At Scaling Down in the 406, we empower individuals on their journey to sustainable, long-term weight loss.

Led by a team of Providers who are trained in treating chronic obesity, we understand the challenges to losing excess pounds and keeping the weight off.

Our holistic approach to sustainable weight loss starts with getting to know you personally  – your medical history, lifestyle, goals and recurring barriers or triggers that prevent you from achieving and maintaining your goal.

Based on your unique circumstances, we create an individualized plan that combines clinical services, prescription medication, lifestyle coaching and ongoing support.

Achieving sustainable weight loss and living a healthy, happier life is possible.

Ready to transform your life?

Scaling Down Start Your Journey
Start Your Journey Start Your Journey

Schedule a personal one-on-one consultation today

At Scaling Down in the 406, we empower individuals on their journey to sustainable, long-term weight loss.

Led by a team of Providers who are trained in treating chronic obesity, we understand the challenges to losing excess pounds and keeping the weight off.

Our holistic approach to sustainable weight loss starts with getting to know you personally  – your medical history, lifestyle, goals and recurring barriers or triggers that prevent you from achieving and maintaining your goal.

Based on your unique circumstances, we create an individualized plan that combines clinical services, prescription medication, lifestyle coaching and ongoing support.

Achieving sustainable weight loss and living a healthy, happier life is possible.

Ready to transform your life?

Scaling Down Start Your Journey
Start Your Journey Start Your Journey

Schedule a personal one-on-one consultation today

Why Choose Scaling Down in the 406?

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    1:1 Provider Care
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    100% personalized plan
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    Provider supervised prescription medication
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    Individualized coaching in nutrition
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    Holistic approach for long term, sustainable weight loss

Holistic Weight Management

Many people struggle to lose weight on their own. Those who do lose weight often fail to keep it off. Eventually they give up.

Why is that?

Lifetime weight management is not just about what you eat. Many factors need to come together to facilitate long term, sustainable weight loss.

As Providers who are experienced in treating individuals with obesity, we understand that long-term weight loss requires a holistic approach—not just a prescription.

While medications can aid in weight loss, we work with our patients to identify barriers, set realistic goals, and make lifestyle changes that lead to lasting results and a healthier, happier life.

Four Pillars of Obesity Management:

  • Nutritional Therapy
  • Physical Activity Tracking
  • Behavioral Modification
  • Medication Management
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A Proven Weight Loss Program

Located in Billings, Scaling Down in the 406 has a team of experienced Providers on site who meet with patients throughout their weight loss journey. In person appointments allow our team to get to know you as an individual, understand your health history at a deeper level, and adjust your plan in real time based on your changing needs.

How We Work

How We Work Initial Consultation
Initial Consultation

New patients  meet one-on-one with a Provider to review their medical history and lab work in detail. You will also discuss your personal challenges in weight management and barriers to success in the past.

How We Work Develop Your Personalized Plan
Develop Your Personalized Plan

Your provider will create an individualized weight loss plan that takes into consideration your overall health, weight loss goals and other conditions which may impact success.

How We Work Regularly Scheduled Appointments
Regularly Scheduled Appointments

Your weight loss plan includes regularly scheduled appointments with your Provider to monitor progress, discuss challenges, review prescribed medications, vitamin injections or IV therapies.

How We Work Develop Review Lab Work
Review Lab Work

At your initial consultation, lab tests may be ordered that include CBC, CMP, TSH, A1C, B12 and Vitamin D.

How We Work Develop Behavioral Health
Behavioral Health

We highly encourage patients to consult with a behavioral health professional throughout treatment.

How We Work Post Weight Loss Maintenance Program
Post-Weight Loss Maintenance Program

Congratulations on achieving your weight loss goal!

Once you achieve your goal, you will move into a maintenance plan that includes ongoing support, including medication if indicated. We recommend monthly check-ins for the first three months for support.

Start Your Journey Start Your Journey
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406 Membership Program

Scaling Down in the 406 offers a membership program that provides a range of advantages to enhance your weight loss journey.
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406 Membership Benefits

  • Reduce cost for initial visit
  • Discounted medications
  • Member only access to FREE vitamin injections and discounts on medication

Weight Loss Medications and Therapies

What is GLP-1?

Glucagon-like-peptide-1 (GLP-1) is hormone that occurs naturally in the body but is short lived. Scientists have formulated medications that act the same as naturally occurring GLP-1 only with a longer lifespan.

GLP-1 medications aid in controlling blood sugar levels, slow the movement of food through the digestive system, and help suppress your appetite – all of which help with weight loss.

Your provider can determine if GLP-1 is right for you.

GLP-1 Medications

Semaglutide

Contains the same active ingredient as brand name medications known as Ozempic and Wegovy in a more affordable, compounded format.

  • Once weekly injection
  • Weight loss potential: 15% when combined with healthy diet and exercise

Liraglutide

Contains the same active ingredient as brand name medication known as Victoza and Saxenda in a more affordable, compounded format.

  • Once daily injection
  • Weight loss potential: 7-8% when combined with healthy diet and exercise

Tirzepatide

The leader in overall weight loss medication, Tirzepatide improves glycemic control, decreases appetite in the brain, and delays gastric emptying which aids in weight loss.

  • Once weekly injection
  • Weight loss potential: 20-23% when combined with healthy diet and exercise

Appetite Suppressants

Appetite suppressants are medications that can help individuals lose  weight by reducing hunger and suppressing cravings. Appetite suppressants can be an ideal option for those only needing to lose 5-15 lbs.

Single Oral Therapy

Metformin

A medication for Type II Diabetes that can be used off-label for modest weight loss.

  • Once or twice daily oral medication
  • Weight loss potential: 2-3%

Bupropion

An oral antidepressant which can increase dopamine levels which helps decrease appetite and suppress cravings.

Topiramate

A medication that is used off-label for eating disorders such as binge eating. Helps with craving control.

Naltrexone

Works in the brain to decrease appetite and help reduce cravings.

Oxytocin

Helps weight loss by reducing appetite and increasing energy expenditure and fat metabolism.

Combination Oral Therapy (Caffeine-Free Options Available)

Bella 3

Combines Bupropion, Caffeine, Oxytocin, Topiramate, Naltrexone and Methylcobalamin.  These ingredients when used together help suppress cravings, control appetite and increase energy.

Bella 5

Combines Bupropion, Naltrexone, and Topiramate.  These ingredients help suppress cravings and control appetite.

Bella Plus

Bupropion, Caffeine, Metformin, Oxytocin, Topiramate, Naltrexone and Methylcobalamin. These ingredients when used together help suppress cravings, control appetite, control blood sugar levels, increase energy which all aid in weight loss.

Support Prescription Medication

Ondansetron

Aids with nausea sometimes caused by GLP-1s.

Lipo-Sculpt Cream and Lipo-Sculpt Cream Max

External use cream that can be applied to targeted areas (i.e., arms, thighs, stomach) to help promote weight loss, firm up skin, reduce fine wrinkles, and help reduce the appearance of cellulite.

Vitamin Injections

Lipo-B

Improves energy, focus and sleep.

Vitamin B Complex

Improves energy , metabolism, hormonal balance.

Amino Blend

Boosts Metabolism, energy, endurance and fat burn.

Biotin

Helps promote healthy skin and hair. Also supports nerves and blood sugar regulation.

Taurine

Promotes hydration, supports digestion and immune system. May also help reduce blood pressure and glucose regulation.

Tri-Immune

Supports the immune system and reduces inflammation.

Mineral Blend

Supports bone, heart, nerve and muscle health.

Vitamin D

Supports immune system, energy, mood, hormone balance, weight loss and bone health.

Vitamin B12

Offers immune and gastrointestinal support. Improves fatigue. Shown to reduce nausea when used with GLP-1.

MICC

Improves energy, mental clarity, sleep and weight loss.

IV Infusions

Alleviate
Helps relieve minor aches and pains especially those associated with PMS symptoms.

B-Lean
Helps support weight loss, burn fat and enhance blood flow and circulation

Brainstorm
Enhances mental clarity

Get Up and GO!
Energy booster

Immunity
Feel better, faster!

Inner Beauty
Fortify hair, skin and nails

Quench
Hydration Support

Reboot
Hangover relief and migraine support

Recovery and Performance
Reduces recovery time

Providers Who Care About Your Health

Our Providers have seen firsthand the long term health problems associated with chronic obesity: Type 2 diabetes, high blood pressure, heart disease, stroke, cancer, depression – and more.

They know that prevention is the best course of action, and that starts with a sustainable weight loss plan paired with new, healthier lifelong habits.

Providers Who Care
Annie Earley, BSN, DNP, FNP-C

Meet Our Providers

Annie Earley, BSN, DNP, FNP-C

Annie Earley is a dedicated Nurse Practitioner with more than 20 years of nursing experience. Specializing in geriatrics, Annie has observed the long-term effects of obesity on health. As someone who is passionate about proactive wellness, Annie is focusing on helping individuals identify barriers to sustained, long-term weight loss and healthy life choices. She believes in following a holistic approach, empowering people to achieve and maintain a healthy weight and lifestyle through personalized strategies.

A longtime resident of Montana, Annie enjoys hiking, spending time with friends and family, and cheering her girls on in sports.

Marji Cunningham, MSN, DNP, FNP-BC

Marji Cunningham worked in a variety of medical fields for more than 20 years before becoming a Nurse Practitioner in 2020. For the past several years, Marji specialized in the field of Geriatrics where she witnessed firsthand the impact of chronic health problems – many related to obesity. Recognizing that many of these health issues can be avoided by maintaining a healthy weight and lifestyle, Marji is now committed to focusing on prevention through weight loss, nutrition, education, and support. At Scaling Down in the 406, she is dedicated to empowering individuals to achieve sustainable, long-term health transformations.

In her free time, Marji enjoys spending time with her husband and five kids. She also enjoys golf and running.

Annie Earley, BSN, DNP, FNP-C
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      Scaling Down in the 406 provides comprehensive clinical and behavioral support services for people who want to lose excess weight and maintain a healthy lifestyle.

      Ready to transform your life?

      Schedule A Consultation Today!

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