The episode was hosted by Aamina Rafiq who asked some really inciteful questions which I was pleased to explore.
The central message was clear: weight gain is not simply about willpower — it is strongly influenced by biology. The full interview can be viewed below or at the Simple Online Pharmacy website – Ask the Expert: Endocrinology – It’s Not Willpower, It’s Biology
How GLP-1 therapies influence appetite hormones
We spent time unpacking how GLP-1 treatments work, with a particular focus on the hormonal control of appetite. Ghrelin is often described as the primary “hunger hormone”, while leptin plays a major role as a “satiety hormone”. We discussed how GLP-1 is a hormone the body produces naturally in the small bowel in response to nutrients, and how it acts on appetite centres in the brain. In simple terms, GLP-1 helps shift the balance towards fullness, supporting satiety by moderating the effects of hormones such as ghrelin and leptin.
Food choices that may support natural GLP-1 release
We also explored how certain food groups may help stimulate the body’s own GLP-1 response. Protein-rich foods, fibre-rich options such as oats and lentils, healthy fats including avocado and olive oil, and fermented foods were all discussed. While diet alone isn’t a substitute for medical therapy where it’s needed, it’s reasonable to consider that emphasising these foods could help support satiety, particularly when trying to transition off GLP-1 treatment.
Stress, cortisol and “comfort food” patterns
Another important topic was stress, and how stress hormones can influence food choices. People experiencing chronic stress and higher cortisol levels may be more likely to reach for highly palatable “comfort foods”. These choices are often calorie-dense, lower in nutritional value, and tend not to promote fullness very effectively, which can make weight management more difficult over time.
Obesity as a long-term condition
We also discussed whether obesity should be approached as a chronic condition. Many people begin GLP-1 therapy hoping that once weight is lost it will stay off permanently, but for many individuals weight regain can occur, sometimes quite quickly, after treatment stops. This is why sustained lifestyle change matters, both for long-term health and to reduce some of the recognised effects of weight loss such as muscle loss. Even with excellent lifestyle habits, some people may still need longer-term medical therapy to maintain weight loss.
Closing thoughts
The Simple Online Pharmacy team have done an excellent job summarising our discussion on their website, and it was a pleasure to take part. I’d be very happy to return in future to help answer more questions on endocrinology, diabetes, and medical weight management.