Rivas Medical Weight Loss review

What it is

Rivas Medical Weight Loss was founded by Dr. Paul Rivas, MD, a board-certified physician with more than 30 years in medical weight loss and the author of five books on the subject. The practice runs 15 clinics, 14 in Maryland and one in Fairfax, Virginia, sees more than 15,000 in-person visits a month and says it has treated more than 35,000 patients. Its telehealth program covers Maryland, Virginia and Florida. Alongside GLP-1s it prescribes phentermine, sells B12 and lipotropic injections, and offers aesthetic and body-contouring treatments. Its footer states LegitScript certification with a seal number that checks out. Disputes under its website terms go to arbitration, and its terms are governed by Maryland law.

How it works

For telehealth, you book a video appointment online in a couple of minutes and complete the health intake before the visit. A licensed provider reviews your history by video and, if a GLP-1 is appropriate, prescribes it during the visit rather than after a separate form review. Compounded medication ships overnight once you're cleared, with everything needed to inject at home; brand-name prescriptions go to LillyDirect, NovoCare or a local pharmacy. You then see your provider by video every month for dose adjustments, with on-call support in between. If you live near a clinic, you can pick up medication there the same day if a shipment fails, have a provider show you how to inject, or switch to weekly in-office care without a new intake. In-office patients instead come in weekly for a weigh-in and an injection given on site.

Pricing transparency

Telehealth starts with a $195 initial visit, which includes your first month of compounded medication. After that, compounded semaglutide is $399 a month and compounded tirzepatide $599 a month, each including the monthly video visit, medication and shipping. Brand-name Wegovy or Zepbound is $100 a month for the visit and prescription, with the drug bought separately. Telehealth is paid monthly, with no contract, and you can cancel any time. In-office care is priced per visit at any dose: $115 a week for semaglutide and $165 for tirzepatide, or $437 and $627 for four-week packages and $1,242 and $1,782 for twelve-week packages; the in-office $195 first visit doubles as a lifetime membership if you return once a year. The practice doesn't bill insurance but provides invoices for reimbursement, and accepts HSA and FSA cards plus Cherry and CareCredit financing. No refund policy is published.

Branded vs compounded

Rivas prescribes compounded semaglutide and compounded tirzepatide, sourced from licensed U.S. 503A compounding pharmacies that it says test every batch for potency and purity, and brand-name Wegovy and Zepbound, which are FDA-approved for weight management. It doesn't name the compounding pharmacy. The practice says it uses semaglutide base rather than salt forms, and it offers microdosing for some patients. Compounded drugs are not FDA-approved finished products, as its telehealth page notes. Its general FAQ, however, justifies compounded semaglutide by pointing to the brand-name shortage and says the drug has the same active and inactive ingredients as Wegovy and Ozempic; the FDA declared the semaglutide shortage resolved in February 2025, and compounded versions are not copies of the brands, so give more weight to the telehealth page. A search of the FDA warning-letter database under the Rivas name returned no letters.

Pros and watch-outs

The evidence behind what Rivas Medical Weight Loss prescribes

We grade the molecules, not the marketing. Here is what the human data actually shows for each thing on their menu.

• What the semaglutide weight-loss trials actually showed

  STEP 1, STEP 4, and SELECT — the efficacy, the rebound, and the cardiovascular signal, read straight from the primary literature.

• Tirzepatide vs semaglutide for weight loss: what the trials actually support

  Most comparisons are cross-trial. Only SURPASS-2 and SURMOUNT-5 randomized one drug against the other — here's the precise distinction.

• “Microdosing” GLP-1 drugs: a trend, not a protocol — what the evidence says

  Sub-therapeutic semaglutide and tirzepatide is spreading fast. The pharmacology is clear, the honest part is clearer: efficacy is dose-related, and no trial has tested intentional microdosing.

How Rivas Medical Weight Loss compares

A few alternatives worth a look, depending on what you’re optimizing for.

• Live Vital

  Pairing a GLP-1 with a wider peptide and longevity protocol

  See Live Vital →
• Trimi Health

  Low-cost compounded GLP-1 with thorough dosing guidance

  See Trimi Health →
• JumpstartMD

  California residents who want a structured, coach-heavy program with labs and body-composition tracking, in a clinic or online

  See JumpstartMD →

More GLP-1 telehealth reviews: New Wave Health · Eviora MD · Hers · Midi Health · Remedy Meds · OrderlyMeds