GLP-1s, Weight Loss, and the Stigma We Don’t Talk About

Bret: 
Welcome to the Metabolic Mind Podcast. I’m your host, Dr. Bret Scher. Metabolic Mind is a non-profit initiative of Baszucki Group, where we’re providing information about the intersection of metabolic health and mental health and metabolic therapies, such as nutritional ketosis as therapies for mental illness.

Thank you for joining us. Although our podcast is for informational purposes only and we aren’t giving medical advice, we hope you will learn from our content and it will help facilitate discussions with your healthcare providers to see if you could benefit from exploring the connection between metabolic and mental health

Many of the interventions we discuss can have potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications. In addition, it’s important to note that people may respond differently to ketosis, and there isn’t one recognized universal response.

Am I biased against someone for losing weight with Ozempic? I recently came across a report in the New York Post that kind of stopped me in my tracks. It found that people using medications, like Ozempic or Wegovy, are actually facing more social stigma than people who don’t lose weight at all.

So, think about that. We have a society that often judges people for being overweight, but now we’re judging them even more harshly for using a tool to fix that. So, as someone who’s been vocal and a little critical about the overuse of GLP-1s, I had to stop and do a serious gut check. Do I have a bias against people for losing weight with these drugs?

Is that what I’m doing by speaking against the overuse of GLP-1s? But after some reflection, I realized the answer is clear and resoundingly no. I’m genuinely happy for anyone who feels better, improves their health, and finds a path that works for them. Every health win is definitely something to celebrate.

My criticism of GLP-1s has really never been about the patient or the desire to get healthy. It’s about the model and about the prescribers. We shouldn’t be stigmatizing the tool itself necessarily. Instead, we should be looking at how the tool is being used, and more importantly, who’s doing the prescribing.

Now, if I have a bias, it’s not against the person taking the medication. My bias is against the doctors who are over-prescribing these drugs with little to no attention to effective lifestyle interventions and metabolic health, right? We’re seeing this drug-only or drug-first approach that ignores the very foundation of human health.

When a clinician writes a script for a GLP-1 but doesn’t spend an equal amount of time discussing protein intake, resistance training, processed carb avoidance, then they aren’t really practicing responsible medicine in my mind. They’re practicing a short-term symptom management and the easy way out, and that’s not the patient’s fault.

And here’s why this matters. We know that many people don’t stay on the medications, and when they stop, they regain all the weight. They lose the cardioprotective benefits, and in the end, they may be metabolically worse off than when they started. And those who stay on the medications, basically, they’re committing to a lifetime dependence on them. Not use but true dependence.

So, in my opinion, neither one of those scenarios are clinical successes and both eventually fail the patient. So, I have to admit, this article in the New York Post about this study got me pretty upset. We truly have to stop the stigma against the patients, whether they lose weight or not. Losing weight is hard, and using a medical assist is a personal choice that should be respected.

But we can’t expect our patients to come up with all the answers on their own. We have to start holding the medical community accountable. We need clinicians who prioritize long-term metabolic integrity over just the quick drop on the scale. GLP-1 is a powerful tool, but it’s only as good as the lifestyle it supports.

So, let’s change the conversation, support the individual, celebrate the weight loss, but demand better from our medical system. So, hopefully, that perspective was helpful. If it was, like and subscribe and leave us a comment. And thank you for watching. I’m Dr. Bret Scher. We’ll see you here next time at Metabolic Mind, a non-profit initiative of Baszucki Group.

Thanks for listening to the Metabolic Mind Podcast. If you found this episode helpful, please leave a rating and comment as we’d love to hear from you. And please click the subscribe button so you won’t miss any of our future episodes. And you can see full video episodes on our YouTube page at Metabolic Mind.

Lastly, if you know someone who may benefit from this information, please share it as our goal is to spread this information to help as many people as possible. Thanks again for listening, and we’ll see you here next time at the Metabolic Mind Podcast