Patient FAQ
Frequently asked questions
GLP-1 medical weight-loss care by telehealth. Updated October 2026.
About ExpressWell
What is ExpressWell?
ExpressWell is the medical weight-loss program of Express Family Care (EFC) in Roanoke, Virginia. You are cared for by the same local team, from home. Our clinicians combine evidence-based nutrition, activity and behavior goals with prescription weight-loss medication when it is appropriate for you.
The program is designed for ongoing care. It is not a one-time prescription, and medication is never guaranteed.
How do telehealth visits work?
Visits take place by secure video on Doxy.me. There is nothing to download: you click the visit link a few minutes early and allow your camera and microphone when asked. You can join from a phone, tablet or computer with a camera.
Because our clinicians are licensed in Virginia, you must be physically located in Virginia at the time of every visit. Your clinician will confirm your location at the start of each visit.
An in-person visit at our Roanoke clinic may be needed if a physical exam is required, measurements are unreliable, symptoms raise concern, or video is not clinically sufficient. You are also welcome to request an in-person visit.
Who may qualify for treatment?
ExpressWell currently treats adults. Medication eligibility is generally based on a body mass index (BMI) of 30 or higher, or a BMI of 27 or higher with a weight-related condition such as high blood pressure, high cholesterol, type 2 diabetes, obstructive sleep apnea or heart disease.
Final eligibility depends on your full medical evaluation, the medication's FDA labeling, safety considerations and your clinician's judgment.
Will everyone who schedules receive a GLP-1 medication?
No. A visit is a medical evaluation, not a promise of a prescription. Depending on what your clinician finds, they may recommend lifestyle treatment alone, additional records or testing, a different FDA-approved option, coordination with your primary-care or specialty clinician, or a higher level of care.
Medications and what to expect
Which medications does ExpressWell prescribe?
When appropriate, your clinician may prescribe Wegovy (semaglutide) injection once a week, Wegovy (semaglutide) tablets once a day, or Zepbound (tirzepatide) injection once a week.
You and your clinician choose together, based on your health history, current product labeling, availability and your preferences, including whether you prefer to avoid injections. You will use only one GLP-1 medication at a time.
Ozempic, Rybelsus and Mounjaro are approved for type 2 diabetes. ExpressWell does not prescribe them as a substitute for a weight-management product.
Do you prescribe compounded semaglutide or tirzepatide?
No. ExpressWell prescribes FDA-approved products only. Compounded drugs are not FDA-approved, and the FDA does not review them for safety, effectiveness or quality before they are sold.
How do these medications work?
They act on the body's natural appetite and digestion signals. They can reduce hunger, help you feel full sooner and slow how quickly your stomach empties. Semaglutide acts on the GLP-1 receptor; tirzepatide acts on both the GIP and GLP-1 receptors.
They work best as part of a long-term plan that includes nutrition, physical activity, sleep and behavior change.
How much weight will I lose?
Results vary from person to person. Average results from clinical trials do not predict any one person's result. Your response depends on the medication, dose, how well you tolerate it, how consistently you take it, your health conditions and your lifestyle changes.
ExpressWell does not guarantee any specific amount or rate of weight loss.
How is the dose increased?
Every medication starts at a low dose. At your monthly follow-up visits, your clinician decides whether to increase the dose, typically about every 4 weeks, following the FDA-approved labeling and how well you are tolerating it.
Dose increases are not automatic. Your clinician may hold, lower or stop your dose if you have side effects, are not eating or drinking enough, have abnormal results or develop other safety concerns.
Is this short-term treatment?
Usually not. Obesity is often a chronic condition, and weight-loss medications are generally used long term when they are effective, well tolerated and safe. Stopping the medication can lead to increased appetite and weight regain. Your clinician will regularly review the benefits, risks, your goals and whether treatment should continue.
Visits, labs and refills
What happens at my first visit?
Your first visit is a relaxed conversation with your clinician. You will confirm your identity and that you are in Virginia; review and sign a consent form and a release form on screen; share your height, weight, medications, allergies, and medical and surgical history; talk about your weight history, past treatments, habits and goals; and discuss whether a medication is right for you.
Your clinician also checks for reasons a medication may not be safe for you, such as certain personal or family medical history, pregnancy plans, drug interactions or upcoming procedures. Payment is collected by card at the end of the visit.
Will I need lab tests?
Yes, in most cases. Your clinician will usually order a complete blood count (CBC), a comprehensive metabolic panel (CMP) and a hemoglobin A1c (HbA1c), to be completed within your first 30 days. You can have them drawn at Express Family Care. Lab fees are separate from your visit fee.
Depending on your history, your clinician may request other tests or outside records. In some cases these are needed before a medication can be prescribed or continued.
How often are follow-up visits?
Most patients have a follow-up video visit about every 4 weeks. Your clinician schedules your next visit with you at the end of each visit, and we send a reminder beforehand.
We try to keep you with the same clinician, but you may sometimes see another member of the ExpressWell team.
What should I have ready for a follow-up visit?
A recent weight (and blood pressure and pulse if requested); your medication name, dose and the date of your last injection or tablet; any side effects; an updated list of all medications and supplements; blood sugar readings if you check them; and any upcoming procedure, pregnancy plans or missed doses. Join from a private location with a reliable internet connection.
Are refills automatic?
No. Refills require regular follow-up visits and up-to-date safety information. ExpressWell may pause or decline a refill if visits are overdue, required measurements, labs or records are missing, side effects have not been reviewed, the medication is not being taken as prescribed, or continuing treatment is not medically appropriate.
Safety and side effects
What are common side effects?
Common side effects include nausea, diarrhea, vomiting, constipation, stomach discomfort, indigestion, burping and tiredness. Injections may also cause redness or irritation at the injection site. Symptoms are often most noticeable after starting or increasing a dose.
After your first visit, we send you a side-effect guide with tips to ease symptoms. Contact ExpressWell if symptoms persist, get worse, or make it hard to eat or drink.
Who should not use Wegovy or Zepbound?
Anyone with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), or who has had a serious allergic reaction to the medication or its ingredients.
Tell us if you have a history of pancreatitis, gallbladder disease, severe stomach or bowel problems (including gastroparesis), kidney problems, diabetic eye disease, an eating disorder or mental-health concerns, if you take diabetes medication, or if you have any procedures planned.
Can I take another GLP-1 medication at the same time?
No. Do not combine Wegovy or Zepbound with any other product that contains semaglutide, tirzepatide or another GLP-1 medication. Always give us a complete medication list, including samples, online prescriptions and compounded products from anywhere else.
What if I have diabetes or take insulin or a sulfonylurea?
Tell us before you start. Taking these medications with insulin or a sulfonylurea (such as glipizide or glimepiride) can increase the risk of low blood sugar, and your diabetes medications may need to be adjusted by the clinician who manages them.
Can I use these medications if I am pregnant, planning pregnancy or breastfeeding?
These medications are not used during pregnancy. Tell ExpressWell right away if you are pregnant, think you may be pregnant or are planning a pregnancy.
Semaglutide (Wegovy): the label advises stopping at least 2 months before a planned pregnancy. Tirzepatide (Zepbound): it can make birth control pills less effective; the label advises switching to a non-oral method, or adding a barrier method, for 4 weeks after starting and after each dose increase.
If you are breastfeeding, your clinician will discuss whether treatment is appropriate based on current product labeling.
What should I do before surgery or a procedure?
Tell your surgeon, anesthesia team and procedure team that you take a medication that slows stomach emptying, and let ExpressWell know as soon as a procedure is scheduled. Your procedure team and prescribing clinician will make a plan specific to you.
Taking your medication
How do I take Wegovy tablets?
Take your tablet once a day on an empty stomach with no more than 4 ounces of plain water. Wait at least 30 minutes before eating, drinking anything else or taking other oral medications. Follow the Medication Guide that comes with your prescription.
Will someone show me how to give an injection?
Yes. If you start an injectable medication, we share a short video showing how to give your injection. You are also welcome to come by the Express Family Care office for help.
What if I miss a dose or my medication was not stored correctly?
Follow the Medication Guide and Instructions for Use that come with your specific product, and contact ExpressWell or your pharmacist if you are unsure. Do not double a dose, and do not use medication that looks damaged, has been frozen or was stored outside the labeled temperature limits.
Can I increase my dose early or split a pen or vial?
No. Use only the exact product, dose, schedule and method your clinician prescribed.
What if my medication is unavailable?
Contact your pharmacy and ExpressWell. Do not substitute another GLP-1 product, buy medication from an unverified seller or restart at a higher dose after a long break. Your clinician will decide the safest way forward.
Cost and insurance
How much does ExpressWell cost?
ExpressWell visits are self-pay and are not billed to health insurance. First visit: $189 ($299 with the required lab panel). Monthly follow-up visit: $99. Payment is collected securely by credit or debit card at the end of each visit.
Is medication included in the visit fee?
No. Medication, pharmacy charges, lab work, outside services and supplies are billed separately from your visit fee.
Will my insurance cover the medication?
Coverage varies widely by plan and can change. Some plans exclude weight-loss medications or require prior authorization. A prescription does not guarantee insurance coverage or pharmacy availability. Please ask us what help with prior authorization is available.
How do I cancel or reschedule?
Because clinician time is reserved for you, please call 540-400-6676 to cancel or reschedule as early as you can.
When to get urgent help
Call 911 for severe or ongoing stomach pain (especially pain spreading to your back), repeated vomiting or being unable to keep fluids down, fainting or signs of serious dehydration, or trouble breathing or swelling of the face, lips, tongue or throat.
Call ExpressWell promptly at 540-400-6676 for significant stomach symptoms, possible gallbladder symptoms, vision changes if you have diabetes, much less urination than usual, or any concerning new symptom. Do not use email or text for emergencies.