Lisa is a successful realtor in Austin—not because she’s one of the cool, coffee-house hipsters, but because she does the work. She doesn’t just sell houses—she pays attention. When a young couple tells her they want “a big yard and an easy commute,” Lisa hears what they actually need: We have a toddler now and another baby on the way. We need great schools, quiet streets, and other young families around. So she finds them a home in a neighborhood with rising school rankings, a strong neighbor community, and kids playing soccer on the weekends. Not just square footage—a place they can build a life.

So when Lisa hit her mid-40s and found herself carrying forty extra pounds, she took that same thoughtful, research-first approach to her health.

The appeal of the quick fix
The weight gain had been slow and steady over many years. At first, she blamed it on work. Then kids. Then just life. She didn’t feel awful—but she no longer felt in control. She stopped buying the clothes she loved and started buying clothes that just “worked.” Her closet became a history of her body: sizes 6 through 14, tags still hanging on things she never got to wear. The only items that ever left the hangers were the biggest ones.

She knew she needed a change, but she wasn’t looking for a fad. She was busy. She knew exercise helped, but she had been in a walking group for years and that hadn’t prevented her from putting on the weight. So she read studies. Compared drugs. Followed clinical researchers and dug into real-world results. Although her A1c had climbed to 6.1 (dangerously closed to diabetes) she wasn’t diabetic — yet. Wegovy was the cheaper option, but Mounjaro caught her attention for the right reasons: better trial outcomes, especially for stubborn weight in women with insulin resistance. She discussed it with her doctor. They agreed. She started.

And it worked—fast.

In the first four months, she dropped nearly 20 pounds. By month six, she’d lost 5 more. Her cravings vanished. She didn’t need to white-knuckle anything. Food was less of an issue. She moved through the world with less effort. People noticed. So did she. She was quickly back to size 10 and even a few 8s. She felt better when she left the house.

The end of the road
But after a year, the honeymoon was over. The excitement gave way to a duller kind of routine.

The nausea was low-grade but persistent. Coffee tasted off. Wine was no longer appealing. Food, which had once been joy and comfort, now felt like maintenance. She didn’t hate it—but she didn’t look forward to it either.

And then there was the cost. With insurance no longer footing the bill, she was out over $12,000. Staying on would cost another $60,000 over five years. And another, and another - you could buy a summer home in Wyoming for that kind of money. And that was for no change at all, because she knew the day she stopped would be the day the weight started to come roaring back. She did her homework — most people were off the drug in less than two years, and almost all of them were fatter than when they started. She felt like she had moved into her “Mounjaro body” and had to keep paying the rent every month. Was she really where she wanted to be?

Then came the signs of perimenopause. Unsteady sleep. Dry skin. Mood swings. A general sense of her body changing again—only now, without clear rules.

Lisa had worked hard to get this body. To everyone in town, she looked better. She didn’t want to throw away the gains she had made. But it didn’t feel like she was on a plateau — it felt like she was in a ditch and she couldn’t get out.

A new beginning
That was when her research led to an article on tapering. Could she taper? Could she reduce the dose slowly and start to build her ideal body? It seemed like too much work before, she was busy and had other reasons not to get in shape. But now it seems like she has no choice. As her dad used to say, “If you can’t get out of it, get into it.” This was the long-term getting-in-shape project she had thought of thousands of times, and now there was no way out.

She talked it over with her dad, who said “Hon, that’s not the right way to think of it.” You’re not in a hole, you’re at the beginning of a new life. You’re going to start doing things that will make you feel fantastic, and once you’re off the drug you’ll feel unstoppable.”

“Unstoppable.” Her dad’s words rang in her ears. He’d been encouraging her to get in shape for decades, and now she realized the only thing stopping her was her attitude.

That was when she found me. She booked an appointment and showed up for our Zoom call. She said she wanted help becoming unstoppable. She wanted to start feeling better, more confident, more enthusiastic about the future. What would that look like?

Good question. It’s easy to say the words. It’s another thing to build your daily life around them.

For Lisa, there are a bunch of things to focus on: weight, drugs, hormones, food, exercise, supplements, sleep, doctors, and more. I told her there won’t be any quick fixes, and there’s a lot of uncertainty as she navigates her way through perimenopause, but I’ll be her partner every step of the way. We can make small, incremental improvements according to how much time she’ll dedicate. She’ll need to start with diet, supplements, and cardio exercise, and every small step forward she can reduce the dose of her Mounjaro. There are no guarantees, but she should see good progress in six months, and if all goes well, she’ll be off the drug with no weight gain in 12. But she’ll have to work at it. In return, she’ll start to feel and look better.

I told her that she is still essentially 40 pounds overweight, she just isn’t carrying it. But her body wants those pounds back. So don’t think of this as a 12-month program, think of it as a four-year program. At the end of four years, she’ll look like the picture in the upper right, above. Did she want that badly enough to work for it and support her transformation? She said yes, but I reminded her that this has been there all along, and she went for the drug instead. I said the way out is available, but you need to put in the work every week. You need to make time and prioritize, and not come up with reasons for not showing up.

Fundamentally, GLP-1 agonists are a debt-based approach to losing weight. You get to lose the weight, then you start paying the interest. And the interest lasts forever. So you lose 25 pounds, but then you’re stuck paying $10,000 a year for those pounds forever. And you’re not in better shape.

She realizes that I’m cheaper than the Mounjaro, but she can’t do this on her own.

“Right,” I said. “That’s why we take baby steps at the beginning, because nothing is free.” She needs a big-picture “unstoppability coach,” not a gym coach. She said “Okay, let’s try it.”

I said “When you say ‘try it,’ do you mean six weeks or six months?”

“Six months,” she said firmly.

She was eager to get started, but I told her, “We need to lay the foundation first, carefully and slowly, or you’ll gain weight faster than you can eat an egg-white omelette. Don’t expect miracles. Expect almost nothing visible for the first six months, but expect to start feeling better mentally within a few weeks, because you’re no longer trapped, you’re digging out of prison into your new body and your new life. Baby steps. A year from now, you should be well on your way to a new you.”

“I understand,” she gulped. “This is what I should have been looking for all along. Let’s do it.”

Don is a tech entrepreneur who has spent too much time staring at his screen and hasn’t ridden his bike in years. He used to race. He used to be on a team. He went on the Thursday evening training rides religiously, got to know all the cyclists in Boulder, and rode for the local cycling club. During his 20s, he enjoyed riding as a category-3 USCF rider and thought about going for a sponsored team, but he joined a startup instead.

The startup was hard work. He put in long hours, made demos, got customers, and became the product manager for a successful enterprise CRM company. Ten years after he joined, the company was acquired, and Don exited with enough money to buy a house.

During this time, he saw less and less of his cycling buddies. By the time he was 40, he had gained 50 pounds and was unhappy with the way he looked. He had stopped riding his bike a few years ago, but he had promised himself he’d get back in shape as soon as the company was sold.

Out of the frying pan into the fire
That didn’t happen. Don had lunch with a Boulder venture capitalist and was quickly convinced to join a new team as a co-founder building an AI-first CRM. He’d barely moved into his new house when he was up to his eyeballs in hiring, pitching, and building as fast as he and his partner could manage.

With no time to exercise, his friend Jim convinced Don to start on Wegovy. Not surprisingly, he lost 20 pounds rather quickly. It was great. He felt better than he had in years, and he was thankful, because he was also busier than he had been in years.

Six months later, Don was down 30 pounds and everyone noticed. He bought a new wardrobe (and got some of his old clothes out of the box because they now fit). He was energized, his start-up was going well, and he felt like a new person.

Over the next six months, nothing happened. He was still 20 pounds overweight and that wasn’t changing. He didn’t taste or enjoy food. He did have more energy, but he didn’t feel healthy.

It was then that Don realized he was going to be paying and injecting himself forever just to stay in this purgatory world of not fat but not thin, not enjoying full health but not wanting to go back to the way he was before. He was half-in and half-out, and he was paying $1,000 a month to stay there. He’d be paying $1,000 a month forever. After ten years, that would be another $120,000 to drug companies just to stay where he is. He’ll be in his 50s then and probably not as energetic.

Then his doctor recommended he go to a cardiologist for a heart check-up, and what he learned was not good news. His LDL was too high, and his blood pressure was high. He was going to have to start on medication to manage his blood pressure.

Another way
That was when he found me. I explained that Wegovy and other similar drugs are a debt-based way to losing weight but not to becoming more healthy. It’s debt, not equity. The drug companies have no interest in helping you get better. They make the most money when you’re trapped in purgatory and have to keep paying interest every month just to keep from sliding back.

Don didn’t like debt. He preferred skin in the game. But he realized that he had avoided having any skin in his own health game and had instead opted for the debt-based approach.

I asked him about his cycling days and he visibly relaxed, telling me stories of racing around Colorado, going to some state and regional events, doing well, having friends who were sponsored riders, and thinking about the early-morning rides, the weight lifting, the runs, the diet, the team van trips, and how great he felt. He realized he had given it all up too suddenly and regretted not at least staying in shape.

We looked at his blood-test results, and they were not good. He was still insulin resistant, and that means poor metabolic health. And he had cardiovascular disease.

There was one way out, and he knew it. Why had he resisted exercising just because he was busy? How did he get so far away from the athlete he used to be? He loved being fit and healthy. He couldn’t see himself staying like this forever, and it scared him to think he would just have to keep taking more pills to prevent the worst from happening.

Program to the rescue
Obviously, he wasn’t going to do this himself. He was in a hole, and he needed help getting out. He didn’t want to stay where he was, he didn’t want the weight to come back, and he definitely didn’t want to find himself in the hospital facing the ceiling as people worked to save his life.

I told him it’s going to take some serious changes. He needs to start with a program to:

• Eat to reduce insulin resistance

• Exercise 45 minutes every day

• Exercise another 2-3 hours on weekends

• Get the right supplements

This is going to take time management more than anything. He’ll need to build exercise into his schedule — something he hasn’t done for 20 years.

I asked if he were truly ready for a serious lifestyle change. He said yes, and he’s ready to pay me to do it. I said “I’m sorry, Don, it takes more than intentions and money. Pick an exercise you can do every day for seven days, then let’s get back on Zoom and you tell me if you did it.”

A giant leap
A week later, he came back and said he was ready to talk again. He had done it. He said he was not only ready to keep going, but he would dedicate a room in his new home to building a gym with whatever I wanted him to buy.

We agreed on a three-month trial period to see if he could follow my program. He would be giving himself the weekly injections during that time, but I told him if it went well, we could talk about reducing his dose or spreading them out a bit. One small step at a time. He agreed to keep track of his exercise and commit to at least six sessions a week, with at least two hours on weekends.

Then Don said “David, my company requires a lot of my time, and it would be easy for me to say just give me another two years, the company will be sold, and I can dedicate all my time to this, but then again I might not have two years until my first heart attack, so don’t believe anything I say, let’s just see what I do.”

I told him that if he does it, he’ll start feeling much better. He may even want to go buy a carbon-fiber superbike and start riding again.

“One step at a time,” he said. “I want to get off this drug and start feeling good about my health again.”

“That’s the spirit, Don,” I said.

Learn more on my weight-loss page, or contact me to set up a time to talk using the form below. If you’re ready to get started, see my pricing page.