There Is No Spoon

I stayed on my GLP-1 for over four years, but the weight still started coming back in year 3. Did it “stop working” or did I “fall off the wagon” and not really learn “good habits”? I dug into the science for answers.

This three-part series follows the GLP-1 journey past the point where most stories stop, into the years when the body starts fighting back, the trials stop watching, and patients start blaming themselves again. By the end, I want you to see regain differently and know exactly what to ask your doctor. And I have a call to action for our providers and even the manufacturers to improve upon this issue.

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The “Lucky” Trash Panda Phenomenon

Everybody knows someone who eats like a trash panda and never gains a pound. Yet no one points at their body as proof of discipline. We call them lucky and joke about their metabolism, but when someone gains weight easily, we skip right past biology and go looking for a flaw in their character.

Researchers tested this decades ago by having identical twins live together in a supervised dorm and overfeeding every man the exact same extra food. Some men gained three times as much as others, yet each twin landed close to his brother, so the difference seemed to follow their DNA.¹ Another study looked at identical twins who grew up in different homes, and they still ended up carrying their weight much like each other.²

Every man ate the same amount of food, and their bodies wrote very different stories, so I struggle to understand why we still blame the person when we see the science. And it’s not just people without obesity blaming us; we blame ourselves too. But WHY? It’s there in black and white from the same people who used to swear it was only about eating less and moving more!

I was never the “lucky” one metabolically. At eight years old, I stood next to my mom’s spaghetti, fighting with myself over thirds while another part of my brain told me I was not supposed to want that much food. I did not know the phrase food noise yet, but I knew food kept calling me back, and the advice never changed: eat less, try harder, push the plate away, or put the fork down.

I must say I’d love to see twin studies for those taking GLP-1, especially with time as the variable. What happens when they are off the meds in terms of regain, and what happens when they are on the meds past the time many studies track…the 3-5 year mark of “maintenance”.

I tried everything

I have lived with obesity for as long as I can remember, and I have been on every diet on the planet. I had a type of bariatric surgery called a Lap-Band only to regain almost all of it by year 5. When GLP-1s came along, I started with Saxenda, moved to Ozempic, then switched to Mounjaro back in the days when many of us were on the Eli Lilly savings card making TikToks about our journeys. Three years later, I had lost around 100 pounds. But now I’m midway through year 4, and something is changing.

But during those first 3 years, for the first time in my life, food stopped running the show, and I felt like Neo in The Matrix. The bullets were hyper palatable and processed foods, and I would just hold up my hand and watch them drop like they were nothing. It was SO EASY not to choose them. And I soon found I wanted foods like Brussels sprouts instead. It was INSANE! And I knew when the food noise turned off…it wasn’t my fault.

Then the bullets came back

Around year three, foods I used to turn down without a thought started pulling at me again, harder and harder, even though I do not love them or think they taste amazing. I feel drawn to them and far less in control, and the white knuckling I thought I left behind is back. So is some of the weight, and even though I never stopped my medicine, people assume I am eating more. And sometimes I am.

I felt like Neo in The Matrix, holding up my hand and watching the food bullets drop. Around year three, that changed.

What left me curious

For three years, I have chased questions like these by interviewing experts on The Plus SideZ Podcast, and when my regain started, I kept thinking about Season 1, Episode 5, “Fat and Lazy,” with bariatric surgeon Dr. Daniel Rosen.³

He explained he read a peer reviewed article about how people had come in with type 2 diabetes to have bariatric surgery and they were showing in remission before they even left the hospital and before they had lost much weight at all. It seems we got it wrong. The weight wasn’t causing the diabetes, the disease of obesity was.

Our bodies make natural GLP-1 at the bottom of the intestine, and surgery reworks the gut so that GLP-1 bursts. Those levels go down over time, and many patients regain weight three to five years later, so I could not stop wondering whether the same thing was happening to me on GLP-1s.

A lot of the creators I met on TikTok during the Mounjaro savings card days started regaining some too, and they blamed themselves with “fell-off-the-wagon” lines in their videos like “I haven’t really been counting calories.” So I took my questions back to my podcast guests, and again and again, I heard some version of “We really just don’t know yet. It’s so complicated.”

They also told me what they do know:

• Genetics play a big role, and willpower is not the answer.

• The brain regulates hunger and body weight, and it defends the weight it has learned to protect: The Set Point Theory.

• Insulin resistance and leptin resistance are common with obesity, making it harder for the body to use energy well and for the brain to hear that it has had enough.

• A calorie deficit matters for weight loss.

• After major weight loss, the body becomes more efficient and burns less energy.

• Stress, perimenopause and other factors affect hunger and probably regain.

• Nutrition and exercise matter for loss and maintenance of the loss, but they do not treat the disease of obesity.

• Staying on the medicine gives you the best chance of avoiding regain or keeping it small.

• The body adapts metabolically, on the medicine and off it.

• Many of the doctors on my show recommend switching agonists or adding in an older anti-obesity medication like Contrave with the GLP-1 you are on.

Over millions of years, our bodies evolved to protect us from starvation, and they still fight weight loss as if a famine is coming, so treatment will likely need to change as the body adapts. GLP-1s do not cure obesity, and while they often can put it in a well-managed state for at least awhile, anyone who understands this disease knows it can come knocking again.

The phases nobody explains

Obesity medicine physician Dr. Ali Novitzki told me that weight loss on treatment moves in three phases:⁴

• Phase one: weight comes off fairly fast while you learn to manage side effects and what to eat.

• Phase two: loss steadies, then stalls for four to six weeks at a time with no movement on the scale, often several times.

• Phase three: you maintain your loss or work on the last 10 or 20 pounds, which can take years.

In my opinion, two phases are missing, so I added them myself: phase zero, which comes before the first shot when you are researching or too scared to take the medicine sitting in your fridge, and phase four, the year 3-5 problem we rarely hear about. The food noise returns some and regain begins.

Phase four lines up with the window Dr. Rosen described after bariatric surgery, when the typical gastric bypass patient has regained about a quarter of the weight they lost by year six.⁵ The longest tirzepatide study we have found shows that people hit their lowest weight just before the two-year mark, and by about three and a half years, roughly 3 in 10 had regained 5% of their body weight while still taking the medicine. Then the study ended, right when the plot gets interesting.⁶

Since Mounjaro came out in 2022, those of us in the first wave on Tirzepatide in market are living phase four right now with almost no research following us. Nobody prepares us for it, so we blame ourselves when it arrives, and some of us pull back from our care. Diet culture runs thick in our psyche. This is when we may say, “screw it” and want to quit. But people with obesity have so much grit. So…we keep seeking answers and try again.

Those of us in the first wave are living phase four right now with almost no research following us.

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The disease keeps moving

Obesity is a chronic, progressive disease that often progresses to type 2 diabetes, which roughly 7 in 10 people with severe obesity develop in their lifetime.⁷ I do not think GLP-1s are a weight loss tool, I’ve learned too much. Nobody calls chemo a tool for cancer, because it treats a disease with remission as the goal, and so do GLP-1s. I think people who call it a tool don’t really think it’s a disease. Nutrition, movement, sleep and stress management are my tools, and GLP-1s treat the biological dysfunction I can’t control.

But we don’t talk enough about metabolic adaptation. I suspect that explains why so many of us move up in dose as hunger creeps back, the deficit gets harder to maintain, and the scale stalls for months while we do all the “right things.”

What nobody told us

I believed this time was the last time, and nobody told me otherwise, nor the hundreds of GLP-1 patients I talk with each week. Sure, thin GLP-1 naysayers warned that the medicine would “stop working” or that we would regain if we quit, but nobody mentioned it might become less effective or what would come next if that happened…until it started happening.

And in year 4 I am definitely eating different. Somewhere between how I ate in year 1-3 and how I used to eat before. I switched back to semaglutide to see if it would be more effective. I am back to tracking and feeling miserable about it. The odd thing is, this all started when I was still not eating enough and exercising every day. Crazy, right?

This is a very complicated disease! It’s honestly like the ocean. We know some things but there’s so much more to explore. So much we still don’t know or understand.

There is no spoon

Clearly, I love the movie The Matrix, and I love the scene where Neo tries to bend the spoon with his mind. It goes something like this:

For me, the spoon is full control over our weight and body size. We desperately want to believe GLP-1s gave us that control, that the medicine cures us and our regain days are over. But treating obesity is like treating a moving target. We’ll have to adapt treatment as our body adapts.

Our genes explain 40 to 70% of the differences in body weight,⁸ and with medical conditions, hormones, and a bodega on every corner, our bodies still run a famine plan in a world full of snacks. I own the choices I make about food, but what drives them? Those choices cannot control all the forces inside my body.

So…what can I control and how? Let’s explore in part 2 and follow the science. We can’t bend the spoon because there is no spoon. So seek to better understand and bend ourselves.

Don’t miss Part 2

If this sounds like your story, subscribe so Part 2 lands in your inbox, and tell me in the comments what year you are in and what changed for you.

In Part 2, I dig into why the body pushes back even on the medicine, from a brain that defends its weight to the insulin and leptin signals working against us.

If you know someone in year three, four or five who has been blaming themselves, send this to them so they can see the science and stop blaming themselves all over again.

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Sources

1. Bouchard et al., NEJM 1990: overfeeding identical twins

2. Stunkard et al., NEJM 1990: twins reared apart

3. The Plus SideZ, Episode 5: Fat and Lazy with Dr. Daniel Rosen

4. The Plus SideZ: Debunking the Lies About GLP-1s with Dr. Matea Rentea and Dr. Ali Novitzki

5. Systematic review of regain after bariatric surgery

6. Tirzepatide regain over three years

7. Lifetime diabetes risk by BMI, Diabetes Care 2007

8. The Genetics of Obesity, review on PubMed Central

Wait. There’s an Ozempic pill? And before the commercial was over, my husband had pointed out something else that stuck with me: what looked, at least to us, like a subtle layer of weight bias in how the people in the ad were visually presented. Not to mention the “Ozempic guy” was the “Dude, get a Dell!” Guy. Whhhhhhat?!

Admittedly, I sometimes spend an unreasonable amount of time following the GLP-1 market & news because I’m an obesity care advocate. I interview doctors and researchers on The Plus SideZ Podcast, read studies and industry news, and talk about these medications every day.

Somehow, I had missed that Ozempic tablets became available in the U.S. in May 2026. In all fairness, my sister passed away in March So I’ve been pretty disconnected. But that’s another Substack for another day.

Naturally, I started Googling.

• Was this basically Rybelsus, which is far from new?

• Was it using the newer oral semaglutide technology I remembered hearing about with the Wegovy pill?

• How does a pill compare with the Ozempic shot?

And to my husband’s observation, what’s up with this psychological twist on body size for the GLP-1 guy chillin in the recliner. Though later, the Ozempic pill girl was too in a different add. Eating popcorn I think.

So what is the “Ozempic” pill?

This industry does have a track record of slapping a new label on something for marketing but it’s the same ingredient as the original. The connection to Rybelsus is pretty direct. Rybelsus has been oral semaglutide for type 2 diabetes since 2019, and the new Ozempic tablets are also oral semaglutide for adults with type 2 diabetes. The newer tablets use an updated formulation that allows more semaglutide to reach the bloodstream.

That’s an important distinction because hearing “Ozempic pill” makes it sound like someone simply took what was in the pen and put it into a tablet. Getting semaglutide to work orally is much more complicated than that.

Semaglutide is a peptide, and our digestive system is very good at breaking peptides down. Helpful when we eat dinner, but less helpful when the peptide is the medication we are trying to absorb.

Oral semaglutide uses an absorption enhancer called SNAC (punny), or salcaprozate sodium. SNAC helps semaglutide survive long enough in the stomach to be absorbed through the stomach lining. Rybelsus already used SNAC, so this technology is not brand new. What has improved is the formulation and how efficiently the medication is absorbed.

According to FDA information, the older Rybelsus formulation had estimated bioavailability of roughly 0.4% to 1%. The newer Ozempic tablet formulation is estimated at around 1% to 2%. Those numbers sound tiny because oral semaglutide is still difficult to absorb, but improving that percentage matters when you are working with a peptide pill.

Here’s what’s crazy!

The newer formulation didn’t add a new absorption enhancer. Instead, they actually removed some ingredients, a filler and a binder, while keeping the semaglutide plus SNAC tech. And that tweak improved bioavailability enough that lower doses of the newer tablet give similar exposure to higher doses of the older one. It’s wild to me that subtraction was the actual innovation because it’s usually the other way around.

This is also the connection I remembered from the Wegovy pill. The newer Wegovy tablets use the same general oral semaglutide approach, so my memory was partly right. I had just mentally filed the whole thing under “new Wegovy pill technology” when the story actually started with Rybelsus and continued evolving from there. Oops. lol

There is one very Rybelsus-like detail that remains. The Ozempic pill still needs to be taken on an empty stomach with a small amount of plain water, followed by at least 30 minutes before food, other drinks or oral medications. We have improved the science. Coffee remains unwilling to compromise. So annoying.

How does the Ozempic pill compare with the shot?

At a high level, both contain semaglutide, but our bodies handle oral and injected semaglutide differently. That means the milligram numbers on the tablet do not translate neatly to the numbers patients are used to seeing on an Ozempic pen.

There is detailed FDA guidance for clinicians on dosing and switching between certain formulations, but that is well outside my lane as an advocate. For patients, I think the more useful questions are whether your current treatment is working, whether you prefer a daily pill or weekly injection, whether the morning fasting routine fits your life, and what your insurance will actually cover. Your prescriber can handle the conversion math.

For anyone who wants the dosing details, the FDA prescribing information for Ozempic tablets lays all of that out.

Then my husband pointed something out…

The commercial was entertaining. It had this game-show-style setup where Ozempic was being compared with a broad category of “other GLP-1s,” rather than one specific medication.

My husband noticed something before I did. He is autistic and sometimes catches visual details and patterns that sail right past me. He pointed out that the people associated with Ozempic appeared leaner and more conventionally fit, while the man representing the broader GLP-1 category had a larger, huskier body.

Once he said it, I saw what he meant. I have no idea whether that casting decision was intentional, and I would not claim that it was. What interested me was the impression it could create without anyone having to say anything directly.

That feels especially relevant with Ozempic because it is approved for type 2 diabetes, while Wegovy is Novo Nordisk’s semaglutide brand for chronic weight management. Yet Ozempic is so culturally connected to weight loss that body size in an Ozempic commercial can carry meaning whether the script talks about weight or not.

And that is where the ad became more interesting to me than the pill…

The FDA has already questioned the campaign’s visual framing

Ruh Roh. When I looked into the broader campaign, I found that the FDA had already raised concerns about a different Ozempic ad from the same campaign. In a February 2026 letter to Novo Nordisk, the agency said the overall presentation could leave viewers with the impression that Ozempic was superior to other GLP-1 medications, even though the studies being referenced did not establish that kind of superiority.

What caught my attention was that the FDA did not limit its criticism to the spoken claims. It specifically mentioned visual choices, including the Ozempic character wearing bright orange while the “other GLP-1s” character wore dull gray. The agency said those choices contributed to the overall impression being created by the ad.

The FDA did not comment on body size in the commercial my husband and I watched. That observation is ours. Still, it made me think about how much we absorb from pharmaceutical advertising before we consciously evaluate the words.

Casting, clothing, color, humor, body size and who appears healthier or more successful can all shape how a viewer interprets an ad. I would call that psychological framing. It is a normal part of advertising, but prescription drug advertising deserves a little more scrutiny because the people watching may be making decisions about their health.

That is ultimately what stuck with me. I started out surprised that there was an Ozempic pill and ended up thinking about two different kinds of absorption: how semaglutide gets through the stomach, and how advertising gets into our heads.

The science behind oral semaglutide has improved, and having another way to take the medication could matter for patients who want an alternative to injections. The commercial that finally told me about it also turned out to be a pretty good reminder to pay attention to what an ad is showing us, not only what it says.

My take on Future Pharma Commercials

It may shock you that I think we need them. Too many meds come out in and aren’t mentioned in a 10 min appointment with a PCP. And I think it’s good for us to see it, research it, take that insight to our doctor and be part of our own care team.

But I think more care should be taken to educate both that obesity and type 2 diabetes are chronic, progressive diseases. Educate people on why they need the med to begin with!

You may think people know, but I can tell you that as someone who speaks to hundreds of people a day who have this disease most of them do not. They think that they are fat, lazy, and they should’ve put the fork down. They don’t understand that 40 to 70% of your weight is predetermined by genetics. They don’t understand that obesity causes the over eating, The over eating doesn’t cause obesity.

Unfortunately, I think that we are still pretty far away from society, accepting obesity as a disease And removing any kind of accountability from someone who has it. But a lot of my work is focused on this.

If you’ve got someone’s attention for 30-60 seconds, which maybe could do more than spread alleged stigma bias we’re all trying to combat. Take the opportunity to teach about the disease and empower patients. Drop with what seem like tampon commercials for medicine.

While I found the new commercials entertaining, I think there’s a bigger opportunity to educate & I hope big pharma takes this note.

But I’m curious what you think. Tell me in the comments.

Sources

FDA approval letter for Ozempic tablets / Rybelsus formulation change
https://www.accessdata.fda.gov/drugsatfda_docs/appletter/2026/213051Orig1s030ltr.pdf

FDA prescribing information for Ozempic tablets
https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/213051Orig1s030lbl.pdf

Novo Nordisk announcement on U.S. Ozempic pill availability
https://www.novonordisk-us.com/media/press-releases/ozempic-pill-us-availability-type-2-diabetes.html

FDA February 2026 letter regarding Ozempic advertising
https://www.fda.gov/media/191387/download

Research on SNAC and gastric absorption of oral semaglutide
https://pubmed.ncbi.nlm.nih.gov/30429357/

WHO: Obesity and overweight
https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

American Diabetes Association, Standards of Care in Diabetes 2026
https://diabetesjournals.org/care/article/49/Supplement_1/S27/163926/2-Diagnosis-and-Classification-of-Diabetes

Now, glp-1 effects everyone uniquely, of course, but as patients are seeking support their questions seem to fall into these categories.

One thing is clear, if you have obesity, this isn’t a weight loss journey. And because obesity is a chronic, progressive disease we will need community support forever. GLP-1s are AMAZING treatments but they are not cures.

And that’s one of several reasons Amanda Bonello and I founded the Cozy Butter GLP-1 Community. Because we’ve all been bathed in diet culture we often don’t realize there’s way more “work” to be done on this journey outside of “eating less and moving more”. Obesity is a massively complex disease. And most PCPs don’t understand how to treat it outside of increasing your dose and telling you to diet & exercise.

We deserve more. We deserve better care!

We deserve The Butter Way! Join Cozy Butter free and help us build something butter. 🧈

We have:

• Peer-to-peer support

• Live support groups

• Ask a Health Coach Chat

• GLP-1 & obesity education

• GLP-1 news & updates

• Tools for nutrition, hydration & side effects, etc.

• A community for us by us

I wanted real answers about my own body, so I asked obesity medicine specialist Dr. Ali Novitzki about it on an episode of The Plus Sidez Podcast. The clarity she gave me completely changed how I look at my journey. She helped me realize that my medication did not fail, and neither did I. My body was just navigating the natural physical phases of a weight loss journey.

The Moving Rate of Weight Loss Dr. Ali explained that weight loss on a GLP-1 is a dynamic process. It does not look like a straight, continuous drop on a graph. Instead, she maps it out as a sequential progression of changing speeds:

• The Rapid Phase: At the very beginning of your journey, weight tends to drop quickly. This happens because the medication suddenly quiets your food noise and suppresses your appetite, resulting in a sharp drop in your overall food intake.

• The Slowing Phase: As you move further along, your rate of loss naturally begins to get slower. Your body starts recognizing the change in mass and tries to adjust to its new baseline weight.

• The Final Phase: Eventually, you reach a phase where weight loss becomes very slow. This is the exact point where progress frequently pauses, and it can feel like a total, permanent plateau.

Dr. Ali notes that she refers to these as biological stages or phases because they directly reflect how your internal metabolism behaves as your physical body mass changes.

What is Happening Inside Your Body During a Stall?

Learning what is happening biochemically when the scale freezes was a massive lightbulb moment for me. Dr. Ali explained that when we hit that very slow phase, it is often because our internal metabolic engine has changed.

Our skeletal muscle acts like a primary pool for glycogen storage, actively pulling fuel and food energy straight out of our bloodstream to keep our systems running. Gaining or keeping your muscle mass improves your insulin sensitivity, which means your body needs less insulin to process the food you eat.

But if your engine shrinks, your baseline insulin requirements actually go up. Because insulin is a storage hormone, higher baseline levels tell your body to hold onto fat tissue, which completely freezes your weight loss progress. Your plateau isn’t a sign of failure; it is your baseline metabolic rate slowing down to adapt to a changing internal environment.

The Plan to Get Back in Control: Protecting your metabolism through these changes does not require complex routines or extreme calorie cutting. Dr. Ali shared a simple, practical framework with me to support long-term metabolic health and safely navigate these natural shifts:

• The 100-Gram Protein Target: Eating roughly 100 grams of protein daily provides the necessary cellular building blocks your system needs to preserve its active lean tissue.

• The 10-Minute Resistance Framework: Committing to just 10 minutes of strength training three days a week provides enough tension to support your metabolism. Dr. Ali assured me you can easily do this at home using your own body weight, resistance bands, or a basic kettlebell.

Living with obesity means managing a complex, chronic biological condition. When your progress pauses, it is not a moral failure. It is just your body navigating a survival mechanism.

To watch my full conversation with Dr. Ali and Dr. Rentea, look at the data, and learn the truth about the common lies surrounding GLP-1 medications, watch our special replay episode on the Plus Sidez Podcast here

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But I think a lot of that panic comes from how oversimplified the public conversation around these medications has become.

GLP-1s are often discussed like they are just appetite suppressants. So people understandably assume that if they feel hungry again, the treatment must be failing. But obesity medicine specialists and researchers talk about these medications in a much more nuanced way than that.

These medications affect satiety signaling, reward pathways, insulin resistance, gastric emptying, blood sugar regulation, and brain signaling connected to food intake and energy regulation. That is part of why so many patients describe the experience as feeling “different” around food, not simply less hungry.

Hunger and Satiety Are Not the Same Thing

I think one of the most important distinctions people miss is the difference between hunger and satiety. Hunger is a biological signal that your body needs energy. Satiety is your body’s ability to recognize that it has had enough.

For many people living with obesity or metabolic dysfunction, that regulation system may not function typically. That is something obesity medicine experts discuss frequently, but it often gets lost online where everything gets reduced to “eat less” or “just stay in a calorie deficit.”

A lot of patients are not simply struggling with hunger. They are struggling with impaired fullness signaling, persistent cravings, reward seeking behavior around food, and constant mental preoccupation with eating.

What Patients Mean When They Talk About “Food Noise”

From my perspective as both a patient and an obesity care advocate who regularly interviews obesity medicine physicians and researchers on The Plus SideZ Podcast, one of the most consistent things I hear is patients describing relief from food noise.

The constant intrusive thoughts about food quiet down. The urgency around eating changes. People often describe finally feeling satisfied after meals instead of continuing to chase fullness. That is very different from simply “not being hungry.”

And honestly, I think this is one of the reasons these medications can feel so emotionally significant for patients. Many people realize for the first time that what they were experiencing was not simply a lack of discipline or willpower.

Hunger Returning May Not Mean Failure

Over time, the experience on these medications can evolve. Early in treatment, some people may have very little appetite at all. Later, hunger may return in a more normal way while satiety, portion control, and reduced food noise remain improved compared to before treatment. That does not necessarily indicate treatment failure.

I think social media sometimes creates unrealistic expectations where people start believing the goal is to never feel hunger again. But hunger itself is normal biology. The more important question is whether the underlying dysregulation around satiety, cravings, compulsive eating patterns, and food noise has improved.

Obesity Is More Complex Than Public Conversations Suggest

Obesity is a complex chronic, progressive disease involving hormones, metabolism, brain signaling, genetics, environment, and energy regulation. GLP-1 medications are interacting with many of those systems simultaneously, which is why the patient experience is often far more nuanced than the simplified headlines people see online.

And honestly, I think patients deserve more conversations that reflect that complexity instead of reducing everything to “they make you not hungry.”

If you’re feeling more hunger on a GLP-1 to where are you feel cannot stay in a calorie deficit, talk to your doctor about possibly increasing the medication dose or adding in another anti obesity medication like Contrave or Qsymia.

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One of the side effects I’ve never been able to get past after 3.5 years on GLP-1 is the exhaustion. I’ve tried everything. I was desperate and tried NAD+ and it’s been a game changer. Like where has this been my whole journey?

I tried the pills first but not much changed. Then I tried subconsciously and after a month WOW! I felt myself again. Energy back! I also trued the nasal spray daily but found it too sticky in my nose.

I’m also going through perimenopause so it’s a double whammy energy zap, crashing by 12. We have NAD in our body and we lose it as we age. I see a doctor at ShedRX and they prescribed through Strive pharmacy. I’m an affiliate. My code saves you 40% off. Kim40

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1. 1. Weight regulation is controlled in your brain and has nothing to do with willpower. It’s not your fault. Google the set weight theory.

3. 2. Diet and Exercise do not TREAT obesity. They are imperative for overall health but they don’t treat your disease.

5. 3.Most people who have obesity have insulin resistance and GLP-1 treat it by having your pancreas produce more insulin, unlocking resistant cells so your body can process insulin more efficiently and not store it in fat. It also treat your brain and food noise driving you to over eat. I’m not saying we’re not accountable for food choices. I’m just sayin they’re driven by a disease and give yourself grace.

7. 4. Adipose tissue is an organ (mostly in your middle) that’s a secrets hormones and wreaks havoc with inflammation that affects all the organs in your body and put you at rest for 13 different kinds of cancer. Hunger and food noise are a symptom of your disease. And all medicines other than surgery only treated the symptom not the root cause which is usually insulin resistance and genetics.

9. 5. Obesity is a vicious, chronic, progressive, multifactorial disease, and you are worthy of care.

11. 6. If you stop taking the medication, you were gaining your weight, but not just because the food noise returns, but because your body is always trying to survive a famine that’s never going to come and again because weight is controlled in your brain. Your fat has memory. Your body literally processes and stores energy in a different way. You’re not weak. You are a sick person that needs medicine.

You’re not alone. It’s not your fault.

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“Here you go, Kim. Taking a diabetes medication to lose weight because you can’t control something as simple as food. You are so pathetic.”

But then I realized… I could hear myself think.

That was rare.

In that moment, I knew this was different. I felt something I’d never felt before: stillness. Quiet. Satisfaction. There was terror in that silence, yes, but there was power too. And I remember asking myself, “Am I going to squander this… or am I going to do everything I can?” I vowed to do everything I could. At the time, I think I thought “everything” just meant diet and exercise. But very quickly, it became about something bigger. It became what I could do for others who struggle like me. Though I am describing the dawn of my purpose, know I’m no saint. I’ve made about every mistake there is, but my intentions are pure. And I care deeply for those who struggle with this disease.

I needed to understand exactly what was happening in my brain and my body. And I needed to tell EVERYONE. Because I knew in that quiet moment, viscerally, it wasn’t my fault. That’s how The Plus SideZ was born.

If you’re new here, I’m Kim. I’m an obesity care advocate and the host of The Plus SideZ Podcast, an education and advocacy show about obesity, metabolic disease, and GLP-1 medications. My podcast features people from the GLP-1 community who share their stories, and I pair them with leading doctors in the field of obesity who validate those experiences with facts, science, and data. In just 2.5 years, the podcast has won four awards and is ranked in the top 1% of podcasts worldwide by Listen Notes.

My story is different in that I am no one, yet I am everyone. Because to me, that’s obesity. It knows no bounds. I lived with obesity for the majority of my adult life. And from the outside looking in, I was incredibly blessed: an amazing family, a great career, wonderful friends. But it never felt like enough, because I couldn’t control something as “simple” as food.

This is my first Substack article. Here, I’m going to tell you about the birth of a movement and how a marginalized community rose up and said: “It’s not our fault.”

I hope you’ll subscribe to follow along.

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Hey Plus SideZ GLP-1 Community! We’ve got a fresh, heartfelt episode to share. If you haven’t yet, now’s a great time to consider becoming a paid subscriber to access exclusive bonus content and get early access to episodes, so you can stay in the loop with all the behind-the-scenes updates, personal stories, and medical insights from doctors.

In this week’s episode, we dive deep into the realities of living with obesity and the life-changing impact of GLP-1 medications. Both Kat and I are two and a half years into our own journeys with GLP-1s, and we reflect on how these medications have transformed our relationships with food, our bodies, and our overall mental health.

Breaking Down the Food Noise

For me, this “Ozempic Journey” has been a game-changer. I’ve struggled with obesity since I was a young child—feeling guilty for needing to restrict my food just to have something to enjoy. A lot of my life was spent consumed by food noise, battling thoughts of "If only I could control my eating, I would be successful." But after starting GLP-1 medication, I finally experienced what it’s like to turn off that noise. I realized it wasn’t my fault. It wasn’t a moral failure. Instead, it was the way my metabolism was wired.

Kat’s story resonated deeply with me too. She shared her own struggles with binge eating disorder and the shame that followed. Her emotional connection to food started early, and it’s been something she’s had to work through. The medication didn’t take away the emotional and mental work, but it certainly helped by turning down the volume on those urges, allowing her to make healthier choices without the constant obsession.

A Powerful Community & A Call for Change

We also had the privilege of speaking with Dr. Lindsay Ogle, a board-certified family medicine and obesity medicine physician, who helped us understand the science behind obesity, GLP-1 medications, and the hormonal shifts that play a crucial role in our health. Dr. Ogle shared insights into how GLP-1 medications help regulate insulin resistance, hunger, and metabolism, and why these medications are not just about weight loss, but about treating the underlying causes of obesity. She explained the importance of understanding the "set weight theory," and how our bodies fight to regain weight as a form of self-protection—a key concept in managing obesity long-term.

As Dr. Ogle discussed, the weight loss journey isn’t linear and varies for everyone, especially during stages like perimenopause and menopause. She emphasized the significance of viewing obesity as a chronic disease that needs continuous treatment, not just a short-term fix. We also explored how chronic health conditions like diabetes, sleep apnea, and even certain cancers are linked to obesity, making treatment and management even more critical.

Amanda’s Story: A Call for Affordable Access

We then invited Amanda, a passionate advocate who shared her deeply personal story about overcoming eating disorders and fighting for affordable access to GLP-1 medications. Amanda has experienced the transformative power of these medications firsthand, but like many in the community, she has faced barriers to obtaining them due to high costs. She shared her efforts to launch a petition for more affordable access and discussed how the community needs to unite and advocate for change.

Amanda’s story struck a chord with both Kat and me, and it reaffirmed why we need to keep pushing for better access to these life-saving treatments. It's not just about the medication; it's about the people who need it. We’ve seen how life-changing this treatment can be, and we can’t afford to let bureaucracy and high costs keep people from the care they deserve.

A Holistic Approach to Health

In this episode, we also dive into the science behind why GLP-1 medications work—especially in terms of how they impact insulin resistance and hunger regulation. Obesity is not about willpower. It’s a chronic disease, and it requires long-term treatment, just like managing other conditions such as diabetes or hypertension. As we continue to learn, we see more evidence showing how treating the underlying metabolic issues makes all the difference in achieving lasting health.

We discussed practical tips for those on their journey, from prioritizing protein to combating night eating disorder and understanding the connection between mental health and weight management. With Dr. Ogle’s insights, we understand that weight loss may not be linear, but it’s the focus on overall health that truly matters.

It’s Not Just About Weight—It’s About Health

As we wrap up this episode, one thing is clear: the journey is not just about weight loss; it’s about health, well-being, and reclaiming control over our bodies. Whether you’re on a GLP-1 or another treatment, or even just beginning your journey, it’s vital to remember that we’re all in this together. The ups and downs, the frustrations, and the victories—they’re part of the process.

We want you to know you’re not alone. There’s a growing community here that’s working to make sure everyone has access to the treatments and support they need to live their healthiest, happiest lives.

Thank you for being a part of this journey with us. Stay loud, stay strong, and don’t forget: it's not your fault. You deserve the right to be healthy, and we’ll keep fighting to make sure you get the care you deserve.

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Resources for the Community:
___________________________________________________________________

https://linktr.ee/theplussidezpodcast 

Ro - Telehealth for GLP1 weight management 

https://ro.co/weight-loss/?utm_source=plussidez&utm_medium=partnership&utm_campaign=comms_yt&utm_content=45497&utm_term=55

If You are having issues accessing Paid Subscriber content please send an email to support@buzzsprout.com and a member of Buzzsprout's technical team will help you access the content.
______________________________________________________________________
The Provider Spotlight is a new bonus series of shorter episodes featuring doctors and specialists from past sessions—think of it as 'doctor shorts.' With over 25k scripts for Zepbound written weekly, many new subscribers haven't seen our earlier episodes, which helps them catch up quickly. Thanks for your support!
On August 29th, 2024, Dr. Michael Albert joined The Plus Sidez to delve into the pressing topic of obesity and the evolving landscape of GLP-1 medications. Tune in for an insightful discussion on how these groundbreaking treatments are shaping the future of weight management and healthcare.

If you would like to watch or listen to the full episode please use the below links 
Youtube
https://youtu.be/AFCoTsgmYz8
Audio
https://www.buzzsprout.com/2167931/episodes/13545988
https://podcasts.apple.com/us/podcast/season-1-episode-24-season-finale-looking-back-forward/id1681163817?i=1000627037558

Dr. Michael Albert, Accomplish Health 
https://www.accomplish.health/about
https://www.tiktok.com/@michaelalbertmd?lang=en
https://www.instagram.com/michaelalbertmd/?hl=en
______________________________________________________________________

⭐️Mounjaro Stanley⭐️

griffintumblerco.Etsy.com

Use code PODCAST10 for $ OFF
______________________________________________________________________

Join this channel to get access to perks:

   / @theplussidez
______________________________________________________________________

#Mounjaro #MounjaroJourney #Ozempic #Semaglutide #tirzepatide  #GLP1 #Obesity #zepbound #wegovy 

Kim Carlos, Executive Producer

TikTok

https://www.tiktok.com/@dmfkim?is_from_webapp=1&sender_device=pc

Instagram

https://www.instagram.com/dmfkimonmounjaro?igsh=aDF6dnlmbHBoYmJn&utm_source=qr

Kat Carter, Associate Producer

TikTok

https://www.tiktok.com/@katcarter7?is_from_webapp=1&sender_device=pc

Instagram

https://www.instagram.com/mrskatcarter?utm_source=ig_web_button_share_sheet&igsh=ZDNlZDc0MzIxNw==

https://linktr.ee/theplussidezpodcast 

Ro - Telehealth for GLP1 weight management 

https://ro.co/weight-loss/?utm_source=plussidez&utm_medium=partnership&utm_campaign=comms_yt&utm_content=45497&utm_term=55

If You are having issues accessing Paid Subscriber content please send an email to support@buzzsprout.com and a member of Buzzsprout's technical team will help you access the content.
______________________________________________________________________
Part 2
In this episode, we delve into the complex world of insulin resistance, exploring its impact on hunger, weight management, and overall health. We'll uncover the science behind this metabolic condition and discuss how it can lead to continued obesity and inflammation. 

We'll also challenge the traditional diet culture narrative, examining why it often leads to a cycle of yo-yo dieting. We'll explore the role of hormones, particularly GLP-1, in regulating appetite and blood sugar levels, and how GLP-1 therapies can be a valuable tool in managing insulin resistance.

We chat about menopause and perimenopause and the evolution of hormone replacement therapy. We also explore the limitations of BMI, and introduce the Body Roundness Index as a more accurate measure of body composition. Join us as we unravel the complexities of obesity management, hormone health, and personalized approaches to well-being.
______________________________________________________________________

⭐️Mounjaro Stanley⭐️

griffintumblerco.Etsy.com

Use code PODCAST10 for $ OFF
______________________________________________________________________

Join this channel to get access to perks:

   / @theplussidez

______________________________________________________________________

#Mounjaro #MounjaroJourney #Ozempic #Semaglutide #tirzepatide  #GLP1 #Obesity #zepbound #wegovy 

Support the show

Kim Carlos, Executive Producer

TikTok

https://www.tiktok.com/@dmfkim?is_from_webapp=1&sender_device=pc

Instagram

https://www.instagram.com/dmfkimonmounjaro?igsh=aDF6dnlmbHBoYmJn&utm_source=qr

Kat Carter, Associate Producer

TikTok

https://www.tiktok.com/@katcarter7?is_from_webapp=1&sender_device=pc

Instagram

https://www.instagram.com/mrskatcarter?utm_source=ig_web_button_share_sheet&igsh=ZDNlZDc0MzIxNw==

https://linktr.ee/theplussidezpodcast 

Ro - Telehealth for GLP1 weight management 

https://ro.co/weight-loss/?utm_source=plussidez&utm_medium=partnership&utm_campaign=comms_yt&utm_content=45497&utm_term=55

If You are having issues accessing Paid Subscriber content please send an email to support@buzzsprout.com and a member of Buzzsprout's technical team will help you access the content.
______________________________________________________________________
Part 1
In this episode, we delve into the complex world of insulin resistance, exploring its impact on hunger, weight management, and overall health. We'll uncover the science behind this metabolic condition and discuss how it can lead to continued obesity and inflammation. 

We'll also challenge the traditional diet culture narrative, examining why it often leads to a cycle of yo-yo dieting. We'll explore the role of hormones, particularly GLP-1, in regulating appetite and blood sugar levels, and how GLP-1 therapies can be a valuable tool in managing insulin resistance.

We chat about menopause and perimenopause and the evolution of hormone replacement therapy. We also explore the limitations of BMI, and introduce the Body Roundness Index as a more accurate measure of body composition. Join us as we unravel the complexities of obesity management, hormone health, and personalized approaches to well-being.
______________________________________________________________________

⭐️Mounjaro Stanley⭐️

griffintumblerco.Etsy.com

Use code PODCAST10 for $ OFF
______________________________________________________________________

Join this channel to get access to perks:

   / @theplussidez

______________________________________________________________________

#Mounjaro #MounjaroJourney #Ozempic #Semaglutide #tirzepatide  #GLP1 #Obesity #zepbound #wegovy 

Support the show

Kim Carlos, Executive Producer

TikTok

https://www.tiktok.com/@dmfkim?is_from_webapp=1&sender_device=pc

Instagram

https://www.instagram.com/dmfkimonmounjaro?igsh=aDF6dnlmbHBoYmJn&utm_source=qr

Kat Carter, Associate Producer

TikTok

https://www.tiktok.com/@katcarter7?is_from_webapp=1&sender_device=pc

Instagram

https://www.instagram.com/mrskatcarter?utm_source=ig_web_button_share_sheet&igsh=ZDNlZDc0MzIxNw==

Resources for the Community:
___________________________________________________________________

https://linktr.ee/theplussidezpodcast 

Ro - Telehealth for GLP1 weight management 

https://ro.co/weight-loss/?utm_source=plussidez&utm_medium=partnership&utm_campaign=comms_yt&utm_content=45497&utm_term=55

If You are having issues accessing Paid Subscriber content please send an email to support@buzzsprout.com and a member of Buzzsprout's technical team will help you access the content.
______________________________________________________________________
The Provider Spotlight is a new bonus series of shorter episodes featuring doctors and specialists from past sessions—think of it as 'doctor shorts.' With over 25k scripts for Zepbound written weekly, many new subscribers haven't seen our earlier episodes, which helps them catch up quickly. Thanks for your support!

On August 8th 2023 Dr Joy Bracey set down with the  The Plus SideZ Podcast to discuss the role GLP-1s can play in addictive behaviors such as over eating or alcohol. The Pharmaceutical industry is doing studies on this now.  Check out the full episode in Season one, episode 23 to hear Brenda's story. 

______________________________________________________________________

⭐️Mounjaro Stanley⭐️

griffintumblerco.Etsy.com

Use code PODCAST10 for $ OFF
______________________________________________________________________

Join this channel to get access to perks:

   / @theplussidez
______________________________________________________________________

#Mounjaro #MounjaroJourney #Ozempic #Semaglutide #tirzepatide  #GLP1 #Obesity #zepbound #wegovy 

Kim Carlos, Executive Producer

TikTok

https://www.tiktok.com/@dmfkim?is_from_webapp=1&sender_device=pc

Instagram

https://www.instagram.com/dmfkimonmounjaro?igsh=aDF6dnlmbHBoYmJn&utm_source=qr

Kat Carter, Associate Producer

TikTok

https://www.tiktok.com/@katcarter7?is_from_webapp=1&sender_device=pc

Instagram

https://www.instagram.com/mrskatcarter?utm_source=ig_web_button_share_sheet&igsh=ZDNlZDc0MzIxNw==

https://linktr.ee/theplussidezpodcast 

Ro - Telehealth for GLP1 weight management 

https://ro.co/weight-loss/?utm_source=plussidez&utm_medium=partnership&utm_campaign=comms_yt&utm_content=45497&utm_term=55

If You are having issues accessing Paid Subscriber content please send an email to support@buzzsprout.com and a member of Buzzsprout's technical team will help you access the content.
______________________________________________________________________
Part 2

This episode explores the complex nature of insulin resistance and the role of GLP-1 therapies in its management. We delve into the concept of a "healthy size," challenging the traditional approach of solely focusing on obesity through diet and exercise. Dr. Mattea Rentea, a renowned obesity specialist, sheds light on the limitations of these methods and the importance of addressing the underlying physiological and also genetic factors contributing to obesity.

We discuss the role of inflammation in obesity and how GLP-1 therapies can help mitigate its adverse effects. Additionally, we examine the integrated approach of the Rentea Clinic, which combines both mental and physical health support to achieve sustainable weight loss and improved overall well-being. By understanding the multifaceted nature of obesity, individuals can adopt effective strategies to manage their weight and improve their quality of life.

Special Guest: 

Dr. Matthea Rentea 

Community Guest 

Jeanie 
______________________________________________________________________

⭐️Mounjaro Stanley⭐️

griffintumblerco.Etsy.com

Use code PODCAST10 for $ OFF
______________________________________________________________________

Join this channel to get access to perks:

   / @theplussidez
______________________________________________________________________

#Mounjaro #MounjaroJourney #Ozempic #Semaglutide #tirzepatide  #GLP1 #Obesity #zepbound #wegovy

Support the show

Kim Carlos, Executive Producer

TikTok

https://www.tiktok.com/@dmfkim?is_from_webapp=1&sender_device=pc

Instagram

https://www.instagram.com/dmfkimonmounjaro?igsh=aDF6dnlmbHBoYmJn&utm_source=qr

Kat Carter, Associate Producer

TikTok

https://www.tiktok.com/@katcarter7?is_from_webapp=1&sender_device=pc

Instagram

https://www.instagram.com/mrskatcarter?utm_source=ig_web_button_share_sheet&igsh=ZDNlZDc0MzIxNw==

https://linktr.ee/theplussidezpodcast 

Ro - Telehealth for GLP1 weight management 

https://ro.co/weight-loss/?utm_source=plussidez&utm_medium=partnership&utm_campaign=comms_yt&utm_content=45497&utm_term=55

If You are having issues accessing Paid Subscriber content please send an email to support@buzzsprout.com and a member of Buzzsprout's technical team will help you access the content.
______________________________________________________________________
Part 1

This episode explores the complex nature of insulin resistance and the role of GLP-1 therapies in its management. We delve into the concept of a "healthy size," challenging the traditional approach of solely focusing on obesity through diet and exercise. Dr. Mattea Rentea, a renowned obesity specialist, sheds light on the limitations of these methods and the importance of addressing the underlying physiological and also genetic factors contributing to obesity.

We discuss the role of inflammation in obesity and how GLP-1 therapies can help mitigate its adverse effects. Additionally, we examine the integrated approach of the Rentea Clinic, which combines both mental and physical health support to achieve sustainable weight loss and improved overall well-being. By understanding the multifaceted nature of obesity, individuals can adopt effective strategies to manage their weight and improve their quality of life.

Special Guest: 

Dr. Matthea Rentea 

Community Guest 

Jeanie 
______________________________________________________________________

⭐️Mounjaro Stanley⭐️

griffintumblerco.Etsy.com

Use code PODCAST10 for $ OFF
______________________________________________________________________

Join this channel to get access to perks:

   / @theplussidez
______________________________________________________________________

#Mounjaro #MounjaroJourney #Ozempic #Semaglutide #tirzepatide  #GLP1 #Obesity #zepbound #wegovy

Support the show

Kim Carlos, Executive Producer

TikTok

https://www.tiktok.com/@dmfkim?is_from_webapp=1&sender_device=pc

Instagram

https://www.instagram.com/dmfkimonmounjaro?igsh=aDF6dnlmbHBoYmJn&utm_source=qr

Kat Carter, Associate Producer

TikTok

https://www.tiktok.com/@katcarter7?is_from_webapp=1&sender_device=pc

Instagram

https://www.instagram.com/mrskatcarter?utm_source=ig_web_button_share_sheet&igsh=ZDNlZDc0MzIxNw==

Ro - Telehealth for GLP1 weight management 

https://ro.co/weight-loss/?utm_source=plussidez&utm_medium=partnership&utm_campaign=comms_yt&utm_content=45497&utm_term=55

If You are having issues accessing Paid Subscriber content please send an email to support@buzzsprout.com and a member of Buzzsprout's technical team will help you access the content.
____________________________________________________________________________________________
Part 2
This episode delves into the intricate relationship between insulin resistance, polycystic ovarian syndrome (PCOS), and obesity. We explore how these conditions often intertwine, leading to a cyclical pattern that can be challenging to break.

We discuss the fascinating study of adipose tissue's remarkable ability to remember past weight gain, even after significant weight loss. This phenomenon sheds light on the persistent challenges faced by individuals who have lost weight and are striving to maintain their progress.

We also delve into the critical role of basal metabolic rate (BMR) and caloric consumption in weight management. Understanding these factors can empower individuals to make informed choices about their diet and exercise routines.

Finally, we compare and contrast two groundbreaking medications, semaglutide and tirzepitide. Both drugs have shown remarkable efficacy in treating obesity, but there are key differences in their mechanisms of action and potential side effects. We explore the latest research to determine which medication may be the best fit for different individuals.
____________________________________________________________________________________________

⭐️Mounjaro Stanley⭐️

griffintumblerco.Etsy.com

Use code PODCAST10 for $ OFF
____________________________________________________________________________________________

Join this channel to get access to perks:

   / @theplussidez
______________________________________________________________________

#Mounjaro #MounjaroJourney #Ozempic #Semaglutide #tirzepatide  #GLP1 #Obesity #zepbound #wegovy 

Support the show

Kim Carlos, Executive Producer

TikTok

https://www.tiktok.com/@dmfkim?is_from_webapp=1&sender_device=pc

Instagram

https://www.instagram.com/dmfkimonmounjaro?igsh=aDF6dnlmbHBoYmJn&utm_source=qr

Kat Carter, Associate Producer

TikTok

https://www.tiktok.com/@katcarter7?is_from_webapp=1&sender_device=pc

Instagram

https://www.instagram.com/mrskatcarter?utm_source=ig_web_button_share_sheet&igsh=ZDNlZDc0MzIxNw==