Chapter 1: Why does weight regain happen after stopping GLP-1 medications?
On this episode of The Dr. Tina Show, we are going to be jumping into this latest scientific publication that has come out recently. It's all about the weight regain after GLP-1s. It came out in the British Medical Journal very recently. The internet is all ablaze. Everybody is having a field day, of course.
Chapter 2: Are GLP-1 medications intended for long-term use?
And we got to cover this. Even though I'm fairly done talking about this GLP-1 conversation for a hot minute, I need a break. But This pulled me back in because this is a perfect example of people being intentionally ignorant. And we need to talk about it. It's a big game of no shit, Sherlock, basically. So without further ado, let's jump in.
Chapter 3: What role do genetics play in obesity and weight regain?
You are tuned into the Dr. Tina Show with Dr. Tina Moore. For more, visit drtina.com. The article is titled, Weight Regain After Cessation of Medication for Weight Loss Management. It's a systemic review and a meta-analysis.
They basically took a bunch of studies going way, way back of all the different types of GLP-1 medications, the different incretin medications, and looked at overall what were the outcomes. And the results were this paper. So... Of the 922 titles screened, 37 studies, 63 intervention arms, 9,341 participants were included. Average treatment duration was 39 weeks.
The average follow-up was 32 weeks. The average monthly rate of weight regain we're going to talk about. There was a lot of weight regain.
Chapter 4: How does lifestyle impact the effectiveness of GLP-1s?
And I want to preface this with some understanding, some definitions, and also some just very basic common sense. What happens when you don't do anything else but take blood pressure medication for your high blood pressure? Drum roll, please. Your blood pressure skyrockets when you go off the medication.
What happens when you go on a statin medication for high cholesterol and you don't do anything to change your high cholesterol levels?
Chapter 5: What does the new BMJ study reveal about weight regain rates?
your cholesterol and lipids skyrocket when you go off the medication. This is the no shit Sherlock game, right? So if an individual goes on a medication to treat a chronic illness, what are the expectations when they go off that medication? Because there is no pharmaceutical that actually cures anything, right? They're all band-aids.
Chapter 6: How do medication and behavior compare in weight management?
There's been no, I have had, my conversation about GLP-1s and microdoses and the healing impacts and all of that Yes, that all still stands. That's not the conversation we're having today because that conversation got twisted up and people took it for what they wanted. And big, big FYI, 99% of you are not microdosing. You think you're microdosing, you're not.
Chapter 7: What are the limits of GLP-1 medications?
The standard starting dose for semaglutide is 0.25 milligrams. Most of you are started on 0.25 milligrams and told you're microdosed. The standard starting dose for trisepatide is 2.5 milligrams. Many of you are put on that dose and told it is a microdose. It is not. Both of those are the standard starting dose.
Chapter 8: What practical solutions can support metabolic health?
They're both the doses that are given to people with extreme obesity and extreme diabetes. You're not microdosing by taking the standard starting dose, okay? A microdose is a fifth to a tenth of the standard starting dose. It is not a weight loss strategy. It was never intended to be a weight loss strategy. It is not a vanity weight loss strategy. You guys have lost the plot.
And I've done a whole podcast about that, so I'm not gonna rant. But continuing on in this game of no shit Sherlock, when you have a chronic illness or chronic disease process going on, and you don't take any lifestyle measures to remedy that chronic situation, then when you go off the medication that you're taking for that chronic situation, the chronicity of the situation returns.
That's just how it works. So there was never any illusion that taking a GLP-1 would magically allow you to lose weight and forever keep it off once you stop the medication. That has never been the case. And yet people love to double down on that. Well, when you go off it, you gain all the weight back. Yes, no shit, Sherlock. Right? Same thing with all the other medications.
And I can make a very strong argument that your high blood pressure and your need for high blood pressure medications is coming from lifestyle. Almost 100%. I would say 90% of lipid issues are coming from lifestyle. There is a hereditary issue there.
There might be a hereditary issue with high blood pressure, but I don't think it's necessarily the high blood pressure as much as it is your cortisol response to things. And what is really high blood pressure anyway? I did a whole podcast about it, but that number keeps changing.
So for the sake of simplicity and the sake of just all of us agreeing, I think we can all agree that most of these conditions, including type 2 diabetes, are lifestyle first. And if you don't change the lifestyle factors, the medication being removed from the scene will allow that disease process to return. So... That's just basic physiology. That's just how it goes, right?
Now, we could argue all day about lifestyle and how much of it is to blame. I will say this. I recently saw a big influencer who I respect him. He... did a post that said, you know, it was kind of like a new year, things we can all agree on in the new year. And number one, obesity is not genetic. This guy's smart.
He doesn't actually have any clinical experience, nor does he have any nutritional training. He's just sort of a self-learned guy, which I'm not dissing. A lot of you are self-learned and you're here. And this is why I teach, because you guys are self-learned and you are smart as hell. So That's fine. But it was such an ignorant thing to say because it's wrong.
And there are genetic components and there are epigenetic components. And this is not a podcast episode about the nuance of the disease of obesity. We can do that another day. I talked to Dr. Spencer Nadolsky. We can put that episode in the show notes. He goes into it a bit. But here's the thing. Those genes, those epigenetic components,
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