ORTHOPEDIC OPTIMIZATION

Orthopedic Optimization is a physician-supervised medical weight loss and fitness program specifically designed for patients to optimize themselves from an orthopedic standpoint. Get strong / Lose weight / Prevent injury Our program combines GLP-1 medications with targeted physical therapy to help you lose weight while maintaining muscle strength—potentially avoiding the need for orthopedic surgery and improving surgical outcomes if surgery becomes necessary.

After signing up, you'll: 1. Complete our online health assessment. 2. Send us your most recent lab work from your last PCP visit. 3. Do a video consultation with Dr. Neubardt. 4. The GLP-1 medication and physical therapy prescriptions will be sent electronically. 5. We will email or text you a short questionnaire the third week of every month which you will need to fill out so we can send the appropriate prescription for your next month’s supply of medication. Contact us directly for any questions or medical issues you encounter while in the program. Consult with your PCP for medical questions. Call 911 or go to a hospital Emergency Department for emergencies.

Initial consultation with Dr. Neubardt and physical therapy should be covered by your health insurance. Dr Neubardt will submit the Wegovy prescription directly to your pharmacy. The pharmacy will attempt to get your insurance company to cover the cost of the medication. If your insurance company refuses to pay for the medication you will have two options to buy the medication on your own. The first option is for you to buy the brand name medication (Wegovy) from your pharmacy. The retail cost of a one month's supply of Wegovy ranges from $550 to $1200. The second, and more cost effective option, would be for you to buy a generic form of the GLP-1 medication directly from a compounding pharmacy. The cost of a one month's supply of compounded Wegovy is $175. Note: If your insurance company denies coverage for treatment with a GLP-1 medication, Dr Neubardt would not be able to continue to bill your medical insurance for consultations, prescriptions and support related to weight loss management. However, with a denial of insurance coverage, you could continue to receive the required monthly prescriptions by enrolling in the OrthoOpti concierge program at a cost of $100 per month. Dr Neubardt’s concierge service includes monthly prescriptions for the GLP-1 medication, dosage modifications as required, Physical Therapy prescriptions, DEXA scan prescriptions, nutritionist prescriptions, updated compounding pharmacy information and program content to help you lose weight and gain strength.

Yes. But be aware that pharmacies like CVS and Walgreens only sell the very expensive, brand name GLP-1 drugs like Wegovy and Ozempic. That's good if you have insurance to cover the cost, or if you've got the finances to pay for it yourself. You cannot get the less expensive generic Wegovy at those pharmacies. If your insurance company won’t cover the brand name Wegovy drug and you must pay cash, the idea of using a compounding pharmacy is a really nice option. For instance, a brand name drug like Wegovy could cost you $1100 per month at CVS whereas the same active ingredient sold as a generic medication by the compounding pharmacy The Chemist Shop is currently only $175 per month.

We require baseline lab work before starting treatment to ensure your safety. We will give you instructions on how you can send us the most recent labs from your PCP. If labs are not available we will give you a prescription to obtain new lab testing.

Exclusion criteria include: · Pregnancy or planning pregnancy · History of medullary thyroid cancer · Multiple endocrine neoplasia syndrome type 2 · Personal or family history of certain endocrine conditions · Severe kidney or liver disease · Diabetes · Severe morbid obesity · Current eating disorders · Not being under the care of a PCP Program is limited to New York State residents only.

No. We will provide a prescription for physical therapy for you to be instructed in “generalized conditioning exercises” but it’s not mandatory that you go to Physical Therapy. We offer an exercise program in a PDF format that you can download and do the exercises at home on your own. A good option would be for you to go to PT for just one or two visits when you start the Ortho Opti program to get a baseline of your strength and make sure you know what exercises to do. Then, check in with the therapist every few months to see how you are progressing with maintaining muscle mass and strength. The physical therapy should be covered by your insurance.

Orthopedic Optimization is the only program that combines orthopedic expertise with weight management and fitness. We address one of the biggest concerns with using the GLP1 drugs-- loss of muscle mass. Our unique approach includes: 1. Medical supervision by a board-certified orthopedic surgeon 2. Integration of physical therapy to prevent muscle loss 3. Regular DEXA scans to monitor body composition are available 4. Focus on improving orthopedic conditions and avoiding injury through weight management

GLP-1 medications have been FDA-approved and extensively studied. Common side effects may include nausea, constipation, and digestive issues, which typically improve over time. We are available to monitor your progress and help manage any side effects. The addition of physical therapy helps prevent muscle loss, a potential side effect of rapid weight loss. Dr. Neubardt's role in the Orthopedic Optimization program is as an orthopedic surgeon overseeing your weight management and strengthening for orthopedic health. He is not your primary care physician (PCP). Your health and safety are paramount, which is why we require this clear division of medical responsibilities. We're here to support your weight loss journey while ensuring you maintain appropriate primary care relationships for your overall health management.

Weight loss varies by individual, but patients typically lose 1-2 pounds per week when combining GLP-1 medications with lifestyle changes. Our focus is on sustainable, SLOW, healthy weight loss while maintaining muscle mass—not rapid results that may be difficult to maintain. For best cosmetic results, it's best to go slow and let your skin contract naturally as you lose the weight. Clinical studies and real-world experience with GLP-1 medications show significant weight loss results when combined with lifestyle changes: Expected Weight Loss: · Most patients lose 15-20% of their total body weight over 12-16 months · Initial results typically show 1-2 pounds of weight loss per week · Many patients see 5-10% total body weight loss within the first 6 months · Some patients achieve over 20% body weight loss with consistent medication use and lifestyle changes

Yes, an initial video consultation is required to ensure appropriate medical oversight and personalized care planning. This, as any typical visit you've had with an orthopedic surgeon, should be covered by your medical insurance.

No. While some patients may benefit from long-term medication use, others may transition off the medication once they've reached their goals and established sustainable habits. We will work with you to determine the optimal duration of treatment. It’s also possible that once you reach your target weight you could stop taking the GLP-1 medication every week and go to a more spaced-out dosing schedule, say, one injection every two weeks or even once a month.

We work with a network of pharmacies to ensure reliable medication access. Our program does not impact the supply for diabetes patients, as we use different dosing and formulations specifically approved for weight management.

Yes. Beyond weight loss, GLP-1 medications have shown benefits including improved blood sugar control, reduced inflammation, and potential cardiovascular benefits. Even though our program specifically focuses on weight management for orthopedic health, we are excited about the additional possible benefits. Here's a review of what appears to be great about the GLP-1 medications: Orthopedic Benefits: · Studies show up to 30% reduction in knee pain for osteoarthritis patients who achieve significant weight loss with GLP-1 medications · Decreased need for total knee replacement surgery in patients with knee osteoarthritis who maintain weight loss · Reduced inflammatory markers associated with joint pain and degradation · Improved mobility and function in weight-bearing joints · Enhanced physical therapy outcomes due to reduced joint stress Metabolic and Cardiovascular Benefits: · Improved blood sugar control and insulin sensitivity · Reduced blood pressure · Lower risk of heart attacks and strokes · Decreased inflammation throughout the body · Improved cholesterol levels · Reduced fatty liver disease progression Cancer Prevention: Recent studies have shown that GLP-1 medications are associated with reduced incidence of several types of cancer: · Pancreatic cancer · Colorectal cancer · Breast cancer · Liver cancer · Endometrial cancer These cancer-protective effects appear to work through multiple mechanisms, including: · Reduced systemic inflammation · Improved insulin sensitivity · Direct effects on cancer cell growth · Decreased obesity-related cancer risk factors Additional Health Improvements: · Better sleep quality · Reduced risk of sleep apnea · Improved kidney function · Enhanced mood and mental clarity · Decreased joint inflammation · Better wound healing outcomes · Reduced risk of diabetes-related complications It's important to note that while these benefits are supported by clinical research, GLP-1 medications in our program are prescribed specifically for weight management to improve orthopedic conditions. The additional health benefits, while significant, should be viewed as positive secondary outcomes of the treatment. Note: Research in many of these areas is ongoing, and new benefits continue to be discovered. Always discuss your specific health conditions with your primary care physician.

We provide comprehensive training on self-injection, including video tutorials and written instructions. The injection process is simple and safe. Our medical team is available to answer any questions about the injection process. Millions of people inject themselves with insulin every day and this is the same process.

Yes, our program may qualify for FSA/HSA reimbursement. We can provide detailed receipts for submission to your plan administrator.

We will submit your Wegovy prescription to your listed pharmacy and they will attempt to have the cost covered by your insurance company. If your insurance company denies coverage you will have two options. Option #1: you may pay cash to buy the Wegovy from your pharmacy (cost range $550-$1100). Option #2: you may purchase a generic form of the Wegovy from a compounding pharmacy (cost is $175 for a one month's supply). With both Option #1 and Option #2, you may submit claims to your insurance company for reimbursement, but we cannot guarantee coverage.

Currently, GLP-1 medications for weight loss are only available as injectable medications. The oral form is only approved for diabetes treatment.

For gosh sakes, you’ve tried everything to lose weight. It’s now time to do something that really works to make a difference. Some people call the GLP-1s “miracle drugs” so why not take advantage of this tremendous medical breakthrough and stop feeling frustrated about the extra weight you can’t lose? As with any medication, it's important to weigh the risks vs the benefits when starting this program. We feel that the risk of staying overweight is far greater than the minimal possible risks of using the GLP-1 medications. Some people would argue that using prescribed medication to treat a medical condition isn't cheating at all—it's taking care of your health. Obesity is a complex medical condition that often requires medical intervention, just like any other health condition. When you go to lunch and your friends say, “You look great!” (and you know they are thinking, “I bet he’s on Wegovy”) just say, “I saw my orthopedic surgeon and he prescribed Wegovy and Physical Therapy. I feel so much better and am even motivated to exercise more. It’s an orthopedic program, so I’m just taking the medication as the doctor prescribed.”

Contact us directly for questions about the common side effects, and we can discuss potential dosage adjustments or management strategies. Dr. Neubardt's role in the Orthopedic Optimization program is as an orthopedic surgeon overseeing your weight management and strengthening for orthopedic health. He is not your primary care physician (PCP) and you should in no way consider his role as your primary care physician. Your health and safety are paramount, which is why we require this clear division of medical responsibilities. We are e here to support your weight loss journey while ensuring you maintain appropriate primary care relationships for your overall health management. To participate in our program, you must: · Maintain an active relationship with your primary care physician (PCP) · Contact your PCP for any significant medical concerns · Seek immediate emergency care for serious side effects or medical emergencies

A DEXA scan provides a precise window into your weight loss journey, measuring exactly how much fat you're losing—and more importantly, how much muscle you're maintaining. This is an optional test that you may elect to do at the start of the program and then as a follow up six months later. We will provide you with a prescription to get the test, however in most cases it will not be covered by insurance. The cash price for the test is $200. NOTE: This is not a regular bone density DEXA scan. Do not go to a facility that only does the bone DEXA scan. What you need is a "Full Body Composition DEXA scan". We recommend that you go to a place such as DEXAFIT in Westport, CT. While GLP-1 medications are powerful tools for weight loss, our DEXA monitoring ensures you're losing the right kind of weight. By tracking your body composition every six months, we can fine-tune your physical therapy program to protect your muscle mass, leading to stronger, healthier, and more sustainable results.

Cancel and leave the Ortho Opti program at anytime with one-click. Go to the “Cancel my subscription button” here. Anything already paid to Orthopedic Optimization is not refundable.

We will regularly evaluate your progress using monthly questionnaires and adjust your medication dosage as needed for optimal results. You will receive an email or text on the third week of every month with a questionnaire asking about your current weight and whether you are having any side effects or problems. Assuming you are doing well, you will have the option to request a modification to your Wegovy dose. We will send a prescription to your pharmacy each month for the Wegovy with the appropriate dose noted. Going up or down on the dose each month is not a problem.

A compounding pharmacy is different from traditional retail pharmacies like CVS or Walgreens. While retail pharmacies primarily dispense pre-manufactured medications, compounding pharmacies are specialized facilities that create custom medications by combining pharmaceutical ingredients to meet specific patient needs. For our weight loss program, we will submit your Wegovy prescription to your pharmacy and it is hopeful that the medication cost will be covered by your insurance. If not covered, a compounding pharmacy is a good choice for you to obtain the generic Wegovy medication. We recommend FDA-registered compounding pharmacies that prepare semaglutide (the active ingredient in Wegovy) in a specialized way. These pharmacies: · Source pure, FDA-approved generic semaglutide powder from licensed manufacturers · Combine it with sterile solutions to create injectable medications · Package it in precise doses for patient use · Maintain strict quality control standards throughout the process This compounding process allows you to get a more affordable alternative to brand-name Wegovy while maintaining the same active ingredient and therapeutic benefits. Here's how compounding pharmacies ensure quality and safety: · Follow strict FDA guidelines and regulations · Operate in sterile clean rooms with specialized equipment · Conduct regular testing of prepared medications · Maintain detailed documentation of all ingredients and processes · Submit to regular inspections and certifications · Employ trained pharmacists specializing in compounding It's important to understand that compounded medications, while more affordable, are just as legitimate as brand-name drugs. The key difference is that compounding pharmacies can create custom formulations that aren't available through retail pharmacies, often at a lower cost. Each batch is prepared specifically for individual patients rather than mass-produced, allowing for more personalized medicine while maintaining high safety and quality standards. Our program gives you information about reputable, FDA-registered compounding pharmacies that sell at the lowest prices and meet rigorous quality and safety standards to ensure you receive safe, effective medication for your weight loss journey.