Not everyone who needs help losing weight is a candidate for GLP-1 medications. Not everyone who is a candidate can tolerate them. And not everyone whose weight loss has stalled on a GLP-1 program is getting everything their protocol needs.
NOM therapy fills that gap.
NOM is a compounded combination of three clinically studied compounds: Naltrexone, Oxytocin, and Methylcobalamin (Vitamin B12). Each targets a different driver of weight gain and weight loss resistance. Together they address appetite, emotional eating, metabolism, and energy through pathways that GLP-1 medications do not reach.
At South Beach Wellness Center, Maribel Dixon, MSN, APRN FNP-C offers NOM therapy as a standalone weight loss protocol and as a complement to GLP-1 programs for patients who need broader support. Every protocol is built around your specific clinical picture, not a standard formula applied to every patient.
We serve patients in Wesley Chapel, Land O’ Lakes, Lutz, New Tampa, and throughout Florida via telehealth.
Maribel Dixon, MSN, APRN FNP-C
NOM therapy is a compounded medication combining three ingredients in a single formulation:
Each ingredient has its own clinical rationale and mechanism. The combination is synergistic, meaning the three compounds working together produce effects that none of them achieves independently. The formulation is customized by a licensed compounding pharmacy and prescribed by Maribel based on your individual needs and health history.
NOM therapy is not an FDA-approved weight loss medication. It is a compounded protocol that draws on the established clinical profiles of its three components and is prescribed under a provider’s clinical judgment for appropriate patients.
Naltrexone is an FDA-approved medication with a well-established clinical track record in addiction medicine, where it is used to reduce cravings and the reward response associated with alcohol and opioid use. At low doses, it has shown benefit in weight loss applications through a different but related mechanism.
In the context of weight management, naltrexone acts on the opioid receptors involved in the reward pathways associated with food. It reduces the drive to eat triggered by reward and craving rather than genuine hunger, which is a meaningfully different mechanism than the appetite suppression produced by GLP-1 medications.
For patients whose eating patterns are driven significantly by cravings, reward-seeking, or compulsive eating behaviors rather than hunger alone, naltrexone addresses something that appetite suppressants do not directly touch. It quiets the reward signal associated with food rather than simply making the patient less hungry.
Naltrexone also influences metabolic function through its effects on endorphin signaling, which plays a role in energy balance and fat metabolism.
Oxytocin is best known as the bonding hormone, released during social connection, physical touch, and positive emotional experiences. Its role in weight management is less widely known but clinically meaningful.
Oxytocin acts on receptors in the hypothalamus that regulate eating behavior. It reduces appetite and food intake through a central mechanism that is separate from GLP-1 pathways. Research has shown that oxytocin reduces consumption of calorie-dense, highly palatable foods specifically, which are the foods most strongly associated with emotional eating and reward-driven consumption.
Beyond appetite, oxytocin addresses the emotional dimension of weight loss that most medical protocols ignore entirely. Stress, anxiety, loneliness, and emotional dysregulation are significant drivers of weight gain and weight loss resistance for many patients. Oxytocin's role in mood stabilization and stress response modulation directly influences the behavioral patterns that undermine sustained weight loss efforts.
For patients who identify emotional eating as a primary challenge, oxytocin addresses the neurological underpinning of that pattern rather than simply trying to override it with appetite suppression.
Oxytocin also has a direct role in metabolic function, influencing fat cell metabolism and energy expenditure through mechanisms that are still being actively researched but consistently show benefit in weight management applications.
Methylcobalamin is the active, methylated form of Vitamin B12, the most bioavailable form for neurological and metabolic function. It supports energy production at the cellular level, red blood cell formation, and neurological health.
In the context of a weight loss protocol, methylcobalamin serves two functions. First, it addresses the fatigue and low energy that commonly accompany caloric reduction and metabolic change, supporting the patient's ability to maintain activity and consistency throughout treatment. Second, it supports the neurological function that the naltrexone and oxytocin components are influencing, contributing to overall neurotransmitter health and cognitive clarity during treatment.
Patients who struggle with the low energy and brain fog that often accompany weight loss programs find that methylcobalamin supports their quality of life during treatment in a way that makes the protocol more sustainable.
NOM therapy is not a replacement for GLP-1 medications in patients who are good candidates for them and can tolerate them. It is a clinically meaningful option for a specific set of patients for whom GLP-1 therapy is not the right answer.
medications. Nausea, gastrointestinal side effects, and other tolerability issues cause a meaningful percentage of patients to discontinue semaglutide or tirzepatide before achieving their goals. NOM therapy offers an alternative pathway that does not share the gastrointestinal mechanism.
Certain personal and family health histories make GLP-1 medications inappropriate. NOM therapy does not share those contraindications and provides an alternative for patients who would otherwise have limited medically supervised options.
Patients who are not consistently hungry but find themselves eating in response to stress, boredom, anxiety, or emotional triggers are often poorly served by appetite suppressants alone. The oxytocin and naltrexone components in NOM therapy directly address the neurological drivers of that pattern.
Adding NOM therapy as a complement to an existing semaglutide or tirzepatide protocol can address aspects of weight loss resistance that the GLP-1 mechanism alone is not fully reaching, particularly for patients whose emotional eating or reward-driven food behavior remains active despite appetite suppression.
NOM therapy is administered as a topical cream or oral formulation rather than a weekly injection. For patients who are averse to injections or for whom injectable medications are not practical, NOM provides medically supervised weight loss support in a non-injectable form.
The methylcobalamin component directly supports energy production and neurological function, making NOM a strong fit for patients whose weight loss is complicated by persistent fatigue.
These are not competing options. They are complementary tools that address different aspects of the weight loss equation.
GLP-1 medications produce the most powerful appetite suppression and metabolic correction currently available in non-surgical weight loss medicine. For patients who are candidates and can tolerate them, they are the highest-efficacy first-line option.
NOM therapy addresses appetite through different neurological pathways, tackles emotional eating and reward-driven food behavior directly, supports mood and stress response, and delivers energy support throughout treatment. It does not produce the degree of weight loss that tirzepatide or semaglutide produces in clinical trials, but it addresses dimensions of the problem that GLP-1 medications do not.
For patients who need GLP-1 therapy but have hit a plateau, combining NOM therapy with their existing protocol can break through resistance that a single mechanism cannot resolve alone. For patients who cannot use GLP-1 medications, NOM provides meaningful medically supervised support through a completely different set of pathways.
Maribel evaluates both options at your consultation and makes a recommendation based on your full clinical picture, your history, your preferences, and your goals.
Our Direct Primary Care members in the Land O’ Lakes and Wesley Chapel corridor come to us for a wide range of primary care needs.
Your first visit includes a full health history review, physical exam, and lab work establishing your metabolic baseline. Maribel reviews your prior weight loss history, your current relationship with food, any prior medication experience, and the specific patterns that have made weight loss difficult for you. This conversation is more detailed than a standard weight loss consultation because understanding whether emotional eating, reward-driven behavior, fatigue, or metabolic resistance is the dominant factor in your situation directly shapes which protocol is the right fit. Body composition is assessed using our seca mBCA Alpha medical-grade analyzer to establish your baseline skeletal muscle mass, visceral fat, body fat percentage, and phase angle.
NOM therapy is compounded specifically for each patient based on Maribel's prescription. Dosing and formulation are individualized. The protocol includes guidance on nutrition, activity, and the behavioral strategies that work synergistically with the neurological support NOM provides.
Follow-up visits monitor your progress, side effect profile, and response to the protocol. Body composition scans are repeated at intervals to track changes in fat mass and lean tissue. Protocol adjustments are made based on what the data shows.
NOM therapy is generally well tolerated. The side effect profile reflects its three components individually.
Naltrexone at the doses used in this protocol is typically well tolerated. Some patients experience mild nausea or sleep disturbance during the initial adjustment period, which generally resolves within one to two weeks. Naltrexone is contraindicated for patients currently using opioid medications or who have opioid dependency, and for patients with acute hepatitis or liver failure. Maribel reviews your medications and health history before prescribing.
Oxytocin at therapeutic doses used in weight management protocols is generally well tolerated. Some patients report mild headache during initial use.
Methylcobalamin is extremely well tolerated at therapeutic doses with no significant side effect profile in most patients.
If you experience side effects that affect your quality of life or ability to maintain the protocol, contact Maribel directly. Protocol adjustments can address most tolerability issues without requiring discontinuation.
Is NOM therapy FDA approved?
NOM therapy is a compounded formulation, not an FDA-approved drug. Each of its three components has its own FDA approval history for other indications. Naltrexone is FDA approved for alcohol and opioid use disorder. Methylcobalamin is a recognized nutritional supplement. The NOM combination is prescribed under Maribel’s clinical judgment as a compounded protocol for appropriate patients.
How is NOM therapy administered?
NOM therapy is typically administered as a topical cream or oral formulation, not an injection. The specific delivery method is determined by the compounding pharmacy and Maribel’s clinical preference for your individual protocol.
How long does it take to see results with NOM therapy?
Results develop more gradually than with GLP-1 medications. Most patients notice changes in craving patterns and emotional eating behavior within two to four weeks. Measurable weight loss typically develops over one to three months of consistent use. Results are sustained with ongoing use and lifestyle integration.
Can I use NOM therapy alongside semaglutide or tirzepatide?
Yes, and for some patients this combination is specifically what Maribel recommends. The mechanisms do not overlap, which means the two protocols are genuinely complementary rather than redundant.
Is NOM therapy appropriate if I have a history of opioid use?
Naltrexone is contraindicated for patients currently using opioid medications. Patients with a history of opioid use disorder should discuss their full history with Maribel before starting. Depending on the specifics, NOM therapy may still be appropriate or a modified protocol without the naltrexone component may be considered.
Do I need labs before starting NOM therapy?
Yes. Maribel requires a baseline lab panel before starting any weight loss protocol, including NOM therapy. Labs establish your metabolic baseline, confirm there are no contraindications, and provide the benchmarks against which your progress is measured.
How does NOM therapy address emotional eating specifically?
Emotional eating is driven by the neurological reward system, stress response pathways, and emotional regulation circuits rather than by hunger alone. Naltrexone reduces the reward signal associated with food. Oxytocin modulates the stress and emotional dysregulation that triggers emotional eating episodes. Together they address the neurological environment that makes emotional eating patterns so difficult to change through behavioral intervention alone.
Schedule a medical weight loss consultation with Maribel Dixon, MSN, APRN FNP-C at South Beach Wellness Center. Maribel will review your full clinical picture and tell you honestly whether NOM therapy, a GLP-1 protocol, or a combination approach is the right fit for your situation.
