Just when it seemed things could not get more exciting in weight management pharmacotherapy, we have had not one, but two, new exciting breakthroughs in FDA approved weight management medical treatment options: a new oral medication called orforglipron and a higher dose available in semaglutide injection!  Let’s take a closer look at each! Semaglutide 7.2 mg Injection This is a new strength now available in semaglutide injection. Previously, the top dose was semaglutide 2.4 m

Nutrition and lifestyle factors heavily impact the efficacy, tolerability, and continued use of GLP 1 treatments. Because of the highly varied results among individuals taking these medications, it is crucial to understand the factors associated with better outcomes long term. This blog focuses on a brief summary of nutritional recommendations to consider.  The most common pitfalls while on treatment with GLP 1 include side effects, varied weight loss results, high discontinu

Chronic weight management pharmacotherapy has been revolutionized in the last few years by gaining FDA approval for three indications that are not weight loss, including metabolic associated fatty liver disease, established cardiovascular disease, and moderate to severe obstructive sleep apnea. This has helped improve access to care as well as focus clinical attention. While reducing excess weight has been well-known to improve cardiometabolic disease and conditions related t

Wegovy was FDA approved in 2021 and Zepbound was FDA approved in 2023. As more people are on these medications for longer and the magnitude of weight loss for some is similar to that achieved with bariatric surgery (30-35% of starting body weight), it is important to pay close attention to the health of lean body mass.  Important subgroups of lean body mass include skeletal muscle, bone, and subcutaneous adipose (fat) tissue).  Let’s look more closely at what can happen, how

Food Noise Over Time on GLP 1s While GLP1 medications are remarkable in their weight loss results, in clinical practice, durable outcomes are hampered by high discontinuation rates. While it is easy to blame cost for this, the truth is that it is probably a lot more complex than that. Since discontinuation is a marker of dissatisfaction with the treatment, let’s look a little closer at why it may be happening. Side Effects, Cost, Contraindications Let’s agree that there are a

Wegovy was recently approved in tablet form in December 2025. What are the important things to know about this new treatment option? There are two differences in the FDA approval between the Wegovy injections and the Wegovy tablets which may or may not make a difference for you. The tablets are only FDA approved for weight management and for the reduction of major cardiovascular events in adults with known cardiovascular disease and overweight or obesity and the tablets are o

At Obesity Week in Atlanta this Fall, much of the content was on common benefits and pitfalls in real-world, large scale clinical use of  GLP1s. To me, the underlying concept for many of these is the balance between hedonic versus aversive signals in the brain. On the one hand, these medications quiet overly active hedonic signals that lead to overeating and overly ingesting highly palatable foods, collectively termed “food noise.” These medications even have been known to re

I had the privilege of attending and presenting at the internal conference of The Obesity Society this week in Atlanta, GA.  It is an international gathering of experts in the latest research on obesity, from bench researchers, to clinical researchers, to clinicians, policy makers and leaders in the industry. They bring to the podium all the newest research that had not yet made it to the mainstream to advance the understanding of the treatment of obesity.  I learned a lot, a

Coverage for weight management medication is all over the map — and often has little to do with medical need. Unlike most other...

A New Use Beyond Weight Loss Wegovy (semaglutide) has already changed lives as a medication for weight loss and heart health. Now, in...

If you’ve heard about GLP-1 medications like Wegovy®, Zepbound®,  or Saxenda® , you know they help people lose weight by reducing...

Many patients ask me what their BMI is and what it should  be. This is essentially another way of asking what they “should” weigh, since...

In the treatment of obesity, sustainable and affordable solutions matter. Phentermine/topiramate , a once-daily oral combination...

Increasing access and reducing barriers to weight management medications is a good thing. Many people turn to online services because...

🧠 What Is Obstructive Sleep Apnea (OSA)? Obstructive sleep apnea (OSA) is a common but serious sleep disorder that causes repeated...

If you’ve been hearing about compounded versions of medications like semaglutide  (the active ingredient in Ozempic and Wegovy) or...

Some people have sent messages asking about changing from semaglutide to tirzepatide following the “news” article that came out...

This blog describes the study on what happened after semaglutide was discontinued in the SELECT 1 trial. The SELECT 1 trial was the...

While taking semaglutide or tirzepatide, sometimes, people eat very few calories. Of course this often leads to a very large amount of...

With the recent election and naming of the US Health Secretary, Ozempic is back in the news again with people choosing sides of lifestyle...