Why Do Two-Thirds of People Regain the Weight After Stopping GLP-1 Medications? (Part 1)

About this Podcast

GLP-1 medications have split into two camps online: one side treats them as a miracle for anyone carrying extra weight, the other treats them as a shortcut that will backfire. Neither camp is asking the question that actually predicts if someone keeps the weight off.

There is no guest this week. Zach Dancel, COO of Nava Health, and Stephanie Misanik, Clinical Director at Nava Health, sit down on Longevity Unfiltered to walk through the data behind GLP-1 outcomes, Stephanie's own resistance to prescribing them years ago, and the specific gap in care that decides who keeps the results and who doesn't.

What this conversation covers: GLP-1 medications work exactly as advertised for weight loss, but the medication alone is not what determines long-term success. The support built around it is.

Neither Side of the GLP-1 Debate Has It Right  

Zach opens by naming the split everyone already recognizes online: one camp that thinks everyone should be on a GLP-1, and a purist camp that treats it as the start of something dangerous. Stephanie's response sets the tone for the whole conversation. In medicine, almost nothing works for 100 percent of people, and pretending otherwise is what's driving the loudest, least useful version of this debate. The real question was never pro or anti. It's whether a specific person, with a specific health history, is a good candidate, and what has to happen alongside the prescription for it to actually work.

Why Stephanie's Own Credentials Come Up  

Before getting into the debate, Zach asks Stephanie to credential herself, and the detour is worth including. She started as a health coach, then went back for a master's degree in applied clinical nutrition, passed a national board exam, and logged a thousand hours of supervised clinical practice to become a Certified Nutrition Specialist. She's since spent over a decade working directly with patients, much of it at Nava. The point isn't credential-flexing. It's that social media has made it easy for anyone with an audience to sound like an expert, and knowing the difference between a basic certificate and a licensed clinical credential changes who's actually worth trusting with a decision this personal.

The History Nava Doesn't Usually Bring Up  

Zach shares a piece of Nava's own past that shapes how the team evaluates any new weight loss tool. The company originally built its offering around an HCG protocol, until federal regulators reclassified it and compounding pharmacies stopped producing it almost overnight. That history is also part of why Stephanie wasn't an easy sell on GLP-1s. She was against adding them back in 2020, worried people would use the medication as a shortcut with no education or support behind it. What changed her mind wasn't the medication. It was realizing Nava already had the piece almost nobody else offering these prescriptions had: a full team of licensed nutritionists.

What COVID Made Impossible to Ignore  

This debate between Zach and Stephanie played out in the middle of the COVID pandemic, and the timing mattered. The country was watching metabolically unhealthy people have dramatically worse outcomes in real time. By Stephanie's account, nearly three in four Americans are already overweight or obese, and most of those people are also metabolically unstable. That backdrop is part of why the two hosts also push on medical training itself: most doctors get very little education in prevention, nutrition, or hormone health, which is part of why so many patients end up managing symptoms instead of catching problems early.

The Real Reason So Many People Regain the Weight  

Zach and Stephanie land on the actual answer to the debate they opened with. The medication was never the missing piece. The support around it is. Both hosts point to a sharp decline in the percentage of GLP-1 patients receiving dietary or behavioral support alongside their prescription, a gap that shows up in short primary care visits and in telehealth services that only send the medication. Without that support, roughly two-thirds of patients regain the weight after stopping. Stephanie's clinical view is direct: a GLP-1 can absolutely be part of addressing the root cause of weight gain, but only when it's paired with real nutrition and lifestyle guidance, not used as a replacement for it.

Frequently Asked Questions  

What is a GLP-1 medication used for?  

GLP-1 medications are most commonly prescribed for weight loss and metabolic health support. Stephanie is direct that the medication doesn't deserve the sweeping, cure-all claims some corners of social media give it.

Why do most people regain weight after stopping a GLP-1?  

Based on the pattern Stephanie and Zach describe, regain is far more common among patients who go on a GLP-1 without dietary or behavioral support, rather than the medication itself failing to work.

What is a Certified Nutrition Specialist?  

A Certified Nutrition Specialist, or CNS, is a licensed nutrition credential that requires a master's degree in clinical nutrition, a national board exam, and a minimum of a thousand hours of supervised clinical practice.

Do you need lifestyle changes if you are taking a GLP-1?  

According to Stephanie's clinical experience, pairing a GLP-1 with nutrition and lifestyle changes is what determines if the results last after the medication is reduced or stopped.

Listen to the full conversation with Zach Dancel and Stephanie Misanik on Longevity Unfiltered.

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