For decades, I started every New Year the same way.

In January, I promised myself this would be the year.

By February, I tried harder.

Every spring, I adjusted the plan.

And by summer or fall, the weight crept back.

That cycle repeated not because I lacked knowledge, discipline, or effort. Instead, it repeated because I misunderstood biology — at least when it came to myself.

This year is different.

For the first time since Ronald Reagan was first elected, weight loss is not at the top of my New Year’s resolution list. Not because I stopped caring, but because I lost 45 pounds with the help of Zepbound over the last year. More importantly, however, I learned something that reshaped how I think about obesity, healthspan, and shame.

Before anything else, let me be clear: this is not medical advice. This is a story. Anecdotes are not evidence, even when the anecdote is from a physician. Nevertheless, stories help us understand science when data alone fails to move us.

And this story matters.

For years, people told me — and millions of others — the same thing: move more and eat less. At first glance, that advice sounds logical. After all, calories matter. Energy balance matters.

However, reality is more complicated.

To begin with, I am a surgeon. Surgical training requires extraordinary willpower. Moreover, I’ve logged food meticulously, cooked Mediterranean-style meals, exercised consistently, and followed every evidence-based recommendation I’ve ever given patients.

Meanwhile, Oprah has willpower. Olympic athletes have willpower. Yet obesity persists.

Sure, willpower works briefly. In fact, go on a liquid protein diet, and the weight will fall off quickly. Unfortunately, the food noise remains. Eventually, biology wins. Always.

In the same way you cannot positive-think your way out of hypertension, cholesterol, diabetes, cancer, or heart disease, you cannot willpower your way out of obesity. Obesity is a disease. It is not a moral failure.

Ironically, I knew this intellectually. Nevertheless, I failed to apply it to myself. We have a name for that: cognitive dissonance.

The real turning point did not come from reading another study. Instead, it came from listening to people I trusted.

One colleague quietly lost weight on a GLP-1. Another friend told me something more striking: the food noise stopped. Alcohol lost its appeal. Smoking no longer called.

That phrase — food noise — suddenly explained decades of struggle.

To illustrate, think of sleeping near Lake Shore Drive in Chicago. At first, traffic noise dominates your awareness. Eventually, it fades into the background. Only when you leave the city do you realize how loud it was.

Food noise works the same way.

When GLP-1 therapy quieted that background signal, eating slowed naturally. Meals ended without effort. Desire changed without rules. Biology shifted.

Notably, calories did not lower my stress. Calories did not improve my sleep. Calories did not stop snoring. Biology did.

Interestingly, weight loss was not the first change I noticed.

Sleep improved almost immediately. Stress dropped dramatically. Commutes that once registered hours of physiologic stress now barely registered minutes. Appetite normalized. Eating slowed.

These changes matter because sleep and stress directly affect inflammation, metabolic health, appetite signaling, and long-term disease risk. In other words, healthspan improved before the scale reflected anything meaningful.

That observation alone reframed the entire experience.

Along the way, something else happened.

Friends noticed.

Predictably, they asked the same question everyone asks: What diet is working? After I answered honestly, several started their own journeys.

Soon enough, we formed an informal support group. People texted. Others called. Questions surfaced: Is this normal? Should I eat this? Does this feeling pass?

Support did not mean coaching. Rather, support meant context. Shared experience reduced anxiety. Honest conversations prevented unnecessary panic.

Not surprisingly, patterns emerged. People still loved great food. Wine interest decreased naturally. Travel did not end. Joy remained intact.

Support mattered because isolation amplifies shame.

Equally important, practical realities surfaced.

Eating less means needing micronutrients, not fewer of them. Unfortunately, some vitamins fail when appetite drops. In fact, the only time I vomited was after taking a vitamin on an empty stomach. That lesson mirrored decades of bariatric follow-up experience.

For me, AG1 worked. No sponsorship exists here. Nevertheless, cost raises questions. With a background in culinary medicine, developing a better formulation makes sense. Thiamine deficiency, for example, causes devastating neurologic consequences. This is not theoretical.

Similarly, bowel habits change. Less intake means less output. Fewer bowel movements do not equal constipation. Fiber still matters. Mediterranean-style eating naturally solves most of this problem.

Understanding physiology prevents fear.

At some point, frustration turned into obligation.

Recently, a physician who has never used a GLP-1 published a book about eating on GLP-1 therapy. That bothered me more than it should have.

Given my background — weight-loss surgery, culinary medicine, and lived experience — I realized I had to write this book. Not to sell diets, but to explain reality.

The working title?

Willpower Is B.S.

Subtlety has never been my strength.

This book will focus on biology, food ideas, micronutrients, behavior, and healthspan. Above all, it will remove shame from the conversation.

Incidentally, my literary agent retired long ago. Therefore, if you know someone who understands medicine, food, and honesty, I’m back in the market.

At the same time, conversations kept expanding beyond weight loss.

Healthspan matters more than thinness. Longevity depends on sleep, stress, nutrition, social connection, and movement. Accordingly, the Mediterranean Healthspan Cruise was born.

This is not a weight-loss cruise. Instead, it’s a learning experience. We will discuss food, medicine, science, and aging. Yes, there will be a GLP-1 support session. Equally, there will be conversations for everyone.

Learning works best in a community.

As I write this, I’m preparing to inject my 7.5 mg dose of Zepbound. I still hate needles. Some things never change.

Nevertheless, this is only part one of the journey.

Science progresses when we admit what we got wrong.

This time, I listened.

1. Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, Kiyosue A, Zhang S, Liu B, Bunck MC, Stefanski A; SURMOUNT-1 Investigators. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022 Jul 21;387(3):205-216. doi: 10.1056/NEJMoa2206038. Epub 2022 Jun 4. PMID: 35658024.
2. Rubino F et al. Joint international consensus statement for ending stigma of obesity. Nature Medicine, 2020.