Did My GLP-1 Stop Working? Food Noise, Weight Regain & What to Check

Thinking about starting a GLP-1 medication or having bariatric surgery? What should you know about your mental health, nutritional deficiencies, emotional eating, and relationship with food before treatment begins? Whether you're considering Wegovy, Zepbound, gastric sleeve surgery, or gastric bypass, preparing for obesity treatment involves more than understanding weight loss and physical side effects. In this episode of Weight & Measure with Mike and Zach, hosts Mike Donnelly-Boylen and Zach Niemiec welcome Dr. Lillian Craggs-Dino, registered dietitian, and Dr. Nini Peterson, clinical and health psychologist, to explore the psychological and nutritional considerations before starting an obesity management medication (OMM) or undergoing metabolic & bariatric surgery. Mental Health & Psychological Evaluations: Why psychological evaluations before bariatric surgery aren't simply pass-or-fail tests, how depression and anxiety fit into treatment planning, and why mental health support should help patients access appropriate care rather than create unnecessary barriers. Vitamin Deficiencies & Mental Health: How deficiencies involving thiamine (vitamin B1), vitamin B12, other B vitamins, and copper may affect neurological and psychological health, and why nutritional screening and monitoring are important. Food Noise & Emotional Eating: How GLP-1 medications and bariatric surgery can change hunger, appetite, coping mechanisms, body image, and relationships with food. The MIND Diet & Brain Health: What the MIND diet is, what research suggests about nutrition and cognitive health, and how its principles may fit into obesity treatment. Family Support & Long-Term Care: Why loved ones shouldn't become the "food police" and why multidisciplinary support from dietitians, behavioral health professionals, and other members of the care team matters. How should I prepare mentally for bariatric surgery or GLP-1 treatment?

What Does Your Gut Microbiome Have to Do With Obesity, GLP-1s & Bariatric Surgery? Can your gut microbiome affect obesity, weight loss, GLP-1 medications, or metabolic & bariatric surgery outcomes? And can what you eat actually change how many calories your body absorbs? In this episode of Weight & Measure with Mike and Zach, we sit down with Karen D. Corbin, PhD, RD, Associate Investigator at AdventHealth Translational Research Institute, for a deep dive into the rapidly evolving science of the gut microbiome, obesity, metabolism, GLP-1 based medications, and metabolic & bariatric surgery. Dr. Corbin starts with the basics: What is the gut microbiome? Is there actually such a thing as “good” and “bad” gut bacteria? What makes a microbiome healthy? And how do diet, fiber, resistant starch, genetics, hormones, environment, and medications shape the trillions of microorganisms living in our gut? Then we get into the obesity science. Dr. Corbin explains research examining how the gut microbiome may influence energy balance and calorie absorption, including her team's controlled feeding study comparing a Western diet with a “microbiome enhancer diet.” Participants eating the microbiome-focused diet absorbed, on average, 116 fewer calories per day, with some individuals showing substantially larger differences in unabsorbed energy. We also explore the questions many people using obesity treatments are asking: Does your gut microbiome change when you take a GLP-1 medication? Could your microbiome influence how well a GLP-1 works? Why do two people taking the same medication sometimes experience different weight-loss responses? What happens to the microbiome after sleeve gastrectomy, gastric bypass, or other metabolic & bariatric surgery? Dr. Corbin explains why much of the research connecting GLP-1 medications and the microbiome still comes from animal models, what scientists need to demonstrate in humans, and why separating the effects of medication, weight loss, diet, GI transit, and metabolic improvements is so difficult. We also tackle the idea of “GLP-1 receptor sensitivity.” Is GLP-1 resistance actually an established phenomenon? Could genetic differences in the GLP-1 receptor affect treatment response? And have supplements and gut-health products gotten ahead of the science by adding “GLP-1” to their marketing? Plus, Dr. Corbin busts a major probiotic myth and explains why adding a handful of bacterial species isn't the same thing as rebuilding an incredibly complex microbial ecosystem. What the gut microbiome actually is “Good” vs. “bad” gut bacteria What makes a healthy microbiome How food and nutrition shape gut bacteria Fiber, resistant starch, whole foods, and ultra-processed foods The gut-brain axis, hunger, satiety, and naturally produced GLP-1 Gut bacteria, calorie absorption, and energy balance The microbiome and obesity GLP-1 medications and gut microbiome changes Why GLP-1 response varies between people GLP-1 receptor sensitivity and genetics The microbiome after metabolic & bariatric surgery Sleeve gastrectomy and gastric bypass Probiotics and microbiome myths What gut-health science can and cannot tell us today How to support your microbiome with food Where microbiome and obesity research goes next One of the most important takeaways: an association between the microbiome and a disease does not necessarily mean the microbiome caused it. The science is promising, but there is still much researchers don't understand. As Dr. Corbin puts it, one practical question we can ask ourselves is: “Have I fed my gut microbiome today?” Subscribe to Weight & Measure with Mike and Zach for evidence-based conversations about obesity, GLP-1 medications, obesity management medications (OMMs), metabolic & bariatric surgery, nutrition, metabolic health, and lived experience. More Science. Less Stigma.

How do GLP-1 medications affect food noise and alcohol use? What does obesity research tell us about talking to children about weight? And what happens when researchers actually listen to people living with obesity? In this episode of Weight & Measure, Mike Donnelly-Boylen and Deb Cooperman are joined by obesity researchers Dr. Michelle Cardel and Dr. Gary Foster for an evidence-based conversation about GLP-1 medications, food noise, alcohol use, childhood weight conversations, weight stigma, and patient-centered obesity research. The conversation begins with food noise, a term patients were using to describe persistent thoughts about food before researchers had a validated way to measure the experience. What exactly is food noise? How is it different from hunger, cravings, or simply thinking about food? Michelle and Gary explain how patient experiences helped researchers define and measure food noise and what we're learning about how GLP-1 medications may affect it. Then the conversation turns to another unexpected experience reported by people taking obesity medications: changes in alcohol use. Michelle discusses research involving more than 14,000 people who started an obesity medication and what researchers observed about alcohol consumption. The group explores how patient reports can provide an important scientific signal while separating interesting observations from conclusions supported by evidence. The episode then moves into children, weight, and the language parents use. Michelle and Gary discuss research examining parents' beliefs about how much control children have over their weight and how those beliefs relate to negative weight comments. What happens when a parent's intention to help doesn't match how a child experiences the conversation? What have young people told researchers about how they want parents to approach conversations about weight? The discussion ultimately raises a bigger question: What does science miss when it doesn't listen to patients? The group explores why meaningful outcomes in obesity treatment may extend beyond pounds lost or BMI. Reduced food noise, improved mobility, quality of life, freedom from constant thoughts about food, and other patient-defined outcomes may matter enormously even when they have historically been difficult to capture in obesity research. In this episode: • What is food noise, and how is it measured? • Food noise vs. hunger and cravings • GLP-1 medications and food noise • Food noise during weight loss and maintenance • Obesity medications and alcohol use • When patient reports become research questions • Social media observations vs. scientific evidence • How parents talk to children about weight • Childhood obesity, weight comments, and weight stigma • What children want from parents when discussing weight • Why weight loss and BMI aren't the only outcomes that matter • How patient experience can shape obesity research Guests Dr. Michelle Cardel is an obesity scientist and registered dietitian whose work has included obesity treatment, nutrition, health disparities, children and families, and incorporating patient perspectives into research. She serves as Senior Medical Director at Kailera Therapeutics. Dr. Gary Foster is a clinical psychologist and obesity researcher whose work has focused on obesity treatment, behavior change, weight stigma, and translating research into people's lives. He serves as Chief Scientific Officer at Lingo at Abbott. Michelle and Gary previously worked together at WeightWatchers, where they collaborated on research examining the experiences of people living with obesity. Weight & Measure with Mike and Zach Person-centered, evidence-based conversations for the obesity, GLP-1, and metabolic & bariatric surgery communities. More Science. Less Stigma. www.weightandmeasurepod.com

What does better obesity care look like when clinicians truly listen to the people receiving it? Dr. Matthea Rentea and Dr. Komal Patil-Sisodia join Mike for a conversation about lived experience, patient-centered obesity care, and the role peer support can play in helping people feel understood, supported, and more engaged in their care. This conversation was originally planned as an American Diabetes Association/Obesity Association webinar for clinicians. After concerns surrounding the ADA and the current scientific boycott, the conversation moved outside of the organization and onto our podcasts. We spend the opening minutes explaining why. But the larger conversation is the one we originally came together to have: how clinicians can provide better obesity care by listening to patients, understanding their experiences, and giving patients a meaningful role in shaping care, education, and health systems. We talk about why patient stories matter, how lived experience can reveal things clinical data alone cannot, and what happens when people feel dismissed, blamed, or unheard in healthcare. We also explore peer support in its many forms, from physician-led group visits and structured programs to informal online communities where people living with obesity share experiences, questions, successes, and frustrations. And while this conversation was designed with clinicians in mind, we believe patients should be at the table for it too. In this episode: • Why listening to patients can improve obesity care • What lived experience adds to clinical expertise • How weight stigma and dismissal can damage trust • Why patient stories matter in medical education and care delivery • What patients can learn from other patients • The role of physician-led group visits and structured peer support • The benefits and limitations of online patient communities • How patients can help shape programs, education, and healthcare systems • Why one patient’s experience should never be treated as everyone’s experience • What meaningful patient involvement can look like in practice This episode is for clinicians, patients, advocates, and anyone interested in building obesity care grounded in both science and the experiences of people living with the disease. Hear more from our guests Follow Dr. Matthea Rentea on The Obesity Guide with Matthea Rentea MD, where she discusses obesity treatment, chronic weight management, GLP-1 medications, and the realities of living with obesity. Apple Podcasts: Follow The Obesity Guide on Apple Podcasts Spotify: Follow The Obesity Guide on Spotify Follow Dr. Komal Patil-Sisodia on Clearly Hormonal, where she brings an endocrinologist’s perspective to hormonal and metabolic health, including menopause, PMOS, obesity, diabetes, and related care. Apple Podcasts: Follow Clearly Hormonal on Apple Podcasts Spotify: Follow Clearly Hormonal on Spotify And if you found this conversation useful, follow Weight & Measure with Mike and Zach wherever you listen. Please consider leaving a rating or review, too. It helps more people find evidence-based conversations about obesity care. More science. Less stigma.

Who gets to decide what a healthy body looks like? Is it the patient? Their clinician? Their family? Their community? And what happens when culture, identity, health, and personal goals don't all point toward the same answer? With Zach away recovering from surgery, Deb Cooperman joins Mike as guest co-host for a conversation with Michelle Tedder, nurse educator and patient advocate, and Dr. Jovonni Spinner, public health researcher and health equity strategist. This episode explores obesity through the experiences of Black women while asking broader questions about health, identity, culture, access, and patient-centered care. Michelle and Jovonni discuss patient autonomy and shared decision-making, including what happens when a patient's goals don't align with a clinician's recommendations or when family and cultural expectations influence treatment decisions. They also challenge the idea that accepting or loving your body means you can't choose to treat obesity. Body acceptance and obesity treatment can coexist. Someone can value their body, reject shame and stigma, and still pursue treatment to improve metabolic health, mobility, strength, or quality of life. The conversation explores how social networks, cultural identity, environment, chronic stress, access to resources, and the meaning food carries within families and communities can influence health decisions. It also examines disparities in obesity care. Insurance coverage, geography, affordability, access to clinicians trained in obesity care, representation in research, and assumptions made inside the exam room can all influence whether someone receives treatment. As Jovonni explains, health equity doesn't mean treating everyone the same. It means meeting people where they are and giving them what they need to have an opportunity to achieve their healthiest life. The group also challenges the association between obesity and laziness, discipline, effort, appearance, or personal worth. Obesity is a chronic disease, and the number on the scale doesn't tell the entire story. So what should success look like? Better blood pressure or blood sugar. Improved cholesterol. Walking farther without pain. Getting stronger. Increasing muscle. Lifting your suitcase into an overhead bin. Running to catch a connecting flight. Maintaining the independence to carry your groceries upstairs at 75. Those outcomes may tell us far more about someone's health than a number on a scale. And while this conversation centers the experiences of Black women, its lessons extend beyond any one community. You don't have to share someone's lived experience to believe it, learn from it, or advocate for better care. Black women aren't a monolith. Neither are people living with obesity. Better care starts by replacing assumptions with curiosity, listening to what matters to the person in front of us, and recognizing that health may look different from one person to the next. Featuring: Mike Donnelly-Boylen | Co-host, Weight & Measure Deb Cooperman | Guest Co-host & Obesity Advocate Michelle Tedder | Nurse Educator, Patient Advocate & Host of Dear Healthcare Provider Dr. Jovonni Spinner | Public Health Researcher & Health Equity Strategist More Science. Less Stigma. #Obesity #ObesityMedicine #HealthEquity #WeightStigma #BlackWomensHealth #PatientAdvocacy #WeightAndMeasure