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Weight loss injections in Puerto Rico: a doctor's evaluation by video
Weight loss injections such as Wegovy (semaglutide) and Zepbound (tirzepatide) are FDA-approved medicines for chronic weight management. In a video visit, Dr. Diana Nieves Castro, MD, a physician licensed in Puerto Rico, reviews your history, BMI and current medicines and orders labs if needed. If appropriate, the doctor prescribes and we send your prescription to your pharmacy.
Is it an emergency? Call 911.
Pay now, then choose your time right away. Full refund if you cancel 24 hours or more ahead.
See the cancellation policy
You can cancel for a full refund or change the time up to 24 hours before your visit. Within 24 hours you can't cancel and there's no refund. If you don't join in the first 10 minutes, there's no refund.
If you choose a time less than 24 hours away, it can't be cancelled or changed.
If the clinic can't see you, for example because of a technical problem on our side, we refund you in full.
Video visit
- Doctor licensed in Puerto Rico (24027) Verify (opens in a new tab)
- Children and adults of all ages
- In Spanish or English
- Secure video link
- Visits are not recorded
- Full refund if the clinic can’t see you
- No insurance needed
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Severe belly pain that won't go away, with or without vomiting, especially if it spreads to your back (possible pancreatitis).
- Pain in the upper right belly, fever, or yellow skin or eyes (possible gallbladder problem).
- Vomiting or diarrhea that won't stop, peeing very little, dizziness or severe weakness (dehydration).
- Swelling of the face, lips or throat, or trouble breathing (allergic reaction).
- Cold sweats, shakiness, confusion or fainting if you also use insulin or a sulfonylurea (low blood sugar).
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On this page(10)
Medical weight loss online: what the program includes
This is a medical weight loss program online, with the same doctor from start to finish. You see Dr. Diana Nieves Castro, MD, a general practice physician licensed in Puerto Rico (license 24027, NPI 1922842756), in English or Spanish. Visits are private and are not recorded.
Medical weight loss is more than a prescription: the doctor looks for the cause, reviews your overall health and builds a plan with you that you can keep up.
- A video evaluation: your weight history, body mass index (BMI), blood pressure, conditions (such as prediabetes, type 2 diabetes, fatty liver, high cholesterol or sleep apnea), the medicines you take and what you've already tried.
- Labs: when needed, the doctor gives you a lab order for a lab near you, for example hemoglobin A1c, a lipid panel, TSH (thyroid) and a metabolic panel with creatinine. For men with a low sex drive and fatigue, she may also order a test for low testosterone in men.
- A treatment plan: eating, activity, sleep and, if appropriate, an FDA-approved medicine. If you are curious about intermittent fasting, talk it over with the doctor first: it is not right for everyone.
- Follow-up visits: the doctor checks your progress, side effects and results, and adjusts the plan. See the follow-up visit.
Before you leave home
Why a video visit
For anything that isn’t an emergency, compare what each option takes.
| Comparison | Video visit | Emergency room | CDT or doctor’s office |
|---|---|---|---|
| Getting there | From home: join from your phone, tablet or computer. | Drive and find parking. | Drive and find parking. |
| Waiting room | Skip the waiting room: join from wherever you are in Puerto Rico. | Yes, a waiting room. | Yes, a waiting room. |
| Hours and time | Every day, any time (Puerto Rico time). Video doctor visits 24/7 — book online and choose your time right away. | In Puerto Rico, a median of 4 h 52 min from arrival to departure for patients sent home (US: 2 h 42 min; Oct 2024–Sep 2025).1,2 | An in-person visit takes about 2 hours on average, including travel.3 |
| Price | US$69 visit · US$49 follow-up · US$35 forms. You see it before you pay; no insurance needed. | Depends on your insurance and on what is done. | Depends on your insurance and on what is done. |
| Language | Spanish or English, with the same doctor. | Depends on the place. | Depends on the place. |
| Prescriptions | If appropriate, the doctor prescribes and we send your prescription to your pharmacy. | Yes, if needed. | Yes, if needed. |
| When to go in person | If the doctor needs to examine you in person or run a test, she tells you and guides you. | In an emergency: chest pain, trouble breathing, weakness on one side or bleeding that won’t stop. Call 911. | If you need stitches, an X-ray or a test on the spot. |
For problems that are not emergencies. In an emergency, call 911.
Table sources
- 1. CMS Care Compare, “Timely and Effective Care – State”, measure OP-18b: median time in the emergency department, arrival to departure, for patients sent home (opens in a new tab), data for Oct 2024–Sep 2025 (accessed 2026-10-02)
- 2. CMS Care Compare, “Timely and Effective Care – National”, measure OP-18b (US figure) (opens in a new tab), data for Oct 2024–Sep 2025 (accessed 2026-10-02)
- 3. Ray KN et al., “Opportunity costs of ambulatory medical care in the United States,” Am J Manag Care 2015;21(8):567-74 (US data, 2003–2010) (opens in a new tab) (accessed 2026-10-02)
We found no published source for what a patient pays at an ER or a CDT in Puerto Rico, so we give no figure.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
How it works in 3 steps
Here is how our weight loss doctor online works:
Request a visit.
The doctor offers video visits any time, including nights and weekends. Request a visit online 24/7 and choose your time right away. Choose Doctor visit on the booking page.
Join by video.
We send you a secure video link. It works on your phone, tablet or computer. Have your weight, height, a recent blood pressure reading if you have one, and your list of medicines handy.
Get your plan.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. If labs are needed, we give you the order and go over the results at a follow-up visit.
Price of a weight loss visit
The first evaluation is a doctor visit with a published price, no membership and no contract. Visits to review results and adjust treatment are follow-up visits. You pay by card when you request the visit, and if the clinic can't see you, you get a full refund. See pricing for details.
The medicine is paid for separately at your pharmacy. Its cost is set by the pharmacy and the manufacturer and depends on the medicine, the dose and your insurance. We do not bill insurance; on request we give you an itemized receipt (superbill) so you can file a claim with your plan yourself.
Video visit
Doctor visit
US$69
For a new problem, urgent care (non-emergencies), primary care, children, birth control, STIs, skin and acne, and visitors. Includes a doctor's note if you need one.
- You’re charged when you request the visit.
- Full refund if the clinic can’t see you
Weight loss medicines the doctor may consider
Under their FDA labels, Wegovy (semaglutide) and Zepbound (tirzepatide) are approved to reduce excess weight and keep it off long term, together with a reduced-calorie diet and more physical activity. Wegovy is also approved to lower the risk of heart attack, stroke and cardiovascular death in adults with heart disease and overweight or obesity, and for a type of fatty liver disease with fibrosis (MASH). Zepbound is also approved for moderate to severe obstructive sleep apnea in adults with obesity.
Ozempic (semaglutide) and Mounjaro (tirzepatide) are approved for type 2 diabetes. Using them for weight loss alone is off-label; the doctor explains when that makes sense and when it doesn't.
Other FDA-approved options for chronic weight management include Saxenda (liraglutide), orlistat and naltrexone combined with Wellbutrin (bupropion), sold as Contrave. The doctor only prescribes FDA-approved medicines, and only if appropriate for you. The clinic does not offer or prescribe compounded semaglutide or tirzepatide; they are not FDA-approved.
To read more about each medicine, see our guides to Ozempic and Wegovy (semaglutide), Mounjaro and Zepbound (tirzepatide), the Ozempic vs Mounjaro vs Zepbound vs Wegovy comparison and weight loss pills.
Who qualifies for weight loss injections?
Under the FDA labels and NIDDK guidance, these medicines are for adults with a BMI of 30 or higher, or 27 or higher with at least one weight-related condition such as high blood pressure, type 2 diabetes, high cholesterol or sleep apnea. The doctor works out your BMI with you and reviews your health before deciding.
Some medicines, such as Wegovy and Saxenda, are also approved for teens 12 and older with obesity; Zepbound is for adults only. For teens, the doctor decides based on the label and her clinical judgment. In Puerto Rico the age of majority is 21: if the patient is under 21, a parent or legal guardian stays on camera for the whole visit.
Results: what the studies show
No one can promise how many pounds you will lose. What we do know comes from large trials:
- In the STEP 1 trial (NEJM, 2021), adults on semaglutide 2.4 mg lost on average about 15% of their body weight over 68 weeks, compared with about 2% on placebo.
- In the SURMOUNT-1 trial (NEJM, 2022), adults on tirzepatide lost on average 15% to 21% of their body weight over 72 weeks, depending on the dose, compared with about 3% on placebo.
These are averages in studies, alongside changes in eating and activity; results vary from person to person. Weight management is long term, which is why the doctor follows up with you.
Safety and side effects
Who should not use them. Under their labels, Wegovy and Zepbound are not used if you or a family member has had medullary thyroid carcinoma, if you have multiple endocrine neoplasia syndrome type 2 (MEN 2), or if you have had a serious allergic reaction to the medicine. They are stopped as soon as a pregnancy is recognized.
Common side effects: nausea, vomiting, diarrhea, constipation and stomach pain. They tend to be stronger at the start and when the dose goes up, which is why the dose is raised gradually per the label.
Serious label warnings: inflammation of the pancreas (pancreatitis), gallbladder problems, low blood sugar if you also use insulin or a sulfonylurea, and kidney injury from dehydration when there is a lot of vomiting or diarrhea. Before surgery or sedation, tell the doctor you take one of these medicines.
Pregnancy and birth control. If you are planning a pregnancy, the Wegovy label says to stop it at least 2 months before. If you take birth control pills, the Zepbound label advises switching to a non-oral method, or adding a barrier method, for 4 weeks after starting and after each dose increase. See birth control online.
When to go to the ER
If you use one of these medicines and have severe belly pain that won't go away or that spreads to your back, vomiting that won't stop, signs of dehydration or signs of an allergic reaction, call 911 or go to the emergency room. See when to go to the ER.
Book your evaluation with a weight loss doctor online
If you want to lose weight in Puerto Rico with medical help, start with a video evaluation. If your visit is about something else, see our doctor online in Puerto Rico page. Book an evaluation; the doctor decides whether a treatment is right for you. Every day, any time (Puerto Rico time).
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
How much do weight loss injections cost?
Where can I get Wegovy, Zepbound, Ozempic or Mounjaro in Puerto Rico?
Can I get Ozempic for weight loss?
Do you prescribe compounded versions?
How much weight do people lose on Wegovy or Zepbound?
Do I need labs before starting?
Does my insurance cover weight loss injections?
Is a weight loss visit private?
Do you prescribe phentermine?
Can I start if I am pregnant or breastfeeding?
Before you pay
Why do I pay before choosing a time?
Can I cancel or change the time?
Do you record the visit?
Need to see the doctor?
US$69Doctor visit
- You’re charged when you request the visit.
- Full refund if the clinic can’t see you
Video doctor visits 24/7 — book online and choose your time right away.
Doctor visit: US$69 — BookPay now, then choose your time right away. Full refund if you cancel 24 hours or more ahead.
See the cancellation policy
You can cancel for a full refund or change the time up to 24 hours before your visit. Within 24 hours you can't cancel and there's no refund. If you don't join in the first 10 minutes, there's no refund.
If you choose a time less than 24 hours away, it can't be cancelled or changed.
If the clinic can't see you, for example because of a technical problem on our side, we refund you in full.
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-10-09 · Updated: 2026-10-11
Sources (10)
- FDA label: Wegovy (semaglutide) prescribing information (opens in a new tab) (accessed 2026-10-09)
- FDA label: Zepbound (tirzepatide) prescribing information (opens in a new tab) (accessed 2026-10-09)
- FDA label: Ozempic (semaglutide) prescribing information (opens in a new tab) (accessed 2026-10-09)
- FDA label: Mounjaro (tirzepatide) prescribing information (opens in a new tab) (accessed 2026-10-09)
- FDA label: Saxenda (liraglutide) prescribing information (opens in a new tab) (accessed 2026-10-09)
- FDA: FDA approves first medication for obstructive sleep apnea (Zepbound, 2024) (opens in a new tab) (accessed 2026-10-09)
- FDA: FDA's concerns with unapproved GLP-1 drugs used for weight loss (opens in a new tab) (accessed 2026-10-09)
- NIDDK (NIH): prescription medications to treat overweight and obesity (opens in a new tab) (accessed 2026-10-09)
- Wilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). NEJM 2021 (opens in a new tab) (accessed 2026-10-09)
- Jastreboff AM et al. Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1). NEJM 2022 (opens in a new tab) (accessed 2026-10-09)