GLP-1 Hub: Support, Community, and Weight Loss

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After gastric bypass, some people make so much of their own GLP-1 that their blood sugar rockets after a meal and then crashes, and the juice or glucose tabs meant to rescue them can restart the whole cycle. Stanford endocrinologist Dr. Marilyn Tan explains post-bariatric hypoglycemia, a condition many patients live with for years before anyone names it, and whether GLP-1 medications make sense after surgery for weight regain. Then she shares phase 3 results for avexitide, an investigational drug that works in the opposite direction from the GLP-1 medications everyone is talking about.

**IN THIS EPISODE**
- Hypoglycemia vs. hyperglycemia in plain language, including what "level 3" low blood sugar means
- What your body's own GLP-1 does after you eat, and why gastric bypass and sleeve surgery amplify it
- Why diabetes can resolve within days of surgery, before the weight comes off
- Whether GLP-1 medications are safe to use after bariatric surgery for weight regain
- What post-bariatric hypoglycemia (PBH) is, who tends to get it, and why it often shows up six months or more after surgery
- The spike-then-crash pattern one to three hours after a carb-heavy meal
- Why the usual low blood sugar advice can backfire for PBH, and what helps stabilize instead
- The strict PBH diet (about 30 grams of carbs per meal, 15 per snack) and how it can tip into malnutrition
- Why PBH is underdiagnosed, and the new ICD-10 diagnosis code
- Inside the phase 3 LUCIDITY trial of avexitide, a GLP-1 blocker that is not FDA approved
- What GLP-1 agonists do and don't do for people who already have PBH
- What's next for avexitide and who else it may help

**ABOUT THE GUEST**
Dr. Marilyn Tan, MD, FACE, FACP, is double board certified in Endocrinology and Internal Medicine. She is a Clinical Professor of Medicine at Stanford University School of Medicine and Chief of the Endocrine Clinic at Stanford Health Care. Her clinical focus is outpatient and inpatient diabetes management, and her research includes diabetes and post-bariatric hypoglycemia. She is also actively involved in resident and fellow education and mentorship.

**CONNECT WITH DR. MARILYN TAN**
Stanford Health Care profile: https://stanfordhealthcare.org/doctors/t/marilyn-tan.html

**SPONSOR**
This episode is brought to you by Timeline. When you buy a one-month supply of Mitopure Gummies, you'll get a free Discovery Size Mitopure Firming Serum, an $85 value. Go to https://www.timeline.com/glp1bundle to claim yours.

**CHAPTERS**
00:00 Cold open
00:22 Ana's intro
01:23 Welcome, Dr. Marilyn Tan
02:30 Low vs. high blood sugar, explained
04:04 What GLP-1 does when you eat
04:27 Why gastric bypass supercharges your GLP-1 response
07:02 GLP-1, the brain, and appetite after surgery
09:39 Can you take a GLP-1 after bariatric surgery?
10:49 Who gets post-bariatric hypoglycemia
12:05 The spike and the crash, symptoms to know
13:27 Sponsor break, Timeline
14:22 Why juice and glucose tabs can backfire
14:52 Stabilizing lows and the strict PBH diet
17:12 How common PBH is, and its new diagnosis code
19:05 Inside the phase 3 avexitide trial
20:51 How a GLP-1 blocker works
22:04 Do GLP-1 medications help or hurt PBH?
24:56 From Ana, the Beyond the Shot guide
26:04 The results, 55% fewer serious lows
26:51 What happens next for avexitide
27:39 Side effects and daily injections
29:00 Where to learn more
29:50 Beyond bariatric surgery, who else this could help
31:08 Closing

MORE FROM GLP-1 HUB
📬 Get The Steady State, Ana's weekly newsletter with GLP-1 guidance from a dietitian who's on one: http://join.glp-1hub.com

🎙 Subscribe wherever you listen to podcasts, and if this episode helped, leave a quick review on Apple Podcasts or Spotify - it's the single best way to help more people find the show.

🌐 Shop GLP-1 essentials, meal plans, and recipes: https://shop.glp-1hub.com
📷 Follow on Instagram: @glp1hub
📺 Watch on YouTube: https://www.youtube.com/@GLP-1hub
*Some of the links shared are affiliate links. When you make a purchase, I will receive a small commission at no cost to you. Thank you for supporting the show.
*The content of this show is for informational purposes only and does not constitute medical advice. The goal of this show is to provide various points of view about GLP-1 Medications. The personal and professional opinion of the guests and their content does not necessarily reflect the opinion of Ana Reisdorf or GLP-1 Hub.

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Does a dinner out or a big trip ever feel like it could undo your progress on a GLP-1? Registered dietitian Holly Larson joins Ana to explain why a GLP-1 is a tool, not a diet, and how to enjoy restaurants and vacations without feeling terrible the next day. You'll learn how to read a menu, what to do with your medication when you travel, and the one word that tells you diet culture is doing the talking.

**IN THIS EPISODE**
- Why a GLP-1 is a tool, not another restrictive diet
- How to spot the "should" voice and talk back to it
- Ordering at a special-occasion restaurant: protein, appetizers as mains, and the foods most likely to cause the "icks"
- Being mindful (not rigid) with bread baskets, alcohol, and fancy coffee drinks
- Everyday restaurant eating: 25 to 30 grams of protein and plenty of fiber
- Continuing or pausing your dose for a trip, and why that decision belongs with your prescriber
- Traveling with your pen: insulin cooler cases, carry-on only, TSA, and international limits
- Planning your vacation meals around the one you're most excited about
- Packing for hydration and GI comfort: electrolytes, prunes, and backup medications

**ABOUT THE GUEST**
Holly Larson is a registered dietitian with almost two decades of experience. She runs a virtual private practice in Ohio supporting women, especially those using GLP-1 medications, with a food-first, no-shame approach.

**CONNECT**
Website: https://hollylarsonnutrition.com
Instagram: @hollylarsonnutrition

**SPONSOR**
Tyde Wellness is the GLP-1 provider Ana uses herself. Visit https://tydewellness.com/GLP1Hub and use code GLP1Hub50 for $50 off your first month.

**CHAPTERS**
00:00 Skip a dose for a food trip?
00:32 Welcome and episode preview
01:25 Meet Holly Larson
03:16 A GLP-1 is a tool, not a diet
05:20 Quieting the "should" voice
09:07 How to order at a special restaurant
10:51 Bread baskets and alcohol
12:05 Sponsor: Tyde Wellness
13:04 Eating out every day
14:48 Drinks and the hidden-calorie salad
16:09 Your medication and travel
18:07 Carrying your pen, TSA, and international trips
21:30 How to eat on vacation
23:22 Ana's Beyond the Shot guide
24:23 Balancing breakfast, steps, and indulgent dinners
26:15 Hydration and GI prep for travel
29:37 Final thoughts and where to find Holly

MORE FROM GLP-1 HUB
📬 Get The Steady State, Ana's weekly newsletter with GLP-1 guidance from a dietitian who's on one: http://join.glp-1hub.com

🎙 Subscribe wherever you listen to podcasts, and if this episode helped, leave a quick review on Apple Podcasts or Spotify - it's the single best way to help more people find the show.

🌐 Shop GLP-1 essentials, meal plans, and recipes: https://shop.glp-1hub.com
📷 Follow on Instagram: @glp1hub
📺 Watch on YouTube: https://www.youtube.com/@GLP-1hub
*Some of the links shared are affiliate links. When you make a purchase, I will receive a small commission at no cost to you. Thank you for supporting the show.
*The content of this show is for informational purposes only and does not constitute medical advice. The goal of this show is to provide various points of view about GLP-1 Medications. The personal and professional opinion of the guests and their content does not necessarily reflect the opinion of Ana Reisdorf or GLP-1 Hub.

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If the scale has stalled or you're worried about losing muscle on a GLP-1, that number may not be telling you the whole story. Fitness coach and competitive powerlifter Andrew Menechian explains why body composition matters more than your weight or BMI, how to set a protein target that actually fits your body, and the minimum strength training it takes to hold on to muscle. You'll also hear why he thinks cutting calories lower and lower backfires, and the diet-break approach he uses instead.

**IN THIS EPISODE**

- What body composition means, and why two people at the same weight can look completely different
- Why BMI misses people who are "skinny fat" and labels muscular athletes as obese
- Beginner gains: why people new to strength training can build muscle and lose fat at the same time
- The two things that protect muscle on a GLP-1: protein and resistance training
- How to set a protein target based on lean body mass instead of total body weight
- How much strength training it takes to maintain muscle versus build it
- Why training first thing in the morning makes the habit easier to keep
- Simple options for older adults and people with injuries or physical limitations
- Muscle first or fat loss first when you're already at a healthy weight
- Metabolic adaptation, reverse dieting, and his diet-break strategy for plateaus

**ABOUT THE GUEST**

Andrew Menechian is an online health coach and head of fitness at Fit Commit, with about 15 years of coaching experience. He is a former head coach at the Clean Health Fitness Institute and former education manager at Fitness Playground in Australia. A competitive bodybuilder and powerlifter, he won the 2015 IFBB Australasian Men's League title and unofficially broke an Australian under-90 kg deadlift record.

**CONNECT WITH ANDREW MENECHIAN**

FitCommit
Website: https://fitcommit.ai
Instagram: https://www.instagram.com/fitcommitai/
YouTube: https://www.youtube.com/@fitcommitai

Andrew Menechian
Instagram: https://www.instagram.com/andrewmenechian/
YouTube: https://www.youtube.com/@andrewmenechian
X: https://x.com/andrewmenechian
LinkedIn: https://www.linkedin.com/in/andrewmenechian/

**SPONSOR**

This episode is brought to you by Timeline. When you buy a one-month supply of Mitopure Gummies, you'll get a free Discovery Size Mitopure Firming Serum, an $85 value. Go to https://www.timeline.com/glp1bundle to claim yours.

**CHAPTERS**

00:00 Preview: why the scale isn't the whole story
00:25 What's in this episode
01:21 Welcome, Andrew Menechian
02:19 From shy kid to bodybuilder and record deadlifter
04:51 Why a goal weight can set you up for disappointment
05:45 What body composition really means
08:06 Why BMI falls short
08:52 Can you build muscle and lose fat at the same time?
11:41 Sponsor: Timeline
12:35 How to avoid losing muscle on a GLP-1
13:12 How much protein you really need
16:53 How much strength training it takes to keep muscle
18:36 Why morning workouts make the habit stick
21:09 Strength training with injuries or physical limitations
23:35 The Plateau Breakthrough Playbook
24:57 Fat loss first or muscle first?
26:56 Metabolic adaptation and reverse dieting
27:24 His diet-break strategy for plateaus
30:33 Where to find Andrew

MORE FROM GLP-1 HUB
📬 Get The Steady State, Ana's weekly newsletter with GLP-1 guidance from a dietitian who's on one: http://join.glp-1hub.com

🎙 Subscribe wherever you listen to podcasts, and if this episode helped, leave a quick review on Apple Podcasts or Spotify - it's the single best way to help more people find the show.

🌐 Shop GLP-1 essentials, meal plans, and recipes: https://shop.glp-1hub.com
📷 Follow on Instagram: @glp1hub
📺 Watch on YouTube: https://www.youtube.com/@GLP-1hub
*Some of the links shared are affiliate links. When you make a purchase, I will receive a small commission at no cost to you. Thank you for supporting the show.
*The content of this show is for informational purposes only and does not constitute medical advice. The goal of this show is to provide various points of view about GLP-1 Medications. The personal and professional opinion of the guests and their content does not necessarily reflect the opinion of Ana Reisdorf or GLP-1 Hub.

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Most people think of a GLP-1 as a weight loss medication, but for your heart, the story starts before the scale moves much at all. Board-certified cardiologist and lipidologist Dr. Sirisha Vadali explains what the research shows about GLP-1s and cardiovascular risk, the simple routine she starts her patients on, and what she monitors along the way. You'll also hear why she doesn't recommend a GLP-1 for family history alone, and about one genetic cholesterol marker that diet and exercise can't change, a lab she says everyone should have checked once in their lifetime.

**IN THIS EPISODE**

- How GLP-1s went from diabetes drugs to heart protection, with or without diabetes
- Why some heart benefit appears before major weight loss, and why no one knows exactly how yet
- Who GLP-1s are currently indicated for in cardiovascular risk reduction, and why semaglutide (Wegovy) is the one with outcomes data so far
- Why muscle mass, protein, and strength training belong in every GLP-1 plan
- Dr. Vadali's simple phase one: 100 grams of protein (30 to 40 grams in the morning), 25 grams of fiber, water, and strength training twice a week at home
- Watching blood pressure, heart rate, hydration, and kidney function on a GLP-1
- Fatigue and low motivation after the shot: what to rule out first
- Whether family history alone is a reason to start a GLP-1
- The heart labs she checks, including Lp(a), ApoB, hs-CRP, and a coronary calcium score
- What Lp(a) is, why it's a one-time lifetime screening, and the treatments expected in the next few years
- A word of caution on buying unapproved triple agonists online
- Simple longevity habits: sleep, stress, walking after meals, and the 80/20 approach
- Why hunger coming back isn't a reason to panic

**ABOUT THE GUEST**

Dr. Sirisha Vadali, MD, is a board-certified cardiologist and advanced lipidologist specializing in prevention, cardiometabolic medicine, and women's heart health. She is program director for HonorHealth's Cardiometabolic Program in Scottsdale, Arizona, and a member of the HonorHealth Women's Heart Health team. Dr. Vadali focuses on prevention-forward care, using advanced lipid testing, coronary calcium scoring, and lifestyle medicine to help patients lower cardiovascular risk and build sustainable, healthy habits.

**CONNECT WITH DR. SIRISHA VADALI**

Website: https://www.sirishavadali.com
Instagram: https://www.instagram.com/vadalimd/
HonorHealth Cardiometabolic Program: https://www.honorhealth.com/physicians/sirisha-vadali

**SPONSORS**

This episode is brought to you by Timeline. When you buy a one-month supply of Mitopure Gummies, you'll get a free Discovery Size Mitopure Firming Serum, an $85 value. Go to https://www.timeline.com/glp1bundle to claim yours.

This episode is also brought to you by Tyde Wellness, the GLP-1 provider Ana uses, with nutrition guidance built for GLP-1s, independent licensed providers, and a care team that answers when something comes up. Go to https://tydewellness.com/GLP1Hub and use code GLP1Hub50 for $50 off your first month.

**CHAPTERS**

00:00 Preview: why wait for a heart attack?
00:12 What's in this episode
01:07 Welcome, Dr. Sirisha Vadali
02:11 How GLP-1s went from diabetes drugs to heart protection
03:35 How GLP-1s protect the heart, even before weight loss
05:35 Semaglutide vs. tirzepatide: which she uses and why
06:17 What lower obesity rates could mean for heart health
08:44 Lower BMI and high risk: lifestyle first, then a low dose
10:26 Her simple phase one routine and at-home strength training
13:23 Kidneys, hydration, and how often to check blood pressure
14:33 Fatigue and low motivation after the shot
15:59 Sponsor: Timeline
16:53 Is family history a reason to start a GLP-1?
18:31 The heart lab panel she recommends
20:10 New Lp(a) treatments on the way
21:08 What Lp(a) is and why it matters
23:25 A caution on unapproved triple agonists
26:41 Sponsor: Tyde Wellness
27:42 Longevity basics: sleep, stress, walks, and 80/20
30:29 Quick fixes, food noise, and when hunger comes back
32:09 Where to find Dr. Vadali

MORE FROM GLP-1 HUB
📬 Get The Steady State, Ana's weekly newsletter with GLP-1 guidance from a dietitian who's on one: http://join.glp-1hub.com

🎙 Subscribe wherever you listen to podcasts, and if this episode helped, leave a quick review on Apple Podcasts or Spotify - it's the single best way to help more people find the show.

🌐 Shop GLP-1 essentials, meal plans, and recipes: https://shop.glp-1hub.com
📷 Follow on Instagram: @glp1hub
📺 Watch on YouTube: https://www.youtube.com/@GLP-1hub
*Some of the links shared are affiliate links. When you make a purchase, I will receive a small commission at no cost to you. Thank you for supporting the show.
*The content of this show is for informational purposes only and does not constitute medical advice. The goal of this show is to provide various points of view about GLP-1 Medications. The personal and professional opinion of the guests and their content does not necessarily reflect the opinion of Ana Reisdorf or GLP-1 Hub.

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A daily GLP-1 pill sounds like an easy way to maintain your weight loss, but what happens when it doesn't work like the shot did? Registered dietitian Whitney Black, who lives with type 1 diabetes, shares what happened when she switched from Zepbound to Foundayo (orforglipron) for maintenance, and why she went back after two months. You'll hear how her fullness cues, blood sugar, and insulin needs changed, and what she tells clients about weight regain. The surprise wasn't the food noise. It was a different signal that quietly went missing. This is one person's experience, not a verdict on how the pill will work for everyone.

IN THIS EPISODE

- Whitney's path to Zepbound with type 1 diabetes, Hashimoto's, and PCOS
- Why hunger and fullness dysregulation is biology, not a personal failing
- Where GLP-1s stand for type 1 diabetes, and why insulin changes need your care team
- What Foundayo is (an oral GLP-1 from Eli Lilly, not tirzepatide) and how its dosing differs
- How her fullness cues and blood sugar changed on Foundayo, and the roughly 15 pounds she regained in two months
- Cost versus effectiveness when choosing a maintenance option
- Switching back to Zepbound and slowly titrating up again
- Practical and mental strategies when weight comes back after a break in medication

ABOUT THE GUEST

Whitney Black, MBA, MS, RD, LD, LMNT, is a registered dietitian specializing in weight management and practical nutrition for individuals using GLP-1 medications. Through her private practice and online education, she helps people navigate nutrition, weight management, and metabolic health with an evidence-based, realistic approach. Whitney also brings her own lived experience with weight management and GLP-1 medications to her work, allowing her to connect clinical expertise with the real-life experience of navigating these treatments. She is also the author of an upcoming GLP-1-focused cookbook with Fair Winds Press.

CONNECT WITH WHITNEY BLACK

Instagram: https://www.instagram.com/whitney.the.dietitian/
Work with Whitney (Nourish): https://signup.nourish.com/providers/whitney-black

SPONSORS

This episode is brought to you by Timeline. When you buy a one-month supply of Mitopure Gummies, you'll get a free Discovery Size Mitopure Firming Serum, an $85 value. Go to https://www.timeline.com/glp1bundle to claim yours.

This episode is also brought to you by Tyde Wellness, the GLP-1 provider Ana uses, with nutrition guidance built for GLP-1s, independent licensed providers, and a care team that answers when something comes up. Go to https://tydewellness.com/GLP1Hub and use code GLP1Hub50 for $50 off your first month.

CHAPTERS

00:00 Preview: why the pill appealed to her
00:21 Introduction
01:04 Welcome, Whitney Black
02:17 Life before GLP-1s with type 1 diabetes, Hashimoto's, and PCOS
04:54 Starting Zepbound as a dietitian
06:53 Fullness cues: it's biology, not willpower
08:38 GLP-1s and type 1 diabetes today
12:29 Maintenance, dosing, and why she tried Foundayo
12:57 What Foundayo is (and isn't)
14:29 Sponsor: Timeline
15:23 Foundayo dosing and the first weeks
16:44 Losing the fullness signal
18:53 Rising blood sugar and insulin resistance
19:26 Cost versus effectiveness
21:40 Back on Zepbound
24:00 Advice when weight comes back after a break
26:14 Sponsor: Tyde Wellness
27:14 Why it's not just an appetite suppressant
30:08 Where to find Whitney
31:26 Closing

MORE FROM GLP-1 HUB
📬 Get The Steady State, Ana's weekly newsletter with GLP-1 guidance from a dietitian who's on one: http://join.glp-1hub.com

🎙 Subscribe wherever you listen to podcasts, and if this episode helped, leave a quick review on Apple Podcasts or Spotify - it's the single best way to help more people find the show.

🌐 Shop GLP-1 essentials, meal plans, and recipes: https://shop.glp-1hub.com
📷 Follow on Instagram: @glp1hub
📺 Watch on YouTube: https://www.youtube.com/@GLP-1hub
*Some of the links shared are affiliate links. When you make a purchase, I will receive a small commission at no cost to you. Thank you for supporting the show.
*The content of this show is for informational purposes only and does not constitute medical advice. The goal of this show is to provide various points of view about GLP-1 Medications. The personal and professional opinion of the guests and their content does not necessarily reflect the opinion of Ana Reisdorf or GLP-1 Hub.