A Peripheral Nerve Surgeon and Exercise Physiologist's Approach to Metabolic Health & Longevity
If you're stalled on fat loss, suspect insulin resistance, or want a serious anti-aging strategy grounded in exercise physiology and clinical medicine — this is the consultation you've been missing.
If you've done everything right and the scale still won't move, the issue may not be effort — it may be approach.
These are patterns common across midlife adults working to optimize their metabolic health. If any of them sound familiar, this consultation may be useful for you.
You hit a fat-loss wall after 40 — and what worked before isn't working now
The same nutrition and exercise approach that worked for years suddenly delivers different results. Your metabolism didn't break — it adapted. The next step often requires a different framework than "eat less, move more."
You suspect insulin resistance but your standard labs came back unremarkable
Standard panels often don't include the markers that catch early metabolic dysfunction. Fasting insulin, HOMA-IR, triglyceride-to-HDL ratio, and continuous glucose patterns can tell a different story than a basic metabolic panel.
You're tired of generic plans that ignore your physiology
Calorie templates, macro calculators, and one-size-fits-all coaching programs don't account for your metabolic adaptation, hormonal context, training history, or current medical reality.
You want a serious anti-aging strategy — not another supplement stack
Real longevity work is built on metabolic health, muscle quality, mitochondrial function, and lifestyle structure — not promotional protocols. The framework is durable, evidence-based, and personalized.
Metabolic health is not a cookie-cutter problem.
Two people with the same weight, the same age, and the same goals can need completely different approaches. Personalization is the difference between progress and frustration.
"Most people can follow a well-designed general framework and make meaningful progress. The ones who can't — who've tried the right things and stalled — usually need something else."
That "something else" is what a personalized consultation provides: an honest read on your specific physiology, your specific labs, and the specific factors that are actually slowing you down. Not someone else's protocol applied to you.
For most people, the book is enough.
Before you book a consultation, consider whether the self-directed framework might serve you well — and save you money.
Why Fat Loss Stalls After 40
A complete framework covering the physiology of midlife fat loss, the lab markers worth tracking, the exercise approach that actually moves the needle, and the nutritional shifts that work when calorie cutting alone stops working. Most readers find what they need here.
Most metabolic guidance comes from one expertise. This brings together several.
A health coach can give you motivation. A dietitian can write a meal plan. A physician can review your labs. The combination of all three — under one credential stack — is rare. That combination is what changes outcomes for people who've stalled.
Motivation, but no medical context
- Generic templates and meal plans
- Cannot interpret bloodwork clinically
- Cannot speak to medication interactions
- Limited exercise physiology depth
- Outcomes based on testimonials, not credentials
Physician + exercise physiologist + author
- Personalized guidance built from your actual labs
- 20+ years of clinical pattern recognition
- Exercise prescription rooted in physiology
- Awareness of how medications affect metabolism
- Approach grounded in clinical experience and published work
Labs and supplements, but limited movement science
- Often leads with gut health or hormones
- Limited exercise prescription depth
- Heavy focus on supplement stacks
- Less attention to muscle and metabolic training
- Often $5,000+ for 6-month programs
Take the Free 5-Minute Metabolic Health Assessment First
Not sure whether a paid consultation is right for your situation? Take the 20-question self-assessment — built around validated clinical frameworks including FINDRISC and the Feel4Diabetes IR Risk Index — and get your personalized risk score and recommended next steps.
Metabolic Health Risk Assessment
Built around validated clinical instruments. Answer 20 yes/no questions and receive your personalized risk tier, plus tailored recommendations based on your specific situation. Results delivered on-screen and to your email.
Three options. No pressure. You decide how far we go together.
Everyone begins with a free 10-minute discovery call. From there, the path is yours — a single consultation, a structured program, or simply the book.
Free 10-Minute Discovery Call
A short conversation to understand what you're working through, what you've tried, and whether we're the right fit. No commitment. If a paid consultation isn't right for your situation, I'll say so — and where appropriate, point you toward what would help instead.
Initial Consultation
$175 60-minute video consultation- 60-minute deep-dive video consultation
- Full review of your health history and labs
- Personalized written plan within 72 hours
- Top priorities for your specific situation
- 14 days of follow-up messaging access
3-Month Metabolic Reset
$299 12 weeks of structured support- 75-minute initial deep-dive consultation
- 2-week early follow-up to lock in progress
- 3 monthly visits (30 min each)
- Written plan + revisions after each visit
- Async messaging (48-hr response)
- End-of-program transition plan
Dr. Michael Fitzmaurice, MD
Physician · Exercise Physiologist · Author
- Medical DegreeDoctor of Medicine
- Specialty TrainingFellowship-Trained Peripheral Nerve Surgeon — Kleinert Institute
- Exercise ScienceFormal training in exercise physiology and cardiac rehabilitation
- Surgical Experience3,000+ peripheral nerve procedures performed
- Years in Medicine20+ years
- AuthorWhy Fat Loss Stalls After 40
- Peer-Reviewed WorkTwo clinical publications on the NeuroAxis formula
The patterns I saw in 3,000 surgeries are what brought me here.
For more than two decades I practiced medicine, the last fifteen as a fellowship-trained peripheral nerve surgeon. I performed over 3,000 nerve procedures across that career — and what I observed in those rooms changed how I think about health.
The patients who recovered fastest weren't always the youngest or the fittest. They were the ones whose metabolic health was intact. Insulin resistance, chronic inflammation, mitochondrial dysfunction, and muscle loss were upstream of nearly every outcome I tracked. The same drivers I saw influencing nerve recovery were the ones quietly shaping metabolism, energy, and how people aged across an entire generation.
My focus now is upstream — working with adults across midlife to address the metabolic dysfunction that drives weight gain, fatigue, and accelerated aging before it ever requires a surgical answer. My approach combines clinical medicine with exercise physiology in a way most physicians and most coaches simply can't replicate.
People I work with sometimes also use NeuroAxis, my clinically-formulated nerve health supplement, when nerve symptoms are part of the picture. But it's never the centerpiece. The centerpiece is your plan — built around your physiology, your labs, your goals.
What people ask before booking
If you have a question that isn't answered here, the discovery call is the right place to bring it up.
Is this medical care or coaching?
Consultations are educational and focused on metabolic health optimization, lifestyle medicine, and exercise prescription. They don't replace your primary care physician's role in diagnosing or treating specific medical conditions. Where appropriate, this complements your existing care rather than replaces it.
Do I need lab work before my consultation?
It helps, but it's not required. If you have recent labs, bring them — fasting glucose, fasting insulin, A1c, lipid panel, and basic thyroid markers are the most useful starting point. If you don't have current labs, we'll discuss what's worth ordering and how to do it efficiently.
Will you prescribe GLP-1 medications?
No. The consultation is focused on lifestyle, nutrition, and exercise interventions — the upstream drivers of metabolic health. Medications have their place, but prescribing happens through your treating physician, not through this consultation.
How is this different from working with a registered dietitian?
Registered dietitians are skilled at nutrition planning. The combination here is broader — physician-level clinical context plus exercise physiology depth. That means lab interpretation, exercise prescription, and an understanding of how nutrition, movement, and medication interact in real bodies. It's a different scope of analysis.
Should I just read the book instead?
For many people, yes. Why Fat Loss Stalls After 40 covers the framework comprehensively and works well for people who follow it carefully. The consultation makes sense for people who've already tried that approach and stalled, or who have specific complications — insulin resistance, multi-medication interactions, training plateaus — that warrant personalized analysis.
What if I just want a one-time review and not a program?
That's exactly what the $175 initial consultation is for. You'll get a 60-minute deep dive, a written plan within 72 hours, and 14 days of follow-up messaging. Many people start there and don't need anything more.
Are consultations covered by insurance?
No. All consultations and programs are private-pay. This allows for the depth of analysis and personalized attention that insurance-billed visits structurally cannot accommodate.
How are sessions conducted?
Everything is virtual. Consultations and program visits happen via secure video call. Async messaging during programs runs through a private communication channel. You can be anywhere with a stable internet connection.
What kind of results can I expect?
Outcomes vary based on starting point, adherence, and individual physiology. What I can offer is depth of analysis, personalized strategy, and genuine investment in your progress. What I won't promise is a specific number on the scale by a specific date — that's marketing language, and it's usually not honest.
The first step is a conversation.
Ten minutes. No commitment. We figure out together whether this is the right fit. From there, you decide what comes next.
Book Your Free Discovery CallConsultations are educational and not a substitute for primary medical care.
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