I Used a GLP-1. I’m a Weight-Loss Surgeon. Let’s Talk.
What losing 45 pounds taught me about food noise, shame, masculinity, and why biology beats willpower
I’m a Weight-Loss Surgeon. I Used a GLP-1. Here’s What That Taught Me.
Some of you have noticed my weight loss.
So let’s start there—plainly.
I started in mid-October of 2024.
I’m on 7.5 mg of Zepbound once a week.
I lost 45 pounds.
I’m now maintaining a weight I haven’t been at since I was 18 years old—
normal weight, not overweight.
And yes—thank you for noticing.
I’m also a weight-loss surgeon.
Those statements are not in conflict. They are experience.
For years, I’ve helped thousands lose weight. I’m certified in Culinary Medicine. I cook. I eat well. I talk about protein, fiber, movement, and metabolic health for a living. None of that changed, because I used a GLP-1.
What changed was the noise
.
The Part We Don’t Talk About Enough: Biology
Obesity is not a failure of character. It is a chronic, relapsing, biologically mediated condition. Hunger signaling, satiety, reward pathways, insulin resistance—these are not moral choices. They are physiology.
GLP-1 medications don’t replace responsibility.
They don’t replace nutrition.
They don’t replace protein, fiber, or movement.
What they do is quiet the constant biological drive to eat—the drive we tell people to “power through,” and then shame them for failing.
Medicine isn’t cheating.
Ignoring biology is.
What Didn’t Change
I still eat real food.
I still prioritize protein.
Fiber still matters—for gut health, glucose control, and satiety.
I still move my body.
GLP-1s didn’t make those things irrelevant. They made them possible without constant friction.
That distinction matters.
Food Noise Is Not Hunger — And This Was the Biggest Change for Me
There’s one part of my GLP-1 experience that surprised me more than the weight loss.
I didn’t know what food noise was—
until it was gone.
A few hours after my first injection, something in my brain went quiet. I didn’t have language for it at first. I just knew something was different. No deprivation. No effort. Just…less noise.
So I tested it.
That night, instead of eating the entire fillet of salmon—about five ounces—I ate half. I finished the vegetables. I ate the grains. And then I stopped.
Not because I was full.
Not because I was being disciplined.
But because there was no longer that internal push to keep going.
And I was fine.
Food noise isn’t hunger. You can be full and still want to eat—there’s always room for dessert. Food noise is mental. It’s the background chatter, the negotiation, the pull toward food cues even when your body doesn’t need more.
The closest analogy I can give is this:
Have you ever had ringing in your ears—and then it suddenly stops?
Or imagine an infant given a drum—beating it nonstop—until he discovers your iPad. The drumming stops. The silence is startling.
Not because something was added.
Because something unnecessary disappeared.
When the Noise Stopped, Choices Became Easy
What the elimination of food noise did was something else I didn’t expect.
It made good choices easy.
Could I still eat a burger? Of course. But if I ate half, I was satisfied—and I didn’t need the rest.
And that word matters.
I wasn’t full.
I’ve been full on this medication.
I was satisfied.
Dessert didn’t disappear either. I might have a bit. But if it isn’t perfect? Meh. I’m done.
Discernment Replaced Powering Through
I used to power through things.
I’d power through meals that weren’t that good.
I’d drink wine that was just “okay.”
I’d finish coffee that didn’t really taste great.
Now I don’t.
If a meal doesn’t taste great, I stop eating it.
If the wine is mediocre, I don’t bother.
If the coffee isn’t good, I set it aside.
Taste became more acute. Texture mattered more.
And yes—cold coffee is more flavorful. Sometimes that just means dropping an ice cube into the mug while the machine pours a fresh cup.
This isn’t restriction.
It’s discernment.
When the noise goes quiet, you don’t need rules.
You just choose—and move on.
Paid subscribers:
In the paid section, I go deeper into what food noise actually is, how GLP-1s act on metabolic and reward circuits in the brain, and why this explains both their effectiveness—and why weight often returns when they’re stopped.
About the Diets People Always Bring Up
Yes, I’ve done low-carb.
Yes, I’ve done vegetarian.
Yes, I’ve done pescatarian.
Yes, I eat plant-forward.
And I remain faithful to the Mediterranean pattern—not for weight loss, but for health.
One-note diets work briefly.
They’re boring.
They’re unsustainable.
GLP-1s didn’t push me to extremes. They allowed me to eat normally—with variety, fiber, pleasure, and flexibility.
What Did Change (And What Didn’t)
The benefits weren’t cosmetic.
My sleep scores improved.
My stress scores dropped—way down.
My heart-rate variability improved.
And importantly: my lean muscle mass hasn’t changed.
I measure this regularly because body composition matters more than weight alone. I track it using a scale from Withings. This isn’t an advertisement—it’s simply a better tool than many basic scales I used years ago in clinical practice.
For the record:
I used to wear a 44-inch waist with a 30-inch inseam.
Now I’m 30/30—occasionally a touch more.
Yes, I enjoy that.
But that’s not the point.
The point is healthspan.
Medicine Improves Biology — Shame Never Has
I take Crestor and Zetia for familial hypercholesterolemia.
I didn’t fail fiber.
I didn’t eat my way into genetics.
And food alone wasn’t going to fix it.
Medicine makes biology better.
The idea that food should cure everything is outdated. It’s time to catch up to at least the 1980s.
(For those interested, I’ve discussed how food and medication work together on the Fork U.)
A Direct Word to Men: Shame Is the Quiet Part
In my years as a weight-loss surgeon, 80% or more of my patients were women.
The responses to my GLP-1 videos are overwhelmingly from women.
That’s not because obesity is a women’s problem.
Men have just as much obesity—often more visceral fat—and men die sooner.
And here’s the part we don’t talk about: shame.
Shame is hard for men to admit. Shame about needing help. Shame about injections. Shame about acknowledging that willpower didn’t fix it.
We’ll go on a steak-and-eggs diet and call it masculine.
But give ourselves a weekly injection—and suddenly we’re worse than a six-year-old going to the pediatrician for a vaccine.
Another extreme diet won’t fix this. You’ll get bored of steaks. And high red-meat patterns increase risks we understand well.
But even if you don’t care about heart disease or cancer, consider this:
Reducing visceral fat improves vascular health.
Better vascular health improves erectile function.
Testosterone tends to rise.
Libido improves.
Less belly means better blood flow.
Better blood flow means better function.
And while interest in food and alcohol often decreases, interest in sex often increases.
Men—you can live longer and better.
And when I say longer, I mean years.
Not metaphors.
Giving up performative toughness isn’t weakness.
It’s choosing function over posturing.
A Brief Word on Compounded GLP-1s
I don’t use or recommend compounded GLP-1s.
Quality, dosing accuracy, formulation consistency, and safety matter—especially for medications that act on the brain and metabolism.
Precision isn’t optional.
The Cost Problem We Can’t Ignore
I could budget for this medication.
Many people cannot.
That’s a structural failure—not a personal one.
Pill forms may eventually reduce costs for Wegovy and Zepbound, but we don’t yet know pricing, coverage, or whether savings will reach patients.
Access remains one of the biggest unresolved issues in obesity care.
Where I’m Headed Now
My goals this year are simple:
More yoga.
Better movement.
And giving my 16-year-old dog the best year possible.
For the first New Year, I am not having weight loss as a goal.
I’ll share more of this journey on TikTok @drterrysimpson and Instagram @drterrysimpsonmd.
If you’re on this path, I’d like to hear from you.
What changed for you beyond the scale?
🔒 PAID VERSION: The Science Behind Food Noise, Stress, and Men’s Health
For paid subscribers, this is where we go deeper.
Food noise
– How GLP-1s act on hypothalamic hunger circuits and reward pathways
– Why food noise often disappears within hours
– Why it returns when medication stops
Stress and heart disease
– Why my stress scores dropped so dramatically
– GLP-1 effects on autonomic balance, cortisol signaling, and cardiovascular risk
Men’s health
– Visceral fat, inflammation, and testosterone
– Erectile function as a vascular marker
– Why longevity and sexual health are the same conversation
This isn’t about motivation.
It’s about physiology.
Upgrade to read the science behind why biology finally worked with me—not against me.
