Bariatric surgeon Dr. Eric Smith joins the BariNation Foundation Podcast to continue the six-part series on the Levers of Control. Today's episode is about the second lever: Whole Food Nutrition. Dr. Eric Smith speaks with April Williams and Melanie Lindell to reveal why whole foods quiet food noise, how ultra-processed foods were engineered for overconsumption, and what it takes to build a sustainable, whole-food nutrition-based life after bariatric surgery and while pursuing a medically based weight loss program.

Don’t miss our first episode in the Levers series: Ep 287 - Mastering Your Metabolic Health and Weight Management

What You Will Learn in this Episode:

✅ Why GLP-1 medications blunt cravings for most foods but not for whole foods, easing food noise

✅ How ultra-processed foods are engineered to keep cravings coming back

✅ The link between emotional eating and metabolic wellness, and how to tell comfort from nourishment

✅ Simple, budget-friendly ways to start whole food nutrition without overhauling your whole weight loss journey

This episode of the BariNation Podcast is produced by the BariNation Foundation, a 501 (c) (3) dedicated to advancing metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. Funding is provided by the generous donations to the BariNation Foundation from listeners and viewers like you, Johnson & Johnson, and the Texas Center for Bariatrics & Advanced Surgery, led by Dr. Joe Cribbins.

TIMESTAMPS:

00:00 Dr. Smith defines whole food nutrition as food with minimal change from nature, not a specific grocery store

07:27 Why the source of sugar changes how the body responds, not just the gram count

09:07 What makes a food ultra-processed, and how convenience and shelf life reshaped the American plate

15:36 Why everything in moderation only holds when the diet is built on whole foods, not engineered snacks

20:52 Food as comfort: unpacking emotional eating, addiction transfer and where cravings really come from

25:29 The Nature magazine study explained: GLP-1 medications blunt cravings for most foods except whole produce

35:46 The big tobacco parallel and why fixing the processed food industry matters as much as new treatments

38:51 Admitting some foods are eaten for pleasure, the results of taking on big tobacco and getting to the root of the problem

45:59 The cost of whole foods and the nutritional cost weighed

49:24 Examples of the perspective of eating

59:51 Practical, budget-friendly steps to start whole food nutrition today, one small swap at a time

KEY TAKEAWAYS:

💎 Diet soda and other zero-calorie tricks can quietly reignite cravings even without added calories

💎 Bariatric patients often lean on protein bars and shakes early on, but lasting health depends on shifting toward real food

💎 True healing from hedonic hunger means removing the trigger, not just numbing it with medication

💎 A foundation of healthy eating habits built on whole food nutrition is the best defense against obesity treatment relapse

ABOUT THE GUEST:

Eric F. Smith, DO, FASMBS, CAQ-MBS

Dr. Smith is a board-certified general, bariatric and robotic surgeon who has been in practice since 2006.

Kentucky Bariatric Institute - Website

Dr. Eric Smith - Instagram

Hyper-Palatable Foods: Development of a Quantitative Definition and Application to the US Food System Database - https://onlinelibrary.wiley.com/doi/10.1002/oby.22639

RESOURCES MENTIONED:

BariNation Community - $19 a month

BariNation Website

BariNation - Email

BariNation’s How to Find an Obesity Specialist Guide

Sign up for BariNation’s Newsletters

Weight recurrence after bariatric surgery or GLP-1 treatment isn't a personal failure, it's often a natural part of treating the chronic disease of obesity. In this episode of the BariNation Foundation Podcast, April welcomes bariatric surgeon and obesity medicine specialist Dr. Saniea Majid to discuss her groundbreaking research on weight recurrence, why the medical community is moving away from the term "weight regain," and how ongoing, individualized care can improve long-term outcomes. Together, they explore the importance of eliminating shame, redefining success beyond the number on the scale, staying connected with your clinical care team, and empowering patients with practical strategies to navigate obesity treatment for life.

What You Will Learn in this Episode:

✅ Why weight recurrence after bariatric surgery is expected and why the word "failure" needs to be stricken from the conversation

✅ The three categories of response (partial, non, and clinically significant) and why each needs its own plan

✅ How consistent follow-up care and multidisciplinary care help prevent or reverse recurrence

✅ Practical ways to shift from shame to action while protecting metabolic wellness

This episode of the BariNation Podcast is produced by the BariNation Foundation, a 501 (c) (3) dedicated to advancing metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. Funding is provided by the generous donations to the BariNation Foundation from listeners and viewers like you, Johnson & Johnson, and the Texas Center for Bariatrics & Advanced Surgery, led by Dr. Joe Cribbins.

TIMESTAMPS:

00:00 Dr. Saniea Majid discusses weight recurrence after treatment and her research regarding standardizing terminology and data sets

04:42 Why patients avoid follow-up care after bariatric surgery

10:01 The wide range of reported weight recurrence after bariatric surgery rates

15:18 Health benefits that remain even with weight recurrence

24:19 The importance of follow-up care

29:15 Why the word failure is banned in modern obesity care

34:44 Recommended definitions for partial response and non-response

45:08 Advice for a listener stuck at limited weight loss two years later

50:32 Dr. Majid answers rapid fire questions related to obesity

01:00:57 Final thoughts on seeking the right team for lifelong care

KEY TAKEAWAYS:

💎 Weight recurrence signals the chronic nature of obesity and calls for more treatment, not self-blame

💎 Regular follow-up care with the right multidisciplinary team is the strongest tool against progression

💎 Revisional surgery and GLP-1 medications are part of continuum care, not last resorts

💎 Patients retain meaningful health gains even when some weight returns

ABOUT THE GUEST:

Dr. Saniea Majid is a board-certified bariatric surgeon and obesity medicine specialist, founder and Medical Director of the Weight Loss and Wellness Center in northern New Jersey. She has built multiple accredited metabolic and bariatric programs and was the first surgeon in the state to perform the SPATZ adjustable gastric balloon and endoscopic sleeve gastroplasty.

A national leader in the field, she just completed a 2 year term of the ASMBS Foundation TREO (Treatment, Research and Education to End Obesity), sits on the ASMBS Board of Directors, and is committed to comprehensive, compassionate care for patients of all ages, including adolescents.

Meet Dr. Majid – Award-Winning Weight Loss Doctor NJ | WLWC

Proposed Definitions and Clinical Recommendations for the Management of Weight Recurrence Following Bariatric Surgery

RESOURCES MENTIONED:

BariNation Community - $19 a month

BariNation Website

BariNation - Email

BariNation’s How to Find an Obesity Specialist Guide

Sign up for BariNation’s Newsletters

J&JMedTech

BariNation, Bariatric Surgery, NSVS, GLP-1, VSG, Vertical Sleeve Gastrectomy, Lapband, Roux-en-Y, Gastric Bypass, Sadi-S, Weight Regain After Bariatric Surgery, Weight Recurrence, Bariatric Surgery, Obesity Treatment, Metabolic Wellness, Follow Up Care, Chronic Disease, Multidisciplinary Care, Bariatric support, Bariatric patient education, Clinically Significant Weight Recurrence, Revisional Surgery, GLP 1 Medications, ASMBS, Shame And Blame, Weight Fluctuations, Surgical Success, Long-term weight loss maintenance

What if the biggest obstacle to getting the help you need isn't your body, but the belief that you have to earn it?

Even therapists struggle with shame, self-doubt, and asking for help. In this episode of the BariNation Foundation Podcast, April sits down with longtime therapist and BariNation supporter Lora Grabow, who shares her own journey through menopause, unexpected health changes, and the difficult decision to begin GLP-1 treatment. Despite decades of helping others heal their relationship with food, Lora discovered she had been holding herself to a different standard, believing she needed to "work harder" before deserving treatment. Together, April and Lora discuss the damaging myths surrounding obesity, menopause, self-worth, and medical care while exploring why community, self-compassion, and evidence-based treatment are essential for lasting health.

This conversation is a powerful reminder that you don't have to suffer in silence, you don't have to earn help, and hope begins the moment you allow yourself to receive the support you deserve.

What You Will Learn in this Episode:

Why obesity is a chronic disease, not a personal failing, and why that reframe lifts shame around GLP-1 weight loss

How menopause weight gain can stall even the healthiest habits, and why biology, not effort, is often the real barrier

Why self-compassion, not self-criticism, is the tool that actually leads to lasting behavior change

How community support helps people move past the belief that they must earn help before accepting it

This episode of the BariNation Podcast is produced by the BariNation Foundation, a 501 (c) (3) dedicated to advancing metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. Funding is provided by the generous donations to the BariNation Foundation from listeners and viewers like you, Johnson & Johnson, and the Texas Center for Bariatrics & Advanced Surgery, led by Dr. Joe Cribbins.

TIMESTAMPS:

00:00 Lora Grabow discusses her two decades in weight management and therapy

06:16 April sets the stage: doing everything right without results

07:48 Lora explains obesity as a chronic disease, not a decision

08:17 Lora shares her menopause weight gain and hormone therapy story

12:17 The friend who asked why Lora wasn't starting a GLP-1

17:15 Unpacking the belief that you must earn help before treatment and the power of community

26:48 Finding safe support in virtual spaces; April shares a personal story

31:20 How are we talking to ourselves and having self-compassion

41:57 Lora reflects on hope, healing, and life after starting Zepbound

46:04 Why it took Lora so long to go on a GLP-1, the many benefits of the drug

KEY TAKEAWAYS:

Shame keeps people stuck. Self-compassion is what actually opens the door to change.

Obesity is a chronic relapsing disease, and no one should have to manage it alone.

GLP-1 medications, like other metabolic wellness tools, aren't something you have to "earn."

ABOUT THE GUEST:

Lora Grabow, LMSW, is an obesity medicine therapist, coach, and professional speaker with over 20 years of experience working with patients in obesity medicine. Lora helps patients discover the missing piece of their treatment plan: A piece she calls Headwork™.

She is the owner of a thriving private practice serving patients affected by obesity. Her expertise includes providing individual therapy and 1:1 coaching, facilitating support groups, and engaging patients in her online course, Foundations in Headwork for Healthy Weight Loss. She is an active leader in the American Society for Metabolic and Bariatric Surgery. (ASMBS) She is a sought-after podcast guest and speaker at national provider and patient obesity medicine conferences.

Lora Grabow Instagram

Lora Grabow - Website

RESOURCES MENTIONED:

BariNation Community - $19 a month

BariNation Website

BariNation - Email

BariNation’s How to Find an Obesity Specialist Guide

Sign up for BariNation’s Newsletters

J&JMedTech

Episode 287: What if everything you believed about obesity was wrong? Bariatric surgeon Dr. Eric Smith joins the BariNation Foundation Podcast to launch a six-part series on Mastering Metabolic Health and Weight Management. Today's episode is about the first lever: Beyond the Scale...Obesity as a Chronic Disease. He explains why only 0.5 to 2% of people can lose enough weight through diet alone to no longer be classified as obese and what the hormones ghrelin and leptin have to do with it. Mental health therapist, bariatric patient and BariNation Foundation Board, Community member, and licensed expert, Melanie Lindell adds the emotional truth: accepting obesity as a chronic disease is not giving up; it is finally getting honest. This conversation will shift how you think about your body, your habits, and your future. Join us for this six-part series, Mastering Your Metabolic Health and Weight Management.

What You Will Learn in this Episode:

Why obesity as a chronic disease cannot be resolved through willpower alone, and what the actual success rates of diet and exercise reveal about the biology working against you

How the hormones ghrelin and leptin resistance change the way your body responds to calorie deficits, making sustainable weight loss far more complex than simply eating less

Why bariatric surgery and GLP-1 medications create the conditions for change but cannot replace the controllable habits that determine long-term metabolic health outcomes

How building consistent habits around sleep, whole food nutrition, and movement forms the true foundation of lasting obesity treatment success

This episode of the BariNation Podcast is produced by the BariNation Foundation, a 501c3 dedicated to advancing metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. Funding is provided by the generous donations to the BariNation Foundation from listeners and viewers like you, Johnson & Johnson, the Texas Center for Bariatrics & Advanced Surgery, led by Dr. Joe Cribbins.

TIMESTAMPS:

00:00 The psychology of results and why visible change drives obesity treatment commitment

04:00 Dr. Eric Smith and Melanie Lindell introduce themselves and the bariatric surgery series

08:04 The six levers of metabolic health and weight management are introduced

09:18 Why diet and exercise alone fail: success rates as low as 0.5% for obesity as a chronic disease

11:56 How triggering life events lead to obesity and why reversing behavior is not enough

23:44 The hormonal science of ghrelin and leptin resistance and their role in weight loss, and why the body fights back against calorie deficits

33:00 The golf analogy: why patients become complacent and stop applying controllable health habits

38:30 The danger of removing friction and how easy access to GLP-1 medications can backfire, and leaning into the idea that obesity is a lifelong disease

44:13 Sleep consistency as a lever: the real science behind sleep and weight loss, and the mental health part of finding joy in yourself

53:08 April's personal gut check and the honest conversation about stalled weight management

1:00:12 How KBI redesigned its entire approach to treating obesity as a chronic disease

KEY TAKEAWAYS:

Obesity as a chronic disease has a biological basis. With success rates of 0.5 to 2% for diet and exercise alone, this is not a failure of character but a failure of biology working against patients without proper obesity treatment.

Surgery and GLP-1 medications provide the spark, but they are not the solution on their own. Without the controllable levers such as whole-food nutrition, sleep, and movement, results will stall or reverse.

Leptin resistance and rising ghrelin levels mean that the longer someone has lived with obesity, the harder the body fights against weight loss, making medical intervention and habit-building both essential.

Goals bring short-term motivation, but habits create lifelong results. Celebrating the consistency of controllable health habits rather than only the scale is what sustains metabolic health over time.

ABOUT THE GUEST:

Eric F. Smith, DO, FASMBS, CAQ-MBS

Dr. Smith is a board-certified general, bariatric and robotic surgeon who has been in practice since 2006.

Kentucky Bariatric Institute - Website

Dr. Eric Smith - Instagram

RESOURCES MENTIONED:

BariNation Community- $19 a month

BariNation Website

BariNation - Email

BariNation’s How to Find an Obesity Specialist Guide

Sign up for BariNation’s newsletters

J&JMedTech

Summer is here, and so is every barbecue, pool party, and 4th of July spread your family could throw at you. No judgment. We're gonna talk about all of it.

April and Nat are back together for a real one, a summer celebration episode built around the four BariNation pillars: movement, mindset, metabolic wellness, and community. They're sharing how they personally live these pillars when routines go out the window, the weather gets hot, and the paper plates get absolutely massive.

This one is for you whether you're six weeks post-op or six years out. Because bariatric life doesn't take a summer break, but it absolutely can feel like a party.

What we get into:

MOVEMENT: Why movement does not have to mean the gym, and how painting rocks, kayaking for the first time, and water balloon fights with your niece absolutely count. Nat shares how she's getting back to exploring outdoors after a really hard school year, and April talks about finally being able to show up at the lake without dreading every moment.

MINDSET: The brain gremlins don't stop just because it's summer. Nat (almost six years post-op!) gets real about still dealing with "what are people thinking about my plate" anxiety at social events. April walks through the "catch it, check it, change it" tool, a practical mindset skill from BariNation's licensed mental health support groups, and why the goal is never to stop having these thoughts, just to get better at catching them.

METABOLIC WELLNESS: Summer food is protein city if you think about it — burgers, ribs, brats. You're already set up. April and Nat talk about the plate size swap that changed everything at Nat's 4th of July prime rib dinner (yes, really), how to set up a buffet table so you naturally eat in the right order, and why 10 BBQ meals out of 400 summer eating occasions is not the thing that derails you.

COMMUNITY: Why the BariNation membership community is becoming both April and Nat's go-to over social media feeds packed with ads and AI content. Real humans, zero algorithm, no one selling you something. Plus, April is launching a summer Whole Food Learning series in the community every Tuesday night with experts and registered dietitians.

AND THE BIG NEWS: BariNation is officially becoming the BariNation Foundation, a 501(c)(3) nonprofit, as of July 1, 2026. That means the podcast is now a foundation production, your support is 100% tax-deductible, AND the BariNation membership community is dropping from $39/month to $19/month. Less than a dollar a day. We are not calm about this.

Links:

• Join the BariNation Community: https://barination.mn.co/plans/1983996?bundle_token=403d003e4d6e5c649341e4319c80a3d8&utm_source=manual
• BariNation Community Calender: https://calendar.google.com/calendar/embed?src=cqvlhco5fdmkk0lsuasl7ggdu88emhuc%40import.calendar.google.com&ctz=America%2FLos_Angeles
• Donate to the BariNation Foundation: https://barination.givecloud.co/fundraising/forms/8NDR96EK
• Follow April: @actively_april
• Follow Natalie: @breakingbari_ers
• Follow BariNation on Instagram: @bari.nation
• Follow BariNation on Facebook: @barination
• Get our weekly newsletter: https://lp.constantcontactpages.com/sl/O2S7vlT
• Visit our website: www.barination.org

Your metabolism is not broken. It just might need a new strategy.

If you've had bariatric surgery (or started a GLP-1 medication like Ozempic or Mounjaro) and you've hit a wall, struggled with cravings, felt like you can't go more than two hours without eating, or watched the scale stop moving entirely, this episode is for you.

Registered dietitian and certified personal trainer Kayla Girgen, RD, CPT is back, and she's here to explain one of the most talked-about, least understood topics in the metabolic health space: metabolic flexibility. What it is, why it matters after weight loss surgery, and what you can actually do about it starting today.

In this episode, we cover:

• What metabolic flexibility actually means (in plain, real-person language)
• The interstate traffic analogy that makes insulin resistance finally make sense
• Why insulin resistance can make it nearly impossible to lose weight and how the disease of obesity is directly connected
• The difference between being metabolically flexible vs. stuck in what researchers call "metabolic gridlock"
• How movement, even a short walk after a meal, can bypass insulin resistance and get your metabolism moving again
• Why sleep is one of the most unsexy, underrated tools for improving metabolic health
• Whether a CGM (continuous glucose monitor) is worth it, and what you can do to balance your blood sugar if one isn't in your budget
• A real community member question about reactive hypoglycemia, weight gain on GLP-1s, and what strength training might do to help

Kayla leads live meetups and classes inside the BariNation community every other month. Drop your questions in the comments or send us an email at [email protected].

Find Kayla at @KaylaGirgenRD on Instagram or at KaylaGirgenRD.com.

BariNation is a 501(c)(3) nonprofit. Learn more and join the community at barination.org.

Nobody tells you that the hardest part of bariatric surgery isn't the surgery. It's year five, when life is full, and your bariatric brain goes quiet.

Jason and Natalie are back for a real, unfiltered catch-up and this one is for every patient who's thought, "I don't even think about it anymore." Because here's the thing: bariatrics doesn't stop asking things of you just because you stopped thinking about it.

Jason shares what happened when a routine gym session turned into an ER visit with a heart rate of 29. Yes, 29. And the wake-up call that followed: a medication he'd been on for years was quietly working against him, because his body had changed so dramatically that the prescription he was given as a very different person no longer fit the person he is now. A physician told him he needed a pacemaker. Another told him to go home and stop taking one pill. The lesson in between? You are a patient for life, not just for the first two years.

Natalie opens up about something a lot of long-term post-op patients feel but rarely say out loud: the guilt of not wanting to check in with the bariatric community anymore. Five years out, thriving in a new career as a teacher, and hitting the wall where bariatric life just isn't at the front of the line every single day. She calls it the "I just can't" season, and she wants you to know it's real, it's normal, and it doesn't mean you've failed.

Together they get into:

• Why your medications may need to change years after surgery (and why nobody is checking unless you ask)
• What "white coat syndrome" (a fear or anxiety around doctors and medical settings) looks like for people who've been heavy patients, and why it doesn't go away just because things are going well
• The difference between pre-op and post-op body literacy: knowing the difference between "I feel fine" and "I actually feel good"
• Why wins in the bariatric journey don't always look like the scale moving
• What it means to be a patient "forever" and how to hold that truth without burning out
• How bariatrics keeps handing you new lessons whether you asked for them or not (Jason's new analogy: an advent calendar of epiphanies that never ends)

This episode is also a love letter to BariNation itself. While April is at ASMBS (the American Society for Metabolic and Bariatric Surgery, the largest professional organization in the field), big things are happening behind the scenes in the world of obesity treatment. The conversation is shifting. Patients are being centered. The gap between doctors and patients is getting a lot of attention, and BariNation is right in the middle of that work.

If you've ever been years out and felt like bariatric life snuck up behind you, this is your episode.

Want to be one of the first to know about our exciting, upcoming changes? Join our email list! Click HERE to join. And we promise- no spam, ever!

BariNation is now officially a nonprofit foundation. If this podcast, this community, or this conversation has ever helped you, consider supporting the mission at BariNation.org. Every dollar keeps the lights on and the mic hot. Become a donor at www.barination.org

Find us everywhere: Instagram, TikTok, YouTube, and the BariNation Community at BariNation.org.

You've been fighting your weight for years. You've tried everything. And now you're finally ready to find someone who can actually help. Where do you start? Your primary care doctor? The websites that offer you another miracle? Should you do what Serena Williams is doing and see a bot doc?

In this episode, April sits down with Dr. Charles Thompson, a bariatric surgeon practicing in Brooklyn and Queens, New York, to give you a real, practical roadmap for finding an obesity medicine provider who will treat you like the whole person you are, not just a number on a scale.

Here's what you'll walk away with:

• What to actually look for when evaluating a provider (hint: it's not the letters after their name)
• Where to search, including which websites are worth your time and which ones to approach with caution
• What to ask at your very first appointment, and why the best providers will ask you questions first
• Why it is absolutely okay to leave a provider relationship that isn't working for you, and why that is not a failure

Dr. Thompson also breaks down the real difference between having insurance coverage for bariatric surgery or obesity medications and actually being able to use it, including why so many patients with qualifying conditions are still being denied care and what you can do to fight back.

You'll also hear him say something that almost no surgeon ever says out loud: "It's not your fault." He means it, and he explains exactly why.

Plus: April shares the story of her own path to surgery, why word-of-mouth changed everything for her, and why she built BariNation for the exact moments when you need a Nation behind you.

Download and print our free step-by-step guide to finding your provider from the show notes. Use it, share it, come back to it. Click HERE to access it.

Obesity is a disease. You deserve care. And now you know how to go get it.

BariNation is a nonprofit podcast and patient community built on the belief that obesity is a disease and that every person fighting it deserves education, community, and care. If this post helped you, consider supporting our mission at BariNation.org/donate. Your support makes conversations like this one possible.

Enjoyed this episode? Share it with someone who's been waiting for permission to take the first step. And if you're already in The Nation, you know what to do. See you in there.

Find Dr. Thompson: BrooklynQueensSurgical.com

Join the BariNation community: barination.mn.co

Support our mission: BariNation.org/donate

#BariNation #BariatricSurgery #ObesityMedicine #ObesityAwareness #WeightLossSurgery

#FindABariatricSurgeon #ObesityIsADisease #BariatricCommunity #InsuranceDenial #MetabolicHealth

#ASMBS #ObesityTreatment #BariatricProvider #WeightManagement

“We are built for scarcity, not abundance.” Most people think obesity is simply about willpower or lifestyle choices, yet its history reveals a long tradition of misconceptions, stigma, and ineffective, somewhat barbaric treatments. In this eye-opening episode, Dr. Nini Peterson, PhD, takes us on a fascinating journey through the history of obesity, showing how misconceptions have persisted for centuries despite advances in science and medicine. Discover how ancient carvings and medical texts from 30,000 years ago to the 19th century reveal haunting echoes of today’s struggles with weight and treatment. You’ll learn how old fallacies, like “eat less, move more,” have hampered progress and how biology, environment, and genetics play critical roles that modern science now understands better than ever.

We break down:

• The historical perceptions of obesity across cultures and eras and their impact on stigma, shame, and treatment.
• The evolution of treatment options, from ancient dieting and surgical experiments to today's promising medications and surgical innovations.
• The misconceptions that still influence doctor-patient relationships and how invalidating these myths can be detrimental to health.
• The importance of a holistic, individualized care team and why finding the right "fit" in treatment is crucial for long-term success.
• How understanding the disease’s history helps us combat shame, advocate for ourselves, and pursue effective, compassionate care.

This episode is a must-listen for anyone living with obesity or those supporting loved ones in their journey. If you’re tired of outdated advice, want to cut through the stigma, and are eager to understand the true complexity of obesity, this conversation will inspire hope and empower action.

Join April Williams as she has a no-holds-barred conversation with Dr. Peterson, an experienced psychologist and obesity expert, who reveals how shifting our understanding of obesity from blame to compassion opens the door to better treatment, more support, and a brighter future.

You’ll leave with a new perspective on this chronic disease, fostering hope that meaningful change is possible, and it starts with knowledge. Perfect for patients, caregivers, clinicians, and advocates committed to a science-backed, patient-centered approach. The time to rethink obesity is now, are you ready?

Explore the rich history of obesity, its treatment evolution, and the importance of personalized care in managing this complex disease.

History of Obesity Presentation

Key Topics

• History of obesity and treatment
• Impact of environment and culture on obesity
• The role of behavioral health in obesity care
• Advances in obesity medications and surgery
• The importance of holistic, individualized treatment

The BariNation Foundation

The BariNation Podcast is a production of the BariNation Foundation, a 501c3 nonprofit that advances metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. The Foundation's mission is to walk alongside individuals pursuing medical, surgical, and comprehensive care, supporting real decisions, challenges, and victories that influence long-term health with the support and guidance of obesity medicine experts.

Learn more about the BariNation Foundation and make a tax-deductible donation by going to BariNation.org

Sound Bites

"We are built for scarcity, not abundance."

“Most people overestimate the risk of bariatric surgery and underestimate the risk of living long-term with obesity.”

Chapters

00:00 The History of Obesity and Its Treatment

07:23 Understanding Obesity as a Disease

19:54 The Stigma of Obesity and Its Impact

26:45 Patient-Care Team Dynamics in Obesity Treatment

27:24 Navigating Life After Surgery

33:32 The Paradox of Treatment

40:15 Evolution of Obesity Treatments

42:56 Evolving Understanding of Health and Behavior Change

45:45 Redefining Success Beyond the Scale

49:44 The Complexity of Health Perception

53:17 The Importance of Seeking Help

55:51 Understanding the Risks of Obesity and Treatment

58:45 The Journey to Bariatric Surgery

01:03:34 Finding the Right Care Team

01:07:15 The Need for Integrated Health Approaches

Nini Peterson Bio

Ninoska "Nini" Peterson, PhD is a Staff Psychologist with the Cleveland Clinic’s Bariatric & Metabolic Institute (BMI) and an Adjunct Assistant Professor at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University in Cleveland, OH.

Her clinical and research interests include psychosocial MBS evaluations, lifestyle treatment of obesity, binge eating treatment, self-monitoring, body-image disturbance, and psychology group treatment/support groups. She has published in peer-reviewed journals on these topics, and has authored/co-authored 3 textbook chapters for SAGES and APA on the role of the behavioral health provider in MBS and pre-surgical psychological MBS evaluations, respectively.

She is the current Integrated Health - Director Elect (2025-2026), former Integrated Health Secretary (2024-2025) and has served on the IH Leadership Counsel since 2021. Nini is also a current member (2017-present) and past Chair (2023-2025 of the IH Support Group Committee, and member of the Health Equity Committee (2023-present). She is a proud member of the inaugural 2024 ASMBS-IH Fellowship class (FASMBS-IH).

Links

BariNationFoundation

Clinical psychologist Dr. Rachel Goldman, PhD joins BariNation hosts April Williams and Jason Smith to discuss the psychological and behavioral tools every person needs to navigate life's hardest moments, especially those living with the chronic disease of obesity.

Drawing from her new book When Life Happens, Dr. Goldman breaks down CBT into accessible, actionable tools for building emotional resilience, managing stress, challenging unhelpful thoughts, and developing a growth mindset. Essential listening for bariatric surgery patients, anyone managing chronic illness, and anyone stuck between knowing what to do and actually doing it.

This episode is supported by AdventHealth Central Florida and the Metabolic Health Institute. If you've struggled with weight loss, you know it's a lifelong journey. At AdventHealth's Metabolic Health Institute, they address the root cause of weight gain with a whole-health approach, from lifestyle support and medication to bariatric surgery. Learn more at http://www.AdventHealthWeightLoss.com

What You'll Learn:

Build a Mental Health Toolbox — One tool is never enough. Dr. Goldman explains why you need at least three coping strategies and the critical difference between self-care tools (preventative) and stress management tools (acute), and why they're actually the same tools used with different intention.

The CBT Core: Your thoughts don't just feel bad, they directly shape your behavior. Dr. Goldman walks through how identifying unhelpful thoughts, examining the evidence, and reframing can rewire the brain over time through neuroplasticity. The goal isn't to eliminate negative thoughts; it's to reduce how long you stay in them. Cognitive Distortions That Keep

You Stuck — All-or-nothing thinking, jumping to conclusions, and "should" statements are three of the most common distortions in people with obesity. Dr. Goldman explains how CBT helps patients identify, challenge, and reframe these patterns instead of accepting them as truth. The Diet Failed You.

You Did Not Fail the Diet. — A powerful reframe Dr. Goldman used with bariatric patients at Bellevue: the surgery failed the patient, not the other way around. This directly challenges the internalized shame that comes from years of failed diets and reframes it through the lens of obesity as a complex, chronic, progressive disease.

Growth Mindset vs. Fixed Mindset — Years of "nothing works" can create an entrenched fixed mindset. Dr. Goldman connects Carol Dweck's research to the lived experience of obesity patients and explores how flexible thinking and self-compassion begin to shift the pattern.

Toxic Positivity: What It Is and Why It's Harmful — "Positive vibes only" invalidates real experience and suppresses important emotions. Dr. Goldman explains the spectrum from toxic positivity to toxic negativity, where healthy realistic optimism lives, and why body acceptance is more sustainable than body positivity for bariatric patients.

Self-Care Is Not a Bubble Bath — Self-care is anything you do for yourself that is preventative and builds you up before life happens. Showing up to a support group, listening to a podcast, sleeping, and breathing exercises all count. It's a non-negotiable daily practice, not a reward.

Imposter Syndrome as a Feature, Not a Bug — The most surprising reframe of the episode: imposter syndrome may actually be useful. Dr. Goldman explains eustress (positive, motivating stress) and why a measured level of imposter syndrome drives preparation, humility, and growth. April and Jason share deeply personal experiences of imposter syndrome in bariatric advocacy.

Community, Vulnerability, and Asking for Help — The people who feel they have no right to take up space in a support group are often the ones who need it most. Asking for help is brave, not weak.

Practice Your Tools Before You Need Them — Like a fire drill, tools must be practiced in calm moments so the response is automatic when life gets hard.

📖 When Life Happens by Dr. Rachel Goldman: whenlifehappensbook.com 🔗 Dr. Goldman: @DrRachelNYC | BariNation: barination.org | @bari.nation Hosts: April @actively_april | Jason @tha_smithsonian_

Supported by AdventHealth Central Florida and the Metabolic Health Institute. Whole-health obesity care from lifestyle support to bariatric surgery. AdventHealthWeightLoss.com

BariNation Foundation*is a 501c3 nonprofit advancing metabolic wellness through evidence-based education and stigma-free support. Donate at barination.org #BariatricSurgery

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