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What if some of the things you were taught about obesity were simply wrong? In this episode of the BariNation Foundation Podcast, April Williams sits down with obesity medicine physician Dr. Michelle Gordon and BariNation community member Tabitha Tyler to discuss what happens when patients and providers are willing to say, “I was wrong,” and follow the science forward. They discuss the physiology of obesity, why “eat less and move more” doesn't tell the whole story, how GLP-1 medication and bariatric surgery can be powerful treatment tools, and why menopause and whole-person care belong in the conversation. They also explore the identity shift that can happen after weight loss, the role of shame and self-belief, and how community and empathy can help people move beyond the stories that have kept them stuck. What You Will Learn in this Episode: ✅ Why obesity needs to be understood as a chronic disease rooted in physiology rather than blame, and why being willing to change your mind is an important part of following the science. ✅ How Dr. Gordon's own experience with obesity, menopause medicine, coaching, surgery and GLP-1 treatment changed the way she approaches patient care. ✅ Why bariatric surgery and GLP-1 medications can be complementary tools, including how hunger and weight regain can change over time after surgery. ✅ How weight loss can create an unexpected identity shift and why changing the story you tell yourself can be an important part of long-term behavior change. This episode of the BariNation Podcast is produced by the BariNation Foundation, a 501 (c) (3) dedicated to advancing metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. Funding comes from generous donations to the BariNation Foundation from listeners and viewers like you, Johnson & Johnson, and the Texas Center for Bariatrics & Advanced Surgery, led by Dr. Joe Cribbins and our newest sponsor, Lilly. TIMESTAMPS: 00:00 – Dr. Michelle Gordon on obesity, weight loss and changing the story 05:28 – Why GLP-1 medication is treatment, not “cheating” 09:44 – The identity shift that can happen after weight loss 14:31 – Tabitha’s bariatric surgery journey and what changed beyond the scale 20:09 – Dr. Gordon’s evolution from surgeon to obesity medicine physician 31:28 – Why “eat less, move more” isn’t the whole story 37:22 – Finding reliable, evidence-based information about obesity treatment 43:38 – The role of empathy, community and support in the obesity journey 48:29 – GLP-1 medications, weight regain and when surgery may be the answer KEY TAKEAWAYS: 💎 Being wrong isn't a failure. Dr. Gordon emphasizes that medicine evolves as new evidence becomes available, and patients and providers alike have to be willing to update what they believe. 💎 Obesity is a disease of physiology, not a moral failure. Treating it with medication or other evidence-based tools is treatment, not cheating. 💎 Weight loss can bring an unexpected identity shift. Changing how you see yourself and the story you tell yourself can be an important part of adapting to life after weight loss. 💎 Bariatric surgery and GLP-1 medications can both be important tools in obesity treatment. Dr. Gordon discusses how treatment decisions can change over time, including the potential role of medication after bariatric surgery. ABOUT THE GUEST: Board certified in obesity medicine, lifestyle medicine, and general surgery. Dr. Michelle Gordon spent fifteen years in surgical practice before specializing in women's metabolic health. https://drgordon.me/ https://www.instagram.com/doctormichellegordon/?hl=en RESOURCES MENTIONED: BariNation Community - $19 a month BariNation Website BariNation - Email BariNation’s How to Find an Obesity Specialist Guide 4 Steps to Find an Obesity Provider Finding Your Holistic Obesity Care Team Sign up for BariNation’s Newsletters Our sponsors J&JMedTech & Lilly

What does it take to decide on weight loss surgery? Therapist Derek Colvin (@giant_therapist) and his wife Sheena share how they each chose sleeve gastrectomy, recorded just two days before their surgery together. Derek is a former basketball player, six foot ten, and a licensed therapist. After three knee surgeries, years of intense workouts, calorie cutting, a carnivore diet, and serious thought about GLP-1 medications, he decided bariatric surgery was the right tool for him. He also had to unlearn two beliefs first: that surgery is "the easy way out," and that he wasn't "big enough" to need it. Sheena wanted surgery for more than ten years. She spent hours at the gym and months on strict diets with results she couldn't see. The operation doesn't scare her. The changes afterward do. Host Jason talks with them about: Getting denied by insurance the day before surgery, and what happened nextEating as part of your identityWhy diet and exercise alone stopped workingGLP-1 medications vs. bariatric surgery, and why both are valid treatmentsThe myth that you have to reach a certain weight to "qualify" for helpSurgery to protect joint health and avoid knee replacements - Sugar cravings and snacking on the pre-op dietGrieving food and the life you had before surgeryAdvice for anyone on the fence about weight loss surgery Whether you're considering surgery, medication, or both, this episode is for anyone on an obesity treatment journey who's still deciding. Follow Derek: @giant_therapist on Instagram and TikTok Meet Derek and Sheena Colvin: Derek and Sheena Colvin have been married for 26 years, raised seven children together, and have spent much of their lives taking care of the people around them. Now, they’re making a major decision together for themselves: undergoing VSG on August 7, 2026. For Sheena, the decision has been years in the making. After four C-sections and struggling with her weight since the birth of their first child, she has also dealt with high blood pressure, sleep apnea, and what she openly recognizes as an unhealthy relationship with sugar. For Derek, a former college basketball player, the decision took longer. At 6'10", being the big guy who could eat a lot had become part of his identity. But after years of trying to lose weight through diet and exercise, recurring knee injuries and three major knee surgeries repeatedly interrupted his progress. Eventually, worsening knee pain, sleep apnea, rising blood pressure, and the emotional toll of no longer recognizing or feeling comfortable with the person he saw in the mirror forced him to reconsider what getting healthy needed to look like. After supporting friends through bariatric surgery and seeing firsthand how life-changing it could be, Derek and Sheena realized it was time to take their own next step. They enter this journey differently, but together—hoping not simply to lose weight, but to reclaim their health, mobility, confidence, and quality of life for themselves, each other, and the family they’ve spent 26 years building. Support the show: The BariNation Podcast is produced by the BariNation Foundation, a 501(c)(3) nonprofit offering science-based, stigma-free education and peer support for people living with obesity. Join our Fall Into Giving campaign and become a $10/month donor: https://www.barination.org Join the community: https://barination.mn.co Watch on YouTube: https://www.youtube.com/@BariNation This episode is for educational purposes and is not medical advice. Talk with your healthcare team about the treatment options that are right for you.

Movement can be so much more than a way to change your body. In this episode of the BariNation Foundation Podcast, April Williams sits down with psychologist, researcher, and movement expert Dr. Kelly McGonigal and BariNation community member Charity Guerrero to completely rethink the role of movement in the obesity health journey. They discuss the “comfort paradox,” why movement may require us to step into discomfort in service of a more meaningful life, and how reconnecting with our bodies can create hope, joy, confidence, and connection. Dr. McGonigal explains the science behind “hope molecules,” why the most important shift is from nothing to anything, why your brain may need time to learn to reward movement, and how supportive movement communities can help us feel like we belong. What You Will Learn in this Episode: ✅ Why movement doesn't have to be about weight, appearance, burning calories, or “fixing” your body, and how it can instead create hope, meaning, joy, and connection. ✅ What the “comfort paradox” means and why choosing meaningful discomfort can sometimes open the door to a fuller, more accessible life. ✅ How “hope molecules” released by working muscles can support physical, metabolic, immune, cardiovascular, and brain health, and why movement is accessible regardless of age, size, or fitness level. ✅ Why the most important movement shift is from “nothing to anything,” how to give yourself space and grace while building a movement habit, and how community can make movement more rewarding. This episode of the BariNation Podcast is produced by the BariNation Foundation, a 501 (c) (3) dedicated to advancing metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. Funding comes from generous donations to the BariNation Foundation from listeners and viewers like you, Johnson & Johnson, and the Texas Center for Bariatrics & Advanced Surgery, led by Dr. Joe Cribbins. TIMESTAMPS: 00:00 Why the brain doesn't immediately reward movement and what it takes to experience the benefits 04:07 Meet Dr. Kelly McGonigal and why she sees movement as a vehicle for hope, meaning, and joy 08:03 The comfort paradox: why treating obesity for comfort can eventually require us to embrace discomfort 14:22 Choosing meaningful discomfort over a life limited by fear and physical discomfort 19:59 How the meaning we assign to physical sensations can change our experience of movement 24:13 Reconnecting with the body through proprioception and discovering what movement can help you feel 33:29 Learning to “befriend” a body that may have felt like a source of shame or betrayal 36:43 Hope molecules: how your muscles act like an internal pharmacy when you move 41:48 From nothing to anything: understanding the dose and intensity of movement 49:34 Why movement may take about six weeks before your brain begins rewarding you for it 51:25 The power of moving together: how supportive movement communities create belonging and connection 57:14 Finding the right movement community and giving yourself permission to keep looking 01:04:21 Rethinking what movement can look like and finding activities connected to your values 01:07:00 How movement can help unlock hope, possibility, belonging, and a sense of purpose 01:11:24 Dr. McGonigal previews her upcoming book, Joy Is a Risk Worth Taking KEY TAKEAWAYS: 💎 Movement doesn't have to be about changing your weight or fixing your body. It can be a pathway to hope, joy, meaning, connection, and a greater sense of what your body can do. 💎 The most important movement shift is from nothing to anything. You don't have to go from the couch to a 5K to benefit from movement. Start with what your body is capable of doing today. 💎 “Hope molecules” are released when muscles contract, giving movement benefits that extend beyond physical fitness and into brain health, resilience, stress, and positive emotions. 💎 Your body may have been a source of shame, fear, or disconnection, but movement can help you rebuild a relationship with your body and experience it as a source of possibility rather than something to fight against. ABOUT THE GUEST: Kelly McGonigal, PhD, is a health psychologist and lecturer at Stanford University, and a leading expert in the new field of “science-help.” She is passionate about translating cutting-edge research from psychology, neuroscience, and medicine into practical strategies for health, happiness, and personal success. https://www.kellymcgonigal.com/ https://www.instagram.com/kellymariemcgonigal/?hl=en RESOURCES MENTIONED: BariNation Community - $19 a month BariNation Website BariNation - Email BariNation’s How to Find an Obesity Specialist Guide 4 Steps to Find an Obesity Provider Finding Your Holistic Obesity Care Team Sign up for BariNation’s Newsletters J&JMedTech

What does it actually take to fund the future of obesity treatment? On this episode of The BariNation Podcast, host April Williams sits down with Dr. Carlos Galvani, a bariatric surgeon of over two decades and President of the TREO Foundation (Treatment, Research, and Education to end Obesity), formerly known as the ASMBS Foundation. Click HERE to join our free, virtual TREO Walk team! Dr. Galvani breaks down the three pillars of TREO's work: advocating for insurance access and utilization, funding original research (including the studies that first linked GLP-1 effects to gastric bypass surgery), and educating both patients and providers on obesity as a chronic, treatable disease. April and Dr. Galvani talk candidly about why so few people with obesity actually receive treatment, why obesity should be approached like cancer or diabetes with multiple, personalized treatment pathways, and why obesity walks struggle to draw the same crowds as breast cancer or ALS walks, even though obesity affects roughly 70% of American adults. This conversation also covers TREO's flagship fundraiser, The Walk, including the free, no-pressure Virtual Walk happening September 26th under this year's theme, "No One Left Behind." In this episode: What TREO stands for and how the organization evolved from the ASMBS FoundationHow GLP-1 medications changed the conversation around obesity as a diseaseWhy only 20 to 25% of people with obesity are receiving any treatment at allThe research TREO has funded connecting bariatric surgery, GLP-1 medications, and cancer protectionWhy a standardized obesity treatment pathway (similar to breast cancer care) is comingHow stigma keeps people from showing up to obesity awareness walksHow to join the TREO Foundation's free Virtual Walk on September 26th Obesity is a chronic disease that deserves the same research investment, treatment pathways, and community support as any other chronic condition. This episode is for anyone considering treatment, currently in treatment, or supporting someone who is. Links: TREO Foundation: www.treofoundation.org Join BariNation's Virtual Walk team: https://fundraise.treofoundation.org/teams/7573 Find an in-person walk near you: https://fundraise.treofoundation.org/walk2026 Email us: [email protected] If this episode resonated with you, subscribe to The BariNation Podcast for more conversations on obesity treatment, bariatric surgery, and GLP-1 care, and follow BariNation for community support, education, and events. http://barination.org The BariNation Foundation is a federally recognized 501(c)(3). All donations are tax-deductible, and no services were exchanged in the production of this episode. #ObesityTreatment #BariatricSurgery #TREOFoundation Participation is the prescription. See you in The Nation, soon. #BariNation #TREOFoundation #ObesityTreatment #BariatricSurgery #GLP1 #ObesityIsADisease #WeightRegain #NoOneLeftBehind

Obesity is a chronic, lifelong disease, not a failure of willpower. In this episode of the BariNation Foundation Podcast, April Williams sits down with bariatric surgeon Dr. Monique Hassan and BariNation community member Jasmine Fernandez to challenge the idea that one tool can treat obesity. They discuss the full range of surgical options: surgery, GLP-1s, mindset, movement, community, self-advocacy, and overcoming shame while treating obesity as a chronic, lifelong disease. If you've ever felt shame about needing more than one treatment, this conversation offers permission to stop apologizing and start healing. What You Will Learn in this Episode: ✅ How bariatric surgery options like sleeve gastrectomy, gastric bypass, and duodenal switch compare, explained through a simple car analogy. ✅ Why GLP-1 medication works for some patients and not others, and how it fits into a full obesity treatment plan. ✅ How to build self-advocacy skills and find a comprehensive care team that treats the whole person. ✅ Why emotional eating, mindset work, and support groups matter just as much as any medical or surgical tool. This episode of the BariNation Podcast is produced by the BariNation Foundation, a 501 (c) (3) dedicated to advancing metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. Funding comes from generous donations to the BariNation Foundation from listeners and viewers like you, Johnson & Johnson, and the Texas Center for Bariatrics & Advanced Surgery, led by Dr. Joe Cribbins. TIMESTAMPS: 00:00 Bariatric surgeon Dr. Hassan shares her magic wand question for setting real weight loss goals 04:07 Why one thing is not enough to treat obesity 05:20 Meet Dr. Monique Hassan, a board-certified bariatric surgeon and Jasmine Fernandez, longtime BariNation member and gastric bypass patient 08:09 Why willpower alone never cures the chronic disease of obesity 10:47 Jasmine's winding path to gastric bypass surgery in 2021 14:54 Naming the inner critic and staying accountable after surgery 18:37 Walking through goals with your doctor and advocating for yourself 31:00 The “fight” and journey of obesity 43:42 Selecting the right tool for you to fight obesity 45:41 The car analogy: sleeve gastrectomy, gastric bypass, and duodenal switch compared 56:48 How to find a comprehensive bariatric surgery provider near you KEY TAKEAWAYS: 💎 Obesity is a chronic, lifelong disease, so bariatric surgery, GLP-1 medication, and mindset work have to work together, not against each other. 💎 A good bariatric surgeon asks about your real-life goals before ever discussing a treatment plan. 💎 Naming your inner critic takes away its power and makes it easier to catch emotional eating before it starts. 💎 Progress over perfection matters more than any number on the scale, especially in long-term obesity treatment. ABOUT THE GUEST: Monique Hassan, MD, is a bariatric and metabolic surgeon who serves as the Division Director of Bariatric and General Surgery and Director of Obesity Medicine at Baylor Scott & White – Temple, and is an Associate Professor of Surgery in the Department of Surgery at The Baylor College of Medicine - Temple Campus. Dr. Monique Hassan - Instagram Dr. Monique Hassan - Facebook Jasmine Fernandez is a wife, mom of two, operations and logistics leader, and someone who completely transformed her health. Her journey hasn’t been about chasing perfection; it’s been about choosing herself every day. Through gastric bypass surgery, lifestyle changes, therapy, and perseverance, she discovered that lasting change comes from consistency, not quick fixes. “I hope that by sharing my story honestly, I can encourage others to believe that no matter where they start, a healthier and happier life is possible.” RESOURCES MENTIONED: BariNation Community - $19 a month BariNation Website BariNation - Email BariNation’s How to Find an Obesity Specialist Guide 4 Steps to Find an Obesity Provider Finding Your Holistic Obesity Care Team Sign up for BariNation’s Newsletters J&JMedTech BariNation, Bariatric Surgery, NSVS, GLP-1, VSG, Vertical Sleeve Gastrectomy, Lapband, Roux-en-Y, Gastric Bypass, Sadi-S, Obesity Treatment, GLP-1 Medication, Duodenal Switch, Weight Loss Surgery, Obesity Medicine, Chronic Disease, Metabolic Wellness, Emotional Eating, Inner Critic, Self Advocacy, weight loss mindset, obesity treatment options, BariNation Foundation

Bariatric surgeon Dr. Eric Smith joins the BariNation Foundation Podcast to continue the six-part series on the Levers of Control. Today's episode is about the second lever: Whole Food Nutrition. Dr. Eric Smith speaks with April Williams and Melanie Lindell to reveal why whole foods quiet food noise, how ultra-processed foods were engineered for overconsumption, and what it takes to build a sustainable, whole-food nutrition-based life after bariatric surgery and while pursuing a medically based weight loss program. Don’t miss our first episode in the Levers series: Ep 287 - Mastering Your Metabolic Health and Weight Management What You Will Learn in this Episode: ✅ Why GLP-1 medications blunt cravings for most foods but not for whole foods, easing food noise ✅ How ultra-processed foods are engineered to keep cravings coming back ✅ The link between emotional eating and metabolic wellness, and how to tell comfort from nourishment ✅ Simple, budget-friendly ways to start whole food nutrition without overhauling your whole weight loss journey This episode of the BariNation Podcast is produced by the BariNation Foundation, a 501 (c) (3) dedicated to advancing metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. Funding is provided by the generous donations to the BariNation Foundation from listeners and viewers like you, Johnson & Johnson, and the Texas Center for Bariatrics & Advanced Surgery, led by Dr. Joe Cribbins. TIMESTAMPS: 00:00 Dr. Smith defines whole food nutrition as food with minimal change from nature, not a specific grocery store 07:27 Why the source of sugar changes how the body responds, not just the gram count 09:07 What makes a food ultra-processed, and how convenience and shelf life reshaped the American plate 15:36 Why everything in moderation only holds when the diet is built on whole foods, not engineered snacks 20:52 Food as comfort: unpacking emotional eating, addiction transfer and where cravings really come from 25:29 The Nature magazine study explained: GLP-1 medications blunt cravings for most foods except whole produce 35:46 The big tobacco parallel and why fixing the processed food industry matters as much as new treatments 38:51 Admitting some foods are eaten for pleasure, the results of taking on big tobacco and getting to the root of the problem 45:59 The cost of whole foods and the nutritional cost weighed 49:24 Examples of the perspective of eating 59:51 Practical, budget-friendly steps to start whole food nutrition today, one small swap at a time KEY TAKEAWAYS: 💎 Diet soda and other zero-calorie tricks can quietly reignite cravings even without added calories 💎 Bariatric patients often lean on protein bars and shakes early on, but lasting health depends on shifting toward real food 💎 True healing from hedonic hunger means removing the trigger, not just numbing it with medication 💎 A foundation of healthy eating habits built on whole food nutrition is the best defense against obesity treatment relapse ABOUT THE GUEST: Eric F. Smith, DO, FASMBS, CAQ-MBS Dr. Smith is a board-certified general, bariatric and robotic surgeon who has been in practice since 2006. Kentucky Bariatric Institute - Website Dr. Eric Smith - Instagram Hyper-Palatable Foods: Development of a Quantitative Definition and Application to the US Food System Database - https://onlinelibrary.wiley.com/doi/10.1002/oby.22639 RESOURCES MENTIONED: BariNation Community - $19 a month BariNation Website BariNation - Email BariNation’s How to Find an Obesity Specialist Guide Sign up for BariNation’s Newsletters

Weight recurrence after bariatric surgery or GLP-1 treatment isn't a personal failure, it's often a natural part of treating the chronic disease of obesity. In this episode of the BariNation Foundation Podcast, April welcomes bariatric surgeon and obesity medicine specialist Dr. Saniea Majid to discuss her groundbreaking research on weight recurrence, why the medical community is moving away from the term "weight regain," and how ongoing, individualized care can improve long-term outcomes. Together, they explore the importance of eliminating shame, redefining success beyond the number on the scale, staying connected with your clinical care team, and empowering patients with practical strategies to navigate obesity treatment for life. What You Will Learn in this Episode: ✅ Why weight recurrence after bariatric surgery is expected and why the word "failure" needs to be stricken from the conversation ✅ The three categories of response (partial, non, and clinically significant) and why each needs its own plan ✅ How consistent follow-up care and multidisciplinary care help prevent or reverse recurrence ✅ Practical ways to shift from shame to action while protecting metabolic wellness This episode of the BariNation Podcast is produced by the BariNation Foundation, a 501 (c) (3) dedicated to advancing metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. Funding is provided by the generous donations to the BariNation Foundation from listeners and viewers like you, Johnson & Johnson, and the Texas Center for Bariatrics & Advanced Surgery, led by Dr. Joe Cribbins. TIMESTAMPS: 00:00 Dr. Saniea Majid discusses weight recurrence after treatment and her research regarding standardizing terminology and data sets 04:42 Why patients avoid follow-up care after bariatric surgery 10:01 The wide range of reported weight recurrence after bariatric surgery rates 15:18 Health benefits that remain even with weight recurrence 24:19 The importance of follow-up care 29:15 Why the word failure is banned in modern obesity care 34:44 Recommended definitions for partial response and non-response 45:08 Advice for a listener stuck at limited weight loss two years later 50:32 Dr. Majid answers rapid fire questions related to obesity 01:00:57 Final thoughts on seeking the right team for lifelong care KEY TAKEAWAYS: 💎 Weight recurrence signals the chronic nature of obesity and calls for more treatment, not self-blame 💎 Regular follow-up care with the right multidisciplinary team is the strongest tool against progression 💎 Revisional surgery and GLP-1 medications are part of continuum care, not last resorts 💎 Patients retain meaningful health gains even when some weight returns ABOUT THE GUEST: Dr. Saniea Majid is a board-certified bariatric surgeon and obesity medicine specialist, founder and Medical Director of the Weight Loss and Wellness Center in northern New Jersey. She has built multiple accredited metabolic and bariatric programs and was the first surgeon in the state to perform the SPATZ adjustable gastric balloon and endoscopic sleeve gastroplasty. A national leader in the field, she just completed a 2 year term of the ASMBS Foundation TREO (Treatment, Research and Education to End Obesity), sits on the ASMBS Board of Directors, and is committed to comprehensive, compassionate care for patients of all ages, including adolescents. Meet Dr. Majid – Award-Winning Weight Loss Doctor NJ | WLWC Proposed Definitions and Clinical Recommendations for the Management of Weight Recurrence Following Bariatric Surgery RESOURCES MENTIONED: BariNation Community - $19 a month BariNation Website BariNation - Email BariNation’s How to Find an Obesity Specialist Guide Sign up for BariNation’s Newsletters J&JMedTech BariNation, Bariatric Surgery, NSVS, GLP-1, VSG, Vertical Sleeve Gastrectomy, Lapband, Roux-en-Y, Gastric Bypass, Sadi-S, Weight Regain After Bariatric Surgery, Weight Recurrence, Bariatric Surgery, Obesity Treatment, Metabolic Wellness, Follow Up Care, Chronic Disease, Multidisciplinary Care, Bariatric support, Bariatric patient education, Clinically Significant Weight Recurrence, Revisional Surgery, GLP 1 Medications, ASMBS, Shame And Blame, Weight Fluctuations, Surgical Success, Long-term weight loss maintenance

What if the biggest obstacle to getting the help you need isn't your body, but the belief that you have to earn it? Even therapists struggle with shame, self-doubt, and asking for help. In this episode of the BariNation Foundation Podcast, April sits down with longtime therapist and BariNation supporter Lora Grabow, who shares her own journey through menopause, unexpected health changes, and the difficult decision to begin GLP-1 treatment. Despite decades of helping others heal their relationship with food, Lora discovered she had been holding herself to a different standard, believing she needed to "work harder" before deserving treatment. Together, April and Lora discuss the damaging myths surrounding obesity, menopause, self-worth, and medical care while exploring why community, self-compassion, and evidence-based treatment are essential for lasting health. This conversation is a powerful reminder that you don't have to suffer in silence, you don't have to earn help, and hope begins the moment you allow yourself to receive the support you deserve. What You Will Learn in this Episode: Why obesity is a chronic disease, not a personal failing, and why that reframe lifts shame around GLP-1 weight loss How menopause weight gain can stall even the healthiest habits, and why biology, not effort, is often the real barrier Why self-compassion, not self-criticism, is the tool that actually leads to lasting behavior change How community support helps people move past the belief that they must earn help before accepting it This episode of the BariNation Podcast is produced by the BariNation Foundation, a 501 (c) (3) dedicated to advancing metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. Funding is provided by the generous donations to the BariNation Foundation from listeners and viewers like you, Johnson & Johnson, and the Texas Center for Bariatrics & Advanced Surgery, led by Dr. Joe Cribbins. TIMESTAMPS: 00:00 Lora Grabow discusses her two decades in weight management and therapy 06:16 April sets the stage: doing everything right without results 07:48 Lora explains obesity as a chronic disease, not a decision 08:17 Lora shares her menopause weight gain and hormone therapy story 12:17 The friend who asked why Lora wasn't starting a GLP-1 17:15 Unpacking the belief that you must earn help before treatment and the power of community 26:48 Finding safe support in virtual spaces; April shares a personal story 31:20 How are we talking to ourselves and having self-compassion 41:57 Lora reflects on hope, healing, and life after starting Zepbound 46:04 Why it took Lora so long to go on a GLP-1, the many benefits of the drug KEY TAKEAWAYS: Shame keeps people stuck. Self-compassion is what actually opens the door to change. Obesity is a chronic relapsing disease, and no one should have to manage it alone. GLP-1 medications, like other metabolic wellness tools, aren't something you have to "earn." ABOUT THE GUEST: Lora Grabow, LMSW, is an obesity medicine therapist, coach, and professional speaker with over 20 years of experience working with patients in obesity medicine. Lora helps patients discover the missing piece of their treatment plan: A piece she calls Headwork™. She is the owner of a thriving private practice serving patients affected by obesity. Her expertise includes providing individual therapy and 1:1 coaching, facilitating support groups, and engaging patients in her online course, Foundations in Headwork for Healthy Weight Loss. She is an active leader in the American Society for Metabolic and Bariatric Surgery. (ASMBS) She is a sought-after podcast guest and speaker at national provider and patient obesity medicine conferences. Lora Grabow Instagram Lora Grabow - Website RESOURCES MENTIONED: BariNation Community - $19 a month BariNation Website BariNation - Email BariNation’s How to Find an Obesity Specialist Guide Sign up for BariNation’s Newsletters J&JMedTech

Episode 287: What if everything you believed about obesity was wrong? Bariatric surgeon Dr. Eric Smith joins the BariNation Foundation Podcast to launch a six-part series on Mastering Metabolic Health and Weight Management. Today's episode is about the first lever: Beyond the Scale...Obesity as a Chronic Disease. He explains why only 0.5 to 2% of people can lose enough weight through diet alone to no longer be classified as obese and what the hormones ghrelin and leptin have to do with it. Mental health therapist, bariatric patient and BariNation Foundation Board, Community member, and licensed expert, Melanie Lindell adds the emotional truth: accepting obesity as a chronic disease is not giving up; it is finally getting honest. This conversation will shift how you think about your body, your habits, and your future. Join us for this six-part series, Mastering Your Metabolic Health and Weight Management. What You Will Learn in this Episode: Why obesity as a chronic disease cannot be resolved through willpower alone, and what the actual success rates of diet and exercise reveal about the biology working against you How the hormones ghrelin and leptin resistance change the way your body responds to calorie deficits, making sustainable weight loss far more complex than simply eating less Why bariatric surgery and GLP-1 medications create the conditions for change but cannot replace the controllable habits that determine long-term metabolic health outcomes How building consistent habits around sleep, whole food nutrition, and movement forms the true foundation of lasting obesity treatment success This episode of the BariNation Podcast is produced by the BariNation Foundation, a 501c3 dedicated to advancing metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. Funding is provided by the generous donations to the BariNation Foundation from listeners and viewers like you, Johnson & Johnson, the Texas Center for Bariatrics & Advanced Surgery, led by Dr. Joe Cribbins. TIMESTAMPS: 00:00 The psychology of results and why visible change drives obesity treatment commitment 04:00 Dr. Eric Smith and Melanie Lindell introduce themselves and the bariatric surgery series 08:04 The six levers of metabolic health and weight management are introduced 09:18 Why diet and exercise alone fail: success rates as low as 0.5% for obesity as a chronic disease 11:56 How triggering life events lead to obesity and why reversing behavior is not enough 23:44 The hormonal science of ghrelin and leptin resistance and their role in weight loss, and why the body fights back against calorie deficits 33:00 The golf analogy: why patients become complacent and stop applying controllable health habits 38:30 The danger of removing friction and how easy access to GLP-1 medications can backfire, and leaning into the idea that obesity is a lifelong disease 44:13 Sleep consistency as a lever: the real science behind sleep and weight loss, and the mental health part of finding joy in yourself 53:08 April's personal gut check and the honest conversation about stalled weight management 1:00:12 How KBI redesigned its entire approach to treating obesity as a chronic disease KEY TAKEAWAYS: Obesity as a chronic disease has a biological basis. With success rates of 0.5 to 2% for diet and exercise alone, this is not a failure of character but a failure of biology working against patients without proper obesity treatment. Surgery and GLP-1 medications provide the spark, but they are not the solution on their own. Without the controllable levers such as whole-food nutrition, sleep, and movement, results will stall or reverse. Leptin resistance and rising ghrelin levels mean that the longer someone has lived with obesity, the harder the body fights against weight loss, making medical intervention and habit-building both essential. Goals bring short-term motivation, but habits create lifelong results. Celebrating the consistency of controllable health habits rather than only the scale is what sustains metabolic health over time. ABOUT THE GUEST: Eric F. Smith, DO, FASMBS, CAQ-MBS Dr. Smith is a board-certified general, bariatric and robotic surgeon who has been in practice since 2006. Kentucky Bariatric Institute - Website Dr. Eric Smith - Instagram RESOURCES MENTIONED: BariNation Community- $19 a month BariNation Website BariNation - Email BariNation’s How to Find an Obesity Specialist Guide Sign up for BariNation’s newsletters J&JMedTech

Summer is here, and so is every barbecue, pool party, and 4th of July spread your family could throw at you. No judgment. We're gonna talk about all of it. April and Nat are back together for a real one, a summer celebration episode built around the four BariNation pillars: movement, mindset, metabolic wellness, and community. They're sharing how they personally live these pillars when routines go out the window, the weather gets hot, and the paper plates get absolutely massive. This one is for you whether you're six weeks post-op or six years out. Because bariatric life doesn't take a summer break, but it absolutely can feel like a party. What we get into: MOVEMENT: Why movement does not have to mean the gym, and how painting rocks, kayaking for the first time, and water balloon fights with your niece absolutely count. Nat shares how she's getting back to exploring outdoors after a really hard school year, and April talks about finally being able to show up at the lake without dreading every moment. MINDSET: The brain gremlins don't stop just because it's summer. Nat (almost six years post-op!) gets real about still dealing with "what are people thinking about my plate" anxiety at social events. April walks through the "catch it, check it, change it" tool, a practical mindset skill from BariNation's licensed mental health support groups, and why the goal is never to stop having these thoughts, just to get better at catching them. METABOLIC WELLNESS: Summer food is protein city if you think about it — burgers, ribs, brats. You're already set up. April and Nat talk about the plate size swap that changed everything at Nat's 4th of July prime rib dinner (yes, really), how to set up a buffet table so you naturally eat in the right order, and why 10 BBQ meals out of 400 summer eating occasions is not the thing that derails you. COMMUNITY: Why the BariNation membership community is becoming both April and Nat's go-to over social media feeds packed with ads and AI content. Real humans, zero algorithm, no one selling you something. Plus, April is launching a summer Whole Food Learning series in the community every Tuesday night with experts and registered dietitians. AND THE BIG NEWS: BariNation is officially becoming the BariNation Foundation, a 501(c)(3) nonprofit, as of July 1, 2026. That means the podcast is now a foundation production, your support is 100% tax-deductible, AND the BariNation membership community is dropping from $39/month to $19/month. Less than a dollar a day. We are not calm about this. Links: Join the BariNation Community: https://barination.mn.co/plans/1983996?bundle_token=403d003e4d6e5c649341e4319c80a3d8&utm_source=manualBariNation Community Calender: https://calendar.google.com/calendar/embed?src=cqvlhco5fdmkk0lsuasl7ggdu88emhuc%40import.calendar.google.com&ctz=America%2FLos_AngelesDonate to the BariNation Foundation: https://barination.givecloud.co/fundraising/forms/8NDR96EKFollow April: @actively_aprilFollow Natalie: @breakingbari_ersFollow BariNation on Instagram: @bari.nationFollow BariNation on Facebook: @barinationGet our weekly newsletter: https://lp.constantcontactpages.com/sl/O2S7vlTVisit our website: www.barination.org

Your metabolism is not broken. It just might need a new strategy. If you've had bariatric surgery (or started a GLP-1 medication like Ozempic or Mounjaro) and you've hit a wall, struggled with cravings, felt like you can't go more than two hours without eating, or watched the scale stop moving entirely, this episode is for you. Registered dietitian and certified personal trainer Kayla Girgen, RD, CPT is back, and she's here to explain one of the most talked-about, least understood topics in the metabolic health space: metabolic flexibility. What it is, why it matters after weight loss surgery, and what you can actually do about it starting today. In this episode, we cover: What metabolic flexibility actually means (in plain, real-person language)The interstate traffic analogy that makes insulin resistance finally make senseWhy insulin resistance can make it nearly impossible to lose weight and how the disease of obesity is directly connectedThe difference between being metabolically flexible vs. stuck in what researchers call "metabolic gridlock"How movement, even a short walk after a meal, can bypass insulin resistance and get your metabolism moving againWhy sleep is one of the most unsexy, underrated tools for improving metabolic healthWhether a CGM (continuous glucose monitor) is worth it, and what you can do to balance your blood sugar if one isn't in your budgetA real community member question about reactive hypoglycemia, weight gain on GLP-1s, and what strength training might do to help Kayla leads live meetups and classes inside the BariNation community every other month. Drop your questions in the comments or send us an email at [email protected]. Find Kayla at @KaylaGirgenRD on Instagram or at KaylaGirgenRD.com. BariNation is a 501(c)(3) nonprofit. Learn more and join the community at barination.org.

Nobody tells you that the hardest part of bariatric surgery isn't the surgery. It's year five, when life is full, and your bariatric brain goes quiet. Jason and Natalie are back for a real, unfiltered catch-up and this one is for every patient who's thought, "I don't even think about it anymore." Because here's the thing: bariatrics doesn't stop asking things of you just because you stopped thinking about it. Jason shares what happened when a routine gym session turned into an ER visit with a heart rate of 29. Yes, 29. And the wake-up call that followed: a medication he'd been on for years was quietly working against him, because his body had changed so dramatically that the prescription he was given as a very different person no longer fit the person he is now. A physician told him he needed a pacemaker. Another told him to go home and stop taking one pill. The lesson in between? You are a patient for life, not just for the first two years. Natalie opens up about something a lot of long-term post-op patients feel but rarely say out loud: the guilt of not wanting to check in with the bariatric community anymore. Five years out, thriving in a new career as a teacher, and hitting the wall where bariatric life just isn't at the front of the line every single day. She calls it the "I just can't" season, and she wants you to know it's real, it's normal, and it doesn't mean you've failed. Together they get into: Why your medications may need to change years after surgery (and why nobody is checking unless you ask)What "white coat syndrome" (a fear or anxiety around doctors and medical settings) looks like for people who've been heavy patients, and why it doesn't go away just because things are going wellThe difference between pre-op and post-op body literacy: knowing the difference between "I feel fine" and "I actually feel good"Why wins in the bariatric journey don't always look like the scale movingWhat it means to be a patient "forever" and how to hold that truth without burning outHow bariatrics keeps handing you new lessons whether you asked for them or not (Jason's new analogy: an advent calendar of epiphanies that never ends) This episode is also a love letter to BariNation itself. While April is at ASMBS (the American Society for Metabolic and Bariatric Surgery, the largest professional organization in the field), big things are happening behind the scenes in the world of obesity treatment. The conversation is shifting. Patients are being centered. The gap between doctors and patients is getting a lot of attention, and BariNation is right in the middle of that work. If you've ever been years out and felt like bariatric life snuck up behind you, this is your episode. Want to be one of the first to know about our exciting, upcoming changes? Join our email list! Click HERE to join. And we promise- no spam, ever! BariNation is now officially a nonprofit foundation. If this podcast, this community, or this conversation has ever helped you, consider supporting the mission at BariNation.org. Every dollar keeps the lights on and the mic hot. Become a donor at www.barination.org Find us everywhere: Instagram, TikTok, YouTube, and the BariNation Community at BariNation.org.

You've been fighting your weight for years. You've tried everything. And now you're finally ready to find someone who can actually help. Where do you start? Your primary care doctor? The websites that offer you another miracle? Should you do what Serena Williams is doing and see a bot doc? In this episode, April sits down with Dr. Charles Thompson, a bariatric surgeon practicing in Brooklyn and Queens, New York, to give you a real, practical roadmap for finding an obesity medicine provider who will treat you like the whole person you are, not just a number on a scale. Here's what you'll walk away with: What to actually look for when evaluating a provider (hint: it's not the letters after their name)Where to search, including which websites are worth your time and which ones to approach with cautionWhat to ask at your very first appointment, and why the best providers will ask you questions firstWhy it is absolutely okay to leave a provider relationship that isn't working for you, and why that is not a failure Dr. Thompson also breaks down the real difference between having insurance coverage for bariatric surgery or obesity medications and actually being able to use it, including why so many patients with qualifying conditions are still being denied care and what you can do to fight back. You'll also hear him say something that almost no surgeon ever says out loud: "It's not your fault." He means it, and he explains exactly why. Plus: April shares the story of her own path to surgery, why word-of-mouth changed everything for her, and why she built BariNation for the exact moments when you need a Nation behind you. Download and print our free step-by-step guide to finding your provider from the show notes. Use it, share it, come back to it. Click HERE to access it. Obesity is a disease. You deserve care. And now you know how to go get it. A Note About BariNationBariNation is a nonprofit podcast and patient community built on the belief that obesity is a disease and that every person fighting it deserves education, community, and care. If this post helped you, consider supporting our mission at BariNation.org/donate. Your support makes conversations like this one possible. Enjoyed this episode? Share it with someone who's been waiting for permission to take the first step. And if you're already in The Nation, you know what to do. See you in there. Find Dr. Thompson: BrooklynQueensSurgical.com Join the BariNation community: barination.mn.co Support our mission: BariNation.org/donate #BariNation #BariatricSurgery #ObesityMedicine #ObesityAwareness #WeightLossSurgery #FindABariatricSurgeon #ObesityIsADisease #BariatricCommunity #InsuranceDenial #MetabolicHealth #ASMBS #ObesityTreatment #BariatricProvider #WeightManagement

“We are built for scarcity, not abundance.” Most people think obesity is simply about willpower or lifestyle choices, yet its history reveals a long tradition of misconceptions, stigma, and ineffective, somewhat barbaric treatments. In this eye-opening episode, Dr. Nini Peterson, PhD, takes us on a fascinating journey through the history of obesity, showing how misconceptions have persisted for centuries despite advances in science and medicine. Discover how ancient carvings and medical texts from 30,000 years ago to the 19th century reveal haunting echoes of today’s struggles with weight and treatment. You’ll learn how old fallacies, like “eat less, move more,” have hampered progress and how biology, environment, and genetics play critical roles that modern science now understands better than ever. We break down: The historical perceptions of obesity across cultures and eras and their impact on stigma, shame, and treatment.The evolution of treatment options, from ancient dieting and surgical experiments to today's promising medications and surgical innovations.The misconceptions that still influence doctor-patient relationships and how invalidating these myths can be detrimental to health.The importance of a holistic, individualized care team and why finding the right "fit" in treatment is crucial for long-term success.How understanding the disease’s history helps us combat shame, advocate for ourselves, and pursue effective, compassionate care. This episode is a must-listen for anyone living with obesity or those supporting loved ones in their journey. If you’re tired of outdated advice, want to cut through the stigma, and are eager to understand the true complexity of obesity, this conversation will inspire hope and empower action. Join April Williams as she has a no-holds-barred conversation with Dr. Peterson, an experienced psychologist and obesity expert, who reveals how shifting our understanding of obesity from blame to compassion opens the door to better treatment, more support, and a brighter future. You’ll leave with a new perspective on this chronic disease, fostering hope that meaningful change is possible, and it starts with knowledge. Perfect for patients, caregivers, clinicians, and advocates committed to a science-backed, patient-centered approach. The time to rethink obesity is now, are you ready? Explore the rich history of obesity, its treatment evolution, and the importance of personalized care in managing this complex disease. History of Obesity Presentation Key Topics History of obesity and treatmentImpact of environment and culture on obesityThe role of behavioral health in obesity careAdvances in obesity medications and surgeryThe importance of holistic, individualized treatment The BariNation Foundation The BariNation Podcast is a production of the BariNation Foundation, a 501c3 nonprofit that advances metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. The Foundation's mission is to walk alongside individuals pursuing medical, surgical, and comprehensive care, supporting real decisions, challenges, and victories that influence long-term health with the support and guidance of obesity medicine experts. Learn more about the BariNation Foundation and make a tax-deductible donation by going to BariNation.org Sound Bites "We are built for scarcity, not abundance." “Most people overestimate the risk of bariatric surgery and underestimate the risk of living long-term with obesity.” Chapters 00:00 The History of Obesity and Its Treatment 07:23 Understanding Obesity as a Disease 19:54 The Stigma of Obesity and Its Impact 26:45 Patient-Care Team Dynamics in Obesity Treatment 27:24 Navigating Life After Surgery 33:32 The Paradox of Treatment 40:15 Evolution of Obesity Treatments 42:56 Evolving Understanding of Health and Behavior Change 45:45 Redefining Success Beyond the Scale 49:44 The Complexity of Health Perception 53:17 The Importance of Seeking Help 55:51 Understanding the Risks of Obesity and Treatment 58:45 The Journey to Bariatric Surgery 01:03:34 Finding the Right Care Team 01:07:15 The Need for Integrated Health Approaches Nini Peterson Bio Ninoska "Nini" Peterson, PhD is a Staff Psychologist with the Cleveland Clinic’s Bariatric & Metabolic Institute (BMI) and an Adjunct Assistant Professor at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University in Cleveland, OH. Her clinical and research interests include psychosocial MBS evaluations, lifestyle treatment of obesity, binge eating treatment, self-monitoring, body-image disturbance, and psychology group treatment/support groups. She has published in peer-reviewed journals on these topics, and has authored/co-authored 3 textbook chapters for SAGES and APA on the role of the behavioral health provider in MBS and pre-surgical psychological MBS evaluations, respectively. She is the current Integrated Health - Director Elect (2025-2026), former Integrated Health Secretary (2024-2025) and has served on the IH Leadership Counsel since 2021. Nini is also a current member (2017-present) and past Chair (2023-2025 of the IH Support Group Committee, and member of the Health Equity Committee (2023-present). She is a proud member of the inaugural 2024 ASMBS-IH Fellowship class (FASMBS-IH). Links BariNationFoundation

Clinical psychologist Dr. Rachel Goldman, PhD joins BariNation hosts April Williams and Jason Smith to discuss the psychological and behavioral tools every person needs to navigate life's hardest moments, especially those living with the chronic disease of obesity. Drawing from her new book When Life Happens, Dr. Goldman breaks down CBT into accessible, actionable tools for building emotional resilience, managing stress, challenging unhelpful thoughts, and developing a growth mindset. Essential listening for bariatric surgery patients, anyone managing chronic illness, and anyone stuck between knowing what to do and actually doing it. This episode is supported by AdventHealth Central Florida and the Metabolic Health Institute. If you've struggled with weight loss, you know it's a lifelong journey. At AdventHealth's Metabolic Health Institute, they address the root cause of weight gain with a whole-health approach, from lifestyle support and medication to bariatric surgery. Learn more at http://www.AdventHealthWeightLoss.com What You'll Learn: Build a Mental Health Toolbox — One tool is never enough. Dr. Goldman explains why you need at least three coping strategies and the critical difference between self-care tools (preventative) and stress management tools (acute), and why they're actually the same tools used with different intention. The CBT Core: Your thoughts don't just feel bad, they directly shape your behavior. Dr. Goldman walks through how identifying unhelpful thoughts, examining the evidence, and reframing can rewire the brain over time through neuroplasticity. The goal isn't to eliminate negative thoughts; it's to reduce how long you stay in them. Cognitive Distortions That Keep You Stuck — All-or-nothing thinking, jumping to conclusions, and "should" statements are three of the most common distortions in people with obesity. Dr. Goldman explains how CBT helps patients identify, challenge, and reframe these patterns instead of accepting them as truth. The Diet Failed You. You Did Not Fail the Diet. — A powerful reframe Dr. Goldman used with bariatric patients at Bellevue: the surgery failed the patient, not the other way around. This directly challenges the internalized shame that comes from years of failed diets and reframes it through the lens of obesity as a complex, chronic, progressive disease. Growth Mindset vs. Fixed Mindset — Years of "nothing works" can create an entrenched fixed mindset. Dr. Goldman connects Carol Dweck's research to the lived experience of obesity patients and explores how flexible thinking and self-compassion begin to shift the pattern. Toxic Positivity: What It Is and Why It's Harmful — "Positive vibes only" invalidates real experience and suppresses important emotions. Dr. Goldman explains the spectrum from toxic positivity to toxic negativity, where healthy realistic optimism lives, and why body acceptance is more sustainable than body positivity for bariatric patients. Self-Care Is Not a Bubble Bath — Self-care is anything you do for yourself that is preventative and builds you up before life happens. Showing up to a support group, listening to a podcast, sleeping, and breathing exercises all count. It's a non-negotiable daily practice, not a reward. Imposter Syndrome as a Feature, Not a Bug — The most surprising reframe of the episode: imposter syndrome may actually be useful. Dr. Goldman explains eustress (positive, motivating stress) and why a measured level of imposter syndrome drives preparation, humility, and growth. April and Jason share deeply personal experiences of imposter syndrome in bariatric advocacy. Community, Vulnerability, and Asking for Help — The people who feel they have no right to take up space in a support group are often the ones who need it most. Asking for help is brave, not weak. Practice Your Tools Before You Need Them — Like a fire drill, tools must be practiced in calm moments so the response is automatic when life gets hard. 📖 When Life Happens by Dr. Rachel Goldman: whenlifehappensbook.com 🔗 Dr. Goldman: @DrRachelNYC | BariNation: barination.org | @bari.nation Hosts: April @actively_april | Jason @tha_smithsonian_ Supported by AdventHealth Central Florida and the Metabolic Health Institute. Whole-health obesity care from lifestyle support to bariatric surgery. AdventHealthWeightLoss.com BariNation Foundation*is a 501c3 nonprofit advancing metabolic wellness through evidence-based education and stigma-free support. Donate at barination.org #BariatricSurgery #MentalHealth #CBT #WhenLifeHappens #DrRachelGoldman #ObesityMedicine #BariNation #GrowthMindset #StressManagement #ToxicPositivity #ImposterSyndrome #BodyNeutrality #WeightLoss #BariatricSurgery #MentalHealth #CBT #GrowthMindset #wls #wlscommunity