Extend Podcast with Darshan Shah, MD 129. Ashley Koff: The GLP-1 Conversation Most People Are Missing
Jan 13, 2026
In a captivating discussion, Ashley Koff, a registered dietitian and founder of The Better Nutrition Program, explores how GLP-1 medications impact metabolism. She reveals that weight loss is less about calories and more about hormonal balance and digestive health. The conversation dives into the underrated role of incretin hormones, the implications of prolonged GLP-1 use, and the importance of detox strategies during weight loss. Koff emphasizes the need for personalized support and planning to prevent relapse, challenging conventional views on weight management.
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Incretin Hormones Are An Ecosystem
- Incretin hormones (GLP-1, GIP, PYY, CCK, amylin) form a weight-health ecosystem that regulates appetite, inflammation, liver and heart tissue.
- These hormones are signals the body naturally makes, not drugs, and explain rapid metabolic changes after bariatric surgery.
Longer-Acting GLP-1s Change Physiology
- GLP-1 agonists are biosimilar hormone replacement therapies that act far longer than native hormones, changing physiology dramatically.
- Prolonged receptor activation creates powerful benefits and also new management needs clinicians must address.
Personalize Nutrition And Recovery On GLP-1s
- Personalize nutrition and recovery while on GLP-1s: monitor sleep, CGM, HRV and adjust meals around medication timing.
- Anticipate delayed gastric emptying and alter meal composition, dose, and timing to avoid fatigue and GI issues.
