Oct 21, 2026 · 28 min · 8 segments
GLP-1 usage has surged as a weight loss management drug. But given how new they are to the market, medical professionals are only now starting to figure out who should – and should not – be using…
Fatima Cody StanfordGuest
Daniel LiebermanGuest
Caroline ApovianGuest
Samantha Laine PerfasHost
My other concern about GLP-1s is about prevention and really goes back to what we started off talking about, which is that, so I have this term I apologize for, which I created called disevolution.
When we treat the symptoms rather than the causes of a mismatch problem, then we just keep the cycle going.
My real nightmare about GLP-1s is that we end up in a world where we cease to pay attention to to the cause of the problem, which is the various reasons that people are struggling with obesity in the first place.
It's like in the supermarket aisle, you can go down one aisle of the supermarket and there are the companies selling all these foods that are really bad for us.
And then the same companies in the next aisle are selling us the weight loss products that deal with the problem that they caused in the other aisle.
Ultimately, what we should all really want to do is prevent this problem from happening in the first place.
It is amazing that these companies medications are able to so effectively help people and also what happens when it becomes a substitute for the lifestyle change that needs to happen.
So by the time the patients get to us, these patients have tried and failed or that lifestyle has tried and failed them.
They can list 25 to 30 different programs that they've tried and failed.
It worked for a short period of time and then it didn't work and their bodies came back.
And so then they're coming to us because they're like, okay, look, I've tried all these things.
And so let's say they go on these medications and they're like, oh, wait a minute, this works.
They are feeling good about themselves going to the gym and seeing the results pay off while they're on the medications.
Their self-worth and self-esteem, unfortunately, deteriorates because they're like, here I am.
I finally got to the quote unquote promised land and it was snatched from me.
If diet and exercise worked and they wouldn't be stigmatized walking down the street because they have obesity, they would have done it.
My other concern about GLP-1s is about prevention and really goes back to what we started off talking about, which is that, so I have this term I apologize for, which I created called disevolution.
When we treat the symptoms rather than the causes of a mismatch problem, then we just keep the cycle going.
My real nightmare about GLP-1s is that we end up in a world where we cease to pay attention to to the cause of the problem, which is the various reasons that people are struggling with obesity in the first place.
It's like in the supermarket aisle, you can go down one aisle of the supermarket and there are the companies selling all these foods that are really bad for us.
And then the same companies in the next aisle are selling us the weight loss products that deal with the problem that they caused in the other aisle.
Ultimately, what we should all really want to do is prevent this problem from happening in the first place.
It is amazing that these companies medications are able to so effectively help people and also what happens when it becomes a substitute for the lifestyle change that needs to happen.
So by the time the patients get to us, these patients have tried and failed or that lifestyle has tried and failed them.
They can list 25 to 30 different programs that they've tried and failed.
It worked for a short period of time and then it didn't work and their bodies came back.
And so then they're coming to us because they're like, okay, look, I've tried all these things.
And so let's say they go on these medications and they're like, oh, wait a minute, this works.
They are feeling good about themselves going to the gym and seeing the results pay off while they're on the medications.
Their self-worth and self-esteem, unfortunately, deteriorates because they're like, here I am.
I finally got to the quote unquote promised land and it was snatched from me.
If diet and exercise worked and they wouldn't be stigmatized walking down the street because they have obesity, they would have done it.
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