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It's been more than a year since I last did an episode about GLP-1 weight loss medications — and a LOT has happened since then.

I've also now had much more experience prescribing and managing these medications as a GP.

I've seen people achieve significant, life-changing weight loss.

I've seen people experience, for the first time in their lives, what it's like not to have the constant chatter about food running through their heads.

I've had patients reach their goal and come off the medication, others decide to remain on it long-term, and plenty who are still somewhere in between.

And I've also seen people handed a prescription with very little guidance about what they should actually be doing while taking it.

So I thought it was time for an update.

In this episode of Opt to Thrive, I'm taking a practical look at GLP-1 weight loss medications including Mounjaro (tirzepatide) and Wegovy (semaglutide) — what we now know, what we're still learning, and what I've learned from actually using these medications with patients in clinical practice.

We talk about how GLP-1 medications work, why they can have such a profound effect on appetite and the phenomenon we now call "food noise", and why some people describe finally feeling in control of their appetite for the first time in their lives.

We look at who these medications are actually recommended for — and importantly, why someone who simply wants to lose a few kilos isn't necessarily an appropriate candidate.

I also unpack some of the other potential health benefits we're learning about, including cardiovascular health, sleep apnoea and fatty liver disease, as well as emerging research around reward and craving behaviours such as binge eating and alcohol consumption.

And then we tackle some of the scary stuff.

Thyroid cancer. Pancreatitis. Depression and suicidality. Hair loss. And the rare eye condition NAION that has generated headlines about GLP-1 medications and blindness.

What do we actually know about these risks — and how do we put a very rare potential harm into context against the health risks of obesity itself?

But perhaps the part I feel most strongly about is how we use these medications.

Because getting the prescription is not the whole treatment.

For my patients — particularly midlife women — I don't simply want to see the number on the scales falling while muscle and bone go with it.

I want to see body fat coming down while we protect muscle, support bone and build habits that will serve them long after the weight loss phase is over.

That means strength training.

Enough protein.

Enough fibre.

Appropriate monitoring.

And weight loss that is steady rather than a race to get the kilos off as quickly as possible.

GLP-1 medications can be incredibly powerful tools when they're used appropriately.

But the medication is the tool.

What we build with it matters.

If you're taking Mounjaro or Wegovy, thinking about starting one, or you're simply curious about what all the fuss is about, this episode will give you a practical, balanced look at what you need to know.

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