Some patients ask why our membership is $299 a month and not $79, because they have seen platforms advertising a low monthly fee for weight loss care. The honest answer is that the $79 number is never the whole bill. It is the entry point to a pricing structure where the medication is billed separately and on some platforms grows as your dose grows. We would rather show you one flat number and explain what it buys than quote a small number that doubles at titration.
We write this without naming any company as villain. There are legitimate businesses charging $79 a month for a membership and the patients who choose them are not careless. But the structure underneath that number deserves a close look, because the structure is where your annual cost is actually decided.
- A low membership fee typically covers platform access and a prescription, while the medication and any dose changes are billed separately.
- On some platforms the separate medication bill is a compounded product, which the FDA has warned carries real safety risks.
- Dose-escalation repricing means the monthly total grows exactly when your treatment is working and your dose titrates up.
- Our $299 flat fee covers the doctor and the quarterly Biomarker Audit and never changes with your dose, because our income does not depend on it.
What a $79 fee usually buys
Across the telehealth weight-loss market, a membership fee in the $75 to $150 range typically covers platform access, an intake review and a prescription. The medication is billed separately. That is not automatically a scam. It is a model. But it means the number you signed up for is not the number you will pay and the gap is where three specific costs hide.
| Cost | Where it hides | What it does to your annual bill |
|---|---|---|
| Compounded medication | Sold as the cheap alternative to branded drug | Lower monthly cost, unverified purity and dosing, FDA warnings about risk |
| Dose-escalation repricing | Monthly fee rises as your dose titrates up | The bill grows precisely when the treatment is working |
| Labs as add-ons | Biomarker panels sold per test | Monitoring becomes a paid extra instead of an included standard |
The compounded line is the one we will not soften. Compounded semaglutide and tirzepatide are not FDA-approved. Their purity, potency and dosing are not verified through the process branded drugs go through and the FDA has warned patients directly about the risks. We do not prescribe them, under any circumstance and we never will.
The math, on both models
Here is what a year looks like on our model. The Cardiometabolic Optimization Membership is a flat $299 per month. You start with a two-month commitment at $598, which covers the first Biomarker Audit, the clinical intake visit, month two of clinical care, the clinical protocol and platform costs. From month three it is $299 per month, month to month, cancel anytime.
- Year one: $598 for the first two months, then ten months at $299, for a total of $3,588.
- What it includes: the physician relationship, four comprehensive Biomarker Audits (ApoB, Lp(a), hs-CRP, HbA1c, lipids, insulin markers, full hormone and thyroid panels), the clinical protocols and ongoing adjustments.
- What it does not include: the medication, which is billed directly by the pharmacy at cost, with zero markup, no molecule upcharge and no dose-escalation fee.
That last line is the whole design. We are fully unbundled. The fee never covers the medicine and the medicine never touches our margin. There is no financial version of this conversation where we benefit from a stronger dose.
A real objection, named plainly: '$299 plus medication is more than $79 plus medication, so you are still the expensive option.' Maybe, on any given month, depending on which branded drug you need and what the pharmacy charges for it. What we can tell you is what will not happen on our model: the fee will not rise when your dose rises, the drug will not be a compounded copy and the labs will not be an upsell. Whether the total is higher or lower than a cheap membership depends on your prescription. Whether the incentives are aligned does not.
Why the flat fee matters clinically, not just financially
A pricing structure is also a clinical instruction. When a practice earns more as the dose climbs, every ambiguous case drifts toward the higher dose. When the fee is flat, the same ambiguity drifts toward the lowest dose that achieves the result. We titrate to the least medicine that gets you the most outcome and we can afford to hold that line because no part of our income moves when we do.
We make money when you get healthier, not when your dose gets stronger.
This is also why we do the quarterly Biomarker Audit as an included standard rather than a paid extra. A patient who is titrated by labs rather than by appetite reports is a patient whose dose means something. Cutting labs from the model to make the membership fee look smaller is how the dose ends up guided by nothing at all.
Who a cheap membership is right for
If your priority is the lowest possible monthly number and you are comfortable evaluating the medication supply yourself, a low-fee platform may be the right trade for you. We would only ask two questions before you sign up. First, is the medication they will sell you branded and FDA-approved or compounded? Second, does your monthly fee change if your dose changes? If the answers are branded and no, the platform is more aligned than most. If the answers are compounded and yes, you now know where the real price lives.
Frequently asked questions
Is the $299 fee really flat or does it change with my dose?
It is genuinely flat. The Cardiometabolic Optimization Membership is $299 per month whether you need the lowest effective dose or a higher one. We titrate to the least medicine that achieves the most result and our fee has no financial connection to that decision. The medication is billed separately by the pharmacy at cost, so dose changes show up only in what the pharmacy charges, never in our fee.
Does the $299 include the medication?
No and that separation is deliberate. The fee covers the clinical relationship, the quarterly Biomarker Audit and the protocols. The medication is billed directly by the pharmacy at cost with zero markup, no molecule upcharge and no dose-escalation fee. Two separate charges, so our income never depends on which drug you take or what dose you are on.
Why is compounded GLP-1 a dealbreaker for you?
Because compounded semaglutide and tirzepatide are not FDA-approved and their purity, potency and dosing are not verified through the branded drug approval process. The FDA has warned patients directly about the risks of compounded GLP-1 copies. We prescribe branded medication only: Wegovy, Zepbound, Ozempic, Mounjaro, Wegovy Tablets and Foundayo.
What does the $598 first charge cover?
The $598 is one charge at checkout covering the first two months of membership combined. It includes the first Biomarker Audit, the clinical intake visit, month two of clinical care, the clinical protocol and platform and affiliate costs. It is not $299 plus $598. From month three the fee is $299 per month, month to month, cancel anytime.
Do cheap platforms ever prescribe branded medication?
Some do. The market has shifted and several large platforms moved toward branded GLP-1s in 2026. The questions to ask any platform are the same regardless of the fee: is the medication branded, do the labs come included and does the fee change at titration. If all three answers are good, the low fee is not a red flag.
What if I cannot afford $299 a month?
Then we are probably not the right fit right now and we would rather say that than pretend otherwise. Our practice is built for patients who want clinical depth and are willing to pay for it and there are legitimate lower-cost options for patients whose priority is the monthly number. What we will not do is strip the labs or the clinical relationship out of the model to compete on price, because that is the part that changes outcomes.
Are labs really included in the fee?
Yes. Four comprehensive Biomarker Audits per year, one every 90 days, are included in the flat monthly membership. They cover ApoB, Lp(a), hs-CRP, HbA1c, lipids, insulin markers and the full hormone and thyroid panels. Additional labs beyond the quarterly cadence are billed to the patient at pass-through cost, with no markup.
Related guides
- Cardiometabolic Optimization: the definitive guide
- How GLP-1s work and what happens when they stop
- What a Biomarker Audit includes
- Our flat-fee model and why it never changes with your dose
External reference: the FDA's guidance on compounded GLP-1 medications explains the safety concerns behind our no-compounding rule.
References
- Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1). 2022. pubmed.ncbi.nlm.nih.gov/35658024/
- Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1). 2021. pubmed.ncbi.nlm.nih.gov/33567185/