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In this episode of Your Checkup, we unpack why relying on willpower alone so often fails — and why that failure isn’t a personal flaw. Willpower is a limited resource that gets drained by stress, decision fatigue, and daily demands, making it unreliable for sustained health change. Instead of asking ourselves to try harder, real progress comes from designing systems that work with our brains: reducing friction for healthy behaviors, increasing friction for unhelpful ones, and anchoring habits to existing routines. By shifting the focus from discipline to supportive environments, we can build changes that last — even on hard days.

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Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN

Artwork Rebrand and Avatars:

Vantage Design Works (Vanessa Jones)

Website: https://www.vantagedesignworks.com/

Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr

Original Artwork Concept: Olivia Pawlowski

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New year energy fades fast, and that’s exactly when most health plans fall apart. We’ve been there—patients telling us “I can’t stay motivated,” and our own early alarms that sometimes lose the argument. So we take a fresh, practical look at motivation: not as a trait you’re born with, but as a state you can design by meeting three basic needs—choice, capability, and support.

We start by ditching the willpower myth. Fear and guilt can get you moving once, but they rarely carry you through February. Instead, we walk through how to create autonomy by making health changes feel like your choice, not a chore. Then we shrink the mountain with competence—tiny, repeatable wins that build evidence you can do this. Finally, we highlight relatedness, the social fuel most of us ignore, from a partner’s quick “you got this” to a clinician who helps you tailor goals to real life.

You’ll hear everyday examples that translate theory to action: reframing exercise from “the doctor said so” to “I feel clearer after a 15‑minute walk,” turning “I need to lose weight” into “steady meals give me steady energy,” and linking medications to the life you want to lead. We cap it with a fast self‑audit you can do today: Does this feel like my choice? Do I feel capable most days? Do I feel supported? Wherever you answer no, you’ll learn how to adjust the plan rather than abandon it.

If you’re ready to turn external pressure into internal purpose and make habits stick without white‑knuckling, press play. Then share this with someone who could use a gentle reset, subscribe for next week’s deep dive on building systems that support your goals, and leave a review to tell us the one small change you’re making first.

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Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN

Artwork Rebrand and Avatars:

Vantage Design Works (Vanessa Jones)

Website: https://www.vantagedesignworks.com/

Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr

Original Artwork Concept: Olivia Pawlowski

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Oral Wegovy is officially FDA approved — but what does that actually mean for patients? In this episode of Your Checkup, we break down the December 2025 approval of oral semaglutide 25 mg for chronic weight management, who qualifies, how it works, and how effective it really is. We review the clinical trial data behind the approval, including expected weight loss, common side effects, and long-term expectations, and explain how oral Wegovy compares to injectable GLP-1 medications. We also tackle common misconceptions, dosing and lifestyle considerations, and the very real challenges of cost and insurance coverage. If you’ve heard the headlines and want the facts — without hype — this episode is for you.

Check out our new graphics. Thank you, Vantage Design Works. Check out our website, you can send us an email, yourcheckuppod@gmail.com. Check out our website, you can find us on Instagram, share us with a friend or a neighbor. But most importantly, stay healthy, my friends.

Support the show

Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN

Artwork Rebrand and Avatars:

Vantage Design Works (Vanessa Jones)

Website: https://www.vantagedesignworks.com/

Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr

Original Artwork Concept: Olivia Pawlowski

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We trade holiday laughs and a Michelin-level dinner recap for a clear look at how five simple questions can transform a medical visit into a relationship. We show how home, routine, joy, and self-perception reveal risks and shape plans that fit real life.

You can reach out to us by email, yourcheckuppod@gmail.com
You can find us on Instagram, you can follow us there
Also active on threads where we share, you know, themes of our episodes and different collections that we think connect to each other
And most importantly, stay healthy, my friends

Support the show

Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN

Artwork Rebrand and Avatars:

Vantage Design Works (Vanessa Jones)

Website: https://www.vantagedesignworks.com/

Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr

Original Artwork Concept: Olivia Pawlowski

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In this episode of Your Checkup, we break down lipoprotein(a) — a largely inherited form of cholesterol that can significantly increase the risk of heart disease and stroke, even when standard cholesterol numbers look normal. We talk about what Lp(a) is, why it matters, who should be tested, and how it helps explain “unexpected” heart events in otherwise healthy people. While Lp(a) can’t currently be lowered with diet or exercise, knowing your level allows you and your care team to be more intentional about prevention by aggressively managing other risk factors like LDL cholesterol, blood pressure, and diabetes. We also discuss what the numbers mean, why most people only need to be tested once, and the promising treatments currently being studied that may change care in the future.

References (for Show Notes)

1. Nordestgaard BG, Langsted A. Lipoprotein(a) and Cardiovascular Disease. Lancet. 2024;404(10459):1255-1264.
2. Reyes-Soffer G, et al. AHA Scientific Statement on Lipoprotein(a). Arterioscler Thromb Vasc Biol. 2022;42(1):e48-e60.
3. Di Fusco SA, et al. Lipoprotein(a): Risk Factor and Emerging Target. Heart. 2022;109(1):18-25.
4. Nasrallah N, et al. Lp(a) in Clinical Practice. Eur J Clin Invest. 2025:e70127.
5. Greco A, et al. Lipoprotein(a) as a Pharmacological Target. Circulation. 2025;151(6):400-415.
6. Bess C, Mehta A, Joshi PH. All We Need to Know About Lipoprotein(a). Prog Cardiovasc Dis. 2024;84:27-33.

Support the show

Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN

Artwork Rebrand and Avatars:

Vantage Design Works (Vanessa Jones)

Website: https://www.vantagedesignworks.com/

Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr

Original Artwork Concept: Olivia Pawlowski

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We share a quick life update, welcome our first guest Mike Rozanski, and clear up the Michelin Guide origin story before shifting to a focused guide on starting GLP-1 medications. Practical strategies cover injections, nausea, constipation, muscle protection, and adjusting other meds safely.

• board certification in obesity medicine and motivation to destigmatise care
• guest segment on Michelin guide history and Philly’s recent stars
• what GLP-1 meds are and how auto-injectors work
• portion sizing to prevent nausea and early side effects
• fiber with fluids to prevent constipation
• protein targets and simple strength training to protect muscle
• when to adjust blood pressure and diabetes medications
• key takeaways and encouragement to start small and follow up

If you found this helpful, a review really does go a long way for a like on whatever app you’re listening to us on

Support the show

Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN

Artwork Rebrand and Avatars:

Vantage Design Works (Vanessa Jones)

Website: https://www.vantagedesignworks.com/

Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr

Original Artwork Concept: Olivia Pawlowski

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We unpack new GLP-1 pricing, coverage hurdles, and whether cash-pay programs make these meds more reachable for diabetes, obesity, and sleep apnea care. Along the way we share candid pros and cons of injections, tease future oral options, and weigh real tradeoffs.

• current cash-pay pricing from major manufacturers
• differences between Wegovy, Ozempic, and Zepbound
• tighter insurance coverage and prior authorization burden
• fears about injections and route-of-administration bias
• potential oral GLP-1 timelines and cost impact
• framing obesity as a chronic, treatable disease
• practical tips to explore HSA or FSA options
• how to decide if the monthly cost is worth it

Support the show

Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN

Artwork Rebrand and Avatars:

Vantage Design Works (Vanessa Jones)

Website: https://www.vantagedesignworks.com/

Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr

Original Artwork Concept: Olivia Pawlowski

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Clear guidance on benefits, risks, and how the FDA’s label changes shift conversations in the exam room about HRT
Nikki's Corner
• Philly’s first Michelin stars and what the tiers mean
• Flying taxis in Dubai
• A cold case solved by college criminology students

Learning
• What HRT is, routes of therapy, and who benefits
• Reframing WHI-era fears with age and timing data
• FDA label changes and clinical implications
• Contraindications and safer use considerations
• Women’s health bias and the cost of not listening
• Practical steps for shared decisions with clinicians

References

1. The 2022 Hormone Therapy Position Statement of the North American Menopause Society. Menopause (New York, N.Y.). 2022;29(7):767-794. doi:10.1097/GME.0000000000002028.
2. Management of Menopausal Symptoms: A Review. Crandall CJ, Mehta JM, Manson JE. JAMA. 2023;329(5):405-420. doi:10.1001/jama.2022.24140.
3. Hormone Therapy for Postmenopausal Women. Pinkerton JV. The New England Journal of Medicine. 2020;382(5):446-455. doi:10.1056/NEJMcp1714787.
4. Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Women: US Preventive Services Task Force Recommendation Statement. Grossman DC, Curry SJ, Owens DK, et al. JAMA. 2017;318(22):2224-2233. doi:10.1001/jama.2017.18261.
5. Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Persons: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. Gartlehner G, Patel SV, Reddy S, et al. JAMA. 2022;328(17):1747-1765. doi:10.1001/jama.2022.18324.
6. Hormone Therapy in the Postmenopausal Years: Considering Benefits and Risks in Clinical Practice. Genazzani AR, Monteleone P, Giannini A, Simoncini T. Human Reproduction Update. 2021;27(6):1115-1150. doi:10.1093/humupd/dmab026.
7. Hormone Therapy in Menopause: Concepts, Controversies, and Approach to Treatment. Flores VA, Pal L, Manson JE. Endocrine Reviews. 2021;42(6):720-752. doi:10.1210/endrev/bnab011.
8. The Women’s Health Initiative Randomized Trials and Clinical Practice: A Review. Manson JE, Crandall CJ, Rossouw JE, et al. JAMA. 2024;331(20):1748-1760.

Support the show

Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN

Artwork Rebrand and Avatars:

Vantage Design Works (Vanessa Jones)

Website: https://www.vantagedesignworks.com/

Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr

Original Artwork Concept: Olivia Pawlowski