Fork U with Dr. Terry Simpson

There may be no phrase in modern nutrition more ridiculous than this:

“Real food protein bar.”

And yet, somehow, we are expected to nod seriously when someone says it.

Recently, internet nutrition personality Paul Saladino introduced what he described as his best “real food” protein bar. While I have nothing personal against the man. I admire the confidence required to sell twelve protein bars for forty-four dollars while talking about ancestral living.

Because let’s be honest for a moment.

Protein bars are the modern candy bar.

They simply come wrapped in better branding, cleaner fonts, and enough wellness language to make people feel virtuous while eating what is essentially an expensive Snickers bar with a podcast sponsorship.

Now, before the internet declares me anti-protein-bar, let me clarify something immediately.

I actually like Aloha bars.

They’re expensive, but they say the right words to me. More importantly, they taste better than most compressed drywall products pretending to be nutritious. At the same time, real life exists, and sometimes convenience matters because airports happen, traffic happens, and long clinic days happen.

Still, pretending industrial engineering somehow untouches these foods is a bit like pretending woodland elves handcrafted a Tesla.

To understand how we got here, we need cereal, because cereal tells the entire story of modern food in one aisle.

The first cereals in America were essentially granolas—dense grain mixtures that required chewing, preparation, and a bit of commitment. While nobody was exactly dreaming about them at night, they solved an important problem because they stored well, traveled well, and provided calories in an expanding industrial society.

Then along came John Harvey Kellogg.

Now, Kellogg was brilliant, strange, deeply moralistic, and profoundly suspicious of pleasure. He believed rich foods, spicy foods, meat, and almost anything enjoyable stimulated dangerous passions, and among those passions, he was particularly terrified of masturbation, which he viewed as one of the great threats to civilization.

So his answer was blandness.

Very blandness.

Little sugar. Little excitement. Little stimulation.

The original breakfast cereal movement was not designed around pleasure.

Instead, it was designed around suppression.

In many ways, those cereals were crunchy moral discipline.

Fast forward a hundred years, and the cereal aisle becomes the exact opposite of Kellogg’s vision.

Sugar increases dramatically.

Crunch becomes engineered.

Colors explode across the box.

Mascots arrive to recruit children before they can read.

Eventually, breakfast stops being a health intervention and slowly transforms into dessert with vitamins sprinkled on top.

And importantly, none of this happened because someone woke up wanting to destroy public health.

That’s the part people often misunderstand.

Before obesity became the dominant nutritional problem, the real challenge facing humanity was hunger.

For most of history, people worried about:

• starvation
• food spoilage
• crop failures
• transportation
• and simple calorie availability

Modern food engineering changed that reality.

Shelf-stable foods mattered.

Affordable calories mattered.

Transportation mattered.

Refrigeration mattered.

And honestly, millions upon millions of lives have been improved because of those advances.

It is very easy for people with stocked refrigerators and grocery delivery apps to romanticize the past, but the past involved a tremendous amount of malnutrition, uncertainty, and hunger.

So modern food systems were not evil.

They were revolutionary.

However, in solving one problem, we slowly created another.

Because once calories became:

• cheap
• portable
• stable
• and endlessly available

…the challenge was no longer finding enough food.

The challenge became stopping.

And this is where modern biology collides with the modern grocery aisle.

Our brains evolved in environments where calorie-dense food was rare and valuable. Suddenly, within just a few generations, we found ourselves surrounded by foods engineered to be affordable, repeatable, and highly rewarding.

That mismatch matters.

Most people have never heard the word extrusion, even though it may be one of the most important food technologies in modern life.

The process is simple.

Take starches, grains, or protein powders.

Apply heat and pressure.

Force them through machinery.

Suddenly, you have:

• cereal
• crackers
• cheese puffs
• protein snacks
• breakfast bars

And here is the important part: extrusion changes texture, and texture changes satiety.

When food crunches perfectly, dissolves quickly, and slides down effortlessly, people consume more of it before fullness has time to register.

That is not a conspiracy.

It is simply biology interacting with engineering.

Food companies did not necessarily set out to create hyper-palatable foods.

Instead, they followed what sold.

And what sold was what people returned to again and again.

So over time, the grocery aisle became a form of natural selection.

Products survived because they triggered pleasure effectively.

Foods that didn’t simply disappear.

And I will confidently say something controversial:

Reese's sells better than Brussels sprouts.

I will die on that hill.

Now, yes, Brussels sprouts can be delicious roasted with olive oil and balsamic, and somewhere at this exact moment, a chef in Brooklyn is shaving them raw onto handmade pottery while explaining their emotional complexity.

Still, Reese’s triggers something primal.

Sweetness.

Fat.

Salt.

Texture.

And your brain immediately says:

“Yes. More of that.”

Food is not just chemistry.

Food is memory.

It is also culture.

What we eat is comfort.

For some people, comfort food is a tamale. For others, it’s lefse. Meanwhile, many people find that comfort in peanut butter cups or a Dove Bar.

The grocery aisle evolved around those emotional realities much faster than human biology evolved to manage them.

And that matters, because modern eating is not simply about willpower.

It is about environment.

Now compare all that to actual cooking.

Not content-creator cooking.

Real cooking.

A stew simmering slowly.

A roast chicken filling the kitchen with aroma.

A tagine building layers of flavor from preserved lemon, apricots, and warm Moroccan spices.

That kind of food slows you down.

You smell it before you eat it.

You notice texture.

You experience layers of flavor.

And interestingly enough, you often need less of it to feel satisfied.

That is one of the great ironies of modern eating.

As food became more engineered for efficiency, it often became less satisfying experientially.

There is another uncomfortable reality that nobody on wellness Instagram likes to admit.

In order to feed a hungry planet, we cannot all live on pasture-raised beef, farm-fresh eggs gathered from cheerful backyard chickens, and organic kale harvested by a local poet-farmer wearing linen.

That is not a food system.

That is a lifestyle catalog.

The modern world has eight billion people.

Food has to:

• travel
• survive droughts
• survive wars
• survive supply chain failures
• and feed cities that no longer produce their own calories

Engineered foods are not going away.

Nor should they.

When human beings eventually colonize Mars, we are not putting cattle on the rocket ship.

Nobody is building a space ranch outside Olympus Mons.

Likewise, we are not stocking the moons of Jupiter with artisanal grass-fed herds wandering peacefully beneath methane clouds.

Instead, we will use engineered foods and lab-grown proteins, because they will be:

• efficient
• reproducible
• resource-conscious
• and eventually taste just as good

That future is not dystopian.

It is practical.

The challenge facing us today is very different from the challenge facing humanity a century ago.

We no longer live in a world where most people fear starvation.

Instead, we live in a world where many people are simultaneously overfed and undernourished.

Calories are abundant.

Satiety is not.

And that is where medications like GLP-1 are helping many people—including me—regain a sense of balance and reality in a food environment that our brains were never designed to navigate.

Food is not evil.

Engineering is not automatically bad.

Convenience matters, and sometimes a protein bar is perfectly fine.

However, pretending that heavily processed convenience foods become “real food” because someone added collagen and an Instagram strategy does not help anyone understand the real issue.

The goal is not perfection.

The goal is awareness.

We need food systems that:

• reduce malnutrition
• prevent shortages
• improve satiety
• and avoid creating environments where obesity becomes the default outcome of modern life

Because feeding humanity was one of civilization’s greatest achievements.

Now we simply have to figure out how to do it without overwhelming the biology that got us here in the first place.

When people start a GLP-1, they are told what to avoid. What side effects to expect, and sometimes how much protein they should be eating. While that information has its place, it misses the part that actually changes your day-to-day life. Because what really shifts is not just how much you eat, but also how you experience it.

At first, that change can feel subtle, almost easy to miss. Because nothing dramatic happens overnight. Although for me it did. In addition, over the course of a few days and weeks, you begin to notice that foods you used to reach for automatically no longer have the same pull, and simultaneously, foods you barely thought about before start to feel more interesting, more satisfying, and more worth your attention.

So instead of asking what you should eat, a better question becomes what you actually want to eat. Because that answer starts to change.

Before this, eating was often fast, automatic, and driven by something that wasn’t quite hunger. Most meals were about filling up rather than tasting anything. Once the plate was in front of you, it didn’t take long for it to disappear.

In many cases, food was less about enjoyment and more about reaching that point of fullness where the urge to eat finally quieted. Which meant convenience foods made sense, large portions felt normal, and finishing everything was exactly what you did.

As a result, you weren’t really tasting food; you were processing it. And that difference matters more than people realize.

After starting a GLP-1, the signal changes. While it doesn’t happen the same way for everyone, it shows up quickly enough that you notice it in small ways. Because you slow down without trying, you pause between bites without thinking, and you stop earlier than you used to.

That pause is important because it gives you a moment to notice what you’re eating. Once you notice, you start making choices that feel different from before, not because you are forcing yourself to be disciplined, but because your body is guiding you in a new way.

Gradually, eating becomes less about quantity and experience, and that shift changes everything.

For most people, lunch is not a carefully planned event, and that’s exactly why it’s a good place to see what actually works.

On many days, I keep it simple because simple is reliable. A chicken breast heated up in the morning with a bit of hot sauce does the job without much effort. while a couple of apples and some grapes can carry me through the late morning and early afternoon without feeling like I need a full sit-down meal. Plus, if I am driving, eating slices of apples and grapes keeps me awake.

At the same time, I don’t force structure onto it, because grazing a bit throughout the day often fits better than trying to recreate the old idea of a formal lunch, and that flexibility makes things easier rather than harder.

On other days, I might grab a sandwich, and while it could be like a triple-decker club. The difference now is not what I order, but how much I eat, because stopping halfway feels natural instead of forced. Whatever is left has a way of disappearing quickly once my son gets home from school.

Eating out follows the same pattern, because one or two tacos are usually enough. While fried foods sometimes feel heavier than they used to, grilled or ceviche-style options bring out flavor without that weight, making the experience better without trying to optimize anything.

At some point, you realize that simple foods start to feel more satisfying than they used to. And something like a good tuna, mixed with yogurt, lemon, and a bit of mustard, becomes a meal that you actually look forward to. Rather than something you eat because you think you should.

Bread becomes optional, not forbidden, and sometimes a bowl or a few crackers is all you need, which removes the sense that meals must follow a certain format.

Seasonal fruit fits into that pattern. Because when something tastes good, you eat it, and when it doesn’t, you move on, which is a different mindset from trying to force certain foods into your day.

Even something as simple as peanut butter and jelly can feel satisfying again, because the experience of eating it has changed.

One thing that becomes more noticeable is how important drinking fluids actually is because when you eat less, you naturally take in less water from food, and that means you have to be more intentional about it.

For me, iced tea works because it adds a bit of flavor without adding much else. Making it overnight in a pitcher means it’s ready when I need it, which turns hydration into a habit instead of something I forget about.

That small shift makes a bigger difference than most people expect, because feeling off is often just a sign that you need to drink more.

Dinner changes in a way that feels less structured and more creative. Because instead of trying to build a large meal, you start thinking about what would actually be enjoyable.

Cooking becomes more interesting, not because you are trying harder, but because you have the space to pay attention. Dishes like salmon, pasta with a well-made sauce, or even something new from a meal kit can feel like something you are exploring rather than something you are consuming.

At the same time, there is more room for variety, because you are not relying on volume to feel satisfied, and that allows you to try different things without needing to make them large.

Even with all these changes, I still track what I eat using Noom. Because awareness doesn’t go away just because the biology works differently. And that habit keeps things grounded without turning it into something rigid.

Going out to eat is still part of life, and in many ways, it becomes more enjoyable because you can focus on what you like rather than how much you can eat, and sharing a meal or splitting something becomes a natural part of the experience.

Dessert is where you can see the shift.

Most of the time, I don’t think about it, and that alone is different, because it used to be automatic.

Every now and then, especially when I’m getting close to my next dose, I’ll notice that I want something sweet, and I might have an ice cream bar, and that’s enough.

That moment says more than any rule ever could. It shows the drive is lower, not gone, and that you can respond to it without being controlled by it.

What has changed is not complicated, but meaningful.

I go for flavor instead of volume.

Timing, now I take my time tasting instead of rushing.

Choosing where and what to eat depends on whether it is worth it, not whether it is popular or convenient.

Food is not the enemy.

It never was.

Some days, I am simply not interested in dinner, and if lunch was larger, I might just have a protein shake and move on, because eating is no longer something I have to do on a schedule.

This is not a diet. It is not a plan. It is not about perfection.

Instead, it is about eating in a way that matches how your body now works, which means paying attention, making choices, and allowing yourself to enjoy food without relying on it for everything else.

Before, I filled my mouth before thinking, and swallowing before experiencing.

Now, I taste.

I started my journey on a GLP-1 in October 2024. While my doctor did what good doctors do—he gave me the warnings, the precautions, the usual advice about what to avoid and watch for—I quickly realized something was missing. No one really told me what it would feel like. More importantly, no one explained that this first month doesn’t unfold in one neat, predictable way, but instead moves along several paths depending on the person, their biology, their habits, and frankly, a bit of luck.

So, as I’ve watched friends, patients, and many people start this same journey, I’ve come to understand that the first month is less about weight loss, and far more about discovery, adjustment, and occasionally confusion. While people expect something simple, they get instead of variation, and that variation can make them think something is wrong when everything is going exactly as it should.

Most people begin this process believing they will take the medication, lose their appetite, and watch the scale steadily drop. While that story is appealing, it simply isn’t how the body works, because biology rarely follows a script, and in this case, the first month is more like learning a new language than following a plan.

What becomes clear quickly is that people fall into different patterns. While none of these patterns are right or wrong, understanding which one you are in can make all the difference in how you interpret the experience.

Some people, myself included, are what we call hyper responders. Although we don’t fully understand why this happens, the effect can be dramatic. Within about twelve hours of my first dose, something shifted in a way I did not expect, as the constant chatter in my head about food—what we used to call head hunger—simply disappeared, and I didn’t even know it had been there until it was gone.

During that first month, I lost twelve pounds, and while most of that was water and glycogen with some fat mixed in, the real change was not on the scale, but in my appetite. This dropped so noticeably that I found myself stretching out the time between doses. Interestingly enough, my obstructive sleep apnea improved, which was not something I had anticipated, but certainly appreciated.

At the same time, my doctor had warned me to drink more fluids, and that advice was critical, because much of the water we normally get comes from food, and when food intake drops, hydration must be a conscious effort. So I adjusted by adding a protein shake in the morning and increasing my iced tea throughout the day, and that simple change made a meaningful difference in how I felt. You can find my recipes for protein shakes on the recipe section of my site, terrysimpson.com.

On the other hand, most people do not have that kind of immediate response, and instead they fall into what I would call the normal responder group, where the changes are subtle at first, and because they are subtle, they are easy to miss, which leads many to think the medication isn’t working, especially when they compare themselves to others who seem to be losing weight quickly.

What they don’t notice, however, is that they are snacking less, leaving a bit of food on their plate, and skipping that second helping more often than before, and while these changes may seem small, they add up over time, because when someone tells me they only lost four pounds in a month, I translate that into nearly fifty pounds in a year, and suddenly the perspective shifts from disappointment to possibility, because that is a sustainable path.

Then there is the third group, the strugglers, and these are the people who feel the effects right away but not in a pleasant way, because nausea, delayed gastric emptying, and an uncomfortable sense of fullness can make the experience feel miserable rather than helpful, and in these cases, intervention becomes important, since without adjustment, these individuals can run into real problems.

What helps here is not complicated, but it does require attention, because smaller meals, avoiding fatty foods early on, focusing on liquids, and most importantly, never eating until full can turn things around, and more often than not, dehydration is the hidden issue, which is why something as simple as popsicles made from electrolyte solutions can provide both relief and hydration, and the key word for this group, more than anything else, is pacing.

Before GLP-1 medications, we often described something called head hunger, which is that feeling of wanting food even when the body does not need it. The distinction between real hunger and head hunger is easier to understand than most people think. If you are truly hungry, something simple like a meatball will satisfy you, whereas if it is head hunger, you will find yourself reaching for cookies, candy, or snacks high in calories but low in nutrition.

This is what we now call food noise, and for many people, it is constant, although they may not recognize it until it disappears, which is exactly what happens on a GLP-1, and that disappearance can feel both liberating and unfamiliar at the same time.

I can always tell when mine starts to come back, and recently, I delayed my dose for a few days because I was celebrating my wife’s birthday, and the next day, before I resumed the medication, I found myself buying multiple boxes of ice cream bars, not because I needed them but because that voice had returned, quietly suggesting that I might want them, and once I took the dose again, that same voice faded, leaving me to wonder why I had bought them in the first place.

That voice is persistent, not loud but steady, and it doesn’t shout like an alarm but instead calls like a siren from an old story, inviting you toward something you don’t need but think you want, and turning that down is one of the most profound changes this medication brings.

As the first month unfolds, the early days are often inconsistent because appetite may vary from one day to the next, and while some meals feel normal, others feel different, and this unpredictability can make people uneasy, especially if they expect immediate stability.

Gradually, however, things begin to settle, and by the third or fourth week, satiety arrives earlier, meals become smaller without effort, and foods that once felt irresistible lose some of their pull, not because they are forbidden but because they are no longer as compelling.

At that point, behavior starts to align with biology, and instead of forcing discipline, people find themselves responding to signals that finally make sense.

Success in the first month comes down to a few consistent themes, and while none of them are complicated, they are easy to overlook, because smaller meals tend to feel better, slower eating becomes natural, hydration proves essential, and real food often becomes more appealing, all while the pressure to eat disappears.

In addition, forcing food when you are not hungry rarely ends well, and learning to stop earlier than you used to becomes one of the most important adjustments you can make.

The Emotional Shift No One Talks About

One of the most surprising aspects of this process is not physical but emotional, because when the constant thinking about food quiets down, there is a sense of relief, yet at the same time, there can be a feeling of disorientation, as if something familiar has gone missing.

For many people, food fills more than just hunger because it fills time, emotion, and habit, and when that changes, there is space to be filled in new ways, which can feel uncomfortable at first but ultimately becomes an opportunity.

The first month on a GLP-1 is not about rapid weight loss, and it is not about perfection, and it certainly is not about willpower, because what it really represents is a shift in how the body communicates and how the mind responds.

Instead of fighting hunger, you begin to understand it, and instead of chasing food, you begin to choose it, and in that process, something changes that goes far beyond the number on a scale.

If you are considering this journey, it is worth finding a board-certified obesity specialist because they have the training and experience to guide you through these changes in a way that most physicians simply do not, and that guidance can make the difference between frustration and success.

And as for that first month, it is less about what you lose and more about what you learn, because what you are really discovering is what it feels like to not be controlled by food for the first time in a very long time.

I want to tell you about two people on a GLP-1.

First, there’s me.

I’ve been on a maintenance dose—7.5 mg of Zepbound—for a while now. And recently, I went to an incredible Michelin-star restaurant. Now, at one point during that meal, I said something that surprised even me.

The beetroot pasta was one of the best dishes I had ever tasted.

Now, let’s pause there—because this matters.

I don’t like beets.

In fact, I’ve always said I hate beets.

And yet, there I was, enjoying beetroot pasta.

So what changed?

Well, not my opinion of beets.

But absolutely my appreciation of flavor.

During that same trip to Italy, I had one remarkable meal after another. For example, I ate at Ristorante Aroma, right next to the Colosseum. Then, I found a small, unforgettable place tucked away in Venice.

Now, let me be clear—this is not a humble brag.

Yes, the restaurants were fantastic. Yes, the trip was memorable.

However, I’ve been to Europe before.

And yet, this time was different.

Because this time, I didn’t just eat the food.

Instead, I tasted it.

Moreover, I slowed down.

In addition, I noticed the precision.

And perhaps most importantly, I appreciated the flavors.

Before, I think I liked good food.

Now, I actually understand it.

On the other hand, there’s my friend.

He’s also on a GLP-1. In fact, he weighs a bit less than I do. However, he told me something that stopped me in my tracks.

“I don’t enjoy food anymore.”

Now, that’s not discipline.

And it’s certainly not success.

Instead, that’s anhedonia.

In his case, the dose was too high. As a result, appetite didn’t just quiet down—it disappeared. Furthermore, dehydration crept in. And on top of that, nutrition slipped just a bit.

Consequently, food wasn’t enjoyable anymore.

It was just… there.

So, we made a small adjustment.

We lowered the dose.

Now yes, that can feel frightening. Naturally, people worry:

“If I lower it, I’ll gain the weight back.”

However, that didn’t happen.

Instead, what came back was enjoyment.

Now, let’s shift gears—because this is where things get interesting.

Every now and then, you need a snack. That’s normal. That’s life.

However, when it comes to protein bars, I have to be honest.

Most of them don’t taste like food.

Instead, they taste like wet sawdust. Or, perhaps more accurately, dry particle board with a chocolate label slapped on it.

Yes, they try. They add peanut butter flavor. They add cocoa.

But still, the texture is off. The taste is off. And ultimately, your brain knows it.

Now, to be fair, I do like some Aloha bars. They’re better than most.

But even then…

Recently, I skipped the bar.

Instead, I had something entirely different:

Tocino.

A few bites.

That’s all.

And yet, those few bites delivered something protein bars rarely do:

Flavor.

Real flavor.

Not engineered. Not simulated. Not “chocolate-adjacent.”

Actual spices. Actual cooking. Actual food.

And, frankly, it was fantastic.

Of course, I also tried one of those dried carnivore steak snacks.

Thirty-two dollars.

And honestly?

Awful.

Dry. Chewy. Completely joyless.

At that point, you’re not eating—you’re making a statement to someone online.

Instead, you’d be far better off flying to Spain and enjoying some

Jamón Ibérico.

Because then, at least, you get flavor. And culture. And an experience.

Most mornings, I have a smoothie.

And it works.

Specifically, I use oat milk, protein powder—this week I’m trying Ora pea protein—along with cocoa, coffee, blueberries, and a bit of banana.

It’s quick. It’s consistent. And importantly, it fits into life.

Especially when you’re stuck in California traffic.

In fact, traffic moves so slowly here that I didn’t even have to get out of the car to move a snail off the road—he made it across before I got there.

So yes, smoothies make sense.

Things change.

Now, there’s nothing wrong with a bowl of Cinnamon Chex.

It’s fine.

But often, I want something more.

So instead, I make:

• Poached eggs
• A splash of Louisiana Hot Sauce
• Pico de gallo
• Fresh tortillas
• Beans

And, of course, real salsa.

Not the jarred kind.

Instead, the kind that takes an afternoon to make. The kind that improves overnight. The kind your neighbor brings over—and yes, you briefly consider paying her to keep making it, before realizing that might get a little awkward.

At this point, you might think this is about “good food” versus “bad food.”

But it’s not.

Instead, it’s about awareness.

Because much of what we eat today comes from a system designed for convenience.

For example, extrusion—the process that creates cereals, protein bars, and many snack foods—makes food:

• Shelf-stable
• Affordable
• Easy to eat

And importantly, easy to overeat.

Because when food requires no effort…

You don’t stop.

There is nothing wrong with food.

Not with cereal. Not with protein bars. Not with convenience.

However, GLP-1 changes something fundamental.

It changes you.

Specifically, it allows you—sometimes even forces you—to slow down.

And because of that, you begin to:

• Notice flavor
• Take your time
• Actually enjoy what you eat

Before, I was filling my mouth before thinking.

And I was swallowing before experiencing.

Now?

I taste.

Because now, I can enjoy:

• The precision of fine dining
• The bold flavors of the Philippines
• The chunky salsa from my neighbor’s kitchen

And suddenly, eating less becomes… more.

More experience.

More appreciation.

More enjoyment.

There’s nothing wrong with Cinnamon Chex.

But it’s not a morning habit anymore.

Instead, it’s an every-now-and-then food.

It’s interesting.

But it’s not better.

Because once you start tasting food the way it’s meant to be tasted…

You don’t go back to eating it the way you used to.

Let’s start with the simplest truth.

A peptide is just a chain of amino acids—like pearls on a necklace. That’s it. Nothing mystical. Nothing magical.

However, structure matters. Sequence matters. Biology cares deeply about both.

Because of that, some peptides are extraordinarily powerful. Others are biologically interesting. And a growing number are simply… marketed.

That last category is where things get messy.

Now rewind to a hospital ward in Toronto in the early 1920s.

Children with diabetes were dying. Not slowly improving. Not plateauing. Dying.

Then Frederick Banting and Charles Best walked in with something crude and experimental.

Insulin.

They injected it.

The children woke up.

Not metaphorically. Not in a graph. They woke up. Families watched death reverse in real time.

That is what a peptide can do when it actually works.

Fast forward a few decades.

Out in the Southwest—near where I started my first job as a bariatric surgeon in Phoenix—lives the Gila monster. Not exactly a creature you expect to change medicine.

Yet inside its venom was a peptide that led, eventually, to drugs like:

Semaglutide

That discovery didn’t go straight to Instagram.

Instead, it went through:

• receptor biology
• pharmacology
• clinical trials
• outcomes research

And the results were real:

• lower blood sugar
• meaningful weight loss
• reduced cardiovascular risk

So yes, peptides can be extraordinary.

But only when the science is finished.

Now, enter the modern peptide market.

Suddenly, everything is a peptide. Everything promises:

• healing
• recovery
• fat loss
• anti-aging

You’ve seen the names:

• BPC-157
• TB-500
• CJC-1295
• Ipamorelin
• MOTS-c
• AOD-9604

Meanwhile, they are sold in places that should make you pause immediately.

Gyms.

Wellness clinics.

Online “research chemical” shops.

Rarely, if ever, through the same channels as actual medicine.

Start with the most famous one.

BPC-157 is marketed as a cure-all:

• tendon healing
• gut repair
• anti-inflammatory
• accelerated recovery

The claims are sweeping. The confidence is impressive.

But then you look at the evidence.

Animal studies? Yes.

Human randomized trials? No.

Long-term safety? Also no.

That gap matters.

Because when something claims to stimulate healing broadly, it raises an uncomfortable question:

What else might it stimulate?

The answer, at this point, is simple.

We don’t know.

Next comes TB-500.

It is sold as a recovery peptide. It promises faster healing and improved flexibility.

The biology is plausible. The mechanism sounds reasonable.

Yet human evidence for those claims is lacking.

Even so, it thrives in:

• bodybuilding circles
• performance clinics
• online forums

In other words, environments where anecdote travels faster than data.

Now we get to the hormone crowd.

CJC-1295 and Ipamorelin are sold as a stack. They stimulate growth hormone release.

That part is real.

What comes next is not.

Because increasing a hormone level is not the same as improving health.

We do not have strong evidence for:

• long-term outcomes
• safety over years
• meaningful clinical benefits

Still, they are marketed as anti-aging therapies.

That leap—from signal to certainty—is where the trouble begins.

Melanotan II is different.

It actually does something.

It increases pigmentation. It affects melanocortin receptors.

And with that comes:

• nausea
• blood pressure changes
• mole darkening
• documented toxicity

So here is the lesson.

When a peptide truly works, you don’t get silence. You get side effects.

The absence of side effects in marketing should never reassure you.

It should make you suspicious.

At the far end of the spectrum are peptides like AOD-9604 and MOTS-c.

They promise:

• targeted fat loss
• exercise-like metabolic effects
• longevity

The evidence?

Mostly cells and animals.

Yet they are already being sold, injected, and promoted.

At this point, we are not even pretending to wait for human data.

Now let’s talk about the vial.

Because this is where things shift from questionable to concerning.

Many of these peptides are:

• manufactured overseas
• shipped in bulk
• repackaged
• relabeled

They are often sold as:

• “research chemicals”
• “wellness therapies”

Independent testing has found:

• incorrect dosing
• contamination
• inconsistent purity

So when someone says they are taking a specific peptide, the real answer is uncertain.

They hope they are.

Recently, Robert F. Kennedy Jr. has pushed to expand access to peptides restricted by the FDA.

The argument is framed as freedom.

The FDA’s concern is simpler:

• lack of safety data
• risk of contamination
• unknown long-term effects

In other words, we do not yet know enough to call these safe.

That is not obstruction.

That is the job.

Now compare all of that to GLP-1 drugs.

They don’t just sound scientific.

They are scientific.

They:

• improve blood sugar
• reduce weight
• lower cardiovascular risk

Most importantly, they do this consistently, predictably, and measurably.

That is what happens when research goes the distance.

Peptides are not the problem.

Peptides gave us insulin.

Peptides gave us GLP-1.

At their best, they are among the most elegant tools in medicine.

But the current peptide market is not built on finished science.

Instead, it is built on possibility, dressed up as certainty.

And that difference matters.

Because the gap between “interesting biology” and “safe, effective therapy” is where patients get hurt.

The difference between a child waking up in a Toronto hospital…

and a vial purchased online…

is not the molecule.

It is the evidence.

Spend a few minutes on social media, and you will hear it. On Bill Maher's podcast the other day, I heard it. Two people who know less about GLP-1 drugs than almost anyone, opining about how GLP-1s are horrific.

Bill Maher says, “Just eat less.”

Jillian Michaels warns that GLP-1 medications are dangerous. Did she even graduate from college?

Meanwhile, a rotating cast of gym bros, coaches, and influencers insists that anyone using these medications is taking the easy way out.

At first glance, these seem like different voices. A comedian, a fitness personality, a group of online trainers.

However, they are all saying the same thing.

If you are overweight, this is your fault.

If you need help, you are weak.

If you use medication, you are cheating.

That message travels well. It is simple. It fits into a tweet. It sounds like common sense. Science shows us that fat shaming doesn't work (reference).

It is also wrong.

The fitness industry has something to lose here, and that part is easy to understand. Entire businesses are built on the idea that weight loss is a matter of discipline. Follow the plan, buy the program, track the macros, and success will follow. If it doesn’t, the explanation is built in.

You didn’t try hard enough.

However, the criticism does not stop there.

When someone like Bill Maher reduces obesity to “just eat less,” it is not about selling a diet plan. Instead, it reflects something else entirely. A kind of cultural impatience with complexity. A belief that if a problem can be described simply, it must also be solved simply.

And when that belief meets a condition like obesity, the result is dismissal.

If I don’t struggle with this, then it must not be real.

If you do struggle, then you must be doing something wrong.

That is not analysis.

That is a failure of imagination.

Medicine has a long history of being wrong in simple ways.

We once believed ulcers were caused by stress alone. Then came Helicobacter pylori and antibiotic treatment. We once thought hypertension was simply a matter of salt intake and personality. Then we developed therapies that addressed the underlying physiology.

Obesity has followed a similar path, except we have been slower to let go of the old explanation.

“Eat less, move more” is not incorrect.

It is incomplete.

Because it ignores the system that determines how much you want to eat, how often you think about food, and how your body responds when you try to lose weight.

For years, I saw the damage this thinking caused.

I ran support groups for patients struggling with weight. I watched them come in carrying not just pounds, but shame. They believed they were weak, that they lacked discipline, that something about them was broken.

We worked to change that.

We talked about biology. About appetite regulation. About how the body defends weight. We tried to replace blame with understanding.

And yet, I quietly held myself to a different standard.

I didn’t blame my patients.

I blamed myself.

If anyone should be able to power through something, it is a surgeon. That is the job. Endure long hours. Stay focused. Push through fatigue. Delay gratification.

So I assumed I could do the same with weight.

I tried diets. I cleaned things up. I ate vegetables, cut back on certain foods, and experimented with structure. And like many people, I saw results.

At first.

Weight loss is not the mystery.

Weight maintenance is.

Because over time, the same thing happened again and again. The body adapted. Hunger increased. Energy dipped. The system pushed back.

And eventually, the weight returned.

When you look beyond personal stories and examine long-term studies, the pattern becomes clear.

In the Diabetes Prevention Program, participants lost weight early, then gradually regained some of it. In the Look AHEAD trial, an intensive lifestyle intervention produced initial success, but the gap narrowed over time.

Observational data suggest that only a small percentage of people—often cited around 3 to 5 percent—maintain significant weight loss at five years.

That number should change the conversation.

Because it tells us this is not a widespread failure of discipline.

It is a predictable outcome of a biological system.

Weight gain does not happen in isolation. It is part of a loop.

Sleep worsens, which increases appetite. Movement becomes uncomfortable, so activity declines. Food becomes more rewarding, not less, because it offers relief.

Then intake increases.

Then the cycle repeats.

And yet, into that loop, we continue to insert the same advice.

Try harder.

For years, I thought I just needed to try harder myself.

I was wrong.

Today, I am down fifty pounds.

Not because I discovered a better diet, but because something changed in the system itself.

I started a GLP-1–based medication.

The effect was immediate in ways I did not expect. My sleep improved. My snoring stopped. That alone changed my appetite and energy. Then something else happened.

The noise went away.

That constant pull toward food, the background awareness that shapes decisions throughout the day, quieted.

From there, everything else followed.

I began moving more. I returned to yoga, not out of obligation, but because it felt good. Because my body allowed it.

This was not about replacing lifestyle.

It was about finally being able to live it.

When critics say this is the “easy way out,” they misunderstand what is happening.

There was nothing easy about fighting biology for years.

What these medications do is change the biology so that effort becomes effective.

That is not cheating.

That is treatment.

The fitness world is not going away.

However, it is going to change.

The coaches who succeed will not be the ones shaming people for using medication. Instead, they will be the ones who understand how to work with it. They will help people build muscle, improve movement, and develop sustainable eating patterns once appetite is regulated.

Mediterranean and DASH-style diets still matter. They remain among the best-supported dietary patterns for long-term health. What changes is the ability to follow them.

When the biology shifts, adherence becomes possible.

One of the most striking changes is how food feels.

You no longer need to treat eating as a constant negotiation. You can eat real food. Greek yogurt, eggs, vegetables, and fruit.

You can enjoy it.

You can eat a peach without worrying about whether you have broken a rule.

That is what happens when the noise quiets.

For a long time, I believed that effort alone would solve this.

I was wrong.

Not because effort doesn’t matter, but because effort without the right biology is not enough.

Science moves forward by showing us where we were incomplete. In this case, we were incomplete in how we understood obesity.

Now we are beginning to correct that.

And as we do, the conversation should change.

Less blame.

More understanding.

Less shame.

More treatment.

Because this was never about character.

It was always about biology.

Menopause changes more than temperature control. It reshapes how the brain handles hunger, fullness, and the quiet signals that guide eating. As a result, many women notice something unsettling. The same meals no longer satisfy. Hunger arrives sooner. Food feels louder.

For years, we blamed metabolism. We told women their bodies were simply slowing down. While that explanation sounds scientific, it misses the most important part of the story.

The brain has changed.

During my years performing weight loss surgery, about 80 percent of my patients were women. Over time, one pattern became impossible to overlook. When menopause or even perimenopause began, weight gain often followed.

Some women had struggled with weight for years. Others had never given it much thought. Yet both groups described the same shift. They weren’t necessarily eating more. Instead, they felt hungrier, less satisfied, and more aware of food throughout the day.

Meanwhile, the advice they received rarely evolved. Eat less. Move more. Try harder.

However, that advice assumes the system regulating hunger still works the same way. In menopause, it doesn’t.

To understand what’s happening, we need to look at the hypothalamus. This small but powerful region of the brain regulates appetite, energy balance, and hormonal signaling. Under normal conditions, estrogen helps keep this system stable.

Specifically, estrogen supports satiety signals and keeps hunger signals in check. In simple terms, it helps your brain recognize when you’ve had enough.

As estrogen declines, that balance shifts. Hunger signals grow stronger. Fullness signals become less reliable. Consequently, the internal experience of eating begins to change.

This shift explains why women often say, “I feel different around food,” even before their diet changes.

Interestingly, appetite changes often appear before measurable increases in calorie intake. Women report thinking about food more often, feeling less satisfied after meals, and noticing hunger earlier in the day.

At first glance, nothing looks different from the outside. Yet internally, the system has already shifted.

Because of that, traditional advice falls short. Telling someone to eat less without addressing the change in signaling is like adjusting the thermostat while ignoring the wiring.

Although metabolism does change with age, it does not fully explain the experience of menopause-related hunger. A slower metabolic rate might affect how calories are used, but it doesn’t explain why appetite feels louder or less controlled.

Instead, the better explanation lies in the brain. The hypothalamus responds differently when estrogen levels fall. As a result, the signals that guide eating become less precise.

In other words, this isn’t just about calories in and calories out. It’s about how the body decides when to eat—and when to stop.

For decades, menopause care focused on symptoms like hot flashes and bone health. Meanwhile, changes in appetite and weight were often attributed to lifestyle or willpower.

Unfortunately, that approach overlooked a key fact. Estrogen plays a direct role in appetite regulation.

Because of that, many women were told to push harder when their biology had already shifted. That message wasn’t just incomplete—it was unfair.

When clinicians discuss estrogen replacement, they often focus on symptom relief. However, estrogen also affects brain signaling related to hunger and satiety.

In the right patient, hormone therapy may help restore some of that balance. It can improve how the brain responds to fullness and reduce the intensity of hunger signals.

Importantly, hormone therapy does not inherently cause weight gain. That belief has persisted longer than the evidence supports.

Still, therapy isn’t for everyone. Each patient requires an individualized discussion that considers risks, benefits, and goals.

More recently, GLP-1 receptor agonists have added another dimension to this conversation. These medications act on the same appetite centers in the brain, strengthening satiety and quieting hunger.

Interestingly, estrogen appears to enhance the effectiveness of GLP-1 signaling. Therefore, menopause may not only reduce estrogen levels—it may also decrease the brain’s responsiveness to satiety cues.

This interaction helps explain why some women experience such a dramatic shift in appetite during midlife.

Once you understand the biology, the approach changes.

Rather than focusing solely on restriction, the goal becomes supporting satiety. Meals should include enough protein, fiber, and volume to sustain fullness. Additionally, sleep deserves attention, as poor sleep amplifies hunger signals. Medication reviews also matter, since some drugs can contribute to weight gain.

For some women, hormone therapy or GLP-1 medications may play a role. For others, dietary structure and lifestyle adjustments provide meaningful improvement.

In every case, the strategy should match the physiology.

Menopause is not a failure of discipline. It is a shift in how the brain regulates hunger.

Once that shift is acknowledged, the conversation becomes more productive. Women can stop blaming themselves and start working with their biology.

Ultimately, the goal isn’t to fight hunger. It’s to understand it.

Menopause doesn’t break the system—it changes the signal.

And once you understand the signal, you can respond with clarity instead of frustration.

Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie. 2022. Mahboobifard F, Pourgholami MH, Jorjani M, et al.

There is a moment in history that most of us think we understand. King Henry VIII—large, immobile, temperamental—has become almost a caricature of excess. We picture a man who simply ate too much, moved too little, and paid the price. It is a tidy story. Unfortunately, it is also likely the wrong one.

Before the 1530s, Henry was something very different. He was athletic, charismatic, and energetic. He hunted, he jousted, he played sports, and he carried himself like the Renaissance ideal—educated, capable, and physically impressive. His armor, still preserved today, tells that story clearly. Narrow waist. Broad chest. Built for motion.

Then everything changes.

In January of 1536, Henry was thrown from his horse during a jousting match. The horse fell on him. He was reportedly unconscious for hours. Not minutes—hours. Even by modern standards, that is a significant traumatic brain injury.

Soon after, in May of that same year, Anne Boleyn was arrested and executed. She was accused not only of adultery but also of witchcraft. That detail matters. Prior to this period, Henry was not known for superstition. He was a rational thinker. Yet suddenly, accusations of witchcraft become part of the story. It is tempting to say this was political theater. It may have been. Still, the timing is difficult to ignore.

Meanwhile, his body begins to change.

At first, historians explained this in simple terms. He ate more. He exercised less. Calories in, calories out. That explanation sounds neat. It fits what we like to believe. Even so, the math does not hold up.

To gain over 200 pounds, you need a massive and sustained excess of calories. A reduction in physical activity alone does not explain that. We measure activity in METS—metabolic equivalents—and even a dramatic drop in activity would not account for that level of weight gain. In other words, you cannot outrun the math.

Yet every January, gyms fill with people who are told exactly that. Move more. Try harder. Burn it off. By February, most of those gyms are empty again. If exercise alone solved obesity, we would not still have the problem.

So what did we miss?

The answer sits deep in the brain, in a small but powerful structure called the hypothalamus. It regulates hunger, satiety, hormones, and stress. When it works, eating feels normal. You get hungry, you eat, you stop. No drama. No constant thinking.

However, when the hypothalamus is disrupted—by injury, disease, or chronic metabolic stress—that quiet system becomes loud. Hunger no longer behaves like a signal. It becomes a drive.

This is not theory. Modern medicine has a name for it: acquired hypothalamic obesity. After traumatic brain injury, some patients develop rapid weight gain, persistent hunger, and changes in impulse control. Studies show that nearly half of patients with significant brain injury gain weight over time. The strongest predictor is not inactivity. It is hyperphagia—an abnormal increase in appetite.

In simpler terms, the problem is not how much people move. It is what their brain is telling them to do.

That pattern feels familiar if you have ever sat with patients. I have. Years ago, working with former NFL players, we noticed something striking. The players who struggled most with weight often had long histories of concussions. Not all of them gained weight. Yet those who did described the same experience—something they had never felt before.

Food noise.

Not hunger. Noise. A constant suggestion that does not go away.

At first, I understood that as a physician. Later, I understood it as a person.

About twelve hours after my first injection of Zepbound, something changed. The world became quiet. For the first time, I realized how much of my thinking had been shaped by that background noise. It did not disappear dramatically. It simply stopped.

Since then, I have lost fifty pounds. More interesting than the weight loss is what happens between doses. As the medication wears off, the noise returns—subtly at first. A thought here. A reminder there. Even my stress levels rise slightly, something I can see on my WHOOP device. Then, a few hours after the next injection, it quiets again.

That experience changes how you see patients. It changes how you see history.

Because now, when we look back at Henry, we are not just looking at excess. We are looking at a possible disruption of the system that regulates behavior itself.

There are hints of this even in his own time. A French ambassador noted that Henry’s chronic leg pain troubled him often and that he compensated by eating and drinking more. Later reconstructions suggest large meals, heavy in meat, along with substantial alcohol intake. Those numbers are estimates, not precise measurements. Even so, the pattern is clear.

Something was driving the behavior.

By the end of his life, Henry could barely move. Mechanical devices were needed to help him stand. He lost close allies, including Thomas Wolsey and Thomas More. His body deteriorated. His mood worsened. This was not simply indulgence. It was decline.

Today, we have tools that speak directly to that system. GLP-1 medications do not give people discipline. They restore control. Patients do not say they are stronger. They say it is quieter.

That distinction matters.

Because obesity was never just about calories. It was about signaling and about biology. It was about a system that, once disrupted, can push behavior in ways that are very difficult to resist.

So when we look at Henry VIII, we should be careful before we judge him as a man who simply lacked restraint.

We may not know exactly how much he ate.

Nevertheless, we know something was driving it.

And when we ignore that truth today, we do more than misunderstand the disease.

We blame the patient for having it.

References

Argente J, Farooqi IS, Chowen JA, Kühnen P, López M, Morselli E, Gan HW, Spoudeas HA, Wabitsch M, Tena-Sempere M. Hypothalamic obesity: from basic mechanisms to clinical perspectives. Lancet Diabetes Endocrinol. 2025 Jan;13(1):57-68. doi: 10.1016/S2213-8587(24)00283-3. Epub 2024 Nov 12. Erratum in: Lancet Diabetes Endocrinol. 2025 Jan;13(1):e1. doi: 10.1016/S2213-8587(24)00368-1. PMID: 39547253.

Nutrition debates rarely begin with money. Yet money almost always explains how they spread.

That fact explains much of the modern carnivore movement.

At first glance, the carnivore diet appears to be a radical nutritional idea: eat beef, organs, and animal fat while avoiding vegetables, grains, legumes, and most fruits. Advocates often present the idea as a return to ancestral eating. According to the story, prehistoric humans thrived on meat, and modern illness appeared only after plants and processed foods entered the menu.

However, once you look past the rhetoric, another pattern appears. The carnivore movement did not grow out of decades of clinical research. Instead, it grew out of a very modern ecosystem: social media, podcasts, influencer culture, and supplement companies.

And once that ecosystem forms, the incentives become clear.

First, someone declares that conventional nutrition science has misled the public. Next, they present a dramatically simple solution. Afterward, they build a community around that solution. Eventually, products appear—supplements, coaching programs, special meat boxes, laboratory panels, and branded lifestyle advice.

In other words, the diet becomes the marketing engine.

And beef becomes the sacrament.

Extreme diets succeed for a reason. Complexity frustrates people, while simplicity reassures them.

“Eat a balanced diet rich in vegetables, whole grains, legumes, fish, and moderate meat” may represent excellent advice supported by decades of research. Unfortunately, that advice does not travel well on social media.

By contrast, statements such as “plants are poison” or “fiber is unnecessary” spread rapidly. Bold claims generate engagement. Engagement produces followers. Followers create revenue streams.

Consequently, the carnivore diet does not function only as a nutritional recommendation. It functions as a brand.

Once someone builds that brand, they must defend it.

Every belief system eventually develops its prophets, and the carnivore world found one in a man who called himself Liver King.

He appeared online with an enormous beard, an even larger physique, and a simple message: modern men had grown weak because they had abandoned the practices of their prehistoric ancestors. According to his message, people should eat raw organs, train like cavemen, reject modern foods, and adopt “ancestral living.”

Conveniently, the ancestral lifestyle also included supplements he sold through his company.

The marketing proved effective. The image of a muscular barbarian rejecting modern science attracted millions of followers and produced a supplement business worth tens of millions of dollars.

Unfortunately, the story collapsed in 2022 when leaked emails revealed the Liver King spent more than $10,000 per month on anabolic steroids and other performance-enhancing drugs. Shortly afterward, he admitted publicly what physicians suspected from the beginning.

Raw liver did not build that physique.

Pharmacology did.

Nevertheless, the episode illustrates the economic logic of the carnivore movement. First comes the doctrine. Then comes the identity. Finally, come the products.

Movements rarely survive on prophets alone. They also require theologians—people who explain the doctrine with intellectual confidence.

Within the carnivore community, one of the most prominent interpreters has been Paul Saladino, a physician originally trained in psychiatry who later rebranded himself as Carnivore MD.

For several years, his message remained uncompromising. Plants contained toxins. Vegetables acted as chemical weapons. Humans thrived best on meat, organs, and animal fat. His book The Carnivore Code argued that modern civilization misunderstood nutrition and that health required a return to meat-centered eating.

However, the human body eventually entered the conversation.

After spending years on a strict carnivore diet, Saladino described several physiological problems: poor sleep, heart palpitations, muscle cramps, and hormonal changes. Consequently, the diet evolved.

Fruit appeared. Honey appeared. Raw dairy appeared.

Today, the diet carries a new label—an “animal-based diet.” In practice, that means meat accompanied by carbohydrates from fruit and honey.

In other words, the diet rediscovered sugar.

This pattern appears frequently in nutrition movements. Early stages emphasize purity and certainty. Later stages quietly reintroduce flexibility when biology refuses to cooperate.

Also, Paul is partners with Liver King.

The economic component remains impossible to ignore.

Carnivore influencers rarely restrict themselves to books and podcasts. Instead, they build supplement companies that sell freeze-dried organs, nutrient capsules, and other “ancestral” products. The marketing narrative follows a familiar path.

Modern food supposedly lacks essential nutrients.

Ancient diets supposedly provided them.

Supplements conveniently deliver them.

When followers adopt the diet, they often purchase the products associated with it. Over time, they invest not only money, but identity in the movement. As a result, they defend the doctrine aggressively, particularly when new treatments threaten the narrative.

This dynamic explains the hostility many carnivore influencers display toward GLP-1 medications, such as semaglutide and tirzepatide.

GLP-1 drugs reduce appetite, improve metabolic health, and produce significant weight loss in clinical trials. For many patients, they represent the most effective medical treatment for obesity ever developed.

However, GLP-1 therapy undermines the core promise of the carnivore movement. Influencers claim that diet alone solves metabolic disease. Pharmaceutical treatments challenge that claim.

Moreover, if people lose weight and improve their health through medical therapy, they may no longer feel compelled to purchase expensive supplements or coaching programs.

Consequently, the drugs become ideological enemies.

Carnivore influencers often portray GLP-1 medications as dangerous, unnatural, or morally suspect. Their followers repeat these arguments across social media platforms, especially on X (formerly Twitter), where the debate frequently resembles a religious dispute, not a scientific discussion.

Within this worldview, GLP-1 therapy resembles a rival faith.

And rival faiths provoke rebellion.

Carnivore advocates occasionally invoke another argument that sounds persuasive until examined closely.

If humans historically consumed vegetables, they ask, why do cave paintings rarely depict them?

The answer lies in the purpose of cave art.

Prehistoric artists painted dramatic events—hunts, animals, danger, survival. These images celebrated moments that mattered in a world where food sometimes fought back.

Nobody returned from hunting mammoths and announced, “Let us commemorate this carrot.”

Cave art told stories.

It did not document grocery lists.

Moreover, the absence of broccoli in cave paintings has an obvious explanation. Broccoli did not exist during the Paleolithic era. Mediterranean farmers cultivated it from wild brassica plants thousands of years later, likely beginning with the Etruscans.

Using cave paintings to prove humans were carnivores resembles using medieval paintings to argue that humans never drank coffee.

Anthropology provides a far more realistic picture.

Scientists studying ancient bones, tools, and coprolites—preserved human feces—consistently find evidence of diverse diets that included roots, tubers, fruits, seeds, fish, and meat.

Geography shaped these diets. Arctic populations consumed more animal foods, while equatorial societies relied heavily on plants.

However, no civilization in human history survived entirely on beef.

Flexibility—not purity—allowed our species to thrive.

Carnivore advocates rarely discuss another drawback of the diet.

It is monotonous.

Human cuisine represents one of the great achievements of civilization. Across cultures, people combine vegetables, grains, spices, and animal foods into extraordinary traditions that reflect geography and history.

Reducing that diversity to an endless rotation of ribeye steaks diminishes both nutrition and culture.

Beef remains delicious. I enjoy it myself. Growing up on a small island in Alaska, I rarely saw beef because it cost too much to ship. Consequently, it felt special when it appeared at the table.

Yet eating beef every day does not create cuisine.

It creates repetition.

Many readers ask a simple question: Is the carnivore diet safe? Short-term, some people lose weight on a carnivore diet because they eliminate ultra-processed foods and increase protein intake. However, long-term health outcomes remain far less reassuring. Diets that exclude vegetables, legumes, fruits, and whole grains remove important sources of fiber, phytonutrients, and micronutrients that support gut health, metabolic regulation, and cardiovascular protection. Large population studies consistently associate dietary patterns rich in plant foods—such as the Mediterranean diet—with lower risks of heart disease, diabetes, and certain cancers. In contrast, diets dominated by red meat and lacking dietary fiber raise concerns about cardiovascular disease, colon health, and long-term metabolic effects. In other words, the real question is not whether beef can be part of a healthy diet—it certainly can—but whether eliminating most other foods improves health. Current scientific evidence suggests the answer is no.

Beef is nutritious.

Steak is wonderful.

But beef does not deserve a priesthood.

When a diet eliminates half the grocery store, sells supplements as sacred tools, and treats competing medical therapies as heresy, the conversation no longer resembles science.

Instead, it begins to resemble theology.

And theology rarely improves nutrition.

1. Willett W et al. Mediterranean diet and cardiovascular disease. N Engl J Med. 2018
2. Satija A, Hu FB. Plant-based diets and cardiometabolic health. JAMA Intern Med. 2017
3. O’Keefe SJ. Diet, microbiome, and colon health. Nat Rev Gastroenterol Hepatol. 2019
4. IARC Working Group. Red and processed meat and cancer risk. Lancet Oncology. 2015
5. Eaton SB, Konner M. Paleolithic nutrition revisited. NEJM. 1985

Every few years, someone announces the solution to weight loss.

Eat less.

Fast longer.

Cut carbs.

Cut fat.

Cut something.

Naturally, the advice usually comes with a tone of moral certainty. If you are hungry, the implication goes, you simply lack discipline.

However, long before social media, diet influencers, and the phrase food noise entered the modern vocabulary, scientists ran an extraordinary experiment that revealed something profound about hunger.

Rather than speculate about appetite, they studied it directly.

In the middle of World War II, researchers deliberately starved healthy young men.

The results changed how we understand hunger forever.

During World War II, much of Europe faced severe food shortages. Cities were bombed, farms disrupted, and supply chains shattered. Consequently, millions of civilians were suffering from malnutrition and starvation.

Yet another problem quickly emerged. Refeeding starving populations turned out to be complicated. If nourishment returned too quickly, dangerous metabolic complications could occur. Doctors needed to understand not only starvation but also recovery from starvation.

Therefore, the U.S. government supported research designed to answer a simple but critical question:

What happens to the human body and mind when calories are severely restricted for long periods?

The scientist leading that effort was Dr. Ancel Keys at the University of Minnesota.

Today, Keys is often remembered for his later work on diet and heart disease. Nevertheless, his wartime research produced one of the most remarkable studies ever conducted in nutrition science.

The results were eventually published in a monumental two-volume work titled:

“The Biology of Human Starvation.”

This massive text, published in 1950, remains one of the most detailed examinations of hunger ever written.

KEYS, ANCEL, JOSEF BROŽEK, AUSTIN HENSCHEL, OLAF MICKELSEN, HENRY LONGSTREET TAYLOR, Ernst Simonson, Angie Sturgeon Skinner, et al. The Biology of Human Starvation: Volume I. University of Minnesota Press, 1950. https://doi.org/10.5749/j.ctv9b2tqv.

To conduct the study, Keys recruited 36 conscientious objectors.

These men had refused military service during World War II for moral or religious reasons. Nonetheless, they still wanted to contribute to the war effort. Participating in this experiment became their way of helping.

Importantly, the volunteers were healthy young men. They had normal body weight, good physical fitness, and no significant psychological problems. In other words, they were ideal research subjects.

Furthermore, they understood the risks.

They would experience months of severe caloric restriction.

Even more remarkable, the experiment took place beneath the University of Minnesota football stadium, turning an athletic facility into one of the most important laboratories in nutrition history.

The study unfolded in three distinct phases.

First came the baseline period. For several months, the men ate normally, consuming approximately 3,200 calories per day. Researchers measured body weight, metabolism, and psychological health to establish a stable starting point.

Next came the central part of the experiment: six months of semi-starvation.

During this period, calorie intake dropped to roughly 1,500 calories per day. That number may sound familiar because many modern diet programs recommend similar intake levels.

The food itself resembled wartime rations. Participants ate simple meals consisting primarily of potatoes, bread, macaroni, turnips, and small amounts of dairy.

Although the men remained physically active, their energy intake was cut in half.

Finally, the experiment concluded with a refeeding phase designed to observe how the body recovers after prolonged starvation.

Researchers expected weight loss.

What surprised them was the dramatic change in the men’s relationship with food.

Gradually, the volunteers became completely preoccupied with eating.

First, they began collecting recipes. Soon afterward, they spent hours reading cookbooks.

Remember that this was long before television cooking shows or the Food Network. Nevertheless, these men read cookbooks the way other people read novels.

Additionally, food became the center of conversation. Participants talked about meals constantly. They debated cooking techniques and discussed ingredients in remarkable detail.

Meanwhile, eating itself changed dramatically.

Many men developed elaborate food rituals. Some cut meals into tiny pieces to make them last longer. Others chewed gum continuously to quiet hunger. Still others drank large amounts of water or coffee simply to fill their stomachs.

Eventually, several participants reported dreaming about food every night.

At that point, hunger had completely dominated their mental landscape.

Alongside this intense food focus came significant psychological changes.

Participants became irritable.

Mood declined.

Social withdrawal increased.

Furthermore, many men lost interest in hobbies and normal activities. Concentration dropped, and emotional resilience weakened.

However, one topic continued to command their attention:

Food.

In modern terms, we might describe this state as persistent food noise—the constant internal dialogue about eating that many individuals with obesity describe today.

The Minnesota experiment demonstrated something important: when the human body senses prolonged energy shortage, the brain amplifies signals related to food.

That response is not weakness.

Instead, it is survival.

The most striking results appeared during the recovery phase.

Once calorie restrictions ended, participants were allowed to eat freely again. Unsurprisingly, many men consumed enormous amounts of food.

Daily intake sometimes reached 5,000 to 10,000 calories.

Importantly, this response was not driven by pleasure alone. Rather, the body was attempting to restore lost energy reserves and rebuild metabolic balance.

Researchers observed that appetite remained elevated for months after the starvation phase ended. In some cases, normal appetite regulation took more than a year to return.

Consequently, the study revealed that hunger leaves a lasting biological imprint.

Although the Minnesota Starvation Experiment occurred more than eighty years ago, its lessons remain highly relevant.

Modern weight-loss advice often emphasizes simple calorie restriction. People are told to eat less, ignore cravings, and rely on willpower.

Yet the Minnesota study demonstrates that prolonged calorie restriction triggers powerful biological responses.

Hunger intensifies.

Food becomes mentally dominant.

Motivation to eat grows stronger.

In other words, the brain fights back.

From an evolutionary perspective, this response makes perfect sense. Humans evolved in environments where food scarcity threatened survival. Therefore, the brain developed mechanisms to detect energy deficit and prioritize eating.

Those mechanisms remain active today.

Modern neuroscience offers further insight into what the Minnesota researchers observed.

Several brain regions participate in appetite regulation. The hypothalamus monitors energy balance through hormones such as leptin, ghrelin, and insulin. Meanwhile, motivational circuits—including the nucleus accumbens—integrate metabolic signals with behavioral drive.

When energy stores decline, these systems increase the motivational pull toward food.

Consequently, thoughts about eating become more persistent and more difficult to ignore.

This process resembles what many patients describe as food noise—a continuous internal signal urging them toward food.

The Minnesota experiment showed that this phenomenon can arise even in healthy individuals when calories remain restricted long enough.

Today, treatments for obesity increasingly focus on restoring normal appetite regulation rather than relying solely on behavioral restraint.

Medications known as GLP-1 receptor agonists offer one example.

Patients using these therapies often report something striking. Many say that the constant mental chatter about food becomes quieter. Meals feel satisfying sooner, and cravings diminish.

In other words, regulation returns.

These observations reinforce an important idea: overeating may not reflect a lack of discipline. Instead, it may result from disrupted biological signaling.

More than seventy years later, the Minnesota Starvation Experiment remains one of the most illuminating studies in nutrition science.

Its findings continue to inform research on appetite, metabolism, and obesity treatment.

Equally important, the work stands as a testament to careful scientific inquiry. The volunteers endured months of hardship so that future physicians could better understand starvation and recovery.

Their sacrifice produced knowledge that still shapes medicine today.

And the book that documented the study—“The Biology of Human Starvation”—remains a landmark text in the scientific literature.

Hunger is not a character flaw.

Instead, it is a biological signal designed to protect survival.

The Minnesota Starvation Experiment revealed that when humans face prolonged calorie restriction, the mind naturally becomes focused on food.

Rather than proving weakness, that response demonstrates how powerfully the body protects itself.

Understanding that reality allows medicine to approach nutrition and obesity with greater compassion—and far better science.