How do I set up a GLP-1 weight loss clinic?

GLP-1 weight loss clinics have become a major growth category for NP-owned practices since 2023. The structural setup overlaps significantly with an aesthetic medspa, with some specific add-ons.

Same as an aesthetic medspa: - Entity structure (PLLC, PC, or MSO/PC depending on state) - Practitioner licensure and DEA registration (Schedule III/IV prescribing matters here) - Good-faith exam requirement for each patient (telehealth GFE permitted in most states) - Cash-pay model dominant (most commercial insurance doesn't cover GLP-1 for non-diabetic obesity, and even when covered, deductibles often exceed cash-pay) - Medical director if state requires collaborating/supervising physician - Professional liability + premises insurance

Specific to GLP-1 / weight-loss clinics:

Patient screening and intake. Standard medical history, BMI, comorbidity assessment, prior weight-loss history, medication review. Some states or carriers require specific documentation for medical necessity (even in cash-pay context, defensible documentation matters).

Lab work. Most GLP-1 protocols require baseline metabolic panel, lipids, A1c, TSH, and (in some protocols) lipase, amylase, and pancreatic markers depending on prior history. Lab can be in-house (if you operate a CLIA-waived lab) or coordinated through Labcorp/Quest. Recurring labs at 3-month or 6-month intervals.

Supply chain decisions. Two paths:

Branded GLP-1 (Wegovy/semaglutide, Mounjaro/Zepbound/tirzepatide, Saxenda/liraglutide). Branded products through standard pharmacy supply. Higher cost per dose. Variable availability (semaglutide supply normalized in 2024; tirzepatide demand still significant).

Compounded GLP-1. Compounded semaglutide and tirzepatide are available through 503A and 503B compounding pharmacies. Significantly lower cost per dose. Quality varies — partner with USP-797-compliant compounding pharmacies with strong reputations. Some states have restricted compounded GLP-1 prescribing or distribution; verify state rules. The FDA's view on compounded GLP-1 has shifted multiple times since 2024 — confirm current FDA guidance before selecting a compounding partner.

Pricing model. Most clinics price by month with the medication included. Common bands: - Compounded semaglutide protocol: $200–$400/month - Compounded tirzepatide protocol: $400–$600/month - Branded Wegovy/Mounjaro (cash-pay if not covered): often $800–$1,200/month at pharmacy prices

Monitoring and follow-up. Weekly or every-other-week check-ins for the first 8–12 weeks, then monthly. Side-effect management protocols (nausea, vomiting, gastrointestinal issues, rare but serious pancreatitis and gallbladder concerns). Documentation of weight, vitals, side effects, dose adjustments.

Compliance specifics: - State-specific telehealth rules for prescribing controlled or non-controlled substances - Ryan Haight Act considerations (if any controlled substance crosses into GLP-1 protocols) - DEA registration for the prescribing clinician - HIPAA-compliant patient communication - Adverse event reporting

GLP-1 clinics integrate naturally with existing aesthetic medspas. The patient overlap is significant — the same demographic seeks weight management, body contouring, and aesthetic injectables. Many NP-owned practices add GLP-1 as a second service line within an existing aesthetic medspa.