FEDERAL (Congress)

Federal (FDA)

STATE: WHAT'S ACTIVELY MOVING

STATE: WHAT STALLED OR DIED

Patient advocates and compounding pharmacy lobbying killed several bills before they could become law.

What you can do

Three state bills dead, one stalled, two actively moving, one signed into law. States are testing different versions of the same regulatory framework, and the ones that pass become the model. The federal bills sitting in Washington could change the equation everywhere at once.

1. Comment on the FDA proposal by June 30. One click here, then “Submit a public comment.” Tell them your story. Real patient voices stand out in a docket full of industry lawyers.

2. Call your reps about the SAFE Drugs Act. Capitol switchboard: (202) 224-3121. Ask for your rep’s office, give your zip code and one sentence about why you oppose it. Done.

3. Get on the right list. Alliance for Pharmacy Compounding is how Washington and Virginia killed their bills.

4. Tell your story out loud. Substack, social, the GLP-1 Collective, journalists. The same story you write for the FDA docket works everywhere.

If you only take one action, make it #1. The FDA is legally required to read every comment that hits the docket, yours included.

Never forget, when you advocate for yourself you advocate for all of us. 📢✊

Disclaimer: I was not paid, sponsored, or compensated in any way for this episode or article. All opinions expressed here are my own and do not reflect the views of the GLP-1 Collective nonprofit or any other organization. This is not medical advice. Nothing in this article, podcast, or platform should be used as a substitute for professional medical care, diagnosis, or treatment. Always consult with a qualified healthcare provider about your health decisions. I also do not formally endorse any guest, clinic, or company featured. The intention is to share stories, not prescriptions.

Taking a GLP-1 in Secret

I didn’t start out as an international advocate for obesity rights. I started out in the closet, like so many of us have.

Sharps disposal wasn’t even a thought until I was holding a used one in my hand wondering what the heck I was going to do with it now. I found a container, that I could hide them in, and called it good.

I was sure that it was a solid solution, until I sat down with the president, co-founders, and marketing specialist for PureWay Compliance.

The First Interview

The first time that I interviewed Omar and Cheyenne, Omar shared a story that will stick with me forever.

If you watched the clip above, it will probably stick with you forever to. You’re welcome.

This story about Omar getting attacked by needles and condoms while kite-surfing creates a visually striking image that really demonstrates what can happen when they aren’t properly disposed of.

All of this to say, I thought I was doing the right thing, until they explained that the container I tossed in the trash, went into the same dump truck as other household waste, and when it got compacted those needles spilled out all over the place.

They ended up in the landfill just as if I had tossed them directly in the garbage.

GLP-1 & Sharps Statistics

When we toss needles in the trash or recycling, it’s genuinely dangerous for the people handling that waste, especially at recycling centers.

Needlestick Injury (NSI) Statistics:

• The estimated needlestick injury rate for Material Recovery Facilities (MRFs) is 2.7 injuries per 100 full-time equivalent (FTE) employees.

• Workers stationed on picking lines face the highest danger, experiencing an NSI rate of 3.9 to 4.2 per 100 FTE.

• Picking line workers account for 98% of all reported MRF needlesticks, with maintenance workers accounting for the remaining 2%.

• In 2016, 56% of surveyed MRFs reported experiencing needlestick injuries, with the majority reporting one or two incidents per year.

• It is estimated that between 781 and 1,484 NSIs occur at U.S. MRFs annually.

With about 12% of US adults currently using a GLP-1, (around 31 million people) it is more important than ever to spread the word on safe disposal.

Help Raise Awareness

I recently sat down to record an episode with a patient advocate named, Tracy Holzman. One of her top tips for GLP-1 patients was safe disposal.

The best part? She followed this up by saying, ”I learned about it, from your podcast…”

I can’t express how grateful I am to know that sharing this information helped even one person. Tracy is proof that when you advocate for yourself you advocate for all of us, and we grow stronger together because of it. 💪

Celebrating Earth Month

This year, when Cheyenne reached out to celebrate Earth Day with the Studio, she got an instant, “heck yes sister!” I was excited to share the news and find out what was new with PureWay.

PureWay taking 2026 by storm:

• They launched a new consumer-facing website this January, after they realized the old one was treating a one-person household the same as a 200-bed hospital. The consumer side is now growing 50% month-over-month and the new site looks fantastic!

• They locked in an exclusive partnership with PPSWG, a consortium representing more than 365 pharmaceutical producers focused on safety and sustainability.

• They’ve integrated AI across their data systems, which used to require stopping everything to pull from multiple sources, run analyses, and figure out what went wrong three months ago. Now AI helps them flags issues in real time.

During the interview I shared what Tracy had said, and pulled out the container they gave me last April. I have been using the same container for 13 months straight.

Literally, I have used one single container this entire GLP-1 journey, including six months of NAD+ injections on top of that.

I thought $50 for one large container felt steep at first, but when you spread it out over a year, it only comes out to about 10 cents a day.

But whose counting when there are multiple ways to get a free one!

How PureWay Recycles Sharps

Before we dive into the free details, I’d be remiss not to mention the thing that really sets PureWay apart, their proprietary recycling system.

The recycling breakdown:

1. Predictable waste makes real recycling possible
Most “recyclable” sharps containers aren’t actually recyclable because recycling facilities can’t handle mixed, unpredictable waste. PureWay works because GLP-1 sharps waste is relatively consistent, which allows recyclers to actually plan for and process it instead of rejecting it.

2. Sterilization using oxygen-free microwave processing
PureWay sterilizes waste in a sealed, oxygen-free chamber using a microwave-based process. Removing oxygen prevents the chemical reactions that typically create toxic emissions in incineration. This destroys any remaining DNA.

3. Lower-heat process protects the plastic
Instead of extreme heat methods like autoclaving (high-temperature steam processing), PureWay uses lower temperatures so the plastic doesn’t break down or “denature.” This keeps it structurally usable.

4. Plastic stays recyclable after processing
Because the material isn’t degraded, it can be safely returned into the recycling stream and turned into new products instead of being downcycled or destroyed.

5. Lower environmental footprint
The full system uses less water and energy than traditional autoclaving or incineration, making the overall process more efficient and resource-conscious.

The water and energy savings matter more now than they did even five years ago, given that data centers are eating an entire grid’s worth of power and water every year. If I’m going to ask Claude to help me organize my week (and I am, I would be lost without him at this point), the least I can do is recycle my needles.

How to Get a Free Sharps Container

Now for the best part. You don’t have to figure out how to dispose of your sharps alone, and you definitely don’t have to pay for it!

Tips you needs to know:

1. Call the manufacturer’s patient support line
Most of us are never told these programs exist, but a lot of GLP-1 manufacturers offer a free sharps container as part of patient support.

2. Ask your doctor
If they don’t know, ask them to find out. Worst case they shrug, best case you walk out with a free system.

3. Check what your state offers
Your state's environmental agency or health department may have local mail-back and drop-off options.

4. Use code EARTH20 at PureWayatHome.com
20% off, good through 5/13/2026. The new consumer site is set up for one-person households now, which it was not the first time I went looking.

5. Enter the PureWay × GLP-1 Studio giveaway
Three winners get a free 1.4-quart mail-back disposal system. To enter:

• Follow @purewaycompliance and @amanda.bonell0 on Instagram

• Repost the giveaway post and tag someone who could use a safe disposal option

Whichever option you choose, that's one less loose needle in the landfill.

Small Steps Make a Difference

Let’s be real. It would be great if we could actually drink from paper straws, bike to work, and compost our own waste.

To the people already doing these things, I salute you. However, it’s just not practical for the average person. So we do what we can, and recycling sharps is just one small thing you can do for yourself, the people who handle our waste, and the environment.

Happy Earth Month!

Disclaimer: I was not paid, sponsored, or compensated in any way for this episode or article, they did give me a little sharps container though. All opinions expressed here are my own and do not reflect the views of the GLP-1 Collective nonprofit or the GLP-1 Studio. This is not medical advice. Nothing in this article, podcast, or platform should be used as a substitute for professional medical care, diagnosis, or treatment. Always consult with a qualified healthcare provider about your health decisions. I also do not formally endorse any guest, clinic, or company featured.

Have you lost GLP-1 coverage through your employer? Or maybe you never had it to begin with because it was just “too expensive.”

I have sat with more patients than I can count and they all say the same thing: losing access is traumatizing, and it permanently changes how people feel about the employers who cut them off.

The data backs this up. People are ready to walk. But you might not have to.

Key Details:

• Eli Lilly launched its Employer Connect program in March 2026 with more than 15 independent partners, each offering a different model for employers to cover Zepbound. Andel is one of those partners.

• Andel is a cooperative technology platform with no PMPM fees, no administrative overhead, and a membership fee of only $9.99 per fill. The all-in cost before employer contribution is $513.99 per 30-day fill.

• Employer contributions start at a minimum of $50 per fill with no ceiling, bringing employee out-of-pocket costs down to as little as $213.99 per fill at a $300 employer contribution.

• There is no prior authorization, step therapy, or utilization management. The prescriber decides and the medication ships next day via UPS.

• Employees do not have to wait for HR to find this. They can refer their own employer directly at andel.org/referral.

How We Ended Up Here

Coffee & Beignets.

I was sitting in a New Orleans airport café, laptop plugged in, working on the “I used to think it was my fault” video we filmed during the OAC’s social listening session at the regional Your Weight Matters conference.

The powdered sugar situation was fully out of control when I looked up and saw Tracy Zvenyach waiting at her gate, right next to mine.

The universe, am I right?

Tracy handles advocacy for the Obesity Action Coalition. We just spent Mardi Gras together. And here she was, four feet away, gate B12 or whatever it was, waiting for the same connection window.

I am sort of an idea person, give me a riddle and I will figure it out one way or another. She asked me what we could do to help get this medication into the hands of the people who need it.

I took that question home and got to work.

I thought I had it all figured out when I sent her a pitch for a group buy program through employers.

The Affordable GLP-1 Solution

With enough people pooling purchasing power through their workplace, the group creates real leverage directly with manufacturers, the same way a buying cooperative negotiates better prices than any single buyer could on their own.

My husband's job does something similar. He meets certain health criteria and gets money knocked off his own premium.

The employer benefits too, because carriers offer discounts to companies that can show they are actively investing in workforce health, the same way they do with smoking cessation programs.

Everyone benefits.

Employees could opt in if they wanted to. Employers would save on sick days, burnout, and the downstream costs of managing chronic diseases that are directly tied to obesity.

People might even be able to run it through their HSA or FSA the same way they do with telehealth clinics. And the employer would not have to blow up their entire benefits structure to make it happen.

My version of the idea was that the employer would mostly just facilitate and look like a hero but Andel took it one step further:

Tracy looked into it. The only organization she could find already doing something close to what I had described was Andel and she was actively trying to get a hold of them when, I kid you not when I say that literally two days later Andel emailed me directly for a guest spot on the podcast.

I emailed Tracy immediately to ask if she had sent them my way. Turns out she had not. She’s just a pro-level manifester and I am signing up for the first class if she starts teaching this skill.

Obviously I said yes because when the universe comes knocking you don’t screw around.

And if you know me at all, you know connecting people in this space is basically my whole thing and this was a very good day for it.

On top of that, I needed to learn everything I could so that I could share it with my lovely friends.

hello, lovely friends 👋

I reported on access issues around employer insurance last year, sharing interviews with Kristi Turner, who lost her coverage on New Year's Eve while everyone else was celebrating, and Jennifer Sansabrino, a small business owner who genuinely wanted to cover her employees but did not have a single formulary available to her with GLP-1s for weight loss.

But, a lot has changed since last summer and the numbers are something else.

This Is Not About Getting Hot

We aren’t seeking out drugs to fit into a smaller jeans size.

We just want to prevent and treat our comorbidities before they take our lives early. That is what is on the line every single time someone loses access to this medication.

Our lives and our livelihood.

Obesity is linked to more than 40 diseases including heart disease, stroke, type 2 diabetes, and certain cancers, some of the leading causes of preventable and premature death in this country.

These are biological conditions, not personal failures.

So when an employer takes that away, it is not a benefits decision.

It is personal.

In fact, according to Andel’s own research, about 44% of members say they would switch jobs for GLP-1 coverage.

Why Employers Stop Covering GLP-1s

To understand why Andel matters, you have to understand why employers have been pulling the plug.

In 2025, insurance coverage became increasingly restrictive:

• GoodRx data showed that the number of people without coverage for Zepbound increased by 14%, leaving 4.9 million more people uninsured.

• For Ozempic, there was a 22% increase in people losing coverage, affecting an additional 1.1 million individuals.

• Unrestricted coverage for Wegovy shrank while prior authorizations expanded.

• Even Mounjaro, which is FDA-approved for Type 2 diabetes, saw unrestricted coverage drop by about 5%.

The rollbacks were happening everywhere at once:

• Independence Blue Cross stopped covering GLP-1s for weight loss.

• Blue Cross Blue Shield of Michigan ended coverage for roughly 10,000 members under large group commercial plans.

• Allina Health in Minnesota cut GLP-1 coverage from its own employee health plan.

• Kaiser Permanente in California dropped coverage for patients with a BMI under 40 when prescribed for weight loss alone.

• The BCBS Federal Employee Program moved GLP-1s to non-covered formulary tiers.

• Chevron began requiring virtual coaching, weigh-ins, and minimum weight loss just to maintain coverage.

And through all of this, over 16 million commercially insured Americans still had zero coverage for any GLP-1 medication prescribed for weight loss.

But that is just the cost of the drug.

On top of that, employers pay something called a PMPM fee, which stands for per member per month, and is charged across their entire workforce. Whether anyone is actually taking the medication or not.

Imagine your office has a snack bar:

💸 Employer pays monthly fee based on headcount
🍭 Whether anyone eats the snacks or not
🍫 Someone grabs a bag of chips
🍬 Employer gets charged again on top of that
📃 End of month: one giant mystery invoice arrives

Nobody can tell you what each chip actually cost. Nobody has seen the rebate, and the person you ask about the chips says the chips are not their department…

That is essentially how GLP-1 coverage works with traditional insurance.

That PMPM cost went from $1.50 in 2019 to $11 in 2023 and jumped to more than $24 per member per month by 2024.

For a company with a few hundred employees, that adds up extraordinarily fast regardless of how many people are actually on the medication.

GLP-1s went from #32 in pharmacy spending to #1 in a single year for one company, and another said they spent half a million dollars and were projected to hit $1.2 million the following year.

So employers were stuck.

Cover these medications and watch costs spiral with no ceiling in sight. Or drop coverage and devastate the employees who depended on it.

Most chose to drop it or never offered it at all. By 2025, only about 19% of companies with 200 or more workers were covering GLP-1s for weight loss.

GLP-1s — The Wellness Program Employees Want

Here’s the thing.

Employers have been spending money on wellness for years:

• Wellness stipends typically run between $500 and $1,500 per employee per year

• Lifestyle spending accounts averaged $1,200 per employee in 2025

• More comprehensive programs with biometric screenings and mental health support can cost anywhere from $800 to $2,500 per employee per year

So the money is already being spent.

The question is what it is being spent on:

• Weight Watchers memberships

• Gym subsidies

• Mental health apps

• Step challenges

Now look at what the research says actually happens when people get consistent access to GLP-1 medications.

• A multi-year Aon study drawing on data from over 192,000 GLP-1 users found that sustained use significantly reduces medical cost growth over the long term.

• Female GLP-1 users experienced a 47% reduction in hospitalizations for major cardiovascular events, approximately 50% lower incidence of ovarian cancer, and a 14% lower incidence of breast cancer compared to non-users.

• By the 30-month mark, medical cost growth was 6% lower for people with diabetes using GLP-1s compared to those who did not, with similar results for people using GLP-1s for weight loss.

An employer contributing $100 per fill through Andel is spending $1,200 per year on that employee’s GLP-1 access. That is less than what many companies are already spending on wellness stipends that cannot deliver those clinical outcomes.

And unlike a gym membership, there is no PMPM overhead, prior authorization process, or pissed off employees eating up HR time and budget.

Now imagine the new snack bar:

💵 The employer puts a set amount on your account each month.
💳 You pay what is left.
💰 No monthly overhead fee charged across people who are not even participating.
📃 AND a receipt showing exactly what everything cost

There’s no competition.

The Real Cost of Doing Nothing: Productivity, Morale, and the Talent You Are Losing

Let me put some numbers on the table that every HR director in America needs to see.

That is not a healthcare cost, that is a productivity cost:

• Brain fog

• Chronic fatigue

• Joint pain that makes it hard to sit at a desk for eight hours

• Sleep apnea that means someone shows up exhausted every single day

These are not problems employees leave at the door, they come to work with people.

When people feel better, they tend to miss fewer days at work, stay more focused, and engage more with their teams.

The disability data alone tells the story.

Modeling research published in PMC shows that modest weight loss reduces annual healthcare spending by approximately 15% per person, with effects rising in patients with higher baseline BMI and more comorbidities.

And the Aon multi-year study found something even more striking: among patients who maintained consistent use, the rate of medical cost growth was cut roughly in half within two years.

For those who maintained consistent GLP-1 use, medical cost growth was six to nine percentage points lower compared to non-users, and female GLP-1 users saw a 47% reduction in hospitalizations for major cardiovascular events. Fewer hospitalizations means fewer emergency absences. Fewer emergency absences means more consistent, present, productive employees.

And then there is the question of loyalty:

• A March 2026 survey of over 1,000 workers found that 51% believe GLP-1 coverage should be a standard health benefit

• 54% said they would give up at least one workplace perk to get it covered

• 13% said they would give up a full week of PTO

Read that last one again. One in eight employees would hand back vacation days in exchange for GLP-1 coverage.

According to NFP’s 2026 U.S. Benefits Trend Report, nearly 1/3 of employees say they would switch employers to gain access to GLP-1 coverage, elevating these medications from a pharmacy line item to a workforce strategy problem.

Nearly half of Gen Z workers say GLP-1 coverage would sway their choice between two otherwise equal job offers.

Employees who have access to GLP-1 coverage often view it as a sign that their employer genuinely cares about their wellbeing, which strengthens retention, improves satisfaction, and positions the company as an employer of choice in a competitive market.

The inverse is equally true.

That is not apathy. That is a workforce that is paying close attention to how they are treated. And in a labor market where replacing a single employee can cost up to 200% of their annual salary, the math on covering this medication starts to look very different very quickly.

Enter Andel.

What Is Andel?

Andel is a healthcare technology platform that enables high-cost medications like GLP-1s to be more accessible through employer benefits.

Jay Bregman, the founder and CEO, is a serial entrepreneur with 20+ years of experience building and scaling companies across mobility, insurance, and healthcare. He’s successfully exited three ventures, including Hailo (now Lyft Europe) and Thimble, which was acquired by S&P 500 insurer Arch.

At Andel, Jay is leading the development of an employer-supported medication marketplace improving access and affordability for GLP-1s and other breakthrough medications.

All this to say:

Jay wanted to solve the biggest problem in healthcare: brand-name prescription pricing and distribution.

He got there by watching C-SPAN.

Specifically, the Senate hearings where pharmaceutical CEOs and PBM executives sat across from Bernie Sanders and everyone yelled at each other for three hours and absolutely nothing changed.

Jay looked at an $850 billion to $1 trillion prescription drug market growing at roughly 10% a year and thought: this is medieval. Someone should do better.

That someone was Jay.

He named Andel after a Danish and Swedish word meaning “a share” or “a part,” a reference to the member-focused cooperatives Scandinavia has been running for hundreds of years.

The idea is structural. You build the platform so the incentives push money toward the drug and toward the patient rather than into administrative overhead.

Andel built its own non-dispensing pharmacy and its own pharmacy management system from scratch, no legacy infrastructure, no inherited bloat.

The platform connects directly to SureScripts, the national prescription network. When a prescriber sends a prescription, the app handles it. No prior authorization request, step therapy appeal, or forced fail first attempts.

The medication ships next day via UPS with supplies included.

There are zero administrative fees or PMPM fees charged to employers. Whatever the employer contributes goes directly toward the cost of the medication.

Nothing disappears into overhead.

Eli Lilly’s Direct-to-Employer Platform

On March 5, 2026, Eli Lilly officially launched Lilly Employer Connect, a program giving employers a direct route to offer Zepbound to their employees at the $449 direct-to-employer price, completely outside the traditional insurance and PBM channel.

The program launched with more than 15 independent program administrators as partners, allowing employers to select from multiple models depending on what works best for their workforce and budget.

Those partners include:

1. Andel

2. 9amHealth

3. Calibrate Health

4. Crux Health

5. eMed

6. FlyteHealth

7. Form Health

8. Goodpath

9. GoodRx

10. Ilant Health

11. Mark Cuban's Cost Plus Drug Company

12. Onsera Health

13. ReviveHealth

14. SALTA Direct Primary Care

15. Sesame

16. Teladoc Health

17. Transcarent

18. Waltz Health

Every option is different, from bare-bones third-party administrator services all the way to wraparound obesity management, lifestyle programs, and full telehealth services.

Andel is a cooperative model:

• No PMPM fees

• No administrative overhead

• A membership fee under $10

• An employer contribution structure that starts at $50 with no ceiling

Andel is not a simple startup. It is a vetted partner inside a program that Eli Lilly built and launched specifically to solve this access problem.

As one expert noted, the evolution here has been radical. Two years ago, drug companies and PBMs were actively fighting against independent vendors offering GLP-1s at a discount.

Today, GLP-1 manufacturers are fully embracing this approach and working directly with vendors and employers to provide better access.

How Much Does Andel Cost?

Now for the part you’ve been so patiently waiting for, the cost.

Before your employer contributes anything:

• Zepbound KwikPen ALL DOSES: $449.00

• Shipping and handling, including 5 needles: $55.00

• Andel membership fee: $9.99

• Total all-in per fill: $513.99

Employers also have the option to cover the $9.99 membership fee on behalf of their employees.

What you actually pay based on your employer’s contribution:

• $50 employer → $463.99 employee

• $100 employer → $413.99 employee

• $150 employer → $363.99 employee

• $200 employer → $313.99 employee

• $250 employer → $263.99 employee

• $300 employer → $213.99 employee

Lilly’s own cash pay price through LillyDirect runs $550 per month. Andel’s direct-to-employer price is already lower than that before your employer contributes a single dollar.

Insurance vs Andel

Curious how Andel holds up to traditional insurance coverage?

See the difference for yourself:

83% of commercial insurance plans require prior authorization, step therapy, or both before a patient can access a GLP-1 prescribed for obesity.

Your doctor writes the prescription, hands it to you, and the insurance company goes: actually, wait.

Have you considered failing at something cheaper first?

No?

Let’s start there.

And it’s not just frustrating. It is life threatening.

Nearly one in three physicians say step therapy has led to serious patient health consequences including hospitalization or permanent disability.

And a real-world Truveta study found that 12.8% of patients discontinued GLP-1 treatment not because it was not working but because they couldn’t afford to continue.

Andel was developed to fix those issues.

Don't Wait for HR to Figure This Out

You do not need HR to find this. You can send it to them yourself.

Here is how:

• Go to andel.org/referral

• Fill out the Refer Your Company form

• Let Andel reach out to them directly

It takes 5 minutes to hand your employer a vetted Lilly partner with transparent pricing, no administrative overhead, and a cost structure that is cheaper than traditional insurance.

That is self-advocacy in the most practical form it can take. And we all know that when you advocate for yourself, you advocate for all of us. 🌎💫

Find Andel: 🌐 andel.org 💼 Andel on LinkedIn 👤 Jay Bregman on LinkedIn

Disclaimer: I am the founder of both GLP-1 Studio LLC and the GLP-1 Collective, a separate 501(c)(3) nonprofit organization. These are two distinct legal entities. GLP-1 Studio does not receive any money from the GLP-1 Collective. All work performed by GLP-1 Studio in support of the Collective is done on a volunteer basis under a separate contract arrangement. I was not paid to write this article. I do not accept payment from pharmaceutical companies, compounding pharmacies, or program administrators to write about their products or services. I do occasionally accept paid speaking engagements. My editorial coverage and opinions are entirely my own.

If you’ve ever felt like you “failed” after surgery… or after stopping a GLP-1… you’re not alone.

An entire system has been built around obesity “care” that expects people to succeed without the support they actually need, then blames them when it doesn’t work long-term.

Key Details:

• Bariatric medicine and obesity medicine are essentially the same thing — both refer to the medical treatment of obesity.

• Bariatric patients have had surgical intervention, while GLP-1 patients are managing obesity through medication — but both are treating the same chronic disease.

• There are several types of bariatric surgeries including gastric sleeve, gastric bypass (Roux-en-Y), gastric band, duodenal switch (DS), and SIPS/SATY (single anastomosis procedures).

• Bariatric surgery boosts the body's natural GLP-1 production, with the strongest effects in the first 12 to 18 months. Over time those hormonal effects can level off and some patients regain weight — in those cases, a GLP-1 medication can help.

• Many private insurance plans already cover dietitian visits at no cost under Medical Nutrition Therapy benefits — call your insurance and ask about code 97802.

Steph Wagner, The Bariatric Food Coach

Stephanie Wagner, MS RDN, Dietitian, owner of the Bariatric Food Coach, and author of Best Fork Forward—has over 15 years of experience in this space.

Steph has been specializing in bariatric surgery patients since 2009.

Here is what she’s found so far:

• Nutrition for bariatric patients and patients on GLP-1 medications is almost entirely the same.

• Protein, fiber, habits.

Which makes sense, both are treatments for the same underlying disease.

But before we get into the fascinating science, I want to take a moment to gush.

Obviously, Steph is impressive. “She’s done the things.” 😉

But what you don’t see when you read the letters after her name or look at the business she’s built is the incredibly radiant soul behind the work.

I don’t go this deep for every guest.

There are two people I have met in obesity care where I instantly thought, wow—if you could see auras, Steph Wagner and Dr. Lindsay Ogle, would outshine the sun.

Which is ironic since Dr. Ogle introduced us to begin with.

Disclaimer’s at the bottom of the article, but just to reinforce—I was not paid to say this, or to interview either of them. I genuinely feel it.

Now back to the fascinating science.

What is Bariatric Surgery?

Steph explained that bariatric medicine and obesity medicine aren’t just basically the same, they’re literally the same thing.

The difference between bariatric and GLP-1 treatments is the tool. Bariatric patients have surgery, while GLP-1 patients use medication to manage the same chronic disease. Same disease, different tools.

But they are more alike than you think.

There are several different types of bariatric surgeries but they do not all work the same way.

Gastric sleeve 🍌

Removes the stretchy part of the stomach, that expands like a balloon to hold your meal while it slowly releases. With 70% of your stomach gone what’s left is the shape of a banana, that can’t really “hold” food anymore, so it pushes through way faster.

How it affects natural GLP-1:

The part of your intestines that makes GLP-1 only turns on when food actually hits it.

L-cells are tiny “food sensor” cells in your lower intestine that release GLP-1 when food hits them.

So when food shows up faster and in bigger chunks, L-cells in the lower intestine go into overdrive and pump out more GLP-1 than they did before surgery.

Food moves faster → hits the gut sooner → more GLP-1 gets released

This is a big reason people feel fuller and less hungry after surgery. But here’s what makes the sleeve special. It doesn’t just boost GLP-1. It also boosts GIP.

K-cells are the “food sensor” cells that make GIP, and they mostly live in the upper part of your intestine.

Sleeve = GIP ↑↑ + GLP-1 ↑↑

Your intestines are still in their normal layout so food passes through both hormone “zones,” giving you a two-for-one effect.

Gastric bypass (Roux-en-Y) 🥚

Shrinks the stomach down to about the size of a small egg and then reroutes part of the small intestine to connect directly to that tiny pouch.

How it affects natural GLP-1:

Food literally skips about 95% of the intestine and lands directly where L-cells are packed the densest. It's like express-shipping a package of undigested nutrients straight to the GLP-1 production line.

That’s how we know this isn’t just a weight loss thing. It’s an anatomical rearrangement thing.

Bypass = GLP-1 ↑↑↑ + GIP ↓

Interestingly, GIP is greatly reduced because food completely skips the place that produces it.

Gastric band (lap band) ➰

An adjustable silicone band wrapped around the top of the stomach to create a tiny pouch above it. Nothing gets removed. Nothing gets rerouted. You just physically can't fit as much food in at once.

How it affects natural GLP-1:

It doesn’t.

The band is purely mechanical. If GLP-1 production depends on food reaching L-cells in the lower intestine faster and in bigger amounts, and the band doesn’t change anything about how fast food travels through your system, there’s no reason for those L-cells to behave any differently than before.

Band = GLP-1 → + GIP →

It works on pure portion control and nothing else. No hormonal help, no metabolic reset.

DS (duodenal switch) and SIPS/SADI-S

Starts with a full sleeve, removing about 80% of the stomach. Then the surgeon separates the intestine just past the stomach and reconnects it lower down.

The valve at the bottom of the stomach stays in place and still works normally. Food leaves the stomach the usual way, it just gets redirected to a lower part of the intestine after that.

Traditional DS (BPD-DS)

Traditional duodenal switch has two intestinal connections. The surgeon does the sleeve, then reroutes things in two places so food and digestive juices travel separately.

SADI-S/SIPS

SADI-S is the same basic idea but with just one connection. Everything flows through a single channel, making it a simpler, lower-risk surgery.

How they affect natural GLP-1:

Because you’re getting both the sleeve effect (faster emptying from losing the stretchy part of the stomach) AND the bypass effect (food landing directly in L-cell territory), these procedures create the most dramatic hormonal changes of any bariatric surgery.

Duodenal switch, makes GLP-1 go way up, and since food skips the part of the intestine where GIP is made, like bypass, GIP is reduced.

DS (BPD-DS) = GLP-1 ↑↑↑ + GIP ↓↓ 

But here’s where it gets wild. A head-to-head study found that SADI-S actually leads to higher GLP-1 levels after eating than the traditional DS.

SADI-S/SIPS = GLP-1 ↑↑↑↑ + GIP ↓↓

So mechanistically they’re doing the same thing (sleeve + bypass of upper intestine), but SADI-S does it with one connection instead of two, and somehow gets an even bigger hormonal response.

Bariatric Surgery vs GLP-1 Medications

It all comes down to how much the surgery changes the path food takes.

The more things get rerouted, the bigger the hormone response:

• Band barely changes anything and doesn’t do much hormonally

• Sleeve speeds things up and gives a moderate boost

• Bypass sends food straight to the GLP-1 zone for a bigger effect

• DS/SADI-S basically does everything at once and hits the hardest.

Bariatric surgery and GLP-1 medications are not rivals.

Surgery is especially effective in that first 12 to 18 months, in part because it dramatically increases your body’s natural GLP-1 levels. That’s actually how scientists figured out GLP-1 mattered in the first place, and eventually turned it into medication.

• Surgery changes your body to help it make more GLP-1

• Medication gives you a synthetic version to help boost levels

And when that natural boost from surgery starts to fade, meds can step in and keep things going.

You Did Not Fail Your Treatment

The hormone boost from bariatric surgery doesn’t last forever for everyone. GLP-1 levels spike right after surgery, hit their peak in the first year or two, and then slowly start to fade.

Around year two is when some people start to see weight come back, and by year three, more people are turning to GLP-1 meds. This doesn’t mean surgery failed. It just means the body adapted, and adding medication is simply continuing what the surgery started.

I have met so many people who carry deep shame about gaining weight back after surgery, or stopping a GLP-1.

Steph put it in a way that hits home:

Obesity is a chronic disease, and chronic disease needs lifelong treatment.

You wouldn’t tell someone with cancer they “failed” because chemo didn’t work the first time. Just like you wouldn’t tell someone doing IVF that they failed if they couldn’t get pregnant.

But when it comes to weight, it gets personal.

Weight regain is not a failure of willpower. It is not a character flaw.

It’s your biology working against you. The hormone boost from surgery fades. The medication only works while you’re on it. None of that is a moral failure. It’s science.

And needing extra support is nothing to be ashamed of.

The Bariatric Food Coach

If you watched this episode and fell in love with Steph as much as I have, you can find her at @bariatricfoodcoach on Instagram, YouTube, Facebook, and Pinterest.

You can find her book Best Fork Forward on Amazon with: 60 high-protein, quick recipes designed for bariatric patients that apply directly to GLP-1 patients.

Steph did not pay for this episode or ask me to promote the book. I am recommending it because it is awesome. I mean a cookbook with a picture for every recipe? Yes, please! What’s more? She cooked every recipe and took every picture herself.

Just amazing…

On top of all of that Stephanie has built something genuinely useful over at bariatricfoodcoach.com:

• Nearly 700 recipes

• An AI chatbot where you can tell it what is in your fridge and ask it to build you a dinner

• A GLP-1 video course

Her community has been active since 2015, which tells you something about whether it works.

I am excited and honored to share that I will be a guest speaker, on self-advocacy, for them on March 27th at 12pm CST, so it’s the perfect time to sign up.

I hope to see some of you there! 🥰

Disclosure: GLP-1 Studio is a for-profit media company founded by Amanda Bonello. The GLP-1 Collective is a separate 501(c)(3) nonprofit organization, also founded by Amanda Bonello. These are two distinct legal entities. GLP-1 Studio does not receive funding from the GLP-1 Collective, and the Collective does not direct or fund the editorial content produced by GLP-1 Studio. This content was not sponsored or commissioned by any pharmaceutical company, telehealth provider, or clinical organization. Amanda Bonello is an independent patient advocate and does not accept payment from pharmaceutical companies or telehealth clinics in exchange for editorial coverage. Steph Wagner did not pay for her appearance on this podcast or to have her book featured in this article. This article contains affiliate links. If you purchase through those links, GLP-1 Studio may earn a small commission at no additional cost to you. Affiliate products are selected because they are genuinely useful to GLP-1 patients — not because of compensation.

2025 GLP-1 Advocacy Wrapped

In late 2024 I started a petition for affordable access to GLP-1s. That grew to more than 27,000 signatures and unexpectedly opened the door to national and international media coverage.

What followed was a year of advocacy. Building the GLP-1 Studio, the Podcast, and founding the GLP-1 Collective nonprofit. It was a year of bonding with the community, learning how to keep moving failure after failure, and learning how to advocate for myself and for everyone else.

Read the full recap here.

FDA's New Threat After Hims & Hers Launches Semaglutide Pill

On February 6, 2026, the FDA announced it intends to take “decisive steps” to restrict GLP-1 active pharmaceutical ingredients (APIs) used in non-FDA-approved compounded drugs, specifically calling out Hims & Hers and warning that companies could face legal action without further notice, including seizure and injunction.

Read about what happened and what it could mean for access to compounded GLP-1 medications.

Interview with Sabina Hemmi, Founder GLP Winner

In this episode, I sit down with Sabina Hemmi, founder of GLP Winner, to unpack the growing wave of federal and state legislation targeting compounded GLP-1 medications, including semaglutide and tirzepatide.

We break down what the Safe Drugs Act and related state bills could mean not just for weight-loss treatments, but for all compounding, from hospice and pediatric care to veterinary medicine. Sabina shares her personal journey as a long-term GLP-1 patient, why transparent pricing matters, and how patients can take action to protect access to the medications that have changed their lives.

Listen here to learn more and find out what this could mean for you.

Bills against Compounded Meds

Multiple states are pushing legislation that would devastate compounded medication access. Washington HB 2613, Florida SB 860/HB 877, and Mississippi SB 2542 would restrict or eliminate compounding entirely—not just for GLP-1s, but for children's medications, veterinary care, and end-of-life pain relief. Some bills limit pharmacies to just 20 "essential copy" prescriptions monthly while major facilities fill 10,000+ daily. Indiana's bill started terrifying but got amended after constituent calls proved our voices work. Virginia's bill was delayed a year. The federal SAFE Drugs Act (HR 6509), introduced by Indiana reps where Eli Lilly is headquartered, requires prescription reporting to fuel pharma litigation. If you're in an affected state, contact your representatives now—even five calls can change the outcome.

Visit GLP-1 Studio to see the current status and location of each bill.

Why Every Advocate Should Attend Your Weight Matters Conferences

This past weekend, I had the honor of attending an OAC’s social listening session and the Your Weight Matters regional conference in New Orleans.

Between the advocacy work and Mardi Gras opening day, it was an incredible experience that deepened my passion for obesity advocacy and for this community.

If there’s a regional event near you, go. These conferences aren’t just educational, they’re essential for anyone serious about advocacy and understanding the science behind the medications changing our lives. 💖

Learn more about the upcoming National Your Weight Matters event.

Disclaimer: The information shared in this article and podcast is for educational and informational purposes only and does not constitute medical or legal advice. I am not a medical professional, attorney, or financial advisor. Always consult with a qualified healthcare provider, pharmacist, or legal professional regarding your specific situation. The views expressed are personal opinions based on research, interviews, and lived experience. Policy discussions are evolving and subject to change. Nothing here should be interpreted as a guarantee of outcomes, regulatory predictions, or medical recommendations.

Sabina Hemmi is one of the people I most respect in this space. She is what the cool kids are calling “the real ones.”

I first met Sabina when I launched the petition for affordable access and still had no idea what I was doing. We became instant friends, and a year later here we are, together in the trenches, on the frontline of healthcare policy and patient advocacy.

Key Details:

• Sabina is the founder of GLP Winner which is a transparent comparison site for GLP-1 clinics

• There are several state bills and a federal bill threatening access to compounded glp-1 medications.

• Some of these bills target compounded medications in general. This includes medications specially made for cats, dogs, end of life care, kids, the list goes on.

• Call, email, visit your local legislature to share your story and let them know how these bills concern you.

• Visit GLP-1 Studio to see the latest updates for each bill.

Transparent GLP-1 Pricing

Sabina was a patient who got screwed by the system and decided to do something about it.

If you’ve looked up more than one glp-1 clinic you already know how traumatizing it is to find pricing. As a person who reviews clinics I cannot tell you how many times I have had to put in my full information, address, email, phone number, sometimes even ID, face scan, and most recently last 4 of my SS#, just to see what the meds cost…

There are some clinics that still don’t show you how much you can expect to spend until after a video consultation. Talk about a waste of time, effort, and money when you finally find out that the price increases by dose and ends up being just as expensive as name brand meds.

Lucky for us, Sabina built the solution. GLP Winner is a transparent comparison site where you can actually see what you’re getting before handing over your soul, I mean your info.

Sabina built GLP Winner because she was paying $550 a month for compounded semaglutide through a local OBGYN, and when they switched compounding pharmacies the price increased to $800.

After experiencing exactly what I described she didn’t just build this much needed tool, she started rotating providers to go through the whole painful process so that you don’t have to. You can watch her review providers and unbox the meds on her socials.

But here’s the thing we respect the most: she didn’t build GLP Winner to make a quick buck off desperate patients.

She built it because she was a desperate patient.

She’s been on GLP-1s for three years now and as an OG in this space she understands better than most what patients need.

GLP-1 Side Effects

During our conversation, Sabina opened up about how rough her journey has been.

She is one of the unlucky 12% who suffer from bad side effects but regardless of how brutal her experience was she wasn’t giving up.

Think about that for a second. The side effects were so bad she was vomiting multiple times a week, and she still didn’t want to stop.

That’s how life-changing this medication is.

Now imagine it being taken away.

Bills Targeting Compounded GLP-1s

Sabina and I have been advocating for access through thick and thin for the last year. She’s even traveled to some of the court proceedings involving pharma and compounded clinics, like Mochi Health.

• The FDA’s months long game of is the medication off the shortage list or not.

• The incessant up-and-down emotional roller coaster of, are we losing access today?

• Clinics getting sued and not effect our prescriptions.

It has not been easy, but just as it started to feel like things were settling down, new legislation is being introduced, and not just from one state, but from all sides.

A federal bill called the Safe Drugs Act and several state bills are targeting compounded GLP-1s.

The bills aim to:

1. Make It Much Harder to Compound GLP-1s

• Redefine what counts as a “copy” of a brand-name drug

• Require pharmacists to prove there’s a meaningful difference for each patient

• Limit pharmacies to compounding certain medications only 20 times per month

• Clarify that adding something minor like B12 does not make it “different enough”

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2. Tighten Where Ingredients Can Come From

• Require raw ingredients to come from FDA-inspected facilities within the last two years

• Require pharmaceutical-grade ingredients with formal documentation

• Require pharmacies to do their own quality testing and keep detailed records

• Prohibit certain versions of GLP-1 ingredients, like salt forms

---

3. Increase Oversight of Facilities

• Require larger compounding facilities to be inspected before operating and regularly after

• Require medical spas offering weight-loss drugs to register and have a responsible practitioner physically present

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4. Add New Reporting Requirements

• Require pharmacies to report when they ship more than 20 prescriptions per month across state lines

• Require pharmacies to provide ingredient and testing records within one business day if requested

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5. Create Serious Penalties for Violations

• Fine pharmacies up to $1,000 per dose for drugs deemed improperly compounded

• Allow immediate license revocation

• Require warning labels stating the drug is not FDA-approved and may have known and unknown risks

What’s worse is that some of these bills don’t just target GLP-1s, they target all compounding.

ALL Compounding

Most of us don’t even know that we’ve likely had a compounded medication before.

Sabina explained that this could affect our veterinary care, hospice, children, anyone who can’t swallow a pill and need a liquid version like:

• Pediatric custom formulations

• Allergy-specific medications

• Veterinary compounds

• Hospice care preparations

• Hormone compounds

• Dermatology compounds

These are actions or guidance aimed directly at compounded semaglutide, tirzepatide, and similar drugs.

They usually focus on:

• Arguing that compounded GLP-1s are “essentially copies” of brand-name drugs

• Restricting use of certain versions, like salt forms

• Clarifying that adding something minor like B12 does not make it legally different

• Ending compounding once a drug is no longer considered in shortage

Intent: Rein in or eliminate compounded versions of specific blockbuster drugs.

Scope: Narrow. Targeted. Drug-specific.

---

The Broader Federal & State Bills

The newer federal and state bills go further.

They don’t just target GLP-1s. They change the rules for compounding in general.

They focus on:

• Capping how many times pharmacies can compound drugs that resemble approved medications

• Raising the bar for what counts as a “significant difference”

• Tightening ingredient sourcing rules

• Increasing federal inspections and reporting requirements

• Imposing faster record production and heavier penalties

Intent: Restructure how traditional compounding works overall.

Scope: Broad. Structural. Applies to many compounded drugs, not just weight-loss medications.

It’s bigger than weight loss.

Healthcare Reform

But here’s what gives us hope. Sabina notes that we’re at a really unique moment in American politics right now.

Our broken healthcare system is not a partisan issue. Democrats and Republicans both know we’re getting ripped off.

GLP-1s present a rare and powerful opportunity.

For the first time, millions of people whose lives have been changed by a medication are actively engaged in the healthcare system in a way they never were before. They are informed. They are organized. And they are willing to advocate for continued access.

Sabina pointed out that most people don’t feel the immediate impact of policy changes.

A law passes, and aside from taxes or paperwork, life goes on.

But being cut off from a medication that is actively treating a chronic disease? That is felt instantly.

GLP-1s are already changing the healthcare system. Actually, let me reframe that.

GLP-1 patients are already changing the healthcare system. And Sabina believes that this level of engagement and passion has the potential to reshape it for everyone, not just those taking these medications.

The Call to Action

If you live in a state where a bill is moving that could restrict access to compounded medications, this is the moment to act. Look up your state representative, call or email them, and tell them clearly that you oppose the specific bill by number. Share your personal story in simple terms. Explain how access to compounded GLP-1s or other compounded medications has affected your health, your finances, and your family. Let them know what losing access would actually mean for you, whether that is unaffordable care, going without treatment, or turning to less safe options. Many lawmakers see titles like “Safe Drugs Act” and assume it improves safety. They often do not realize these bills can reduce access, increase costs, and unintentionally push people toward unregulated markets.

Even if your state does not currently have a bill, you can still be proactive. If you have the time and feel strongly about this issue, contact your representatives and educate them before legislation appears. Compounding pharmacies are critical healthcare infrastructure, and most people, including lawmakers, did not understand their importance until recently. In-person visits can be especially powerful. When representatives hear directly from real constituents in their district, even a small number of calls or visits can make a meaningful difference.

Call to Action:

• Look up your state representative by entering your address on your state legislature’s website

• Call or email and reference the specific bill number if one is active

• Share your personal story and explain what losing access would mean for you

• Emphasize affordability, safety, and access in plain language

• If possible, visit your representative’s local or state office in person

• If you are not in an impacted state, share information with friends who are

• Consider contacting your federal representatives about broader legislation such as the SAFE Drugs Act

• Stay engaged and speak up early if legislation is expected in your state

This isn’t just about protecting access to a medication that changed so many people’s lives.

It’s about defending access to medications for hospice patients, children, pet owners, and anyone who relies on customized medicine.

It’s about a healthcare system that millions of Americans already know is broken, and a moment where patients are finally organized, informed, and unwilling to go back to suffering in silence.

In her words,

Connect with Sabina

Tiktok: https://www.tiktok.com/@lawliepop
Instagram: https://www.instagram.com/lawliepops/
Youtube: https://www.youtube.com/@lawliepop
X/Twitter: https://x.com/lawliepop
Substack: https://substack.com/@lawliepop
Linkedin: https://www.linkedin.com/in/sabina-hemmi/

Disclaimer: Sabina is a paid subscriber to GLP-1 Studio and has previously donated to the GLP-1 Collective nonprofit as a supporter of patient advocacy. She did not pay to be featured on the podcast or in this article. GLP-1 Studio does not accept funding from pharmaceutical companies or compounding clinics. The views expressed here are my own and do not represent any sponsor or partner.

On February 6, 2026, the FDA announced it intends to take “decisive steps” to restrict GLP-1 active pharmaceutical ingredients (APIs) that are being used in non-FDA-approved compounded drugs.

Key details:

• FDA will use “all available compliance and enforcement tools” including seizures and injunctions

• Companies can no longer claim compounded products are generic versions, contain the same active ingredient, or are clinically proven

• DOJ now investigating Hims for potential federal law violations

• Enforcement priorities include: compounding without documented medical necessity, misleading marketing, poor API sourcing, and use of research-grade ingredients

• Hims stock crashed 50% this year, down from $68 to below $17

• The “regulatory gray space” that existed in 2024 has collapsed into “a tightly policed corridor” by 2026

What Happened With Hims & Hers and the FDA

Hims crossed a major line by trying to copy Novo’s oral Wegovy pill, which uses a special patented absorption technology called SNAC (salcaprozate sodium) to protect semaglutide as it passes through the digestive system.

Hims claimed they could replicate SNAC using “liposomal technology,” but there are literally no publicly available human trials showing that works on semaglutide.

Former FDA Commissioner David Kessler straight up told The New York Times:

And get this, he added that a 2mg compounded semaglutide pill may not act anything like its brand-name counterpart, with absorption off by upward of 30%, meaning one pill will have little effect while another will overdo it, meaning that you literally can’t know ahead of time what you’re getting…

Former FDA Commissioner Scott Gottlieb pointed out on CNBC:

This means that Hims wasn’t just compounding, they were essentially creating an entirely new unapproved drug.

Gottlieb also noted that the FDA typically takes administrative steps before escalating to the DOJ, suggesting the agency may be eager to go to court and secure a ruling against Hims.

So the FDA got mad. Hims wasn’t playing by any of the traditional compounding rules, they were trying to innovate around patented technology, mass-market it as equivalent to the FDA-approved version, and do it all without any clinical trials proving their version actually works.

It was basically regulatory arrogance on steroids, and the FDA made an example out of them.

In my opinion the FDA had no choice but to act. Hims kicked the hornets nest and the rest of us may potentially get stung.

What the FDA Actually Said They’ll Do

Here’s where it gets real for all of us, the FDA says it will use “all available compliance and enforcement tools” to address violations, which explicitly includes seizure and injunction.

Translation: they’re not messing around anymore.

Specifically, they’re planning to:

• Restrict API access, this could potentially cut off the supply chain at the source.

• Crack down on marketing claims, companies can’t claim their compounded products are generic versions, the same as FDA-approved drugs, contain the same active ingredient, or are clinically proven.

• Go after “mass compounding,” meaning those without documented medical necessity, unlicensed manufacturing, improper storage and shipping, poor API sourcing, and use of research-grade ingredients.

This confirms that the remaining pathway to compounded GLP-1s is narrow, technical, and heavily scrutinized.

The Worst Case Scenario for Patient Access

Okay, let me paint you the absolute nightmare scenario, because I think we need to be realistic about what could happen:

• If the FDA actually follows through on restricting API access, this would essentially end the ability of compounding pharmacies to create these medications.

• Most of the accessible, affordable compounding options disappear.

• If other telehealth companies face similar pressure and lawsuits as Hims & Hers, they may just... fold. And then where does that leave patients?

• If DOJ starts bringing criminal charges or massive civil penalties against compounders, the chilling effect will be immediate and brutal. Nobody’s going to risk federal prosecution to provide affordable medication.

Regulatory tolerance began to collapse under manufacturer pressure and federal scrutiny. This isn’t just about one company or one product. This is the FDA drawing a line in the sand for the entire compounding industry.

The absolute worst case?

What’s your take on all this? Are you seeing panic just yet? Or are we all traumatized by last years “will we get cut off today or wont we” roller coaster?

Leave a comment

Disclaimer: This content is for informational and educational purposes only and reflects publicly reported information, regulatory statements, and personal analysis at the time of writing. It is not legal advice, medical advice, or investment guidance. Regulatory actions are evolving and interpretations may change as additional details become available. Nothing here should be interpreted as a definitive statement about the legality of any specific company, pharmacy, telehealth provider, or compounded medication. Patients should speak directly with their licensed healthcare provider and pharmacist regarding their individual treatment options. Businesses should consult qualified legal counsel regarding compliance with federal and state law. Any opinions expressed are personal commentary based on publicly available reporting and do not represent official findings by the FDA, DOJ, or any regulatory authority.

Key Details:

• Launched a petition for affordable access to GLP-1s and raised 27,000+ signatures

• Featured nationally and internationally in 11 media pieces

• Hosts and produces the GLP-1 Studio Podcast, ranked in the top 10% globally

• Founded the GLP-1 Collective nonprofit to support patients through education and resources

• Launched GLP-1 Studio, an advocacy media production platform built to push this work further

The Petition: What Started it All

In October 2024, I took to Reddit for real GLP-1 patient experiences.

I’d heard all of the horror stories:

• Stones in your gut

• Thyroid cancer

• Lizard venom

The list goes on, but every person I talked to was either on one or knew someone who was and they weren’t just living.

They were thriving.

I needed to know the truth. I went looking for “I lost weight and didn’t end up with Ozempic face” stories.

Two comments stuck with me.

One person who went from barely walking to running half-marathons. And another who’d been sober since starting GLP-1s after 14 years of alcoholism.

I thought, “How could anyone hear these stories and think that it was ok to take this medication away?”

I realized then that this wasn’t just about a drug, it was about the people who needed this medication to live healthy, happy, long lives.

There had to be some organization or group of people already advocating for access on a large scale.

At the time:

• Dave Knapp was working on his Release the Vials campaign to bring down the price of brand-name medications.

• Kim Carlos was advocating fiercely for obesity rights through the Plus Sidez Podcast.

• Individual patients were speaking up on social media, but the work was scattered.

We needed something that could spread the word and bring patients together at the same time.

On November 19, 2024, I launched a Change.org petition demanding affordable access to GLP-1s.

The media reached out almost immediately.

The Media: The First Rallying Cry

Politico and USA Today both contacted me within the same week, and not long after, local news wanted an interview. That’s when it became clear this was bigger than I could have imagined.

I started hustling for signatures on Reddit right away and ran into a surprising amount of pushback.

People told me,

But if a problem stays hidden, nothing changes, and this wasn’t your average problem, this was a BIG one, and now it was front and center. This wasn’t about a petition magically fixing anything.

It was about giving people a visible rallying point so we could organize and make a real difference.

Since then, I’ve been featured nationally and internationally:

1. Politico: Prescription Pulse newsletter (November 26, 2024)

2. USA Today: Coverage on drug costs (December 1, 2024)

3. ABC’s Local 5 News: Local coverage urging FDA support (December 19, 2024)

4. CNBC: Zepbound shortage impact (December 24, 2024)

5. USA Today: Coverage compounding decisions (March 2, 2025)

6. Childhood Obesity News: FDA compounding decisions (March 5, 2025)

7. Fast Company: Potential disappearance of compounded medications (March 12, 2025)

8. Audacy’s KRLD NewsRadio 1080: Radio interview on FDA bans (April 1, 2025)

9. Wired: GLP-1 copycats and compounding landscape (May 14, 2025)

10. Reuters: Compounding crackdown and patient struggles (May 23, 2025)

11. Danish Broadcasting Corporation: International coverage on Novo Nordisk litigation (October 20, 2025)

Beyond that, I’ve helped Reuters, WIRED, New York Times, Couch Health, I-MAK, a Danish documentary film crew, and Danish Broadcasting connect with GLP-1 patients. I even hosted Danish Broadcasting in my home.

But before DR visited my small Iowa home, I’d been working nonstop to make as many waves as possible. And once I saw how powerful media could be for reaching people, the next step was obvious.

A podcast.

The GLP-1 “Collective” Podcast: Formerly

On December 28, 2024, I launched the “GLP-1 Collective Podcast.”

From the beginning, it was built around three core goals:

1. Interview patients to share their stories and bring compassion and understanding to this space, showing just how much access truly matters.

2. Fight stigma and misinformation through expert-led education, helping people understand how these medications actually work so they don’t have to fear the unknown.

3. Be a sounding board by keeping people informed about what’s happening, how they can take action together, and where to find community support.

That foundation became the heart of the podcast, and it delivered. Within its first year, it ranked in the top 10% globally.

I’ve had the honor of interviewing patients, experts, and advocates across 31 episodes. I’m grateful to have been able to share these inspirational journeys, along with quality education and supportive tools.

Highlights include:

• Kim Carlos: Host of The Plus Sidez Podcast

• Dr. Lindsay Ogle: Founder of Missouri Metabolic Health

• Jamie Selzler: Executive Director of the North Dakota Democratic Party

• Tahir Amin: Co-founder of I-MAK, co-hosted on The Plus Sidez Podcast

• Dr. Craig Primack: Head of Weight Loss at Hims & Hers and former OMA president

I’m even more grateful to have been featured on some of the best podcasts in this space, including: The Plus Sidez, Missouri Metabolic Health, GLP-1 Hub, and In The Know With Nina.

Those conversations reinforced why this work matters and how powerful sharing stories can be.

One episode that’s especially close to my heart is the very first Studio Special, “Ozempic Saved My Life.” It features Cherie Sandholtz, who lost access to her medication and reached out to me when she didn’t know where else to turn.

This episode explores what happens when access gets cut off and the very real consequences that follow.

Around this same time, I launched TikTok and Instagram for the first time and quickly realized people weren’t just looking for updates. They were looking for each other.

The podcast was a powerful tool, but stories like Cherie’s made it clear that people needed a place they could actually go for resources and support.

The GLP-1 Collective Nonprofit: Supporting Patients

On January 10, 2025, I founded the GLP-1 Collective nonprofit.

The nonprofit had three main goals:

• Support

• Education

• Advocacy

Through the nonprofit, I focused on supporting patients however I could.

I created programs and led events like:

• Monthly Support Group: A monthly space for questions, connection, and support.

• Patient Stories Blog: Patient stories that put access into real-world context.

• GLP-1 Starter Kits: Donation-based starter kits with practical tools and trusted resources for patients new to GLP-1s.

(Currently paused while supplies are restocked.)

• Local Iowa Chapter Meetups: Natural Grocers has generously allowed us to use their cooking classes as a space to meet up, connect, and learn something healthful together.

• Live GLP-1 Q&As with Experts: I hosted live GLP-1 workshops that gave the community a chance to ask questions and get expert answers.

  • Dr. Lindsay Ogle: board-certified family and obesity medicine physician

  • Misty Tatom: nurse practitioner

  • Dr. Matthea Rentea: obesity medicine physician, host of The Obesity Guide podcast)

  • Tara Rothenhoefer: original Mounjaro clinical trial participant, lost 220 lbs

  • Gianna Beasley, MS, RDN: author of The GLP-1 Solution

This work mattered, and I’m proud of the impact it made. I’m grateful to everyone who showed up for the Q&As, and I’m especially grateful to Pureway Compliance and Natural Grocers for donating to the support kits.

But supporting the community was not my only objective. From the beginning, I wanted to make a tangible difference.

Advocacy Efforts:

Before the petition existed, I was just trying to build awareness.

Letters to the FDA

I reached out to multiple local and national news outlets, my local legislature, even Bernie Sanders’ HELP Committee, and finally I wrote to the FDA but no one got back to me.

At that point, it was clear we needed something big enough that it couldn’t be ignored. So I started the petition.

Once it reached 27,000+ signatures, it had real weight. I reached out to the FDA again, this time with four appendixes attached, including hundreds of comments from people struggling to access their medication.

Nothing puts it into perspective quite like reading page after page of comments like this.

But still I got no response.

I-MAK (Institute for Medicines, Access & Knowledge)

As this work grew, I-MAK reached out for help connecting with patients who were struggling to access their medication.

They were already deep into a major report on how drug manufacturers use patent thickets to extend GLP-1 monopolies, keeping prices high and cheaper options out of reach. What they needed was the human aspect to support the data, and that meant patient stories.

Patient connections are kind of my specialty.

I’d already been collecting stories and building relationships, so when I-MAK reached out, I was grateful for the opportunity to advocate for access alongside them, and especially grateful to the community members who trusted me enough to share.

That experience made one thing painfully obvious. This was a structural issue coming from multiple angles, and change was only going to happen if awareness existed at every level.

Letter to the USPTO

I-MAK is what inspired me to write to the U.S. Patent and Trademark Office next.

Patent evergreening was, and still is, harming real people by limiting access to these life-changing medications. They needed to know that patients are paying attention, and that we are actively advocating for patent reform.

Once again, there was no response, and patients continued to lose access. So I documented it.

Insurance Barriers

I wrote an article and created a full video spotlighting four women who were cut off from their GLP-1 medications for entirely different reasons, but with the same outcome.

Statistically, coverage looked widespread. In reality, access was far from attainable.

Some employers wanted to cover GLP-1s but couldn’t because their benefits plans excluded them for weight loss. Others fought through prior authorization, finally gained access, and were then cut off when policies changed.

One school district switched pharmacy benefit managers and reset the whole process overnight. Another patient had diabetes, changed jobs, and suddenly had to fight for a medication that had already been working.

This wasn’t abstract policy. It was happening in real time. And documenting the damage wasn’t enough. These stories needed to reach the people with power.

I’d exhausted every federal route I could. Congress was next.

Contact Congress Day

I organized a Contact Congress Day, rallying people to reach out to their local officials and share their lived experiences to show just how essential access truly is.

One patient did receive a response. A New York State legislator initially agreed to meet, then went silent when we followed up. But meetings weren’t the goal.

When people start calling and writing their representatives, legislators take notice, whether they agree with the issue or not. That pressure doesn’t stop at local offices. It’s what leads to broader policy conversations.

Obesity Action Coalition (OAC)

Eventually, I was invited to join an Obesity Action Coalition advocacy group.

OAC is a national nonprofit that works at the policy level through education, advocacy, and lobbying to improve obesity care and reduce weight stigma.

This relationship has only just started, and I’m excited to see what comes next.

The Reality Check

Working with patients and organizations showed what was possible when advocacy is collective.

But inside all of that were two wildly large aspirations:

1. Help people pay for their medication.

2. Take advocacy to the next level.

What I didn’t fully understand at the time was just how difficult it would be to accomplish them.

The nonprofit came with rules that made it nearly impossible to pull off. In fact, if I continued advocating the way I was, it could risk the nonprofit’s very existence.

And I wanted to advocate loudly, creatively, and without limits.

The GLP-1 Studio: An Advocacy Media Platform

On September 3, 2025 I founded the GLP-1 Studio and rebranded the podcast as the GLP-1 Studio Podcast.

After seeing how effective media could be at reaching people worldwide, I wanted to build an independent, patient-first advocacy media production platform with the potential for maximum reach.

Very quickly, the Studio began opening doors I never expected.

Obesity Week

I received media credentials to attend Obesity Week, one of the leading conferences in obesity care.

Being there meant sitting in concurrent scientific sessions, hearing the latest and upcoming research, shaking hands and talking with experts, and speaking up as a patient advocate in rooms where patients are usually talked about, not included.

It also meant meeting several podcast guests and community members in person.

GLP-1 Community Meetups

I attended several GLP-1 community meetups through Downsized and BioCare, and they ended up meaning more to me than the trip itself.

The BioCare girls showed up in a big way, advocating for access with me outside the GCCW building, and then hosting a series of meetups that kept the warm feelings going all week. I’ve been drinking the Kool-Aid (or Protein shakes 😉) ever since.

The meetups were expected. What came next was completely out of left field.

GLP-1s Covered Under Medicaid & Medicare

While I was at Obesity Week, a presidential announcement dropped that instantly changed GLP-1 patient access. GLP-1s for weight loss could now be covered under Medicare and Medicaid, with a co-pay of just $50.

This was the biggest news in patient access we’d ever seen.

and Zach Niemiec invited me to join a private filming session with a Danish GLP-1 documentary crew. I had previously connected them with a patient for interviews, and now I was meeting them in person.

The three of us sat side by side on a hotel room couch, cameras rolling, recording our reactions as the presidential announcement unfolded.

It was completely surreal.

And with Novo Nordisk being one of Denmark’s largest companies and employers, the documentary crew wasn’t the only Danes paying close attention.

Almost simultaneously, DR reached out again, just months after filming in my home, to capture my reaction as I rushed to the airport.

Talk about a whirlwind of a week. Scratch that. A whirlwind of a year.

My Work Beyond Formal Advocacy

Alongside formal advocacy, I’ve been freelancing as a health writer and consultant to help support the work and my family when advocacy alone wasn’t enough.

That’s meant helping patients understand how to navigate the healthcare system and advocate for themselves, helping organizations better understand the patient experience so their strategies are actually compassionate, writing deeply researched and medically reviewed GLP-1 guides, and doing GLP-1 clinic reviews.

It’s been one of the most educational parts of my work, and I can say with full confidence that finding safe, affordable options is not easy and often comes with a catch.

I rotate providers and go through the full process firsthand so patients don’t have to waste months of time, money, and emotional energy figuring it out the hard way.

Closing Out 2025

2025 was purely reactive. I just wanted to help people. That meant starting a petition when people were scared, turning stories into media when patients needed a voice, and helping people find each other when there was nowhere else to turn.

It was a hard year. Emotionally. Financially. For my family. For my sanity.

Most of the time it felt like I was learning how to do everything the hard way, often by myself, because no one was coming to save us. We had to be the heroes we needed. So I built the podcast, the nonprofit, the Studio, and everything in between out of pocket.

As painful as it was at times, it was worth every second.

I’ve stayed independent through all of this. That matters to me. But it also means there’s no institutional safety net behind the scenes. Everything I’ve built came from my own time, energy, resources, and your support. I genuinely could not have done any of this without the 27,000+ people who signed the petition.

To the advocates who came before me, like who was out there talking about how GLP-1s were changing lives, interviewing people, and going to DC long before I showed up, thank you for paving the way.

To everyone still fighting for access: we’re just getting started. 📢

Thank you from the bottom of my heart,

Amanda Bonello 💖
Founder, GLP-1 Collective | GLP-1 Studio
Host, GLP-1 Studio Podcast

Disclaimer: The information shared in this publication is for educational and informational purposes only and is not intended as medical, legal, or financial advice. Nothing published here should be considered a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about your health or medical care. I do not receive affiliate income, referral fees, or compensation from pharmaceutical companies, drug manufacturers, or compounded GLP-1 clinics. My advocacy and media work are independent and self-funded unless explicitly stated otherwise. Any views expressed are my own and based on lived experience, research, interviews, and publicly available information. While I strive for accuracy, healthcare policy, insurance coverage, and regulatory guidance can change, and readers should verify information with appropriate professionals or official sources. Participation by patients in media, research, or advocacy efforts referenced here is voluntary. When compensation is involved, it is disclosed transparently.

Aja Beckett Built the Tool She Wish Existed

Aja isn't just someone who saw a gap and waited for someone else to fill it. Nope, she grabbed that gap by the horns.

When she started her GLP-1 journey, she hopped on Reddit like so many of us have, and quickly realized we were basically navigating this new world in the dark with little information and even less useful tools.

But Aja, didn’t just complain, she created a solution.

She’d just wrapped up building The Athletic App for the New York Times. Then turned around and poured that same IOS engineering superpower into creating Shotsy, the first of its kind for this community.

Others have tried to replicate it, but Shotsy has something they don’t, genuine heart. And that’s all Aja.

The Human Story Behind Shotsy

Behind every brilliant tool is a need, stemming from a very real human story and Aja’s journey was a whole very relatable maze itself.

Aja was living with obesity, Hashimoto’s, and chronic inflammation, and she was willing to pay whatever it cost for relief:

Luckily, she didn’t have to go into debt to afford her GLP-1. Eventually, she landed a full-time job with good health insurance. But by “good,” I mean a $500 co-pay every month for Zepbound.

That’s the reality she was up against, and she paid it.

If an extra rent-sized payment every month sounds bonkers to you, you’ve probably never faced the fear of losing access to a medication that gives people a life they never thought was possible.

Cherie’s story puts this all into perspective. I shared her story in a recent Studio Special. She spent every last dollar she had, went into debt, and sold her belongings just to stay on this medication. And now she’s officially been cut off.

If you understand how that feels and want to help her afford her next dose, her GoFundMe is linked below.

Cherie's GoFundMe

Cherie’s story is exactly why I do what I do, and why I love what the Shotsy app brings to the table.

Shotsy as a Tool for Self-Advocacy

The real beauty of Shotsy isn’t just tracking data to help you survive GLP-1 prior authorizations, though if you’ve ever dealt with insurance, you know how valuable that alone can be.

But unlike other trackers, Shotsy helps you self-advocate in your own doctors office.

It goes beyond simple tracking, turning your data into a visual estimate of what your GLP-1 hormone levels might look like at any given time.

And that’s powerful, because it gives your doctor a PDF snapshot of your full experience, which opens the door to personalized dosing instead of the default one-size-fits-all titration schedule.

If you caught the GLP-1 Studio Podcast episode with Dr. Craig Primack head of weight loss at Hims & Hers, then you know how important personalized dosing is.

Titration schedules weren’t built for comfort, they were designed to achieve the greatest weight loss in the shortest amount of time.

In reality, staying at a lower (and often cheaper) dose for longer can help people avoid side effects, which are the second biggest reason people quit GLP-1s, after cost of course.

But this app isn’t only useful for self-advocacy.

This is Where Shotsy Shines

If you’re planning a vacation, Shotsy helps you see when your GLP-1 levels are likely to be lowest, which is especially useful when you’re trying to avoid scheduling shot-day fatigue on the same day as a two-day buffet cruise.

Don’t do it. Trust me.

It also helps you plan nutrition around how full you might feel. Many people notice less food noise control a day or two before their shot, which can make that window ideal for a “protein preload,” especially if appetite drops post-injection.

All of this is why I think this app is especially helpful for two groups: those who are just starting out and have no idea what to expect.

And those moving into maintenance… who also have no idea what to expect.

The M word is intimidating for a lot of us, not because we’re not ready, but because there’s no clinical guidance. And when I say none, I mean none. Full stop.

Patients are often left to figure it out mostly on their own, sometimes with a supportive doctor, but still experimenting in real time with their own bodies. Shotsy brings long-term tracking and predictive insight to an otherwise unstructured experiment.

All of this sounds great, but what makes it truly special isn’t just what it does. It’s who built it.

Leave a comment

“It’s Not Your Fault”

Aja is a patient first, someone who knows the shame and stigma of being told they’ve “failed” at eating less and moving more.

She was eager for a solution and she knew GLP-1s would be a “game changer” for her:

• She lost 95 pounds

• Went from being unable to buckle her ski boots… to skiing again.

• Kicked a 20 year long addiction to the diet soda.

• Climbs stairs and bleachers without fear.

• And the chronic ankle pain she lived with daily? Gone, she cant even remember which side it was on.

This wasn’t just weight loss; it was a complete transformation. But the most profound change of all was the food noise finally going quiet.

She admits she didn’t fully understand what people meant by “food noise” until it disappeared. And when it did, she had the same life-altering realization so many of us do:

I had my own version of that moment, one I shared in of the GLP-1 Studio Podcast. nothing feels more liberating than the day you finally realize… it’s not your fault.

I shared my own version of that experience in season 1 episode 5 of the GLP-1 Studio Podcast. When the food noise goes quiet, the silence is deafening, and that’s when you finally realize it’s not your fault.

Aja puts it plainly:

That truth is life-changing. Which is why the first chapter in GLP-1 Strong: A Framework for Self-Advocacy is titled, It’s Not Your Fault. Before you can advocate for yourself, you have to let go of the belief that you are undeserving of care in the first place.

Through both her story and her work, Aja makes one thing unmistakably clear: we are deserving.

Stay Connected

Here’s where you can find Aja and learn more about her work:

• 🌐 Website

• 📱 Instagram

• 💻LinkedIn (Aja)

• 💻LinkedIn (Shotsy)

• 📱 TikTok

Thank you for Reading

I’m grateful you took the time to be here and read this. 💖
Learn more and listen here:

• 🎙️ GLP-1 Studio Podcast

• 🌐 GLP-1 Studio

• 🎧 Spotify

• 📱 Apple

• 📖 SubStack

• 💻 YouTube

Disclaimer: I was not paid, sponsored, or compensated in any way for this episode or article. All opinions expressed here are my own and do not reflect the views of the GLP-1 Collective nonprofit or any other organization. This is not medical advice. Nothing in this article, podcast, or platform should be used as a substitute for professional medical care, diagnosis, or treatment. Always consult with a qualified healthcare provider about your health decisions. I also do not formally endorse any guest, clinic, or company featured. The intention is to share stories, not prescriptions. The GoFundMe link in this article is not mine, and I do not receive any funds from it.

🔔 Quick Call-Out for GLP-1 Patients and allies

started a petition to stop the SAFE drugs act, a proposed policy that could cut off access for thousands of GLP-1 patients and prevent compound pharmacies from stepping in during future GLP-1 shortages.

You can sign here. Thank you for standing with us.

A lot happened last month and BioCare was a huge part of it.

I sat down with Caroline Colavita from BioCare Nutrition and Mario Testa from their parent company, Robard. Caroline leads brand and growth. Mario is the VP of Sales. Together, they’re helping shape what real nutrition support looks like for GLP-1 patients.

BUT… This is so much more than just an interview.

Key Takeaways

1. BioCare shows up for GLP-1 patients beyond the product.
   Their presence at ObesityWeek centered real connection, advocacy, and community, not just branding.

2. BioCare’s protein is designed around how GLP-1 patients actually eat.
   It simplifies nutrition, replaces multiple supplements, and supports patients who struggle to meet protein needs through food alone.

3. Data confirmed protein support is helping preserve muscle.
   Body composition scans provided real evidence that consistent protein intake is supporting muscle during GLP-1 weight loss.

4. BioCare and Robard addressed lead concerns directly and proactively.
   Third-party testing and clear communication helped cut through fear around protein powders.

5. Robard brings decades of clinical nutrition experience into modern GLP-1 care.
   Together, BioCare and Robard are adapting long-standing medical nutrition support to meet the realities of today’s GLP-1 and weight loss patients.

How I met the BioCare Girlies

When I was at Obesity Week in Atlanta last month, BioCare didn’t just show up, they brought the whole vibe.

They hosted multiple GLP-1 community events throughout the week, and I’m a little embarrassed to admit that the time I spent with them might be the most memorable part of the entire conference.

I met thousands of extraordinary people:

• I shook hands with some of the leading minds in obesity science and medicine.

• I met several guests I’ve interviewed for the GLP-1 Studio Podcast, including my personal hero, Kim Carlos, from Season 1, episode 3.

• I was even filmed with Michael Donnelly-Boylen and Zachary Niemiec by a Danish documentary crew in real time as the White House dropped the biggest policy news in GLP-1 patient history.

• The Danish Broadcasting Corporation (not related) who came to my home last September later called me for my reaction as well.

Truly surreal, “how is this my life” kind of moments, nothing about that week was small.

And still.

The moments that stayed with me the most weren’t the headlines or the cameras or the proximity to power. They were the quiet, connective, human moments I spent with the BioCare girls.

Let me tell you why…

Community Is the Story (Not the Product)

Like I said BioCare didn’t just host one community event at Obesity Week and call it a day.

• They joined us at the Downsized meetup.

• Showed up for me at the GWCC to help advocate for affordable access to GLP-1s.

• And hosted several GLP-1 meetups, different spaces, same energy.

None of it felt transactional. It felt warm and honestly… fun.

Through those events, I met several GLP-1 patients who quickly turned into friends, like Jackson Lemay, who listeners might recognize from Season 1, Episode 4 of the GLP-1 Studio podcast.

Back when the podcast was just getting started, Jackson was instantly supportive, before I even really knew him. Warm, welcoming, and clearly someone who advocates loudly and proudly, not just for GLP-1 patients, but for people in general.

Meeting him and his husband felt like running into friends you didn’t know you were missing your whole life. I talked with them all night and easily could’ve kept it up into the morning and beyond.

I also met Jesse Kesner founder of Alnu Health, who was featured in Season 2, Episode 4. I can’t imagine there is a single person who has met Jesse and didn’t immediately adore him. I know I did, and in a weird, very on-brand twist, Jesse is also the reason the BioCare girls and I fully connected.

Caroline, Delilah, and I initially met through zoom, but when Jesse’s name came up, everything clicked. It was an immediate, collective, “Wait… you know Jesse?” moment. Yes. I know Jesse. I love Jesse. They love Jesse. And just like that, the universe said, great, you’re all friends now.

I met too many people to list them all, but the connections made in this space are unlike anything I’ve experienced before. This is a shared sentiment.

GLP-1 patients are connecting almost instantly, on another level.

Community in the GLP-1 space isn’t just nice to have. It’s necessary.

GLP-1 patients are not just meeting each other online. They are traveling cross country, sometimes multiple times a year, to form lifelong connections.

Most of us are figuring this out in real time. These medications aren’t new, but for the mainstream? This is uncharted territory. There’s a serious lack of clear information, limited resources, and new “GLP-1” products popping up almost daily. It can feel overwhelming fast.

During this interview, Caroline, who is a GLP-1 patient herself, said something that really stuck with me:

We’re all trying to make careful decisions about our health in a world that loves to misunderstand and take advantage of us. What matters most to me isn’t that a company makes products for GLP-1 patients, but that they’re paying attention to the humans actually using them and providing something genuinely helpful.

I Like Being Marketed To (I Just Don’t Like Being Lied To)

My husband hates being marketed to. He watches YouTube, but absolutely refuses to sign in because he doesn’t want the algorithm ...

I’m the opposite.

I actually like seeing things pop up that I might genuinely want or need. Show me something useful. Show me something I can benefit from. Half the time, I wouldn’t find it otherwise.

The problem isn’t marketing. The problem is misleading marketing.

And GLP-1 patients are about to be flooded.

We’re already seeing it. “Natural GLP-1 supplements” in the form of patches, gummies, pills, you name it. I’ve reviewed a few, and there’s nothing special about them except their ability to give people hope, and then crush it.

That’s the part I can’t tolerate.

This isn’t casual. This is life-changing, potentially life-extending territory. People are already dealing with fears about needles, concerns about dependency, anxiety around side effects, and the constant weight of other people’s judgment.

When something is marketed to this community, it has to be honest about what it can and cannot do. Otherwise, it’s not just ineffective, it’s harmful.

That’s why I’m selective about who I talk to and what I share. I want to interview people who are actually building things for GLP-1 patients, not just trying to capitalize on them. I want to vet them. I want to understand how they operate. And eventually, I want to be able to point people toward a short list of companies that are genuinely doing right by this community.

Which brings me to BioCare.

Because as tempting as it might be to assume they won me over immediately… that’s not actually what happened.

Why BioCare Didn’t Win Me Over at First

BioCare didn’t instantly win my heart. And I think that’s important to say out loud.

The first time I saw it, I was interested, sure. It’s clearly made for GLP-1 patients, and when you start a GLP-1, you immediately want to know what might actually help support this whole new version of your life.

Honestly, having “GLP-1” in the description alone piques my curiosity. But if I’m being real, the price tag gave me pause. It was very much a do I need this, or is this just expensive optimism? moment. The math wasn’t mathing at first.

I toyed with the idea of buying it more than once, then talked myself out of it. But it kept popping up in the community. And at a certain point it started to feel like that whole “if your friends jumped off a bridge…” situation. And yeah. I probably would. Peer influence is real.

So eventually, I gave in.

I actually started drinking BioCare before I ever met Caroline, Mario, or Delilah. And truthfully, it tasted good. I’m pretty picky about protein because most of them taste like chalk coated in an aggressively chemical sweetness.

This wasn’t the usual “this is fine if I choke it down fast” kind of good. It was good enough that I only needed to mix it with water, which is saying something. Most protein shakes require milk for me.

And still, even then, BioCare hadn’t fully won me over.

What finally did it was meeting them in person.

Seeing how they showed up for the GLP-1 community. Watching how they listened. Feeling the emphasis on people over products. The vibe wasn’t salesy. It was thoughtful. It was human. It was very clear that community wasn’t a marketing angle for them, it was the point.

That’s when it clicked for me. I wasn’t just drinking a protein shake anymore. I was supporting a team that actually understands the space they’re operating in.

That’s when I became a proud BioCare baddie.

And I’m glad I did because I got hard proof that their protein is making the difference.

Muscle, Fear, and the Data That Finally Gave Me Peace of Mind

In the last episode of the GLP-1 Studio podcast, I interviewed Dr. Nina Crowley from SECA Health. While I was at Obesity Week, I not only ran into Nina, but I had the rare opportunity to get scanned myself.

Keep in mind, a SECA scan has been shown to closely match MRI results, which are the gold standard for measuring body composition. And I can’t overstate how much I needed that data.

I’ve been on a GLP-1 for about a year now. I’ve lost over 50 pounds. And like a lot of other GLP-1 patients, I’ve been quietly terrified about what that might mean for my muscle.

We all know the average bathroom scale is doing its best, but it’s not exactly medical-grade. It can show you a general trajectory, but it can’t tell you what’s actually happening inside your body. And when you live in a world where everyone is yelling about muscle loss, it’s really easy to assume the worst.

When I saw my scan results and learned my muscle was in good shape, I felt instant relief. After a decade of bulimia and periods of punishing over-exercise, knowing I’m no longer destroying my body and still maintaining healthy muscle felt like a massive win.

Right now, I drink one protein shake a day, lift twice a week, and walk the rest. That’s it. And the data confirmed it’s enough for my body.

But muscle isn’t the only thing that patients angst over.

Food After Food Noise on a GLP-1

GLP-1s don’t necessarily erase food noise. They just redirect it. Instead of obsessing about when we eat next, nutrition becomes top of mind in a completely different way.

For me, getting enough protein from food alone isn’t realistic. I rarely eat meat, and if I have so much as a piece of steak, I’m reaching for papaya enzymes like it’s my job.

That’s why at least one protein shake a day isn’t optional for me. It’s foundational.

And before BioCare, that meant protein shakes plus a small pharmacy worth of supplements, vitamins, and minerals. All of it. Which adds up fast, in cost, mental load, and honestly, how much your body has to process every day.

Being able to simplify that down to one shake a day is huge.

But we can’t ignore the question everyone’s asking right now. What about the lead?

Lead in Protein Supplements & Shakes

Just before this interview, my husband saw a news segment about protein powders with high levels of lead.

Suddenly, he was looking at my daily protein habit like it was a slow-moving crime scene. According to the headlines, people were basically giving themselves lead poisoning in the name of gains. Great. Love that journey for us.

To be fair, it was a legitimate concern. Protein supplements are everywhere right now. Everything has protein in it. Bars. Chips. Pop-Tarts. And when something becomes that ubiquitous that fast, quality control can get… questionable.

So I asked Mario about it.

He shared that as soon as that news started circulating, they immediately sent their products out for third-party testing.

That response told me a lot. Not just about the testing, but about how seriously they take concerns when fear starts spreading faster than facts. Any company can say they’re trustworthy. Not everyone backs that up by proactively testing their products when the internet starts spiraling.

But something else that stood out was how BioCare’s parent company, Robard, has quietly been helping patients all along.

Robard Corporation, Helping Clinicians Help Their Patients

During one of the BioCare events, a long-time Robard customer stopped by, an obesity specialist who owns several clinics in the Atlanta area. She came because she wanted to better understand GLP-1 patients.

Her clinics have used Robard’s medically supervised nutrition programs, New Direction and New Metra, for years. These aren’t vanity shakes. They’re clinical nutrition tools used when patients need real support.

But things have changed.

GLP-1s are changing the entire healthcare system. Keeping up means listening, learning, and being willing to adapt.

Clinics are popping up everywhere, and a lot of them are trying to figure out how to support patients beyond just prescribing medication.

Some have started offering meal kits, which makes sense on paper. Food support is part of the equation. Patients are eating less. Nutrition matters more.

But here’s where real life kicks us in the butt.

Meal kits still require time. Planning. Cooking. Cleanup. Mental bandwidth. And for a lot of people, like me, that’s just asking too much.

I run a nonprofit. a media production platform, host a podcast. and actively advocate. I have a family. I love the idea of cooking. I do not love the reality of it most days. Give me something high protein with fiber that takes five minutes and doesn’t require a sink full of dishes afterward.

And I’m not alone in that.

For a lot of GLP-1 patients, the barrier isn’t motivation. It’s logistics, and when you’re eating less overall, every bite has to work harder. That’s why full nutrition support matters more than meal kits alone.

Not everyone needs recipes. Some of us need reliable, clinically sound nutrition that fits into real schedules and actually helps our bodies. The kind of support that acknowledges how people actually live, not how we’re told we should live.

Watching how BioCare and Robard think about this, especially in the context of telehealth, made the next step feel obvious. I asked if BioCare was planning on teaming up with any weight loss clinics. it seemed like the obvious next step. Robard has been supporting patents through their clinicians for decades. Mario confirmed that they are working on expanding.

And it’s not just telehealth clinics. It’s your local grocery store too. After this interview, I got an update that BioCare was on the shelf at the Hy-Vee near me, and I immediately jumped in the car to check it out.

My son, who just turned 14 last week, recorded and edited the video himself, and we were both ridiculously proud. It turned into a really fun thing to work on together. 💖

And I’m stoked to be able to grab my protein from five minutes down the road, rather than waiting on shipping or stressing about delays. And when I saw they had more than one option?

Let’s just say I stocked up.

This Conversation Wasn’t Really About Protein

It wasn’t even really about BioCare or Robard, at least not in the way people usually mean when brands come up. It was about what happens when companies choose to pay attention to patients instead of just marketing to them. When community isn’t an afterthought, but the point.

GLP-1 access is expanding. Fast. And that’s a good thing. But it also means more noise and more people trying to cash in on a population that’s just trying to improve their quality of life.

What sold me on BioCare wasn’t the product itself. It was the mission behind it, and how deeply I felt it when Caroline said:

Patients deserve better. They deserve real support.

If you’re on a GLP-1, or just trying to find answers, I hope this helped. And if nothing else, I hope it reminded you that you don’t have to do this alone.

If you’re curious about upcoming BioCare events in your area, stay tuned, they have a full lineup planned for 2026. You can follow BioCare on TikTok or Instagram to stay connected.

And if you do make it to one, I hope I get the chance to see you there. ✨💕

Disclaimer: This article and interview were not sponsored or paid for by BioCare or Robard. No compensation was provided for the interview, the written content, or the opinions shared here.

I am a BioCare affiliate, which means I may earn a small commission if you choose to make a purchase through my affiliate link, at no additional cost to you.

Separately, BioCare compensated me for a video showing my personal in-store purchase of BioCare products at Hy-Vee. That compensation applied only to that specific video content and did not influence this article, the interview, or my independent experiences and opinions.

This article reflects my personal experience and perspective and is provided for informational purposes only. It is not intended as medical advice, nor does it diagnose, treat, cure, or prevent any condition. Always consult with a qualified healthcare professional regarding medical or nutritional decisions.

Any references to research, testing, or data are based on information shared during interviews or publicly available sources and are included for general educational context. Individual results may vary.

Please… tell me how to stay on the medication that finally gave me my life back.

Some come in hopeful. Some sound like the last exhale before slipping underwater. Every single one reminds me this isn’t a side project, it’s the line between staying afloat and being pulled under.

But when Cherie Shanholtz showed up in my inbox, her message hit different.

The subject line read:

Cherie’s Story: A Life Rebuilt

Cherie once weighed nearly 380 pounds.

Severe obesity.
Insulin resistance.
Metabolic syndrome.

All the things society labels as “choices,” when in reality her biology had been stacking the odds against her for decades.

When she finally got on Ozempic, her world bloomed like a flower and she flew out of it reborn, a little fairy with pixie dust still on her wings.

Cherie lost over 235 pounds.

Her blood pressure came down. Her cholesterol improved. And her breathing finally stopped acting like a full-time job.

She could move without hurting, and actually live in her body instead of going twelve rounds with it every day.

But this is the part we don’t focus on enough.

GLP-1s don’t just give you great selfies, they give you selfhood. She told me, “I always dreamed of wearing beautiful, feminine clothes,” and for the first time in her adult life, she could actually put them on and feel like the woman she’d imagined as a little girl.

Joy in feeling beautiful is not vanity. It’s deeply human, and she deserved every bit of it.

Some people have concerns about GLP-1s causing depression or suicidal thoughts… no honey. The reality for most of us is the opposite.

What’s actually depressing is living with chronic inflammation, constant pain, exhaustion, shame, judgment, and being blamed for things you were never in control of to begin with.

When your body stops fighting you, your mind finally gets to breathe. The weight isn’t just physical, it’s emotional. And losing it gives you back pieces of yourself you thought were gone forever.

Cherie could finally see herself again.

And just when she started to trust that this otherworldly experience was real, her insurance ripped the carpet out from under her.

A Lifeline Pulled Away

For six months, her insurance covered the medication that made all of this possible. And then out of nowhere it just stopped. No warning. No explanation. One day she was covered, and the next she was stranded.

Cherie paid $800 out-of-pocket trying to hold her life together.

• She sold belongings.

• Skipped essentials.

• Pushed her mental health beyond its limits.

Eventually she found a compounded option, cheaper but still too much after months of bleeding herself dry.

And the stress, the crushing fear of losing the body she fought for, cost her her job.

This is what GLP-1 patients are actually living when people call these “vanity drugs” and giggle when they get taken away. This isn’t about Instagram angles. This is survival.

A BMI of 40 or higher can mean up to “14 years of life lost.” But beyond the stats, there’s a heavy mental health toll.

Imagine having the freedom to:

• Fly without a seatbelt extender.

• Eat in a restaurant without the side-eye.

• Shop in the “regular” section instead of being relegated to the plus-size aisle.

• Buy clothes because you like them, not because they’re the only thing that fits.

• Ride a roller coaster.

• Take a photo with friends without hiding behind them.

• To feel human.

Imagine finally getting a glimpse of what “normal” feels like, holding the things other people don’t even notice… and then watching every single one of them slip through your fingers.

Imagine standing there, helpless, as your own life starts playing in reverse. Like watching a rerun you never wanted to see again, only this time you can’t look away. You know exactly how it ends… and the dread settles in your bones long before the credits roll.

This is the difference between functioning and falling apart.

Cherie is still fighting, and I’m helping her with every tool I can. But stories like hers are only going to become more common as we head into 2026.

We’ve Played These Games Before

In May I wrote about the coverage drops that hit right after the holidays.

The new restrictions, the prior authorizations, the denials, the out-of-pocket tsunami that blindsided people who thought they were safe. 💸

It’s happening again in January 2026

And compound pharmacies are surely bracing themselves for the flood.

The Future of GLP-1 Coverage

2025 was the year employers built the GLP-1 obstacle course; 2026 is the year they put walls around it and shut most of the doors, leaving only a narrow side entrance for the lucky few who can make it through.

2025: The “Uh-Oh” Year

The demand for GLP-1s skyrocketed and insurance coverage couldn’t keep up. Employers panicked, pharmacy budgets blew out, and millions of patients got dropped.

Employment GLP-1 coverage:

• 96% covered for type-2 diabetes

• 67% covered for obesity

• 34% covered for heart disease

• 96% of employers worried about long-term GLP-1 costs

The drop-offs were brutal:

• Zepbound®: 14% more people lost coverage (4.9 million cut off)

• Ozempic®: 22% more people lost coverage (1.1 million cut off)

• Wegovy®: fewer plans with full coverage; more prior-auths or no coverage

• Mounjaro®: Unrestricted coverage slipped by 5%, and “no coverage at all” rose by 3%.

From the outside, it might look like GLP-1s were widely covered, but:

• 90% required Prior Authorization (Denial rate: not included)

• 54% required participation in a weight-management program

• 48% required a BMI threshold and/or additional comorbidities beyond FDA indication

If you thought that was bad then buckle up.

2026: The “Buckle Up, Baby” Year

Costs are climbing even faster and employers are bracing for impact. GLP-1 demand isn’t slowing down, and everyone is sweating through their spreadsheets.

What we’re barreling towards:

• Cost trend projection: 9%

• Pharmacy trend: 11–12%

• Employers seeing rising GLP-1 use: 79% (now)

• Employers anticipating more increases: 15%

• Employers requiring PA for obesity GLP-1s: 90%

Employers and insurance companies are tightening their fists.

As one Washington Post investigation reported, patients are already navigating what one obesity specialist called an “absolutely insane” maze of insurance denials, cost barriers, and constant policy shifts. And it’s about to get worse.

To sum things up:

2025: GLP-1 demand exploded → employers panicked → pharmacy budgets caught fire.
2026: GLP-1 crackdown begins → stricter rules → coverage stagnates → cost trend still climbs.

So yes, 2026 sounds terrifying but there is still hope for some.

Hope on the Horizon with a Cliff Beneath It

Let’s talk about the Most-Favored-Nations announcement.

Medicare patients will receive MFN-priced GLP-1 coverage, for obesity, nationwide, with a $50 co-pay, and Medicaid can opt in at the same prices.

This is huge, even history-making:

• This could reshape obesity care in America.

• Medicare and Medicaid could finally cover obesity treatment.

• Prices could drop.

• Weight-loss indications could move from “optional” to “standard.”

It’s the closest thing we’ve ever had to a real turning point. But here’s the thing.
Every single state has to opt in.

Some states will likely:

• Drag their feet.

• Outright refuse.

• Only cover specific GLP-1s.

• Bury patients in prior auth hell for months.

• And some formularies won’t update for a year.

However, even if some states make it harder than it needs to be, this is finally opening the door for people who could never afford the out-of-pocket costs in the first place, and that alone is worth celebrating.

But will MFN move the needle on broader coverage?

Commercial Insurance: The Wild Card

The Most-Favored-Nation agreement does not automatically apply to commercial insurers.

This means it doesn’t, force employer plans to lower prices, guarantee they’ll expand coverage, or require them to change a single formulary line item. But that doesn’t mean we are outright screwed.

What we do know:

What we don’t know:

Anything beyond that. There’s no mandate, enforcement, or timeline. And without that pressure, commercial insurers can still do what they’ve always done, continue treating obesity care like a “lifestyle choice” instead of the medical need it is.

While Medicare and Medicaid inch forward, commercial patients are left hanging over the gap with nothing but compound medication and a prayer.

That’s the real cliff edge.

Because most people living with obesity are covered by employer-sponsored insurance. And unless those employers decide to cover these medications, unless their benefit managers renegotiate and opt in, none of the MFN relief touches them.

They’re still stuck paying around hundreds of dollars a month, which is already out of reach for most households. And with more coverage drops coming, more patients will be forced to pay out of pocket or go without when they can’t afford it. or worse… go grey.

Yes, help is coming.

But not fast enough for the people falling off the cliff in January. And not fast enough for the ones already spiraling in real time.

People like Cherie and Amanda Fratello.

Amanda’s Story: Losing Access

You may remember Amanda from Season 1, episode 12 of the GLP-1 Studio Podcast.

At sixteen, she was diagnosed with Hashimoto’s and hypothyroidism. A double-hit that lit her body on fire with inflammation.

And doctors did what doctors have done to so many of us: they blamed her.

It took finding the right doctor, a year of appeals, and prior auth gymnastics before Amanda finally got approved in June of 2024. It felt like someone cracked a window open in a suffocating room.

And it worked. It didn’t just “help with weight.” It gave her life back.

Until it was taken away.

Watching the Car Go Under

In November the notice arrived. Her insurance was dropping coverage for weight loss.

She was terrified of what was going to happen to her. She was terrified of what was going to happen to her. She’d been paying a $30 co-pay, living paycheck to paycheck, and even compounded options were financially out of question.

At that point she had six shots left.

I’ve talked to Amanda twice since then. First she had one left. Then she had none.

Watching Amanda lose her medication shot by shot felt like locking eyes with someone trapped in a sinking car.

You see the water rising. You see the panic behind the glass. You know exactly what happens next, and you’re pounding on the window, praying for a miracle but you already know can’t help her out in time.

Losing access is like mourning the death of a beautiful life taken too soon.

Amanda is still grieving. Not just the medication, but the version of herself she had only just met.

I wish I could tell you Amanda’s story is rare, but this story arc is on repeat.

What Are We Supposed to Do in the Meantime?

Let’s be honest.

Most still can’t afford “discounted” compounded options at $190–$300 a month.

Yes, there are options on paper:

• PAN Foundation, if you fit the diagnosis and income needle-thread

• Manufacturer cash-pay programs, if you have hundreds a month lying around

• Compounded medication, if you’re comfortable with the risk and still have the money

• Medicaid, maybe, if and when your state opts in

• Medicare, maybe, depending on state, indication, and a thousand unknowns

But hope is not a solution. “Wait and see” is not a solution.

For people paying out of pocket right now and the ones bracing for the shove, it’s prior-auth and fail-first hell, with hoop after hoop… and then what?

A denial letter and some advice to “eat less and move more?”

That isn’t a treatment plan. That’s abandonment with a paper trail.

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The Question I Keep Coming Back To

What happens to the people who’ve done it all, and still can’t their medication?

If you’re on a GLP-1 right now:

What would you be willing to do to stay on your medication?
And what would you do if you lost access tomorrow?

That’s the reality millions are living.

And it’s why I’m going to keep doing my best to help, sharing resources, connecting them to assistance programs, and amplifying these stories until we stop pretending this is anything other than a healthcare crisis.

The Future of Obesity Care

GLP-1 patients are already reshaping the healthcare landscape, and we’re only just getting warmed up.

What you can do to help:

• Sign the petition for affordable access

• Support my petitions on SWAY pushing for PBM reform, healthcare reform, and shutting down patent evergreening

• Donate to Cherie’s GoFundMe so she can afford her next dose

• Help OAC advocate for the Treat and Reduce Obesity Act (TROA)

• Reach out to your local representatives to let them know this issue matters to you.

• Subscribe to the Studio newsletter …and if you ever feel moved to go paid, just know it fuels the caffeine that keeps the sparkle in this work and keeps these stories in the spotlight where they belong.✨

People deserve better, so I will keep fighting for better obesity care.

Are you with me?

Disclaimer: Nothing in this article is medical advice. I am not paid, sponsored, or compensated for mentioning any organizations, resources, companies, or individuals. Cherie’s GoFundMe is entirely her own and has no affiliation with the GLP-1 Collective. My opinions are my own and do not reflect or represent the views, policies, or positions of any employer, organization, nonprofit, or company. Nothing here should be taken as an endorsement. Always speak with a licensed medical professional about your own health and treatment options.

She’s a Registered Dietitian, Health Psychologist, and bona-fide Body Composition Expert who has spent two decades in the obesity-care trenches helping both patients and clinicians do better by people living in larger bodies.

She leads Clinical Education and Partnerships at SECA – Precision for Health, serves on the Board of Directors for the Obesity Action Coalition, and somehow still finds time to host her own podcast, In the Know with Nina.

She’s wicked smart, deeply compassionate, and the kind of educator who can explain complex research without ever talking down to you.

Think science in stilettos.

In The Know With Nina

I first met Nina through Dr. Lindsay Ogle (one of my favorite obesity specialists and a beloved Season One guest of the GLP-1 Studio Podcast.) Lindsay has this uncanny talent for connecting people who were clearly meant to collaborate, and Nina was no exception.

GLP-1 Studio

Dr. Lindsay Ogle, MD: A Doctor Who Truly Cares 💙

Listen now

a year ago · Amanda Bonello

We hit it off immediately.

I had the privilege of being featured on her show, where we talked about advocacy, access, and freedom from food noise.

At that time Nina joined me to record the episode you’re reading about now, where she makes “bioimpedance vector analysis” sound like plain English… a magic trick, honestly.

We wrapped the interview, sent it off for editing, and I figured the story would pause there for a moment…

ObesityWeek

Fast-forward. I arrived at ObesityWeek representing the GLP-1 Studio Podcast and was heading back to my hotel when the universe decided to get playful. I didn’t just see one familiar face. I saw three.

Nina, , and .

Nina was instantly recognizable because she was in the middle of a handstand in front of the Olympic rings at Centennial Olympic Park.

It was a pose I’d seen often in her LinkedIn posts, and it was pretty easy to assume this woman knows how to have fun when you see her flipped upside down with a smile on her face at every serious conference.

We laughed, took a selfie, and promised to catch up later.

Unfortunately, later never happened because reasons, but there will absolutely be a next time.

And my story with Mike and Zach? Historical relevance that deserves a chapter of its own later. 

And that tiny bit of serendipity ended up mattering more than I expected.

SECA Exhibit

Here’s where the universe pulled its little full-circle moment: the episode we recorded together, this episode, was already in queue.

I had just spent an hour listening to Nina re-explain, in detail, how the SECA system measures fat, muscle, and water using something called bioimpedance analysis.

Then I’m walking the exhibit floor with my GLP-1 girl gang and there it is. A full on SECA exhibit: 2 machines, and a giant screen that displayed the results.

Historically, sharing my stats would make me want to melt into the floor like a spilled latte, but let’s be real, we were all on GLP-1s and the whole point of this journey was to stop hiding and start self-advocating.

Besides, it felt like fate was tapping me on the shoulder saying:

The GLP-1 Girlies Get Scanned

Naturally, my friends wanted in, and it’s a good thing we jumped in when we did. It was practically a mosh pit by the time we finished.

One by one, they got scanned, all of them landing solidly in the healthy muscle range. Our resident fitness baddie, was nearly off the charts.

Then I stepped up to the plate and when my results flashed onto the big screen, my jaw dropped.

Now I didn’t just understand the data… I felt it.

When The Data Becomes Personal

This wasn’t your average bathroom scale. The vibrations running through my legs sent me, and seeing those charts was giving MRI without the MRI.

This was the exact science Nina had explained on the podcast, but now it was in living color with my name on it. I realized something important. I didn’t just understand it before. I only thought I did.

This time it actually landed.

The Numbers

BMI said average but “overweight,” but my skeletal-muscle index told a different story. It said healthy, strong, and absolutely capable. And for the first time in my life, getting weighed in public didn’t make me shrink. It made me curious.

The scan told me I had a healthy amount of muscle, but that I could stand to build about two more pounds. It wasn’t judgmental. It was factual.

Weight: 179.9 lbs
BMI: 27.4
Fat Mass: 71.4 lbs (about 40%)
Fat-Free Mass: 108.5 lbs (about 60%)
Skeletal Muscle: 50.6 lbs
Recommended Goal: Gain 2 lbs of muscle

Was the number on the scale flattering? Absolutely not. But let’s be honest, I’m on a GLP-1 for a reason. These numbers weren’t an insult; they were a road map.

And that small note, gain two pounds of muscle, became a healthy, science-based, totally achievable goal.

Why Body Composition Matters

This last year has been a masterclass in fear-based headlines: “Losing weight but gaining weakness? What Ozempic might be doing to your muscles.” And lets not forget, “Singer Avery Reveals Ozempic Left Her With Deadly Bone-Thinning Disease.”

Proof that GLP-1s must be the villain.

Never mind her age, medical history, nutrition, movement patterns, or the million other variables that affect bone health. 

Here’s the part that keeps getting twisted: some GLP-1 studies report that in certain GLP-1 trials, reductions in lean mass accounted for 40–60% of the total weight lost. And that sounds terrifying, if you assume “lean mass” means pure skeletal muscle. But it doesn’t.

Nina explains:

Then she added the part most people never hear:

The good news? Newer research is finally drawing that line clearly.

Papers like the 2025 review in Acta Diabetologica on muscle loss and GLP-1 agonists say it outright: changes in “lean mass” on a scan do not mean your muscles are vanishing.

Most of the weight lost is still fat, and in many cases muscle quality and function are stable or even improving as metabolic health gets better.

Once you see that distinction, the whole panic narrative starts to look less like biology and more like the research-equivalent of someone reading half a sentence and fainting on a velvet chaise.

The Patient Prospective

A lot of us carry this quiet, almost shame-soaked fear that we’re losing muscle, as if the world needed one more thing to blame us for.

For years it was weight. Now it’s muscle loss, a brand-new moral failing to shame us for.

So when we saw that we all checked out healthy, there was this soft, almost sacred collective sigh of relief.

The old stigma that you’ll wither away just didn’t hold up.

Can someone lose too much muscle on a GLP-1? Absolutely. The same way it can happen during crash diets, extreme calorie deficits, illness, or weeks stuck in bed.

That’s physiology, not a character flaw.

But the idea that these medications melt your muscle like whipped cream on a hot latte?

No, babe. Just no.

And now, instead of relying on guesswork or a $20 scale that shoots an electrical whisper up one leg and prays for statistical magic, we can actually see what’s happening inside our bodies.

In real time, with real accuracy.

That changes everything. Because Seca doesn’t just hand you a number; it hands you direction. A measurable goal. A roadmap toward health instead of a prophecy of doom.

That’s peace of mind. That’s empowerment.
And beyond that?

It gives providers actionable data.

Subscribe now

Calling All Healthcare Organizations

You need a SECA scale.

At just under ten thousand dollars, this isn’t something you toss in your mom’s basement next to the elliptical from 1998. This is serious, medical-grade tech. It’s the kind of machine that belongs front and center in a clinic hallway or a high-traffic gym lobby where it can actually help people.

This scale gives real, scientific data, it’s not the average step on, step off special.

So if your clinic or gym is still using a fifty-dollar scale from Amazon to guide care or training, it’s time to level up. SECA is the standard for modern obesity care, metabolic health, and performance-based training.

And this episode is here to show you exactly why.

Where You Can Find Nina

When she isn’t doing hand stands in public.

LinkedIn
Twitter/X
Instagram
TikTok
Facebook
Check out her Podcast below ⬇️

Leave a comment

Disclaimer: I did not receive any payment, compensation, or financial benefit from SECA for this episode or for sharing my personal experience with their equipment. My review and commentary are entirely my own.

I do earn affiliate income from BioCare and other clearly disclosed partners. Any link marked as an affiliate link may result in a commission at no additional cost to you.

The GLP-1 Studio Podcast was formerly known as the GLP-1 Collective Podcast and is a completely separate entity from the GLP-1 Collective nonprofit. Nothing said on this podcast or in this article reflects the views, positions, or endorsements of the GLP-1 Collective, and the GLP-1 Studio does not represent or speak for any organization mentioned.

All opinions expressed by me or my guests are personal perspectives, not medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional for guidance specific to your health or medical condition.

No content in this episode, on this website, or through any GLP-1 Studio platform should ever replace professional medical care.

Nov. 6th, the White House made an announcement that could potentially reshape the health of our entire nation.

As if the announcement itself wasn’t big enough, the way the news dropped and who I was with, made it that much more of a whirl.

The Announcement

The White House confirmed new pricing agreements with Eli Lilly and Novo Nordisk under the federal TrumpRx program.

This new agreement brings the list price for brand name GLP-1 medications like: Ozempic, Wegovy, and Zepbound down to Most-Favored-Nation (MFN) levels, finally putting Americans on par with what other countries pay.

For the first time ever, Medicare and Medicaid will cover these drugs for obesity—and with only a $50 co-pay!

Now that list prices are finally being standardized across the board, I’m hopeful that commercial insurers will follow suit and expand access for people who are above the federal poverty line but still struggling to pay for their medications out of pocket.

Price Breakdown

Here’s What’s Changing for GLP-1 Medications:

Most-Favored-Nation (MFN)

The U.S. has been paying some of the highest medication prices in the world because drug companies could charge whatever they wanted.

Same medicine, but in other countries, people pay only a fraction of the cost.

MFN pricing is a new rule that says, If other countries get a lower price, we should get that price too.

TrumpRx

TrumpRx is a list of fair prices. This list shows how much certain drugs, like Ozempic or Wegovy, should really cost.

It’s not a pharmacy or a discount card. It’s more like a rulebook that keeps prices fair.

Before this system, people couldn’t really see what medicines were supposed to cost. Every pharmacy and insurance company had different prices, and most of it was a secret.

Now, with this new system, everyone can finally see the actual price. It makes the cost fair and clear, so no one in the U.S. pays more than people in other countries for the same medicine.

Think of Most-Favored-Nation pricing as the government’s version of a “price-match guarantee.” If another wealthy country gets a better deal on a drug, the U.S. automatically gets that deal too. 

Pharmacy Benefit Managers (PBMs)

PBMs are the middlemen who sit between drug companies, insurance plans, and pharmacies. They’ve had a huge influence on drug prices — often driving costs up so they can take a bigger cut.

Here’s what this new system could mean for them:

• Less secrecy: Prices are public and fixed, so no more hiding behind rebate deals.

• Smaller profits: Slimmer price margins take away their biggest source of extra revenue.

• Less control: The federal price list sets a ceiling they can’t inflate.

• More accountability: With less room for hidden markups, PBMs will face growing pressure to show how they actually save money.

PBMs have long helped keep prices high because the system rewarded them for it. The new TrumpRx and MFN plan could finally shine a light on how the system really works and make medicine prices clear instead of marked up.

What This Means for Patients

This announcement is massive and it’s going to touch so many lives in so many different ways.

With this policy in place, it means:

• Recognition: Obesity care is now seen as essential medical treatment, not elective or cosmetic.

• Medicare: Coverage will finally include obesity medications, giving millions of older adults new access.

• Medicaid: Programs in all 50 states can offer coverage with a $50 copay for those under the federal poverty line.

• Prescribing: Doctors may be more willing to recommend GLP-1s as cost and coverage barriers disappear.

• Cash-pay: Patients paying out of pocket may not see big changes yet, but coverage expansion is the goal.

• Commercial: Private insurers often follow once Medicare and Medicaid set the standard.

• Validation: GLP-1s are now seen as a public-health tool, not a luxury.

When these medications first came to market, they came with eye-watering $1000+ price tags. Most people, even those with insurance, couldn’t begin to afford that.

Now, with MFN pricing and public coverage, the wall between “who can afford treatment” and “who can’t” is finally starting to come down.

Leave a comment

What This Means to Me

For the past year, I’ve poured everything I have into affordable access.

It’s been equal parts passion and exhaustion, doing a thousand little things that sometimes felt like they barely made a dent.

I started petitions (Change.org and Sway), launched a Podcast, founded a nonprofit, wrote letters to the FDA (seen here and here) and USPTO, organized Contact Congress Day, connected patients with reporters and organizations, and shared their stories with anyone who would listen.

Somewhere along the way, GLP-1 Studio grew into a full-blown media production—a home for me and a lifeline for people searching for hope.

So when I heard the words “Medicare and Medicaid will cover GLP-1s for obesity,” I think of the thousands of people who’ve shared their stories with me: those who rationed doses, sold belongings, or went without entirely, and it brings me to tears.

I’ve lived that reality too.

Watching this announcement, while standing shoulder to shoulder with other advocates, and a Danish documentary crew filming us, felt completely surreal, like watching history unfold in real time.

At its core, my goal has always been: affordable access for anyone who needs it.

The truest version of that is real coverage, with a fair copay. There’s still work to do, but for the first time, the future we’ve been fighting for is finally beginning to take shape.

Disclaimer: This post is for informational and advocacy purposes only. It reflects my personal understanding and interpretation of recent policy announcements and publicly available information from the White House, Eli Lilly, and Novo Nordisk as of November 2025. I am not a medical professional or government representative. Always consult your healthcare provider for medical advice, and check with official sources for the most current policy and coverage details.

Nov. 6th, the White House made an announcement that could potentially reshape the health of our entire nation.

As if the announcement itself wasn’t big enough, the way the news dropped and who I was with, made it that much more of a whirl.

The Announcement

The White House confirmed new pricing agreements with Eli Lilly and Novo Nordisk under the federal TrumpRx program.

This new agreement brings the list price for brand name GLP-1 medications like: Ozempic, Wegovy, and Zepbound down to Most-Favored-Nation (MFN) levels, finally putting Americans on par with what other countries pay.

For the first time ever, Medicare and Medicaid will cover these drugs for obesity—and with only a $50 co-pay!

Now that list prices are finally being standardized across the board, I’m hopeful that commercial insurers will follow suit and expand access for people who are above the federal poverty line but still struggling to pay for their medications out of pocket.

Price Breakdown

Here’s What’s Changing for GLP-1 Medications:

Most-Favored-Nation (MFN)

The U.S. has been paying some of the highest medication prices in the world because drug companies could charge whatever they wanted.

Same medicine, but in other countries, people pay only a fraction of the cost.

MFN pricing is a new rule that says, If other countries get a lower price, we should get that price too.

TrumpRx

TrumpRx is a list of fair prices. This list shows how much certain drugs, like Ozempic or Wegovy, should really cost.

It’s not a pharmacy or a discount card. It’s more like a rulebook that keeps prices fair.

Before this system, people couldn’t really see what medicines were supposed to cost. Every pharmacy and insurance company had different prices, and most of it was a secret.

Now, with this new system, everyone can finally see the actual price. It makes the cost fair and clear, so no one in the U.S. pays more than people in other countries for the same medicine.

Think of Most-Favored-Nation pricing as the government’s version of a “price-match guarantee.” If another wealthy country gets a better deal on a drug, the U.S. automatically gets that deal too. 

Pharmacy Benefit Managers (PBMs)

PBMs are the middlemen who sit between drug companies, insurance plans, and pharmacies. They’ve had a huge influence on drug prices — often driving costs up so they can take a bigger cut.

Here’s what this new system could mean for them:

• Less secrecy: Prices are public and fixed, so no more hiding behind rebate deals.

• Smaller profits: Slimmer price margins take away their biggest source of extra revenue.

• Less control: The federal price list sets a ceiling they can’t inflate.

• More accountability: With less room for hidden markups, PBMs will face growing pressure to show how they actually save money.

PBMs have long helped keep prices high because the system rewarded them for it. The new TrumpRx and MFN plan could finally shine a light on how the system really works and make medicine prices clear instead of marked up.

What This Means for Patients

This announcement is massive and it’s going to touch so many lives in so many different ways.

With this policy in place, it means:

• Recognition: Obesity care is now seen as essential medical treatment, not elective or cosmetic.

• Medicare: Coverage will finally include obesity medications, giving millions of older adults new access.

• Medicaid: Programs in all 50 states can offer coverage with a $50 copay for those under the federal poverty line.

• Prescribing: Doctors may be more willing to recommend GLP-1s as cost and coverage barriers disappear.

• Cash-pay: Patients paying out of pocket may not see big changes yet, but coverage expansion is the goal.

• Commercial: Private insurers often follow once Medicare and Medicaid set the standard.

• Validation: GLP-1s are now seen as a public-health tool, not a luxury.

When these medications first came to market, they came with eye-watering $1000+ price tags. Most people, even those with insurance, couldn’t begin to afford that.

Now, with MFN pricing and public coverage, the wall between “who can afford treatment” and “who can’t” is finally starting to come down.

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What This Means to Me

For the past year, I’ve poured everything I have into affordable access.

It’s been equal parts passion and exhaustion, doing a thousand little things that sometimes felt like they barely made a dent.

I started petitions (Change.org and Sway), launched a Podcast, founded a nonprofit, wrote letters to the FDA (seen here and here) and USPTO, organized Contact Congress Day, connected patients with reporters and organizations, and shared their stories with anyone who would listen.

Somewhere along the way, GLP-1 Studio grew into a full-blown media production—a home for me and a lifeline for people searching for hope.

So when I heard the words “Medicare and Medicaid will cover GLP-1s for obesity,” I think of the thousands of people who’ve shared their stories with me: those who rationed doses, sold belongings, or went without entirely, and it brings me to tears.

I’ve lived that reality too.

Watching this announcement, while standing shoulder to shoulder with other advocates, and a Danish documentary crew filming us, felt completely surreal, like watching history unfold in real time.

At its core, my goal has always been: affordable access for anyone who needs it.

The truest version of that is real coverage, with a fair copay. There’s still work to do, but for the first time, the future we’ve been fighting for is finally beginning to take shape.

Disclaimer: This post is for informational and advocacy purposes only. It reflects my personal understanding and interpretation of recent policy announcements and publicly available information from the White House, Eli Lilly, and Novo Nordisk as of November 2025. I am not a medical professional or government representative. Always consult your healthcare provider for medical advice, and check with official sources for the most current policy and coverage details.

Nicholas Cayan, better known on TikTok as @nicky_glp1wellness, joined me for this episode to talk about how GLP-1 medications helped him lose weight and gain muscle.

Yes, gain it.

When I first stepped into this space, there were a lot of questions with few answers. One of the loudest was, Is muscle loss inevitable? And when singer Avery shared that she developed osteoporosis and osteopenia after 1 year on Ozempic, it dialed the drama to max.

Spoiler alert: that story had layers far beyond the medication itself. Let me know your thoughts in the comments.

People like Nicky give the rest of us a reason to exhale. His TikToks aren’t just progress updates, they’re proof that some muscle loss is expected with any weight loss, but it’s not inevitable in a harmful way.

Protein, Peptides, and Purpose

Nicky’s journey started with his doctor literally telling him, that he couldn’t believe he was alive.

“…and he’s like, oh my God, I can’t believe you’re alive. And I’m like, why? He’s like, your A1C is ridiculous. And I was like, oh, like I knew it was gonna be high, but I was like, like how high?

And so he’s like, your A1C is like, I think he said it was a 12.3, 12.5. And I was like, oh, that’s not too high. He’s like, you’re supposed to be under six. And I’m like, oh, well then yeah, that’s kind of high.”

In the beginning, when Nicky went looking for guidance, he found a gap big enough to drive a truck through. Most of the creators he saw online were already deep into maintenance or women whose experiences, like lady cycles, side effects, even appetite patterns, didn’t line up with his own.

So he made a decision that changed everything: he’d start documenting his own journey.

At first he could barely stand the idea of taking selfies. He eased in with bathroom-and-gym mirror shots, half-torso only, because full-body pics felt like too much.

Months later, scrolling back, he realized his camera roll had quietly shifted: “When did I start taking full-body selfies?” Confidence had crept in, one rep and one snapshot at a time.

@nicky_glp1wellness"Nobody watches you at the gym...” WRONG. I am. I'm nosey. I love watching form, the gym fits, and what you're doing. I LIVE for people watching. @elara

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Nicky’s feed is a time capsule of consistency. You can literally scroll back through his videos and watch the change happen in real time.

His hope is to inspire, educate, and motivate:

“Prior to my journey, I was eating fast food every single meal… two, three, sometimes four times a day because I was just hungry. Now I spend it on protein powder and peptides.”

This line landed and I knew what I had to do next.

On Stigma and Strength

Nicky didn’t just share his strengths, he also shared his experience with the mental aspect “that people don’t really talk about.”

“Nobody talks about the mental part,” he said. “Everyone talks about the weight, the snacks, the numbers… but the emotions are a whole different thing. You could make a whole podcast just about that.”

He talked about how hard it can be to accept compliments now, how he never got them before, and he doesn’t know how to feel.

“I feel a little awkward,” he said. “I’m not used to compliments. It brings back childhood stuff. I just say thank you, but I don’t really know what to do with it.”

That moment reminded me of something Dr. Angela Tran shared in her interview on The GLP-1 Studio Podcast. She said:

“…but I always warn people, hey, tell me how you felt when someone told you you were skinny because that can really bring a whole gamut of things you have to work through also. So that’s part of like the whole management of this medication is not just the side effects, but it’s just sort of like the changes around you that you don’t even see.”

Dr. Tran was right. It’s not just a physical transformation, it’s emotional. Even positive attention can stir up old memories and insecurities. And Nicky was the first to admit that we don’t talk about that enough.

The physical changes are measurable, but the emotional ones are just as real and just as important to acknowledge.

Amazing Transformations

In our conversation, Nicky admitted that he didn’t think his story was amazing enough.

“I don’t think my story is really significant compared to other guests that you have, you know, that have these huge stories of why they took it… Even when you sent me the message to sign up for this, I’m like, my god, I’m gonna share my little story about my little GLP-1 journey.”

He’s seen others in the community go through huge, headline-worthy transformations, people who’ve lost hundreds of pounds or overcome life-threatening complications.

Like Jamie Selzer, who shared that he was once 650lbs in Season 1, Episode 18.

Compared to that, he said, his own journey felt small. But that’s exactly why his story matters.

Stigma & Self Advocacy

When Nicky talked about stigma, it hit home.

He said it himself, people see the before-and-after photos, but they don’t see the mental and physical work behind it.

“…I just wish everyone knew this, and instead of having that whole stigma of, you know, it’s cheating or you’re taking the easy way out. Really, I’m not, because I don’t think I’ve ever worked this hard for my health before.”

It’s people like Nicky sharing their stories online that helps the rest of us have the courage to step out of the GLP-1 pantry.

That’s why I’ve created the GLP-1 S.T.R.O.N.G. Framework and why I’m writing GLP-1 Strong: A Framework for Self-Advocacy. Stigma doesn’t just live online: it shows up in doctor’s offices, in conversations with family, and in the tiny looks that make you question your worth.

I truly believe self-advocacy can change the world and I want to help people make that happen.

Affordable Access to GLP-1s

By the end of our conversation, Nicky turned his focus outward, to access.

He told me he hadn’t even realized it was an issue until he started listening to the podcast:

“In the beginning, I was like, why is there a podcast about GLP-1s? I thought it was just going to be about food or weight loss stories. I didn’t know the whole access thing was this big. I thought everyone could get it. And then I listened to your podcasts and I was like, holy crap. That is effed up.”

This meant the world to me because it doesn’t always feel like I’m making a difference. But if I can reach even 1 person with the message that, this isn’t about weight loss, it’s about treating a life threatening disease, then it makes it all worth.

Nicky added:

“People don’t have access to it, and I don’t understand why… It’s sad that it has to be limited.”

That’s the truth we keep coming back to.

Nicky’s story reminds us why we share these conversations in the first place. Every voice adds another layer to this movement: each one proof that obesity care, access, and advocacy are about people.

That’s what GLP-1 Studio is about. Amplifying stories to help advocate for access. 📢

We’re changing the conversation about obesity and GLP-1s one story at a time, and stories like Nicky’s are how it happens.

Disclaimer: The views and opinions expressed in this episode are my own and do not represent the official positions or policies of the GLP-1 Collective nonprofit, GLP-1 Studio, or any affiliated organizations.

The GLP-1 Studio Podcast—formerly known as the GLP-1 Collective Podcast—is produced and owned by GLP-1 Studio LLC, a for-profit media company.

This podcast is for informational and educational purposes only. It is not medical advice, and it should not be used to diagnose, treat, or replace care from a qualified healthcare professional.

Mention of any products, services, companies, or individuals does not imply endorsement. Sponsorships or affiliate relationships, if present, are always disclosed.

© 2025 GLP-1 Studio LLC. All rights reserved.

Health With & Without Medication

Dr. Angela Tran D.O., is a board-certified obesity medicine physician and the founder of Med-Fit Medical Weight Loss.

She’s not on GLP-1s herself, but she works with patients every day who are and has seen firsthand how these medications can give people something they haven’t had in years: a pause.

She makes a point to remind women that you can be healthy and lose weight with or without medication.

When She Faced Her Own Challenges

Dr. Angela shared that when she had gestational diabetes and thyroid problems, GLP-1s weren’t even available yet.

And she was honest, if they had been, she would’ve said yes in a heartbeat.

Not because of weight, but because she was scared of what could happen long-term, and of not knowing what her body might decide to do next.

But she knew she had to be congruent with the message she was giving her patients, to live what she teaches.

For her, that meant showing that health is possible with or without medication and helping others find what works best for their own bodies.

Tips For Healing the Whole Person

Dr. Tran shared some practical, real-world tips for healing, focusing on mindset, movement, identity, and the kind of everyday habits that help you feel whole again.

Food Noise

We talked about that constant chatter in your head around food. She made it clear that GLP-1s don’t delete food noise.

They create a pause.

That small slice of time where you can take a breath and make a different choice. In that space you get your mind back for a second. Sometimes you notice you don’t want the food after all.

She describes food noise like fear that may never disappear, so you learn to stop letting it run the show.

She uses these steps to keep her own food demon at bay:

• Keep a safe snack available (She loves sugar-free Jell-o)

• Plan meals in advance

• Track when you last ate

• Create distance between the signal and the action

Identity

Dr. Tran emphasizes that identity is deeply tied to our weight and that language matters, when attempting to heal the whole person.

For example:

Say this: “I am a person who sometimes binge eats.”
Not this: “I am a binge eater.”

Say this: “I am a healthy person learning new habits.”
Not this: “I am an unhealthy person.”

You are not your hardest day. That shift opens the door to growth instead of guilt.

She gave the best analogy for this:

It’s a visual you can feel. It strips out the shame and points you toward the real work. Check the engine. Stop blaming the driver.

Start fixing the system.

Movement

Dr. Tran works hard to reframe exercise as moving energy, rather than a punishment. Think movement as energy in motion.

• Walk

• Dance

• Stretch

• Meditate

It’s not about burning calories, it’s about shifting what’s stuck, to create space inside yourself.

Self Advocacy

She makes a point that good doctors don’t just hand you a script and send you out the door.

They ask and answer questions:

• Who is your support team?

• Do you need a dietitian?

• This is what happens at month one, month two, month three.

• This is how you handle side effects.

• This is what to expect when people start commenting on your body.

The plan they create for you lives two steps ahead.

She explains that you are the decision maker and that it’s important to advocate for yourself.

If the information does not feel right, get a second opinion. If a clinician treats obesity like a character flaw, find one who shares your belief that this is a treatable medical condition with many tools.

Key Takeaways

Dr. Tran is the kind of doctor who makes you exhale the second she starts talking. She’s warm, grounded, and deeply compassionate.

Her mix of science, honesty, and heart makes you feel like you’re being cared for by someone who actually cares. Anyone would be lucky to have her in their corner.

If you take anything away from this episode remember this:

• You are not broken

• You’re definitely not alone

• And you don’t need to change a thing, other than letting go of whatever’s holding you back

My favorite takeaway is this:

Disclaimer: This episode is for informational purposes only. It is not medical advice. Always talk to your healthcare provider before making any changes to your medication, treatment plan, or lifestyle. The GLP-1 Studio Podcast, which used to be called the GLP-1 Collective Podcast, is now produced by GLP-1 Studio LLC. This episode has nothing to do with the GLP-1 Collective nonprofit. This is not a paid advertisement. I am not an affiliate. Everything I say in this episode is my personal opinion. It does not represent the views of the nonprofit, GLP-1 Studio, or Dr. Angela Tran and her clinic. Now let’s get into it.

The Birth of the GLP-1 Collective Podcast

Let me take you back for a second.
I started my own GLP-1 journey in October 2024, totally overwhelmed, completely confused, and deeply aware of how few good resources were out there.

There was stigma.
There was shame.
There were Facebook groups filled with chaos, and doctors still repeating the same outdated line: “eat less and move more.”

Oh wait… all of those things are still happening…

And I thought, “I need to do something about this.”

So I made a podcast.

Introducing the GLP-1 Collective Nonprofit

The podcast is a place for patients to share their stories, bring compassion where there’s been judgment, and help people understand why access isn’t optional, it’s a necessity.

It exists to empower and support GLP-1 patients everywhere.

But as powerful as stories are, they aren’t enough on their own. We needed something tangible.

Real support.
Resources.
And a way to move beyond awareness and into action.

So I founded the nonprofit.

The GLP-1 Collective was built because the podcast just wasn’t enough.

People needed:

• Support groups

• Educational resources

• Actual help paying for their meds

So I got scrappy, did the paperwork, and made it official.
And I’m so proud of what that nonprofit has become.

But here’s the thing no one tells you about running a nonprofit:

It is… a whole entire situation.

Why I Founded the GLP-1 Studio

I’m talking:

• Forms

• Legal fees

• Compliance hoops

• Backend costs

And more red tape than a holiday clearance bin at Target!
Everything, and I mean e-v-e-r-y-t-h-i-n-g, moves slower.
Which is fine when you’re building infrastructure.

But not when:

• People are losing access

• Losing time on this earth with their loved ones

• And losing hope

That’s when I realized I needed a second lane. A place where I could move fast without 1000 hurdles.

That’s why I started GLP-1 Studio, my for-profit home for media, communications, and all the things I needed freedom to actually do.

No grant applications. No waiting for approvals. Just… action.

What Was GLP-1 Access

I originally called this new love of mine GLP-1 Access, which spoke to the advocacy side of things, but felt too narrow for what I was building.

I wanted space to:

• Produce the podcast

• Collaborate with anyone who cares

• Advocate for policy change like PBM reform

• Start a speakers bureau

• Write and SPEAK freely

All without confusing people or stepping on the nonprofit’s mission.

So I landed on GLP-1 Studio.
And honestly? It fits. 🎙️

But then came the awkward part, explaining why the GLP-1 Collective Podcast was suddenly being produced by something called GLP-1 Studio but technically had nothing to do with the nonprofit.
Yeah…
Not ideal…

So I changed the name.

Incoming GLP-1 Studio

Simple as that. Same show. Same mission. Same heart.
Now with a name that reflects where it actually lives, and where I live, creatively speaking.

So if you’ve been wondering why the logo looks different, or why I’m suddenly saying “Welcome to the GLP-1 Studio Podcast”… now you know.

GLP-1 Collective (the nonprofit) is still, focused on free, community-centered resources.

GLP-1 Studio (my media baby) is growing fast and reaching people in all kinds of new ways.

And the podcast? It’s a free bird 🕊️ doing what it does best.

Thanks for sticking with me through the journey. And if you were confused for a second?

Honestly, same. 😂

But I’m so happy with where it’s landed.

Here’s to more stories, advocating for access, and more ways to make this community feel like home.

xo,
Amanda☕💖

📖 Table of Contents

• Why Start Here

• What Is Obesity

  • Genetics

  • Epigenetics

  • Hormones

  • Environment

  • Trauma

  • Medical Conditions

    • Insulin Resistance

  • Medications

  • Food

• Why “Eat Less, Move More” Fails

  • Eat Less

  • Move More

  • Set Point Theory

  • Dieting and Insulin Resistance

  • When Exercise Backfires

• The Food Noise Revelation

• The Myth of Noble Suffering

• Say It With Me: “It’s Not My Fault”

Why Start Here

Before we can talk about scripts, strategies, or how to stand up to stigma, we need to begin with one truth: It’s not your fault.

This is the ground everything else in this book stands on:

• If you carry shame, you will shrink when you should speak.

• If you believe you’re to blame, you’ll hesitate to demand respect.

• And if you think compassion is something you haven’t earned, you won’t believe you deserve it from anyone else.

What Is Obesity

Obesity is a chronic, relapsing disease. It’s not caused by one thing, and it can’t be fixed by one thing.

In other words, medical organizations around the world recognize it as a life-long medical condition that has many different overlapping causes that work together to damage your health.

Some of the factors that can contribute to obesity include:

Genetics

Your DNA is not just a backdrop; it is the stage. Genes influence appetite, metabolism, fat storage, and even how your brain responds to food.

• Obesity tends to run in families

• Genes explain about 40–70% risk of having obesity

• In severe or early-onset cases of obesity, genes can account for 80-85% risk

• Over 40 specific genes are linked to obesity and how fat is distributed in the body

• FTO, can add 4-6 pounds of body weight

• MC4R, is linked to bigger appetites and early-onset obesity in kids

• Heritability tells us how important genes are in general

In a well-known study, identical twins were about twice as likely as fraternal twins to both have obesity, showing that genetics has a powerful influence on body weight.

Epigenetics

Epigenetics is the process that controls how your genes are switched on or off, without altering the DNA itself.

Think of your DNA as the instruction book, and epigenetics as the bookmarks, highlights, or sticky notes that tell your body which pages to read and which to skip.

• It starts in the womb. A mother’s diet during pregnancy can leave marks on a baby’s genes, raising obesity risk later

• It can pass to kids and grandkids. Some epigenetic changes can be inherited.

• “Epigenetic scores” can measure and predict obesity risk, and they reflect both genes and environment

• Epigenetic score can explain about 32% or one-third of why people’s body weights differ, these scores do a better job at predicting weight than DNA-only scores

Hormones

Hormones are like the “control panel” for hunger and energy use. When these systems are dysregulated, the brain sends stronger “eat” signals and weaker “stop” signals.

Leptin: the fullness hormone

• Signals the brain that you’re full and should stop eating

• Helps your body burn energy

In obesity, leptin levels are high but the brain stops responding, this is called leptin resistance.

Ghrelin: the hunger hormone

• Tells your brain when it’s time to eat

• Levels go up before meals (that “I’m starving” feeling) and drop after eating

• In obesity, fasting ghrelin levels are usually lower than in lean people

After eating, with obesity, ghrelin doesn’t drop as much as it should, so the brain doesn’t get a strong ‘I’m full’ signal.

Insulin: the blood sugar control hormone

• Moves sugar from the blood into your cells for energy or storage

• Obesity causes insulin resistance, so the body pumps out more insulin

• Higher insulin levels predict more future weight gain

Insulin is like a key, and your cells are like locked doors. In a healthy body, the key (insulin) easily opens the door so sugar can move inside for energy.

With insulin resistance, the locks get rusty, the key still fits, but it doesn’t open the door all the way, so your body makes more and more keys (insulin) to force the doors open.

GLP-1: the satiety hormone

• Sends signals to your brain that you’ve had enough to eat

• Tells your pancreas to release insulin so sugar from food moves into your cells for energy

• Keeps your liver from making too much sugar

• Slows down how fast your stomach empties, so you feel fuller for longer

GLP-1 medications don’t make you feel artificially full, they mimic and extend your body’s natural GLP-1 hormone, helping your gut send clearer signals to your brain so it knows when you’ve eaten enough.

Cortisol: the stress hormone

• Fuels cravings for quick, high-calorie foods

• Chronic stress (stress that doesn’t go away) raises cortisol

Normally, cortisol peaks in the morning (to wake you up) and drops at night (so you can fall asleep). But with long-term stress, cortisol stays elevated into the evening, making it harder to fall asleep, stay asleep, or get deep, restful sleep.

Poor sleep then raises hunger hormones like ghrelin, lowers satiety hormones like leptin, and makes cravings even worse, creating a cycle that fuels weight gain.

Environment

The world around us shapes the bodies we live in.

Obesogens are chemicals that make you store fat.

Endocrine-disrupting chemicals (EDC)

• Bisphenols (BPA, BPS, BPF): found in plastics, can linings, receipts

• Phthalates: used in plastics, cosmetics, food packaging

• Organotins (Tributyltin, TBT): once used in paints and industrial products

• Perfluoroalkyl substances (PFAS): “forever chemicals” in non-stick pans, waterproof coatings, food wrappers

• Polychlorinated biphenyls (PCBs): industrial chemicals, now banned but still persistent in the environment

• Dioxins: byproducts of industrial processes and waste burning

Pesticides & fungicides

• DDT/DDE: banned in many countries but still lingering in the environment.

• Atrazine: a widely used herbicide in agriculture

• Organophosphates and carbamates: pesticide groups with links to metabolic disruption

Other suspected obesogens

• Polycyclic aromatic hydrocarbons (PAHs): from air pollution, smoke, and charred foods

• Heavy metals: like arsenic and cadmium, which can disrupt metabolism

• Parabens: preservatives in cosmetics and personal care products

Even at low levels, they can change how fat cells grow and store energy, shifting the body “set point” to hold more weight and interfering with appetite and blood sugar regulation.

Trauma & Depression

Depression and trauma can drive obesity, creating a cycle where pain fuels overeating, weight gain worsens mood, and both feed each other.

Trauma

Trauma doesn’t just live in memories. It lives in the body.

• Early trauma (like abuse, neglect, or growing up in chaos): changes how the brain and hormones develop

• Stress hormone overload: Chronic stress raises cortisol, which makes you crave comfort foods and pushes your body to store fat

• Constant fight-or-flight: Living in survival mode keeps your system on high alert, draining energy and messing with appetite signals

Studies show that adults who experienced trauma as children have significantly higher rates of obesity. Trauma alters the stress-response system, rewiring metabolism and appetite.

This isn’t psychological weakness, it’s biological adaptation.

Depression

The relationship with depression goes both ways: obesity can contribute to depression through stigma, stress, and health effects, while depression can lead to weight gain through changes in appetite, activity, and hormones.

• About 1 in 10 people have depression and 2 in 3 are overweight, so they often overlap.

• Women with obesity are more likely to have depression

Depression can make obesity worse because it drains energy and motivation.

Exercising or cooking healthy meals can feel impossible, when it’s hard to even get out of bed or brush your teeth.

Medical Conditions

Some medical conditions can both cause obesity and also be caused by obesity, creating a vicious cycle that’s almost impossible to escape without medical help.

• Hypothyroidism: Slows metabolism, making it easier to gain weight and harder to lose it.

• Hypothalamic injury or disease: Damage from tumors, trauma, surgery, or radiation can disrupt appetite regulation and lead to severe weight gain.

• Prader-Willi syndrome: A rare genetic disorder that causes constant hunger due to abnormal brain signaling, making obesity almost inevitable without strict intervention.

• Other rare genetic syndromes (e.g., Bardet-Biedl, Alström): These inherited conditions include obesity as a core feature, often beginning in childhood.

• Cushing’s syndrome: Causes chronically high cortisol, which promotes fat storage, especially around the belly.

• Polycystic ovary syndrome (PCOS): Creates a hormonal imbalance and insulin resistance that both increase weight gain risk.

• Hypogonadism / Low testosterone (in men): Lowers muscle mass and raises fat accumulation, shifting body composition.

• Growth hormone deficiency: Reduces lean muscle while increasing fat mass, leading to slower metabolism and weight changes.

PCOS, low testosterone, and insulin resistance can all make weight gain easier, but once obesity develops, it worsens those same problems.

The result is a feedback loop: the condition fuels obesity, and obesity fuels the condition.

This cycle traps people in a state where their biology is actively working against weight loss, no matter how hard they try with diet and exercise.

Insulin Resistance

Insulin resistance happens when your cells stop responding properly to insulin.

To keep blood sugar stable, your pancreas produces more insulin, but those high insulin levels push your body to store more fat and make it harder to burn the fat you already have.

This creates a vicious cycle: obesity raises insulin resistance, and insulin resistance in turn drives more weight gain.

• 70% of people with obesity have insulin resistance.

• About 1 in 3 Americans has insulin resistance.

• In the U.S., around 40% of younger adults (ages 18–44) have it.

• More than 7 in 10 people with obesity also develop insulin resistance.

Type 2 Diabetes Link

Insulin resistance is the root problem behind prediabetes and type 2 diabetes.

At first, the pancreas produces extra insulin to keep blood sugar in check, but eventually it can’t keep up. That’s when prediabetes turns into full type 2 diabetes.

• About 1 in 3 U.S. adults (96 million people) has prediabetes, and most don’t know it.

• 90–95% of all diabetes cases in the U.S. are type 2, which develops from insulin resistance.

• Up to 70% of people with prediabetes will eventually develop type 2 diabetes without treatment (ADA).

• People with obesity have about a 7 times higher risk of developing type 2 diabetes than those at a healthy weight (Harvard).

GLP-1 Connection

GLP-1s can reverse insulin resistance and put type 2 diabetes into remission.

They improve insulin sensitivity even before weight loss starts, lower inflammation in fat tissue, reduce appetite, and drive significant weight loss, tackling the root causes of type 2 diabetes.

Semaglutide (GLP-1):

• Cut insulin resistance by about 30–45% in trials.

• In the STEP trials, about 80% with prediabetes went back to normal blood sugar (vs 37% on placebo).

• Many people with type 2 diabetes on semaglutide were able to reduce or stop other diabetes meds.

Tirzepatide (Dual GLP-1/GIP):

• Improved insulin sensitivity by up to 65% — almost double what GLP-1s alone do.

• Drove greater weight loss (20–22% of body weight vs ~15% with semaglutide).

• More effective than semaglutide at improving insulin sensitivity and blood sugar control in type 2 diabetes.

This makes GLP-1s especially important for people with conditions like PCOS, low testosterone, or insulin resistance, who get trapped in the cycle where the disease drives obesity and obesity makes the disease worse.

Medications

Many common medications can cause weight gain by changing the way the body handles appetite, hormones, or energy use.

Steroids and some diabetes drugs raise insulin or cortisol levels, pushing the body to store more fat. Antidepressants and antipsychotics act on brain chemicals that increase hunger, cravings, or fatigue, making it easier to eat more and harder to move.

Even drugs not directly tied to metabolism, like antihistamines or beta-blockers, can slow energy burn or raise appetite.

Medications that cause weight gain:

• Glucocorticoids (steroids)

• Insulin & some diabetes meds (sulfonylureas, thiazolidinediones)

• Antidepressants (SSRIs, tricyclics, MAOIs)

• Antipsychotics (especially atypicals like olanzapine, clozapine)

• Mood stabilizers (lithium, valproate)

• Antihistamines & beta-blockers (in some cases)

Ironically, many of the very medications used to treat conditions tied to obesity, like diabetes, depression, or chronic pain, can actually cause weight gain themselves, creating a frustrating cycle.

Insulin and certain older diabetes drugs promote fat storage, while antidepressants and antipsychotics drive appetite.

For many, the weight gain isn’t about lifestyle at all, but about the chemical side effects of the drugs they need to stay alive.

Food

The link between food and obesity is undeniable.

The modern diet is dominated by ultra-processed products, oversized portions, and sugar-laden drinks and snacks, all reinforced by an environment where unhealthy options are cheaper, easier, and more aggressively marketed than healthier ones.

Together, these factors don’t just add calories, they create a system that makes weight gain likely and weight loss difficult.

Ultra-Processed Foods

• In the U.S., 57–60% of daily calories now come from ultra-processed foods.

• These foods are calorie-dense, low in fiber, and engineered to trigger overeating.

• Controlled NIH trial: People eating an ultra-processed diet consumed ~500 extra calories/day and gained weight in just 2 weeks compared to when the same people ate minimally processed foods..

Portion Sizes & Calories

• Portion sizes of packaged and restaurant food have doubled or tripled since the 1970s, adding 200–300 calories per meal.

• Restaurant meals average 1,200 calories per plate, nearly twice what’s recommended for a meal.

Sugary Drinks & Snacks

• Just one sugary drink a day increases obesity risk by 26%.

• Snacking now makes up 1 in 4 calories Americans eat, compared to minimal snacking 40 years ago.

• Americans consume ~17 teaspoons of added sugar daily, over twice the WHO’s limit.

Food Environment

• People living in “food swamps” (fast food and convenience store dense areas) face 5–20% higher obesity risk, even after adjusting for income.

• More than 18 million Americans live in food deserts where access to fresh, affordable produce is limited.

• On average, U.S. adults get 11% of daily calories from fast food.

Marketing & Cost

• Calorie-for-calorie, junk food is 1.5–2x cheaper than fruits and vegetables, pushing low-income families toward processed foods.

Global Evidence

• Countries adopting Western diets (fast food, sugary drinks, ultra-processed snacks) see obesity rates double within one generation.

• Since 1975, global obesity rates have tripled, with obesity now killing more people worldwide than undernutrition.

While food is a contributing factor to obesity, it is never the sole cause of obesity.

As you can see from the factors listed in this chapter, it’s the combination of multiple issues all working together to create a cycle that makes obesity inevitable for some and incredibly difficult to escape.

Why “Eat Less, Move More” Fails

If you live with obesity, you’ve heard it: “Just eat less and move more.”

Yes, food and exercise matter for health. But they are not a cure for obesity. For most people, dieting and exercise alone don’t just fail, they backfire.

Research shows almost anyone can lose weight short-term. But about 80% of people regain most or all of it within 2–5 years if they rely on diet and exercise alone.

Eat Less

When you cut calories, your body fights back.

Your brain doesn’t think, “Great, we’re getting healthy.”

It thinks, “We’re starving.”

And it pushes you, with cravings, low energy, and slowed metabolism, back toward your starting weight.

• After dieting, calorie burn per day can drop by 200–500 calories

• People who lose 10% of body weight often experience about a 15% drop in metabolism, making maintenance much harder

Hormone Changes After Dieting:

• Hunger hormones rise 20%

• Fullness hormones drop 30%

• Your metabolism slows down to save energy

• These changes last for at least 1 year

• Brain scans show stronger reward response to food cues, especially energy-dense foods, after weight loss.

Dieting & Insulin Resistance

When you slash calories, your body doesn’t cheer you on.

It panics.

Hunger hormones like ghrelin rise, fullness hormones like leptin plummet, and metabolism slows down to conserve energy.

At first, you may see weight loss. But eventually, the hunger wins.

• Rebound eating floods your body with insulin (the hormone that helps store sugar from food)

• Over time, those repeated insulin surges make your cells stop responding as well (insulin resistance)

• Once insulin resistance develops, your body pumps out more and more insulin to manage food

• High insulin doesn’t just sit quietly in the background, it actively promotes fat storage

This is why research shows about 80% of regain most or all the weight they lose within 2–5 years of dieting.

Insulin resistance can improve with weight loss especially early on or in prediabetes.

Move More

Exercise is vital for health, but the way society pushes it as a “fix” for obesity often causes more harm than good.

• Exercise alone: Only contributes to about 4–6 lbs average weight loss

Yes, a long run burns calories in the moment. But if you aren’t protecting your muscle with strength training and enough fuel, your body burns muscle along with fat.

Cardio without strength training = muscle loss → lower metabolism → increased hunger

• 25–30% of weight loss can come from lean muscle instead of fat (without strength training).

• For every pound of muscle lost, your body burns 30–50 fewer calories per day while at rest.

• Endurance exercise often increases appetite (especially in women).

Cardio example:

• You’re body burns 2,000 calories a day at rest (your resting metabolic rate).

• After repeated restrictive diets and muscle loss, maybe that number drops to 1,500 calories a day.

• You go for a run and burn 500 calories.

Instead of creating a meaningful deficit, you’ve just punished a system that now burns far less all day, every day.

It’s like downsizing the engine in your car, it uses less fuel no matter how far you drive.

On top of that, exercise increases hunger. Your body’s natural response to burning energy is to demand more energy.

If you’re restricting calories at the same time, the hunger can become overwhelming, and when the rebound happens, insulin resistance deepens.

Strength training = higher metabolism → increased hunger

• Gaining 10 pounds of muscle can increase your resting calorie burn by about 130 calories per day.

• More lean muscle also boosts appetite because it takes more energy for your body to maintain.

If you stop working out as intensely or cut back your routine, you lose muscle and burn fewer calories, but your appetite often stays the same.

This is one reason many retired athletes gain weight once they’re no longer training at the same level.

Strength training example:

• You’re body burns 2,000 calories a day at rest (your resting metabolic rate).

• After strength training daily, you build muscle and now burn an additional 1,000 calories per day from a higher resting burn plus your workouts.

• You increase your daily calorie intake to feed the new muscle.

• You stop training at the same level and now burn only 500 calories per day instead of 1,000.

• Your hunger does not drop right away. You keep eating as if you were still training.

• You end up about 500 calories over maintenance each day.

Weight lifting is powerful for health and body composition, but it is not a standalone cure for obesity.

The single best thing you can do is choose a way of moving that you are willing to keep doing for years, not weeks. If the routine changes, the results will change too, so pick activities you actually enjoy.

Consistency beats perfection.

There are about a hundred different weight lifting scenarios that we could go over but for the sake of staying on track I’m only sharing this very common one.

Set Point Theory

Set point theory suggests every person has a defended weight range. When you lose weight, the body treats it as a threat and pulls you back by increasing hunger and lowering energy expenditure.

Your weight is like a thermostat. Drop below the range and biology heats the system back up.

In episode 8 of the GLP-1 Collective Podcast, Dr. Lindsay Ogle, MD an Obesity Specialist with her own private practice, Missouri Metabolic Health, describes set point theory as the reason why “eat less, move more” fails.

The Food Noise Revelation

GLP-1 medications like semaglutide and tirzepatide don’t just help people lose weight, they quiet the food noise.

Food noise is that constant chatter in your head about food:

• What’s in the fridge?

• What will I eat next?

• How much should I have?

It’s relentless.

When GLP-1s work, the noise goes quiet.

In episode 3 of the GLP-1 Collective Podcast, described this as the moment her life changed.

Oprah herself has described the same experience, saying GLP-1s silenced the food noise she had battled her entire life.

This silence is why so many patients fight desperately for access.

Once you’ve experienced it, you understand: this disease was never about weakness. It was about biology.

Willpower alone cannot overcome biology. And if you’ve regained weight, it isn’t because you were weak. It’s because your body is designed to fight back.

The Myth of Noble Suffering

Our culture worships grit. “Push harder. Restrict more. Sweat more.”

But is it noble to try and fail again and again while your biology pulls you further away from success?

Or is it wiser, and braver, to recognize that suffering for the sake of suffering doesn’t heal you? That using medical tools science has given us is actually safer for your health and your future?

Say It With Me: “It’s Not My Fault”

Before we move forward, I want you to pause.

Take a deep breath.

Put a hand on your chest if you need to.

And repeat these words:

“It’s not my fault.”

Good.

Now say it again and again until you believe it and forgive yourself for being so hard on yourself.

Obesity is a complex disease, not a moral failing:

• You don’t owe anyone an explanation for your weight.

• You don’t need to apologize for your body.

• You don’t need to carry around the shame.

You take your power back with this one simple truth:

It’s not your fault.

You didn’t cause this, and you don’t deserve to feel ashamed for your biology.

Before you can advocate in the doctor’s office, with your partner, at work, or anywhere else, you have to start here: with yourself.

Because when you know it’s not your fault, you finally begin to stand S-T-R-O-N-G.

📖 Table of Contents: Introduction

• This Is Not a Diet Book. This Is a Survival Guide.

• The Shocking Truth

• Beyond Blame

• Why This Book Exists

• A Note About the Next Generation

This Is Not a Diet Book. This is a survival guide.

If you are living with obesity or excess weight, you already know what it feels like to carry the weight of stigma as much as the weight on your body.

You’ve heard the comments. You’ve felt the judgment. Maybe you’ve even avoided the doctor’s office because you couldn’t face another lecture that ignored your actual health concerns.

The Shocking Truth

By adulthood, the numbers are staggering:

• About 40% of U.S. adults are living with obesity.

• 1 in 10 adults live with severe obesity.

• Obesity contributes to ~500,000 deaths annually, that’s ~1,370 lives cut short every single day.

Severe obesity can shorten life expectancy by 5–20 years. Class III obesity has been shown to take away up to 14 years of life.

These aren’t small numbers.

They’re decades.

And we’ve seen the cost in names you know:

• Latonya Pottain: star of My 600lb Life, died of a heart attack at age 41.

• John Candy: beloved comedian and actor, died of a heart attack at age 43.

• James Gandolfini: The Soprano’s actor, died of a heart attack at age at age 51.

The sad reality is that each of these lives lost very likely tried and “failed,” a thousand times, to “eat less and move more.”

No one has tried harder to follow this script than those living with this disease.

But this isn’t just about celebrities.

It’s personal.

Both of my grandparents died from complications of type 2 diabetes before I was even born.

Think about how many loved ones you may have lost too early, to something that could have been treated if only the right tools had been available.

Beyond Blame

Obesity doesn’t just affect physical health:

• People living with obesity are more likely to experience depression, anxiety, and disordered eating.

• They face workplace discrimination, social isolation, and stigma in healthcare.

• And when they do seek care, they are too often dismissed with “just lose weight” instead of receiving real treatment.

Society tells us:

• “Eat less, move more.”

• “No shortcuts.”

• “If you just had more willpower…”

But science has proven obesity is a chronic, complex, relapsing disease.

Why This Book Exists

This book will not hand you a diet plan.
It will not give you a workout routine.
It will not shame you into submission.

What it will do is give you a warm hug and teach you how to hold your head high.

It will give you the words, the knowledge, and the confidence to move through this world without apology.

Shame is not the answer.

Advocacy is.

A Note About the Next Generation

Obesity does not only start in adulthood.

• Nearly 1 in 5 U.S. children already live with obesity

• 80% of teens with obesity will carry it into adulthood.

Kids face the same stigma, the same food noise, the same mental health risks, and even higher risk of early death. They deserve tools to fight back too.

I’ve met many mothers who are fierce advocates for their children in this space, advocating for access so that their children don’t have to grow up under the same cloud of stigma, depression, and shame that they endured their whole lives.

That’s why I’m also working on GLP-1 Strong: Kids Edition and GLP-1 Strong: Teens Edition.

These are guides that will give young people their own tools to self-advocate, shut down shame, and grow up with confidence.

Author’s Note

• Why I Wrote This Book

Introduction: Why This Book Matters

• This Is Not a Diet Book

• The Stakes: Why Obesity Advocacy Is Urgent

• What You’ll Learn in These Pages

• Why Obesity Advocacy Matters

Part I: Foundations

Chapter 1: It’s Not Your Fault

• Why Start Here

• What Is Obesity

  • Genetics

  • Epigenetics

  • Hormones

  • Environment

  • Trauma

  • Medical Conditions

    • Insulin Resistance

  • Medications

  • Food

• Why “Eat Less, Move More” Fails

  • Eat Less

  • Move More

  • Set Point Theory

  • Dieting and Insulin Resistance

  • When Exercise Backfires

• The Food Noise Revelation

• The Myth of Noble Suffering

• Say It With Me: “It’s Not My Fault”

Chapter 2: Why We Need the Framework

• The Toll of Obesity

• Healthcare Bias and Stigma

• Fitness Culture: “No Cheats, No Shortcuts”

• Why Scripts and Tools Are Essential

Chapter 3: The Framework

• Introducing STRONG

• Stop the Shame

• Tell Your Truth

• Reclaim Your Voice

• Offer Clarity

• Navigate with Boundaries

• Grow Stronger Together

Part II: The STRONG Framework

S — Stop the Shame

Chapter 4: Naming Shame When It Shows Up
Chapter 5: Knowledge Is Power
Chapter 6: Self-Advocacy with Yourself

T — Tell Your Truth

Chapter 7: Your Story Is Enough
Chapter 8: With Your Partner
Chapter 9: With Friends & Family

R — Reclaim Your Voice

Chapter 10: In the Doctor’s Office
Chapter 11: At Work & School
Chapter 12: In Public & Online

O — Offer Clarity

Chapter 13: Educating Without Apologizing
Chapter 14: Using Science as Your Shield
Chapter 15: When to Teach, When to Walk Away

N — Navigate with Boundaries

Chapter 16: Saying No Without Guilt
Chapter 17: Family Dynamics & Boundaries
Chapter 18: Boundaries in Healthcare

G — Grow Stronger Together

Chapter 19: Sharing Stories to Build Confidence
Chapter 20: Advocacy Beyond Yourself
Chapter 21: Stronger Together

Part III: Toolkit & Closing

Chapter 22: The Strong Toolkit

• Scripts & Responses

• Myth-Busting Fact Sheets

• Self-Advocacy Checklists

Conclusion: GLP-1 Stronger Together

• How Change Happens

• Your Role in the Movement

• Stronger Together