A coordinated medical weight-loss program built around the goal you actually have: fat down, muscle kept. $149 a month for the management — your provider, your labs, your body-composition scans, your MIC injections. Your medication is prescribed in person and billed by the pharmacy at the time of fill. Six months minimum, then month-to-month. Not an app and a pen in the mail.
A vial that arrives at your door cannot see the muscle you're losing alongside the fat. It cannot catch the thyroid quietly slowing things down. It cannot adjust the dose to how you actually feel three weeks in. We can — because we're in the room with you, with your labs in front of us, every month.
The drug is the easy part. What makes the weight stay off — and the muscle stay on — is everything that happens around it. Every one of these is built into the $149 monthly fee. Learn about our diagnostics →
You're not assigned to one person and stuck there — you have a coordinated team of providers, all working from one chart. Whoever sees you this month already knows what we tried last month, what your labs said, and what the InBody showed. Your dose is titrated in conversation, not by an app form.
Fat and muscle measured separately, not a single number on a scale. So when the program is working, we can prove it. When it isn't, we change something before the plateau lasts a month.
Not a one-time questionnaire. Metabolic, thyroid and lipid panels at the cadences that matter, included — so the dose stays calibrated to what's happening inside, not just what's happening on the scale.
B12, methionine, inositol and choline — in clinic, weekly, included. The fuel for the energy and the fat metabolism that keeps you in the gym while the appetite is quiet.
Compounded semaglutide or tirzepatide, prescribed by your provider after labs, dispensed by a licensed 503A partner pharmacy. Not the cheapest internet vial — the one your provider would put in their own body.
Nausea on Tuesday? Question about timing your dose? You don't wait three weeks for a 12-minute video call — you message the team and get a real answer the same day.
MIC is shorthand for three lipotropic compounds — methionine, inositol and choline — that the liver uses to move and metabolize fat. Given as a small intramuscular injection (not an IV) at your monthly visit, included in the $149 membership at no additional charge.
Methionine, inositol and choline — cofactors the liver actually uses to mobilize fat for energy. A small intramuscular injection at your monthly visit, not a separate appointment and not an IV drip.
The GLP-1 quiets the appetite and slows the stomach. The MIC supports the liver in processing what the body is now mobilizing. Two different jobs, one program — that is why both are in the monthly fee, not sold back to you separately.
Some patients report a modest energy bump in the day or two after — useful when appetite is low and protein and training matter most. Not everyone feels it, and the metabolic support is the real reason it is in the protocol.
An honest note: MIC injections are a longstanding adjunct, not a magic fix. They earn their place in the program because they support a piece of the work — liver-side fat metabolism — not because they replace the medication, the labs, the training or the protein you put on your plate.
Your medical management — provider visit, follow-up labs, MIC injections and body-composition scans — for one monthly fee. Medication, supplies and shipping are billed separately by the dispensing pharmacy at the time of each order. Six-month minimum commitment ($894 total), then month-to-month with thirty (30) days' written notice to cancel.
Six-month minimum commitment ($894 total). After the six-month term, the membership continues month-to-month until you provide thirty (30) days' written notice. Medical discontinuation — an adverse reaction, pregnancy or other clinical reason determined by your provider — waives the remaining commitment.
The arc is the same for everyone — the medicine works on a curve that doesn't care about your calendar. Here is what a real six-month program looks like at Bespoke.
Lab draw, InBody, history, goals. Your provider sits with the data and recommends a starting medication and dose.
Medication starts at the lowest titration. Weekly MIC injections begin. Side-effect plan in your hand, your provider's number in your phone.
Repeat labs. InBody trend. Dose calibrated to what your body is actually doing — not the protocol everyone else is on.
Full lab and InBody redraw against your baseline. Maintenance plan and a real conversation about what comes next — not a contract renewal.
No bundled-but-not-really pricing. No surprise pharmacy bill three weeks in. Here is exactly what you pay, when you pay it, and what medication adds to it.
The honest versions of the questions that show up in every consult. If yours isn't here, bring it to the consult — we'd rather work through it in person than guess on a webpage.
Most patients lose 5 to 20% of body weight over six to twelve months, and the honest answer is it depends on starting point, biology and whether you do the protein and strength work alongside the medication. We track it with InBody every visit so you can see what is fat, what is muscle and what is water — not a single number on the bathroom scale.
Because bundled pricing punishes the people who titrate slowly and the people who can't tolerate a higher dose. Splitting the medical management ($149) from the pharmacy invoice means you pay for the medical work we actually do every month, and for exactly the medication you actually receive. No padded mark-up to cover the rest of the membership.
Because anything shorter is biology theatre. The first month is dose titration; real measurable change shows up at month two or three; and the lab redraws that tell us whether the underlying metabolic markers are moving don't happen until month three and month six. A 30-day program is a sales tactic. Six months is the shortest window where we can honestly say whether the protocol is working for you.
That is a conversation with your provider, not a checkbox on a website. Your history, your labs, your side-effect tolerance, your starting weight and your goals all factor in. Many patients start on semaglutide; some switch to tirzepatide later if appetite control plateaus or side effects don't settle. Both are compounded by a licensed 503A pharmacy at our prescription.
Nausea, reflux and constipation are common in the first few weeks, especially right after a dose increase. Almost always manageable with hydration, fiber, smaller meals and slower titration. Doses move up one month at a time so we can hold or back off the moment something doesn't feel right — in a real conversation, not a support ticket.
That is the failure mode we're built to prevent. Most patients taper to a low maintenance dose rather than stopping cold, and the protein and resistance work we layer in from week one is what keeps the muscle — which is what keeps the loss. The Month 6 conversation is about the maintenance plan, not a renewal.
We tell you up front: compounded preparations are made by a licensed 503A pharmacy and are not identical to FDA-approved finished products. Salt form, concentration and excipients can differ. Your provider walks through every one of those details, and the relevant FDA notices, before anything is prescribed.
If your provider determines the medication should be discontinued for medical reasons — adverse reaction, pregnancy, contraindication that emerges in your labs — the remaining six-month commitment is waived. You don't pay for a program you can't medically be on.
Before any medication is dispensed, we sit down with your baseline labs and an InBody scan — so the plan that follows is built on your numbers, not a questionnaire.
Compounded semaglutide and tirzepatide are prescribed at the discretion of a licensed provider following evaluation and labs. Compounded medications are not FDA-approved products. Medication, supplies and shipping are billed separately by the dispensing pharmacy at the time of each order. Individual results vary; this membership is not a guarantee of any specific outcome.
Plus: how we’d use a summer with the schedule on your side. One page, refreshed each month.
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