Spring is here, the perfect time to reset and focus on your weight and metabolic health. Whether you’re exploring weight loss medications, tackling common weight challenges, or simply looking for a little motivation boost before summer, learn from true.’s Director of Metabolic Health & Obesity Medicine, Dr. Celia Egan. In this month’s Let’s Chat, she explains the science behind weight loss, the difference between FDA-approved weight loss medications and compounded versions, and empowers you to advocate for the care you deserve. 

Your Weight Breakdown

When we don’t understand why our bodies are holding onto weight, it can be exhausting and difficult to give ourselves grace, no matter where we are in our health journey. So, if you are asking yourself “Why is my body holding onto weight?” you aren’t alone and there is a biological reason why. Here’s a breakdown of why the body resists weight loss and what might be happening beneath the surface.

Fat cells are essential! They provide our bodies with the extra energy we need when we aren’t eating. Getting rid of fat cells is not always as easy as burning calories because the size and amount of fat cells are regulated by communication between our major organs. Our brain is a major player in our weight journey, as it takes feedback from other organs to determine how much fat we need in our body to maintain an energy supply. Organs like the liver work to take the food we eat and convert it into essential nutrients, such as glucose and fatty acids, to support our overall function. After these essential organs are fed, our skeletal muscle receives energy to fuel activity. 

Our fat cells constantly respond to the complex communication amongst our organs to determine when to repack, utilize, and redistribute. These signals can sometimes become disrupted or blocked, preventing fat cells from receiving the proper cues needed for fat loss. For example, when insulin levels are high, it can “lock” fat cells into storage mode, making it difficult for them to release stored fat. Thyroid dysfunction and the natural hormonal shifts of pregnancy, perimenopause, and menopause influence our body’s ability to lose weight. Estrogen plays a key role in the phases of ovarian function for women and the decline of estrogen during menopause can disrupt the signals that regulate fat cells. This is why many women experience changes in body composition and increased fat storage during their midlife. 

Nourishing Our Bodies for Natural Weight Loss

Whether or not you’re considering weight loss medication, building sustainable habits, and practicing mindful nutrition are essential for healthy aging. No matter where you are on your journey, here are some reminders to help you champion your health and feel confident in your own skin:

• If you struggle with intense cravings and high hunger, it can be hard to make healthy food choices. Ultra-processed or high-sugar foods can activate the reward centers in the brain, creating even stronger cravings. Make sure to limit these types of foods and focus on whole foods instead. 
• Completely eliminating certain foods from your diet may work for a little, but what happens next time your friends get together for dinner or you are on vacation? This type of diet is not sustainable; remember, balance is key.
• Moving your body regularly has the power to help reshape your relationship with food.
• You can’t do it all at once! Take small, realistic steps. Maybe that is adding in a walk every day or limiting snacking.
• During perimenopause or menopause, hormone therapy can help support mood, sleep, and energy, which can indirectly help with weight-related habits.
• BMI isn’t always the best indicator. Try creating goals that focus more on building muscle or reducing fat.
• Life phases like pregnancy, perimenopause, or high-stress periods can trigger rapid weight gain. There are options available to help support your health during these transitions.

Obesity Medicine 

Like any field, obesity medicine has continued to evolve alongside weight loss drugs to best meet the needs of patients. Over the last couple of decades, drugs have adapted and targeted different aspects of the body’s weight regulation processes. About 30 years ago, the first round of medication, while effective, had a lot of side effects. Doctors took a new approach in the early 2000s with medications focusing on blocking fat absorption. The following generation of drugs targeted the brain’s reward system, helping individuals who struggled with binge eating habits and intense cravings. More recently, a new class of medications, GLP-1 receptor agonists, have emerged. 

GLP-1 mimics the signaling that comes from the GI Tract naturally and is sent to all the organs, letting them know there is food. This signaling supports weight loss by telling the brain to reduce hunger, directing the liver to repackage sugars and fatty acids, and signaling to fat cells that it’s safe to shrink because food is available. At first, the medication was FDA-approved to offer a more effective treatment for Type 2 Diabetes. Prior medications effectively regulate individuals’ blood sugar, but often caused weight gain. GLP-1 offers the ability to regulate blood sugar while still helping individuals meet their weight goals.​​ The first versions led to modest weight loss, but by adapting and enhancing those molecules, researchers significantly improved the weight loss effects of these drugs, giving them a new purpose for a broader audience. Not only is this medication a game changer for weight loss, but it was recently FDA-approved for the prevention of recurring heart attacks or stroke. Research continues to uncover more potential benefits, like treatment for prediabetes, fatty liver disease, and PCOS.

This remarkable category of drugs has two main medications:

• Semaglutide, branded as Wegovy or Ozempic, is a molecule GLP-1 that mimics the signaling of when the natural hormone, GLP-1, is released from the small intestine. Clinical trials have shown impressive results, with individuals losing an average of 16% of their body weight.
• Tirzepatide, branded as Mounjaro or Zepbound, is a dual agonist medication. This means Trizepatide mimics not only the GLP-1 hormone but also the GIP hormone leading to greater weight loss. Mounjaro is FDA-approved for Type 2 Diabetes while Zepbound is approved for obesity treatment and shows significant relief for severe disruptive sleep apnea. These medications have been shown to help some individuals lose up to 33% of their body weight.

While this drug class offers new hope in this space, many individuals are struggling with the price of treatment, getting it covered, and its availability. With such a large demand, the FDA placed this drug class on the shortage list. This allowed compounding pharmacies to fill that gap, leading to an influx of non-FDA-approved versions of these drugs at more affordable rates. While compounding pharmacies have a necessary and essential purpose in the medical field, our team found too many issues and uncertainties with compounded medications to offer them to our patients. Dr. Egan explains the reason true. does not recommend any non-FDA approved compounded medications. Watch the video linked below (start at 28:58 through 34:30)

Summary of Main Concerns:

• Medications being presented and labeled as FDA approved. 
• The active ingredient and dosage level are not always consistent with the brand name version of these drugs. This introduces the problem of unregulated dosage and ingredients:
  • Dosage can vary, causing a lack of effectiveness or an increased risk of side effects. This inconsistency can be concerning if patients aren’t aware of the dosage they are receiving.
  • Research has found unidentified molecules present in these compounded medications posing a risk for cancer cell growth. This can also activate an immune response where the body attacks the hormone the medication produces and the naturally occurring GLP-1 receptors.

Find Trusted Support

At true., we encourage everyone debating weight loss medication or considering their next steps to work with a medical professional. This journey can be difficult and an expert guide will provide sound and science-backed information, help you reach your goals, and age well. While GLP-1 medications offer powerful benefits, they’re still relatively new, and there are many factors to consider, such as how to eventually transition off them and what maintenance might look like. These medications can lead to unintentional consequences like nutrient deficiency, muscle loss, and osteoporosis. With the help of a medical professional, you can reach your goals without sacrificing other areas of your health. At true., we want to support you as you reach your goals with regular check-ins, nutrition and adaptable treatment plans, and healthy lifestyle habits. 

You Deserve the Right Medication

If this were cancer or heart disease, we wouldn’t offer second-rate care, and we shouldn’t do it for weight and metabolic health either. Obesity is a real, chronic disease. And at true., we believe the women facing it deserve access to safe, evidence-based medications that truly work. We want to empower women to make informed choices and fight for better options—not just “what’s available.” The barriers that are present now for many women frustrate us too, but obesity medicine continues to evolve constantly, giving us hope that these issues with coverage and shortages will not continue to prevent women from getting the care they deserve. The success of these new weight loss drugs has laid the foundation for future variations. 15  variations are currently in developmental phases and will allow doctors to provide the best treatment option for the individual’s biochemistry and situation. Remember that you deserve the best medication for you and that expert support is available!

Five Questions For Your PCP?

1. Am I a candidate for anti-obesity medications? 
2. Do I have any other comorbidities associated with excessive weight?
3. What is your knowledge of anti-obesity medication?
4. Am I losing too much weight?
5. How is my nutritional status? Am I a candidate for nutritional labs? 

Five Take-Home Tips:

1. What is your picture of self?
2. What is your relationship with food?
3. Consider anti-obesity medication (there is more than one class)
4. Are your medications safe?
5. What is the right weight for me?

Watch Here: