Medical Weight Management
A physician-supervised GLP-1 program managed by Yuleisy Coto, MSN, APRN, FNP-C. Starts with a full metabolic workup. Medication is titrated with regular monitoring. Weight reduction directly improves musculoskeletal outcomes for patients managing joint degeneration.
Medical weight management at Cobblestone Spine and Joint Institute is a physician-supervised program managed by Yuleisy Coto, MSN, APRN, FNP-C (FL APRN License No. APRN11009024). The program uses GLP-1 receptor agonist therapy as the pharmacological foundation, combined with a full panel blood analysis that establishes the metabolic baseline before any medication begins. Weight is a metabolic problem in most cases of significant obesity. Managing it requires a medical approach, not willpower.
GLP-1 receptor agonists work by mimicking the incretin hormone glucagon-like peptide-1, which the gut releases after eating. They slow gastric emptying, reduce appetite at the hypothalamic level, increase insulin sensitivity, and in higher doses produce direct effects on fat metabolism and cardiovascular risk markers. The clinical literature on semaglutide and tirzepatide is the most robust weight loss evidence base in pharmacological history. Mean weight loss in the SURMOUNT-1 trial with tirzepatide reached 22.5 percent of body weight at 72 weeks among participants without diabetes. These are not modest effects. They are clinically transformative for patients who have not been able to achieve meaningful weight loss through diet and exercise alone.
Schedule a Consultation
Royal Palm Beach, FL 33411
| Monday | 9:00 AM – 7:00 PM |
| Tuesday | 3:00 PM – 7:00 PM |
| Wednesday | 9:00 AM – 7:00 PM |
| Thursday | Closed |
| Friday | 9:00 AM – 7:00 PM |
| Saturday | 9:00 AM – 12:00 PM |
| Sunday | Closed |
Related Services
- Hormone Replacement Therapy
- Blood Analysis
- PRP Therapy
- Stem Cell Therapy
Related Conditions
The Medical Case for Treatment
Weight management matters directly to musculoskeletal health. Every pound of body weight generates approximately four pounds of compressive force across the knee joint with each step. A patient who is 40 pounds above their optimal weight is loading each knee with an additional 160 pounds of compressive force per step. That load accelerates knee cartilage degeneration, increases lumbar disc compression, and worsens sacroiliac joint dysfunction. Patients at Cobblestone who are receiving PRP therapy or stem cell therapy for joint degeneration benefit directly from weight reduction because it removes a significant portion of the mechanical stress that is driving the degeneration.
Metabolic dysfunction also affects hormonal health. Visceral adiposity is a primary driver of testosterone decline in men, because adipose tissue converts testosterone to estrogen through aromatization. Patients receiving testosterone replacement therapy who are carrying significant excess weight are working against a continuous biochemical process that reduces the effectiveness of the therapy. Addressing both simultaneously produces better hormonal and metabolic outcomes than either alone.
What the Program Includes
The program begins with a full metabolic workup including fasting glucose, fasting insulin, HOMA-IR, HbA1c, thyroid function, and a lipid panel with fractionation. This establishes whether the patient is insulin resistant, identifies thyroid dysfunction that may be contributing to weight difficulty, and provides the baseline against which progress will be measured.
Yuleisy Coto then reviews the results and the patient's history to determine candidacy and select the appropriate medication and starting dose. GLP-1 medications are titrated gradually over several weeks to minimize the gastrointestinal side effects that occur at higher doses when the medication is started too quickly. Nutrition and supplementation guidance is provided. Follow-up appointments occur at regular intervals to assess response, adjust dosing, monitor for side effects, and track metabolic markers.
The program is not a prescription delivery service. It is supervised medical care with appropriate monitoring and adjustment throughout. The distinction matters for both safety and outcomes.
Who Is a Candidate
GLP-1 therapy is FDA-approved for chronic weight management in adults with a BMI of 30 or greater, or BMI of 27 or greater with at least one weight-related comorbidity such as type 2 diabetes, hypertension, dyslipidemia, or obstructive sleep apnea. A personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 is a contraindication. Active pancreatitis is a contraindication. Yuleisy Coto reviews your full history and laboratory results at the initial consultation to determine whether the program is appropriate for your specific situation.
Royal Palm Beach, Wellington, and Greenacres patients who have been managing weight through primary care with limited success, or who have been told by an orthopedic surgeon that they need to lose weight before joint replacement, are the patients most likely to benefit from this program at Cobblestone. Call (561) 753-2225 or request a consultation here.