A lot of people say that GLP-1 medicines should be the last resort for weight loss. However, they may actually need to be first resort for those at high risk.

"I turned down free airport food on the flight out, and didn’t even think about the free brownies in the United club lounge. This was a HUGE a-ha moment for me. Also I'm staying active because I WANT TO not because I HAVE TO!" - one of my patients taking a GLP-1 medicine

5 truths about losing a lot of weight 1. You need to get into a calorie deficit 2. Lift weights to not lose muscle 3. You don’t need to do cardio, but it may help keep the weight off 4. It’s not going to be easy and you may need medicine to help 5. Food choice matters

You generally have to take GLP-1 meds indefinitely just like you generally have to keep exercising and following your diet to keep weight off. Astonishing I know.

To sum up my recommendations for every single patient: 1. Resistance training 2-5x/week 2. A diet with many plants and lean protein (carbs and fat according to goals and preferences) 3. Aerobic training 2-5x/week 4. 7-8 hours of sleep per night 5. Walk and laugh a lot in between

If a doctor gives out testosterone without doing a full work up then you don’t have a doctor you have a steroid dealer.

We don’t shame those who need hearing aids to help them hear. So why do we shame those with obesity who need help with their appetite?

“I feeling like I’m eating to live instead of living to eat now.” “I’m finally free from all the food thoughts.” - patient who started a GLP-1 med last month

Weight stigma is harmful. Excess weight (adiposity) can be harmful too. Not mutually exclusive.

“You’re are just brainwashed by mainstream media.” - guy who is brainwashed by alt-right podcast

Who needs April Fools’ Day when people still believe: 1. Artificial sweeteners are worse than sugar 2. Obesity is due to a lack of discipline 3. GLP-1 meds are just a bandaid 4. LDL cholesterol doesn’t cause heart dz 5. Carbs are inherently fattening

Is obesity due to fast food and lack of wanting it enough?

Me: Vaccines are good Deplorable: That’s because you make money from them! Me: I don’t make a dime from them Deplorable: Well you’re still a terrible doctor!

If you believe obesity is a choice then you also believe heart disease is a choice and hypertension and type 2 diabetes are a choice.

The top 5 supplements for losing a large amount of fat: 1. 2. 3. 4. 5. Just kidding. They are none.

“I used to like you when you weren’t political.” Well I mean I didn’t think science was political but here we are.

They’re taking the SSRIs, they’re taking the vaccines, they’re taking the drugs from the people that live here.

On this week’s DocsWhoLift podcast, @drnadolsky.bsky.social and I discuss how bad the @hims & @Hers #SuperBowl ad was.From an outside perspective, the ad may have seemed good.But when you dig deeper, it was actually really bad.Listen to learn. podcasts.apple.com/us/podcast/d...

“You need to lose weight. You’re unhealthy.” Person tries to lose weight with diet/exercise. Loses weight then regains “You didn’t try hard enough.” Person hires coach. Loses weight. Regains “You didn’t want it bad enough.” Person gets medicine. Loses weight and keeps it off “That’s cheating!”

"You're just mad about RFK because you're not going to make as much money!" LOL rest assured it will have little bearing on my income. I worry about vaccine hesitancy increases and more measles and other preventable communicable disease outbreaks.

No not everyone needs a GLP-1 med to lose weight. Yes most people who use them will likely need to continue taking them. No they aren’t going to solve everyone’s obesity (at this time anyway). Yes they can have side effects. No they shouldn’t be used for vanity only

99.9% of doctors: “Do not confirm RFK jr. He will harm our country.” Jeff, the guy with an American flag and eagle as his profile picture and a bio that says Patriot: “Nuh uh your just scared he will take your big pharma money!”

My GLP-1 DEXA/strength study just enrolled the first patient. This first study is observational, but will have RCTs in the future to see how various strategies like resistance training and levels of protein alter (or not) body composition changes while taking a GLP-1 medicine.

I have a few hundred patients who are PhD or MD grads. They know how to lose weight. They just struggle to actually do it not because of knowledge but because of biology (appetite).

“ I know what to do to lose weight. I just need help actually doing it.” What most of my patients say

“If you just prescribed a keto or carnivore diet, your patients wouldn’t need a GLP-1 medicine.” - someone who clearly hasn’t worked with many people

In order to Make America Healthy Again we MUST bring down the costs of GLP-1 meds.

There are new amazing drugs for helping you eat fewer calories and lose weight. There are 0 meds currently that take the place of exercise both aerobic and resistance training. They are trying to develop muscle building/preserving medicines but the act of exercise likely won’t be replicated soon.

The “ideal body weight” is bullshit. Too many of my patients believe they need to get to some arbitrary number on the scale because some doctor told them in the past to hit that number. Get to the lowest healthiest weight without being miserable and focus on body composition and quality of life.

Most of my patients aren’t looking to get abs. They say things like “less knee pain” or “able to breathe while walking up the stairs.” Yes they want to look better but they mostly want an improved quality of life.

“If people would just stick to a diet they wouldn’t need medicine.” I mean, that’s what the medicine does. It helps them do it when they couldn’t before. That’s the point.

“You just need to try harder.” - Doctor to patient who came in asking for weight loss help despite trying hard for the past 20 years.

Using chemotherapy for cancer isn’t cheating. Using SSRIs for depression or anxiety isn’t cheating. Using statins for cholesterol isn’t cheating. Using ace inhibitors for blood pressure isn’t cheating. So why would using GLP-1s for obesity be cheating?

Patient with psoriatic arthritis tried multiple biologics (eg humira) and lifestyle changes with minimal relief. When they started on tirzepatide, the pain and stiffness improved immensely.

May 2025 be the year we understand: 1. Calories matter most for weight loss, but hormones influence how many we eat. 2. Exercise isn’t amazing for weight loss by itself, but it’s great for you regardless. 3. Most won’t have long term weight loss from diet and exercise alone.

The top 5 foods you need to AVOID in 2025 to get healthier 1. These 2. Lists 3. Are 4. Really 5. Stupid

I get some patients who don’t lose much weight with their GLP-1 medicine. When I ask if them if they want to stop they say no. Despite little weight loss, they have improvement in how they feel. Sometimes it’s the “food noise” or their joints or other physical feelings.

Patient today said they knew how to eat and exercise, but they struggled to do it due to extreme fatigue and exhaustion. Telling them that they just need a calorie deficit (while true) is not helpful. Figure out the fatigue then work on the diet and exercise.

Merry Christmas to everyone! …. Except those who believe people with obesity aren’t trying hard enough.

“Taking a GLP-1 medicine is cheating!” Okay then taking a blood pressure medicine for blood pressure is cheating. Taking an anti-depressant for depression is cheating! See how that sounds?

❓Have you heard advice that women must alter their exercise routines around their menstrual cycles? 🦄Myth or truth? 💪🏽We had the honor of speaking with a leading researcher in the field on this week’s DocsWhoLift podcast! Episode link: open.spotify.com/show/2umc46j... @drnadolsky.bsky.social

“If you think GLP-1 medicines are so good, why aren’t you taking one?” I don’t have an indication for it 🤷‍♂️

“You are the company you keep.” Noticing more and more low carb and other diet zealots mingling with anti-vax folks. Then they wonder why they aren’t taken seriously. 🤷‍♂️

Excited about IRB approval of our first study looking at body composition and strength changes in those taking GLP-1 receptor agonists (Semaglutide/tirzepatide). Will share more details soon!

Unfollow doctors and influencers who say we should only focus on the food environment and not GLP-1 receptor agonists.

On this week’s DocsWhoLift Podcast, we discuss “top line” results of #WeightLoss meds #Wegovy vs #Zepbound, more analysis of health safety/benefit data of GLP1ra & ADA statement on compounded versions of these meds open.spotify.com/episode/2stv... #ozempic #mounjaro @drnadolsky.bsky.social

It’s possible to believe that some big pharma drugs are pretty amazing (GLP-1s) while also believing big pharma is greedy as hell. Crazy I know.

“Diet and exercise is 100% effective for resolving obesity.” - someone who has never ever read a single diet and exercise trial for obesity

There is no food or supplement that even gets close to the effect of a GLP-1 receptor agonist like Ozempic, Wegovy, Mounjaro, or Zepbound.

“You should only eat foods that come from earth.” Right. As opposed to Uranus.