A doctor who knows your name
Your care starts with a video visit with a board-certified physician, not a questionnaire. The same doctor's team stays with you from then on.
Physician-led metabolic care · Launching in Texas
Your GLP-1 got you here. Now what?
A named, board-certified doctor, quarterly labs, and a written plan for staying on, tapering, or stepping off, built around protecting your muscle and the progress you've made.
What membership includes
The part of treatment nobody planned for
Most people stop a GLP-1 within a year, and too many leave with no plan for what comes next. We start where the prescription ends.
A written plan, not a guess
Whether you're staying on, tapering, or already off, you get a written plan covering dose, timing, protein and training targets, and what to watch for.
Quarterly labs
A baseline panel, then a repeat every three months: metabolic, lipids, A1c, thyroid, and hormones when they're relevant. Decisions follow the trend, not a hunch.
Muscle, measured
Body composition tracking, not just the scale, so we can see whether you're losing fat or losing muscle and adjust before it matters.
Side effects, handled
Nausea, constipation, and fatigue are why many people quit. You'll have a plan for them from day one and a clinician to message when they show up.
Check-ins between visits
Monthly check-ins and messaging keep your plan current. AI helps us draft and organize them, and a physician reviews every clinical decision. We always tell you when AI is involved.
Your physician
James Lagucik, DO
I've prescribed GLP-1 medications since 2015, years before they were a weight-loss headline. I've watched them change lives, and I've watched people lose muscle, stop abruptly, and end up back where they started with no one to call.
Before this, I built a primary care clinic from zero to more than 800 patients as its only physician, and ranked first in patient satisfaction nationally among the clinicians at the world's largest HIV care provider. Holdfast is the practice I wanted to be able to refer my own patients to.
- BoardBoard-certified in Family Medicine (AOBFP)
- SpecialtyHIV Specialist, American Academy of HIV Medicine (AAHIVS)
- FocusMetabolic medicine, GLP-1 therapy, men's health and hormone care
- LicenseTexas, active and unrestricted
Membership
One monthly price. No surprises.
Planned launch pricing. Cancel anytime.
Core
$129 /month
For anyone on, tapering, or off a GLP-1 who wants a real plan and a doctor behind it.
- Physician video intake
- Written taper and maintenance plan
- Quarterly lab review and body composition tracking
- Monthly check-ins and unlimited messaging
Labs and medications billed separately at cost.
Plus
$179 /month
Everything in Core, plus hormone care when your labs and history say you need it.
- Everything in Core
- Testosterone or menopause care when clinically indicated
- A clinician touchpoint twice a month
- Priority scheduling
Labs and medications billed separately at cost.
Founder's Circle
$349 /month
Direct access to Dr. Lagucik for people who want the most time with their physician.
- Everything in Plus
- Your visits are with Dr. Lagucik
- Extended visits
- In-person option in Austin
Limited to 150 members.
Services start with Texas residents 18 and older, with more states to follow. Pricing is planned and may change before launch.
Don't figure out what comes next alone.
Join the waitlist for first access, founding-member pricing, and first claim on Founder's Circle seats.