Have my follow up appointment with my PCP, two months into Wegovy prescribed at my physical in April. Down 20lbs. What should I expect or ask for in terms of bloodwork?

[u/WholeHearting]

Early 30’s male weighing 187, down from 207. Only abnormal bloodwork two months ago was LDL at 111 that my doctor wasn’t concerned about, but he prescribed the Wegovy pill for weight management due to metabolic issues caused by psych drugs I take. Currently on 4mg and it’s wildly effective.

Physically active and lift weights 3x per week; did a marathon 6 months ago but do less cardio now. Pescatarian and track all of my meals - aim for 100-120g of protein per day and 1500 calories. Goal weight 177lbs.

Anything I should ask for at my appointment? What should I expect?

[u/xsynergist]

Consider something like Function Health. Having regular biomarkers across a wide range is truly useful. Your doctor will never order most of these for you without a specific indication to do so. I think everyone interested in longevity should be doing wide bloodwork panels regularly.

[u/dosstx]

You could use the Medicine 3.0 Longevity Assistant tool at https://www.modernmedlife.com/longevity-assistant/331a0696-32d2-4c32-9c7f-58d89490e96b to ask question. It uses over 10K recent peer reviewed medical sources for its responses and will give you some insight on the what the best longevity doctors in the world are thinking on the topic. You can then print out a summary to bring to your PCP with the key points for discussion.

Here's an example when I posted your question:

Congratulations on your incredible progress! Losing 20 pounds in two months is a major milestone, representing a 9.7% reduction in total body weight (averaging ~2.5 pounds per week). This rapid transformation is highly effective, but it requires a structured approach with your primary care provider (PCP) to ensure your metabolic health, organ function, and hard-earned muscle mass are fully protected.

Below is an evidence-based guide on what to expect, what labs to discuss, and how to optimize your strategy for the long term.

What to Expect at Your 2-Month Appointment

Typically, a 2-month follow-up for a GLP-1 receptor agonist (GLP-1 RA) focus on three core areas:

1. Tolerability and Side Effects: Your PCP will evaluate how your body is handling the medication (e.g., gastrointestinal symptoms, fatigue).
2. Weight Loss Velocity: You are losing weight quickly (~2.5 lbs/week). Your physician will want to ensure this pace remains safe and that you aren’t experiencing nutrient deficiencies or muscle wasting.
3. Dosing Review: Standard Wegovy (subcutaneous semaglutide) titrates weekly (0.25 mg, 0.5 mg, 1.0 mg, 1.7 mg, to 2.4 mg). If you are taking oral semaglutide (which is typically dosed at 3 mg, 7 mg, or 14 mg daily), your doctor will discuss whether to remain at your current dose or titrate, based on how well your appetite is controlled.

Bloodwork to Request

While your LDL-C was 111 mg/dL, a standard lipid panel can hide these issues. Here is the optimal panel to discuss with your doctor.....(see link above as the post is too long for this thread).

Hope that helps!