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 stress. Then hormones. 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 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. Ozempic was the headline-maker, but Mounjaro caught her attention for the right reasons: better trial outcomes, especially for stubborn weight in women with insulin resistance (her A1c had climbed to 6.1 — dangerously closed to diabetes). She brought it to 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 30. Her cravings vanished. She didn’t need to white-knuckle anything. She just ... ate less. She moved through the world with less effort. People noticed. So did she. She was wearing clothes that looked “right.” She felt better when she left the house.

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 like “a new person.” 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 hole.

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, but now it seems like a long-term project that will pay huge dividends. What would that look like?

That was the question she asked me on a zoom call.

For Lisa, there are four things to navigate: weight, drugs, hormones, and lifestyle. I told her there won’t be any quick fixes. We can make small, incremental improvements according to how much time she’ll dedicate to the project. 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 better 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.

She said she’s going to need help.

Right. That’s why we take baby steps at the beginning, because nothing is free. And the hormone changes are just around the corner, so she needs a big-picture approach, not a gym coach. This is a new world for her. She needs a guide she can trust. We’re starting slowly, building a foundation for the rest of her life. Things haven’t changed for her physically, but they are starting to change mentally. It’s the solution she was looking for all along. The drug just got her started.

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.