The Original Weight Loss Meds: Phentermine, Qsymia, and Contrave

The Original Weight Loss Meds: Phentermine, Qsymia, and Contrave

GLP-1 medications are everywhere right now, but the “older” obesity medications never stopped helping real patients and they can still be the right tool when matched well. I walk through the three FDA-approved first-generation obesity management options and how I think about using them safely in modern obesity medicine, especially when cost, access, or specific symptoms like cravings are part of the story. We start with phentermine, the original FDA-approved weight loss medication, and get practical about what it actually does: appetite suppression, typical stimulant-like side effects, morning dosing, expected weight loss, and the key reasons it may be unsafe (like uncontrolled high blood pressure, certain heart conditions, glaucoma, or uncontrolled hyperthyroidism). Then we move into Qsymia, the phentermine plus topiramate combination, including why it tends to produce more weight loss, what to know about pricing, and the topiramate-specific risks like teratogenicity, kidney stones, fatigue, taste changes, and tingling sensations. Next, we dig into Contrave (bupropion plus naltrexone) and why it can be a great fit when food cravings, emotional eating, mood symptoms, or goals like cutting back on alcohol or smoking are front and center. I also explain the non-negotiable safety rules: no history of seizures, and no opioids of any kind, including products like kratom or 7OH, due to the risk of precipitated withdrawal. We close by talking strategy, including combining these oral options with GLP-1 therapy, using them for maintenance, and an honorable mention of metformin for insulin resistance and metabolic health. Subscribe, share this with someone who needs clear guidance, and leave a review so more people can find the podcast and improve their metabolic health. ------------------------------------------------- Qsymia discount program [https://qsymia.com/patient/multiple-ways-to-save] Contrave discount program [https://contrave.com/save/] 👩🏼‍⚕️ Live in Missouri? Want to be my patient? Telehealth clinic: https://missourimetabolichealth.com [https://missourimetabolichealth.com/about-telehealth-clinic] 🥑 Have questions you want answered on the podcast? Email support@missourimetabolichealth.com ✨Freebies✨ Anti-Obesity Medication Options [https://drlindsayogle.kit.com/medications] How To Prevent Diabetes [https://drlindsayogle.ck.page/diabetes] Healthy Habits Workbook [https://drlindsayogle.kit.com/habits] Preventative Health Checklist [https://drlindsayogle.ck.page/1eecd5e72f] 🤗 Socials: Instagram: https://www.instagram.com/dr.lindsayogle/ [https://www.instagram.com/dr.lindsayogle/] TikTok: https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1 [https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1] YouTube: https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg [https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg]

Weight Gain During Menopause With Dr. Komal Patil-Sisodia, MD

Dr. Komal Patil-Sisodia is a triple board certified endocrinologist & women's health specialist based out of Washington state. Website: eastsidemm.com [https://www.eastsidemm.com/about] Instagram: @drpatilsisodia [https://www.instagram.com/drpatilsisodia/] TikTok: @dr-komal-patil-sisodia [https://www.tiktok.com/discover/dr-komal-patil-sisodia] Menopause symptom questionnaire: Greene Climacteric Scale  Menopause is a single moment on the calendar, but the real story is the long runway leading up to it and the way your whole body can change while your lab work still looks “fine.” We sit down with triple board certified endocrinologist and women’s health specialist Dr. Komal Patil-Sisodia to define menopause, perimenopause, and post-menopause in plain language, then connect the dots to what so many women actually feel: unpredictable cycles, shifting mood, sleep problems, brain fog, palpitations, vaginal dryness, recurrent UTIs, and even joint and muscle changes that can show up in midlife. We also tackle the elephant in the room: why hormone replacement therapy became so controversial after the Women’s Health Initiative and how the headlines shaped two decades of care. Instead of absolutes, we focus on nuance and shared decision making, including why symptom relief is the primary goal, how to think about risk, and why the route of estrogen matters when discussing blood clot concerns. Finally, we get practical about metabolic health and weight management. HRT is not a weight loss drug, but it may help body composition in some women and there’s emerging research on pairing menopause hormone therapy with GLP-1 medications like tirzepatide for improved outcomes. If you’re navigating PCOS, prediabetes, diabetes, or obesity in perimenopause, you’ll hear why individualized care beats blanket advice and how to advocate for the support you deserve. Subscribe, share this with a friend who needs it, and leave a review so more women can find evidence-based menopause and metabolic health guidance. 👩🏼‍⚕️ Live in Missouri? Want to be my patient? Telehealth clinic: https://missourimetabolichealth.com [https://missourimetabolichealth.com/about-telehealth-clinic] 🥑 Have questions you want answered on the podcast? Email support@missourimetabolichealth.com ✨Freebies✨ Anti-Obesity Medication Options [https://drlindsayogle.kit.com/medications] How To Prevent Diabetes [https://drlindsayogle.ck.page/diabetes] Healthy Habits Workbook [https://drlindsayogle.kit.com/habits] Preventative Health Checklist [https://drlindsayogle.ck.page/1eecd5e72f] 🤗 Socials: Instagram: https://www.instagram.com/dr.lindsayogle/ [https://www.instagram.com/dr.lindsayogle/] TikTok: https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1 [https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1] YouTube: https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg [https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg]

Osteoporosis Screening And Prevention With Dr. Uzma Khan

Osteoporosis is one of those diagnoses that can hide in plain sight until the day a wrist snaps from a minor fall or a hip fracture changes everything. We sit down with Dr Uzma Khan, board-certified in internal medicine and endocrinology, to explain what osteoporosis and osteopenia actually mean inside the bone and why “no pain” does not mean “no risk.”  We talk through bone density screening with a clear, listener-friendly roadmap: when women should get a DEXA scan (typically starting at 65), when men should be screened (often starting at 70), and why earlier testing matters for ages 50 to 64 in women and 50 to 69 in men when risk factors show up. We cover the big red flags to bring up at your next visit, including family history, prior fractures, long-term prednisone or other steroids, smoking, vitamin D deficiency, celiac disease and other malabsorption issues, rheumatoid arthritis, diabetes, cancer therapies that lower estrogen or testosterone, and premature menopause.  Then we shift into prevention you can start today, no matter your age: building peak bone mass earlier in life, getting enough calcium from food, prioritizing protein and key minerals, and using vitamin D from diet and appropriate sun exposure to support absorption. We also share why walking helps, why resistance training is a bone-health multiplier, and how these habits overlap with better metabolic health overall.  Finally, we tackle a timely question: do GLP-1 receptor agonists like semaglutide affect bone density, or is the concern more about rapid weight loss, lower nutrition intake, and less mechanical loading on the skeleton? We discuss what current studies suggest, what remains unclear, and how to think about risk versus benefit with your prescriber. Subscribe, share this with someone you care about, and leave a review so more people can find reliable, practical health information. 👩🏼‍⚕️ Live in Missouri? Want to be my patient? Telehealth clinic: https://missourimetabolichealth.com [https://missourimetabolichealth.com/about-telehealth-clinic] 🥑 Have questions you want answered on the podcast? Email support@missourimetabolichealth.com ✨Freebies✨ Anti-Obesity Medication Options [https://drlindsayogle.kit.com/medications] How To Prevent Diabetes [https://drlindsayogle.ck.page/diabetes] Healthy Habits Workbook [https://drlindsayogle.kit.com/habits] Preventative Health Checklist [https://drlindsayogle.ck.page/1eecd5e72f] 🤗 Socials: Instagram: https://www.instagram.com/dr.lindsayogle/ [https://www.instagram.com/dr.lindsayogle/] TikTok: https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1 [https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1] YouTube: https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg [https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg]

Dietitian Advice on a GLP-1 with Steph Wagner, RD

Steph Wagner is a Registered Dietitian with 15 years of experience in bariatric surgery nutrition and now GLP-1 medications. She’s the owner and creator of Bariatric Food Coach, a comprehensive membership website for with resources, education and community for post-op surgical patients. Website: BariatricFoodCoach.com [http://BariatricFoodCoach.com] Instagram: @bariatricfoodcoach [https://www.instagram.com/bariatricfoodcoach/] Facebook: @bariatricfoodcoach [https://www.facebook.com/bariatricfoodcoach/] YouTube: @BariatricFoodCoach [https://www.youtube.com/@BariatricFoodCoach] Pinterest: bariatricfoodcoach [https://www.pinterest.com/bariatricfoodcoach/] Steph Wagner joins us to explain what changes when nutrition stops being simple and starts affecting your symptoms, your labs, and your day-to-day life. We break down how dietitians support bariatric patients and people on GLP-1 medications while keeping care realistic, compassionate, and personalized.  • knowing “healthy foods” versus building a plan that fits real life  • using a dietitian when obesity and chronic disease make nutrition confusing  • insurance coverage basics for dietitian visits and why Medicare rules frustrate patients  • bariatric surgery nutrition goals compared with GLP-1 nutrition goals  • managing GLP-1 side effects with protein timing meal texture and hydration  • differences we see between semaglutide and tirzepatide tolerance  • why a daily multivitamin often makes sense when intake drops  • watching for deficiency clues and using symptoms to guide targeted labs  • reducing triggers for people with disordered eating and screening for eating disorders  • common barriers like time shame and finding a provider who feels safe  • motivational interviewing as a way to set goals you actually own  • navigating diabetes meds and when to ask about GLP-1s and SGLT2 inhibitors  If you found this information helpful, please share with a friend, family member, or colleague. Please subscribe and write a review.  👩🏼‍⚕️ Live in Missouri? Want to be my patient? Telehealth clinic: https://missourimetabolichealth.com [https://missourimetabolichealth.com/about-telehealth-clinic] 🥑 Have questions you want answered on the podcast? Email support@missourimetabolichealth.com ✨Freebies✨ Anti-Obesity Medication Options [https://drlindsayogle.kit.com/medications] How To Prevent Diabetes [https://drlindsayogle.ck.page/diabetes] Healthy Habits Workbook [https://drlindsayogle.kit.com/habits] Preventative Health Checklist [https://drlindsayogle.ck.page/1eecd5e72f] 🤗 Socials: Instagram: https://www.instagram.com/dr.lindsayogle/ [https://www.instagram.com/dr.lindsayogle/] TikTok: https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1 [https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1] YouTube: https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg [https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg]

Medicare GLP-1 Bridge Program

Medicare’s new Bridge program could open access to GLP-1 medications starting July 1, 2026, with an expected $50 monthly copay for eligible beneficiaries. We walk through the exact qualification rules and the practical safety steps we use when prescribing GLP-1s for adults 65 and older.  • Medicare Bridge program timeline and why it could influence commercial insurance coverage  • How Bridge eligibility differs from FDA-approved GLP-1 indications  • BMI 35+ qualification and why highest documented BMI matters  • BMI 30+ plus qualifying conditions like heart failure, resistant hypertension, or CKD stage 3A+  • How to spot CKD in labs using eGFR on a BMP or CMP  • BMI 27+ pathways including prediabetes, prior heart attack or stroke, and symptomatic PAD  • PAD basics and symptoms to bring to your clinician  • Older adult safety basics including slow titration and avoiding dehydration  • Nutrition priorities including adequate calories, protein, and micronutrients  • Strength and mobility support through PT and beginner-friendly strength training  • Why medication doses for blood pressure and diabetes may need adjustment during weight loss  • Osteoporosis screening around age 65 and why it matters during GLP-1 treatment  If you found this information helpful, please share with a friend, family member, or colleague. Please subscribe and write a review. ------------------------------------------------------- Supportive GLP-1 Community:     Deb Cooperman TikTok [https://www.tiktok.com/discover/debcooperman]     The Plus SideZ Podcast [https://theplussidez.net/]     Mike on a Mission TikTok [https://www.tiktok.com/@mike.onamission2]     GLP1 Collective [https://glp1collective.org/] GLP Strong (accessible exercise) [https://www.glpstrong.com/] Dr. Uzma Khan, MD explains Osteoporosis  [https://modernmetabolichealth.buzzsprout.com/2513787/episodes/19333368-osteoporosis-screening-and-prevention-with-dr-uzma-khan] 👩🏼‍⚕️ Live in Missouri? Want to be my patient? Telehealth clinic: https://missourimetabolichealth.com [https://missourimetabolichealth.com/about-telehealth-clinic] 🥑 Have questions you want answered on the podcast? Email support@missourimetabolichealth.com ✨Freebies✨ Anti-Obesity Medication Options [https://drlindsayogle.kit.com/medications] How To Prevent Diabetes [https://drlindsayogle.ck.page/diabetes] Healthy Habits Workbook [https://drlindsayogle.kit.com/habits] Preventative Health Checklist [https://drlindsayogle.ck.page/1eecd5e72f] 🤗 Socials: Instagram: https://www.instagram.com/dr.lindsayogle/ [https://www.instagram.com/dr.lindsayogle/] TikTok: https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1 [https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1] YouTube: https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg [https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg]