Weight Loss That Works on Cravings, Not Just Appetite

Contrave is an FDA-approved prescription weight loss medication that combines two drugs in a single pill: naltrexone and bupropion. You may recognize bupropion as an antidepressant (sold as Wellbutrin), and naltrexone from its use in addiction medicine. Together, they work on the parts of the brain that drive cravings, compulsive eating, and the reward cycle around food.

It is not a GLP-1. It does not slow digestion or suppress appetite the way Ozempic or Wegovy do. Contrave works through a different pathway entirely, which is exactly why it may be the right fit for some patients and not others.

That last part matters more than most people realize. A missing signature, an expired lab result, or a vaccine documented the wrong way can send the form back and delay everything. Doing this thousands of times means we know exactly what USCIS is looking for.

1. 1

   Before you come

   Bupropion activates pathways that reduce appetite and increase energy expenditure. Naltrexone blocks the reward signals that reinforce overeating. Together, they interrupt the cycle where eating feels like relief, comfort, or compulsion rather than hunger.

2. 2

   The visit

   For patients who describe eating in response to stress, boredom, or emotions rather than physical hunger, this mechanism matters. It is not that willpower was missing. The brain's reward wiring was working against the effort. Contrave addresses that directly.

3. 3

   Vaccines, only the ones you need

   We compare your records against the USCIS vaccine list. Where a record exists, you are done. Where one is missing, immunity testing can usually show you are already protected, so you don’t repeat shots you have already had.

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.

Contrave may be a good fit if you prefer a pill over an injection, if GLP-1 medications like Ozempic, Wegovy, Mounjaro, or Zepbound are not covered by your insurance or are not the right match for you, or if emotional and reward-driven eating is a significant part of your pattern.

It is also worth considering if you have tried phentermine or Qsymia and want a different approach, or if you are curious about how your mental health history might intersect with weight. Dr. Gougian's family medicine background includes mental health, and she is well-positioned to look at the full picture before recommending any medication.

No one here will ask you to prove you are sick enough or heavy enough. The conversation starts with where you are and what you have already tried.

GLP-1 medications like Ozempic, Wegovy, Mounjaro, and Zepbound work through gut hormones that slow digestion and reduce appetite. Contrave works through the brain's reward and craving pathways. It is also a pill, not an injection. For patients whose eating is driven more by emotion or habit than by hunger, the neurological approach Contrave takes can be a meaningful difference. Both types of medication are available at Pandora Family Medicine, and Dr. Gougian can help you think through which fits your situation.

This is a fair and important question. Bupropion, one of the two ingredients in Contrave, is also used as an antidepressant, so there are real intersections with mental health history worth discussing. Contrave is not appropriate for everyone with a psychiatric history, and there are specific contraindications, including a history of seizures or certain eating disorders. Dr. Gougian's scope in family medicine includes mental health, so she reviews this carefully before prescribing. The goal is a medication that fits your whole picture, not just your weight.

Our office is at 6300 Baltimore Ave, University Park, MD 20782, on Route 1 between Hyattsville and College Park, a short drive from Washington, DC and close to Metro’s Green Line.

Patients come from across the region because there are not many Civil Surgeons who do this volume of exams, and fewer still who do them in Spanish. We regularly see patients from Hyattsville, College Park, Langley Park, Takoma Park, Silver Spring, Riverdale Park, Greenbelt, Laurel, and Washington, DC.