The Tamsen Show: Episode Summary

Episode: The #1 Ozempic Doctor Reveals The Truth About GLP-1s and Microdosing
Release Date: March 26, 2025
Host: Tamsen Fadal
Guest: Dr. Alexandra Soa, Dual Board-Certified Internist and Obesity Medicine Specialist

Introduction

In this illuminating episode of The Tamsen Show, host Tamsen Fadal sits down with Dr. Alexandra Soa, one of the leading experts in metabolic and obesity medicine. The conversation delves deep into the world of GLP-1 medications, their role in weight loss, the nuances of microdosing, and their implications for women navigating menopause. This episode aims to demystify these medications, address common misconceptions, and provide actionable insights for listeners considering or currently using GLP-1s like Ozempic and Wegovy.

Guest Background: Dr. Alexandra Soa

Dr. Soa brings a wealth of experience to the discussion, having dedicated the past decade to obesity medicine. She shares her journey into this specialized field, motivated by a desire to shift medical focus from disease treatment to prevention.

Dr. Alexandra Soa (03:39): "I found this amazing small specialty early on because I became very disillusioned with the traditional medical education. [...] I just knew there had to be a better way that we could help prevent."

Her personal connection to the issue is profound, rooted in her family's struggles with weight and the emotional toll it has taken.

Understanding GLP-1 Medications

What Are GLP-1s?

GLP-1 (Glucagon-Like Peptide-1) medications, such as Ozempic and Wegovy, are synthetic versions of a hormone naturally produced in the body. Initially introduced in 2005 for managing type 2 diabetes, these medications have gained prominence for their efficacy in weight loss.

Dr. Alexandra Soa (05:42): "GLP1 encompasses this whole class of drugs that colloquially we use Ozempic. [...] It is a hormone that naturally occurs in the body."

How Do They Work?

GLP-1s operate by targeting multiple areas in the body:

• Brain: Reduces appetite, helping individuals feel satiated longer.
• Gut: Enhances the body's ability to process and utilize food efficiently.
• Pancreas: Regulates blood sugar levels and insulin secretion.

Dr. Alexandra Soa (06:56): "They target the brain, they target the gut, and then they target the pancreas at the level of blood sugar and insulin."

Dosage and Delivery

While initial formulations required daily injections, advancements have led to weekly injectables, with future options including monthly injections and oral pills.

Dr. Alexandra Soa (07:08): "We now have weekly injectable medications. [...] In the pipeline of drug development is actually a monthly injection or oral pills."

Debunking Weight Loss Myths

A significant portion of the discussion challenges the pervasive myth that weight loss is solely about willpower.

Dr. Alexandra Soa (09:06): "Weight loss is not about willpower. It is biology."

Tamsen shares her personal struggles with weight during her college years and how societal pressures can lead to unhealthy relationships with body image.

Tamsen Fadal (01:35): "I pushed myself to dangerous extremes at some points to fit into this ideal. Even when I fit into that ideal, I never felt good enough."

Comprehensive Approach to Weight Loss with GLP-1s

Dr. Soa emphasizes that while GLP-1s are powerful tools, they are most effective when combined with behavioral changes and habit formation.

1. Finding Your "Why"

Understanding personal motivations is crucial for sustained weight loss.

Dr. Alexandra Soa (12:27): "One can be rooted in vanity. [...] But then you have to dig deeper."

2. Building Healthy Habits

Starting small with manageable habits lays the foundation for long-term success.

Dr. Alexandra Soa (11:44): "We start small, we start really small. [...] Even before getting into habits, I'll have people tell me why they're doing it."

3. Tracking Food and Emotions

Keeping a journal of food intake and emotional states helps identify triggers and patterns.

Dr. Alexandra Soa (14:13): "Start writing down your food, not tracking calories or macronutrients. [...] Let me tell me how you felt about it."

Microdosing and Compounding Concerns

Microdosing Explained

While "microdosing" is a trending term, Dr. Soa clarifies its ambiguous usage in the context of GLP-1s.

Dr. Alexandra Soa (22:03): "Microdosing is very trendy. Truthfully, I'm not entirely sure what microdosing means."

Generally, it refers to taking smaller-than-standard doses, often through compounded medications not FDA-approved, which poses safety and efficacy concerns.

Dr. Alexandra Soa (25:15): "Microdosing, ... comes from compounding pharmacies."

GLP-1s in Menopause

Menopause brings about significant hormonal changes that affect weight distribution and metabolic health. GLP-1s offer benefits beyond weight loss, such as reducing inflammation and improving insulin resistance.

Dr. Alexandra Soa (42:52): "GLP1 medication affects cascades that really do bring down inflammation. [...] I believe, in about 10 years time have the studies that tell us actually this lowering of inflammation is preventing dementia."

Integration with Hormone Therapy

GLP-1s are increasingly being used alongside hormone therapy to address the multifaceted challenges of menopause.

Tamsen Fadal (34:15): "Are you seeing a lot more women in menopause talking about this, taking it alongside hormone therapy, realizing hormone therapy might not do it itself and they need something else?"

Potential Challenges and Side Effects

While GLP-1s are effective, they come with potential side effects that can often be managed with proper guidance.

Managing Side Effects

Common side effects include decreased appetite and reduced thirst, which can lead to inadequate hydration.

Dr. Alexandra Soa (28:13): "People need to know that they're there. But we can mitigate them if you're prepared. They do get better, generally."

Importance of Correct Dosage

Finding the right dosage is essential to minimize discomfort and ensure efficacy.

Dr. Alexandra Soa (30:25): "If someone has to stop these medications due to side effects, that means two things to me. One, there was no behavior change."

Sustainability and Long-Term Use

GLP-1s are typically prescribed as lifelong medications for managing chronic conditions. Dr. Soa stresses the importance of understanding this commitment beforehand.

Dr. Alexandra Soa (41:15): "The majority of people will not get off these medications and that is because we are treating a chronic disease."

She addresses societal biases that question the necessity of long-term medication, reinforcing that dependence on GLP-1s does not equate to personal failure.

Dr. Alexandra Soa (41:46): "They are not a failure if you cannot come down or off of these medications."

Final Thoughts and Takeaways

The episode concludes with key takeaways that emphasize a holistic approach to weight loss and health management:

1. Body Fat Percentage Over BMI: Aiming for a body fat percentage under 30% for women is more realistic and health-focused than chasing an often unattainable BMI.

   Tamsen Fadal: "First was the body fat range around 30%, which actually feels a little more realistic and empowering than chasing that impossible ideal."

2. Strength Training: Incorporating strength training is vital for building a resilient and capable body, especially during menopause.

3. Mental Health Integration: Collaborating with mental health professionals ensures that the emotional aspects of weight loss are addressed alongside physical changes.

4. GLP-1s as Tools, Not Shortcuts: These medications should be viewed as part of a broader health strategy, complementing other healthy habits rather than replacing them.

5. Societal Support and Non-Judgmental Approaches: Encouraging open conversations without judgment helps women navigate their health choices confidently.

Dr. Alexandra Soa (40:48): "We need to be informed."

Conclusion

This episode of The Tamsen Show serves as a comprehensive guide for women considering or using GLP-1 medications for weight loss, especially in the context of menopause. Dr. Alexandra Soa's expert insights debunk myths, highlight the importance of a holistic approach, and underscore the significance of mental and emotional well-being in the journey toward better health.

Listeners are encouraged to seek personalized medical advice, understand the commitments involved with GLP-1s, and embrace a balanced approach that integrates both medical interventions and healthy lifestyle changes.

Connect with Dr. Alexandra Soa:

• Book: The Ozempic Revolution available on Amazon and getsowell.com
• Website: getsowell.com

Follow The Tamsen Show:

• Website: podcastampsenfadel.com
• Social Media: @tamsenfadal on various platforms

If this episode resonated with you, please consider leaving a five-star review on Apple Podcasts, Spotify, or your preferred platform. Your feedback helps us continue these important conversations.