Let's Talk Off Camera with Kelly Ripa

Episode: Dr. Fatima Cody Stanford: Weight loss, GLP-1s and Can You Ever Stop

Date: September 24, 2025
Host: Kelly Ripa
Guest: Dr. Fatima Cody Stanford (Obesity Medicine Physician & Scientist)

Episode Overview

In this highly anticipated episode, Kelly Ripa dives deep into the rising phenomenon of GLP-1 medications (like Ozempic, Wegovy, and Zepbound) for weight loss. Joined by Dr. Fatima Cody Stanford—a leading expert in obesity medicine—the conversation covers the science behind GLP-1s, who they help, alternatives for those for whom they don’t work, real-world patient experiences, common misconceptions, costs, international access, and pressing listener questions about efficacy, side effects, and long-term use.

Key Discussion Points & Insights

1. What Are GLP-1s? Understanding the Basics

• GLP-1s (Glucagon-Like Peptide-1 receptor agonists) are hormones already present in the human body that regulate hunger and satiety. (03:07)
• Medications like Ozempic and Wegovy are synthetic versions designed to help those with a GLP-1 pathway deficiency.
• Having more GLP-1 naturally means you’re likely to have an easier time feeling full and regulating weight; less means you’re predisposed to carrying more fat.

“GLP1s... is a hormone, a peptide that’s actually in our bodies. It helps regulate our hunger and satiety signals.” — Dr. Stanford (03:18)

• Hunger and satiety cues are biologically regulated, not simply about willpower.

2. Medication Efficacy: No “One Size Fits All” Solution

• GLP-1 drugs don't work for everyone; weight regulation is complex, and multiple neural pathways can be responsible for excess weight.

"Do these work for every single person? Is this miracle? Absolutely not." — Dr. Stanford (06:31)

• Alternatives include medications like phentermine (norepinephrine pathway), topiramate (GABA pathway), and bupropion/naltrexone (Contrave), all working differently for different individuals. (07:47)

“Different people need different combinations, right? Because our pathophysiology is different. It’s what makes us unique, is what makes us human.” — Dr. Stanford (08:22)

• Treatment requires individualized approaches; continuous adjustments are usually necessary.

3. Patient Experiences: Food “Noise,” Plateaus, and Individualized Responses

• Some patients find GLP-1s "quieten" food noise, others do not experience this as strongly.

“It’s not muted, it’s quieter.” — Albert (06:08)

• For some, the medication enables them to stop eating when full or share meals for the first time (10:20).

4. Self-Medication and Online Access: Risks and Monitoring

• Dr. Stanford warns against purchasing GLP-1s online or outside medical supervision due to:
  • Risk of unknown formulations/doses
  • Lack of monitoring for side effects

"...if we're looking for something that's potentially online, I don't know what to expect from those things...I need to know what to anticipate.” — Dr. Stanford (13:07)

• Proper medical oversight is essential for both safety and optimizing outcomes.

5. Long-Term Use: Do You Have to Take GLP-1s Forever?

• Key theme: For >85% of patients, stopping GLP-1 medications leads to regaining most or all lost weight (17:32).
  • These drugs address the biological underpinnings; if withdrawn, the body tends to revert to its pre-treatment baseline.

“About 85% of the patients will regain all of their weight.” — Dr. Stanford (15:32)
“These are meant for chronic use.” (16:02)

• Only about 10–15% successfully maintain weight loss after stopping, and there's no way to predict who they’ll be.

6. The Cost & Access Dilemma

• Major barrier: Most insurance still doesn’t cover GLP-1s for obesity, due to continued stigma and the high prevalence of obesity.
  • Cost can be ~$500+/month out-of-pocket (17:39).
• Oral versions and international options (e.g., Canada, Israel) might eventually lower costs, but access/legality is complex (24:13, 36:49).

“Companies still don't believe obesity is a disease, or if they believe it's a disease, it's one that's too expensive for them to cover.” — Dr. Stanford (18:05)

7. Side Effects: Beneficial and Adverse

Positive “Side Effects”

• Decrease in alcohol consumption, reduced impulsive behaviors (gambling, shopping)
• Potential benefit for neurodegenerative and inflammatory conditions (27:09)

Negative Side Effects

• Most common: Nausea (40% of users), constipation, diarrhea, fatigue (29:09)
• Rarer but serious: Gallbladder issues, bowel obstruction (34:34)
• Unfounded rumors (social media-blamed sudden “blindness” not substantiated by studies) (29:24)

Other Concerns

• “Ozempic face” (saggy/aged facial appearance) and hair loss are simply byproducts of any rapid weight loss, not unique to these drugs (45:22, 49:57)

“Whenever we lose weight...we lose fat mass. We carry fat stores in our face...This idea of Ozempic face comes from the fact that when we lose weight, we can lose it from anywhere.” — Dr. Stanford (45:22)

• Hair loss solutions: Topical/pill minoxidil (Rogaine ingredient), biotin supplements/shampoos (49:57)

8. Caller Questions: Real-World Issues

Caller 1: Jennifer (Daytona, ~15:07)

• Lost 125 lbs on Zepbound; wants to wean off due to cost.
  • Dr. Stanford reiterates high risk of regain if stopping.
• On healthy habits: Most patients already have strong routines; meds are not a shortcut but a necessary adjunct (19:44).
• Dr. Stanford hopes oral options may lower cost barriers soon.

Caller 2: Ann (San Diego, ~24:27)

• On Ozempic; concerned about a neck lump after seeing ad warnings.
• Dr. Stanford: Lump concern is mostly for those with medullary thyroid cancer risk; quick reassurance and reiteration—chronic use is necessary for maintenance (25:24).
• Ann’s doctor said it’s not related; Dr. Stanford emphasizes proper monitoring.

Caller 3: Samantha (Minnesota, ~32:38)

• Rapid weight loss; liver enzymes elevated; bowel obstruction after switching to Manjaro.
  • Dr. Stanford: Mild, temporary liver changes are rare but possible; bowel obstruction relates to slowed gut motility.
  • Recommends hepatologist follow-up and more time for normalization (34:34).

Caller 4: Sue (Michigan, ~36:10)

• Traveling to Mexico; wonders about buying cheaper meds abroad.
  • Dr. Stanford: Cheaper in many countries but require prescription by doctor licensed in the country; warns against over-the-counter or unregulated purchases (36:49)

Caller 5: Tracy (Allentown, ~44:20)

• New diabetes diagnosis; worried about “Ozempic face” and aging.
  • Dr. Stanford reassures: Lose weight, any method, lose fat everywhere including face. Focus is on heart health first (45:22).
  • Tracy on metformin + Ozempic: Dr. Stanford explains they’re commonly used synergistically in diabetes management.

Caller 6: Monica (Palm Desert, ~51:04)

• In perimenopause, asked about “GLP-1 booster” fiber supplements for modest weight loss.
  • Dr. Stanford: Total gimmick; fiber can help satiety, but supplements labeled as GLP-1 boosters are marketing ploys (51:58). For perimenopausal gain, considers endocrinology and HRT evaluation.

9. Upcoming/Alternative Treatments

• Oral GLP-1s: Eli Lilly’s Orforglipron (oral, non-peptide); about 13% weight loss in trials, expected lower cost, but still pending FDA approval (40:09)
• “Peptides”: Friends sometimes use code language to describe their regimens (41:28)

Notable Quotes & Moments

• On Individualization:

  “I realize that this person needs a little sprinkle of this, and this person needs a little sprinkle of that…and guess what? Some people need a little sprinkle of all of it. I need to put it all in a big stew, right?”
  — Dr. Stanford (08:22)

• On Weight Regain after Stopping GLP-1s:

  “When you pull back on those medications, just like if we were to take away a cholesterol medicine…your body will go back to wherever the state was before you were taking the medication.”
  — Dr. Stanford (16:02)

• On Social Media “Ozempic Face”:

  “That’s not really a thing. I understand that it’s been popularized by social media, but it’s not really specific to Ozempic.”
  — Dr. Stanford (45:28)

• On Stigma and Insurers:

  “Companies still don't believe obesity is a disease, or if they believe it’s a disease, it’s one that's too expensive for them to cover…”
  — Dr. Stanford (18:05)

Timestamps for Key Segments

• Main topic intro/GLP-1 explanation: 03:03–05:40
• Are GLP-1s a miracle drug? Alternatives: 06:31–09:51
• Personal stories on food noise/response: 09:56–10:41
• Individualized treatment, not “one size fits all”: 11:37–12:54
• Risks of buying online/off-label: 13:06–14:47
• Long-term use and weight regain: 15:32–18:05/25:39/48:54
• Costs, coverage, and access: 17:39–19:17/36:49
• Positive/negative side effects: 27:09–29:24
• Oral GLP1s future: 40:09
• Social/marketing gimmicks ("boosters"/"peptides"): 41:25/51:58
• Perimenopause/Hormone therapy and weight: 54:33

Final Thoughts

Dr. Stanford’s parting message:

• Obesity is a chronic disease requiring individualized, often chronic treatment.
• GLP-1s (and other agents) are tools— not magic bullets — best used with medical guidance, alongside lifestyle measures.
• There's no shame or “failure” in needing pharmacological or surgical help.
• Stigma, cost, and access barriers remain high.
• Stay skeptical of online “quick fixes” or supplement claims.

“I was surprised, as I think the callers were, and surprised their doctors didn’t sort of inform them of this: that they are going to be on these medications for the rest of their lives.” — Kelly Ripa (55:28)

This episode offers a deeply informative, honest, and approachable look at the current state (and limitations) of GLP-1 therapy for weight management—busting myths, setting realistic expectations, and empowering listeners to make their own best choice.