Sustainable, achievable weight loss

Scale Down is a telemedicine weight loss program serving clients exclusively in Massachusetts & New Hampshire and now Maine

Get started in the comfort of your own home

1. Free Phone Consultation

At Scale Down your weight loss journey starts with:

A free 15 minute consultation by phone to review what we can offer you.
We will briefly review your medical history and your weight loss goals to see what the best approach would be.
Call or text us at 603-600-0700

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2. Initial Telemedicine Visit

If you are interested:

We will send a link to our HIPPA compliant patient portal and have you fill out some paperwork.
We will order lab work that can be done through your insurance or another lab for an additional fee.
Initial telemedicine visit to review history and lab work and determine if you would like to move forward with a weight loss package. Initial visit is 150.00 but included in your package.

3. Choosing a Package

If you decide to choose a weight loss package, each package includes:

The initial consultation fee and weekly telemedicine visits.
Any recommended supplements will be available with a 10% discount through Full Scripts.
We do prescription based packages with counseling and prior authorization for medications.
We also offer compounding medications for those whose insurance won't cover medications and/or if brand name medications are not available.
No contracts

Experience

Nurse Practitioner

Scale Down is led by Jennifer Limongiello, PhD, FNP-BC, a board certified Nurse Practitioner with a doctoral degree in Public Health. She has been a RN for over 35 years and a Nurse Practitioner for the last 25 years. Jennifer understands first hand the difficulty of losing weight and keeping it off. Now, she is trying to help others do the same.

FDA APPROVED

Medication and Supplements to assist your weight loss journey

We offer many medications and supplements including but not limited to:
Bupropion/Naltrexone
Phentermine
Phentermine with Topiramate
Semaglutide
Tirzapetide
Stimulant free supplements
Bella supplements
10% discount off Full Script supplements

Patient Centered Care

This is patient centered care offered at an affordable price while taking the time to listen to the client and develop a realistic, sustainable plan for weight loss. We look at the whole patient to try to uncover the root of the problem. This is done by assessing your overall health, eating behaviors, sleep patterns, and much more. Lab work can uncover metabolic and endocrine dysfunction. All of this information helps to offer you the best strategy.

What do we offer?

The initial 15 minute phone call is free.
The initial 1 hour consultation via telemedicine (covered in package fee).
Labwork is required to develop the initial plan. Labwork can be done through your own insurance or through another lab for a discounted fee (less than 100.00). Recent labwork also works.
At the initial consult, you will meet with our NP and discuss your medical history and review your labwork results. We will develop a personalized plan to meet your goals.
We have various plans available depending on the medications and services/insurance.

Ongoing Support

We are accountable to so many people and things in our life. Our lives are so busy with family, jobs, pets, etc. Sometimes we need to be accountable to someone else before we can be accountable for ourselves. Scale Down understands this and is here to help you. Telemedicine visits and frequent contact helps keep you on track.

NEW YEAR IMPROVED YOU

Changing Behaviors

Do you get hungry all the time? Do you feel like you know where all the food is in your kitchen at all times? Are there foods that you can't eat just one or two, you have to eat the whole package? Do you crave sugar and carbs? Do you feel like you never get full? Do you feel like you eat when you are driving, watching tv, or doing work? Do you plan out what you will eat, or just eat on the fly? Medications can help, changing behaviors slowly can ensure that you can manage this after you lose the weight, after you stop the medications.

CASH PAY Versus INSURANCE

Cash Pay versus Insurance

We have a variety of packages available. If you qualify for weight loss medications, we can see if your insurance will cover first. If not, we also can obtain medication from other pharmacies that compound generic forms. We will discuss all of this with you during your free telephone consult.

We will try to obtain preauthorization for medications through your insurance. We are able to provide a bridge program using compounding for the first months and then switch over to brand name in pharmacy.

Articles & Resources

Check here for helpful information, resources, and our blog. See FAQs below this section.

Frequently Asked Questions

I'm interested, how do I get started?

Please click on the "schedule" button and it will lead you to a scheduling site or text us at 603-600-0700. Let us know what is a good time to set up a 15 minute phone call with you. After that, if you are interested, we wll invite you to the patient portal which is a HIPPA compliant electronic medical record. Here you will be asked to sign some consent forms, practice policies, and a patient intake form. We will order lab work. Next we will set up a 1 hour telemedicine visit and go from there. Currently, we can only accept patients that live in MA, NH, or Maine.

Do I have to take medications and/or supplements to be on the program?

No. After the initial consultation and lab work, it will be determined what medications/supplements would be safe and beneficial to you, but you are the one that ultimately decides. We do offer a package without any medications.

We offer so much more than medications. We offer nutritional counseling, behavioral counseling, and support through the weight loss process.

What medications do you offer?

We offer 5 FDA approved medications:‍

GLP-1s

Semaglutide- A weekly GLP-1 RA injection. If covered by insurance the brand name is Wegovy or through compound pharmacy as Semaglutide. Ozempic is Semaglutide but marketed for diabetics.
TIrzepatide is avaiilable as Zepbound for weight loss. (Mounjaro is brand name which is only FDA approved for Diabetes so far)
Liraglutide or Saxenda which is a daily GLP-1 RA injection. This is the same med as Victoza that is marketed for diabetics.
Oral Medications:
Bupropion/Naltrexone- oral medications brand name is Contrave if through insurance.
Phentermine oral medication given up to 3 months
Phentermine with Topiramate, brand name Qsymia, given up to 3 months
Other medications

What if after the initial 1 hour consultation, I do not want to join any subscription?

You will pay just for the initial consultation, and no further commitment. You will just pay 150.00 for the consult.

What are the prices?

Semaglutide Compounding: Monthly membership for medications ranging from 250.00 to 350.00 as you ramp up on the medications. The membership includes the initial consult, weekly telehealth visits, medications and supplies, Access to provider through text/email/phone.

Tirzepatide Compounding: Monthly memebership includes everything above and ranges from 300.00 to 550.00 per mnonth.

Bridge Program: Get approved for Wegovy through your insurance, start out on compounding for 7 weeks for 350.00 (one time) and then swtich over to Wegvoy at your pharmacy. 1.7 m and 2.4 mg doses are usually in stock. You then would pay your copay at the pharmacy for the medication and would be on a 50.00 per month program.

Oral medications: We do have oral semaglutide capsules and troches in 3 mg and 6 mg. They are more expensive than the injections.

Other oral medications are available through compounding or through your insurance if approved.

Where do I get the medication from?

We work with state regulated compound pharmacies throughout the U.S. that can offer a better price for medications and supplements and in turn can pass the savings on to you. They legally can make any medication that is on the FDA shortage list (which has been Semaglutide, Tirzepatide, and Liraglutide).

We can also do a prior authorization with your insurance to see if they will cover Wegovy (if available), Saxenda (if available), Zepbound and other medications.

Where do I get my labs done?

We can give you the medical lab order to bring to your lab and they can bill your insurance. Coverage depends on your individual insurance and you are responsible for any fees that the insurance doesn't pay. Currently we have an account with Quest Labs. If you have a high deductible insurance, we can order your labs from a cash pay lab at reasonable prices even as low as 100.00 or less. They are drawn at LabCorp. Sometimes recent labwork will suffice.

Why do I need to have labs done?

In order to help you on your weight loss journey, it is important to know if you have underlying prediabetes or metabolic syndrome. This allows us to recommend the safest medications and supplements if needed. This also allows us to see things improve over time after weight loss i.e. cholesterol levels, blood sugar, etc.

What are compounding pharmacies?

Compounding pharmacies are allowed under the U.S. Food, Drugs, and Cosmetic Act. They are required to use only FDA regulated facilities and manufacturers to compound medications. They are subject to FDA and State Board Pharmacy inspections. If the drug is currently experiencing a shortage, the FDA looks to the compounding pharmacies to fill the gap. They also can make custom formulas that might not be offered by brand name drug manufacturers. They require a prescription just like the local pharmacy.

Can I use my FSA or HSA through work?

Please check with your employer and benefits but you should be able to use FSA or HSA for payments. We can also give you a Superbill that you can submit to your insurance company for possible payment.

Scale Down is a telemedicine weight loss program serving clients exclusively in Massachusetts, New Hampshire and now Maine.