Inside UCLA’s Fit for Health Program

Tatyana Meshcheryakova January 21, 2026 No Comments

As we’ve written time and time again, childhood obesity is a complex condition shaped by far more than diet and exercise alone. At UCLA Health’s Fit for Health Program, clinicians are embracing a comprehensive model that treats obesity as a medical, emotional and social condition — one that requires coordinated, compassionate care. Let’s take a quick look at what works in the current environment and what the challenges are.

Founded nearly 15 years ago by Dr. Wendelin Slusser, a UCLA Health physician specializing in clinical care, medical training and obesity research, the program has long focused on improving outcomes for children and adolescents. Since 2024, however, the clinic has expanded its reach and scope under new leadership.

Dr. Vibha Singhal, who took over the program last year, said she broadened its approach by integrating new therapies, obesity medications and bariatric surgeries related to weight loss. Beyond treatment, the clinic also serves as a learning environment, with undergraduates, medical students, residents, and fellows contributing to patient care.

Research is a central pillar of the program’s mission, Dr. Singhal said, noting:

I have my own lab where we have studies primarily around obesity and obesity treatments… Addressing food insecurity, how we can build that into our program, evaluating for potential eating disorders, evaluating the newer medications and the risks of infertility effects on the next generation.

Addressing food insecurity and eating disorders

For many families, access to healthy food remains a barrier to care. The program currently uses a small food bank grant to help clinicians address food insecurity among patients, Dr. Singhal said.

Eating disorders are another common challenge. Many patients struggle with binge eating and related conditions, according to Dr. Singhal. To meet these needs, the clinic relies on a multidisciplinary care team that includes psychologists, nutritionists and social workers who collaborate closely.

Dr. Natacha Emerson, the program’s psychologist, said:

We are sort of a one-stop shop… Unlike going to a doctor’s visit, where they just refer you to a psychologist or a dietitian, all three of those providers are actively working together to focus on shared goals to make sure that we are helping patients the way that they want to be helped.

Rapid growth brings new challenges

The demand for this integrated model of care has surged. Since October 2024, the clinic’s patient volume has doubled, Dr. Singhal said. To keep up, the program added two new physicians and expanded availability for nutritionists and psychologists.

Still, growth has brought strain. Dr. Singhal said:

We doubled the volume, but we didn’t double all our resources… It adds a lot of work on the team… It’s getting hard to keep up.

Insurance coverage remains a significant hurdle as well. Many obesity treatments are not covered, and Dr. Singhal said she anticipates further medication cuts at both the state and federal levels starting in January.

Serving vulnerable families

The clinic often serves families who are underinsured or undocumented, which can make accessing care difficult. Dr. Emerson noted that fear and uncertainty around immigration status can discourage families from seeking medical help. She said:

In the last year, we have had a lot of our patients who want to be healthier and have healthier bodies, but some of our families also have parents that are undocumented, and that has made seeking health care scary in this certain climate.

Telehealth has helped bridge that gap. According to Dr. Singhal, the clinic’s no-show rate has dropped as families increasingly return for care, including through video visits. Dr. Emerson offered:

Thankfully, we’re able to keep patients via video visit, which is sometimes a good way to make people feel more secure, especially when there are transportation and other barriers to getting to the clinic.

Integrating mental and physical health

A defining feature of the Fit for Health Program is its commitment to addressing mental health alongside physical health. Dr. Emerson said part of her role is identifying mental illnesses that may be influencing a child’s weight, allowing the team to intervene early and appropriately.

Dr. Singhal also shared a long-term vision for the clinic: creating a structured program specifically for patients with developmental disabilities, including autism, Down syndrome and genetic disorders.

Meanwhile, the program’s social worker, Bobby Verdugo, leads a mindfulness initiative that helps families navigate complex social and behavioral challenges. He said:

We tailor the (mindfulness) curriculum to the family… Some families may want to work a lot on portions, some want to work more on what they’re eating too fast and others on physical activity. We really adjust it to the family and I think that’s pretty unique — the ability to provide this intervention, to customize it to the family and then to continue to work with families in this kind of holistic, multidisciplinary way.

Redefining success beyond the scale

For many young patients, emotional well-being is just as important as physical health. Dr. Emerson said children often arrive with negative body image and pressure to be thinner rather than healthier — an expectation the clinic works to gently reshape.

At UCLA’s Fit for Health Program, progress is measured not just in pounds lost, but in confidence gained, barriers reduced and families supported, which we believe is an approach that reflects the true complexity of childhood obesity.

Speaking of UCLA…

Dr. Pretlow, the creator of BrainWeighve, a weight loss app for overweight and obese children, is conducting a BrainWeighve clinical trial at UCLA. The trial has expanded to include 10 subjects currently taking GLP-1 medications. This addition aims to help researchers understand how lifestyle and behavioral tools enhance medication or possibly even reduce the need for medication over time.

The program is designed for obese teens and uses a self-directed, physician-supervised approach to tackle overeating one “problem food” at a time. By helping participants rechannel emotional urges into healthier coping mechanisms, BrainWeighve aims to support sustainable weight loss — and reduce dependence on willpower alone.

Your responses and feedback are welcome!

Source: “UCLA Fit for Health Program adopts holistic approach to childhood obesity,” Daily Bruin, 1/14/25
Source: “Fit for Health Program,” UCLA.org, undated
Image by Los Muertos Crew/Pexels

Inside America’s New Dietary Guidelines

Tatyana Meshcheryakova January 14, 2026 No Comments

The federal government has unveiled a sweeping overhaul of the nation’s dietary advice, signaling a sharp departure from decades of nutrition policy. Health Secretary Robert F. Kennedy Jr. announced new dietary guidelines last week that emphasize whole foods, protein, and healthy fats — while calling for a significant pullback from highly processed foods.

At a press conference, the administration introduced a newly redesigned food pyramid, one that looks nothing like its predecessors. In the new visual, red meat, cheese, vegetables, and fruits appear at the top, symbolizing foods Americans are encouraged to prioritize.

Kennedy framed the update as a historic turning point. He described the guidelines as the most significant reset of U.S. nutrition policy to date, arguing that past recommendations steered Americans toward foods that ultimately harmed public health.

“Protein and healthy fats are essential and were wrongly discouraged in prior dietary guidelines,” Kennedy said. “We are ending the war on saturated fats.”

Turning the pyramid upside down

The original food pyramid, introduced in the early 1990s, placed grains at its wide base, encouraging heavy consumption, while fats and oils sat at the narrow top. That model was retired in 2011, replaced by the “MyPlate” graphic championed by then–First Lady Michelle Obama. Now, the pyramid is back — but flipped on its head.

In an introduction to the new guidelines, Kennedy and Agriculture Secretary Brooke Rollins wrote,

We are reclaiming the food pyramid and returning it to its true purpose of educating and nourishing all Americans.

They also highlighted the health crisis driving the change, noting that more than 70% of American adults are overweight or obese. According to Kennedy and Rollins, the problem stems from a diet that has “become reliant on highly processed foods and coupled with a sedentary lifestyle.”

The guidelines call for a “dramatic reduction” in foods described as “highly processed foods laden with refined carbohydrates, added sugars, excess sodium, unhealthy fats, and chemical additives.” At the same time, they encourage diets that include meat and dairy and set limits on added sugar.

Pushback from nutrition experts

Not everyone is on board with the new approach. Some nutrition scientists argue that elevating red meat and saturated fat contradicts decades of research.

Christopher Gardner, a nutrition expert at Stanford University and a former member of the Dietary Guidelines Advisory Committee, stated:

I’m very disappointed in the new pyramid that features red meat and saturated fat sources at the very top, as if that’s something to prioritize. It does go against decades and decades of evidence and research.

Gardner favors shifting protein intake toward plant-based sources like beans rather than emphasizing animal protein.

Both the American Heart Association and the Academy of Nutrition and Dietetics also point to evidence linking excess saturated fat to heart disease.

According to NBC News, the American Heart Association said in a statement that it “commends” including several important science-based recommendations in the new guidance, including eating more fruits, vegetables and whole grains, while cutting back on added sugars and processed foods.

However, it continued,

We are concerned that recommendations regarding salt seasoning and red meat consumption could inadvertently lead consumers to exceed recommended limits for sodium and saturated fats, which are primary drivers of cardiovascular disease.

The American Medical Association (AMA) applauded the new guidance for spotlighting ultra-processed foods, added sugars and sodium, which it says fuel chronic diseases, including heart disease, diabetes and obesity.

Dr. Bobby Mukkamala, president of the AMA, said in a statement,

The Guidelines affirm that food is medicine and offer clear direction patients and physicians can use to improve health.

Marion Nestle, professor emerita of nutrition, food studies and public health at New York University, said that the advice to limit highly processed foods is a major improvement but that “everything else is weaker or has no scientific justification.” The new guidelines still retain a long-standing recommendation to limit saturated fat to 10% of daily calories. NBC News quoted Nestle’s email that states that the focus on protein…

[…] makes no sense (Americans eat plenty) other than as an excuse to advise more meat and dairy, full fat, which will make it impossible to keep saturated fat to 10% of calories or less.

Dairy takes center stage

One of the most notable changes is the elevation of cheese and other dairy products to the top of the pyramid. This shift opens the door for full-fat milk and dairy products to be offered in school meals, an idea once considered controversial.

Dariush Mozaffarian, a cardiologist, public health scientist, and director of the Food is Medicine Institute at Tufts University, said:

There’s growing evidence, based on nutrition science, that dairy foods can be beneficial… It’s pretty clear that overall milk and cheese and yogurt can be part of a healthy diet… Both low-fat and whole-fat dairy versions of milk, cheese and yogurt have been linked to lower cardiovascular risk… What’s quite interesting is that the fat content doesn’t seem to make a big difference.

Whole grains still matter, but not the refined ones

Although whole grains appear at the smallest point at the bottom of the new pyramid, the guidelines still instruct Americans to “prioritize fiber-rich whole grains.” The key difference is a sharper line drawn between whole grains and refined grains. The recommendations call for two to four servings per day of whole grains while significantly reducing refined carbohydrates such as white bread and many packaged or ready-to-eat foods.

Mozaffarian supports this part of the guidance, especially the focus on food processing. He said,

Highly processed foods are clearly harmful for a range of diseases, so to have the U.S. government recommend that a wide class of foods be eaten less because of their processing is a big deal and I think a very positive move for public health.

While the guidelines avoid the term “ultra-processed,” they repeatedly emphasize eating “real food that nourishes the body.” They also recommend no added sugar at all for children under the age of 10.

New guidance on alcohol

The updated guidelines also revise long-standing alcohol recommendations. Instead of specifying daily limits (previously up to one drink per day for women and two for men) the guidance now simply states: “Consume less alcohol for better health.”

The guidelines also clearly identify groups who should avoid alcohol entirely, including pregnant women, people recovering from alcohol use disorder, those who cannot control how much they drink, and individuals taking medications or managing medical conditions that interact with alcohol.

Although many Americans may never read the dietary guidelines themselves, their impact is far-reaching. These recommendations shape what’s served in school cafeterias, on military bases, and through federal nutrition programs for mothers and infants by setting standards for calories and nutrients.

As debate continues among scientists and health organizations, one thing is clear: The new dietary guidelines mark a bold and controversial shift in how the federal government defines healthy eating in America.

Your responses and feedback are welcome!

Source: “RFK Jr.’s new dietary guidelines go all in on meat and dairy,” NPR, 1/8/26
Source: “RFK Jr. rolls out new dietary guidelines backing more protein and full-fat dairy,” NBC News, 1/7/26
Image courtesy of USDA, used under Fair Use: Commentary

Medicare May Open the Door to Affordable Weight-Loss Drugs

Tatyana Meshcheryakova January 7, 2026 No Comments

Millions of older Americans could soon gain access to popular weight-loss medications at a fraction of their current cost. The Centers for Medicare and Medicaid Services (CMS) announced a new voluntary model program that would allow certain Medicare beneficiaries to obtain GLP-1 drugs for obesity for as little as $50 per month.

Under current law, Medicare is prohibited from covering medications prescribed solely for weight loss. However, both the Trump and Biden administrations have argued that obesity should be treated as a chronic disease and that GLP-1 medications play an important role in preventing serious health conditions such as diabetes, heart disease, and stroke.

The newly announced initiative, known as Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth (BALANCE), is designed to expand access to GLP-1 drugs while keeping costs under control. CMS has negotiated discounted prices with drugmakers Eli Lilly and Novo Nordisk, pairing medication access with lifestyle and nutrition support through Medicare Part D plans.

CMS Administrator Dr. Mehmet Oz said the effort is intended to “democratize access to weight-loss medication” that has previously been out of reach for many Americans. The program aims to combine medical innovation with healthier living strategies in a way that benefits patients while limiting costs for taxpayers.

How the program would work

CMS plans to negotiate both pricing and eligibility standards with drug manufacturers. Under the agreement announced last month, eligible Medicare enrollees would pay $50 per month for certain GLP-1 medications approved for obesity and diabetes, while Medicare would cover an additional $245 per prescription.

Eligibility would be limited. Those who qualify include people who are overweight with prediabetes, individuals who have experienced a stroke or other cardiovascular events, and patients with obesity combined with diabetes or severe, uncontrolled high blood pressure. Officials estimate that roughly 10% of Medicare beneficiaries would meet the criteria.

Participation in the BALANCE model is voluntary for drug manufacturers, state Medicaid programs, and Medicare Part D insurers. State Medicaid agencies can opt in starting in May 2026, with Part D plans following in January 2027. In the meantime, CMS plans to launch a short-term demonstration program that could allow Medicare beneficiaries to access GLP-1 medications as early as July. That temporary program would run through December 2031.

A shift from previous policy debates

Last year, the Biden administration proposed reinterpreting Medicare law to allow obesity drugs to be covered as treatment for a chronic condition, an approach estimated to cost Medicare $25 billion over 10 years. That effort was paused earlier this year. The current plan, by contrast, includes negotiated price reductions, which the Trump administration says will make the expansion cost-neutral.

The agreement also extends to Medicaid. Eli Lilly and Novo Nordisk have committed to offering GLP-1 medications at lower prices to state Medicaid programs, although coverage decisions will depend on individual state negotiations. As of October, 16 state Medicaid programs covered GLP-1 drugs for obesity. However, several states, including North Carolina and Michigan, have recently scaled back coverage due to rising costs.

Industry and insurer reactions

Some insurers are cautiously optimistic. The Alliance of Community Health Plans noted that GLP-1 drugs have been shown to improve health outcomes, but also warned that side effects can cause many patients to discontinue treatment within the first year. The group said it is seeking more clarity on insurer costs and long-term sustainability.

With more than 70% of U.S. adults classified as overweight or obese, CMS argues that expanding access to effective treatments could significantly reduce the burden of chronic disease nationwide. Whether the BALANCE model succeeds may depend on how well it balances affordability, patient adherence, and long-term health outcomes.

Your responses and feedback are welcome!

Source: “Medicare opens door to covering blockbuster drugs for weight loss,” CNN.com, 12/23/25
Source: “US health agency unveils weight-loss drug coverage model,” Reuters, 12/24/25
Image by RDNE Stock project/Pexels

FDA Approves Wegovy Pill

Tatyana Meshcheryakova December 26, 2025 No Comments

The landscape of medical weight loss just had one major change. On Monday, the Food and Drug Administration (FDA) approved a pill version of Wegovy, Novo Nordisk’s blockbuster GLP-1 weight loss drug, making it the first oral GLP-1 medication approved specifically for weight loss.

Until now, GLP-1 drugs such as semaglutide (found in Ozempic and Wegovy) and tirzepatide (used in Mounjaro and Zepbound) have only been available as injections. While highly effective, injections can be a barrier for many patients. The arrival of a daily pill could change that.

Novo Nordisk expects the Wegovy pill to be widely available in January, according to a company spokesperson. A competing oral GLP-1 pill from Eli Lilly is also expected to gain FDA approval in the coming months.

Why the Wegovy pill matters

GLP-1 drugs were initially developed to treat type 2 diabetes, but they quickly gained attention for their ability to drive significant weight loss. Their popularity has soared in recent years as obesity treatment has shifted toward more effective medical options.

Dr. Christopher McGowan, a gastroenterologist who runs a weight loss clinic in Cary, North Carolina, told NBC News:

This is a meaningful step forward in the field… It won’t replace injectables, but it broadens our tool kit in an important way.

Dr. McGowan emphasized that the form of the medication itself may help more people feel comfortable starting treatment:

Pills are familiar, nonintimidating and fit more naturally into most people’s routines… For many patients, a pill isn’t just easier, it’s psychologically more acceptable.

Novo Nordisk already sells an oral version of semaglutide called Rybelsus for diabetes, but it comes in a lower dose. The newly approved Wegovy pill is formulated specifically for weight loss, and at higher doses.

Cost, coverage, and access questions

Novo Nordisk has not yet released the list price for the Wegovy pill, which must be taken daily, but it is expected to cost less than the weekly injections. Insurance coverage, however, remains uncertain. Many private insurers restrict coverage of injectable weight loss drugs because of their high cost.

Medicare is legally barred from covering medications approved solely for weight loss. However, the Wegovy pill was also approved for lowering heart disease risk, which Medicare does cover — potentially opening the door for broader access.

In November, Novo Nordisk reached an agreement with the Trump administration to sell the lowest dose of the pill for $149 per month for people paying out of pocket, in exchange for tariff relief. Eli Lilly made a similar deal for its own weight loss pill.

How effective is the Wegovy pill?

Clinical trial data suggest the pill works nearly as well as the injectable version — if taken correctly. Phase 3 trial results published in The New England Journal of Medicine showed that participants taking the highest dose of the Wegovy pill lost an average of 16.6% of their body weight after 64 weeks. By comparison, those in the placebo group lost just 2.2%. That result is roughly on par with injectable Wegovy, which reduced weight by about 15% after 68 weeks in earlier trials.

However, adherence may be a major challenge. Dr. Shauna Levy, medical director of the Tulane Weight Loss Center, noted that the pill must be taken first thing in the morning, on an empty stomach, with no more than four ounces of water. Participants who failed to follow the strict schedule lost less weight, about 13.6% of their body weight on average.

The key uncertainty is how patients will do outside of clinical trials. The open question is “real-world performance,” Dr. McGowan said. “Will patients tolerate the daily dosing and strict timing? Will they stay on long enough to see meaningful results? We don’t know yet.”

Side effects and comparisons to injections

Like injectable GLP-1 drugs, the most common side effects reported with the Wegovy pill were gastrointestinal, including nausea and vomiting. In some cases, those effects may be stronger.

Dr. McGowan explained that side effects from the pill version can feel “more intense” because the medication reaches the stomach all at once. “The challenges we see with injectable GLP-1s don’t magically disappear with a tablet,” he said.

While the Wegovy pill delivers weight loss comparable to injectable Wegovy, newer injectable drugs still lead the field. Lilly’s Zepbound helped patients lose 22.5% of their body weight after 72 weeks in clinical trials, and its next-generation injection, retatrutide, produced average weight loss of 24% after just 48 weeks.

Novo Nordisk says the differences may come down to how the medication is absorbed. Because pills are broken down in the digestive tract, less of the drug reaches the bloodstream compared to injections. To compensate, the Wegovy pill is taken daily and at higher doses.

The pill’s effectiveness is closer to Lilly’s oral drug orforglipron, which led to about 10.5% weight loss after 72 weeks in late-stage trials. These figures, however, are not from direct head-to-head comparisons.

Avoiding past shortages

When injectable Wegovy first launched, it was plagued by prolonged shortages. This time, Novo Nordisk says it has increased pill production ahead of the rollout. Another consideration is that oral medications are often easier to manufacture than injectables, which could help prevent supply issues and improve access.

For now, the Wegovy pill represents a promising new chapter in the rapidly evolving science of weight loss treatment.

Your responses and feedback are welcome!

Source: “FDA approves Novo Nordisk’s Wegovy pill, the first and only oral GLP-1 for weight loss in adults,” PR Newswire, 12/22/25
Source: “FDA approves Wegovy weight loss pill from Novo Nordisk,” NBC News, 12/22/25
Image by JESHOOTS.com/Pexels

New Gut Research for Obesity and Diabetes

Tatyana Meshcheryakova December 17, 2025 No Comments

Scientists have long suspected that the trillions of microbes living in our gut do more than help digest food. Now, new research suggests they may play a direct role in shaping how our bodies handle sugar and fat — key factors in obesity and type 2 diabetes.

A recent study conducted at Harvard University, with support from Brazil’s São Paulo Research Foundation (FAPESP), has uncovered a network of small molecules produced by gut microbes that travel from the intestine to the liver and then throughout the body. These compounds, known as metabolites, appear to influence how the liver processes energy and how sensitive the body is to insulin. The findings were published in the journal Cell Metabolism and could open the door to new ways of treating metabolic disease.

The gut–liver highway

To understand the discovery, it helps to know how blood flows through the body. Much of the blood leaving the intestine doesn’t go straight into the general circulation. Instead, it travels through a special vessel called the hepatic portal vein, which delivers nutrients and microbial byproducts directly to the liver first.

“The liver is essentially the first organ to see what’s coming from the gut,” explains lead author Vitor Rosetto Muñoz, a postdoctoral researcher at the University of São Paulo who conducted part of the study at Harvard’s Joslin Diabetes Center. Once these gut-derived compounds reach the liver, they can be modified, broken down, or released into the bloodstream to affect other organs.

By comparing blood from the hepatic portal vein with blood circulating throughout the rest of the body, the researchers were able to pinpoint which metabolites come from the gut and how they may influence metabolism along the way.

Why the gut microbiome matters

In recent years, researchers have learned that people with obesity, insulin resistance, or type 2 diabetes often have a different mix of gut bacteria than people without these conditions. What’s been harder to determine is exactly how those microbes affect metabolism.

To explore this, the team studied mice with different genetic risks for obesity and diabetes. They analyzed metabolites in both portal vein blood and peripheral blood, offering a clearer picture of what the liver is exposed to right after digestion.

In healthy mice, researchers identified more than 100 metabolites enriched in blood traveling from the gut to the liver. But in mice genetically prone to obesity and diabetes (and fed a high-fat diet), that number dropped dramatically. This suggests that diet and genetics together can reshape the chemical messages sent from the gut to the liver.

Interestingly, mice that were naturally resistant to metabolic disease showed a different metabolite pattern altogether. This points to a complex interaction between a person’s genes, their environment, and their gut microbiome.

Disrupting the microbiome changes metabolism

To test whether gut bacteria were truly responsible for these changes, researchers treated some mice with antibiotics that altered their gut microbiome. As expected, this disrupted microbial populations and also shifted the types of metabolites found in the blood.

One metabolite that increased stood out: mesaconate, a compound involved in the Krebs cycle, which is the process cells use to generate energy. When scientists exposed liver cells to mesaconate and related molecules in the lab, they saw improvements in insulin signaling. The compounds also helped regulate genes linked to fat buildup and fat burning in the liver — two processes that are often impaired in metabolic disease.

These findings suggest that certain gut-derived metabolites can directly improve liver metabolism, even in the context of a high-fat diet.

What this could mean for the future

While this research was done in mice, it provides a detailed map of how gut microbes may influence metabolic health through the liver. The next step is to better understand how each metabolite is produced and how it behaves in the body.

Over time, this work could help scientists identify specific microbial byproducts that might be used as treatments—or inspire therapies that reshape the gut microbiome to improve insulin sensitivity and reduce the risk of obesity and type 2 diabetes.

So, remember: What happens in your gut doesn’t stay in your gut. It may travel straight to your liver and shape your metabolic health in powerful ways!

Your responses and feedback are welcome!

Source: “Harvard gut discovery could change how we treat obesity and diabetes,” ScienceDaily, 12/14/25
Source: “Metabolites produced in the intestine play a central role in controlling obesity and diabetes,” Agencia.fapesp.br, 11/26/25
Source: “Portal vein-enriched metabolites as intermediate regulators of the gut microbiome in insulin resistance,” ScienceDirect, 10/7/25
Image by Wassily Kandark/Pexels

GLP-1 Medications Should Be Paired With Lifestyle Modifications

Tatyana Meshcheryakova December 10, 2025 No Comments

GLP-1–based therapies, popularized by medications like semaglutide and tirzepatide, are reshaping the way we think about obesity, metabolic health, and even chronic disease prevention. While these drugs first gained widespread attention for supporting significant weight loss, new research shows their influence reaches deep into multiple body systems.

At UC Davis Health, experts are taking a comprehensive look at how GLP-1 medications affect the entire body, from the gut and brain to the heart, muscles, and bones. Their findings point to a future where obesity treatment is not only more effective but also more holistic.

According to Miranda Stiewig-Rapp, assistant professor of endocrinology at UC Davis Health and incoming director of the system’s new Obesity Clinic (opening in 2026), GLP-1 agonists are redefining what’s possible in medical weight management.

Early clinical trials show average weight loss of 15-20%, compared to the 5-10% typically achieved with earlier generations of medication. And while these drugs offer powerful support, experts emphasize that pairing them with lifestyle changes creates the strongest outcomes.

The systemic impact of GLP-1 therapies

UC Davis Health recently brought together leading scientists, clinicians, researchers, and industry innovators to examine how GLP-1 drugs influence the body as a whole. Their findings reveal broad metabolic shifts that reinforce the importance of personalized nutrition, fitness, and long-term support.

The gut

GLP-1 slows gastric emptying, a mechanism that helps regulate blood sugar and prolong satiety. But it also influences the trillions of microbes that make up the gut microbiome.

These medications change how food moves through the digestive tract and alter fermentation patterns — shifts that can reshape the microbiome itself. A healthier microbiome can improve insulin sensitivity and support the metabolic benefits of GLP-1 therapies.

However, gastrointestinal side effects such as nausea, vomiting, or diarrhea remain common as the body adjusts. Supporting gut health with probiotics, fiber, and nutrient-dense meals can help minimize discomfort.

The brain

GLP-1 signals travel to the brain through the bloodstream and vagus nerve, reducing hunger and quieting the persistent “food noise” many patients describe.

Emerging research suggests that GLP-1 therapies may also influence reward pathways, potentially affecting cravings for sweets, fatty foods, and even substances like nicotine or alcohol. With appetite and reward signaling both shifting, many patients find it easier to adopt healthier eating patterns.

The muscles

While GLP-1 medications promote fat loss, rapid weight reduction may also lead to a loss of lean mass. Experts note that 15-25% of weight lost during calorie reduction — whether through medication or diet — can be lean mass.

Maintaining physical activity and prioritizing high-quality protein are essential for preserving muscle and keeping metabolism strong. Resistance training and structured exercise plans remain important companions to GLP-1 therapy.

The bones

Bone is metabolically active and responds to hormonal shifts, including those influenced by GLP-1. Rapid weight loss, reduced food intake, and nutrient gaps can place extra stress on bone density, especially in older adults and postmenopausal women. A balanced diet rich in calcium, vitamin D, magnesium, and protein, along with weight-bearing exercise, helps protect bone strength during GLP-1 therapy.

The heart

Beyond blood sugar control and weight loss, GLP-1 receptor agonists offer significant cardiovascular protection. Clinical trials show they reduce the risk of major heart events such as heart attack and stroke. Multi-agonist medications that combine GLP-1 with GIP or glucagon may enhance these heart benefits even further by improving fat metabolism and reducing inflammation.

Nutrition matters more than ever

Because GLP-1 medications suppress appetite, patients often eat less, which can make it harder to get the nutrients the body needs. Precision nutrition approaches can help close these gaps. The recommendations include choosing smaller, nutrient-dense meals; prioritizing high-quality protein; taking vitamins like B12, D, folate, magnesium, and iron; staying hydrated; and supporting gut health with probiotics and fiber.

Behavioral insights and BrainWeighve

At the 2025 conference on Obesity and Chronic Diseases (ICOCD) in Boston in November, Dr. Robert Pretlow, publisher of Childhood Obesity News, presented emerging insights into how GLP-1 medications interact with behavior, reward, and lifestyle habits. Dr. Pretlow’s core message was clear: GLP-1 medications work best when paired with lifestyle modification.

Dr. Pretlow is the creator of BrainWeighve, a weight loss app for overweight and obese children. In breaking news, Dr. Pretlow announced that the BrainWeighve clinical trial at U.C.L.A. has expanded to include 10 subjects currently taking GLP-1 medications. This addition aims to help researchers understand how lifestyle and behavioral tools can enhance — or possibly even reduce — the need for medication over time.

How GLP-1s affect the reward system

The mechanism of action for GLP-1 agonists is believed to involve the inhibition of reward cues, which may reduce cravings and compulsive eating behaviors. This could help “quiet” displacement mechanisms — behaviors people use to soothe emotional or psychological discomfort through food.

But a key question remains: What happens if displacement is never addressed?

According to Dr. Pretlow, pairing displacement interventions with GLP-1 therapy may allow patients to use lower doses of medication, support tapering off GLP-1s over time, help non-responders gain better results, and provide long-term tools for managing eating addiction and emotional hunger.

These early findings suggest that displacement activities — redirecting urges into harmless or productive behaviors — may offer meaningful support to individuals struggling with overeating.

The BrainWeighve study

These concepts are at the heart of BrainWeighve, a behavior modification and weight loss app currently in clinical trials at UCLA. The program is designed for obese teens and uses a self-directed, physician-supervised approach to tackle overeating one “problem food” at a time.

By helping participants rechannel emotional urges into healthier coping mechanisms, BrainWeighve aims to support sustainable weight loss — and reduce dependence on willpower alone.

As Dr. Pretlow summarized in his presentation:

Displacement activity may provide individuals with hope that they can curb overeating without relying entirely on medication or willpower.

Your responses and feedback are welcome!

Source: “UC Davis Health examines systemic impact of GLP-1–based therapies,” UC Davis Health, 12/5/2025
Source: “Treatment of Eating Addiction and Obesity As Displacement Activity: A Pilot Study,” ICOCD presentation, 11/7/25
Image by Dr. Pretlow

WHO Releases First Global Guidelines on Weight-Loss Medicines

Tatyana Meshcheryakova December 3, 2025 No Comments

The World Health Organization (WHO) has issued its first-ever guideline on a new generation of weight-loss medications — a major move that could reshape global obesity treatment as rates continue to climb.

The recommendations center on GLP-1 therapies, a fast-growing class of drugs that includes liraglutide, semaglutide, and tirzepatide. WHO’s new guidance offers conditional recommendations on how these medicines can be used safely and effectively as part of long-term obesity care.

A growing global crisis

Obesity now affects more than one billion people worldwide, contributing to an estimated 3.7 million deaths in 2024. Without stronger action, the WHO warns the number of people living with obesity could double by 2030. This surge poses enormous challenges for healthcare systems and could result in $3 trillion in annual economic losses.

Given WHO’s role as the world’s leading public health authority, the new guideline is expected to influence national policies, insurance decisions, and clinical practices at a time when demand for effective weight-loss treatments is exploding.

WHO Director-General Tedros Adhanom Ghebreyesus commented:

Obesity is a major global health challenge. Our new guidance recognises that obesity is a chronic disease that can be treated with comprehensive and lifelong care. While medication alone won’t solve this global health crisis, GLP-1 therapies can help millions overcome obesity and reduce its associated harms.

Obesity recognized as a complex and chronic condition

The WHO stresses that obesity is not simply due to poor lifestyle choices. Instead, it is a complex chronic disease shaped by genetics, biological factors, environment, and social conditions.

A recent mindbodygreen article stresses that:

What makes this announcement meaningful isn’t only the endorsement of medication; it’s the explicit recognition embedded within it.

The WHO is formally acknowledging obesity as a chronic, relapsing disease requiring comprehensive, lifelong medical management. Not a character flaw. Not a willpower deficit. A complex metabolic condition deserving the same comprehensive, lifelong care we afford any other chronic illness.

Obesity increases the risk of heart disease, type 2 diabetes, and several cancers, and it can also worsen outcomes for infectious diseases. For many individuals, long-term weight loss is extremely difficult without medical assistance.

GLP-1 therapies help by mimicking a natural hormone that regulates appetite, blood sugar, and digestion. These medications can trigger meaningful weight loss and significant health improvements.

WHO added GLP-1 therapies to its Essential Medicines List in 2025 for high-risk diabetes patients, and the new guideline now recommends long-term use for adults with obesity, except during pregnancy.

However, the guidance remains conditional because of limited long-term safety data, questions around maintaining weight loss after stopping treatment, high cost, and concerns about unequal access across regions.

Medication isn’t enough

A major theme throughout the guideline is that GLP-1 drugs cannot serve as a standalone solution. mindbody green chimes in:

The WHO’s new guidelines recommend these medications for long-term obesity management in adults (excluding pregnant women), but with a critical caveat: they must be combined with what the document calls “intensive behavioural interventions,” structured, ongoing programs involving nutrition counseling, physical activity support, and behavioral health services…

This integrated approach (pharmaceutical intervention plus foundational lifestyle medicine) represents the future of metabolic health. GLP-1 therapies can be powerful catalysts for change, but they work best when layered into a broader foundation of movement, nutrition, sleep, stress management, and community support.

WHO also highlights the broader need for systems-level action. Creating healthier food environments and early intervention programs requires cooperation between governments, healthcare providers, and industry, not just individual effort.

Ensuring access, affordability, and safety

Demand for GLP-1 medicines already far outpaces supply. Even with expanded manufacturing, the WHO estimates fewer than 10% of eligible people will have access by 2030. Without careful planning, this scarcity risks widening existing health inequities. To counter this, the WHO urges governments to consider pooled procurement, fair pricing strategies, and voluntary licensing agreements.

Another emerging issue is the rise of fake or substandard GLP-1 products, driven by global shortages. WHO stresses the importance of regulated supply chains, proper prescribing, and strong oversight to ensure patient safety.

WHO plans to update the recommendations as new research becomes available, and in 2026, the organization will work with global partners to prioritize access for people most at risk.

Your responses and feedback are welcome!

Source: “GLP-1 Medications Just Got WHO’s Backing — Here’s The Part You Can’t Ignore,” mindbodygreen.com, 12/1/25
Source: “WHO backs wider use of weight-loss medicines, calling obesity a chronic disease,” UN.org, 12/1/25
Source: “WHO issues global guideline on the use of GLP-1 medicines in treating obesity,” WHO.int, 12/1/25
Image by Karola G/Pexels

New Global Review Reveals Key Early-Life Factors Driving Childhood Obesity

Tatyana Meshcheryakova November 26, 2025 No Comments

A growing body of research has long suggested that the first years of life shape long-term health outcomes. Now, a major new analysis has brought unprecedented clarity to the early-life factors most strongly linked to childhood obesity — and what parents, healthcare providers, and policymakers can do to intervene earlier and more effectively.

According to the review,

A comprehensive new review of 177 global studies has pinpointed the strongest maternal and infant factors linked to childhood obesity in the first 1,000 days of life, offering insights to guide early prevention strategies.

A landmark global analysis

The review, “A major new systematic review, published this month by Obesity Reviews [the link is ours], has identified the most consistent maternal, paternal and infant factors linked to childhood obesity in the first 1,000 days of life.” Conducted by an international team from the Early Nutrition and Long-Term Health Task Force at ILSI Europe, the project represents the most extensive effort to date to map early-life influences on obesity risk.

As the report summarizes,

The researchers screened more than 17,000 publications and analysed 177 studies — including data from over 1.8 million children across 37 predominantly high-income countries. The average childhood obesity prevalence reported across these studies was 11 percent.

Ultimately, “In total, the team identified 23 risk factors consistently associated with a higher likelihood of childhood obesity.”

The strongest early-life risk factors

The findings underscore how maternal health, fetal development, and infant growth patterns collectively shape obesity risk. According to the review, the most influential factors include maternal health, and birth and infancy. In particular, “Higher maternal pre-pregnancy weight, excessive gestational weight gain and smoking during pregnancy.” And “Higher birthweight, being large for gestational age, lack of breastfeeding and rapid infant weight gain” for birth and infancy.

Critical knowledge gaps still remain

Despite the massive scope of the study, researchers warn that significant blind spots remain. As the report notes,

Despite the breadth of available evidence, the authors report several notable research gaps. These include limited study of paternal factors and the preconception period, as well as a lack of research using non-invasive biomarkers. The review also calls for more standardised data collection to support large-scale meta-analyses and more accurate models for predicting childhood obesity risk.

Closing these gaps, the authors say, will be essential for developing more accurate, personalized early-life obesity risk assessments.

Opportunities for earlier and more effective prevention

Research proves that multi-faceted intervention on an earlier side helps prevent childhood obesity. One of the central messages of the review is that intervention must begin before birth, and ideally even earlier. Chair of the expert group, Dr. Romy Gaillard, emphasized the importance of using the first 1,000 days as a window for prevention:

Parents-to-be or parents of newborns are in frequent contact with healthcare workers, and are often motivated to make lifestyle changes that benefit both their own health and the health of their children. Our systematic review provides the most comprehensive overview of family-based risk factors for childhood obesity from preconception to two years of age.

She also notes that improved predictive tools may transform how obesity prevention is delivered:

She added that improved early-life risk assessment, supported by advanced modelling, could help target prevention strategies more effectively.

This landmark review offers the clearest picture yet of how early-life environments shape obesity risk — and how early, targeted interventions may hold the key to reversing global childhood obesity trends. With evidence spanning millions of children and dozens of countries, the message is unmistakable: Supporting families before and after birth is not just beneficial — it is essential.

Your responses and feedback are welcome!

Source: “Risk Factors in the First 1000 Days of Life Associated With Childhood Obesity: A Systematic Review and Risk Factor Quality Assessment,” Obesity Reviews, 11/19/25
Source: “New systematic review reveals strongest early-life risk factors for childhood obesity,” New Food, 11/24/25
Source: “Multi-component school intervention reduces obesity and improves health behaviors in children: a cluster-randomized controlled trial,” Nature.com, 11/18/25
Image by Vanessa Loring/Pexels

GLP-1 Medications Get a Major Price Drop As New Research Highlights Benefits for Youth

Tatyana Meshcheryakova November 19, 2025 No Comments

The cost of two of the most widely discussed GLP-1 medications — Wegovy and Ozempic — is about to drop significantly. Novo Nordisk, the Danish pharmaceutical company behind both drugs, announced that beginning on Monday, November 24, the cash price for each medication will fall by 30%, lowering the monthly cost from $499 to $349 for people paying out of pocket.

The new prices will take effect at 70,000 retail pharmacies across the United States, including major chains such as Walmart and Costco. These reductions apply to customers who choose to self-pay or who lack insurance coverage for GLP-1 therapies.

Dave Moore, executive vice president at Novo Nordisk, emphasized the company’s commitment to expanding access:

As pioneers of the GLP-1 class, we are committed to ensuring that real, FDA-approved Wegovy and Ozempic are affordable and accessible to those who need them. […] Our new savings offers provide immediate impact, bringing forward greater cost savings for those who are currently without coverage or choose to self-pay.

Moore also noted that the price reduction is part of a broader strategy that includes collaborating with telehealth providers, expanding insurance coverage options, and working with U.S. officials to improve affordability for people living with chronic conditions like obesity and type 2 diabetes.

Notably, the previous cash price for Wegovy aligned with the cost of a full dose of Zepbound, a direct competitor from Eli Lilly. With GLP-1 demand still at an all-time high, the price shift marks a significant move in an increasingly competitive market.

High blood pressure in children has doubled

While access to GLP-1 medications is improving, new research reveals troubling trends in children’s health. A comprehensive global review published in The Lancet Childhood & Adolescent Health found that the rate of high blood pressure in children has doubled over the past two decades.

By analyzing data from 443,914 children worldwide, researchers discovered that the prevalence of pediatric hypertension rose from 3% in 2000 to 6% in 2020, now affecting an estimated 114 million children. The authors warn that this surge “should raise alarm bells,” especially given the long-term risks high blood pressure poses for cardiovascular health.

The rise in childhood hypertension parallels other concerning trends, including earlier onset of obesity and type 2 diabetes — conditions increasingly seen in adolescents.

New study shows GLP-1s outperform metformin in adolescents

Adding to the evolving conversation around youth metabolic health, a new real-world study shows that advanced GLP-1 therapies may offer major advantages for adolescents newly diagnosed with type 2 diabetes.

The study, published in the Journal of Pediatric Endocrinology and Metabolism, compared the effectiveness of metformin, a long-standing first-line treatment, with newer GLP-1-based therapies such as semaglutide (the active ingredient in Ozempic and Wegovy) and the dual GIP/GLP-1 agonist tirzepatide (found in Zepbound and Mounjaro).

Key findings include: GLP-1 therapies provide similar glycemic control to metformin but deliver superior weight-loss benefits, which can be critical for managing early-onset type 2 diabetes.

What these developments could mean

Together, these updates paint a multifaceted picture. For one, lower GLP-1 prices may increase access for adults who have struggled with obesity or diabetes but lack adequate coverage. Second, rising childhood hypertension highlights the growing urgency of addressing youth metabolic health. Third, new GLP-1 research in adolescents suggests that more effective early interventions may soon be on the horizon.

We can only hope that as the cost of treatment falls and evidence for early, more comprehensive care grows stronger, the landscape of metabolic health is poised for rapid change across all ages.

Your responses and feedback are welcome!

Source: “Poll: 1 in 8 Adults Say They Are Currently Taking a GLP-1 Drug for Weight Loss, Diabetes or Another Condition, Even as Half Say the Drugs Are Difficult to Afford,” KFF.com, 11/14/25
Source: “GLP-1 drugs beat metformin for weight control in teens with type 2 diabetes,” News-Medical.net, 11/10/25
Image by Pavel Danilyuk/Pexels 

The Fast-Changing GLP-1 Landscape and Employee Coverage

Tatyana Meshcheryakova November 14, 2025 No Comments

GLP-1 medications continue to dominate conversations in the world of employer-sponsored health benefits, and it’s not hard to see why. These drugs have already reshaped care for millions of people living with type 2 diabetes and obesity, delivering meaningful improvements in weight (including in children), cardiovascular health, and overall quality of life. And their reach is expanding fast.

Beyond their well-established role in diabetes and obesity treatment, GLP-1s are now being researched for a wide range of additional conditions — everything from osteoarthritis and Alzheimer’s disease to diabetic complications — and even addiction. As scientific interest grows, so do the complexities employers face in managing pharmacy benefits, projecting future costs, and determining what coverage makes sense. This, of course, directly affects the employees and their families, including their kids.

Let’s take a quick look at the latest developments in the GLP-1 market and what they could mean for employer health programs in the months and years ahead.

Oral GLP-1s are poised to change the market

One of the most anticipated shifts in the weight-loss drug space is the arrival of oral GLP-1 therapies. Oral semaglutide — built on the same active ingredient used in Ozempic, Wegovy, and Rybelsus — is expected to receive approval soon for obesity treatment and for reducing cardiovascular risk in people with obesity. If authorized, it will become the first oral GLP-1 specifically approved for weight management.

Another contender, Lilly’s orforglipron, is expected to receive approval in 2026. Clinical trials show promising results: patients lost roughly 7.8% to 12.4% of their body weight over 72 weeks, only slightly below the outcomes typically seen with injectables.

Because many people prefer pills over injections, oral GLP-1s may boost both uptake and adherence. That likely means increased utilization and higher claims volume. What about pricing? Despite lower manufacturing costs, oral GLP-1s are unlikely to be much cheaper than injectables, and some may even carry a premium due to convenience and strong clinical outcomes.

Generics and new pricing pressures

Cost relief may finally be on the horizon, albeit slowly. Generic versions of Victoza (for diabetes) are already available, and the first generic alternative to Saxenda (for weight loss) has been approved. More generics for Saxenda are expected by March 2026, which should drive prices down.

However, employers won’t see generic versions of the most in-demand injectables (like Ozempic) until at least 2031. Another form of price pressure is emerging: semaglutide products (Ozempic, Wegovy, Rybelsus) appear on Medicare’s 2027 drug price negotiation list. New “Maximum Fair Prices” will be announced in November, and while manufacturers aren’t required to extend discounts to commercial plans, some ripple effects are possible.

What does it mean? Generics won’t dramatically reduce GLP-1 spending in the short term. Medicare negotiations may influence commercial pricing, but the extent is impossible to predict. And employers that currently exclude weight-loss drugs might consider a future “generic-only” benefit once Saxenda generics are plentiful and affordable.

Direct-to-consumer (DTC) models are shaking up pricing

The GLP-1 boom has sparked a wave of direct-to-consumer (DTC) offerings that drastically undercut typical retail prices. Lilly Direct (for Zepbound) and NovoCare (for Wegovy) give patients simplified access and steeply discounted rates. Novo Nordisk even partnered with Costco (yes, Costco) to offer Wegovy at its DTC price through Costco pharmacies. Employers that exclude weight-loss GLP-1s are exploring how to guide employees toward low-cost DTC options without adding these drugs to the plan.

Is this the next “Wonder Drug” class?

GLP-1 therapies continue to earn FDA approvals for conditions beyond diabetes and weight management. Recent developments include Wegovy being approved to treat metabolic-associated steatohepatitis (MASH), and Zepbound being approved for obstructive sleep apnea in people with obesity.

Meanwhile, ongoing trials are evaluating potential use in osteoarthritis, diabetic complications, Alzheimer’s, and addiction — studies that could dramatically widen the patient population in future years.

What does this mean for employer plans?

Employers that already cover GLP-1s for weight loss likely won’t see a large increase in utilization, since the affected populations overlap significantly. Employers that don’t cover weight-loss GLP-1s must make strategic decisions about new indications and potential cost implications, as rebates are typically unavailable unless all FDA-approved indications are covered.

It’s also worth noting that cost-benefit profiles vary widely by condition. In some areas, like MASH, GLP-1s may be cheaper than alternative treatments. In others, such as sleep apnea, they may cost more than existing non-drug therapies.

The weight-loss drug pipeline is exploding

GLP-1s may be leading the market now, but they’re far from the only players. More than 170 weight-loss drug candidates are moving through development pipelines across 82 manufacturers. Many follow GLP-1 pathways, but others target entirely different biological mechanisms, some of which may reduce common side effects like nausea.

One standout is Amgen’s MariTide, a monthly injectable that has shown an impressive 20% average weight loss in one year of clinical trials. Its monthly dosing may appeal to patients looking for convenience over weekly injections.

GLP-1 therapies and the broader weight-loss drug category are moving faster than almost any other segment of pharmacy benefits. For employers, that means the long-term strategy must remain flexible and data-driven as employees may increasingly request coverage for themselves and whoever else is included in their health plan.

Your responses and feedback are welcome!

Source: “Top Five Developments in GLP-1s, Weight-Loss Drugs,” CBIA.com, 11/12/25
Source: “Ozempic at Costco? Discount Giant Expands Into $100 Billion Weight-Loss Drug Market,” Yahoo.com, 10/19/25
Image by JESHOOTS.com/Pexels

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Profiles: Kids Struggling with Weight

Profiles: Kids Struggling with Obesity top bottom

The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:

Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources