WEIGHTLOSS.
A physician-supervised GLP-1 medication program — compounded semaglutide, careful screening, real follow-up. Designed for patients ready to do the work alongside the medication.
A GLP-1 program, under medical supervision.
Medically supervised weight loss at Reviv combines a GLP-1 receptor agonist medication — compounded semaglutide — with the screening, dosing, and follow-up that prescription medication requires. GLP-1 agonists work by mimicking a hormone your body already produces; they reduce appetite, slow gastric emptying, and improve satiety, which makes it easier to eat less without feeling deprived.
This is not a quick fix. Semaglutide is a chronic-care medication; results require months on the program, paired with lifestyle changes you can actually keep. We will not enroll patients we do not think the program will help, and we will not push it on anyone for whom the risks outweigh the benefits.
Most patients see meaningful weight change in the first 3 to 6 months of titrated dosing, with a 12 to 15% body-weight reduction over 12+ months in clinical trials of brand-name semaglutide. Individual response varies.
Screening, dosing, and follow-up.
The weight-loss program at Reviv Med Spa in Millbrae is supervised by our Medical Director Dr. Gayle Misle, MD. Our Aesthetic Nurse Megan Sosnick, RN, walks patients through self-injection technique and ongoing visits. Screening, dosing, and monthly follow-up are all built into the program structure — this is medical care, not a prescription handoff.
This medical infrastructure matters because GLP-1 weight-loss programs are easy to do badly — and the failure modes (under-screening, under-dosing, over-dosing, ignoring side effects) cause real harm. We have put the people and process in place to do it carefully.
We discuss compounded vs brand-name semaglutide honestly:
- Brand-name semaglutide by Novo Nordisk
- Wegovy and Ozempic. FDA-approved for specific indications. Often via insurance with prior authorization.
- Compounded semaglutide licensed compounding pharmacy
- Same active molecule, prepared under physician prescription. Not FDA-approved; different regulatory framework. Typically cash-pay, lower cost, faster access.
- Compounded tirzepatide licensed compounding pharmacy
- A dual GLP-1/GIP agonist. Active molecule of Mounjaro and Zepbound, in compounded form. Discussed when appropriate.
Program structure: initial consultation with full medical history and screening; first injection (administered or self-administered with RN guidance) at the lowest dose; titration over weeks 1–4 with monthly check-ins; continued titration toward maintenance over months 2–6; maintenance dosing in months 6–12+; tapering or discontinuation under physician guidance once goals are reached.
Six pieces, one program.
A medical weight-loss program is more than a single injection. We discuss what fits at consultation — including labs, lifestyle counseling, and adjuncts where they help.
Compounded semaglutide
GLP-1 receptor agonist. Same active molecule as Wegovy and Ozempic, prepared by a licensed compounding pharmacy under physician prescription.
Brand-name semaglutide
Wegovy and Ozempic by Novo Nordisk. FDA-approved for specific indications. Discussed at consultation alongside compounded options.
Compounded tirzepatide
Dual GLP-1/GIP receptor agonist. The active molecule in Mounjaro and Zepbound, available in compounded form.
B12 + amino acid injections
Adjunct injections used in some patients to support energy and protein synthesis during titration.
Baseline labs
Screening labs as indicated — thyroid, lipid, liver, A1c. Required before the first dose for many patients.
Lifestyle counseling
Protein-forward eating, hydration, sleep, and resistance-training conversation built into every visit.
What we screen for.
Medullary thyroid carcinoma history
Personal or family history of medullary thyroid cancer or MEN2 rules out the program. The FDA boxed warning for all GLP-1 agonists applies.
Pregnancy and breastfeeding
Pregnancy, planned pregnancy, or breastfeeding rules out the program. We screen at every consultation.
Pancreatitis history
Active pancreatitis or significant pancreatitis history is a contraindication. Pancreatitis is a rare but serious risk on GLP-1 agonists.
GI motility, retinopathy, eating-disorder context
Severe gastroparesis, diabetic retinopathy under active management, eating-disorder history, and certain mental-health contexts may rule the program out or require careful coordination.
Tirzepatide GLP-1 Weekly Lab work Screening Goal weight Maintenance Semaglutide Tirzepatide GLP-1 Weekly Lab work Screening Goal weight Maintenance Semaglutide Tirzepatide GLP-1 Weekly Lab work Screening Goal weight Maintenance What to know, in four lines.
- 01
Semaglutide is a chronic-care medication, not a quick fix. Most patients stay on the program 6 to 12+ months to reach their goal weight.
- 02
GI side effects (nausea, decreased appetite, constipation) are common in the first weeks and typically improve with dose titration. We adjust if they don't.
- 03
The FDA boxed warning for all GLP-1 agonists addresses the rare risk of medullary thyroid carcinoma. We screen carefully and decline the program when contraindications are present.
- 04
Compounded vs brand-name is an honest conversation, not a marketing claim. We discuss both at consultation so you can make an informed choice.
From first dose, to long-term maintenance.
Initial consultation, full medical history, and screening. Baseline labs as indicated. First dose at the lowest titration step under nurse guidance.
Titration phase. Weekly self-administered injection at home. GI side effects (nausea, decreased appetite) are most common here and typically improve with the next dose step.
Early weight change becomes visible for most patients. Monthly check-ins to monitor tolerance, dose response, and any labs. Continued titration toward your maintenance dose.
Many patients reach their goal in this window. Conversation begins around tapering, transitioning to a lower maintenance dose, or discontinuation under physician guidance.
What it actually costs.
Weight-loss program pricing at Reviv is per month and includes the medication, supplies, initial consultation, and follow-up visits. Final cost depends on the medication selected (compounded vs brand-name), your dose, and whether labs are included — and we quote the full cost picture in writing at consultation, before any treatment begins.
Who it's for — and who it isn't.
- Adults seeking medical support for weight management alongside lifestyle work
- Patients ready for a 6 to 12+ month program with regular follow-up
- Patients who can self-administer a once-weekly subcutaneous injection
- Patients with realistic expectations and willingness to adjust diet, activity, and protein intake
- Patients with personal or family history of medullary thyroid carcinoma or MEN2
- Patients who are pregnant, planning pregnancy, or breastfeeding
- Patients with active pancreatitis or significant pancreatitis history
- Patients seeking a quick fix without the lifestyle work — the medication does not work alone
Your weight-loss team.
Dr. Gayle Misle, MD
Founder of Reviv Med Spa & Laser Treatment. Supervises the weight-loss program — including initial medical screening, contraindication review, and ongoing dose decisions.
Megan Sosnick, RN
Aesthetic Nurse and Practice Manager. Walks every patient through self-injection technique at the first visit and runs the cadence of weight-loss follow-up appointments.
What people say about Reviv.
The whole team takes their time. No upselling, no pressure — just a thoughtful plan and beautiful results. The space itself feels like a sanctuary.
I've tried four other med spas in the Bay Area. Reviv is the only one where I feel genuinely listened to. Worth the drive from the city.
Conservative, honest, and skilled. They told me I didn't need half of what I was considering — and the things they did do were perfect.
No weight-loss-tagged reviews yet — these are recent reviews from across our practice.
Read all reviewsFrequently asked.
Is this the same as Wegovy or Ozempic?
Both Wegovy and Ozempic are brand-name semaglutide products from Novo Nordisk. The medication we use is compounded semaglutide — the same active molecule, prepared by a licensed compounding pharmacy under physician prescription. Brand-name and compounded forms are not identical: dosing, formulation, and FDA status differ. We discuss this honestly at consultation so you can make an informed decision.
How much weight will I lose?
Outcomes vary widely based on starting weight, dose tolerance, lifestyle, and genetics. Clinical trials of brand-name semaglutide show average weight reductions of 12–15% of body weight over 12+ months when paired with diet and activity changes. Your individual result may differ. We track progress monthly.
How much does the program cost?
Pricing is per month of medication and includes initial consultation, screening, and follow-up visits. We discuss the full cost picture at consultation — no surprises.
Does the injection hurt?
Most patients describe the once-weekly self-injection as a 1–2 out of 10. We use a small, short subcutaneous needle. Megan Sosnick, RN, our Aesthetic Nurse, walks you through self-injection technique at the first visit. Most patients are comfortable doing it at home by the second week.
Are there side effects?
GI side effects — nausea, decreased appetite, constipation, occasional reflux — are the most common in the first weeks and typically improve with time and dose titration. Less common: fatigue, headache, injection-site reactions. Rare but serious: pancreatitis, gallbladder issues. We monitor and adjust dosing accordingly.
Who should not take semaglutide?
Patients with personal or family history of medullary thyroid carcinoma, multiple endocrine neoplasia syndrome type 2 (MEN2), or active pancreatitis. Patients who are pregnant, planning pregnancy, or breastfeeding. Patients with certain GI conditions. We screen carefully at consultation and decline the program when indicated. The FDA boxed warning around medullary thyroid carcinoma applies to all GLP-1 agonists.
How long is the program?
Semaglutide is a chronic-care medication, not a quick fix. Most patients stay on the program for 6 to 12+ months to reach their goal, then transition to a lower maintenance dose or discontinue under physician guidance. Weight is more likely to return after stopping if lifestyle changes haven't been built — we work on those alongside the medication.
Do I need to change my diet and exercise?
Yes. The medication helps reduce appetite and slow gastric emptying, but it works best alongside protein-forward eating, adequate hydration, and regular movement. We don't prescribe a strict meal plan — we work with what fits your life.
Will I lose muscle?
Rapid weight loss carries some lean-mass loss risk regardless of method. We address this with adequate protein intake (we recommend 1.0–1.6 g/kg body weight depending on goals) and resistance training, which preserves muscle through the loss phase.
What happens at follow-up visits?
Brief 15- to 30-minute consults — we review weight, dose tolerance, side effects, and any labs. Visit cadence is typically every 4 weeks during titration, then less frequent during maintenance.
Patients come to us from across the peninsula.
Reviv Med Spa is at 31 S El Camino Real in Millbrae, California — easy to reach from across the Bay Area peninsula. Patients come to us from Burlingame, San Mateo, Hillsborough, San Bruno, Foster City, and the broader peninsula including Atherton, Belmont, Brisbane, Daly City, Half Moon Bay, Menlo Park, Pacifica, Palo Alto, Portola Valley, Redwood City, San Carlos, and South San Francisco. Off the 101, just south of SFO. Free parking on site.