Habits and Hustle, Episode 523

Guest: Ashley Koff, RD | Host: Jen Cohen

Topic: GLP-1, Weight Loss, and the Mistakes That Create Rebound
Date: January 27, 2026

Episode Overview

In this insightful episode, Jennifer Cohen welcomes renowned dietitian and author Ashley Koff, RD, to break down the realities versus the hype behind GLP-1 agonist medications (like Ozempic, Semaglutide, Tirzepatide) and their effects on weight loss, health, and the common mistakes that can lead to rebound weight gain. The conversation challenges the growing obsession with being thin at any cost, debunks misconceptions, and offers a nuanced view on health, behavior modification, digestion, nutrient absorption, and the pitfalls of modern health culture.

Main Themes & Key Discussion Points

1. The GLP-1 Craze and the "Thinner at Any Cost" Trend

• [00:07-03:27]
  • Jen notices a surge in people appearing thin in L.A., attributing it to widespread GLP-1 use.
    Quote: "If you walk around LA or anywhere at this point, everyone is thin now...I feel like, are we living in a pseudo reality?" – Jen [00:53]
  • Ashley highlights: Being thin ≠ being healthy; not all weight loss is beneficial or aesthetically positive.

2. Understanding What GLP-1 Agonists Do and Don’t Do

• [03:27-07:00]
  • Ashley explains GLP-1 analogues mimic naturally occurring weight-health hormones, but stay active far longer, with pronounced metabolic effects. Quote: "They are a biosimilar hormone replacement...Our own body hormones stay on for two to five minutes. These stay on for 24 hours, now for seven days." – Ashley [04:15]
  • Importance of using these drugs as tools, not quick-fix solutions.

3. Dangers of Using Medication As a Shortcut

• [07:00-13:29]
  • Jen questions if these meds are being misused, as their original intent was for diabetes.
  • Ashley challenges societal judgment of who "should" be on these drugs, but warns of risks when deeper health issues (like digestive problems) are ignored in favor of simply medicating. Quote: "Now anyone taking a medication to lose weight or a doctor prescribing it to lose weight is actually in an old system and creating problems for people." – Ashley [06:40]

4. Mistakes That Lead to Rebound Weight Gain

• [11:49-12:43]
  • Jen and Ashley recall how behavior modification is being skipped; the result is muscle loss, appetite returning "with a vengeance," and yo-yo effect. Quote: "People acclimate to the medication and then their appetites come back...when they get off of it...they gain all their weight back and more." – Jen [12:11]

5. Personalized Approaches Over One-Size-Fits-All

• [14:03-17:31]
  • Ashley uses her own lifelong struggle with weight to illustrate genetic, behavioral, and medical complexities; blanket advice never works. Quote: "If you are following what somebody else did for themself and you're expecting the same outcome. You are to blame." – Ashley [14:47]

6. Who Should Use GLP-1s? Ashley’s Perspective

• [17:36-24:30]
  • Ashley candidly shares her own cautious, low-dose use of GLP-1 agonists, and why she stopped (digestive side effects).
  • She describes a “kitchen sink” approach: exercise, digestive health, protein, psychosocial factors.
  • Nuance matters—she’s not pro or anti GLP-1s, but advocates for careful, case-by-case evaluation ("agnostic").

7. Compounded vs. Pharma GLP-1s, and The New Wave of Medications

• [26:10-32:07]
  • Ashley is concerned about compounded GLP-1s and lack of consistency in ingredients.
  • Explains difference between single (semaglutide), dual (tirzepatide), and triple agonists; new oral small-molecule agonists may present unknown risks. Quote: "An agonist by definition means that it's doing what your body would normally do...But the new class of medications coming out are not bioidentical…That has me very concerned.” – Ashley [28:32]

8. What Actually Makes for "Weight Health"?

• [34:38-41:43]
  • Ashly uses the "pizza analogy": crust = digestion & hydration, sauce = nutrition (quantity, quality, timing, balance), cheese = lifestyle choices.
  • Biggest foundational pillar: optimize digestion & hydration, not just calorie-counting or intermittent fasting.

9. Protein & Digestive Health: Myths and Optimization

• [41:44-46:41]
  • Are people eating too much protein? Possibly—especially with digestive issues or poor protein variety.
  • Digestive Enzymes vs. Magnesium: When to use each, how they function differently, and why simply increasing fiber or supplements isn’t always the answer.

10. Absorption, Testing, and “Obsessive Health” Culture

• [49:49-54:02]
  • Jen raises the issue of not absorbing nutrients despite healthy eating. Ashley advocates for periodic absorption tune-ups, and sees a glut of unnecessary, expensive biomarker testing. Quote: "If you're not absorbing your nutrients, nothing is going to improve in any of those markers." – Ashley [60:06]

11. Too Much Tracking, Too Much Data

• [75:01-76:45]
  • Both discuss health info overload, with people “wearable”-obsessed and worried they can’t reach true health without expensive tools and tests. Quote: "If you want to be entertained by nutrition and health, great. But if you are obsessive compulsive about it, it is not better for you than anything else." – Ashley [75:42]

Notable Quotes & Memorable Moments

• On the hype:
  "We turn around and we say, like, I could look at you...my doctors are telling me that I should go on this medication. And I'm thinking, like, are they trying to tell me I'm fat? And I said, no. What they're trying to tell you is...your appearance isn't what doesn’t tell me anything. I want to know: are you healthy inside of you?" – Ashley [08:41]

• On GLP-1 misuse:
  "If somebody's using a GLP-1 and they're not eating, they're using too much of it and they're using it wrong." – Ashley [23:30]

• On personalized health:
  "At the end of the day, the opinion is it has to be personalized." – Ashley [33:55]

• On over-focusing on health:
  "What's making us all crazy and sick is the fact that we're all hyper-focused on health and living until 150...The stress that people info-obesity. We're just in obesity. Too much information." – Jen [75:03]

• On nutrient absorption:
  "Your body doesn't give you credit until it is broken down into nutrients and in the cells and able to be used by the cells." – Ashley [49:24]

Actionable Takeaways & Practical Advice

Timestamps indicated by [MM:SS]

• GLP-1s are not magic: Use them only as part of a comprehensive plan that includes food, behavior, and healthcare review. [03:50–07:00]
• Optimize digestion and hydration ("the crust"): Without this, nothing else (food, supplements, drugs) will work properly. [34:40]
• Protein & timing: Don’t just “eat more protein.” Find the right variety, digestibility, and portion for you. Excess can backfire. [45:28]
• Don’t blindly chase lab numbers: Regular lab work is helpful if focused, but endless biomarker panels won’t replace tuning basic health behaviors. [59:46]
• Over-tracking is risky: Wearables and apps are only helpful if you’re using the data to facilitate true lifestyle changes, not guilt or anxiety. [75:42]
• Tune up absorption regularly: Quarterly checks (Ashley’s recommendation) on digestion support better health outcomes than just lab test after lab test. [51:15]
• Movement over formal "exercise": Frequent, varied movement through the day matters more than just hitting the gym. [40:24]
• Use personalized, not influencer-driven, plans: What works on Instagram won’t necessarily work for you. [72:46]

Handy Reference: 10 Key Health Markers (from Ashley’s book) [63:32]

1. Hemoglobin A1C
2. Vitamin D
3. LDL cholesterol
4. Triglycerides
5. Fasting insulin (if available)
6. Hs-CRP
7. ALT
8. AST
9. Heart rate variability
10. In-depth digestion and hydration assessment

Sample Personalized "Digestive Tune-Up" Strategies

• Don't overload the system: eat moderate portions, avoid dumping nutrients all at once [65:22].
• Hydrate in small, regular doses with attention to electrolytes and dehydrators like stress, caffeine, alcohol [71:01].
• Move your body in diverse, low-key ways daily (chair twists, rolling, walking, playing), not just formal exercise [39:39].
• Consider adding glutamine or digestive enzymes during periods of stress, travel, or poor absorption, but only with assessment [68:25].

Final Takeaway

Ashley and Jen agree: effective, sustainable weight health requires attention to digestion, movement, and personalized approaches. Medications like GLP-1s and high-tech optimism should be part of a bigger, thoughtfully tailored plan – not a replacement for getting to the root of your body's needs. Above all, stop chasing one-size-fits-all solutions, resist the lure of health-fad overkill, and focus first on foundational habits you can build and sustain.

"Progress is better than perfection. Could you agree to take glutamine for six weeks before you get any labs drawn?" – Ashley [77:00]

Ashley Koff’s New Book:
"Your Best Shot: The Personalized System for Optimal Weight Health"
Find resources, self-assessments, and more at Ashley's website (details in the episode).

[Episode ends at 80:31]