In Episode 49 of the Pound of Cure Weight Loss Podcast, Dr. Weiner and Zoe examine the steep costs of obesity medications like Wegovy, the influence of pharmacy benefit managers (PBMs), and the role of big pharmaceutical companies in shaping healthcare. Highlighting recent Senate hearings led by Bernie Sanders with Novo Nordisk’s CEO Lars Fruergaard Jørgensen, this episode sheds light on how the current system prioritizes profit, often at the expense of patients’ access to care.

Wegovy Cost: Breaking Down High Prices in the U.S.

Wegovy, a GLP-1 medication, costs around $1,349 per month in the U.S., while in other countries like the U.K., prices are as low as $92. Dr. Weiner explains that this discrepancy illustrates a broken healthcare model, where the U.S. market fuels corporate profit but leaves millions unable to afford essential treatments. With 72% of Novo Nordisk’s revenue coming from U.S. sales, the company’s pricing strategy relies on American consumers, who are left paying significantly more for the same medications.

Big Pharma’s Influence on Policy and Profits

This episode delves into Big Pharma’s control over drug pricing, particularly the stark contrast between their research and development costs and their profits. For example, while Novo Nordisk spent $21 billion on R&D, they spent twice as much—$44 billion—on stock buybacks and dividends. Dr. Weiner highlights how political influence plays a crucial role, with both major parties receiving substantial donations from pharmaceutical companies, leading to stalled efforts in drug price regulation and patient access.

Pharmacy Benefit Managers (PBMs): Hidden Gatekeepers Driving Up Costs

PBMs, the intermediaries between insurers and pharmacies, are supposed to negotiate better prices, but Dr. Weiner and Zoe point out that they often drive costs higher through hidden fees. In many cases, PBMs have financial incentives to push higher-priced drugs, creating a “pay-to-play” system that limits patient access. For example, PBMs profit by taking a percentage of negotiated drug price savings, meaning higher drug list prices generate greater profits for them. Dr. Weiner underscores how PBMs complicate and inflate pricing, making it even harder for patients to get GLP-1 medications through insurance.

Do We Need Health Insurance Companies and PBMs?

Dr. Weiner questions the necessity of insurance companies and PBMs in the healthcare system, arguing that they don’t provide direct patient care yet extract billions from the system. He suggests that healthcare can function without these financial middlemen, allowing for a more transparent, patient-centered system where costs are lower and patients have better access to needed treatments.

The Morality of Obesity Treatment Costs

The episode closes with Dr. Weiner and Zoe discussing the stigma surrounding obesity and the moral implications of restricting access to life-changing medications like Wegovy. They emphasize that obesity is a complex, chronic disease requiring comprehensive treatment, not simply a “lifestyle” issue. Dr. Weiner advocates for recognizing obesity treatment as essential, which could lead to a shift in how these medications are accessed and covered.

Final Takeaways

While the healthcare landscape remains challenging, Dr. Weiner believes patient advocacy, legislative changes, and innovation can improve access to these life-saving treatments. This episode offers insights into navigating the current system while emphasizing the need for systemic change to prioritize patient health over profits.

In Episode 48 of the Pound of Cure Weight Loss podcast, Dr. Matthew Weiner and Zoe Schroeder explore the future of compounded GLP-1 medications, the dangers of the health halo effect, and debunk common diet myths that often lead to confusion for those trying to lose weight.

Compounded GLP-1 Medications: A Controversial Solution on the Brink of Extinction

Dr. Weiner and Zoe kick off the discussion by addressing the fate of compounded GLP-1 medications. Medications like Zepbound and Wegovy, FDA-approved for obesity, have faced shortages, leading to the rise of compounded alternatives. These non-FDA-regulated versions, sourced from China and mixed in US compounding pharmacies, have been a lifeline for patients who can't access the brand-name medications.

However, Dr. Weiner highlights that these compounded versions may soon become unavailable due to regulatory changes. Compounded GLP-1 medications can only be produced during shortages of the original drugs and with supply stabilizing, their production may soon be banned. Patients currently relying on compounded alternatives will need to explore other options, such as the Pound of Cure Weight Loss Platinum Program.

Diet Myths: Dispelling Common Misconceptions

Dr. Weiner and Zoe also tackle pervasive diet myths, particularly the belief that weight loss is simply a matter of calorie counting. This outdated “calories in, calories out” philosophy ignores the body’s hormonal responses to food. They explain that hormones like GLP-1, ghrelin and leptin play crucial roles in regulating hunger and metabolism, which is why focusing purely on calorie restriction often leads to failure.

Another myth they address is the idea that fat is the enemy. While processed and animal fats should be avoided, healthy fats from sources like avocados, nuts, and seeds are vital for long-term weight management. Additionally, Zoe clarifies that not all carbs are bad — distinguishing between refined carbs and whole-food sources like vegetables and legumes is key for sustained energy and weight loss.

The Health Halo Effect: How Marketing Tricks Consumers

The health halo effect is another topic of discussion, focusing on how food marketing can deceive consumers into making poor health choices. Labels such as “organic,” “vegan,” “low-carb” or “gluten-free” often create the illusion of health, even when the products are filled with sugar or unhealthy ingredients.

Dr. Weiner and Zoe stress the importance of avoiding these traps by focusing on real, unprocessed foods like vegetables, lean proteins, fruits, nuts, beans and seeds. This approach helps ensure that you’re making choices that genuinely support your health and weight loss efforts, rather than falling for misleading marketing.

Conclusion

In this episode, Dr. Weiner and Zoe offer valuable insights into the future of compounded GLP-1 medications, clarify persistent diet myths, and explain how the health halo effect misleads consumers. As the regulatory landscape changes and food marketing continues to evolve, staying informed and focusing on a balanced, whole-food diet is crucial to achieving long-term success in your weight loss journey.

In Episode 47 of the Pound of Cure Weight Loss Podcast, Dr. Matthew Weiner and Zoe Schroeder, RD dive into weight loss topics like compounded GLP-1 medications, ultra-processed foods and their link to heart disease, and processed meat alternatives.

Ultra-processed Foods: Are Some Worse Than Others?

A recent study published in The Lancet found that ultra-processed foods make up a shocking 73% of the U.S. food supply, with significant consequences for heart health.

Dr. Weiner and Zoe discuss how this study highlighted an 11% increased risk of heart disease for those who consumed the most ultra-processed foods. The study particularly focused on the worst offenders: processed meats and sugar-sweetened beverages. These foods were shown to have the strongest links to heart disease.

One fascinating finding from the study is that not all ultra-processed foods have the same impact. When processed meats and sugary drinks are removed from the equation, the difference in heart disease risk between people who eat a lot of ultra-processed foods and those who don’t becomes much smaller. This reinforces the idea that not all ultra-processed foods are equal when it comes to heart disease risk. Avoiding processed meats and sugary drinks can significantly lower your risk, while focusing on healthier food choices can improve your long-term health.

Nutrition and Heart Health: How to Eat Smarter

When it comes to improving heart health, Dr. Weiner and Zoe offer practical advice on what foods to choose instead of processed meats. Zoe emphasizes the importance of focusing on whole, unprocessed foods, such as:

• Fruits and vegetables: These are packed with vitamins, minerals, and antioxidants that help support heart health.
• Lean animal proteins: Opt for fish, chicken, and lean cuts of red meat as alternatives to fatty cuts of red meat and processed meats. These options provide high-quality protein without the unhealthy fats found in processed meats.
• Nuts and seeds: Rich in healthy fats, fiber, and protein, these are great plant-based alternatives to meat.
• Legumes: Beans, lentils, and chickpeas are nutrient-dense and provide a satisfying source of protein and fiber.

The key is to focus on nutrient-dense, whole foods rather than simply trying to restrict calories or follow fad diets. The Pound of Cure philosophy encourages a shift in mindset toward eating for nutrition and long-term health and weight loss rather than fast weight loss which will, ultimately, come back.

Zoe also mentions the importance of minimizing food noise—the constant mental distraction and cravings for unhealthy foods—by incorporating satisfying, high-quality meals into your daily routine. By making smarter food choices, you can naturally reduce your cravings for processed foods and improve both your heart health and overall well-being.

Replacing processed meats with nutrient-dense foods like fruits, vegetables, lean proteins, nuts, seeds, and legumes is a smart strategy for improving heart health and managing weight.

The Role of GLP-1 Medications in Weight Loss

The episode concludes with an in-depth discussion on the role of GLP-1 medications in weight loss, particularly focusing on the recent shortages and their implications. These medications, like Wegovy and Zepbound, have been highly sought after due to their ability to lower the body’s set point. However, earlier shortages led many patients to seek compounded versions of these drugs.

Dr. Weiner explains that compounded GLP-1 medications are custom-made by compounding pharmacies, which mix the active ingredients (Semaglutide or Tirzepatide) with saline, B12 or other additives.

Release the GLP-1 Vials

The shortage of GLP-1 medications, like Wegovy and Zepbound, was primarily caused by the manufacturing of inj

In this episode of the Pound of Cure Weight Loss podcast, Dr. Weiner and Zoe explore the key strategies and medical options available for weight loss, focusing on GLP-1 medications, a comparison between gastric bypass and sleeve gastrectomy, and effective obesity treatment plans. This episode provides valuable insights for individuals exploring weight loss surgery, those using GLP-1 medications, and anyone interested in long-term, sustainable weight management.

GLP-1 Medications and Their Role in Obesity Treatment

The episode starts with an in-depth discussion about GLP-1 medications, such as Wegovy (semaglutide) and Zepbound (tirzepatide). Dr. Weiner explains that these medications represent a significant development in the medical treatment of obesity. GLP-1 medications work by modifying hormonal pathways that regulate hunger, fullness, and metabolism, thereby influencing the body’s internal set point for weight. Rather than simply curbing appetite, these medications help adjust how the body manages energy and fat storage, making weight loss more achievable and sustainable over time.

Dr. Weiner emphasizes that while GLP-1 medications can be highly effective, they are most beneficial when combined with a structured nutrition program and, when appropriate, surgical intervention. He notes that addressing obesity often requires a multi-faceted approach that goes beyond medication alone. Zoe adds that integrating these medications into a comprehensive weight management strategy that includes lifestyle changes is key for long-term success.

Gastric Bypass vs. Sleeve Gastrectomy: What’s the Difference?

One of the central discussions of this episode is the comparison between Gastric Bypass vs. Sleeve Gastrectomy. Dr. Weiner explains the key differences, benefits, and considerations for each procedure, helping listeners understand which option might be best suited for their specific situation.

Gastric Bypass: This procedure involves rerouting the digestive system, creating a small stomach pouch that is connected directly to the small intestine. Dr. Weiner explains that gastric bypass tends to result in greater weight loss and has a strong track record for addressing severe GERD (Gastroesophageal Reflux Disease). For patients who experience significant acid reflux, gastric bypass is often the preferred option since it bypasses the portion of the stomach that makes digestive enzymes​​.

Sleeve Gastrectomy: Also known as VSG (Vertical Sleeve Gastrectomy), this surgery removes a large portion of the stomach, leaving a sleeve-like structure. Dr. Weiner notes that while the procedure is less invasive and has a shorter recovery time, it may not be ideal for patients with pre-existing acid reflux. Studies show that up to 5-10% of patients who undergo sleeve gastrectomy can experience worsening GERD symptoms, which may necessitate a revision to gastric bypass​​.

Dr. Weiner explains that the choice between these procedures often depends on factors such as the patient's starting BMI, the presence of GERD, and individual health goals. He encourages patients to work closely with their surgical team to determine which option is most effective for their needs. Additionally, online tools and assessments provided by the practice can help patients explore which procedure might suit them best based on their health history and weight loss goals​.

A Comprehensive Approach to Obesity Treatment: Combining Surgery, Medication, and Nutrition

Dr. Weiner emphasizes that obesity treatment is most effective when it includes a combination of surgical, medical, and nutritional strategies. For many patients, integrating GLP-1 medications with bariatric surgery can amplify weight loss results, as these interventions work synergistically rather than in isolation. Both approaches target hormonal pathways that influence hunger and fullness, creating a more comprehensive shi

In this episode of the Pound of Cure Weight Loss Podcast, we sit down with BethAnn, whose journey through bariatric surgery has completely transformed her life. From struggling with weight her entire life, trying countless diets, and facing health challenges, to finally achieving long-term success after surgery, BethAnn's story is one of determination, resilience, and self-care.

BethAnn didn’t just stop at weight loss—she took additional steps to feel comfortable in her new body, including skin removal surgery. She also navigated the self-pay bariatric surgery route, making informed decisions to get the best results for her personal situation.

Let’s dive into her incredible journey and learn how bariatric surgery can change not just your body, but your entire outlook on life. Whether you're exploring bariatric surgery for yourself, curious about skin removal after weight loss, or considering self-pay options, BethAnn’s story is packed with insights that may guide you on your own path.

Bariatric Surgery Success Story: BethAnn's Lifelong Weight Struggles

BethAnn’s story is one that many can relate to. She had been battling her weight since childhood, trying everything from Richard Simmons’ Deal-a-Meal to more extreme options like OptiFast, a liquid-only diet. While she did experience short-term weight loss success with these diets—losing as much as 150 pounds—BethAnn found herself regaining the weight over and over.

By the time she reached her late 40s, BethAnn had resigned herself to living with the constant weight struggle. After undergoing a hysterectomy, she noticed her weight began to redistribute to her midsection, leading to additional health concerns like high blood pressure and rising cholesterol. She knew she needed a long-term solution.

"I’d done this seven times—lost the weight, gained it back," BethAnn explains. "The real battle for me was not losing the weight, but keeping it off."

That's when she began to seriously consider bariatric surgery. Initially, like many, she hesitated, thinking of it as "cheating" or "taking the easy way out." But as she reframed the narrative, it became clear that bariatric surgery was a tool that could give her a second chance at a healthier life.

After researching extensively and watching Dr. Weiner's video series, BethAnn decided to move forward with a gastric bypass procedure. This decision would turn out to be the start of her success story.

Choosing Gastric Bypass Over VSG

BethAnn’s success with bariatric surgery didn’t happen overnight, and her choice to go with gastric bypass rather than VSG (Vertical Sleeve Gastrectomy) was strategic. For her, avoiding weight regain was the ultimate goal. She was determined to pick the surgery that gave her the best long-term chance of success, and after careful research, she saw that gastric bypass offered better outcomes for maintaining weight loss over the years.

"I was less concerned about losing the weight and more focused on keeping it off," she says. "I knew that gastric bypass had better stats when it came to avoiding weight regain, and I’d been through enough yo-yo dieting to know that was my biggest challenge."

At the time of her surgery, BethAnn weighed just under 200 pounds—making her a lower BMI patient for bariatric surgery. Still, her choice of gastric bypass was a decision based on her history of weight regain, not just her starting weight.

Skin Removal After Weight Loss: A Necessary Next Step

After her weight stabilized at around 115-120 pounds, BethAnn faced another challenge that many post-op patients encounter: loose skin. This is a common side effect of significant weight loss, especially after bariatric surgery. Skin doesn’t always “snap back” into place after the weight is gone, and for BethAnn, it was more than just a cosmetic issue.

"It wasn’t like the loose skin was only visible at certain angles

Episode 44 of the Pound of Cure Weight Loss podcast offers a deep dive into cutting-edge treatments and strategies for long-term weight management, focusing on GLP-1 medications for weight loss, the emerging technology of duodenal mucosa ablation, and the issue of weight regain after GLP-1 treatment cessation. Hosted by Dr. Matthew Weiner, bariatric surgeon, and Zoe Schroeder, registered dietitian, this episode explores innovative methods to combat weight regain while delivering practical nutritional advice for sustained success.

The episode begins with a light conversation about nutrition, as Zoe highlights how bananas are often unfairly demonized. Dr. Weiner suggests a simple hydration solution—water and a banana—as a healthier alternative to processed electrolyte supplements, setting the tone for the podcast’s emphasis on whole, unprocessed foods.

Weight Regain After GLP-1 Medications

The focus then shifts to the weight regain after GLP-1 medications—a challenge faced by many patients after discontinuing these treatments. Dr. Weiner introduces Revita, a new device that uses duodenal mucosa ablation to help maintain weight loss following the cessation of GLP-1 drugs. Revita recently received FDA breakthrough device designation for its ability to treat patients who experience weight regain after stopping GLP-1 medications for weight loss. Dr. Weiner discusses how this endoscopic device works by ablating (burning) the mucosa in the duodenum, a section of the small intestine, potentially mimicking the effects of gastric bypass surgery. This approach aims to create a bypass-like effect without traditional surgery, helping to address the critical issue of weight regain after GLP-1 medication cessation.

Duodenal Mucosa Ablation - Skepticism and Safety Concerns

While Dr. Weiner expresses some skepticism about the theory behind the duodenal mucosa ablation, he acknowledges the potential of the Revita device, particularly given the high economic burden and ongoing shortages of GLP-1 medications for weight loss. He notes that while the data is promising, safety concerns—such as the risk of perforation and chronic inflammation—must be addressed before widespread adoption of this technology.

In addition to discussing duodenal mucosa ablation and the challenges of weight regain after GLP-1, Dr. Weiner and Zoe offer practical nutritional guidance. They emphasize the importance of long-term dietary changes, including incorporating more whole foods, fruits, and vegetables, especially for patients on GLP-1 medications for weight loss or recovering from weight loss surgery. The podcast underscores that successful weight management requires sustainable habits, from meal planning to making healthier choices amidst busy schedules.

As they wrap up the episode, Dr. Weiner and Zoe reflect on the future of obesity treatment, acknowledging that a combination of GLP-1 medications for weight loss, non-surgical techniques like GLP-1 medications and the duodenal mucosa ablation, and proper nutrition will continue to evolve. While these treatments are not magic solutions, they hold significant promise in tackling the persistent challenge of weight regain after GLP-1 cessation.

Episode 44 provides a valuable perspective on the latest developments in weight management, particularly for those using GLP-1 medications for weight loss or considering alternatives like duodenal mucosa ablation. Dr. Weiner and Zoe's thoughtful discussion offers essential insights for patients navigating the complexities of weight loss surgery, medication, and nutritional strategies for long-term success.

In episode 43 of the Pound of Cure Weight Loss Podcast, Dr. Matthew Weiner and Zoe Schroeder, RD, explore key bariatric surgery weight loss factors, the best diet for weight loss, and how to manage malabsorption after bariatric surgery. The episode emphasizes that post-surgery success involves much more than effort alone.

Bariatric Surgery Weight Loss Factors

Dr. Weiner explains that multiple factors influence weight loss after surgery, including age, gender, and genetics. For example, younger patients lose more weight than older people do. And men, tend to lose more weight than women. Diabetes also complicates weight loss due to higher insulin levels. However, following the Metabolic Reset Diet can help reverse diabetes and promote more weight loss both before and after surgery. Factors like mobility issues and medications can also slow the process​.

Best Diet for Weight Loss

The hosts highlight that the best diet for weight loss focuses on nutrient-dense foods like fruits, vegetables, beans, lean proteins, and nuts. Dr. Weiner stresses that it's not about eating less but rather, eating differently. Highly processed foods pack in “bad calories” that hinder your metabolism, while whole foods support weight loss and overall health. The goal is to shift your calorie intake toward nutrient-dense foods and away from processed junk​​.

Malabsorption After Bariatric Surgery

Dr. Weiner also addresses concerns about malabsorption after bariatric surgery. Particularly after procedures like a gastric bypass, where certain nutrients like iron, calcium, and vitamin B12 may not be absorbed efficiently. Lifelong supplements and regular blood work are crucial to manage these deficiencies.

Long-Term Success: More Than Just Surgery

While surgery can significantly lower your body’s setpoint, long-term success depends on lifestyle changes. Dr. Weiner and Zoe recommend combining surgery with nutrition and movement in order to produce the best, most durable weight loss.

When those aren’t enough, Dr. Weiner will also combine surgery with GLP-1 medications to reduce hunger and make it easier to maintain a healthy diet. These medications lower the setpoint and help manage "food noise," but they need to be taken consistently to prevent weight regain​.

Conclusion

In this episode, Dr. Weiner and Zoe emphasize that bariatric surgery weight loss factors include things beyond effort, like age and the type of surgery chosen. The best diet for weight loss focuses on nutrient-dense foods, and malabsorption after bariatric surgery is manageable with proper care.

If you have a question that you would like answered on the podcast, comment on our website or any of our social media platforms.

On today’s episode we explore one of the most important yet often overlooked aspects of bariatric surgery—the emotional journey. While many focus on the physical transformation, it’s the emotional and mental changes that often determine long-term success. Bariatric surgery isn’t just about losing weight; it’s about reshaping your relationship with food and developing healthier ways to manage emotions.

The Emotional Impact of Bariatric Surgery

We’ll start by diving into the emotional impact of bariatric surgery. Many people use food as a way to cope with stress, sadness, or boredom. But after surgery, that emotional crutch isn’t available anymore. This shift can lead to feelings of frustration, anxiety, or even what’s known as "bariatric grief." In this episode, we discuss what it’s like to let go of old habits and how to find new ways to handle difficult emotions​.

Emotional Eating After Bariatric Surgery

One of the biggest challenges many people face post-surgery is emotional eating. Although your stomach is smaller and physically can’t handle the same amount of food, the emotional triggers that lead to overeating don’t just disappear. Emotional eating can show up in new ways, like making bad food choices. We’ll talk about how to spot these behaviors early and provide practical tips, such as keeping a food journal and working with a therapist, to address emotional eating head-on​.

Mental Health Support is Crucial

In this episode, we also cover why mental health support is so crucial after bariatric surgery. Many people go through a psychological evaluation before surgery, but the real emotional work often needs to happen afterward. We’ll explore how the adjustment to a new lifestyle can bring up anxiety, fear of weight regain, or feelings of frustration, and how important it is to develop healthy coping strategies. From practicing mindfulness and talking to a therapist to joining support groups, we discuss several ways to manage emotional ups and downs​​.

Community is Key

A key theme of today’s discussion is the importance of community. Having a strong support system can make all the difference in your post-surgery journey. Whether it’s friends, family, or a support group, feeling understood and supported plays a huge role in staying on track emotionally. We’ll share how connecting with others who are going through similar experiences can help you feel less alone and offer practical advice on building your own support network​.

Emotional Ramifications of Weight Regain

Lastly, we’ll touch on the reality of weight regain and why it’s important not to view it as a failure. Weight can fluctuate, but it’s part of the process. By focusing on your emotional well-being and continuing to build healthy habits, you’ll be better equipped to handle any bumps in the road without turning back to old, unhealthy patterns​.

So, whether you’re thinking about bariatric surgery, in the early stages of recovery, or years post-op, this episode offers valuable insights into managing your emotional health and navigating the mental challenges that come with such a life-changing procedure. Tune in for a conversation that will help you embrace your new, healthier life while taking care of your emotional well-being along the way!