Obesity Isn’t A Willpower Problem: The Role Of GLP-1s | Dr. Spencer Nadolsky
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Who are the guests and what is the focus of today's episode?
You are tuned into the Dr. Tina Show with Dr. Tina Moore. For more, visit drtina.com. On this episode of The Dr. Tina Show, I'm so excited to bring on Dr. Spencer Nadolski. Dr. Nadolski is someone I've been following for a long time on Instagram. He's an obesity specialist. He's a lipidologist. He also is the owner and founder of Vineyard, which is an online direct care model. He specializes in GLP-1s and we are going to have the obesity conversation that you all have been asking me for. You know I've been talking about these peptides for a long time outside of weight loss, outside of type 2 diabetes, although my message has been skewed over the past few years. I've been trying to talk about them in relation to all of the other benefits throughout the body that they may or may not have in the clinical data. That said, this is an important conversation to have. We need to talk about obesity as a disease, and I need folks to really understand what that means. And I can't think of a better person for the job than Dr. Nadolski.
So without further ado, let's jump in. Dr. Spencer Nadolski, I'm so excited to have you on the Dr. Tina show today. And we are going to talk all things obesity, GLP-1s. This is a conversation I wanted to have because I've been trying to seeing the praises of glp-1 agonists outside of obesity and weight loss and type 2 diabetes just more in a metabolic health cardiovascular uh you know neuroprotective way and everybody's been begging me to bring on an obesity doctor and a specialist like yourself so here we are thank you for coming we're doing it yes i'm excited i'm excited so i've been following you for years and i'm a huge fan of your work and i see more often than not these days You sort of playing pickleball with all the GLP-1 misinformation and nonsense that comes constantly into our inboxes. I don't even get into it. I just let you do it.
It's exhausting. It's exhausting. Like a game of pickleball could be, I suppose.
Yes, yes. And then you have... really created this awesome, innovative direct care platform called Vineyard. So we're going to talk about that too, because I think what you're doing is exciting. I think you and I agree on a lot of things. One is that these telemed companies for the most part, and I have heard good feedback from a few of them for really uncomplicated cases for people who really just needed a little something, something. But in the case of most people and most patients, especially those dealing with
What are the risks of improper GLP-1 dosing and vanity prescribing?
at least a moderate to more excessive amount of obesity and or type 2 diabetes i think that docs or patients need a much better care system and i see you talking about that online can you extrapolate on that a bit more yeah you know these medicines are amazing i would call them miracle medicines but they there's no there's never a free lunch and you may be one of the people um
that do just fine on a little dose and go through your journey, just fine, no issues. And that does happen. However, I would say it's not rare. It's still uncommon, but common enough when you have hundreds of patients that you see some of these side effects, especially at the higher doses that get brushed off by someone if they don't listen. For example, the one that I'm seeing more recently and I've made some videos on is anhedonia, just kind of feeling meh, blah. And it actually happened quickly in 2022 when Manjaro came out. We were all using it off-label. Everybody's like, oh, how dare you use that drug off-label? I'm like, well, the Surmount trial was out. It just wasn't available as that found yet.
It wasn't approved yet, but the Phase 3 trial was out. So we were using it for obesity a lot. And people were feeling tired. And you see it with WeGoV2, the semaglutide. But terzapatide, we were seeing it and people were like, well, it's got to be from the calorie deficit. And that makes sense that people would feel tired from a calorie deficit.
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Chapters
8 chapters
1
Who are the guests and what is the focus of today's episode?
0:24–2:54
2
What are the risks of improper GLP-1 dosing and vanity prescribing?
2:54–10:31
3
How did obesity treatment evolve before and after GLP-1 medications?
10:31–14:05
4
Why is obesity considered a chronic disease and how does it affect the brain?
14:05–16:46
5
What role do genetics and lifestyle factors play in obesity?
16:46–18:07
6
How do telemedicine and PBMs impact obesity treatment?
18:07–19:08
7
Why is strength training important for those on GLP-1 therapy?
19:08
8
What is the importance of personalized dosing and careful management of GLP-1s?
2:36–1:07:05
Speakers
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