By Dr. Evelyn Le Ellis, ND, MPH, FAIHM | Prolific Well Integrative Medicine

Your metabolism influences much more than your weight. It affects how your body uses energy, regulates blood sugar, processes fats, maintains muscle, and supports cardiovascular and liver health.

You may be eating healthier but still struggling to lose weight. Perhaps your blood sugar is creeping higher, your cholesterol is elevated, or your doctor has mentioned insulin resistance, prediabetes, or fatty liver disease.

These concerns often overlap, but they do not all have the same cause or treatment.

At Prolific Well Integrative Medicine in Olympia, Washington, I provide personalized metabolic health and medical weight management care for women and men. My approach combines medical evaluation, laboratory testing, clinical nutrition, physical activity, lifestyle medicine, and prescription treatment when appropriate.

My goal is not simply to help you lose pounds. It is to help you understand your metabolic health, reduce preventable disease risks, preserve muscle, and build habits that support healthy aging.

Schedule a Metabolic Health & Weight Management Consultation

What Is Metabolic Health?

Metabolic health refers to how effectively your body regulates blood sugar, blood pressure, blood lipids, and other processes involved in energy use and cardiovascular health.

Metabolic health is influenced by genetics, nutrition, physical activity, sleep, medications, age, and certain medical conditions.

Common metabolic health concerns include:

• Prediabetes and type 2 diabetes

• Insulin resistance

• Metabolic syndrome

• Excess abdominal fat

• High triglycerides or cholesterol

• High blood pressure

• Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly called nonalcoholic fatty liver disease

• Weight gain or difficulty managing weight

A person can have metabolic risk factors at almost any body size.

That is why I evaluate more than body weight or body mass index (BMI). We also consider blood pressure, glucose, cholesterol, medical history, and other clinically relevant findings.

What Metabolic Health & Weight Management Services Does Prolific Well Offer?

1. Prediabetes, Type 2 Diabetes & Blood Sugar Management

Prediabetes occurs when blood sugar levels are above the normal range but below the threshold for diabetes.

Type 2 diabetes develops when the body cannot maintain normal blood glucose regulation, often involving insulin resistance and changes in pancreatic insulin production.

What are the signs of high blood sugar?

Many people with prediabetes have no symptoms.

When blood sugar becomes significantly elevated, symptoms may include:

• Increased thirst

• Frequent urination

• Fatigue

• Blurred vision

• Unexplained weight changes

• Slow-healing wounds

Diabetes is diagnosed using established criteria, including hemoglobin A1c, fasting plasma glucose, oral glucose tolerance testing, or random plasma glucose with classic symptoms.

For reference:

TestPrediabetesDiabetesHemoglobin A1c5.7–6.4%6.5% or higherFasting plasma glucose100–125 mg/dL126 mg/dL or higher2-hour glucose after a 75-g oral glucose tolerance test140–199 mg/dL200 mg/dL or higher

In the absence of unequivocal hyperglycemia, diabetes diagnosis generally requires confirmation.

At Prolific Well, management may include individualized nutrition, physical activity, weight management, medication review, appropriate prescriptions, and monitoring.

For people with established diabetes, we also consider cardiovascular, kidney, eye, and nerve health, with referrals and coordinated care when needed.

Why is early treatment important?

Addressing prediabetes and metabolic risk factors can reduce the likelihood of progression to type 2 diabetes. Lifestyle interventions are especially valuable, and some patients may benefit from medication.

2. Insulin Resistance & Metabolic Syndrome

Insulin is a hormone that helps move glucose from the bloodstream into cells.

Insulin resistance occurs when cells respond less effectively to insulin, requiring the body to produce more insulin to maintain glucose regulation.

Over time, insulin resistance can contribute to prediabetes, type 2 diabetes, and other metabolic concerns.

Metabolic syndrome describes a cluster of risk factors that commonly include:

• Increased waist circumference

• Elevated triglycerides

• Low HDL cholesterol

• Elevated blood pressure

• Elevated fasting glucose

Typically, three or more qualifying risk factors are used to identify metabolic syndrome, with thresholds depending on the clinical criteria and population.

How do you know if you have insulin resistance?

There is no single routinely recommended blood test that diagnoses insulin resistance in every patient.

Assessment often focuses on clinical history, waist circumference, glucose or A1c, lipid levels, blood pressure, and associated conditions.

Fasting insulin or other specialized markers may occasionally provide additional context, but they are not universally necessary or standardized for routine diagnosis.

Treatment focuses on improving metabolic risk through appropriate nutrition, physical activity, sleep, weight management when indicated, and medications for specific conditions.

3. Weight Gain & Difficulty Losing Weight

Weight regulation is influenced by multiple biological and environmental factors.

These may include:

• Genetics and age

• Appetite and satiety signaling

• Dietary intake and food environment

• Physical activity and muscle mass

• Sleep duration and sleep disorders

• Medications

• Menopause and other hormonal transitions

• Thyroid disease when present

• Stress and behavioral factors

• Certain endocrine or metabolic conditions

Why am I gaining weight even though I eat healthy?

Healthy food choices matter, but total energy intake, portion sizes, activity, sleep, medications, and underlying health conditions can also influence weight.

A weight-management evaluation should not assume that everyone has a hormonal disorder or that weight gain is simply a lack of discipline.

At Prolific Well, I review your health history, medications, lifestyle, metabolic risk factors, and goals before recommending a plan.

For some patients, weight reduction is medically appropriate. For others, improving glucose control, cardiovascular fitness, strength, or nutritional adequacy may be the more important priority.

The goal is improved health, not an arbitrary number on the scale.

4. High Cholesterol & Triglycerides

Cholesterol and triglycerides are fats carried in the bloodstream.

They play different physiological roles, but elevated levels of certain blood lipids can increase cardiovascular risk.

LDL cholesterol is a major contributor to atherosclerotic cardiovascular disease.

HDL cholesterol is involved in cholesterol transport, although raising HDL alone has not been shown to reliably reduce cardiovascular events.

Triglycerides are influenced by genetics, diabetes, alcohol intake, diet, medications, and other factors.

At Prolific Well, lipid management may involve:

• Reviewing a standard lipid panel

• Evaluating overall cardiovascular risk

• Considering additional markers such as ApoB or lipoprotein(a) when appropriate

• Nutrition and physical activity counseling

• Reviewing medications and contributing conditions

• Discussing lipid-lowering medications when indicated

• Monitoring treatment response

Can high cholesterol be treated naturally?

Dietary changes, physical activity, and other lifestyle interventions can improve some lipid measures and cardiovascular risk factors.

However, some patients, particularly those with established cardiovascular disease, very high LDL cholesterol, familial hypercholesterolemia, or elevated overall risk, benefit substantially from prescription medication.

Supplements should not automatically replace evidence-based lipid-lowering treatment.

5. Fatty Liver & Metabolic Risk Factors

Fatty liver disease is increasingly recognized as an important metabolic health concern.

The term metabolic dysfunction-associated steatotic liver disease (MASLD) describes excess liver fat in the setting of cardiometabolic risk factors, after appropriate consideration of alcohol intake and other causes.

MASLD is associated with conditions such as:

• Insulin resistance

• Type 2 diabetes

• Excess abdominal adiposity

• Elevated triglycerides

• High blood pressure

Many people with fatty liver disease have no obvious symptoms.

Evaluation may involve liver enzymes, metabolic testing, noninvasive fibrosis risk assessment, and imaging or specialist referral when appropriate.

Can fatty liver improve?

Yes. For many patients, improvements in nutrition, physical activity, metabolic risk factors, and sustained weight reduction when indicated can reduce liver fat and improve metabolic health.

However, some individuals develop liver inflammation or fibrosis and require additional evaluation and monitoring.

At Prolific Well, I focus on identifying metabolic contributors while assessing whether advanced liver evaluation or specialist care is needed.

6. Clinical Nutrition for Metabolic Health

Nutrition is one of the most practical tools we have for supporting blood sugar, cholesterol, weight management, and long-term cardiovascular health.

However, there is no single diet that works best for everyone.

A personalized nutrition plan may emphasize:

• Adequate protein to support muscle preservation

• Fiber-rich vegetables, fruits, legumes, and whole grains

• Appropriate portions of carbohydrates

• Unsaturated fats from foods such as olive oil, nuts, seeds, and fish

• Reducing sugar-sweetened beverages

• Limiting highly processed foods where practical

• Consistent eating patterns

• Adequate hydration

• Meal planning that fits your culture, schedule, and budget

Do you have to stop eating carbohydrates to improve blood sugar?

No. Carbohydrate quality, quantity, and meal composition all matter.

Whole grains, beans, fruit, and other fiber-containing carbohydrate foods can fit into many diabetes and metabolic health eating patterns.

I encourage patients to focus on sustainable improvements rather than automatically eliminating entire food groups.

For additional education, explore the Prolific Well Nutrition & Health Articles.

7. Movement, Muscle & Healthy Metabolism

Physical activity supports metabolic health through several pathways.

Aerobic exercise can improve cardiovascular fitness and insulin sensitivity.

Resistance training helps preserve or increase muscle mass, which is important for physical function and glucose metabolism.

For many adults, a reasonable long-term goal is to work toward:

• At least 150 minutes per week of moderate-intensity aerobic activity, when medically appropriate

• Muscle-strengthening activities at least two days per week

• Less prolonged sedentary time

• Gradual progression based on fitness, mobility, and health status

People with certain medical conditions may need individualized exercise recommendations.

Why does muscle matter for metabolic health?

Skeletal muscle is an important site for glucose uptake and plays a central role in physical function, strength, and healthy aging.

Preserving muscle is especially important during intentional weight loss and as we get older.

8. Medication-Assisted Weight Management When Appropriate

Lifestyle interventions remain foundational, but some patients may benefit from prescription medications as part of a comprehensive weight-management plan.

Depending on the patient's diagnosis, medical history, eligibility, and treatment goals, options may include:

• FDA-approved anti-obesity medications

• GLP-1 receptor agonist medications when indicated

• Dual GIP/GLP-1 receptor agonist medications when indicated

• Other appropriate prescription therapies

• Medications for diabetes, cholesterol, or related metabolic conditions

Are GLP-1 medications appropriate for everyone?

No.

Medication eligibility depends on factors such as BMI, weight-related medical conditions, contraindications, treatment history, and individual risk-benefit assessment.

These medications can have side effects, including gastrointestinal symptoms, and some have important warnings or contraindications. Pregnancy plans, medication interactions, and other health conditions must also be considered.

Not everyone who wants to lose weight is a candidate for prescription weight-loss treatment.

When medication is appropriate, I emphasize adequate nutrition, protein intake, resistance training, side-effect monitoring, and long-term planning.

Medication-assisted weight management should be part of comprehensive medical care, not a substitute for it.

What Tests Help Evaluate Metabolic Health?

Testing depends on your symptoms, medical history, medications, and risk factors.

Test or assessmentWhat it helps evaluateHemoglobin A1cAverage blood glucose over approximately 2–3 monthsFasting plasma glucoseCurrent fasting blood glucoseLipid panelLDL, HDL, total cholesterol, and triglyceridesComprehensive metabolic panelKidney function, electrolytes, and liver-associated markersBlood pressureHypertension and cardiovascular riskWaist circumferenceCentral adiposity and metabolic riskThyroid testingThyroid disorders when clinically suspectedApoB or lipoprotein(a)Additional cardiovascular risk information in selected patientsLiver fibrosis assessmentRisk of advanced liver disease in appropriate patients

Not every patient needs advanced laboratory testing.

My approach is to choose tests that help clarify a diagnosis, estimate risk, or guide treatment decisions.

For more on personalized evaluation, read How Integrative & Functional Medicine Uncover the Root Cause of Hormone Imbalance and Chronic Fatigue.

Why I Take a Whole-Person Approach to Metabolic Health

My interest in metabolic health is personal.

Growing up, I witnessed the effects of chronic illness in my family, including diabetes. My grandmother's death from diabetic ketoacidosis left a lasting impression on me.

It helped shape how I think about prevention and the importance of recognizing metabolic disease before serious complications develop.

As a physician, I want patients to understand that metabolic health is not simply about weight or appearance.

It is about protecting your blood vessels, brain, kidneys, liver, muscles, and ability to remain active as you age.

In my practice, I often see patients who are trying to improve their health but feel overwhelmed by conflicting nutrition advice, weight-loss trends, supplements, and medication options.

Some have tried restrictive diets. Others are frustrated because their laboratory results are changing despite their efforts.

I believe the best place to start is with a clear medical assessment and a practical plan.

That might mean improving blood sugar regulation, addressing sleep apnea, treating high cholesterol, increasing protein intake, building muscle, or considering medication when appropriate.

The goal is not perfection. It is measurable progress that supports a healthier future.

You can learn more about my background and clinical philosophy on the Meet Dr. Evelyn Le Ellis page.

What to Expect at Your Metabolic Health Consultation

Step 1: Comprehensive Health Review

We discuss your health history, weight changes, dietary habits, activity level, sleep, medications, family history, and goals.

Step 2: Review of Metabolic Risk Factors

Depending on your needs, we evaluate blood pressure, glucose, cholesterol, liver health, body composition, and other clinically relevant findings.

Step 3: Personalized Treatment Planning

Your plan may include:

• Nutrition recommendations

• Physical activity and resistance training

• Sleep and stress management

• Medical treatment for diabetes, cholesterol, or other conditions

• Prescription weight-management medication when appropriate

• Further diagnostic evaluation or specialist referral

Step 4: Follow-Up & Monitoring

We assess changes in symptoms, metabolic markers, treatment response, medication tolerance, and long-term health goals.

Weight is only one possible measure of progress.

Metabolic Health & Medical Weight Management in Olympia, Tumwater, Lacey & the South Sound

Prolific Well Integrative Medicine provides individualized metabolic health and weight-management care in Olympia, Washington, serving patients from Tumwater, Lacey, Tenino, Shelton, Centralia, Chehalis, McCleary, Elma, Aberdeen, and surrounding South Sound communities.

In-person and telehealth appointments are available when clinically appropriate.

Prolific Well Integrative Medicine
1820 Black Lake Boulevard SW, Suite 101C
Olympia, WA 98512

Phone: (360) 339-6169

Schedule Your Metabolic Health Consultation

Frequently Asked Questions About Metabolic Health & Weight Management

Where can I find a metabolic health doctor in Olympia, WA?

Dr. Evelyn Le Ellis, ND, MPH, FAIHM, provides metabolic health and weight-management care at Prolific Well Integrative Medicine in Olympia, Washington. Services include evaluation of prediabetes, type 2 diabetes, insulin resistance, high cholesterol, weight concerns, and metabolic risk factors.

What is the difference between metabolic health and weight loss?

Metabolic health involves factors such as blood glucose, blood pressure, cholesterol, and cardiovascular risk. Weight loss refers to reducing body weight. Weight reduction can improve metabolic health for some people, but weight alone does not fully describe metabolic risk.

Can insulin resistance be improved?

Yes. Physical activity, dietary changes, weight reduction when appropriate, adequate sleep, and treatment of contributing conditions can improve insulin sensitivity. Some patients may also benefit from medication.

Can prediabetes be reversed?

Blood glucose levels can return to the normal range in some people with prediabetes, particularly with sustained lifestyle changes. However, ongoing monitoring remains important because future diabetes risk may persist.

Do I need to lose weight to improve my blood sugar?

Not always. Nutrition, physical activity, and medications can improve glucose regulation even without substantial weight loss. For some patients, modest weight reduction provides additional benefits.

Why am I gaining belly fat as I get older?

Changes in body composition can reflect aging, physical activity, muscle loss, menopause, genetics, sleep, and other factors. A medical evaluation can help identify contributing conditions when indicated.

Can a naturopathic doctor prescribe weight-loss medication in Washington?

Washington-licensed naturopathic physicians have prescribing authority within their defined scope. Whether a particular medication can be prescribed depends on state regulations, clinical indications, and the patient's medical history.

Do you offer GLP-1 weight-management treatment?

Medication-assisted weight management, including evaluation for appropriate GLP-1-based therapies, may be considered when clinically indicated. Eligibility, medication availability, prescribing requirements, insurance coverage, and safety considerations are reviewed individually.

What is the best diet for insulin resistance?

There is no single best diet for everyone. Eating patterns that emphasize adequate protein, fiber-rich foods, appropriate carbohydrate portions, and unsaturated fats can support metabolic health. The plan should account for medications, diabetes status, preferences, and nutritional needs.

Can high triglycerides improve with diet?

Yes. Reducing excess alcohol intake, improving dietary patterns, increasing physical activity, and addressing diabetes or other contributing conditions can help lower triglycerides. Some patients also need medication, particularly when triglycerides are severely elevated.

Can fatty liver disease improve without medication?

Many patients can improve liver fat and metabolic risk through sustained lifestyle changes and weight management when indicated. However, patients with suspected liver fibrosis or advanced disease require additional assessment and may need specialized treatment.

Does insurance cover medical weight management?

Coverage depends on the insurance plan, diagnosis, network status, and services. Some medical visits may be covered while weight-management medications, specialized testing, or other services may require additional payment. Confirm benefits before scheduling.

About Dr. Evelyn Le Ellis, ND, MPH, FAIHM

I am a Washington-licensed naturopathic physician and founder of Prolific Well Integrative Medicine in Olympia, Washington.

My educational background includes a Doctor of Naturopathic Medicine from Bastyr University, a Master of Public Health from the University of Washington, and a Bachelor of Science in Biochemistry from Baylor University. I am also a Fellow of the Academy of Integrative Health and Medicine.

My clinical interests include metabolic health, weight management, hormone and thyroid disorders, digestive health, preventive medicine, and longevity.

I believe patients deserve evidence-informed care, clear explanations, and realistic strategies that support both quality of life and long-term health.

Ready to Take Control of Your Metabolic Health?

Whether you are managing prediabetes, type 2 diabetes, insulin resistance, elevated cholesterol, fatty liver, or persistent weight concerns, you deserve a plan that considers your individual health needs.

At Prolific Well Integrative Medicine, we focus on understanding your metabolic risk factors, identifying appropriate treatment options, and building sustainable habits that support your health over time.

Schedule Your Metabolic Health & Weight Management Consultation

Prolific Well Integrative Medicine
1820 Black Lake Boulevard SW, Suite 101C
Olympia, WA 98512
(360) 339-6169

Medical disclaimer: This page is intended for general educational purposes and does not replace individualized medical evaluation, diagnosis, or treatment. Diabetes medications and other prescriptions should not be stopped or adjusted without medical guidance. Severe hyperglycemia, vomiting with dehydration, confusion, or other potentially serious symptoms require prompt medical evaluation.