“It takes five or six doses to reach equilibrium.” — Dr. Ian Ellis

In this episode of Compound Wisdom, Steve Suen sits down with Dr. Ian Ellis — former ER physician, fitness specialist, and founder of a multi-state telehealth clinic — to break down what most people misunderstand about GLP-1 medications and why standard dosing protocols often lead to unnecessary side effects, muscle loss, and early drop-off. Instead of fixed weekly dose ladders, Dr. Ellis argues for a pharmacokinetic, level-based model that targets the exact drug concentration where a patient feels and functions best.

Dr. Ellis shares his personal journey from obsessive fitness and disordered eating patterns through emergency medicine burnout and significant weight gain, to discovering GLP-1 therapy firsthand. His early experience with semaglutide produced dramatic appetite control — but also severe side effects and unexpected muscle loss under standard dosing. That failure pushed him to study the drug’s half-life and accumulation curves, leading to a key insight: each weekly dose stacks on top of what’s already in the body, meaning patients are often escalating into overdose territory without realizing it.

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From there, the conversation turns practical and technical. Dr. Ellis explains his “My Level” dosing approach — a calculator-driven system that models drug levels in the body and adjusts each dose to return patients to their personal sweet spot instead of blindly increasing amounts. He describes how this method helps patients use significantly less medication, experience fewer side effects, retain more muscle mass, and stay on therapy longer — while still matching or exceeding expected weight-loss outcomes.

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They also cover real-world scenarios most protocols don’t handle well: travel timing, missed doses, running out of medication, and plateau phases. Dr. Ellis explains why standard instructions fail in these cases and how level-targeted dosing provides precise catch-up and adjustment strategies. The broader theme is that GLP-1 drugs are powerful but narrow-window tools — and without precision, the industry risks creating a thinner but weaker, less functional population instead of a healthier one.

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The throughline of the episode is straightforward: GLP-1s are potentially transformative, but only if dosing becomes individualized, data-driven, and physiology-aware rather than schedule-based.

1. Dr. Ian Ellis is a former ER physician who left emergency medicine to focus on metabolic and longevity care.
2. He founded a telehealth clinic focused on GLP-1s, peptides, and regenerative health.
3. His interest in weight and fitness began in his teens and evolved into extreme dieting patterns.
4. He describes a long period of obsessive training, restriction, and rebound weight gain.
5. Medical school, residency, and family pressures led to major weight gain and burnout.
6. He first used semaglutide under a standard dosing ladder without tight supervision.
7. Early GLP-1 use reduced appetite dramatically but triggered escalating side effects.
8. Weekly GLP-1 dosing stacks because half the drug is still present at the next dose.
9. Patients reach higher...