Do I need an evaluation before starting?

Yes. Every strategy begins with an individual clinical assessment.

Does everyone need medication?

No. Treatment depends on each patient’s situation.

Do you work with tirzepatide?

Yes, where there is a medical indication and the patient has been appropriately evaluated.

Do I have to reach 15 mg?

No. Not everyone requires the maximum dose. Progression is defined by response and tolerability.

What is the difference between Equilibra and treatment by dose?

Equilibra combines doses, medical follow-up, nutrition, the app and other benefits in one monthly fee. Treatment by dose offers more payment flexibility and individual administration.

What does the patient app include?

Nutrition plan, goals, weight tracking, history of visits and doses, and meal logging.

How much weight can I lose?

This varies from person to person. It is defined with you during the evaluation and follow-up. We do not offer guaranteed results.

Do you see patients in English?

Yes. Consultations can be held in English or Spanish.

Do you see patients in both Managua and Matagalpa?

Yes, at both locations, by appointment.

Metabolic health

Understand your metabolism before trying to change it.

The scale is a data point. Your metabolism is the context that explains it.

Metabolic assessment aims to understand how your body responds: body composition, anthropometric measures, habits and, where indicated, laboratory parameters. It is what gives a treatment decision something to stand on.

Book a consultation

What is assessed

Techniques are selected according to each patient’s clinical needs.

Body weight
Waist circumference
Other anthropometric measures
Body composition where appropriate
Diet, activity and sleep habits
Clinical progress and tolerability
Metabolic parameters where indicated

Laboratory

Within certain programmes, patients have access to laboratory tests at preferential pricing. Tests are carried out by partner laboratories, not within the practice itself.

Scope of this care

A single body composition measurement is not a diagnosis. Its value lies in the trend across follow-up.

We measure more than your weight

Know more than your weight.

The scale tells only part of the story. Throughout follow-up we assess a range of indicators to understand how your body is responding and to guide treatment decisions.

Bioimpedance
Body composition measured, not eyeballed. It shows whether what you are losing is fat or muscle.
- Weight and body fat percentage
- Fat mass and muscle mass
- Body water and visceral fat
- Waist circumference and other measurements
Nutrition
A personalized nutrition plan and tools to understand what you eat, without diet language.
- Personalized nutrition plan
- Calorie and macronutrient counting
- Meal logging in the app
- Adjustments as you progress
Preferential lab pricing
Metabolic tests at preferential pricing within the Equilibra and Equilibra+ programs.
- Metabolic parameters when indicated
- Preferential pricing on Equilibra
- Preferential pricing on Equilibra+
Tests are performed by partner laboratories, not on site.
24/7 medical follow-up
An open channel with your medical team between visits. Asynchronous: write at any hour and the team replies as soon as it is available.
- Triage of your questions and symptoms
- Asynchronous, over messaging
- Weekly in-person evaluations
- Comprehensive care: primary care medicine
- Referral to specialists as needed
This is not an emergency service. In an emergency, go to the nearest emergency department.