GLP-1 medications like Ozempic, Wegovy, and Mounjaro have become household names, celebrated as breakthrough treatments for weight loss and obesity. But while headlines showcase dramatic before-and-after photos and promises of rapid transformation, when we step beyond the marketing, a more nuanced reality comes to light.

In this candid conversation, Dr. Mark Cucuzzella, a family medicine physician, and Dr. Tro Kalayjian, board-certified in internal and obesity medicine, draw on decades of clinical experience to examine where GLP-1s truly shine, where they fall short, and why the foundation for lasting health can’t come from a prescription alone.

They make the case for integrating GLP-1s into a comprehensive care plan, one that addresses nutrition, movement, sleep, and stress. Without these pillars, patients face higher risks of side effects, reduced long-term benefits, and the all-too-common rebound weight gain.

In this interview, you’ll learn:

• Which patients benefit most from GLP-1 therapy (and which may not)
• How “medication stewardship” ensures safe, responsible use
• Why starting at the lowest effective dose and tapering matters
• How lifestyle-first programs can match or exceed drug results at a fraction of the cost

Drs. Cucuzzella and Kalayjian remind us that true success lies in restoring metabolic health and building habits that last long after the injection ends. GLP-1 medications can be powerful allies, but they’re not a silver bullet. Without a foundation of nutrition, movement, sleep, and stress management, they risk becoming just another short-term fix.

Expert Featured:

Dr. Mark Cucuzzella

• Website: https://www.drmarksdesk.com/

Dr. Tro Kalayjian

• Website: https://toward.health/
• IG: https://www.instagram.com/doctortro/
• X: https://x.com/DoctorTro

Resources Mentioned:

TOWARD: a metabolic intervention that improves addiction and binge eating symptoms

• https://doi.org/10.3389/fpsyt.2025.1612551

CMEs Mentioned:

Managing Major Mental Illness with Dietary Change: The New Science of Hope

• https://www.mycme.com/courses/managing-major-mental-illness-with-dietary-change-9616

Brain Energy: The Metabolic Theory of Mental Illness

• https://www.mycme.com/courses/brain-energy-the-metabolic-theory-of-mental-illness-9615

Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.

Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/

About us:

Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.

Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

What is treatment resistant depression and perhaps more importantly, what does it say about the ineffective care many receive?

Treatment-resistant depression (TRD) is defined as major depressive disorder (MDD) that fails to respond to at least 2 anti-depressant medications.

Nearly 10% of the adult population in the U.S. experience a major depressive episode each year. The numbers in our youth are even more alarming with some studies suggesting that between 40-50% of college-aged students are living with depression.

While anti-depressant medications tend to be the first-line treatment for MDD, as Dr. Georgia Ede highlights, “it’s more common not to respond to standard antidepressants than it is to respond to them.”

This makes TRD the “norm”, but the name itself is misleading.

It doesn’t mean your brain is broken or that you’ve run out of options. In fact, it says more about the limits of our current standard of treatments than about you.

In this first episode of a three-part series, cardiologist Dr. Bret Scher sits down with Harvard-trained psychiatrist @GeorgiaEdeMD‬ to unpack what treatment-resistant depression really means, why it’s more common than most people think, and why the term can be so harmful.

In this episode, you’ll learn:

• How depression is diagnosed
• The surprising prevalence of TRD
• Why antidepressants often fail to deliver lasting relief
• The biological factors (from inflammation to metabolic dysfunction) that may be driving MDD
• The importance of broadening the treatment toolbox beyond medication

If you or someone you love has been labeled with “treatment-resistant” depression, this conversation is an important reminder: there are other options to explore, and more importantly, there is hope.

Be on the lookout for episode 2 of this 3-part TRD series, where Dr. Scher and Dr. Ede cover alternative treatments and cutting-edge therapies including neurostimulation, psychedelic-assisted therapy, and metabolic interventions that could offer new hope.

Expert Featured:

Dr. Georgia Ede

• Website: https://www.diagnosisdiet.com/
• Book: https://www.diagnosisdiet.com/change-your-diet-change-your-mind
• YouTube: ‪@GeorgiaEdeMD‬
• X: https://x.com/GeorgiaEdeMD
• IG: https://www.instagram.com/georgiaedemd/

Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.

Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/

About us:

Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.

Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

Is food addiction a mental illness? Should ultra-processed foods rich in sugar and refined carbohydrates be classified alongside alcohol, nicotine, and other addictive substances linked to substance use disorders?

Food addiction (especially to processed, packaged, carb-heavy foods) is real, widespread, and often misunderstood by both the public and healthcare professionals.

Dr. Bret Scher and Dr. Georgia Ede sit down with Dr. Jen Unwin, a psychologist with over 30 years of NHS experience, to explore the science, diagnostic challenges, and recovery strategies for ultra-processed food addiction.

In this interview, you’ll learn:

• Why food addiction isn’t yet formally recognized as a substance use disorder
• How food addiction differs from emotional or disordered eating
• Biological mechanisms driving addictive patterns, such as dopamine spikes from refined carbohydrates
• The six WHO criteria for substance use disorder and how they apply to food
• The role of ketogenic and low-carb diets in recovery from food addiction
• The influence of artificial sweeteners
• The importance of defining the addictive substances involved

You’ll hear practical strategies for treatment, including abstinence-based approaches, personalized dietary plans, group support, and brain-retraining education. The conversation also explores the rise of GLP-1 medications—where they can help, where they fall short, and how they compare to dietary interventions in addressing root causes.

If you or your patients struggle with cravings, cycles of relapse, or feelings of helplessness around food, this discussion offers hope, clarity, and actionable next steps toward lasting recovery.

Expert Featured:

Dr. Jen Unwin

• https://x.com/drjenunwin
• www.the-chc.org

Dr. Georgia Ede

• ‪@GeorgiaEdeMD‬

Resources Mentioned:

The International Food Addiction Conference

• www.the-chc.org/fas/conference

Dr. Unwin’s Book

• https://www.amazon.com/Fork-Road-Hopeful-Guide-Freedom-ebook/dp/B08XZL1LLJ/

CME’s Mentioned:

Managing Major Mental Illness with Dietary Change: The New Science of Hope

• https://www.mycme.com/courses/managing-major-mental-illness-with-dietary-change-9616

Brain Energy: The Metabolic Theory of Mental Illness

• https://www.mycme.com/courses/brain-energy-the-metabolic-theory-of-mental-illness-9615

Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.

Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/

About us:

Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.

Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

Ketogenic therapy for mental health is gaining traction, but what happens when it doesn’t seem to work or even makes things worse?

In this episode, Dr. Georgia Ede and Dr. Bret Scher answer some of the most common questions about ketogenic diets, including what to do when your mental health doesn’t improve, how to properly enter ketosis, and why sweeteners, snacks, and dairy might be holding you back.

They break down the difference between a ketogenic diet and ketogenic therapy, and why things like ketone levels, medication adjustments, and lifestyle factors matter. You’ll also learn why some people experience initial worsening symptoms, how to transition more gradually, and when to seek support from experienced clinicians.

From food choices to long-term outcomes, this episode covers key troubleshooting strategies for making ketogenic therapy work for your brain and body.

Have questions about ketogenic therapy and mental health? Drop them in the comments, we’d love to hear from you!

Expert Featured:

• Dr. Georgia Ede

Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.

Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/

About us:

Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.

Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

Is high protein intake responsible for chronic kidney disease? Have you ever heard that ketogenic diets are harmful to your kidneys?

These are just a few of the common kidney health myths debunked in this interview with Dr. Thomas Weimbs, who says that traditional views on what causes chronic kidney disease are “definitely not founded in science.”

Dr. Thomas Weimbs, professor and vice chair at UC Santa Barbara, has spent decades studying chronic kidney disease (CKD). His recent research explores the impact of ketogenic interventions on kidney function, and the findings may surprise you. Rather than harming the kidneys, Dr. Weimbs is finding that keto can actually improve kidney function in people living with CKD.

According to Dr. Weimbs, “Clearly, the number one cause of chronic kidney disease is not protein in excess—it’s, of course, carbohydrates in excess and type 2 diabetes. Insulin resistance is causing chronic kidney disease.”

In this episode, you’ll learn:

• Why longstanding myths about protein and kidney function need to be re-examined
• Why misconceptions around keto and kidney health exist
• How ketogenic diets are showing promise for chronic kidney disease (including PKD)
• About results from randomized controlled trials and the 2-year Virta Health study
• How ketones may directly benefit kidney health

Dr. Weimbs also shares insights from his lab’s ongoing research—findings that challenge conventional thinking and call for a re-examination of how we understand and treat chronic kidney disease.

Expert Featured:

• Dr. Thomas Weimbs
• https://www.facebook.com/groups/256099897773551/
• https://santabarbaranutrients.com/

CMEs Mentioned:

Managing Major Mental Illness with Dietary Change: The New Science of Hope

• https://www.mycme.com/courses/managing-major-mental-illness-with-dietary-change-9616

Brain Energy: The Metabolic Theory of Mental Illness

• https://www.mycme.com/courses/brain-energy-the-metabolic-theory-of-mental-illness-9615

Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.

Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/

About us:

Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.

Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

What’s the difference between a low-carb diet and a ketogenic diet, especially when it comes to mental health?

In this premiere Mailbag episode, Dr. Bret Scher (Medical Director at Metabolic Mind) and Harvard trained psychiatrist Dr. Georgia Ede answer some of the most common questions they receive about ketogenic diets specifically for mental illness.

Whether you're new to ketogenic therapy or have been experimenting for years, this discussion offers valuable clarity on concepts that often cause confusion, even among clinicians.

💡 Topics covered include:

• The difference between low-carb and ketogenic diets for mental health
• Why being “in ketosis” matters more than just eating low carb
• How high ketones may need to be for mood and psychiatric benefit
• When (and how often) to test ketone levels
• Factors that may affect your ability to stay in ketosis, including stress, sleep, exercise, and protein intake
• Whether a ketogenic diet needs to be lifelong for mental health benefits
• When (or if) supplements like MCT oil or exogenous ketones are appropriate

This episode is not a deep dive into every topic, but it sets the stage for future discussions—and highlights just how individualized ketogenic therapy can be.

📬 Have a question for Dr. Ede and Dr. Scher?

Leave a comment below or DM us on Instagram or X/Twitter (@MetabolicMind). Your question may be featured in a future Mailbag episode!

🔗 Learn more about ketogenic therapy for mental health: https://www.metabolicmind.org

#KetogenicDiet #MentalHealth #LowCarbVsKeto #DrGeorgiaEde #DrBretScher #MetabolicPsychiatry #NutritionForMentalHealth #BrainEnergy #Ketosis #Depression #BipolarDisorder #Schizophrenia #MailbagEpisode #MetabolicMind

Expert Featured:

• Dr. Bret Sher
• Dr. Georgia Ede

Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.

Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/

About us:

Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.

Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

GLP-1 medications like Ozempic and Wegovy are changing how the medical system approaches obesity and metabolic disease. But are they a replacement for dietary intervention? Or are dietary interventions a replacement for these medications? Could they be used together for even better outcomes?

In this conversation, Dr. David Ludwig (Harvard, Boston Children’s Hospital) and journalist Gary Taubes explore the science behind GLP-1s, their impact on insulin, weight loss, and chronic disease, and where dietary strategies like low carb or ketogenic therapy fit in.

They break down:

• The overlap between GLP-1 drugs and low carb diets
• Why long-term use of these drugs may come with hidden costs
• How shared mechanisms open the door to combination therapy
• What current studies are missing and the urgent need for better trials
• Why metabolic health (not just weight loss) should be the focus

This conversation challenges the idea that the answer is either medication or nutrition therapy. The reality is that every individual is different, and for many, the most effective path to healing may involve a thoughtful combination of both. Rather than choosing one over the other, we should focus on tailoring care to the unique needs of each individual with the goal of getting the best outcomes.

Expert Featured:

Dr. David Ludwig

• X: https://x.com/davidludwigmd

Gary Taubes

• https://x.com/garytaubes
• https://uncertaintyprinciples.substack.com/

Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.

Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/

About us:

Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.

Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

Ketogenic therapy for mental illness is changing lives. And now, it’s becoming more accessible than ever.

Dr. Bret Scher chats with licensed mental health counselor Nicole Laurent about her innovative online program and nonprofit initiative aimed at providing low-to-no-cost metabolic therapy support to people with serious mental illness.

Nicole shares how her own journey through cognitive impairment led her to ketogenic therapy, and how that experience transformed her clinical practice. Today, her Brain Fog Recovery Program is helping individuals with Schizophrenia Spectrum Disorder, bipolar disorder, anxiety, depression, early Alzheimer's, and more—many of whom are on disability and unable to access traditional care options.

We at Baszucki Group were proud to offer a matching grant to help Nicole expand access to more people in need, and we’re happy to report that the matching goal has been reached between the time of recording and posting. However, that is not the end of the support needed to expand the capabilities and awareness of this life-changing program.

Topics discussed:

• Why ketogenic therapy can be so effective for mental illness
• How Nicole’s program offers structured, compassionate support
• Her nonprofit’s mission to serve low-income and disabled populations
• What the fundraising campaign is doing to expand access
• How to sign up for the program or contribute to its growth

Expert Featured:

• Nicole Laurent, LMHC

Resources Mentioned:

• Visit: https://www.every.org/brain-fog-recovery-source
• 📩 Email for nonprofit access: [email protected]
• 📩 Email for private consultation: [email protected]

Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.

Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/

About us:

Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.

Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

Does psychiatric medication withdrawal exist — or is it just a myth?

For anyone who’s lived through it, the question alone can feel insulting.

Psychiatric drug withdrawal is real. While the experience varies widely, for many, it’s not “brief and mild” as many guidelines state it is. It can be intense, destabilizing, and often misunderstood. One of the most painful challenges is trying to determine whether what you're experiencing is withdrawal or relapse.

Unfortunately, current clinical guidelines don’t help. They often frame withdrawal as short-lived and minor, dismissing anything more severe as a return of illness. A potentially dangerous oversimplification that can leave patients feeling gaslit or unsupported.

In this interview, Dr. Mark Horowitz, a psychiatrist and researcher who’s both studied and experienced withdrawal firsthand, unpacks a new JAMA study that exemplifies the problem: guidelines built on inadequate evidence.

In this episode, you’ll hear:

• Why current drug withdrawal guidelines fall short
• Overview of the new JAMA paper Incidence and Nature of Antidepressant Discontinuation Symptoms
• The critical distinction between withdrawal and relapse
• The truth about psychiatric drug withdrawal
• How to design better research that reflects real-world experiences
• Why this information is often not reaching clinicians
• How we can conduct research that can better inform patient support

Dr. Horowitz’s story is one of courage and insight. As a clinician, he had no idea how wrong the guidelines were, until he tried coming off medication himself. What he discovered was far more complex than anything he’d been taught.

To those navigating psychiatric medication withdrawal — especially in the face of oversimplified headlines and a healthcare system not yet equipped to support you — our hearts go out to you. You deserve care that is informed, compassionate, and grounded in lived experience as well as science. We won’t stop until you have this.

Expert Featured:

• Dr. Mark Horowitz
• X: @markhoro
• Website: https://markhorowitz.org/

Resources Mentioned:

Incidence and Nature of Antidepressant Discontinuation Symptoms A Systematic Review and Meta-Analysis

• https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2836262

3 Long-Term Psychiatric Medication Studies

https://www.biologicalpsychiatryjournal.com/article/S0006-3223(98)00126-7/abstract

https://journals.lww.com/intclinpsychopharm/abstract/2002/09000/discontinuation_symptoms__comparison_of_brief.2.aspx

https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/interruption-of-selective-serotonin-reuptake-inhibitor-treatment/F0241958CB073C51F366E2AABE636B5D

Outro Clinic

https://www.outro.com/

The Maudsley Desprescribing Guidelines: Antidepressants, Benzodiazepines, Gabapentinoids and Z-drugs

https://www.amazon.com/Maudsley-Guidelines-prescribing-Prescribing/dp/111982298X

CMEs Mentioned:

https://www.metabolicmind.org/for-clinicians/trainings-courses/

Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.

Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/

About us:

Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.

Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

Visceral fat, insulin resistance, and metabolic dysfunction are driving the chronic disease epidemic—and yet, they're still misunderstood. In this compelling conversation, former FDA commissioner Dr. David Kessler, MD, explains why he believes visceral adiposity is the greatest public health failure of our lifetime.

Dr. Kessler brings decades of experience (as a pediatrician, legal expert, policy leader, and author of “The End of Overeating” and “Diet, Drugs, and Dopamine”) to explore how ultra-formulated foods impact our biology, why GLP-1 drugs are only a short-term tool, and how we’ve misunderstood addiction when it comes to food. He also opens up about his own struggles with weight gain and metabolic health, despite having all the professional knowledge and discipline in the world.

This interview covers:

• The link between processed food, dopamine, and metabolic disease
• Why insulin—not just glucose—should be front and center
• The role of ketogenic and lower-carb diets for people with visceral fat or food addiction
• What went wrong with the dietary guidelines
• And what it will take to reverse course and reclaim our health

If you're a clinician, researcher, or someone navigating your own metabolic journey, this conversation is compelling viewing. Dr. Kessler doesn’t offer easy answers, but he does help clarify where the real problem lies and how we might begin to fix it.

Expert Featured:

• Dr. David Kessler, FACHE

Resources Mentioned

• https://www.amazon.com/Diet-Drugs-Dopamine-David-Kessler-ebook/dp/B0D33Y6L42/

Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.

Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/

About us:

Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.

Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.