Do GLP-1 medications affect bone health?

GLP-1 medications have transformed obesity treatment, but they've also sparked important questions about bone health, bone density, and fracture risk.

In this episode, I’m joined by obesity medicine specialist Dr. Sandra Cortina to unpack what the current evidence actually shows about bone health during GLP-1 therapy. We separate evidence from headlines and explore how clinicians and patients can make informed decisions while balancing the substantial benefits of GLP-1 therapy with potential risks. This is a nuanced, evidence-based conversation for anyone interested in the science of obesity treatment.

Find Dr. Cortina:
Instagram @cortinaweightmedicine

Website
www.cortinaweightmedicine.ca in British Columbia, Canada

Home Exercises Referenced by Dr. Cortina:
https://www.youtube.com/@silversneakers

You're eating healthy, exercising, and doing everything you think you should, but the scale isn't moving. So what's going on?

In this episode, we explore the five most common reasons weight loss stalls, including hidden calorie intake, chronic under-fueling, metabolic adaptation, and lifestyle factors like sleep, stress, and movement. You'll learn why your body isn't broken and how building consistent, sustainable habits is the key to long-term success.

In This Episode
- Why healthy eating doesn't always lead to weight loss
- The difference between overeating and under-fueling
- How chronic dieting can affect your metabolism
- The importance of protein, balanced meals, and consistency
- Why sleep, stress, strength training, and patience matter

Mentioned in This Episode
- Episode 170: Why Eating 1,200 Calories Is Working Against You: https://www.sashahighmd.com/podcasts/the-obesity-doctor-podcast/episodes/2149162617

- Resting Metabolic Rate (RMR) Calculator:
https://www.calculator.net/bmr-calculator.html

Work With Us:
O​​ntario-Wide Virtual Obesity Management Clinic
https://www.highmetabolicclinic.com

Join my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight

Recover Strong for Binge Eating
https://www.sashahighmd.com/bed

Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide

Menopause is something every woman will experience, yet many still feel confused, dismissed, or overwhelmed when symptoms begin. In this conversation, I’m joined by Dr. Sheila Wijayasinghe to unpack the realities of perimenopause, menopause, and hormone therapy in a practical, evidence-based way.

We talk about what the menopause transition actually looks like, why symptoms can begin years before periods stop, and why so many women are told their labs are “normal” even when they don’t feel normal. We also break down some of the biggest misconceptions around hormone therapy, including safety concerns, breast cancer risk, cardiovascular risk, and whether bloodwork is actually useful in making a diagnosis.

In this conversation, we cover:
- The difference between perimenopause and menopause
- Early symptoms women may notice in their 40s
- Whether hormone testing is necessary
- What menopausal hormone therapy (MHT) is and who may benefit
- The difference between regulated bioidentical hormones and compounded products
- How hormone therapy may impact sleep, mood, bone health, urogenital symptoms, and brain fog - Non-hormonal approaches to symptom management
- How women can advocate for themselves if they feel dismissed in healthcare settings

My hope is that this episode helps bring clarity to a stage of life that still carries so much confusion and misinformation, and that women walk away feeling more informed and empowered to make decisions about their health.

Links & Resources

You can follow Dr. Sheila Wijayasinghe on Instagram at @drsheilaw and check out the Doc Talk Podcast for more evidence-based health conversations.

Menopause Management Resource from the Centre for Effective Practice
https://cep.health/clinical-products/menopause-management/

Menopause Symptom Tracker
https://menopausefoundationcanada.ca/resources/menopause-symptoms/

I’m joined by Dr. Lauren Colenso-Semple to unpack the rapidly growing world of wellness peptides — from BPC-157 and CJC-1295 to Ipamorelin, Tesamorelin, NAD, and the so-called “fat-burning” and “healing” peptides taking over social media. We discuss what peptides actually are, why they’ve become so popular, and how legitimate medical therapies have blurred into a largely unregulated wellness industry.

We also break down the claims being made about popular peptides marketed for fat loss, recovery, anti-aging, and performance enhancement, while taking a closer look at what evidence truly exists (and what doesn’t). Dr. Lauren shares important insight into the safety concerns, marketing tactics, and cultural obsession with optimization that are fueling this trend online.

If you’ve been curious about peptides or wondering whether the internet hype matches the science, this episode will help you think more critically before jumping on the trend.

Check out Dr. Lauren Colenso-Semple’s work here: https://www.drlaurencs.com/

In Part 2 of this series, we're diving into the practical nutrition strategies that can help you feel your best while taking medications like Ozempic, Mounjaro, and Zepbound.

From constipation and digestive changes to hitting your protein goals with a low appetite, this episode focuses on the habits that support long-term success and help you maintain your results.

We'll cover:

• Why constipation is so common on GLP-1 medications and how to prevent it
• How to reach your protein goals when you get full quickly
• What to do when protein foods don't sound appealing
• How GLP-1 medications change hunger and fullness cues
• What to expect if you need to temporarily stop your medication

GLP-1 medications can be powerful tools, but they work best when paired with the right nutrition and lifestyle habits. Learning how to fuel your body, support digestion, and adapt to your changing appetite is key to protecting your health while achieving sustainable weight loss.

WORK WITH US:
O​​ntario-Wide Virtual Obesity Management Clinic
https://www.highmetabolicclinic.com

Join my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight

Recover Strong for Binge Eating
https://www.sashahighmd.com/bed

Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide

In this episode, Dr. Neil Naik and I unpack a foundational question—is obesity actually linked to cancer, and what’s really driving that connection? We explore the underlying biology, from chronic inflammation and insulin resistance to the hormonal activity of adipose tissue, and why visceral fat may matter more than we think.

We then move beyond risk and into what happens after a diagnosis—how obesity can influence treatment response, toxicity, dosing, and outcomes across chemotherapy, surgery, and radiation. The conversation also highlights the often-overlooked phase of survivorship, including the role of metabolic health in recurrence risk and long-term prognosis.

We close by discussing where emerging therapies like GLP-1 medications fit, how clinicians can move beyond BMI toward more individualized care, and how to talk about the obesity–cancer connection in a way that informs without adding shame.

My Guest Dr. Neil Naik

Dr. Neil Naik, a family physician, educator, and innovator based in Waterloo, Ontario. Trained at the Royal College of Surgeons in Ireland, he completed residencies in Newfoundland and Nunavut and holds an Executive MBA from Ivey, where he focused on technology-driven healthcare innovation.

He runs a Family Practice and an obesity medicine clinic in Waterloo, along with an AI-enabled skin cancer screening program, while teaching medical students at both McMaster University and the University of Waterloo.

Dr. Naik advises startups, leads regional primary care and cancer prevention initiatives, and champions universal healthcare, leveraging AI to make safe, high-quality care accessible to everyone, everywhere.

LinkedIn: https://www.linkedin.com/in/neil-naik/

GLP-1 medications like Ozempic, Mounjaro, and Zepbound are changing the conversation around obesity and weight loss — but there’s one major problem: most people are starting these medications with little to no guidance on how to properly nourish their body while taking them.

And that matters.

Because while GLP-1s can be incredibly effective tools for weight loss, they can also lead to muscle loss, under-eating, fatigue, nausea, hair loss, and long-term metabolic issues when nutrition is neglected.

In today’s episode, I’m breaking down the biggest nutrition mistakes people make on GLP-1 medications — and exactly how to protect your metabolism, preserve muscle, maintain energy, and build sustainable habits while losing weight.

We’ll cover:
- Why protein becomes non-negotiable on GLP-1 medications
- How much protein you actually need
- The hidden dangers of under-eating
- Why rapid weight loss can harm your metabolism
- How to preserve muscle while losing fat
- The critical role of strength training
- What to do if you have no appetite
- Tips for nausea and food aversions
- How to create sustainable eating habits while on GLP-1s
- Rebuilding a healthier relationship with food

This episode is especially important if you’ve ever thought:
“I’m barely eating… so why do I feel exhausted?”
“Why am I losing muscle instead of just fat?”
“How do I hit my protein goals when I’m never hungry?”

GLP-1 medications are not magic — but when combined with proper nutrition and lifestyle support, they can become powerful tools for long-term health.

If you’re currently taking a GLP-1 medication, considering one, or supporting someone who is, this episode is a must-listen.

And if you’re looking for support along your journey, Dr. Sasha High and I would love to welcome you into our women’s coaching program, Best Weight, where we openly discuss treatment options like GLP-1 medications and help women build sustainable, healthy weight loss habits together.

WORK WITH US:
O​​ntario-Wide Virtual Obesity Management Clinic
https://www.highmetabolicclinic.com

Join my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight

Recover Strong for Binge Eating
https://www.sashahighmd.com/bed

Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide

FOLLOW SASHA
Instagram
https://www.instagram.com/sashahighmd/

ADDITIONAL RESOURCES:
BMI Calculator
Basal Metabolic Rate Calculator(BMR)

REFERENCES:
Carbone, J. W., & Pasiakos, S. M. (2019). Dietary Protein and Muscle Mass: Translating Science to Application and Health Benefit. Nutrients, 11(5), 1136. https://doi.org/10.3390/nu11051136

McCarthy, D., & Berg, A. (2021). Weight Loss Strategies and the Risk of Skeletal Muscle Mass Loss. Nutrients, 13(7), 2473. https://doi.org/10.3390/nu13072473

Scott Butsch, W., Sulo, S., Chang, A. T., Kim, J. A., Kerr, K. W., Williams, D. R., Hegazi, R., Panchalingam, T., Goates, S., & Heymsfield, S. B. (2025). Nutritional deficiencies and muscle loss in adults with type 2 diabetes using GLP-1 receptor agonists: A retrospective observational study. Obesity pillars, 15, 100186. https://doi.org/10.1016/j.obpill.2025.100186

Brian Baumal lost 100 pounds, and more importantly, he’s kept it off for over 14 years.

But what he really understands is this: it’s not a lack of knowledge that keeps people stuck, it’s the psychology. The urgency that drives all-or-nothing thinking.

Brian works as a Toronto-based psychotherapist and is the guest on today’s episode of THE OBESITY DOCTOR PODCAST. We break down why urgency isn’t discipline, and what actually works if you want change to last.

Work with Brian:
https://alivapsychotherapy.com/

WORK WITH ME
O​​ntario-Wide Virtual Obesity Management Clinic
https://www.highmetabolicclinic.com

Join my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight

Recover Strong for Binge Eating
https://www.sashahighmd.com/bed

Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide

FOLLOW SASHA
Instagram - https://www.instagram.com/sashahighmd/

In today’s episode, we’re talking about one of the biggest challenges during a weight loss journey — balancing social eating while still making progress.

With summer approaching, there are naturally more opportunities for eating out, patio dinners, vacations, parties, and weekend plans. Many people feel confident and consistent during the week, but struggle when social events come up and feel like their progress gets completely derailed.

In this episode, Tedi Glik, RD will cover:

- Why there is no such thing as a “cheat meal”
- How to build balanced meals even when eating out
- The importance of protein and veggies at social meals
- Why skipping meals before dinner outings backfires
- How restriction leads to overeating Letting go of the “good” vs. “bad” food mentality
- How scarcity around food increases cravings and binge eating
- Tips for navigating pizza nights, desserts, restaurant meals, and alcohol
- How to enjoy flexibility without guilt while still supporting your goals

The goal is learning how to make healthy eating sustainable in real life — not just during perfect weeks at home.

WORK WITH US:

Join my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight

Recover Strong for Binge Eating
https://www.sashahighmd.com/bed

O​​ntario-Wide Virtual Obesity Management Clinic
https://www.highmetabolicclinic.com

Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide

FOLLOW SASHA
Instagram
https://www.instagram.com/sashahighmd/

Bariatric surgery is one of the most effective tools we have in obesity medicine—and also one of the most misunderstood.

In this episode, I’m diving into where surgery truly fits in the treatment of obesity and metabolic health. While we often focus on medical therapies like GLP-1s, it’s important to understand the role bariatric surgery can play—and why it continues to be underutilized or dismissed by many patients.

I’m joined by Toronto-based bariatric surgeon Dr. Lazar Klein, who shares his expertise on what bariatric surgery actually involves, who it’s for, and how it fits into a comprehensive, long-term approach to care. We walk through the most common procedures available — including gastric bypass, sleeve gastrectomy, and duodenal switch variations — and clarify why older procedures like gastric banding are no longer recommended.

Dr. Klein addresses common fears around surgery, including concerns about surgical complications, dumping syndrome and lifelong changes, while offering a realistic and balanced perspective on risk.

We explore the long-term outcomes as well—how surgery impacts conditions like type 2 diabetes, sleep apnea, and cancer and even mortality, and what the evidence shows about weight maintenance years down the road.

If bariatric surgery has ever felt confusing, intimidating, or “not for you,” this episode will help bring clarity to the conversation.

Resources & Links
Ontario Bariatric Network
https://www.ontariobariatricnetwork.ca/

High Metabolic Clinic
https://www.highmetabolicclinic.com/