Modern Metabolic Health with Dr. Lindsay Ogle, MD
Join Dr. Lindsay Ogle, a board certified family medicine and obesity medicine physician, as she explores evidence-based strategies and practical tips to prevent and treat weight and metabolic conditions. Dr. Ogle provides insights on managing diabetes, PCOS, metabolic syndrome, obesity and related conditions through lifestyle optimization, safe medications and personalized care.
Modern Metabolic Health with Dr. Lindsay Ogle, MD
Breaking Weight Loss Plateaus With Dr. Matthea Rentea, MD
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Dr. Matthea Rentea is a double board certified physician in Internal Medicine and Obesity Medicine. She owns the Rentea Metabolic Clinic, a comprehensive Telehealth obesity medicine clinic for residents of Indiana and Illinois. She is the host of the 20+ ranked podcast The Obesity Guide with Matthea Rentea MD.
Website: RenteaClinic.com
TikTok: @matthearenteamd
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The scale can be cruel: you’re drinking the water, hitting protein, moving your body, and showing up week after week… and then nothing happens. That moment makes smart, motivated people feel like they’re broken. We’re not buying that story. We sit down with Dr. Matea Rentilla, a double board-certified internal medicine and obesity medicine physician, to explain what a true weight loss plateau is, how long it needs to last to “count,” and why it’s often your physiology adapting rather than your effort failing.
We dig into why body composition matters so much when scale weight is stagnant. If you’re losing fat and preserving muscle, your metabolic health is improving even if the number looks frozen. From there we get practical: a 14-day data audit that tracks what you eat and when you eat it, plus hydration, sleep, movement, and daily stress. The goal is not obsessive tracking or shame. It’s pattern-finding, then choosing one realistic 10% change you can actually keep.
We also tackle plateau myths fueled by diet culture and social media, like doubling down on restriction, adding more intense workouts, or stopping GLP-1 medications to “restart” weight loss. We talk about stress, cortisol, hunger signals, and why maintenance is not a defeat. If you want evidence-based obesity medicine guidance, a calmer mindset, and strategies for sustainable weight loss and long-term weight maintenance, this conversation is for you.
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Welcome And Medical Disclaimer
SPEAKER_01Welcome to the Modern Metabolic Health Podcast with your host, Dr. Lindsay Ogle, Ford Certified Family Medicine and Obesity Medicine Physician. Here we learn how we can treat and prevent modern metabolic conditions such as diabetes, PCOS, fatty liver disease, metabolic syndrome, sleep apnea, and more. We focus on optimizing lifestyle while utilizing safe and effective medical treatment. Please remember that while I am a physician, I am not your physician. Everything discussed here is provided as general medical knowledge and not direct medical advice. Please talk to your doctor about what is best for you.
SPEAKER_00I am so excited. Today's guest is Dr. Matea Rentilla. She is an amazing double board certified internal medicine and obesity medicine physician, and she sees patients in Indiana and Illinois through her clinic on the Rentilla Metabolic Clinic. And she sees patients virtually in those two states. She also has a wonderful podcast, The Obesity Guide with Matea Rentilla. And I have personally listened to all of her podcasts. She has great information, practical knowledge that you can apply. And she was gracious enough to have me on a couple of months ago to talk about wellness and wellness exams and screenings. And I'm so excited to have her on today to share more knowledge. And we're going
What A True Plateau Looks Like
SPEAKER_00to talk about a really important topic: weight loss plateaus.
SPEAKER_02Thank you so much for having me on. I love watching the interviews that you're doing with everybody.
SPEAKER_00Thank you. So I'd love to hear, um, I guess we'll just start with what um a weight loss weight loss plateau is and what's actually going on in the background. Is it biological? Is it behavioral? What's happening?
SPEAKER_02Yeah, I so what I want to say with this is there's not a standard definition of a weight loss plateau, right? So that's what's tricky is that I'll say what I think, but we could get five obesity medicine physicians in the room and everyone would disagree. So I I do think that the first thing that really uh needs to be looked at here is that you are consistently doing the behaviors for weeks on end and nothing is changing. And I'm talking nothing. So I would say for my clinic, it's at least three to four weeks. So we kind of reach that month mark and you're consistently hitting the water goals, the exercise goals, the nutrition. It's not like, oh, well, two, three days a week, things are kind of happening in a way I don't know what's happening. I'm kind of out of control. And then the other days I'm okay. It's really you're always sort of doing those things and nothing is moving. And this is really usually when when the behaviors are in place and nothing's been moving, it's a biologic thing that's happening. So your body is sort of usually getting to a place where it says, I would rather not really release anymore right now. And people fight this. It's normal, it's natural to get to plateaus. And what I find is because this is a time when your hormones can reset during that time. So, for example, like ghrelin that says you're hungry, start eating. Sometimes ghrelin can calm down some. Uh, you know, you can sometimes cortisol levels can go down because you can be quite stressed actually, losing a bunch of weight. You're normally like exercising a lot and you know, doing a ton of things that put stress on the body. And so I would say for four weeks, you are doing all the things, nothing is moving. And I'm talking recompositions are not happening, like body fat's not going down, muscles not going up, inches are not going down, nothing is changing. That would be what I would define as a weight loss plateau.
SPEAKER_00Thank you so much for going over that. That is really helpful information. And I know, you know, so many people are really just looking at the number on the scale. And like you mentioned, there is so much more going on. And I know you do a lot of body composition analysis with your patients.
Scale Weight Versus Body Composition
SPEAKER_00I think that's very important to get a true and accurate picture of what's happening because the number on the scale may be stagnant, but actually there's some recomposition happening, and that's a positive thing.
SPEAKER_02Yes. And people, uh, whenever they're using body composition, they're so grateful to know that because they think nothing has changed, right? So everyone that's listening, what we're talking about is uh last month compared to this month, the net number, meaning when you just happen a scale, the number you're seeing looks the same, but they might have lost a pound of fat and put on a pound of muscle. That is you heading in a healthy direction. That is actually hard work, but you're thinking nothing's different, but really you got healthier. And if you were to keep sticking with that, even if nothing else changed and you kept going in that direction, in a few years, you'd be in a radically different spot.
SPEAKER_00Absolutely. That's so powerful. And I can imagine when somebody hits a weight loss plateau or a stall or whatever you want to call it, that is incredibly frustrating and can be demoralizing, especially if we um are not looking at body composition or if we are and that hasn't been changing either. Um, do you have any, you know, go-to recommendations for your patients when they reach a weight loss plateau?
SPEAKER_02Yeah. So, first of all, 100% what you're saying, how
The Two Week Data Reset
SPEAKER_02people are so discouraged. Because you're everyone's working hard, right? It's like there's so many things that have to change to ever get any traction. So, all right, let's say you notice that you're you're at a stall or plateau. I would like to use the term instead of that that you're maintaining. So instead of being like, I'm stalled, like when we say that, it's it's it's so dramatic, it makes us feel shame. Like it's just so many things. So I like to say you've been maintaining, which is beautiful, by the way, because if you look at data, most people are gaining, not maintaining. So you have figured out how to maintain, yay to that. So I always say we come back to the data. So this is a time to let our emotions to the side a little bit, kind of put that down and come back to data. So my recommendation would be about a two-week period, 14 days. Can you track what you're eating, not only what you're eating, but when you're eating it? Uh, hydration, your sleep, your stress levels, rate it one to 10 every day, you know, because you you might have a period where you're super stressed, and you can see that with the data. So you do this for two weeks, and you don't even necessarily need to measure and weigh everything. What we're really first trying to look for when you write out those two weeks, it's not to shame or make radical changes at first, it's to be able to find patterns. So the problem is when we look back, like hindsight with our brain, we think, uh, we think we're really accurate at what we're uh kind of pulling out, and we're usually not. So when we have it written out, we can say, oh, look at this. Every single evening, I'm having a snack at night when I'm not hungry, or I've been starting to like double up on whatever portion, or my hydration fell off a cliff. Like I thought I was doing great in the winter, I really prioritize it. Suddenly in the summer I forgot it exists, right? Or vice versa. And so you look through there, and then I would say you take one thing and you look for a 10% change. So that could be my step count is this, and I'm gonna increase it by so much. Um, my hydration is this, and I increase it by two cups. It's
Find Patterns Then Make 10% Changes
SPEAKER_02not radical shifts in everything. You can't maintain it. So once you have those two weeks, what's the one area that I think it would give me some traction? What's the 10% change? And then you repeat the process. Um, maybe, you know, do it, putting that uh thing into place for a few weeks and then you look back. Did it make a difference or not? And you look at the data, not do I feel it's different or not, what is the data actually showing me? That's always, I always say it tells the truth. What's happening?
SPEAKER_00Yeah, absolutely. I love everything you just said, and I want to go back to what you said in the beginning about just using different terminology instead of saying a weight loss plateau or a stall, like you said, that has a negative connotation to it. But really, if we frame it as weight maintenance, which we know in the field of obesity medicine is sometimes the hardest part and often is the hardest part. And I just did a podcast with um the plus sides podcast uh earlier this week that was great. I'm so excited for it to come out. But we kind of touched on this and how um if we, you know, if we get to a weight loss plateau and um reframing that mindset and what if we did maintain, you know, moving forward, how much healthier we would be long term, that big picture versus if we were going back to kind of like the yo-yo dieting that was happening before we had, you know, our really effective tools like our GLP1 agonist. Um, because previously, you know, the weight maintenance was so difficult to achieve. And now we're actually getting to a point where so many people are able to get to that point where the weight maintenance is really the goal and you know where people are at. And so I think it's we're just not used to it. Totally.
SPEAKER_02It wasn't achievable before, right? At least I'll speak to my own journey because I'm a patient as much as I am a physician with this, and I could never maintain what I had lost. It didn't matter how little or little or big, it was like it would be like two seconds of staying there be right back up, right? So the the fact of maintaining it, it is a big deal, but I know that everyone always wants it to go quicker. Like there's this uh push. I actually asked this online the other day and I got some really interesting responses, but I said, why the urgency? Like, what is this where we uh within a year need to have lost a hundred pounds? And people had a lot of good responses, but at the end of the day, I don't think
Reframing Plateaus As Maintenance
SPEAKER_02people quite realize what a lifetime commitment this is. Like this disease unfortunately isn't going anywhere. And so we have to manage it for life. So the quicker we can get on board that there's gonna be times when things don't move, there's gonna be times when I'm frustrated, there's gonna be maybe some uh like backslides involved, you know, some regains for valid reasons. And the quicker we can get on board with that, I think we move past the things a lot quicker when we stop like resisting. It's actually like a lot of energy to be resisting things.
SPEAKER_00Absolutely. And I'd love to hear your thoughts on how beneficial it could be to work with an obesity medicine physician or, you know, a really great primary care physician, or you know, just having a healthcare team during, you know, the long haul of managing the chronic disease of obesity. Totally.
SPEAKER_02I so the thing is when you're not working with a specialist, they can write you a medication, they can kind of see you, I don't know, every three months, six months, you know, things like that. The problem is the challenges are endless in weight care. Especially, I would say, and I wonder what your thoughts are on this, but especially in the first two years, and especially the first six months to year. I mean, that's just like a hotbed zone, right? Like side effects and all of that, but also the mental mindset of like, how do I keep going? What pivots can be made? Um, and
Why A Specialist Team Helps
SPEAKER_02so when you work with someone, instead of something uh thinking, oh, this medication doesn't work for me, or oh, I'm doing all these things and they're not working, we're able to just constantly pivot and make changes because we have a lot more in our toolbox compared to someone that's not doing this all day long. And I think that people think it's just a med. And it's like, uh no, there's about like a thousand other tools. And so that person can adjust things for you more, can help you realize that you're not alone, can help reframe things. Like this is literally 90% of what I'm doing monthly in the uh clinic with my patients. It's looking at the data, they think it's not that good. I literally just had a visit with someone since February. They've lost 20 pounds of fat and only half a pound of muscle. That's phenomenal. Like, that's phenomenal. And they're like, well, I didn't know. And I'm like, listen, I was like, because they're like, oh, you're not gonna be happy with me because the muscle had gone down a little, right? And I was like, no, I'm very right. I'm like, I'm very happy. This is so good compared to the sort of like national averages that we would expect with muscle loss. So when you're working with someone, I find people make faster progress long term, they feel really capable and secure instead of feeling like at any moment the weight's coming back. Cause that's a real concern with people that they they feel like at any moment they're just like stumble on the weight returning, right? And they don't realize, like I call it this list of a hundred. You are doing so many things to get a different result, but when you're not working with a specialist, you don't realize all that. And then very quickly you go back to things that don't support you.
SPEAKER_00Yeah, a hundred percent. And what I see often in my practice is that um, well, a couple of things. Patients are often comparing their journey to others that they're seeing on social media or their friends or family members. And, you know, as you know, everybody is different, even if you're on the same dose of the same medication, you're gonna have a different response. And that's okay because you have a different biology and you know, other factors in your life. So that is something I'm constantly reminding people is that you know, we're gonna have different, a different journey, and and that's okay because we're tailoring your treatment to you and what's best for you. And also I see the kind of like the finish line or the goal move over time. And I have to remind people where we started and what that initial goal was because often they're already past that initial goal, but they're still frustrated because you know they've seen that success and they've, you know, had that change and then they changed the goal. But we need to acknowledge and celebrate the fact that, you know, we have already got that initial goal. And because we've done so well, then you know, that new goal popped up, which is okay and that may be appropriate, but you didn't fail because you haven't reached the second or third goal that you created for yourself.
SPEAKER_02Totally. You know, something that you bring up this where the goalpost moves, because I see this too with every single patient. I think it's really important when you're starting, I call it a weight care journey, but when you're starting this journey, you need to write down an inventory of where things stand at that moment because I want you, like I want you to write down things like I'm waking up a lot at night, my sleep quality is bad, my knees are hurting, it's hard to breathe when I walk. I uh went to the kids' school and couldn't walk the whole field during field day, whatever these things are, because you're gonna forget it in a hot second. And then you don't know how far you've come and you can celebrate that. You can come back to that at any time. But if you never wrote it down, it's really hard to sort of like retrospectively go back and try to remember because we just don't have great brains with memory.
SPEAKER_00No, and I think that that's why working with a physician who is solely focused on that is gonna be so beneficial because, you know, I think most of us try to keep detailed notes and we know what your symptoms were in the beginning and we're able to compare that over time and you know, remind you of, you know, those non-scale victories as well, which are so important. I would love to hear some of the myths
The Restrict More Myth
SPEAKER_00that you've heard about weight loss plateaus or maintenance phase, or whether that's why it's happening or strategies to overcome it and why they're not true, and then maybe some better ways to approach it.
SPEAKER_02I I think probably if I had to think about kind of like myths or like the things that people think are needed, but that a lot of the time don't work, but it's counterintuitive, right? Would be that people think that more restriction is always the answer. So they assume because we've really been indoctrinated with this calories in and calories out, which I'm not denying the realities of energy, right? But but there's a lot of factors that go into our weight set point and things like that. And so people, their first reaction is restrict more and exercise more. So restrict the food and exercise more. And what's interesting is sometimes, a lot of the time, the reason you even got into the plateau is because your body's overly stressed. Like it's a stress to even lose weight, to have that fat release. It's a stress, uh, some of the things that you're asking yourself, you might be waking up earlier in the morning to exercise. There's a lot that's going on. And so when you then push even harder, your body's like, now we're gonna shut down even more. So that's what I see is that instead of like the best results I see are when people just, I'm gonna use the term chill out, very medical, but but it's like ironically, it's like, let's not uh strength train five days a week. Let's cut that back a little bit. Let's take some, just let's call it low cortisol walks. Let's let's do some walks, let's do some swimming, let's do other things, let's get you um other hobbies to relax. Let's actually take the focus off of this for a moment. Not that we're abandoning self. I always say, I'm like, we're still doing nutrition, we're still doing these things, but we change the focus. And a lot of the time, even that stress reduction helps people to keep going. Um, and you're able to see more clearly what it is you want to do. But this instant reaction of I decrease food and I increase movement, that's not necessarily the answer that's gonna get people there. That's the biggest one I see. Um, what do what do you typically like? What are people's reaction in your clinic when they reach that?
SPEAKER_00Yeah, I think that's the number one as well that I see. And that's just you know, diet culture ingrained in all of us. Um, and also what we sometimes hear on social media. Um, I also want to mention, I guess, kind of on social media and thinking about the stress response. I've had a few patients recently who just clearly, and they they, you know, voice it, and it's also clear to me when they're talking, is they they just they just are in inundated with so much information, so much advice from all different angles and different perspectives, some of it evidence-based, some of it not, and they are stressed out that they are making the wrong decision and they're hurting their adrenal glands or whatever. And it it just is it's negatively impacting them. And I my advice is just to, you know, stop, stop following all of these people and listen to yourself. You know, they have they already have all the knowledge that they need, and we just need to pare it down and you know, focus on the things that are really gonna have the biggest impact.
Social Media Misinformation And Med Breaks
SPEAKER_00And those are the simple things. We we don't need to be worried about, you know, every single plastic that's you know hitting our bodies or anything like that. Um, so I that's something that I've been seeing, you know, a lot lately.
SPEAKER_02Yeah, it's so true. I feel like, and then they'll they'll catch weird trends that are happening. So, like, I don't know if you uh ever talked about this here recently, but there was this period where people were like, stop the meds and then come back to it a month later and restart the titration. And I never see it happen worse than when we have to do that with someone. And that's for bad reasons, right? Like they'll get a surgery or you know, the there's different scenarios where that would be medically needed, but people think that that quote unquote jump starts things. And I'm like, that can't be further from the truth. But one person did it, that went viral, and then now everyone thinks that that's the case. And so I feel like um what you're talking about with the taking breaks from social, you just have to because every every video or thought that you're hearing, you have to manage it when it comes in. That's a lot to manage, especially when everyone's in a different direction with what they're doing.
SPEAKER_00Well, um, and I think the other thing I would say with you know, stopping the medicine and then maybe restarting later on, another myth I, you know, see would be that people say that the medicine is no longer working. And, you know, I'm not losing any more weight. So the medicine's not working. And that's not true. The medicine is working, the medicine is still helping with appetite suppression, helping with fullness, helping offset insulin resistance, and it's helping you maintain. And that's how, you know, every other in primary care, that's how every other chronic medicine works, you know, for chronic conditions like high blood pressure or cholesterol. They don't keep um treating that chronic condition until you know whatever it's treating goes down to zero. It gets it controlled. Um, and so the same thing with our medications for obesity. And then if we still are not at our goal, whatever that is, that you decide, you know, as a patient and with your healthcare provider, then sometimes we do need to add on another medication. And it's so it's adding and not substituting.
SPEAKER_02Totally. I think when you're going on this journey on the way up, not relying on, oh, I'm so super suppressed, I can hardly eat. That's not what we're going for. And so if you there are some of my patients that they love that, right? Like on the way up, they're like, oh my, I really feel it's working. I'm like, let's not fall in love with that. And let's make sure that the dose is low enough where you're getting in whole-based foods. We want it as a tool. It's a help metabolically, but this is not, we create disordered eating where you're not eating and suddenly you think that that's amazing, that you know, that's when the scale drops. It's like that's not sustainable long term. You lose muscle that way, it's not healthy. Oh, I mean, there's many ways in which that's problematic, but that is not the reason that we're using the medications. And I think that gets glorified online as well. This, like, I couldn't
When Medication Is Still Working
SPEAKER_02eat, I forgot to eat for three days. It's like, no, that's not amazing at all. That's unhealthy.
SPEAKER_00No, no, not good, not good. Um, well, thank you so much for taking the time to talk about this important topic. Um, do you have any last thoughts or any, you know, words of hope for patients who may be on this journey and maybe in maintenance phase?
SPEAKER_02I I'm gonna provide my own story here for a second because I think that I think, and again, I feel like part of what we've talked about here, how social kind of messes us up. So my journey has been something I've been working on my weight set point for about six years now. And it was like, it was like 10 pounds a year, 10 pounds a year, 10 pounds a year, 20 pounds, 30 pounds. The point is, just keep going. Just because you have months on end where the scale is not changing, you can still be working on habits. You can still be becoming a different person. It doesn't mean that that's where you're gonna stay. So part of what you need to work on is the belief that you are going to be a different person, that you are really solidifying things, that it's no longer a question anymore that you get your protein or that you get your fiber or that you do your morning walk, whatever it looks like for you in your scenario, you keep moving forward regardless. And the length of time that you're in that maintenance phase, it's not an indication of where you're gonna land long term. And I think that that's something really important to hear because I think sometimes we hear data like, well, within the first six months to one year, that's where you're gonna end up. I don't find that to be true. The people that keep going, like I had a patient say to me one time, she said, there is no option to stop. She's like, you know, I'm gonna keep coming to visits, I'm gonna keep doing stuff. That's the attitude of the person that's gonna make it long term because this requires every day a renewal of commitment to what you're doing. And so don't let the length of the stall, the plateau, whatever name you want to give it, don't let that define you. Every day there's a new sense of you can keep going and make this happen. So I just talk about my own story because like I don't hear anyone talk about it in that way where I feel like I just keep going. And um, I think that that's really important for people to hear that it doesn't have to be this one person that
Staying The Course And Where To Follow
SPEAKER_02loses a hundred in a year. You can keep going, you can still reach your goals.
SPEAKER_00Thank you so much for that. And thank you for being vulnerable and sharing your story. I think it's very helpful for many people who um may be likely to give up if they're not having those results that they see other people have, those immediate results. But again, we're thinking big picture, your lifelong health. And that's what our focus is in obesity medicine. Um, so thank you so much again. And how can people find you if they want to find reliable and helpful information on socials?
SPEAKER_02Yeah, so I spent a lot of my time on TikTok, but TikTok and Instagram, I have the same username. It's Matea Rentia MD on both of those. And then the best place to find me is really on my website, rentiaclinic.com. And it uh there, if you click on uh podcast, you can find the links to Apple and Spotify and all of that. And I really, my podcast, The Obesity Guy was Matea Rentia MD, I put a lot of energy into it because I really think that, you know, just like the work you're doing, we do not have enough evidence-based, compassionate knowledge, but that's also like interesting and you actually want to listen to, right? And so if that's something where you're looking for sort of like continued support, I think that that would be a good resource for people.
SPEAKER_01Thank you for listening and learning how you can improve your metabolic health in this modern world. 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. I look forward to our conversation next week.