Holly Springs Direct Primary Care
Holly Springs Direct Primary Care
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    • HOME
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      • PRIMARY CARE
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      • PROCEDURES
      • IMAGING
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  • HOME
  • SERVICES
    • PRIMARY CARE
    • WEIGHT MANAGEMENT
    • SMALL BUSINESSES
  • MEMBERSHIP
    • PRICING
    • LABS
    • PROCEDURES
    • IMAGING
  • ABOUT
  • FAQ
  • CONTACT
  • BLOG
  • PHILANTHROPY

Medical Weight Loss

Medical Weight Loss in Holly Springs

Our office offers board certified obesity medicine care to help you achieve your goals!

Now Prescribing GLP-1s including Wegovy and Zepbound

Sign up now for better health

It's no secret that losing weight is difficult, and maintaining weight loss can be even more difficult. For more on why it's so hard to lose weight, check out our blog post here. Even with the right lifestyle changes in place, sometimes additional support is needed, which is where we can help.


Along with coming up with individual lifestyle modifications, there are many medications to choose from, and we'd love to go through these with you, look at the pros and cons, and together decide on what may be in your best overall interest. Check out what we can offer below. Our medical weight loss program is included in our primary care membership or can be subscribed to virtually by itself to patients in North Carolina. Membership covers the initial visit plus all follow ups, both those in person and those by video visit, phone, email, or text. The cost of medications is not included though we will help fight with your insurance on your behalf to try and get them covered.

Social History Review

Weight Specific History

Social History Review

We want to help our community!

  • review of how things around you are impacting your health
  • individualized recommendations to maximize health improvement


Family History Review

Weight Specific History

Social History Review

True family medicine!

  • review of your genetic contribution to your weight
  • explore the multifactorial aspect of your weight loss journey

Weight Specific History

Weight Specific History

Weight Specific History

Medical weight loss

  • what has worked and what hasn't?
  • help decide on the best plan going forward

Lifestyle Medicine

Medications for Weight Loss

Weight Specific History

Lifestyle medicine

  • diet, exercise, sleep, toxic substances, social connections, and stress management
  • discuss how to overcome obstacles and barriers 

Medications for Weight Loss

Medications for Weight Loss

Medications for Weight Loss

Wegovy, Zepbound, semaglutide

  • review your current meds that may be contributing to weight struggles (you may be surprised!)
  • discuss the long list of medication options and decide which may be the best option, when appropriate

Long Term Follow Up

Medications for Weight Loss

Medications for Weight Loss

Weight loss doctor

  • long term follow up from the start
  • partnership model of care with the goal to maximize your health and longevity

Benefits of Our Weight Management Membership

  • 1 on 1 coaching and visits with a triple board certified physician who has done extensive additional training in lifestyle and obesity medicine. Build a longer and deeper relationship than you'll get with a different weight management company
  • personalized broad health plan with spending more time on specifics where they are needed (eg, nutrition planning, exercise discussion, medication interactions and prescriptions, etc)
  • initial intake visit and close follow up thereafter (can be all telemedicine)
  • easy communication through text or email in between scheduled visits, all with no copays or surprise bills
  • medication management and prescriptions (medication cost not included in membership fee, but many patients have coverage through insurance)
  • we will help with prior authorizations and fight with insurance on your behalf to try and get name brand medications approved that we think are medically necessary (often copays are $25 or less if covered by your insurance)
  • certain labs may be required prior to medications being prescribed. If you have had recent labs through your PCP or elsewhere, we can review those and provide personalized recommendations based on your specific results. Otherwise, benefit from our discounted labs, with a complete set of labs (including CBC, CMP, A1C, and lipids) for only around $15
  • save thousands of dollars per year with our low monthly membership compared to expensive online companies

Weight loss is hard but we can help.

Success is the sum of small efforts, repeated day in and day out.


Robert Collier

FDA Approved Medications To Consider

Wegovy (semaglutide)

Zepbound (tirzepatide)

Zepbound (tirzepatide)

  • GLP-1 agonist, weekly self injections
  • suppresses appetite by stimulating neurons within the arcuate nucleus of the hypothalamus in the brain; helps you stay full longer
  • decreases excessive glucose production from the liver, delays gastric emptying
  • estimated 15% weight loss when combined with lifestyle modifications, with more than half of patients losing more than 15%

Zepbound (tirzepatide)

Zepbound (tirzepatide)

Zepbound (tirzepatide)

  • the most recently approved option, has been around for diabetes for a while
  • combination of a GLP-1 and GIP agonist
  • 18% weight loss based on trials, which is the most effective option on the market

Saxenda (liraglutide)

Zepbound (tirzepatide)

Qsymia (phentermine/topiramate)

  • also a GLP-1 agonist, daily injection
  • same mechanism of action as Wegovy, but has been around longer
  • not quite as much weight loss compared to Wegovy based on studies but still more weight loss than most other available options

Qsymia (phentermine/topiramate)

Contrave (buproprion/naltrexone)

Qsymia (phentermine/topiramate)

  • oral pill, combo of the stimulant phentermine and migraine/anti seizure-med topiramate
  • decreases appetite
  • potential medication interactions and have to be careful with certain underlying medical conditions
  • can cause birth defects if taken during pregnancy so birth control is extremely important

Contrave (buproprion/naltrexone)

Contrave (buproprion/naltrexone)

Contrave (buproprion/naltrexone)

  • oral pill, combo of the depression medication bupropion and naltrexone, which helps potentiate bupropion's action
  • decreases appetite
  • potential medication interactions and have to be careful with certain underlying medical conditions

Phentermine (3 mo)

Contrave (buproprion/naltrexone)

Contrave (buproprion/naltrexone)

  • oral stimulant, can be used by itself
  • only the 3 mo course is FDA approved
  • decreases appetite
  • potential medication interactions and have to be careful with certain underlying medical conditions

Non FDA Approved Medications To Consider

compounded options

Topamax (topiramate)

compounded options

  • semaglutide = active ingredient in Ozempic and Wegovy
  • tirzepatide = active ingredient in Mounjaro and Zepbound
  • both are once per week injections and made by a compounding pharmacy
  • no formal studies or trials have been done on these so the FDA is not able to give their approval
  • see more below

Metformin

Topamax (topiramate)

compounded options

  • cheap, oral option classically used for diabetes or prediabetes
  • may cause GI side effects
  • helps with PCOS and insulin resistance

Topamax (topiramate)

Topamax (topiramate)

Topamax (topiramate)

  • cheap, oral option, decreases appetite
  • can cause fatigue, which may help with insomnia
  • should not be used with a history of glaucoma, kidney stones, or certain kidney issues
  • can cause birth defects if taken while pregnant

phentermine (>3 mo)

Wellbutrin (bupropion)

Topamax (topiramate)

  • can use >3 mo at a time off label
  • caution with significant anxiety or BP issues
  • controlled medication
  • suppresses appetite

Wellbutrin (bupropion)

Wellbutrin (bupropion)

Wellbutrin (bupropion)

  • classically used for depression or smoking cessation
  • can suppress appetite, but could worsen anxiety and raise BP
  • avoid w/ seizure history or certain eating disorders

naltrexone

Wellbutrin (bupropion)

Wellbutrin (bupropion)

  • does not contribute to weight loss by itself but can be added to bupropion to enhance its appetite suppressing benefit 
  • should not be taken with opiod pain medications

Curious about compounded weight loss medications?

FDA approved name brand options (Wegovy or Zepbound) should be tried first, but if those are not options (because of insurance coverage issues, cost, supply problems, etc) then compounded options could be explored. Compounded medications for weight loss have not undergone formal studies or trials, so there is no data for the FDA to look at to give their formal approval. Keeping that in mind, the risks and benefits of using compounded medications should be discussed with Dr. Bartkoski with your individual health information at the forefront of that discussion. The known risks of untreated and worsening obesity (such as high cholesterol, high blood pressure, diabetes, heart disease, etc) should be weighed against the theoretical risks of compounded medications, and if the benefits outweigh the risks, they can be considered.


There is ongoing litigation between Eli Lilly (who makes Zepbound) and several compounding pharmacies and 4 telemedicine weight loss companies. Until this is resolved, we are not currently offering semaglutide through our office. 

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Holly Springs Direct Primary Care

1100 Holly Springs Road, Suite 203. Holly Springs, NC 27540.

(984) 464-4764 info@hollyspringsdpc.com

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