Dr. Spencer Nadolsky

Dr. Spencer Nadolsky explains how he decides whether to raise, lower or keep a patient's GLP-1 dose.

1. 0:00 Introduction to GLP-1
2. 0:29 Limitations of clinical trials
3. 1:04 Dr. Nadulski's protocol
4. 1:47 Prioritizing side effects
5. 2:51 Rate of weight loss
6. 4:20 Determining weight targets
7. 5:06 Managing appetite and plateaus
8. 5:31 Patient preference and cost

• Side effects mentioned: nausea, vomiting and gallbladder
• Who is speaking: Clinician (Dr. Spencer Nadolsky)

Dr. Spencer Nadolsky responds to an Instagram post by Dr. Mike Israetel saying most adults should consider taking tirzepatide even if they are not overweight. Nadolsky objects to pairing the phrase "evidence-based" with a recommendation for people who are not overweight.

1. 0:00 Should GLP-1s be “in the water”?
2. 0:25 The problem with “evidence-based” claims
3. 0:54 What the trials actually tell us
4. 2:04 Are we in an evidence-free zone?
5. 2:50 What is clinical obesity really?
6. 4:03 Could most people benefit?
7. 4:30 Surprising off-label effects (alcohol, binge eating, PCOS)
8. 6:55 Autoimmune and heart health potential

• Who is speaking: Clinician (Dr. Spencer Nadolsky)

In this video, Dr. Spencer Nadolsky describes what he calls the five most common side effects of GLP-1 receptor agonists, drawing on both trial data and his clinical practice.

1. 0:00 GLP-1 Side Effects Overview
2. 0:27 1 Nausea , Causes & Fixes
3. 4:54 2 Constipation , Prevention & Relief
4. 7:18 3 Reflux , Triggers & Treatment
5. 8:34 4 Diarrhea , Quick Solutions
6. 9:30 5 Fatigue , Why It Happens
7. 11:56 Final Thoughts & Next Steps

• Side effects mentioned: nausea, vomiting, constipation, diarrhea, fatigue and heartburn or reflux
• Who is speaking: Clinician (Dr. Spencer Nadolsky)

In this video, Dr. Spencer Nadolsky explains how he approaches patients who say they have maxed out their GLP-1 dose and stopped losing weight. He says the first step is deciding whether the person clinically needs to lose more.

1. 0:00 Dealing with GLP-1 plateaus
2. 0:17 Assessing true clinical need
3. 1:14 Switching GLP-1 medication
4. 1:48 Medical and lifestyle factors
5. 4:45 Adding non-GLP-1 medications
6. 7:41 Alternative medical therapies
7. 9:37 Considering bariatric surgery
8. 10:59 Focusing on body composition

• Doses mentioned: 10 mg and 15 mg
• Prices mentioned: $100 a month and $99 a month
• Who is speaking: Clinician (Dr. Spencer Nadolsky)

Dr. Spencer Nadolsky explains how he approaches hair loss in patients taking GLP-1 medicines. He notes that the SURMOUNT 1 tirzepatide data reported alopecia in about 5% of people, while he sees roughly 10% of his own patients report some hair loss.

1. 0:00 Hair loss on GLP-1 meds explained
2. 0:33 How common is it really? (What studies show)
3. 1:00 The main reason: weight loss, not the drug itself
4. 1:40 What telogen effluvium means
5. 2:30 When to take it seriously
6. 3:00 Step 1: Check protein, vitamins, and minerals
7. 3:45 Step 2: Monitor your rate of weight loss
8. 4:30 Step 3: When to slow down or adjust your dose

• Doses mentioned: 2.5 mg
• Side effects mentioned: hair loss
• Who is speaking: Clinician (Dr. Spencer Nadolsky)

Dr. Spencer Nadolsky addresses the claim that GLP-1 medicines cause depression and suicidal thoughts. He says the concern partly comes from early reports of a possible signal in some studies, and that US and European agencies looked into it.

1. 0:00 Do GLP-1s Cause Depression?
2. 0:14 Why Early Studies Raised Concerns
3. 0:46 What FDA and EU Investigations Found
4. 1:17 How GLP-1s Affect Mood and Reward Pathways
5. 1:51 The “Zepbound Blahs” and Anhedonia Explained
6. 2:36 Signs Your Dose Might Be Too High
7. 3:16 When Lowering the Dose Improves Mood
8. 3:35 Using Bupropion to Restore Motivation

• Doses mentioned: 10 mg and 15 mg
• Who is speaking: Clinician (Dr. Spencer Nadolsky)

In this podcast episode, Dr. Spencer Nadolsky and a co-host discuss how they are prescribing oral Wegovy (semaglutide) now that it is available.

1. 0:00 Intro to Oral Wegovy and GLP-1 Pills
2. 1:00 What Oral Wegovy Is and How It Works
3. 3:30 Oral vs Injectable GLP-1 Differences
4. 6:30 Dosing and Titration Basics
5. 9:30 Switching From Wegovy or Zepbound to Oral Wegovy
6. 12:30 Tolerability and Side Effects Considerations
7. 15:00 How and When to Take Oral Wegovy
8. 18:00 Cost, Access, and Real-World Use

• Doses mentioned: 3 mg, 4 mg, 14 mg and 25 mg
• Prices mentioned: $149 a month
• Who is speaking: Clinician (Dr. Spencer Nadolsky)