**Disclaimer**this was recorded prior to PCOS (Polycystic Ovarian Syndrome) being renamed PMOS (Polyendocrine Metabolic Ovarian Syndrome).

Learn more about Lindsay Nelson, RD at her website and follow her on Intsagram

We break down what PCOS is, how it’s diagnosed, and why insulin resistance often sits at the center of symptoms like irregular cycles, acne, hair growth, and stubborn weight gain. We also map out practical next steps for fertility, labs to ask for, and lifestyle strategies that make PCOS feel manageable instead of overwhelming. 

• What PCOS is and the three diagnostic criteria 
• Why irregular cycles often mean irregular ovulation and lower fertility chances 
• Root causes that can block ovulation including high insulin, high testosterone, vitamin D deficiency, and stress 
• Inositol as a supplement option and how it compares with metformin for some people 
• How insulin resistance affects cravings and weight management plus why fasting insulin can reveal problems early 
• Long-term risks including diabetes, heart disease, endometrial concerns, and higher eating disorder risk 
• Conventional treatments like birth control, metformin, and spironolactone versus root-cause lifestyle work 
• Diet fundamentals including fiber, anti-inflammatory foods, plate balance, and avoiding “naked carbs” 
• Exercise guidance for PCOS including cycle-aware intensity, cortisol, sleep, and postpartum recovery 
• Why baby-step goals make change realistic and sustainable 

If you found this information helpful, please share with a friend, family member, or colleague. We need to do all we can to combat the dangerous misinformation that is out there. Please subscribe and write a review. This will help others find the podcast so they may also improve their metabolic health.

👩🏼‍⚕️ Live in Missouri? Want to be my patient?
Telehealth clinic: https://missourimetabolichealth.com

🥑 Have questions you want answered on the podcast? Email [email protected]

✨Freebies✨
Anti-Obesity Medication Options
How To Prevent Diabetes
Healthy Habits Workbook
Preventative Health Checklist

🤗 Socials:
Instagram: https://www.instagram.com/dr.lindsayogle/
TikTok: https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1

YouTube: https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg

Schedule an appointment with Dr. Montgomery (Missouri only) here

We welcome Dr. Elizabeth Montgomery to the Modern Metabolic Health Podcast and talk about why family medicine naturally leads to treating obesity with compassion and science. We break down why our goal is better long-term health, not fast weight loss, and how personalized care builds trust and real progress. 
• Dr. Montgomery’s path through Missouri and into family medicine 
• Why obesity medicine aligns with whole-person primary care 
• Explaining obesity as a chronic disease like hypertension or diabetes 
• How hormones and brain chemistry affect weight regulation 
• Correcting myths about weight loss safety and GLP-1 medications 
• Why guided medical care differs from online medication use 
• When obesity medications can help, especially with comorbidities 
• Stigma in healthcare and removing shame from weight care 
• How to know if your doctor is the right fit 
• Building individualized plans for nutrition and exercise 
If you found this information helpful, please share with a friend, family member, or colleague. We need to do all we can to combat the dangerous misinformation that is out there. Please subscribe and write a review. This will help others find the podcast so they may also improve their metabolic health. 

Schedule an appointment with Dr. Montgomery (Missouri only) here

👩🏼‍⚕️ Live in Missouri? Want to be my patient?
Telehealth clinic: https://missourimetabolichealth.com

🥑 Have questions you want answered on the podcast? Email [email protected]

✨Freebies✨
Anti-Obesity Medication Options
How To Prevent Diabetes
Healthy Habits Workbook
Preventative Health Checklist

🤗 Socials:
Instagram: https://www.instagram.com/dr.lindsayogle/
TikTok: https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1

YouTube: https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg

We break down why it can feel like you are fighting yourself when you try to change your health habits, and we show how to use simple planning to make follow-through easier. We explain forebrain vs hindbrain, then turn that insight into a practical nutrition plan that supports metabolic health and self-trust.
• forebrain vs hindbrain and why they can clash
• the motivational triad: seek pleasure, avoid pain, conserve energy
• how modern life triggers threat-scanning and anxiety
• why decision fatigue pushes you toward easy food choices
• building a nutrition plan instead of a restrictive diet
• planning 24 hours ahead or a week ahead based on your life
• making reasonable changes and using baby steps
• scheduling treats to reduce guilt and rebellion
• starting with one planned meal, especially breakfast
• prioritizing protein, water, and fiber for steadier hunger
• considering a coach, dietitian, therapist, or health professional for support
If you found this information helpful, please share with a friend, family member, or colleague. We need to do all we can to combat the dangerous misinformation that is out there. Please subscribe and write a review. This will help others find the podcast so they may also improve their metabolic health.

👩🏼‍⚕️ Live in Missouri? Want to be my patient?
Telehealth clinic: https://missourimetabolichealth.com

🥑 Have questions you want answered on the podcast? Email [email protected]

✨Freebies✨
Anti-Obesity Medication Options
How To Prevent Diabetes
Healthy Habits Workbook
Preventative Health Checklist

🤗 Socials:
Instagram: https://www.instagram.com/dr.lindsayogle/
TikTok: https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1

YouTube: https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg

Seeing wild success stories about GLP-1 medications can mess with your head, especially if your own scale is moving slower or not at all. We’re pulling back the curtain on what we actually see in obesity medicine: hyper responders, hypo responders, and true non-responders, and why none of those labels says anything about your effort or worth.

We talk through the real-world range of outcomes with Zepbound (tirzepatide) and Wegovy (semaglutide), including what “average” weight loss means and why those numbers usually play out over a year or more. We also zoom in on pace. Losing more than about two pounds per week can come with real medical downsides, from gallstones and dehydration to fatigue, constipation, nutrient deficiencies, and delayed hair shedding. If the weight is dropping because you feel sick or can’t eat enough protein and fiber, that’s not the win it looks like on social media.

Then we get practical about dosing and titration. We explain why the starter dose is often just a tolerability step, how to find the effective dose that controls appetite and food noise without crushing your nutrition, and why slower responders often end up with better long-term metabolic health. And if GLP-1s don’t get you where you need to go, you still have options, including combination anti-obesity medications and metabolic and bariatric surgery, especially when type 2 diabetes is difficult to manage.

If you want a safer, calmer way to judge progress and make decisions with your prescriber, listen now, then subscribe, share with someone who needs this perspective, and leave a review so more people can find evidence-based metabolic health guidance.

First Generation Obesity Management Medications

👩🏼‍⚕️ Live in Missouri? Want to be my patient?
Telehealth clinic: https://missourimetabolichealth.com

🥑 Have questions you want answered on the podcast? Email [email protected]

✨Freebies✨
Anti-Obesity Medication Options
How To Prevent Diabetes
Healthy Habits Workbook
Preventative Health Checklist

🤗 Socials:
Instagram: https://www.instagram.com/dr.lindsayogle/
TikTok: https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1

YouTube: https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg

Bad sleep doesn’t just make you groggy. It can nudge your hormones, cravings, and food choices in a direction that makes weight loss and blood sugar control feel twice as hard. We walk through how sleep connects to metabolic health, including why poor sleep can raise hunger hormones like ghrelin, increase sugar cravings, and make “easy” processed foods more tempting when your energy and patience are low.

Then we get practical with eight sleep hygiene strategies you can actually use. We talk about locking in a consistent bedtime and wake time (yes, weekends count), building a bedroom that supports sleep with darkness, cooler temps, and less noise, and dialing in your personal cutoff for caffeine and other stimulants. We also cover timing your meals and being realistic about alcohol, since it may help you drift off but often disrupts sleep quality later in the night.

We round it out with movement and recovery habits that set you up for deeper rest: exercising earlier in the day, getting sunlight when you can, limiting long naps, creating a wind-down routine, and keeping the bedroom for sleep and intimacy so your brain stops associating bed with work stress. We also share a simple target for most adults: at least six hours of sleep and usually no more than nine. If this helps, subscribe, share the show with someone who needs better sleep, and leave a rating or review so more people can find us.

👩🏼‍⚕️ Live in Missouri? Want to be my patient?
Telehealth clinic: https://missourimetabolichealth.com

🥑 Have questions you want answered on the podcast? Email [email protected]

✨Freebies✨
Anti-Obesity Medication Options
How To Prevent Diabetes
Healthy Habits Workbook
Preventative Health Checklist

🤗 Socials:
Instagram: https://www.instagram.com/dr.lindsayogle/
TikTok: https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1

YouTube: https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg

We explain what split dosing Zepbound can look like in real practice and why some patients do better with a customized plan than a standard once-weekly schedule. We also walk through pen logistics, refill timing, and the questions people keep asking so you can bring smarter, safer questions to your clinician. 
• what “split dosing” means in clinic and why off-label dosing is common 
• three patient groups we consider for split dosing 
• lowering or “in-between” doses to reduce GLP-1 side effects during titration 
• dividing a weekly dose into two injections for steadier appetite control 
• why tirzepatide’s half-life can create end-of-week drop-off for some people 
• using higher-strength pens for cost savings by counting clicks with clinician oversight 
• priming each dose and why it matters for air bubbles 
• where to get extra pen needles and how much they cost 
• LillyDirect refill rules and the 45-day ordering window 
• expiration guidance, room-temperature handling, and common pen concerns 
If you found this information helpful, please share with a friend, family member, or colleague. We need to do all we can to combat the dangerous misinformation that is out there. Please subscribe and write a review. This will help others find the podcast so they may also improve their metabolic health.

Buy extra Zepbound needles here

Learn more about Zepbound KwikPen

Learn more about LillyDirect

Learn more about Medicare Bridge Program

👩🏼‍⚕️ Live in Missouri? Want to be my patient?
Telehealth clinic: https://missourimetabolichealth.com

🥑 Have questions you want answered on the podcast? Email [email protected]

✨Freebies✨
Anti-Obesity Medication Options
How To Prevent Diabetes
Healthy Habits Workbook
Preventative Health Checklist

🤗 Socials:
Instagram: https://www.instagram.com/dr.lindsayogle/
TikTok: https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1

YouTube: https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg

GLP-1 medications can feel like a breakthrough and a minefield at the same time, and the difference is often the plan behind the prescription. I’m Dr. Lindsay Ogle, board certified in family medicine and obesity medicine, and I’m sharing what I’ve learned from prescribing GLP-1 receptor agonists and hearing real feedback from patients about what helps, what backfires, and what actually makes the process sustainable.

We start with the most important step: getting established with a qualified clinician and following up regularly, especially during the first months of dose titration. I also call out common red flags, like services that provide GLP-1 weight loss meds without meaningful medical oversight. Then we zoom out to the big picture: “start low and go slow,” speak up about side effects early, and never increase a dose just because the calendar says it’s time. Obesity is a chronic condition, and GLP-1 therapy works best when it’s treated as long-term medical care, not a race to a number.

From there, we get practical with the lifestyle foundations that protect your results: hydration (and why dehydration can masquerade as nausea or fatigue), protein targets to preserve lean muscle, fiber goals that support gut health and the microbiome, and how to increase fiber gradually to avoid GI distress. We also talk about resistance training as a key tool for metabolic health, with realistic options that don’t require a gym, plus the mindset shift that helps you stay patient through plateaus and build a support team when you need it.

If this helped, subscribe, share the episode with someone who’s considering GLP-1 medications, and leave a review so more people can find safe, evidence-based guidance.

👩🏼‍⚕️ Live in Missouri? Want to be my patient?
Telehealth clinic: https://missourimetabolichealth.com

🥑 Have questions you want answered on the podcast? Email [email protected]

✨Freebies✨
Anti-Obesity Medication Options
How To Prevent Diabetes
Healthy Habits Workbook
Preventative Health Checklist

🤗 Socials:
Instagram: https://www.instagram.com/dr.lindsayogle/
TikTok: https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1

YouTube: https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg

Weight regain after bariatric surgery can feel like a personal failure, but it’s often a predictable collision of biology, appetite signaling, and changing metabolism. We walk through one of the most common questions we get as obesity medicine physicians: when GLP-1 agonists fit before or after metabolic and bariatric surgery, and how to use them in a way that protects your health.

We start with the pre-op side, where GLP-1 medications may help people with class 3 obesity or very high BMI reduce surgical risk and improve conditions like type 2 diabetes, insulin resistance, sleep apnea, and fatty liver disease. We also cover practical perioperative considerations, including why many surgical teams ask patients to stop GLP-1s about a week before anesthesia to reduce aspiration risk.

Then we move into post-op strategy. Because bariatric surgery already changes your GI system and appetite, we explain why many clinicians wait 1 to 2 years before restarting a GLP-1, and what needs to be true first: stable recovery, thoughtful evaluation, and optimized nutrition. We dig into micronutrient labs, bariatric supplements, and why slow titration matters so much after sleeve gastrectomy or gastric bypass. We also break down medication absorption differences between injectable vs oral options and when non-GLP-1 weight loss medications may be a better fit.

If you care about metabolic health, safe weight management, and evidence-based guidance beyond internet noise, subscribe, share this with someone you love, and leave a review so more people can find the show.

ProCare Supplements 10% off CODE: MetabolicHealth

First Generation Obesity Management Medications

👩🏼‍⚕️ Live in Missouri? Want to be my patient?
Telehealth clinic: https://missourimetabolichealth.com

🥑 Have questions you want answered on the podcast? Email [email protected]

✨Freebies✨
Anti-Obesity Medication Options
How To Prevent Diabetes
Healthy Habits Workbook
Preventative Health Checklist

🤗 Socials:
Instagram: https://www.instagram.com/dr.lindsayogle/
TikTok: https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1

YouTube: https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg

***DO NOT STOP MEDICATIONS WITHOUT TALKING WITH YOUR DOCTOR***

Weight gain after starting a medication is common, real, and often missed in routine care, so we walk through which prescriptions and OTC drugs are more likely to contribute and why it varies by person. We also share how to ask for a full medication review and what safer, more weight-neutral alternatives you can discuss with your prescriber. 

• why you should never stop certain medications abruptly and when tapering matters 
• how a “brown bag” medication visit works and why we recommend it yearly for 6+ meds 
• using metformin alongside a weight-promoting medication as an option to discuss 
• mood medications that may contribute to weight gain and why Paxil stands out among SSRIs 
• gabapentin and pregabalin for nerve pain plus seizure risk with abrupt stopping 
• steroids like prednisone, weight gain risk, and why to monitor fasting glucose or A1C 
• type 2 diabetes medications tied to weight gain and why newer GLP-1 and SGLT2 options matter 
• beta blockers that may cause weight gain and weight-neutral blood pressure alternatives 
• hormones, birth control, HRT, and the importance of individualized choices 
• OTC Benadryl and how long-term use can add subtle weight gain 

If you live in Missouri, I would love to help you through this. And you can schedule an appointment through my telehealth clinic, MissouriMetabolic Health.com. 
If you found this information helpful, please share with a friend, a family member, or a colleague. We need to do all we can to combat the dangerous misinformation that is out there. Please subscribe and write a video. This will help others find the podcast that they may also improve their metabolic health. 

👩🏼‍⚕️ Live in Missouri? Want to be my patient?
Telehealth clinic: https://missourimetabolichealth.com

🥑 Have questions you want answered on the podcast? Email [email protected]

✨Freebies✨
Anti-Obesity Medication Options
How To Prevent Diabetes
Healthy Habits Workbook
Preventative Health Checklist

🤗 Socials:
Instagram: https://www.instagram.com/dr.lindsayogle/
TikTok: https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1

YouTube: https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg

We break down how LillyDirect works for people who want GLP-1 medications like Zepbound but can’t get insurance coverage or face an unaffordable copay. We walk through the ordering flow, device choices, safe handling basics, and the pricing rules that can save you money or unexpectedly raise your cost. 
• why GLP-1 access is so frustrating in the US and what is changing 
• what LillyDirect is and how direct-to-consumer fulfillment works through Gifthealth 
• delivery options and what to expect after your clinician sends the prescription 
• Zepbound quick pen vs single-use vials and why we usually prefer the pen 
• priming the pen each dose and where to get additional needles if needed 
• refrigeration guidance, what to do if it reaches room temperature, and what the 30-day guidance really means 
• LillyDirect pricing by dose and how higher doses change monthly cost 
• the 45-day refill window, grace periods, and how late orders can raise prices 
• when a copay coupon at the pharmacy may be a better long-term move 
• why LillyDirect purchases do not apply to your insurance deductible 
If you found this information helpful, please share with a friend, family member, or colleague. We need to do all we can to combat the dangerous misinformation that is out there. Please subscribe and write a review. This will help others find the podcast so they may also improve their metabolic health. 

Buy extra Zepbound needles here

Learn more about Zepbound KwikPen

Learn more about Foundayo

Learn more about Medicare Bridge Program

👩🏼‍⚕️ Live in Missouri? Want to be my patient?
Telehealth clinic: https://missourimetabolichealth.com

🥑 Have questions you want answered on the podcast? Email [email protected]

✨Freebies✨
Anti-Obesity Medication Options
How To Prevent Diabetes
Healthy Habits Workbook
Preventative Health Checklist

🤗 Socials:
Instagram: https://www.instagram.com/dr.lindsayogle/
TikTok: https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1

YouTube: https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg