Your Metabolic Health, Seen as a Whole Picture

It is a structured medical evaluation that looks at how your body is managing energy, blood sugar, fat, and inflammation. Not just one number in isolation, but the full picture of how those systems interact.

A standard physical might flag an abnormal lab value and leave it at that. A metabolic health assessment connects the dots. Elevated fasting glucose, high triglycerides, low HDL, increased waist circumference, and rising blood pressure often appear together, and together they tell a story that individual results do not.

Dr. Gougian uses this evaluation as the starting point for physician-guided weight loss treatment when that is appropriate, and as a standalone check-in for patients who want to understand where they stand before a problem develops.

1. 1

   Some signs are obvious. Others are not.

   Fatigue that does not improve with rest, difficulty losing weight despite real effort, blood sugar creeping up year over year, cholesterol numbers that keep trending the wrong direction. These are not just inconveniences. They are signals.

2. 2

   Sometimes there are no signs at all.

   That is the harder conversation. A patient can have insulin resistance, early fatty liver disease, or borderline cardiovascular risk and feel nothing unusual. The assessment exists precisely for this reason: to find what is developing before it becomes a crisis.

3. 3

   You do not need to be in poor health to benefit.

   Patients who feel fine, patients who are managing weight, patients who are somewhere in between. The assessment is about understanding where you actually are, not confirming that something is already wrong.

4. 4

   Results and the sealed envelope

   When lab results are back, Dr. Gougian completes and signs the I-693 and seals it in an envelope for USCIS. With complete records and normal labs, that is often within a few days of your visit. If a vaccine dose or repeat test is needed, we give you a realistic date before you leave. Don’t open the sealed envelope; you receive a separate copy to keep.

5. 5

   If something turns up

   A positive tuberculosis blood test, for example, usually means a chest X-ray, not a denial. We explain what it means, arrange what is needed, and complete the form when it is done. You are never left guessing.

We know the timeline matters. Many patients are working against an interview date or a request for evidence, and we schedule and process exams with that in mind. The exam is a flat fee quoted before you book; blood tests and vaccines are itemized and added only if you need them, so there are no surprise costs.

The evaluation pulls together lab work, physical measurements, and a detailed health history. Blood work is drawn in our office, so there is no separate lab visit and no waiting on results from somewhere else.

We look at fasting glucose and insulin levels, HbA1c, a full lipid panel, liver enzymes, inflammatory markers, thyroid function, and other values that affect how your body processes energy and stores fat. Liver health is part of this evaluation. Metabolic dysfunction-associated steatohepatitis (MASH, formerly known as NASH) is increasingly recognized as a downstream consequence of metabolic dysfunction, and identifying early liver involvement changes how we approach treatment.

Physical measurements include body composition, waist circumference, and blood pressure. These matter alongside the labs, not instead of them.

The assessment is not an end point. It is the foundation for what comes next. After reviewing your results, Dr. Gougian will talk through what she found, what it means, and what options make sense for you specifically.

For patients where weight is part of the picture, that conversation may include physician-guided weight loss treatment, which can involve medications like Ozempic, Wegovy, Mounjaro, Zepbound, phentermine, or Qsymia depending on your health history and goals. There is no subscription model here. The initial weight loss visit is $200, and follow-up visits are $150. We are also happy to work with your insurance and handle prior authorization when coverage is available.

If you have been told your blood sugar is borderline, if your weight has been trending up and you are not sure why, if your cholesterol numbers have been creeping in the wrong direction, or if you simply want a clearer picture of your cardiovascular and metabolic risk, this assessment is worth doing.

You do not need to qualify. You do not need to prove you are sick enough. If you are curious about where you stand, that is reason enough.