Weight loss synced to your metabolic rhythm

GLP-1 Experts • Board-Certified MDs • Virtual Concierge

A path toward feeling better, living longer, and taking control of your health—while preventing $500K+ in future medical costs and gaining 5-10 quality years.

Real MDs. FDA-Approved Medications.

Board-certified physicians who have practiced and taught at Mayo Clinic, UCSF, and University of Minnesota—pursuing or holding American Board of Obesity Medicine certification. As a concierge clinic, we maintain a limited patient panel for personalized attention. FDA-approved medications only.

Board-certified obesity specialists, not generalists

Navigate Insurance Successfully

Expert team. Every pathway. Appeals included. Coverage in 2 weeks. We fight for your coverage every step of the way. Insurance expertise that actually gets approvals when others fail.

Insurance expertise that delivers results

360° Remote Monitoring From Home

No waiting rooms. See your MD this week, not in 3 months. Daily weight, BP, body composition tracking. More comprehensive than endocrine clinics. Better monitoring than specialist offices—all from home.

Better monitoring than any specialist office

Get Your Transformation Right the First Time

We know the journey. We adjust to YOUR metabolism, not protocols.

Your metabolism. Your data. Your success.

"After three denials and my PCP refusing to prescribe, I found Cadence. They got me approved in 2 weeks and I've lost 32 pounds."

— Michelle K., Minnesota

The Premium Care Difference

Concierge Medicine Applied to Weight Loss

Many use mid-level providers with generic protocols. Some offer risky compounded drugs instead of FDA-approved medications. We provide experienced board-certified physicians who personalize your treatment with FDA-approved medications exclusively, following clinical best practices for optimal outcomes.

Academic Medicine Standards

Hospital-trained physicians with decades of practice. FDA-approved medications exclusively (no compounded drugs). Clinical-grade monitoring with labs (not just apps). Treatment paced to YOUR metabolic rhythm, not generic protocols.

See all frequently asked questions →

Your Path to Success

1

Medical Evaluation

Real MD review

2

Insurance Approval

We handle appeals

3

Precision Dosing

YOUR metabolism drives dosing

Ready? Use the "Begin Assessment" button above

Medical Monitoring & Support

We monitor your health and coordinate with your PCP

🔬 Health Screening & Monitoring

  • ✓ Metabolic health screening
  • ✓ A1C and glucose monitoring
  • ✓ Lipid panel review
  • ✓ Liver function checks
  • ✓ Body composition tracking
  • ✓ Results shared with your PCP

💊 Weight Loss MD Expertise

  • ✓ Personalized GLP-1 protocols
  • ✓ Side effect management
  • ✓ Muscle preservation guidance
  • ✓ Nutrition recommendations
  • ✓ PCP coordination for other conditions
  • ✓ Insurance documentation support

📊 Ongoing Support

  • ✓ Quarterly progress reviews
  • ✓ Expert GLP-1 optimization
  • ✓ Weight & body composition tracking
  • ✓ Insurance appeals assistance
  • ✓ Lab results documentation
  • ✓ Communication with your PCP

The Medical Difference

Other services: "Here's your prescription, good luck"
Cadence: "As board-certified MDs specializing in weight loss, we optimize your GLP-1 therapy, monitor your metabolic health, and coordinate with your PCP for comprehensive care."

Real medical care means better outcomes AND better insurance coverage

How We Make The Difference

Board-certified MDs specializing in weight loss. 360° monitoring from home. Real results.

Protect Your Whole Body

Beyond weight loss: Reduce heart attacks, strokes & kidney problems by 20%+
Metabolic reset: Normalize A1C, reverse insulin resistance
Organ protection: Improve liver health, kidney function
Longevity boost: Add 5-10 quality years to your life

Feel Better Emotionally

Less stress around food. Better self-confidence. Greater sense of control over health. The emotional impact is often as powerful as the physical transformation.

Ripple Effects of Success

More energy for family. Better sleep. Higher daily functioning. Fewer medical visits. Lower healthcare costs. A more secure, active future.

Our Expertise Delivers These Outcomes

A path to feeling better, living longer, and taking control:

-20%
Heart & Kidney Risk
Proven protection
15-20%
Body Weight Loss
Sustained results
Better
Mental Well-Being
Less food stress
$500K+
Costs Prevented
Lifetime savings

The ripple effects mean more energy, improved sleep, and a higher quality of daily life.

The Cadence Method

Concierge medicine. Not mass protocols.

Week 1-2: Foundation

Virtual MD visit this week (not in 3 months). Insurance navigation. Baseline labs. Start lowest dose. Daily 360° monitoring—all from home.

No waiting rooms, no time off work

Month 1-3: Optimization

Bi-weekly dose adjustments. Side effect management. Nutrition guidance. Muscle preservation focus.

Finding YOUR sweet spot

Month 3-6: Acceleration

Therapeutic dosing. Maximum results. Quarterly labs. Disease markers improving.

This is where magic happens

What Makes Us Different

High-Volume Clinics

Quick prescription. No diagnosis. Generic dosing. Mid-level providers. High dropout rates.

Cadence Concierge Clinic

Full medical evaluation. Personalized protocols. Limited patient panel. Board-certified physicians. Designed for long-term success.

360° Health Monitoring

Concierge-level care exceeding traditional endocrinology—from your home

Diabetes & NASH Prevention

  • • A1C (prediabetes) (covered)
  • • Liver enzymes (NASH) (covered)
  • • Glucose tracking (covered)
  • Advanced ($):
  • • Insulin resistance (HOMA-IR) (cash)
  • • hsCRP (cancer risk) (cash)
  • • Thyroid panel (varies)

Heart Attack & Stroke Risk

  • • Cholesterol panel (covered)
  • • Blood pressure trends (daily)
  • • Heart rate variability (daily)
  • Advanced ($):
  • • ApoB (stroke predictor) (cash ~$75)
  • • Lp(a) (genetic risk) (cash ~$100)

Kidney & Organ Health

  • • eGFR (kidney disease) (covered)
  • • Liver function (NASH) (covered)
  • • Nutritional markers (nutrition)
  • • Anemia screening (covered)

Muscle Loss Prevention

  • • Lean muscle monitoring
  • • Fat-to-muscle ratio
  • • Visceral fat tracking
  • • Sarcopenia prevention

Pill mills (using NPs & compounds): Quick prescription, no labs, no monitoring, high failure rates

Cadence: Comprehensive care that transforms your health, not just your weight

Billing Transparency: We'll maximize insurance coverage using applicable diagnosis codes (obesity E66.9, prediabetes R73.03, metabolic syndrome E88.81). However, insurance often considers weight loss "cosmetic" so advanced tests may require cash payment. We'll always discuss costs before ordering non-standard labs.

Our Medical Team

Where expertise meets empathy

Our board-certified physicians have practiced and taught at Mayo Clinic, UCSF, University of Minnesota, and other leading academic medical centers. With decades of experience in internal medicine, all hold or are pursuing American Board of Obesity Medicine certification.

Medical Director: Dr. Nishant Sahni, MD, MS
Internal Medicine • Molecular Biology • 20+ years
Mayo Clinic • UCSF • University of Minnesota
ABOM certification candidate • Metabolic specialist

Why We Do This

"After 20 years as a hospitalist, I've seen the true cost of metabolic disease - not just the $500K+ in lifetime medical bills, but the lost decades with family, the careers cut short, the dreams unfulfilled. My molecular biology training helps me understand how GLP-1s transform your metabolism at the cellular level. This isn't about losing 30 pounds. It's about gaining 10 healthy years."

— Dr. Nishant Sahni, MD, MS
Medical Director

What This Expertise Means For You

Expert GLP-1 optimization • Safe, evidence-based protocols • Real metabolic transformation • Physicians who understand the science • Care that adapts to your body's response

Pricing

Graduated, transparent pricing

$259/month
Complete medical supervision
Months 6-12: $209/month
Year 2+: $179/month
Start Today
Begin with direct-pay while we handle your insurance pre-approval and prior authorization
Comprehensive medical assessment
Insurance authorization support
Prescription management
Continuous health monitoring
Direct physician access

Month-to-month flexibility • No long-term commitment
Medication costs additional ($50-550/month)

Ensuring Your Success

We want every patient to achieve their transformation goals

You'll Succeed With Us If:

  • • You understand that optimal results typically take 3-4 months
  • • You're ready to engage with regular check-ins (video or text)
  • • You're willing to track your health metrics regularly
  • • You view this as medical treatment, not a quick fix
  • • You're investing in disease prevention, not just weight loss
  • • You want physician supervision, not just a prescription
  • • You're prepared to follow the complete protocol

Consider Other Options If:

  • • You prefer minimal medical supervision
  • • You're looking for medication only, without monitoring
  • • You need a shorter-term solution
  • • Budget is your primary consideration
  • • You're unable to engage with any consultations or text support
  • • You prefer a self-directed approach

Comprehensive medical supervision with regular progress monitoring.
Now accepting new patients for our metabolic transformation program.

Frequently Asked Questions

Everything you need to know.

We provide comprehensive medical care, not just prescriptions. Our program includes quarterly labs with inflammation markers (hsCRP), continuous body composition monitoring to ensure healthy fat-to-muscle ratios, nutritional assessments, and weekly physician review. This level of medical oversight follows clinical best practices designed for optimal long-term outcomes.
Coverage varies, but we fight for every patient. We handle prior authorizations, appeals, and work directly with your insurance to get you the lowest cost possible. With good insurance coverage, many patients pay as little as $0. Even without insurance coverage, we ensure access through manufacturer programs.
  • With insurance approval: Often $0-50/month copay
  • Zepbound™ manufacturer program: $349-$549/month for all doses
  • Wegovy® with GoodRx: Starting at ~$499/month (check prices)

We explore every avenue - prior authorizations, appeals, manufacturer programs - to make your medication affordable. We exclusively prescribe FDA-approved medications.

Yes! You can begin treatment immediately with cash payment while we work on your insurance pre-authorization in parallel. This means no delays in starting your transformation. We handle all the paperwork, appeals, and documentation required by your insurance company. Many patients find our $259/month rate competitive with or better than their insurance copays, especially when you factor in deductibles and prior authorization delays.
We provide comprehensive metabolic monitoring that saves you thousands in specialist visits. We track muscle mass to prevent GLP-1 related muscle loss, screen for prediabetes and insulin resistance with HOMA-IR testing, monitor liver health for NASH, check detailed lipid profiles beyond basic cholesterol, watch for hypertension development, provide nutrition counseling, and address psychological factors affecting your weight. We also refer to dietitians and mental health professionals when needed. We treat you as a complete patient, not just a GLP-1 customer.
We know the insurance approval pathway inside and out. If you're not immediately approved, we create a personalized roadmap to meet your insurer's requirements. This might include starting with metformin or other medications first, documenting supervised weight loss attempts, or gathering specific medical documentation. We guide you through each step, handle the paperwork, and resubmit when you meet criteria. Most insurers require 3-6 months of documented attempts - we make sure you're building that record while still making progress.
Online-only companies operate like prescription services - quick questionnaire, minimal monitoring, medication shipped. We're a complete medical practice. You get real physicians who know your entire health picture, comprehensive lab monitoring that catches issues early, active management of side effects so you don't quit, coordination with your other doctors, and support for the whole journey - not just prescriptions. When you develop nausea, muscle loss, or lab abnormalities, we actively manage them. We're physicians, not a pill mill.
Results vary. In clinical trials, patients lost 15–22% of their body weight over 12–18 months with lifestyle support. Most notice appetite changes within weeks, with steady progress as doses increase.
We're committed to making GLP-1 therapy accessible. We explore every avenue - insurance prior authorizations, appeals, manufacturer programs, and strategic diagnostic coding when appropriate. With good insurance coverage, many patients pay as little as $0. Even without insurance, we'll help you access manufacturer programs that cap costs at $349-$549/month. We don't give up after the first denial - we'll work tirelessly to find an affordable solution.
Unlike online services using nurse practitioners and compounded drugs, we provide board-certified MD supervision with comprehensive metabolic monitoring. Quarterly labs include: A1C and HOMA-IR (insulin resistance), advanced lipids (LDL, HDL, triglycerides, ApoB), inflammation marker hsCRP, liver function (ALT, AST), kidney function (eGFR), thyroid panel, and nutritional markers (B12, D3, ferritin). We track your fat-to-muscle ratio and visceral fat reduction to ensure you're losing the right kind of weight while preserving lean muscle mass.
Our program is month-to-month with no long-term contracts required. However, we strongly recommend staying through the initial titration phase (typically 3-4 months) for optimal results. FDA-approved GLP-1 medications require gradual dose escalation over 8-16 weeks for safety, and most patients see their best results after completing this process. Stopping prematurely can lead to side effects and poor outcomes. Think of it like physical therapy—the full treatment timeline produces the best results. Most patients choose to continue beyond the titration phase as they experience the full benefits and our pricing becomes more affordable.
Our transparent pricing eliminates confusion and decision fatigue while rewarding long-term commitment. Starting at $259/month, you receive comprehensive medical care that gets more affordable as you succeed: $209/month after 6 months (loyalty rebate), and $179/month in year 2+ (lifetime member rate). Visit frequency adapts to your needs—up to bi-weekly initially, then as needed for maintenance—with pricing that reflects this personalized approach. This rewards patient dedication while ensuring continuous supervision that prevents the 80% weight regain seen without support.
Absolutely. You can begin with self-pay ($259/month) and start your transformation immediately. We'll simultaneously submit your insurance preauthorization in the background. If approved, you can switch to insurance coverage and potentially receive retroactive reimbursement. Many patients prefer this approach to avoid delays—you're getting treatment while we handle the paperwork.
We'd recommend scheduling a brief consultation to discuss your best approach. Many patients try online services first—and some succeed with that level of care. However, we often see patients who struggled with online services due to side effects, insurance issues, or lack of medical oversight. We're happy to review your situation and honestly advise whether you'd be better served starting with us or trying an online option first. Your success matters more than where you start.
The program fee is a cash-pay investment that gets more affordable with commitment. Starting at $259/month, reducing to $209/month after 6 months, and $179/month for lifetime members (year 2+). While we don't bill insurance directly, we provide documentation (superbills) with all necessary codes for potential out-of-network reimbursement. Many PPO plans offer partial reimbursement for physician services. HSA and FSA cards are accepted for all program fees at every tier.
Most patients need intensive monitoring for 3-6 months during dose titration, but YOUR timeline depends on YOUR metabolic cadence. Visit frequency adapts to your progress—up to bi-weekly as needed initially, then maintenance visits as your body stabilizes. Pricing reflects this personalized approach: $259/month initially, $209/month after 6 months, and $179/month for lifetime members (year 2+). This graduated system ensures continuous medical supervision while rewarding your commitment to long-term success.
We understand medication costs can be challenging. We'll work with you to explore all options including different GLP-1 medications that may have better coverage, trying different diagnostic codes if medically appropriate, and providing detailed documentation for insurance appeals. Our goal is to find a solution that works for your budget. No patient should have to give up on their health due to cost.
Basic labs: Standard tests (CBC, CMP, lipids, A1C, TSH) are typically covered by insurance with obesity diagnosis (E66.9). Out-of-pocket: usually $0-50 per quarter.

Advanced markers (optional): Specialized tests like insulin, HOMA-IR, ApoB, and Lp(a) are rarely covered by insurance for weight loss. If you choose these, expect $200-300 quarterly out-of-pocket. We'll use all applicable diagnosis codes to maximize coverage.

Bottom line: Most patients only need basic labs ($0-50). Advanced markers are optional for those wanting detailed metabolic tracking.
Our program is cash-pay with graduated pricing that rewards commitment. Starting at $259/month, reducing to $209/month after 6 months, and $179/month for lifetime members (year 2+). Many insurance plans cover Remote Patient Monitoring (RPM) under codes 99453, 99454, and 99457. We'll provide documentation with appropriate RPM codes for reimbursement. Coverage varies by plan, but Medicare and many commercial insurers reimburse $50-120/month for qualifying RPM services, which can significantly offset your program costs.
Recommended devices ($150-195 total with our exclusive Withings discount):

• Withings Body+ Smart Scale - tracks weight, body fat %, muscle mass
• Withings BPM Connect Blood Pressure Monitor - measures BP and heart rate
• Special pricing: Save up to $45 with our exclusive patient discount code

Already have devices? We can work with most smart scales and BP monitors that have data export capabilities. During onboarding, we'll help you set up whatever monitoring system works best for you - whether that's Withings, your existing devices, or even manual tracking if preferred.

What's included: Your monthly fee covers physician review of your health data, trend analysis, and integration with your treatment plan - regardless of which monitoring method you choose.
You'll purchase Withings devices directly for approximately $150-195 total (regularly $195+) using our exclusive patient discount code provided at onboarding. Some insurance plans, FSA, and HSA accounts may cover these FDA-cleared medical devices with a letter of medical necessity, which we can provide. Check with your specific plan about durable medical equipment (DME) coverage for remote monitoring devices.
A prior authorization (PA) is paperwork your insurance requires before covering medication. We submit this electronically through CoverMyMeds with details from your visit. Reviews usually take 3–5 business days.
You still have options:

Manufacturer programs: Wegovy® DirectPay (~$499/month), Zepbound™ DirectPay ($349-$549/month).

GoodRx coupons: Sometimes reduce pharmacy prices, though manufacturer programs are usually cheaper and more reliable.
If your pharmacy doesn't have your medication:

• Ask them to check nearby locations.
• Request a prescription transfer.
• Sometimes lower-dose pens may be available temporarily — only with our guidance.
Yes, periodic labs are important for safe and effective treatment. We typically order basic labs (A1C, metabolic panel, lipids) before starting and quarterly during treatment. These basic labs are usually covered by insurance with proper diagnosis codes. Advanced metabolic markers are optional but recommended for optimal results - these may require out-of-pocket payment. We'll always discuss costs before ordering any tests and help maximize your insurance coverage.
No. It's not recommended if you have:

• Personal/family history of medullary thyroid cancer or MEN2
• Prior pancreatitis
• Are pregnant or breastfeeding

We carefully screen your history to ensure safety.
Initial Care (First 3-6 months, varies by patient): Bi-weekly video consultations with your physician during dose titration, plus text support between visits. Duration depends on your metabolic response and clinical progress.

Ongoing Care (Ongoing maintenance): Monthly video consultations with ongoing text support, quarterly lab reviews, and annual comprehensive assessments

Throughout your journey, you have direct text access to your physician for questions, dose adjustments, and support. The program gets more affordable as you progress: $259/month initially, $209/month after 6 months, and $179/month for lifetime members (year 2+). You'll also receive a personalized titration calendar and comprehensive side-effect management guide.
Most patients notice appetite changes within weeks. Meaningful weight loss builds gradually over months as doses increase. Clinical trials show average losses of 15–22% over 12–18 months with lifestyle support.
If within a few days, take it when you remember and continue weekly from that new day. If much longer, message us before restarting. Never double up.
Yes. On request, we'll send a summary to your PCP so they stay in the loop. We complement, not replace, your primary care.
No. The program is cash-pay with graduated pricing that rewards long-term commitment: $259/month initially, $209/month after 6 months, and $179/month for lifetime members (year 2+). HSA/FSA cards accepted at all tiers. We provide documentation for potential insurance reimbursement.
No medical therapy can guarantee outcomes or stock. What we do guarantee is evidence-based care, physician oversight of your metabolic health, and multiple access pathways (insurance, manufacturer programs, retail pharmacies) to maximize your chances of success.
Clinical trials demonstrate significant A1C normalization in prediabetic patients with GLP-1 therapy. We track insulin resistance (HOMA-IR) quarterly to monitor metabolic improvements. Many patients see A1C improvements within 3-6 months. Early intervention transforms your entire life trajectory - preventing not just diabetes, but cascading complications: kidney failure ($500K), heart disease ($1M+), stroke ($250K), blindness, amputations. This is about adding 5-10 quality years to your life.
The SELECT trial demonstrated 20% reduction in major cardiovascular events with semaglutide. We monitor key predictors: ApoB (which may predict stroke risk better than LDL), blood pressure trends, and inflammation (hsCRP). Many patients show improvement in cardiovascular markers within 6-12 months. Combined with weight loss and metabolic improvements, long-term cardiovascular risk may be reduced.
Without proper monitoring, studies suggest a significant portion of weight loss can be muscle mass. That's why we track your fat-to-muscle ratio using smart scales and optional DEXA scans. We focus on preserving lean muscle through protein optimization and resistance exercise guidance. Our goal: promote healthy fat loss while maintaining muscle mass.
We monitor kidney function (eGFR, creatinine) quarterly for early detection of changes. Weight loss and improved blood sugar may help protect kidney health. Research shows obesity increases risk for multiple cancer types. Emerging studies suggest potential benefits of GLP-1s for certain cancers, though more research is needed. We track inflammation (hsCRP) as studies link chronic inflammation to various health risks.

Important Note: We provide prescribing services only. We do not sell or ship medications. Dispensing and pricing are handled by your pharmacy and/or insurance.

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