that treats weight as a health condition. You attend visits in person, and the office can run labs and check your vitals on the spot.
- Who runs it
- A physician, nurse practitioner, or physician assistant who can prescribe. Some physicians hold board certification in obesity medicine. Some offices add a registered dietitian.
- What the first visit looks like
- A health history, a list of your medicines, your height and weight, and your blood pressure. Blood tests often follow. The clinician walks through your options, and a prescription is one possible outcome, not a given.
- How medication fits
- The clinician decides whether an FDA-approved GLP-1 medication fits you. For adults, the Wegovy and Zepbound labels cover a BMI of 30 or more, or 27 or more with a weight-related condition such as high blood pressure. The prescriber sets the dose schedule and sees you in person as it changes.
- Ask before you sign up
- Who is the licensed prescriber, and will I see that person at follow-up visits?
- What does the monthly price cover: visits, labs, and the medication?
- Is the medication FDA-approved?
- Does the office bill my insurance?
Telehealth GLP-1 programs
- What it is
- A program you run from your phone or laptop. You fill out an intake form and talk with a clinician by video or message. If the clinician prescribes, a pharmacy sends the medication to you.
- Who runs it
- A clinician licensed in your state: a physician, nurse practitioner, or physician assistant. The company behind the app is often separate from the practice that employs the clinician. Ask for the clinician's name and license state.
- What the first visit looks like
- An online intake covering your height, weight, health history, and current medicines. Then a video call or secure messages with the clinician. Some programs ask for lab results or records first.
- How medication fits
- GLP-1 medication is the center of these programs. The clinician decides whether one fits you, chooses the drug, and sets the titration. The FDA says unapproved GLP-1 products do not undergo its review for safety, effectiveness and quality before they are marketed.
- Ask before you sign up
- Which medication will I receive, and is it FDA-approved?
- Will a clinician licensed in my state read my history before any prescription?
- Is the monthly price all-in, with the medication included?
- How do I reach the clinician when side effects start, and how fast do they answer?
Skinny shot clinics
- What it is
- "Skinny shot" is a marketing name, not a medical one. It covers two different products: lipotropic or B12 injections, and prescription GLP-1 medications.
- Who runs it
- It varies. Some are physician practices. Others are med spas or wellness clinics where a nurse gives the injection under a supervising physician's protocol. Ask who the supervising physician is.
- What the first visit looks like
- Often short. Expect a weight check, a few health questions, and, for a lipotropic shot, an injection the same day. A prescription GLP-1 needs a licensed clinician to review your health history first.
- How medication fits
- Lipotropic and B12 shots are not FDA-approved for weight loss. GLP-1 medications such as Wegovy and Zepbound are approved for weight management and need a prescription.
- Ask before you sign up
- Which injection is it, and what is in it?
- Is it FDA-approved for weight loss?
- Which licensed clinician prescribes or supervises, and when do they see me?
- What does each visit cost, and how many visits does the plan assume?
- Where to find one
Dietitian-led programs
- What it is
- A program built around food, habits, and activity. A dietitian meets with you over several sessions and adjusts the plan as your weight and routine change.
- Who runs it
- A registered dietitian, credentialed as RD or RDN. That credential requires an accredited degree, supervised practice, and a national exam. The title nutritionist is not protected in every state, so ask which credential the person holds.
- What the first visit looks like
- A review of what you eat now, your health history, your schedule, and your goals. You may keep a food log before the next session.
- How medication fits
- A dietitian does not prescribe GLP-1 medication. Some programs work with a prescriber. A dietitian can also help you plan meals when a GLP-1 lowers your appetite.
- Ask before you sign up
- Are you a registered dietitian?
- Do you coordinate with my doctor or prescriber?
- How many sessions do you recommend, and does my insurance cover them?
- Where to find one
Bariatric surgery referral
- What it is
- A referral to a surgical weight-loss program. The program covers the operation, the evaluation before it, and follow-up care after. Common operations include sleeve gastrectomy and gastric bypass.
- Who runs it
- A bariatric surgeon working with a team that often includes a dietitian and a behavioral health clinician. Many programs take a referral from your primary care doctor. Some accept self-referral.
- What the first visit looks like
- A consultation or information session, then an evaluation. Expect lab work, nutrition and behavioral health assessments, and insurance paperwork. Many insurers set their own rules before they approve surgery.
- How medication fits
- Surgery is a separate treatment from GLP-1 medication. Teams differ on whether they use a GLP-1 medication before surgery, after it, or not at all. Ask how the team you choose handles it.
- Ask before you sign up
- Which operations do you perform, and how often?
- What does follow-up look like in the first year and after?
- What must I complete before my insurer and your program approve surgery?
- Is the program accredited by a national bariatric quality program?
- Where to find one
Do weight loss programs prescribe GLP-1 medications?
Some do. A program run by a physician, nurse practitioner, or physician assistant can prescribe one when the FDA label fits your health. A dietitian does not prescribe, though some dietitian-led programs work with a prescriber. Skinny shot clinics vary, so ask who the licensed prescriber is. Bariatric teams differ on how they use these drugs.
How can I tell a legitimate weight loss program from a risky one?
Look for a named, licensed clinician who reviews your history before any prescription. Ask whether the medication is FDA-approved and what the all-in monthly price is. Walk away from a program that will not name its clinician or wants a large payment before anyone has spoken with you. The FDA lists its concerns about unapproved GLP-1 drugs used for weight loss.
Can I use more than one type of program?
Yes. A prescriber and a dietitian can work side by side, for example. Tell each clinician about the others so they can coordinate your care.
How much weight do people lose on a GLP-1 program?
The numbers come from clinical trials, and programs vary. In STEP-1, adults with obesity, or overweight with at least one weight-related condition, lost an average of 14.9% of body weight on semaglutide over 68 weeks. In SURMOUNT-1, adults with obesity, or overweight with at least one weight-related condition, lost an average of 20.9% over 72 weeks on the highest tirzepatide dose. Both trials paired the drug with diet and activity changes. Your result could differ. The weight-loss calculator shows a projected range from the same trial results.
This page is information, not medical advice. Listings do not imply endorsement. Talk to a licensed clinician before you start or change a treatment.