#228: GLP-1 Medications: What We Know About Safety, Food Noise, and Weight Loss with Ragen Chastain
GLP-1 medications like Ozempic, Wegovy, Mounjaro, and Zepbound have gone from relatively niche diabetes medications to one of the biggest (and most controversial) stories in health and wellness.
As you may have noticed, I’ve taken a bit of a hiatus from the podcast the past couple of months while I’ve been recovering from a SCAD heart attack. But there is no better way to kick off this new season of episodes (and this new chapter of my work, as I figure out what life looks like now) than with Ragen Chastain.
Ragen returns for her second time on the pod to speak with me about the science of GLP-1s — beyond the headlines, and in the most recent research. We do a deep dive into what it means physiologically for GLP-1 medications to be used for weight loss. Plus the science of food noise and hunger, whether these drugs are contributing to weight stigma, and what we know (so far) about their safety and long-term effectiveness.
More specifically, we talk about:
Ragen’s journey from dieting and doing her own literature review to becoming a researcher and advocate in the weight-inclusive healthcare space
The specific research on the failure of long-term weight-loss interventions
Weight-inclusive healthcare and why it shouldn’t depend on whether we believe people can or cannot lose weight
How GLP-1 medications work, including their effects on blood sugar, gut motility, digestion, and hunger
How medications developed for type 2 diabetes became major players in the weight-loss industry
The difference between diabetes dosing and the higher doses used for weight loss
What food noise means (and what it doesn’t mean)
How diet culture and restriction can affect hunger and thoughts about food
Why the same symptoms can be interpreted and treated differently depending on the size of the person experiencing them
Weight stigma in healthcare, and the assumption that weight loss is the answer to an enormous range of health concerns
The long-term safety of GLP-1 medications for weight loss
Study dropout and what can get lost when we look only at headlines, abstracts, and conclusions
Conflicts of interest and transparency in pharmaceutical research
What happens when medications designed to suppress hunger are used in people whose bodies are otherwise regulating blood sugar normally
About Ragen
Ragen is a researcher, writer, speaker, and board-certified patient advocate who has spent more than 20 years examining the intersections of weight science, weight stigma, and healthcare. She brings a research- and statistics-informed perspective to a conversation that is often dominated by pharmaceutical marketing, influencer anecdotes, and very simplified claims about what these medications do.
Before you listen, a gentle note:
This conversation is not a commentary on any individual person’s decision about their body or whether or not they take a GLP-1 medication. People have all kinds of reasons for making decisions about their health and their bodies, and those decisions belong to them.
My interest here is in the much bigger conversation surrounding these medications: the science, the research we have (and the research we don’t), the way hunger and weight get talked about, the influence of pharmaceutical companies and weight-loss culture, and what happens when we start treating certain bodies, symptoms, or experiences differently because of their size.
I think we can have serious questions about the evidence and the systems surrounding these medications without turning those questions into judgments about individual choice. My hope is to provide dialogue that is not steeped in anti-fat bias and gives you more information that what’s being told through headlines and social media narratives.
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