Miracle or Misused? Benefits, Risks, and Responsible Use of GLP-1s

Glucagon-like peptide-1 (GLP-1) can transform metabolic health, but only with smart dosing, adequate dietary protein, regular strength training, and mental health support. 

In this episode, we explore how GLP-1 medications work in the brain and gut, why metabolic health is more than BMI or a weight on the scale, and how to use these drugs safely. Our expert guest, gastroenterologist, Dr Supriya Rao shares practical dosing, side effect strategies, and what makes results stick.

• Defining metabolic health beyond BMI and weight
• How GLP-1s reduce appetite and slow gastric emptying
• Healthy weight loss pace and preserving lean muscle
• Practical + science-backed dosing and individualized titration
• The unknown risks of compounding and microdosing
• Managing nausea, reflux, and constipation
• Diet shifts: smaller meals, more fiber, adequate protein
• Mental health, body image, and stigma in care
• Durability of results and maintenance dosing
• New indications: MASH (metabolic dysfunction-associated steatohepatitis), sleep apnea, cardiovascular protection
• Building an educated care team

References/Resources:

Tzang CC, Wu PH, Luo CA, Chen ZT, Lee YT, Huang ES, Kang YF, Lin WC, Tzang BS, Hsu TC. Metabolic rebound after GLP-1 receptor agonist discontinuation: a systematic review and meta-analysis. EClinicalMedicine. 2025 Nov 28;90:103680. 

Ghusn W, Hurtado MD. Glucagon-like Receptor-1 agonists for obesity: Weight loss outcomes, tolerability, side effects, and risks. Obes Pillars. 2024;12:100127. Published 2024 Aug 31. 

Moiz A, Filion KB, Tsoukas MA, Yu OHY, Peters TM, Eisenberg MJ. The expanding role of GLP-1 receptor agonists: a narrative review of current evidence and future directions. EClinicalMedicine. 2025 Jul 17;86:103363. 

Integrated Gastroenterology Consultants (Dr. Supriya Rao's practice site)

Book: The GLP-1 Kitchen: A Cookbook for Living Well on Weight Loss Medications Escobar S-N et al. (contains affiliate marketing link)

Learn more about Kate and Dr. Riehl:

Website: www.katescarlata.com and www.drriehl.com
Instagram: @katescarlata @drriehl and @theguthealthpodcast

Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS.

The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.