A physician-led GLP-1 and tirzepatide program for patients across the Inland Northwest.
Achieving your ideal aesthetic often requires a comprehensive strategy that addresses the foundations of health and metabolism. Dr. Sand, Barbara Sand, PA-C, and our team of Registered Nurses understand that significant weight gain can impact overall body contour and facial harmony. Our medically supervised, functional medicine-based Weight Loss and Wellness Program is designed to optimize your health from the inside out, providing a foundation for powerful and sustained body transformation under the clinical oversight of our dedicated providers.
This program goes beyond simple prescriptions, embracing a functional medicine philosophy that treats the whole person. We utilize a multi-faceted approach combining breakthrough pharmacotherapy with therapeutic-grade peptides, targeted vitamins, and lifestyle medicine to modify your “body set weight,” manage cravings, and support your overall well-being under the direct guidance of our medical team.
Physician-Supervised Weight Loss with Surgical-Grade Oversight
We are committed to providing cutting-edge, evidence-based treatments. Our program is a medically rigorous, tailored approach that integrates breakthrough pharmacotherapy with essential aesthetic and wellness support.
- Clinical Team Oversight: While Dr. Sand, a Double Board-Certified Facial Plastic Surgeon, oversees the program, day-to-day management, patient visits, and medication titration are primarily managed by our experienced Licensed Medical Providers, including Barbara Sand, M.C.H.S., PA-C, and our team of Registered Nurses. This ensures safety, customized dosing, and consistent support.
- Comprehensive Wellness: Integration of advanced peptides, hormone balancing, and lifestyle optimization to support not just weight loss, but superior overall health.
- Body & Face Connection: Preparing the body with significant weight loss before or after surgical procedures (like FaceTite, Neck Lift, or Body Contouring) ensures the best possible, enduring aesthetic outcomes.
Am I a Candidate for Medical Weight Loss?
Our medical weight loss program is designed for adults who have struggled to reach or maintain a healthy weight through diet and exercise alone. Patients typically have a BMI of 27 or higher, or a BMI of 25+ with weight-related health concerns such as elevated blood pressure, prediabetes, or sleep disruption. Candidates should be in generally good health, willing to commit to regular follow-ups, and free of the small number of medical histories that make GLP-1 therapy inadvisable (a personal or family history of medullary thyroid cancer or MEN2, active pancreatitis, or current pregnancy). Your initial consultation with Barbara Sand, PA-C, or one of our Registered Nurses will confirm whether the program is right for you.
Semaglutide, Tirzepatide, and GLP-1 Programs
We offer the most advanced, evidence-based GLP-1 and GIP receptor agonists available, with the protocol matched to each patient’s goals, tolerance, and medical profile.
Semaglutide for Weight Loss
A once-weekly injectable GLP-1 receptor agonist. Semaglutide works by suppressing appetite and reducing the “food noise” that drives between-meal cravings, helping patients reach a sustainable lower caloric intake. It is the most clinically studied GLP-1 medication for weight loss.
Tirzepatide for Weight Loss
A dual GLP-1 and GIP receptor agonist administered weekly. Tirzepatide combines appetite suppression with enhanced metabolic action and has demonstrated higher average weight loss than semaglutide alone in head-to-head studies, making it our preferred option for patients seeking maximum results.
Combination GLP-1² Protocol
For select patients whose response or tolerance benefits from a layered approach, we offer a compounded protocol combining semaglutide and tirzepatide. This option is reserved for cases where the combination is medically appropriate and is determined in consultation with your provider.
Note on Medication Access: Due to high demand and insurance complexities, we utilize high-quality, fully tested compounded formulations of the active ingredients, providing a reliable and cost-effective pathway to treatment.
What to Expect: Your First Visit
Every journey begins with a meticulous diagnostic phase to establish a foundation for success.
Initial Consultation & Screening Includes:
- Consultation with a Licensed Provider: Your initial comprehensive visit will be conducted by Barbara Sand, PA-C, or one of our highly trained Registered Nurses who specialize in clinical weight management.
- Detailed review of patient medical history, weight history, and current medications.
- Body composition analysis and target weight goal setting.
- Required laboratory panels to assess underlying metabolic and hormonal health:
- Lipid and Liver Function Tests
- Thyroid Hormone Balance
- Hormone Levels (Estrogen, Testosterone, DHEA-S)
- Micronutrient and Vitamin Status (e.g., B12, Vitamin D)
Ongoing Support: Wellness, Nutrition, and Skin
Our approach is holistic. We integrate supplementary treatments to boost energy, preserve lean muscle mass, and enhance skin quality during rapid weight loss.
Metabolic & Energy Enhancement
Procedures offered include:
- LipoMIC+ Skinny Shots: A potent blend of Methionine, Inositol, and Choline combined with essential B Vitamins to boost fat metabolism and energy levels.
- NAD+ Therapy: Available as injections, nasal sprays, or face creams to support cellular energy, anti-aging, and detoxification, which is vital during significant weight reduction.
- Sermorelin: A Growth Hormone Releasing Hormone (GHRH) peptide that can help improve body composition and reduce fat mass.
- IV Hydration & Vitamin Drips: Targeted IV therapy (e.g., Energy Drip, Skinny Drip) to ensure optimal hydration and nutrient absorption.
Body Aesthetics & Skin Tightening
Weight loss is often followed by concerns about skin laxity. We seamlessly integrate non-surgical aesthetic solutions into your plan:
- Skin Firming: Recommendations for non-surgical skin tightening like FaceTite and BodyTite, of which Dr. Sand is the exclusive Spokane and Coeur d’Alene provider, and RF Microneedling to proactively address loose skin and volume loss during or after achieving your goal weight.
- Nutritional Planning: Guidance on high-protein, nutrient-rich food choices to support muscle retention and prevent nutritional deficiencies.
- Lifestyle Optimization: Personalized plans for sleep, stress management, hydration, and incorporating appropriate exercise (HIIT, walking) to ensure the weight stays off and health markers improve.
Frequently Asked Questions
How much weight can I expect to lose?
Results vary by individual, but published clinical trials show average weight loss of 15 to 22% of body weight over 12 to 18 months with semaglutide or tirzepatide when paired with lifestyle changes. Most of our patients begin seeing measurable results within the first 4 to 8 weeks.
Is the program covered by insurance?
GLP-1 medications for weight loss are inconsistently covered by commercial insurance. Our program uses high-quality compounded semaglutide and tirzepatide, which provides a more predictable and cost-effective pathway than navigating brand-name insurance approvals. We discuss specifics at your initial consultation.
What are the most common side effects?
Mild gastrointestinal symptoms (nausea, reduced appetite, occasional constipation) are the most frequently reported and usually resolve within the first few weeks as the body adjusts. Our team manages dosing carefully to minimize these effects.
How is this different from getting GLP-1s from a med spa or online clinic?
Our program is run inside a board-certified surgical practice with on-site physician oversight, real lab work, and integration with the rest of your aesthetic goals. Patients planning future facial or body procedures benefit from coordinated care across weight loss, skin tightening, and surgery.
Do I need to be planning surgery to enroll?
No. The medical weight loss program is open to anyone in the Spokane and Coeur d’Alene area who meets the medical criteria, regardless of whether they’re considering future procedures.
How long is the program?
The program is structured around a maintenance philosophy, not a fixed end date. Most patients follow an active treatment phase for 9 to 18 months followed by a longer maintenance phase at reduced dosing to preserve results.
Next Steps to Begin Your Program
Take the first step toward a healthier weight and a revitalized aesthetic.
- Schedule a Consultation with our Medical Weight Loss Team (PA-C or RN)
- Learn More about our non-surgical body contouring options.
About Your Care Team
The Sand Plastic Surgery Medical Weight Loss Program operates under the clinical oversight of Jordan P. Sand, M.D., F.A.C.S., one of the only double board-certified facial plastic surgeons in the Inland Northwest, with faculty appointments at the University of Washington School of Medicine and WSU Elson S. Floyd College of Medicine. Day-to-day patient care is led by Barbara Sand, M.C.H.S., PA-C, and a team of Registered Nurses with specialized training in clinical weight management.