Dr. Ian Justl Ellis, physician and founder of VoFit, joins Bo to break down GLP-1 weight-loss medications, why patients can experience significant side effects, and how he approaches precision dosing. Dr. Ellis explains that because these medications have long half-lives, drug levels can continue accumulating even when the weekly dose stays the same—potentially pushing a patient beyond what he calls their therapeutic “sweet spot.” 

They explore semaglutide, tirzepatide, retatrutide, appetite suppression, nutrition, muscle preservation, body composition, and peptide therapies. Dr. Ellis also shares his own experience with GLP-1s and describes the level-based dosing system and app he developed to calculate medication levels and individualized dosing. 

Guest Resources

Website: voafit.com
MyLevel: voafit.com/mylevel
Consultation: go.voafit.com
Social Media: @voafitmd 

Value Bombs

More Medication Isn’t Necessarily Better: Dr. Ellis argues that excessive GLP-1 dosing can create nausea, reflux, vomiting, diarrhea, food aversion, and difficulty consuming adequate nutrition. 

Your Dose and Your Drug Level Aren’t the Same Thing: Because semaglutide has a long half-life, some of the previous dose remains when the next weekly dose is taken. Dr. Ellis says understanding that accumulation is critical to understanding why the same dose can feel different from week to week. 

Find the Sweet Spot: His goal is to identify a level that provides appetite suppression and continued weight-loss progress without making the patient sick or preventing adequate protein and plant intake. 

Escalation Shouldn’t Be Automatic: Dr. Ellis says his protocol increases a patient’s target level only after progress plateaus, and then makes comparatively small adjustments rather than automatically doubling or rapidly escalating doses. 

Less Drug, Strong Results: Dr. Ellis reports that in a review of his first 114 consecutive patients using level-based dosing, patients lost weight faster than the trial comparison while using less than half the average medication, with no patients in that cohort quitting because of side effects. 

Protecting Muscle Matters: He emphasizes maintaining enough nutrition—particularly protein—alongside exercise and appropriate dosing rather than pursuing weight loss through extreme appetite suppression. 

Smaller, More Frequent Dosing Is Part of His Approach: Rather than allowing medication effects to swing dramatically over a week, Dr. Ellis describes using calculated, potentially more frequent doses designed to return an individual to their target level. 

The Goal Isn’t Just Losing Weight: Dr. Ellis describes the broader objective as improving body composition—reducing excess body fat while preserving or potentially improving strength and muscle mass through appropriate nutrition, exercise, and medical management. 

Sponsors

Grit Fitness
Elevate your fitness with cutting-edge training and expert coaching.

D3 Capital
Unlock sophisticated investment strategies designed to protect and grow your wealth.

Show Notes

00:00 – Meet Dr. Ian Justl Ellis, VoFit, and why he focuses on precision GLP-1 dosing

02:00 – What happens when patients discontinue GLP-1 medications and why maintaining results can be difficult

03:00 – Semaglutide, tirzepatide, retatrutide, and the differences Dr. Ellis sees between them

05:00 – Appetite suppression, gastric emptying, nausea, food aversion, and the consequences of excessive dosing

07:00 – Tirzepatide, GIP receptors, insulin resistance, blood sugar, and tolerability

09:00 – Retatrutide, appetite, metabolic rate, fat loss, and why Dr. Ellis finds the drug interesting

11:00 – Retatrutide’s investigational status and Dr. Ellis’s perspective on prescribing it

15:00 – Physicians, pharmacies, FDA oversight, and the responsibilities Dr. Ellis believes providers have

18:00 – Why these medications require active medical management

20:00 – The GLP-1 half-life problem and why weekly doses can accumulate

22:00 – Why patients can feel great one week and terrible the next while taking the same dose

24:00 – Clinical-trial dosing versus finding the right therapeutic level for an individual

25:00 – Finding the GLP-1 “sweet spot”: appetite control without excessive side effects

26:00 – Dr. Ellis’s personal experience with semaglutide and how it changed his thinking about dosing

27:00 – Losing 30 pounds but seeing an unfavorable lean-tissue-to-fat-loss outcome

28:00 – How he began calculating medication levels manually and developing his own protocol

29:00 – Minimum effective levels and making small adjustments when weight loss plateaus

30:00 – Results Dr. Ellis reports from his first 114 patients using level-based dosing

32:00 – The MyLevel app and automating individualized GLP-1 calculations

33:00 – Muscle loss, body composition, and what Dr. Ellis learned from his own experience

35:00 – Tesamorelin, growth hormone production, and Dr. Ellis’s body-recomposition experience

38:00 – How his background in emergency medicine shaped his initial view of off-label treatments

39:00 – Peptide therapies and why his perspective on them changed

41:00 – Strength, skeletal muscle mass, and the results Dr. Ellis says he experienced

42:00 – Cycling off GLP therapy and maintaining his body-composition changes

44:00 – Nutrition, exercise, testosterone, HGH secretagogues, and a broader approach to body composition

46:00 – Why excessive appetite suppression can make it difficult to eat enough calories and protein

48:00 – The cycle of overeating, undereating, weekly dosing, and muscle loss

49:00 – Dr. Ellis’s case for smaller, more frequent, individually calculated dosing

50:00 – Keeping doses low, avoiding side effects, and potentially transitioning off medication

51:00 – The MyLevel app, patient safety, and how to learn more about VoFit

52:00 – Where to connect with Dr. Ellis

Killer Resources

VoFit: Dr. Ellis’s clinic specializing in precision dosing of GLP-1 weight-loss medications. 

MyLevel: Dr. Ellis’s system for calculating medication levels and determining the dose needed to reach a patient’s selected target level. 

D3 Capital eBook: Master tax reduction and long-term wealth strategies.

Grit Fitness Blog: Training, recovery, and performance insights from elite coaches.

Health & Performance Picks

Don’t Chase the Highest Dose: The central argument of the episode is that the goal should be finding an individualized effective level rather than automatically progressing toward a maximum dose.

Prioritize Protein and Nutrition: Appetite suppression isn’t automatically a win if it becomes so extreme that adequate protein, micronutrients, and calories become difficult to consume. 

Pay Attention to Body Composition: Scale weight alone doesn’t tell the full story. Dr. Ellis uses his own first GLP-1 experience—where he says much of the weight he lost was lean tissue—to illustrate why preserving lean mass matters. 

Pair Medication With Training: Dr. Ellis repeatedly emphasizes nutrition and exercise as important components of achieving a better body-composition outcome rather than relying on medication alone. 

Work With a Qualified Medical Provider: These are powerful medications, and Dr. Ellis strongly recommends working with a physician who actively manages the patient’s treatment rather than simply supplying medication. 

Like This Episode?

Subscribe to Raw and Relentless on your favorite podcast platform.