Sigma Nutrition Radio #582: GLP-1 Agonists: Side Effects, Management and Diet – Dr. Spencer Nadolsky
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Oct 28, 2025 Dr. Spencer Nadolsky, a board-certified obesity physician and host of the Docs Who Lift podcast, discusses the revolutionary role of GLP-1 receptor agonists in treating obesity. He delves into how these medications, like semaglutide and tirzepatide, lead to significant weight loss and frame obesity as a chronic disease. The conversation highlights managing common side effects like nausea, dietary adjustments for users, and the broader public health implications, including access and cost issues, all while dispelling safety myths surrounding the treatments.
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What GLP-1 Medicines Are
- GLP-1 is an intestinal incretin hormone that boosts insulin and reduces appetite when sustained.
- Scientists modified GLP-1 into longer-lasting peptides to create effective diabetes and obesity drugs.
How Much Weight These Drugs Produce
- Semaglutide (2.4 mg) produces ~15% total body weight loss and tirzepatide ~20% in trials.
- These results sit between lifestyle alone (
6–7%) and bariatric surgery (30%).
Obesity As A Chronic Brain Disease
- Obesity behaves like a chronic disease with physiological appetite adaptations that drive regain.
- Trials show weight often returns if GLP-1 therapy is stopped, supporting long-term treatment for many.