Medically Supported Weight Loss Program

Midlife brings unique challenges to achieving and maintaining a healthy weight. Shifts in metabolism, hormones, stress, and everyday life can make weight loss feel overwhelming. Our program is designed specifically for women in midlife—addressing your body’s individual needs and supporting your long-term health goals with a holistic, sustainable approach.

What Sets Our Program Apart

  • Personalized Telehealth Care: Receive expert, one-on-one support from a menopause specialist. Your care is never rushed—instead, it’s truly tailored to YOU.

  • Holistic Care: We evaluate your symptoms, order labwork, review supplement options, make recommendations for midlife screenings, and provide educational resources to inspire a transformational experience and the beginning of a healthier, more vibrant next phase of life. We can also discuss the option of hormone therapy for women who are interested.

  • Collaborative Support: We evaluate the support you need and link you with trusted nutritionists (RDNs), fitness trainers, and resources to help ensure success (the cost of these services are separate).

Details & Fees

  • Complimentary Consultation

    Video consults take place via my secure online patient portal. Schedule a complimentary 15-minute consult to discuss your situation and see if this program is a good fit for you.

    15-minutes
    Free

  • Initial Appointment

    ❖ A Welcome Packet will be sent to you after you schedule the appointment including an in-depth health questionnaire that you will return to me before our video appointment.

    ❖ During the video appointment, we will review your health history and risk factors, set goals, discuss options including lifestyle changes and medications, review benefits, risks, and side effects, and order labs if needed.

    ❖ Labs or imaging will be done at your convenience (fees charged by facility).

    Up to 90 minutes
    $375

  • Follow Up Appointment

    ❖ We will review the lab results, receive a personalized weight loss plan, prescription/s if appropriate, and initial instructions for medication, if used.

    Up to 45 minutes
    $190

    AFTER THIS, you start your journey—with continued support every step of the way:

    Monthly clinical check-ins $100

    (Discounted 6-month package if paid in advance: $500)

    ❖ Review your progress, prevent or address side effects, titrate dose, and strategize for success.

    ❖ Easy messaging for questions & concerns.

Your Commitment Matters


Medications are powerful tools, but not magic. Your readiness to make changes—however small—will make all the difference. Together, we’ll set achievable milestones and celebrate your wins.

Commitment to quality nutrition and consistent exercise is key to weight loss success and maintenance over time, so having a solid plan for nutritional and exercise support is a requirement of our program. It also ensures that weight loss does not result in a significant loss of muscle mass and fragility as we get older.

The goal: healthy AND strong

Program Highlights

Root-Cause Approach

We look beyond just the number on the scale. The first step is identifying the underlying contributors to weight challenges, such as hormonal changes, metabolic shifts, stress and sleep problems, nutritional deficiencies, and lifestyle habits

Individualized Plan

Your journey starts with a thorough medical and lifestyle assessment and the creation of a plan tailored to your

  • Metabolism and health history

  • Nutrition preferences and goals

  • Activity levels and interests

Evidence-Based Medication Options

Together, we will select an appropriate medication depending on your health history, weight loss goals, insurance coverage, and financial resources. Medication options include GLP-1s or GLP-1/GIP Receptor Agonists (Semaglutide, Tirzepatide), Contrave (Bupropion-Naltrexone), or Qsymia (Phentermine-Topiramate) and others. These work in some of the following ways:

  • Help manage appetite and cravings

  • Support healthy blood sugar balance

  • Slow stomach emptying

  • Target hunger and reward centers in

  • the brain

Food-First, Not Food-Fear

We believe that food should be enjoyable and nourishing. It’s a joyful cornerstone of family and community life, especially in places like Napa Valley, where we are based! Our approach:

  • Focuses on nutrient-rich, satisfying meals, never restriction alone

  • Aims for progress, not perfection

  • Zero judgment—just inspiration and real support

Tools and Education to last a lifetime

  • Regular check-ins (monthly virtual visits, unlimited messaging)

  • Ongoing education on nutrition, fitness, mindset, and habits

  • Referrals to nutritionists (RDNs) and fitness professionals and other resources for a truly integrative experience

What Can You Expect? Realistic Results, Lasting Change!

Most women achieve a 15–22% weight loss over 12–18 months using a combination of lifestyle change and medication. This is not a “quick fix”, but can be life-changing.

The biggest gains?

More energy, better health markers, and improved confidence and quality of life. You deserve this!

Hormone expert for midlife women Heidi Biegel holds flowers and looks straight ahead.

I’m a Midlife Midwife, guiding women through midlife hormonal and life changes with information, education, and support.

I believe that health and wellness is a journey. Midwife means “with woman,” and as a certified nurse-midwife (CNM), it is my honor to walk WITH you on your path, giving you in-depth information about the changes in your body (and mind and mood!), recommendations (and orders) for lab testing or imaging, and evidence-based options to address perimenopausal and menopausal symptoms as well as their root causes. Together we’ll create a personalized treatment plan based on your unique situation and weave in the best of what conventional and integrative & functional medicine have to offer so that you have a wide range of options to consider as you chart your path through perimenopause and menopause.

A photo of the moon in a blue sky with light clouds.

Examples of midlife concerns that I can evaluate and treat, or provide integrative support* during surgical or specialty treatment:


Gynecology & Hormone Health

  • Contraceptive counseling and management

  • Painful periods and PMS

  • Pelvic pain or irregular bleeding  

  • Urinary problems

  • Endometriosis, PCOS, fibroids, ovarian cysts*

  • Preconception preparation and fertility optimization

Discomforts of Perimenopause & Menopause

  • Hot flashes + night sweats

  • Trouble sleeping

  • Fatigue

  • Period problems

  • Painful sex, vaginal dryness, low libido

  • Brain fog and memory changes

  • Mood swings, anxiety, and depression

  • Weight and body changes

  • Hair and skin changes

  • Joint pain, bone loss, and risk of fracture

FAQs

  • Currently, I provide all consultations by telehealth. Telehealth can be ideal for discussing health history, reviewing symptoms and lab results, and exploring treatment options. In some ways, it returns us to the heart of midwifery: you can receive care in your own familiar setting and your own comfortable clothes. However, not all concerns can be cared for virtually, and patients will generally have a primary care provider and a gynecologist as well for in-person visits when needed. I will let you know when an in-person visit is advisable. In that case, I am happy to refer you to the appropriate medical provider and make sure they have the labs, imaging, and medical chart they need to care for this aspect of your health.

  • I can care for women who are in either California or Maine, the states where I am currently licensed.

  • Yes. As a Certified Nurse-Midwife, I can prescribe medications (such as bioidentical hormone therapy, treatment for infections, contraception, etc.) and have an account at Fullscript where you can purchase high-quality supplements at a discount.

    VISIT MY FULLSCRIPT PHARMACY HERE →

  • Yes. I can order labs to be done at Quest Diagnostics and can order specialty labs which can be done by mail. During our appointment, we will discuss which labs are essential (depending on your situation) and which are optional if we want more in-depth information. I can work with you to prioritize labs according to your budget. Insurances often cover conventional labs, but usually not specialty labs. You can use an HSA or FSA (if you have one) to pay for lab fees.

  • Yes. I can order imaging such as pelvic or breast ultrasounds, mammograms, or bone density scans as needed, at any facility that you prefer.

  • As a telehealth consultant practice, I am not available for urgent in-person visits. In an emergency, you will need to seek care at your nearest emergency room or with your PCP or gynecologist (depending on the concern).

  • If you have prior labs, imaging, or medical records from the past 1-2 years that may be helpful in our work together, we will discuss having them sent to me or you can upload documents through the patient portal once an appointment has been made and you have an account.

  • To provide the quality of care and time I believe all women deserve, I am not able to accept insurance. I am happy to provide you with a superbill to submit to your insurance for possible reimbursement. You can use an HSA or FSA (if you have one) to pay for visits.

  • I do not participate in Medicare. This means that if you are on Medicare, neither you nor I can submit bills to Medicare and you cannot be reimbursed by Medicare for my services.

  • You will be asked to pay for your appointment when it is made, to reserve that time for you. You can make the appointment and pay through this website, or through the ChARM Electronic Health Record patient portal for future appointments once you have made the Initial Visit and have access.

  • You may cancel or reschedule your appointment up to 48 hours before the visit and your fee will be reimbursed.

  • If you cancel less than 48 hours before the appointment or do not attend the appointment, the fee will not be reimbursable.

  • A CNM is a highly trained women’s health clinician with a nursing degree and then a Master of Science in Nursing and specialization in Midwifery. In many states (including CA and Maine), CNMs can practice independently, collaborating or consulting with physicians and specialists as needed. We are trained to provide women’s healthcare throughout the lifespan from adolescence through menopause, in addition to prenatal care and delivering babies (though I am not doing this now). We can order labs and imaging and prescribe medications that are appropriate to the care that we provide, including contraceptives, antibiotics, bioidentical hormones, and most other medications.

  • Integrative medicine is an approach that can include a wide range of modalities that are effective for treating a specific illness or disease in a treatment plan. The plan might include conventional treatment and medications, and it might also integrate dietary changes and nutritional support, supplements, botanicals (herbs), homeopathy, Traditional Chinese Medicine as well as body/mind modalities such as exercise, physical therapy, acupuncture, chiropractic, massage, yoga, mindfulness, behavioral therapy (such as cognitive behavioral therapy/CBT), and hypnosis. A patient may be referred to other providers for some of these services.

    Functional medicine is a framework focused on identifying the root cause of a particular illness or disease so that the treatment can address not only the symptoms but also the underlying source of the problem. There is an understanding in functional medicine that all the systems of the human body are connected and that we need to consider many factors to evaluate what may be contributing to a health concern and to treat it, such as genetics, the environment, stress, sleep, nutritional status, immune system, gut health, and detoxification pathways.