Same drug. Completely different plan.
Most GLP-1 programs push you to the highest dose, as fast as possible, and stop there. There’s no plan for what comes after — because there isn’t one. Summit is built backward from the exit.
Higher, faster isn’t the goal. Getting off it is.
The manufacturers write a titration schedule built to get you to a high dose quickly. We don’t follow it. Dr. Miranda dose-escalates slower than the label recommends, on purpose — the goal is the lowest dose that actually works, held for as long as possible, not the fastest climb to the top.
Slow, custom escalation
Your dose increases only as fast as your response calls for — against the manufacturer’s default schedule, not with it.
See the real numbers → 2A paced loss rate
We target 1–1.5 lbs a week — controlled, not fast, and calibrated to how conservatively we’re dosing.
Why the pace matters → 3Planned breaks
Every 25 lbs lost, the dose holds so your body and habits can catch up before we go further.
Why breaks are designed in → 4The exit strategy
At goal weight, we taper — slowly, deliberately, to whatever floor holds your weight.
See the taper plan →Fast and no exit isn’t a shortcut — it’s a bounce-back waiting to happen.
Rushing the dose
Faster titration means more side effects and a plateau you hit before you’re anywhere near goal.
No planned breaks
A dose that only ever climbs never lets your body or your habits catch up to the new normal.
No exit strategy
Stop the drug at your highest dose and the weight has nothing holding it — that’s the rebound story you’ve heard.
Summit’s answer
Slow up, paced loss, planned breaks, slow down — a real maintenance floor instead of a cliff.
Two tracks, often combined.
Most patients need more than a prescription. Your program is built from one or both of these, based on what your labs and history show.
GLP-1 Metabolic Program
Compounded semaglutide or tirzepatide, custom-titrated by Dr. Miranda per the philosophy above and filled through Aspire Pharmacy, an independent licensed 503A compounding pharmacy. Semaglutide is the active ingredient in Ozempic® and Wegovy®; tirzepatide is the active ingredient in Mounjaro® and Zepbound®. Compounded medications are prepared for you individually and are not approved or evaluated by the FDA for safety, effectiveness, or quality — Dr. Miranda reviews both compounded and brand-name options with you. About semaglutide · About tirzepatide
Hormone Optimization (HRT)
For patients whose hormones are part of the picture — thyroid, cortisol, insulin, and sex hormones. Optimizing the underlying axis is often what makes weight loss hold, and taper possible.
Paperwork, labs and your patient app — in one place.
New patients complete a short intake and consent online, then everything — visits, secure messaging, labs and your care plan — lives in the Healthie patient app.
Apply & paperwork
Start your application and complete intake & consent forms online in a few minutes.
Start nowPatient app (Healthie)
Visits, secure messaging, labs and your care plan — all in one secure portal.
Learn moreCompanion tools
Meal planner, exercise planner and daily check-ins — free to use, patient or not.
Open freeA program with a finish line.
Apply in about five minutes. Dr. Miranda reviews every application himself.