Weight, health, and metabolism — without extremes or oversimplification. Hosted by Internal Medicine and Obesity Physician Dr. Sasha High, this podcast explores the biology of weight, the reality of behaviour change, and the nuance often missing from mainstream conversations. From GLP1 medications to emotional eating, from metabolic health to mindset, you'll get practical, evidence-based insights without extremes or oversimplification. This podcast is for those who want to understand their bodies, make sustainable changes, and build health that lasts. FOLLOW Instagram - https://www.instagram.com/sashahighmd/ WORK WITH ME Obesity Medicine Clinic in Ontario, Canada - https://www.highmetabolicclinic.com Best Weight for Women - https://www.sashahighmd.com/bestweight Recover Strong for Binge Eating - https://www.sashahighmd.com/bed
Do GLP-1 medications affect bone health? GLP-1 medications have transformed obesity treatment, but they've also sparked important questions about bone health, bone density, and fracture risk. In this episode, I’m joined by obesity medicine specialist Dr. Sandra Cortina to unpack what the current evidence actually shows about bone health during GLP-1 therapy. We separate evidence from headlines and explore how clinicians and patients can make informed decisions while balancing the substantial benefits of GLP-1 therapy with potential risks. This is a nuanced, evidence-based conversation for anyone interested in the science of obesity treatment. Find Dr. Cortina: Instagram @cortinaweightmedicine Website www.cortinaweightmedicine.ca in British Columbia, Canada Home Exercises Referenced by Dr. Cortina: https://www.youtube.com/@silversneakers
You're eating healthy, exercising, and doing everything you think you should, but the scale isn't moving. So what's going on? In this episode, we explore the five most common reasons weight loss stalls, including hidden calorie intake, chronic under-fueling, metabolic adaptation, and lifestyle factors like sleep, stress, and movement. You'll learn why your body isn't broken and how building consistent, sustainable habits is the key to long-term success. In This Episode - Why healthy eating doesn't always lead to weight loss - The difference between overeating and under-fueling - How chronic dieting can affect your metabolism - The importance of protein, balanced meals, and consistency - Why sleep, stress, strength training, and patience matter Mentioned in This Episode - Episode 170: Why Eating 1,200 Calories Is Working Against You: https://www.sashahighmd.com/podcasts/the-obesity-doctor-podcast/episodes/2149162617 - Resting Metabolic Rate (RMR) Calculator: https://www.calculator.net/bmr-calculator.html Work With Us: Ontario-Wide Virtual Obesity Management Clinic https://www.highmetabolicclinic.com Join my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight Recover Strong for Binge Eating https://www.sashahighmd.com/bed Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide
Menopause is something every woman will experience, yet many still feel confused, dismissed, or overwhelmed when symptoms begin. In this conversation, I’m joined by Dr. Sheila Wijayasinghe to unpack the realities of perimenopause, menopause, and hormone therapy in a practical, evidence-based way. We talk about what the menopause transition actually looks like, why symptoms can begin years before periods stop, and why so many women are told their labs are “normal” even when they don’t feel normal. We also break down some of the biggest misconceptions around hormone therapy, including safety concerns, breast cancer risk, cardiovascular risk, and whether bloodwork is actually useful in making a diagnosis. In this conversation, we cover: - The difference between perimenopause and menopause - Early symptoms women may notice in their 40s - Whether hormone testing is necessary - What menopausal hormone therapy (MHT) is and who may benefit - The difference between regulated bioidentical hormones and compounded products - How hormone therapy may impact sleep, mood, bone health, urogenital symptoms, and brain fog - Non-hormonal approaches to symptom management - How women can advocate for themselves if they feel dismissed in healthcare settings My hope is that this episode helps bring clarity to a stage of life that still carries so much confusion and misinformation, and that women walk away feeling more informed and empowered to make decisions about their health. Links & Resources You can follow Dr. Sheila Wijayasinghe on Instagram at @drsheilaw and check out the Doc Talk Podcast for more evidence-based health conversations. Menopause Management Resource from the Centre for Effective Practice https://cep.health/clinical-products/menopause-management/ Menopause Symptom Tracker https://menopausefoundationcanada.ca/resources/menopause-symptoms/
I’m joined by Dr. Lauren Colenso-Semple to unpack the rapidly growing world of wellness peptides — from BPC-157 and CJC-1295 to Ipamorelin, Tesamorelin, NAD, and the so-called “fat-burning” and “healing” peptides taking over social media. We discuss what peptides actually are, why they’ve become so popular, and how legitimate medical therapies have blurred into a largely unregulated wellness industry. We also break down the claims being made about popular peptides marketed for fat loss, recovery, anti-aging, and performance enhancement, while taking a closer look at what evidence truly exists (and what doesn’t). Dr. Lauren shares important insight into the safety concerns, marketing tactics, and cultural obsession with optimization that are fueling this trend online. If you’ve been curious about peptides or wondering whether the internet hype matches the science, this episode will help you think more critically before jumping on the trend. Check out Dr. Lauren Colenso-Semple’s work here: https://www.drlaurencs.com/
In Part 2 of this series, we're diving into the practical nutrition strategies that can help you feel your best while taking medications like Ozempic, Mounjaro, and Zepbound. From constipation and digestive changes to hitting your protein goals with a low appetite, this episode focuses on the habits that support long-term success and help you maintain your results. We'll cover: • Why constipation is so common on GLP-1 medications and how to prevent it • How to reach your protein goals when you get full quickly • What to do when protein foods don't sound appealing • How GLP-1 medications change hunger and fullness cues • What to expect if you need to temporarily stop your medication GLP-1 medications can be powerful tools, but they work best when paired with the right nutrition and lifestyle habits. Learning how to fuel your body, support digestion, and adapt to your changing appetite is key to protecting your health while achieving sustainable weight loss. WORK WITH US: Ontario-Wide Virtual Obesity Management Clinic https://www.highmetabolicclinic.com Join my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight Recover Strong for Binge Eating https://www.sashahighmd.com/bed Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide
In this episode, Dr. Neil Naik and I unpack a foundational question—is obesity actually linked to cancer, and what’s really driving that connection? We explore the underlying biology, from chronic inflammation and insulin resistance to the hormonal activity of adipose tissue, and why visceral fat may matter more than we think. We then move beyond risk and into what happens after a diagnosis—how obesity can influence treatment response, toxicity, dosing, and outcomes across chemotherapy, surgery, and radiation. The conversation also highlights the often-overlooked phase of survivorship, including the role of metabolic health in recurrence risk and long-term prognosis. We close by discussing where emerging therapies like GLP-1 medications fit, how clinicians can move beyond BMI toward more individualized care, and how to talk about the obesity–cancer connection in a way that informs without adding shame. My Guest Dr. Neil Naik Dr. Neil Naik, a family physician, educator, and innovator based in Waterloo, Ontario. Trained at the Royal College of Surgeons in Ireland, he completed residencies in Newfoundland and Nunavut and holds an Executive MBA from Ivey, where he focused on technology-driven healthcare innovation. He runs a Family Practice and an obesity medicine clinic in Waterloo, along with an AI-enabled skin cancer screening program, while teaching medical students at both McMaster University and the University of Waterloo. Dr. Naik advises startups, leads regional primary care and cancer prevention initiatives, and champions universal healthcare, leveraging AI to make safe, high-quality care accessible to everyone, everywhere. LinkedIn: https://www.linkedin.com/in/neil-naik/
GLP-1 medications like Ozempic, Mounjaro, and Zepbound are changing the conversation around obesity and weight loss — but there’s one major problem: most people are starting these medications with little to no guidance on how to properly nourish their body while taking them. And that matters. Because while GLP-1s can be incredibly effective tools for weight loss, they can also lead to muscle loss, under-eating, fatigue, nausea, hair loss, and long-term metabolic issues when nutrition is neglected. In today’s episode, I’m breaking down the biggest nutrition mistakes people make on GLP-1 medications — and exactly how to protect your metabolism, preserve muscle, maintain energy, and build sustainable habits while losing weight. We’ll cover: - Why protein becomes non-negotiable on GLP-1 medications - How much protein you actually need - The hidden dangers of under-eating - Why rapid weight loss can harm your metabolism - How to preserve muscle while losing fat - The critical role of strength training - What to do if you have no appetite - Tips for nausea and food aversions - How to create sustainable eating habits while on GLP-1s - Rebuilding a healthier relationship with food This episode is especially important if you’ve ever thought: “I’m barely eating… so why do I feel exhausted?” “Why am I losing muscle instead of just fat?” “How do I hit my protein goals when I’m never hungry?” GLP-1 medications are not magic — but when combined with proper nutrition and lifestyle support, they can become powerful tools for long-term health. If you’re currently taking a GLP-1 medication, considering one, or supporting someone who is, this episode is a must-listen. And if you’re looking for support along your journey, Dr. Sasha High and I would love to welcome you into our women’s coaching program, Best Weight, where we openly discuss treatment options like GLP-1 medications and help women build sustainable, healthy weight loss habits together. WORK WITH US: Ontario-Wide Virtual Obesity Management Clinic https://www.highmetabolicclinic.com Join my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight Recover Strong for Binge Eating https://www.sashahighmd.com/bed Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide FOLLOW SASHA Instagram https://www.instagram.com/sashahighmd/ ADDITIONAL RESOURCES: BMI Calculator Basal Metabolic Rate Calculator(BMR) REFERENCES: Carbone, J. W., & Pasiakos, S. M. (2019). Dietary Protein and Muscle Mass: Translating Science to Application and Health Benefit. Nutrients, 11(5), 1136. https://doi.org/10.3390/nu11051136 McCarthy, D., & Berg, A. (2021). Weight Loss Strategies and the Risk of Skeletal Muscle Mass Loss. Nutrients, 13(7), 2473. https://doi.org/10.3390/nu13072473 Scott Butsch, W., Sulo, S., Chang, A. T., Kim, J. A., Kerr, K. W., Williams, D. R., Hegazi, R., Panchalingam, T., Goates, S., & Heymsfield, S. B. (2025). Nutritional deficiencies and muscle loss in adults with type 2 diabetes using GLP-1 receptor agonists: A retrospective observational study. Obesity pillars, 15, 100186. https://doi.org/10.1016/j.obpill.2025.100186
Brian Baumal lost 100 pounds, and more importantly, he’s kept it off for over 14 years. But what he really understands is this: it’s not a lack of knowledge that keeps people stuck, it’s the psychology. The urgency that drives all-or-nothing thinking. Brian works as a Toronto-based psychotherapist and is the guest on today’s episode of THE OBESITY DOCTOR PODCAST. We break down why urgency isn’t discipline, and what actually works if you want change to last. Work with Brian: https://alivapsychotherapy.com/ WORK WITH ME Ontario-Wide Virtual Obesity Management Clinic https://www.highmetabolicclinic.com Join my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight Recover Strong for Binge Eating https://www.sashahighmd.com/bed Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide FOLLOW SASHA Instagram - https://www.instagram.com/sashahighmd/
In today’s episode, we’re talking about one of the biggest challenges during a weight loss journey — balancing social eating while still making progress. With summer approaching, there are naturally more opportunities for eating out, patio dinners, vacations, parties, and weekend plans. Many people feel confident and consistent during the week, but struggle when social events come up and feel like their progress gets completely derailed. In this episode, Tedi Glik, RD will cover: - Why there is no such thing as a “cheat meal” - How to build balanced meals even when eating out - The importance of protein and veggies at social meals - Why skipping meals before dinner outings backfires - How restriction leads to overeating Letting go of the “good” vs. “bad” food mentality - How scarcity around food increases cravings and binge eating - Tips for navigating pizza nights, desserts, restaurant meals, and alcohol - How to enjoy flexibility without guilt while still supporting your goals The goal is learning how to make healthy eating sustainable in real life — not just during perfect weeks at home. WORK WITH US: Join my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight Recover Strong for Binge Eating https://www.sashahighmd.com/bed Ontario-Wide Virtual Obesity Management Clinic https://www.highmetabolicclinic.com Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide FOLLOW SASHA Instagram https://www.instagram.com/sashahighmd/
Bariatric surgery is one of the most effective tools we have in obesity medicine—and also one of the most misunderstood. In this episode, I’m diving into where surgery truly fits in the treatment of obesity and metabolic health. While we often focus on medical therapies like GLP-1s, it’s important to understand the role bariatric surgery can play—and why it continues to be underutilized or dismissed by many patients. I’m joined by Toronto-based bariatric surgeon Dr. Lazar Klein, who shares his expertise on what bariatric surgery actually involves, who it’s for, and how it fits into a comprehensive, long-term approach to care. We walk through the most common procedures available — including gastric bypass, sleeve gastrectomy, and duodenal switch variations — and clarify why older procedures like gastric banding are no longer recommended. Dr. Klein addresses common fears around surgery, including concerns about surgical complications, dumping syndrome and lifelong changes, while offering a realistic and balanced perspective on risk. We explore the long-term outcomes as well—how surgery impacts conditions like type 2 diabetes, sleep apnea, and cancer and even mortality, and what the evidence shows about weight maintenance years down the road. If bariatric surgery has ever felt confusing, intimidating, or “not for you,” this episode will help bring clarity to the conversation. Resources & Links Ontario Bariatric Network https://www.ontariobariatricnetwork.ca/ High Metabolic Clinic https://www.highmetabolicclinic.com/
In this episode, I walk through what’s actually happening with generic semaglutide right now—and what it means for you in real life, not just in headlines. I explain where semaglutide fits in the bigger picture, how it compares to tirzepatide, and why generics are entering the market now. I also break down what “bioequivalence” really means—and why that nuance matters when it comes to effectiveness and side effects. I talk about early pricing estimates, what we might see happen with brand-name costs, and how pharmacy-level substitution could impact what patients are actually given. We get into the practical questions I’m already hearing: what the devices will look like, whether dosing will feel the same, and how switching between products might affect different patients. I also share how I’m thinking about this clinically—who will likely transition easily, and who may need a more cautious, individualized approach. And importantly, I address a growing issue: access to medication is not the same as access to care. Obesity treatment is more than a prescription—it’s ongoing, structured medical care. Bottom line: I’m genuinely encouraged by the potential for improved access—but your treatment should still be guided by your individual response, not just what’s available. This is an evolving space, and I’ll keep you updated as we learn more. WORK WITH ME Ontario-Wide Virtual Obesity Management Clinic https://www.highmetabolicclinic.com Join my Healthy Lifestyle Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight Binge Eating Disorder Treatment - https://www.sashahighmd.com/bed Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide FOLLOW ME on Instagram - https://www.instagram.com/sashahighmd/
Long-term change isn’t just about knowing what to do—it’s about how we see ourselves while we’re doing it. In today’s podcast episode, we explore why so many people get stuck in that gap between where we are and who we’re trying to become. I’m joined by Registered Psychotherapist Margo Green, and we talk about how visualization and imagery can make the future feel more real and connected to who you are today. We also dive into identity-based motivation, and how the way you see yourself quietly shapes your behaviours—often more than motivation ever does. We cover practical ways to use these tools during difficult moments, and how to begin shifting identity in a realistic, sustainable way. Key takeaway: Motivation fades, but identity drives behaviour. If you’re feeling stuck, start with one small shift in how you see yourself—and take action from there. If you’d like therapy support from Margo, you can find her at: www.highmetabolicclinic.com/psychotherapy
In this episode of the Obesity Physician Podcast, the dietitians from High Metabolic Health—Nada, Lauren, and Tedi—break down what actually works when it comes to eating for weight loss. If you’re tired of restrictive diets and conflicting nutrition advice, this conversation focuses on practical, sustainable principles instead of quick fixes. The team shares how to build a solid foundation for long-term success, including how to structure your meals, what foods to prioritize (and limit), and where to begin your journey toward better metabolic health. What You’ll Learn - Why dieting often fails—and what to focus on instead - The core eating foundations for sustainable weight loss - How to build a plate that keeps you full, satisfied, and energized - Key foods to prioritize for metabolic health - Foods and habits to limit (without strict restriction) - Simple, realistic starting points for your weight loss journey WORK WITH OUR DIETITIANS https://www.highmetabolicclinic.com/nutrition WORK WITH ME Join my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight Recover Strong for Binge Eating https://www.sashahighmd.com/bed Ontario-Wide Virtual Obesity Management Clinic https://www.highmetabolicclinic.com Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide FOLLOW SASHA Instagram - https://www.instagram.com/sashahighmd/
In this episode, I break down everything you need to know about GLP-1 medications like Ozempic, Wegovy, and Mounjaro—including the real-world side effects I see in clinical practice. While these medications can be incredibly effective for improving metabolic health, there’s often confusion online: some people are scared away by exaggerated side effect stories, while others underestimate what to expect when starting treatment. My goal here is to give a balanced, evidence-informed perspective so patients can make informed decisions without fear or misinformation. This episode is for educational purposes only and does not replace personalized medical advice. Always speak with your licensed healthcare provider before starting or changing any treatment. We cover side effects and how to manage them, like: Nausea, bloating, diarrhea, constipation Sulphur burps and reflux Appetite suppression and food aversions Injection site reactions Gallbladder disease Hair thinning Ozempic face Rare: NAION If you’re in Ontario and need support with obesity or metabolic health, you can request a referral to my multidisciplinary clinic, the High Metabolic Clinic. Learn more at www.highmetabolicclinic.com .
Hi everyone, I have a quick update I want to share. The High on Life Podcast has a new name! It’s now The Obesity Doctor Podcast . I loved the old name — it was fun and fit my personal brand — but over time I realized the conversations here have become very clearly rooted in obesity medicine. We talk about the biology of weight, behaviour change, medications, metabolism, mindset, psychology… and the realities of navigating all of that in real life. This shift is about better alignment — making it clear that this podcast is all about evidence-based, straightforward medical education, while also supporting the ways we care for and nourish our bodies. That’s been a big part of what I've done from day one, and it continues to be central to these conversations. I’ll also be bringing on other obesity physicians and health experts to share their perspectives, so you’ll get a broader, deeper look at the science and the practice behind lasting health. Nothing is changing about the conversations themselves — same nuance, same depth, same approach. It’s still about understanding your body, making sense of your patterns, and building health that lasts. If you’ve been here for a while—thank you for being part of this. And if you’re new, welcome! Thanks for trusting me as a voice and advocate in the world of medicine, health and obesity care. I’m excited for this next chapter, and I can’t wait to keep exploring these topics with you. Thanks for listening!
In this episode, I share how marathon training reshaped the way I think about food—and how those lessons apply to weight loss and metabolic health. Many people assume that eating less is the key to losing weight, but restriction can actually backfire, slowing metabolism and increasing cravings. I walk through the five most important lessons I’ve learned: 1. Fuel for energy, not just calories – Nourishing your body properly supports metabolism, fat loss, and mental clarity. 2. Hunger is a signal, not a failure – Learn to respond strategically to hunger instead of ignoring it. 3. Carbs and sugar aren’t the enemy – Used in the right context, they support energy, recovery, and metabolic health. 4. Focus on quality and timing – Protein, healthy fats, and carbs in the right balance enhance results. 5. Restriction backfires—fueling wins – Sustainable weight loss comes from intentional, moderate fueling. I also share personal anecdotes from my running journey and patient experiences to show how these strategies work in real life. By shifting your mindset from restriction to fueling, you can improve energy, optimize metabolic health, and build habits that actually last. Tune in for practical tips to fuel your body, support weight loss, and maintain metabolic health—without guilt or obsession. WORK WITH ME Join my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight Recover Strong for Binge Eating https://www.sashahighmd.com/bed Ontario-Wide Virtual Obesity Management Clinic https://www.highmetabolicclinic.com Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide FOLLOW SASHA Instagram - https://www.instagram.com/sashahighmd/
Scarcity isn’t just about lacking resources—it’s a mindset that shows up early and often. I see it in how we eat (finishing food, eating when not hungry, “last supper” thinking), and how that drives the restrict–overeat cycle. This isn’t a discipline problem—it’s a natural response to perceived scarcity. On today’s podcast, we talk about how to shift this in a practical way: creating consistency with meals and nutrition reducing urgency around food building trust in your body and your routines I share small, everyday examples (like airplane snacks and hotel toiletries) to highlight how subtle and automatic scarcity thinking can be. The core idea: many of our behaviours—around food, business, and decision-making—are responses to perceived scarcity. The shift isn’t about “thinking positively,” but about building consistency and trust so that urgency starts to quiet down. A more sustainable way to operate—in both health and business. WORK WITH ME Join my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight Recover Strong for Binge Eating - https://www.sashahighmd.com/bed Ontario-Wide Virtual Obesity Management Clinic https://www.highmetabolicclinic.com Business & Career Coaching for Women Physicians www.sashahighmd.com/entrepreneur FOLLOW SASHA Instagram - https://www.instagram.com/sashahighmd/
In this episode, we break down how to lose fat without sacrificing muscle so your metabolism stays strong and your results actually last. The Problem Extreme calorie cutting, like eating 1,200 calories per day, may lead to quick weight loss but often at the cost of muscle. Losing muscle slows your metabolism and makes weight regain more likely. The Smarter Approach: Body Recomposition 1. Create a Small Calorie Deficit Reduce intake by about 200 to 300 calories instead of drastically cutting. If you are stuck eating very low calories, you may need to slowly increase them before trying to lose fat again. 2.Prioritize Protein Aim for 0.8 to 1 gram of protein per pound of ideal body weight each day. Spread protein evenly throughout the day, targeting around 30 grams per meal to support muscle maintenance and growth. 3. Balance Your Macros Simply Start with a 1 to 1 ratio of protein to carbohydrates. Fats fill the remaining calories in your daily target. Include a carbohydrate source at each meal to support energy and training. 4. Resistance training Incorporate resistance training at least twice per week, with the goal to build up to three times per week. Resistance training is essential to preserve and build lean muscle while losing fat. Bottom Line Crash diets wreck metabolism. Strength-focused nutrition reshapes you. RESOURCES: BMR (Basal Metabolic Rate) CALCULATOR: https://www.calculator.net/bmr-calculator.html ***Disclaimer: The information in this podcast episode is for educational purposes only, and is not individual nutrition therapy, for understanding individual needs please consult with your health care professional. GROCERY GUIDE: https://www.sashahighmd.com/high-on-life-podcast-grocery-guide WORK WITH US Join us in our Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight Recover Strong for Binge Eating https://www.sashahighmd.com/bed Ontario-Wide Virtual Obesity Management Clinic https://www.highmetabolicclinic.com Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide FOLLOW US ON INSTAGRAM : Instagram https://www.instagram.com/sashahighmd/
GLP-1 medications are either wildly overhyped or harshly criticized depending on the week—and one of the loudest concerns right now is that they “cause muscle loss.” In this episode, I’m digging into what the research actually shows about lean mass changes on GLP-1s, what’s being misunderstood online, and what patients and clinicians can do to protect muscle while still benefiting from these powerful therapies. To help me unpack this, I’m joined by Dr. Michael Tsoukas, Associate Professor of Medicine in the Division of Endocrinology at the McGill University Health Centre, Co-Director of the Metabolic & Weight Optimization Clinic, and a clinician-scientist whose work focuses on GLP-1 pharmacotherapy and obesity treatment. He’s trained at Tufts, McGill, and Harvard, and has authored over 50 peer-reviewed publications. We talk about where the muscle-loss concern came from, how GLP-1 weight loss compares to bariatric surgery and diet-only approaches, and whether lean mass loss always reflects true functional muscle loss. We also get practical, discussing resistance training and protein targets (it’s more than you may think!). If you’re on a GLP-1, considering one, or prescribing them—this is a science-based conversation that separates fear from facts. Guest: Dr. Michael Tsoukas Website: mwoc.ca WORK WITH ME Join my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight Recover Strong for Binge Eating https://www.sashahighmd.com/bed Ontario-Wide Virtual Obesity Management Clinic https://www.highmetabolicclinic.com Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide FOLLOW SASHA Instagram https://www.instagram.com/sashahighmd/
In this episode, I’m joined by Dr. Michael Beyaert — a General Internist trained at the University of Toronto with a special interest in cardiovascular disease. With a background in Nutrition and Dietetics (Western University) and a Master’s in Neuroscience (McMaster), he brings a rare, practical lens to metabolic health that connects medicine, nutrition, and the brain. We dig into what body composition actually means, why visceral fat is so metabolically harmful, and why muscle and strength may be the most overlooked health markers in modern weight loss conversations. We also talk about sarcopenia (age-related muscle loss), why rapid weight loss can increase risk, and what we actually know — and don’t know — about “safe” amounts of muscle loss during weight reduction, including with GLP-1 medications. Most importantly, Dr. Beyaert shares the real-world advice he gives patients: prioritize strength training, fuel your body (especially protein), monitor the rate of weight loss, and shift your focus from the scale to outcomes like strength, function, and quality of life. If you take one thing from this episode, it’s this: strength is health — and rather than obsessing over losing the next 10 pounds, most people would benefit more from gaining their first pound of muscle. Home BIA Scale Options We recommend one of two at-home BIA scales that you can easily purchase from Amazon.ca: 8-electrode BIA scale (higher accuracy): Provides more precise data by measuring arms, legs, and trunk separately Standard foot-to-foot BIA scale (more affordable): Still effective for tracking overall trends Both options are acceptable. The most important factor is consistency. WORK WITH US Ontario-Wide Virtual Obesity Management Clinic https://www.highmetabolicclinic.com Join my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight Recover Strong for Binge Eating https://www.sashahighmd.com/bed Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide
