The Weigh In: Dr. Amy Shah on why food can be medicine and how GLP-1s are revolutionizing obesity care

This week, Dr. Amy Shah joins host Samhita Mukhopadhyay to break down the lifestyle changes you may consider when embarking on a GLP-1 journey. They discuss how these medications work, what they can reveal about obesity treatment, why all doctors should understand their effects on the body, plus the ways to move (and eat) if you’re on one. Combining her extensive medical knowledge, nutrition expertise, and lived experience of 90s diet culture, twice board-certified Dr. Shah also touches upon why Weight Watchers — of all places — is the right home for this conversation.

Watch the full conversation above, listen in on your preferred podcast platform, or read the highlights below.  

These are the kinds of real, honest questions — and much more about weight, health, and GLP-1s — you’ll find being discussed on The Weigh In, a new weekly podcast from Weight Watchers. It’s hosted by Samhita Mukhopadhyay, a journalist, author, and head of content at Weight Watchers. (As always, this is for education purposes. Talk to your doctor for questions about your health.)

“You naturally produce GLP-1, and [this medication] binds to GLP-1 receptors in our body, and it creates different results:  the signals go into your brain to [make you feel] full. It helps produce insulin so that your blood sugars will go down. It slows down digestion, and it makes you less hungry. A lot of people, for the first time in their life, are able to feel full [on GLP-1s]; they never really felt satisfied [before].”

“Women, especially, were told to count calories, that calories were the enemy. And so not only were you fixated on calorie counting, you [were] thinking about food. A lot of people didn't have enough of that signaling to their brain that they're full, and so it created this very, very loud food noise. The diet culture that we grew up with in the '90s exacerbated this. You would always be thinking about your next meal or your next snack.

 Doctors would say to patients,’You just need to eat less and move more.’ How frustrating [is that] for someone who has the food noise, who can't feel, doesn't feel satisfied? It's a shame that we did that because we didn't understand the brain mechanisms.”

“A lot of people are taking doses that are making them lose weight very quickly, and they're not doing resistance training, and they're not supported through their dietary protein intake. They're losing weight, but they're also losing muscle. This is particularly true for women over the age of 35. If you're in that perimenopausal, menopausal transition, you're likely already losing muscle and bone [faster than when you] were pre-menopause. And so to combine that with a GLP-1 agonist, [while] you're not eating enough protein or weight training, you have a multiplier effect on your bone and muscle.”

“If  you're not [able] to commit to the diet and lifestyle strategies to support your bones, muscle, and mental health [on a GLP-1], then you're not doing yourself any favors. Work with a practitioner who makes sure that you're not losing weight too fast, that you are losing weight in a healthy way, that it's helping your blood markers, like your lipids, your hemoglobin A1C, and that you are eating enough protein and doing some resistance training and really having high-quality nutrient-dense foods. If you had to [commit to the] real big needle movers, [they] would be: 30 grams of protein in your first meal, 30 grams of fiber throughout the day, and three servings of probiotics or fermented foods a day for your gut health. 

Then you're going to do weight training. I have this 4-3-2-1 mnemonic for exercise. So four days a week, move your body in the way that you love. Walking is the simplest. It can be dancing. And then three days a week, you're going to weight train, and then two days a week, heat therapy–so sauna, hot yoga, anything like that. And then one day a week, give your heart a little test with a sprint. So whether it's a bike sprint or a run sprint or a swim sprint, that would be ideal.”

“ The craving pathway is really dulled when you have protein and fiber in the morning. I know for me, if I start my day with protein and fiber, all my choices are better throughout the day.   

Fiber used to be something that we could just easily get from food. If we ate food in its classic forms, we would be getting enough fiber, but because [foods like] breads have the fiber stripped out, [many people are] not getting adequate fiber. Lots of fiber would fill you up really quickly. But if you strip out the fiber [in food], then you can eat more of it without feeling full. Protein has the precursors to our neurotransmitters, like dopamine and serotonin. And so not only the cravings, but [your] mood [may be better supported] when you have protein in your system early in the day.  

We have to remember that we've lived in diet culture for so many years, but it's okay to have a cookie…as long as you're also having your fiber and protein and probiotic foods.”

“The sun and the dark cycle really run our bodies. When you see the sun first thing in the morning, it rewires your brain in a certain way, and then shortly after that you should have food. And maybe try to have as much food as you can before sunset because if you think about it evolutionarily, we didn't have all the delivery systems for huge meals at midnight. And so living in accordance with circadian rhythms can help.”

“Weight Watchers [offers] that so well*, so I think that's really special. It's a scary world out there without that. People don't realize that [a GLP-1 is not] a short-term thing. I've had patients reach out to me and say, ‘I just wanna get on it for a couple months so I can reach my goal weight.’ That's not the right use for it. It's a long-term medication, like blood pressure medication. Once you stop it, your blood pressure is going to go back to where it was unless you made a lot of lifestyle and dietary changes.” 

*All medical services are provided through our affiliated medical group, WeightWatchers Clinic.

“Food can be medicine. It's going to change the way you think, the way you live, the way you look. But mostly, how you perform and come out to the world is through the food that you eat, and I think people need to understand that. Especially if you're on a GLP-1 agonist and you're not eating all the things that you used to, and you only have a limited number of things that you're going to eat in a day. You have to make sure that they are full of vitamins or support your health in some way. 

 What you eat determines who you are. ‘Your inputs become your outputs.’ So what you're saying to yourself, what you're eating, who you're spending time with, what you're taking in from the world, the information that you decide to take in, that becomes who you are.”