Weight loss medications: A Balanced “weigh” in on the topic

Apr 26, 2024 | Hormones, weight loss, Women's Health

Today’s conversation is with Rachel Smith who has been practicing weight management medicine or obesity medicine since 2016.

I wanted to have Rachel on the podcast to shed some light on the recent uptick in weight loss medications and offer a balanced opinion about what these medications are all about.

Today we talk about the GLP 1 agonists, semaglutide, ozempic….

We dive into the obesity epidemic, and yes it is an epidemic in our country.

We talk about the drivers of this, people who have dieted all their lives, what the medications actually do and who benefits the most from them.

As a health coach my purpose in having Rachel here for this conversation is really to illuminate the fact that we can’t just take a pill and expect our overall health to improve without putting in the effort.  The fact remains that lifestyle and the choices we make on a daily basis are still the most important part of this weight loss medication journey.

If you take these medications and you don’t focus on eating healthy, protein loaded foods often during the day and focusing on exercising and lifting weights you can be end up in a nutritionally depleted state and with incredible muscle loss.  That is not sustainable nor healthy yet that is happening all over the place.

Rachel and I talk about how to do that and who might be the best candidate for this approach.

This conversation is really important.

I have to say in the beginning I was in the camp of “these medications are not safe and no one should be on them for just weight loss” but I now feel that there are populations of people who can benefit from their use.  Those who have been chronically obese for years, have metabolic syndrome, high blood pressure, diabetes, NAFLD.  All of these conditions are helped by losing weight but doing it in a way that supports a healthy lifestyle not just taking a pill and not eating.

The research still needs to be done about the connection with the gut microbiome and how that shifts during the medication use.

We talk about how to find someone who can do this work for those who truly would benefit from it and are focused on the safest method and support.

It’s not just for someone who wants to lose 20 lbs and can’t get there…

We also have to consider the mindset and mental health of those who are struggling with weight.  Rachel and I didn’t talk enough about this but maybe that is another podcast.

I have talked about mindset here many times and there is no healthy living without shifting our mindset about what we are capable of and….we are capable of so much more than we could ever imagine.

Digging into the “why” around weight gain and lifestyle choices cannot be ignored.

The medications here are a jump start but they are not effective if you are not changing your eating habits, exercise, sleep, stress and overall lifestyle.  This is so important to take away from this conversation.

So who is Rachel Smith?

Rachel graduated from the Midwifery Institute at Philadelphia University in 2006.

She fell in love with metabolic health and obesity medicine in 2016 after developing a weight management program for a large obstetrical practice.

She trained as a health and wellness coach at Duke University, which is how we know one another…then she obtained advanced training in functional medicine and obesity medicine and switched her focus to obesity medicine.

Rachel has since added a family nurse practitioner degree from Frontier University as well as a Doctorate in Nursing.

As an advance practice nurse Rachel has focused her career on health promotion and patient-centered care working with hormonal and metabolic optimization.

Rachel has been the program director for a successful obesity medicine practice in Bradenton for the past 5 years and has now started her own practice in obesity medicine called Aspect Wellness!

Check show notes for her links!

She is a member of the Obesity Medicine Association, the American Academy of NursePractitioners, the American College of Nurse Midwives, the Florida Obesity Society, theObesity Action Coalition, and the North American Menopause Society

See below links to Instagram and Rachel’s website.



Books – “The Last Diet” Shahroo Izadi


Dr. Gabrielle Lyon – Forever Strong