Dr. Spencer Nadolsky and Karl break down two brand new randomized controlled trials that put hard numbers on a question they have been navigating clinically for years: what actually happens to patients on GLP-1 medicines when they try to lower their dose, switch to a cheaper option, or come off entirely. In this episode they cover why obesity biology actively fights back against weight loss through hunger hormones, fat cell hormones, and hypothalamic signaling in ways that make maintenance genui...
May 25, 2026•40 min•Ep. 153
Dr. Spencer Nadolsky and Karl sit down with Dr. Susan Brian, a Yale-trained endocrinologist, certified menopause provider, and medical director of a clinic with seven endocrinologists who runs an active bone fragility fracture clinic, to answer the question that has been flooding social media since a viral abstract with two fake bones on a surgical table convinced people their skeletons are quietly dissolving. Follow Dr. Susan here In this episode they cover why the preclinical and mechanistic d...
May 18, 2026•32 min•Ep. 152
Dr. Spencer Nadolsky and Karl sit down with Dr. Eryn Russo, a board-certified occupational and environmental medicine physician with nearly 20 years of experience working at Hill Air Force Base, where she deals with real toxic metal exposures every single day. She is one of less than one percent of all board-certified physicians practicing in this specialty, which makes her exactly the person you want explaining why the heavy metal detox content flooding your social media feed is not medicine. I...
May 05, 2026•53 min•Ep. 151
Dr. Spencer Nadolsky and Karl sit down with Dr. Adam Auton, geneticist at 23andMe, to break down a brand new paper using data from over 27,000 people that identified specific genetic variants linked to how well GLP-1 medications work and how likely someone is to experience side effects. 23andMe has over 11 million people in their research database and used voluntary survey data on medication use, dosage, duration, weight loss, and side effects to match against genetic profiles at scale, making t...
Apr 21, 2026•25 min•Ep. 150
5:37 PM Dr. Spencer Nadolsky and Karl sit down with Dr. Henning Langer, PhD researcher at the Charité in Berlin and founder of his own muscle metabolism lab, to break down his newly published paper combining rodent and human data to look directly at what GLP-1 medicines actually do to skeletal muscle beyond what a DEXA scan can tell you. Dr. Langer spent time at Boehringer Ingelheim specifically studying skeletal muscle during obesity and anti-obesity treatment before bringing that work to his o...
Apr 14, 2026•36 min•Ep. 149
Dr. Spencer Nadolsky and Dr. Karl Nadolsky sit down with Dr. Stuart Phillips, senior author on the newly updated American College of Sports Medicine position stand on resistance training, to break down what 137 systematic reviews and over 30,000 participants actually tell us about building muscle, getting stronger, and improving function across the lifespan. The last version of these guidelines was published in 2009 and the science has come a long way, even if the fundamentals have not. In this ...
Apr 02, 2026•52 min•Ep. 148
Dr. Spencer Nadolsky, Dr. Karl, and chief science officer Dr. Grant Tinsley sit down with Dr. Steven Heymsfield, physician at the Pennington Biomedical Research Center and lead author on the BELIEVE trial, to break down what happens when you combine bimagrumab with semaglutide and why over 90 percent of weight lost in the combination group was pure fat. Dr. Heymsfield has published over 600 peer reviewed articles and is widely considered one of the foremost body composition researchers in the wo...
Mar 23, 2026•39 min•Ep. 147
Dr. Spencer and Karl Nadolsky bring on Dr. Alyssa Olenick, exercise physiologist and postdoctoral researcher in menopause and metabolism, to cut through the noise on one of the most misrepresented topics in women's health. Dr. Olenick holds a PhD in exercise physiology, completed postdoctoral training focused on menopause and body composition, and is the founder of the Liss Method, a hybrid training program combining strength and endurance. She has been doing women-specific and sex-difference re...
Mar 13, 2026•50 min•Ep. 146
Takeaways: Creatine is a naturally occurring compound that helps regenerate ATP, the energy currency of the cell. Supplementing with creatine can enhance performance in high-intensity exercise but may not be beneficial for endurance activities. The majority of creatine is stored in muscle, and supplementation can help fill those stores for better energy availability. Creatine monohydrate is the most studied and effective form of creatine, and it's also the cheapest. There is no need to cycle cre...
Mar 06, 2026•35 min•Ep. 145
Takeaways: The 11-Minute Rule: Why blue light isn't the villain you think it is. The Melatonin Mistake: Why "less is more" (and the exact dosage for success). Trackers vs. Reality: When to throw away your Apple Watch or Oura Ring. The Bedrock Principle: Why sleep is the lead domino for fat loss and metabolic health. Sex & Sleep: The surprising biological difference in how men and women recover. Tap Here to follow Shelby Shelbys Book Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.c...
Feb 23, 2026•49 min•Ep. 144
Get The Lucky Egg Book Here Takeaways: Dr. Lucky Sekhon is a reproductive endocrinologist and author of 'The Lucky Egg'. The pathway to reproductive endocrinology involves extensive training in OB-GYN and specialized fellowship. Social media became a tool for Dr. Sekhon to combat misinformation during the pandemic. Common myths in fertility include the idea that one can reverse the biological clock. Understanding the fertility knowledge gap is crucial for patients seeking help. Insulin resistanc...
Feb 12, 2026•54 min•Ep. 143
Takeaways Excellence is not a standard but a process of becoming. Involved engagement means caring deeply about what you do. The pursuit of excellence shapes you into a better person. Consistency is key to achieving long-term goals. It's important to align your pursuits with your values. Youth sports can be beneficial but also harmful if not approached correctly. Weight loss should shift from a focus on numbers to health and well-being. Building a diverse identity can help prevent burnout in ath...
Jan 30, 2026•45 min•Ep. 142
Key Episode Takeaways Oral Wegovy is real, but it’s not “just a pill version of the shot.” Absorption rules, dosing schedules, and patient selection matter a lot more than most headlines suggest. Switching from injections to oral GLP-1s requires a plan. The transition isn’t one-size-fits-all, and dose timing, GI tolerance, and expectations need to be managed carefully. Weight regain after stopping GLP-1s is common, but not universal. SURMOUNT-4 data shows large variability, reinforcing that biol...
Jan 20, 2026•25 min•Ep. 141
Takeaways: Dietary guidelines have evolved since the 1980s. The food pyramid was introduced in 1992 and has influenced public perception. New dietary guidelines emphasize healthy fats but retain some old recommendations. There are contradictions in the new guidelines regarding saturated fat and protein intake. The definition of processed foods remains vague and controversial. The guidelines are intended for healthcare professionals, not consumers. Public policy needs to align with dietary guidel...
Jan 12, 2026•30 min•Ep. 140
Takeaways: Cortisol is essential for various bodily functions, especially during stress. Adrenal glands have a circadian rhythm that affects cortisol production. Cushing's syndrome can result from excess cortisol and has specific symptoms. Diagnosis of adrenal disorders requires careful testing and consideration of symptoms. Mild autonomous cortisol secretion can complicate diabetes management. The Catalyst trial explored the effects of cortisol antagonism on diabetes. Future research may focus ...
Jan 07, 2026•1 hr 3 min•Ep. 139
Takeaways: Slimmer's Paralysis is a recognized condition. Ethical boundaries are crucial in patient relationships. Medical professionals must maintain professionalism at all times. Humor can sometimes arise in serious discussions. Patient stories should always be handled with care. The importance of clear communication in medical settings. Understanding patient experiences is vital for effective care. Ethics in medicine is a complex and nuanced topic. Medical discussions can lead to unexpected t...
Dec 05, 2025•32 min•Ep. 138
Takeaways: Drug transfer during lactation is complex and challenging. Semaglutide was not detected in women taking any dose. Low amounts of tears epitide were found in milk. Tissue damage can affect drug absorption. Mastitis and engorgement complicate the lactation process. Injections are necessary for effective drug delivery. The analogy of an elephant illustrates the difficulty of drug transfer. Detection of drugs in milk is a critical concern for breastfeeding mothers. Understanding turnover ...
Nov 19, 2025•34 min•Ep. 137
Takeaways: Behavior change is a complex process that requires understanding motivation and discipline. Motivation is not just a feeling; it's a psychological skill that can be developed. Many common phrases about behavior change are misleading and oversimplified. Exercise should be viewed as a choice rather than a habit that becomes automatic. Self-efficacy is crucial for successful behavior change and can be built through mastery experiences. Future self thinking can help individuals align thei...
Nov 12, 2025•35 min•Ep. 136
Testosterone therapy can improve libido in postmenopausal women. Sexual dysfunction in women is complex and multifactorial. Low sexual desire is only considered a disorder if it causes distress. Psychosocial factors play a significant role in sexual health. Testosterone levels do not change significantly at menopause. The placebo effect can significantly influence treatment outcomes. Individualized care is crucial in managing sexual dysfunction. Dosing for testosterone therapy should be carefull...
Nov 03, 2025•1 hr 1 min•Ep. 135
Show Notes: In this episode of Docs Who Lift , the Nadolsky brothers welcome back Dr. Sean Wharton , clinical trialist and one of the leading researchers behind the next generation of oral GLP-1 medications. Together, they break down: The OASIS-4 trial results on 25mg oral semaglutide and how it stacks up to injectable Wegovy How orforglipron , Eli Lilly’s new small-molecule GLP-1, differs from peptide-based drugs Why these new therapies could make weight management more accessible and affordabl...
Oct 23, 2025•32 min•Ep. 134
In this episode of Docs Who Lift , the Nadolsky brothers dive deep into the newly released American Association of Clinical Endocrinology (ACE) Algorithm for Obesity Care led by Dr. Karl himself. They explore: Why ACE moved away from a BMI-only approach to a person-centered, complication-centric model The new staging framework (ABCD) that helps individualize treatment intensity How to interpret “clinical” vs “preclinical” obesity under the new model Updated targets for clinically meaningful weig...
Oct 13, 2025•48 min•Ep. 133
Takeaways The book aims to dispel myths surrounding the Biggest Loser study. Miscommunication in media has led to public confusion about metabolism. Metabolic adaptation is a response to weight loss, not a determinant of it. Cultural factors significantly influence eating habits and food choices. The food environment plays a crucial role in dietary behaviors. Bipartisan support is necessary for effective food policy changes. Understanding metabolism requires a nuanced approach beyond just calori...
Sep 25, 2025•58 min•Ep. 132
Takeaways Menopausal women often prioritize weight gain concerns over other symptoms. The study observed an association between hormone therapy and weight loss with GLP-1 medications. Retrospective studies have limitations but can provide valuable insights. Future research should focus on randomized controlled trials to confirm findings. The relationship between estrogen and GLP-1 signaling needs further exploration. Funding for research can be challenging, especially for early career investigat...
Sep 01, 2025•39 min•Ep. 131
We covered: Fasted training Protein timing and many more fitness topics! Hear Dr. Lauren Colenso-Semple and Dr. Stacy Sims discuss outcomes versus mechanisms and much more Tap Here for Dr Stacy Sims References Tap Here for Dr. Colenso-Semples References Dr. LCS Instagram Dr. SS Instagram Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising....
Aug 29, 2025•1 hr 7 min•Ep. 130
Takeaways The podcast features Dr. Grant Tinsley, a body composition expert. The discussion revolves around a case series on body composition effects. GLP-1 receptor agonists are a focus of the research. The importance of resistance training in weight loss is emphasized. Patient case studies provide insights into individual experiences. The first patient lost a significant amount of fat mass while preserving lean mass. The second patient achieved remarkable body composition changes in a short ti...
Aug 22, 2025•34 min•Ep. 129
Takeaways Direct-to-consumer lab testing is on the rise, with significant marketing efforts behind it. Many patients feel brushed off by traditional healthcare providers, leading them to seek alternative testing options. Communication between patients and healthcare providers is often inadequate, contributing to misunderstandings about health. Over-testing can lead to unnecessary anxiety and misinterpretation of results. Fitness influencers often promote lab testing without proper medical traini...
Aug 16, 2025•50 min•Ep. 128
In this episode of the Dr. Lift podcast, hosts Dr. Spencer Nadolsky and Dr. Karl discuss the recent changes in obesity medication coverage, particularly focusing on the CVS Caremark decision to drop ZEPBound from their formulary in favor of Wegovi. They explore the implications of this decision for patients and providers, the role of pharmacy benefit managers (PBMs) in healthcare, and the ongoing advocacy efforts to ensure access to effective obesity treatments. The conversation highlights the c...
Aug 08, 2025•20 min•Ep. 127
In this episode of the Dr. Lift podcast, hosts Dr. Spencer Nadolsky and Dr. Karl discuss the Surpass CVOT trial, which evaluates the cardiovascular outcomes of Monjaro compared to Dulaglutide (Trulicity). They delve into the significance of the trial, the implications of the results, and the potential benefits of Monjaro for patients with type 2 diabetes and cardiovascular risks. The conversation highlights the importance of understanding cardiovascular outcome trials and the evolving landscape ...
Aug 03, 2025•11 min•Ep. 126
How the STEP-UP trial came to life, and what made the 7.2mg dose possible What the data actually says about weight loss and side effects at higher doses Why trial design, pharmacokinetics, and estimands matter more than you think What’s coming next in obesity meds: duals, triples, and even antagonists The real talk on intermittent fasting, access issues, and preaching vs. science Sign up for Dr. Spencer''s Clinic Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about...
Jul 24, 2025•42 min•Ep. 125
Takeaways The study examines the overlap between clinical and anthropometric obesity. Anthropometric measures include waist circumference, waist-to-hip ratio, and BMI. Challenges exist in applying the Lancet Commission's definitions in clinical practice. Metabolically healthy obesity is a debated topic in obesity research. The study highlights the importance of data from the All of Us Research Program. There is a significant prevalence of preclinical obesity in individuals with normal BMI. The c...
Jul 02, 2025•32 min•Ep. 124
