Weight Loss

Janine Higbie, MS, CNS, CDN, is a licensed Dietitian Nutritionist with a master's in Integrative and Functional Nutrition. She specializes in women’s health and hormones, including PCOS, endometriosis, fertility, pre/post-natal, and menopause.

Whether you’re looking to balance hormones, achieve sustainable weight loss, or get the most out of weight loss injectables, Janine can help.  She provides tangible advice, healthy swaps, and simple, delicious, and nourishing recipes or customized meal plans.  All sessions are offered via telehealth and are individualized to meet your needs and goals.

If you’re feeling overwhelmed or inundated by seemingly conflicting nutrition information, you’re not alone.  Janine can cut through the noise, guiding you with a clear plan.  As a busy mom of three, she blends a real-world perspective with the latest research-backed science.  Janine is passionate about empowering women with the tools to achieve vibrant health through small, stackable changes that deliver big results. 

 Please ask Dr. Amersi about working with Janine to help you meet your goals and feel your best.

Why do I have difficulty losing weight?

Women experiencing PCOS, perimenopause, menopause, or thyroid disorders have a hormonal imbalance that can lead to metabolic issues affecting their overall health and appearance. These women have unexplainable weight gain and very little success in losing weight with traditional methods such as diet and exercise.

Menopause

Menopause and perimenopause can reduce estrogen levels and increase muscle loss, which slows metabolism and makes weight loss more challenging. 

PCOS

More than half of women with PCOS are overweight. One reason may be that PCOS is associated with insulin resistance, causing difficulty converting glucose to energy. Carrying excess weight may also worsen PCOS symptoms. 

Dr. Amersi can provide effective, life-changing treatments if you’re struggling with weight loss to help you get back to a place where you feel confident again.

What is medically supervised weight loss?

Medically supervised weight loss with Dr. Amersi includes healthy eating, regular exercise, and medication. Reaching an ideal weight offers several health benefits, including:

• Stable blood sugar
• Reduced insulin resistance
• Improved chronic disease management
• Reduced risk of heart attack and stroke
• Diminished PCOS symptoms
• Decreased appetite
• Enhanced fat burning
• More energy
• Increased self-confidence
• Reduced risk of medical problems

Entrepreneur Elon Musk, comedian and talk show host Chelsea Handler, and TikTok creator and model Remi Bader are among the many celebrities who have used prescription medicines to lose weight.

How do weight loss medicines work?

Weight loss medications contain substances that combat insulin resistance and reduce your appetite. Dr. Amersi uses the following drugs:

Semaglutide

WEGOVY and Ozempic semaglutide injections work by prompting the pancreas to make more insulin during periods of high blood sugar. They also prevent your liver from releasing too much sugar and slow down food movement from your stomach, so you feel full longer.

Tirzepatide

Mounjaro is a weekly tirzepatide injection that helps patients with diabetes. Zepbound® is the FDA-approved weight loss version of Mounjaro.

Metformin

Metformin is an anti-diabetic drug that helps manage high blood sugar levels in patients with Type 2 diabetes. It lowers glucose production in the liver, reduces intestinal glucose absorption, and improves insulin sensitivity.

All these drugs work best with dietary changes and exercise.

Are weight loss medications right for me?

Dr. Amersi personalizes each treatment plan based on your unique needs. To determine if weight loss medications are right for you, she discusses your medical history, checks your vital signs, weighs you, and evaluates your body mass index (BMI). She also reviews your usual diet and exercise habits. 

Dr. Amersi completes a physical exam and orders blood work and additional diagnostic tests to determine if you have diabetes, prediabetes, PCOS, nutritional deficiencies, hormone imbalances, or other medical conditions that might require additional treatment.

Microdosing GLP-1s: A Doctor’s Guide to Gentle, Effective Metabolic Reset
By SHAMSAH AMERSI MD, FACOG

GLP-1 medications—like semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro/Zepbound)—have changed the way we treat metabolic disorders, insulin resistance, PCOS, and even support hormonal balance through perimenopause and beyond. But while the standard dosing protocols are effective for many, they don’t work for everyone.

As a physician, I’ve seen a growing need for a more personalized, gentler approach: microdosing.

What Is Microdosing GLP-1?

Microdosing GLP-1s means starting at significantly lower doses than standard guidelines—sometimes as low as 0.05 to 0.1 mg of semaglutide per week, compared to the usual starting dose of 0.25 mg.

The goal? To allow the body to adapt slowly, minimizing side effects like nausea, fatigue, or GI distress, while still gaining the benefits of appetite regulation, insulin sensitivity, and metabolic rebalancing.

Why Microdose?

Most patients are surprised to learn that more is not always better. Microdosing offers distinct advantages:

1. Fewer Side Effects

Many people stop GLP-1s early due to nausea, reflux, constipation, or fatigue. Starting at a microdose lets the body gently adjust to the medication, often eliminating the need for aggressive symptom management.

2. Smoother Appetite Regulation

Microdosing avoids the intense appetite suppression or early aversion to food that some patients feel. Instead, it supports natural satiety and mindful eating—making it easier to build sustainable habits rather than relying solely on the medication to “do the work.”

3. Metabolic Health First

When used at low doses, GLP-1s help correct blood sugar instability and insulin resistance even before any weight loss occurs. This is particularly powerful in women with PCOS, perimenopausal weight gain, or metabolic sluggishness—where balancing hormones and blood sugar is key.

4. Hormone-Sensitive Support

Women going through hormonal transitions (perimenopause, menopause, PCOS, postpartum) often need a more nuanced approach. Microdosing helps stabilize metabolic and mood shifts without triggering overwhelming physical changes too quickly.

How I Microdose GLP-1s in My Practice

Here’s a simplified version of how I typically guide patients through microdosing:

Week Semaglutide Dose Notes

1–2 0.05 mg weekly: Observe for tolerance, hydration, appetite effects
3–4 0.1 mg weekly: Gradual titration if tolerated
5–6 0.15–0.2 mg weekly: Only if needed; many patients plateau here
7+ 0.25 mg or individualized: Adjust based on goals, labs, and response

Note: Tirzepatide microdosing follows a similar philosophy but with slightly different increments.

This slow titration reduces the risk of unpleasant side effects and allows for more control. We monitor labs, hormonal markers, and clinical symptoms along the way to ensure we’re optimizing—not overwhelming—the body.

Who Is Microdosing Best For?

Women with PCOS, perimenopause, or insulin resistance

Patients with GI sensitivity or history of medication intolerance

Individuals seeking metabolic or hormonal balance without rapid weight loss

Patients who want to layer GLP-1s with lifestyle changes, not use them as a crutch

Is Microdosing Less Effective?

Not at all. In fact, for many patients, microdosing is more effective—because it allows them to stay on the medication longer, build foundational health habits, and avoid the “yo-yo” cycle of starting and stopping due to side effects.

The body responds to consistency, not intensity. Microdosing honors that principle.

Final Thoughts

GLP-1s are powerful. But power doesn’t need to mean aggression. By microdosing, we’re leveraging the benefits—insulin regulation, appetite reset, inflammation reduction—without shocking the system.

This approach aligns with my philosophy of medicine: root-cause healing, gentle rebalancing, and giving the body what it needs to restore itself.

If you’re curious whether GLP-1 microdosing is right for you, or if you’ve tried it before and felt overwhelmed, you’re not alone. There’s another way—and it starts small.