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Anyone who has opened the fridge after a draining day knows that stress eating and weight loss are rarely as simple as “eat less and move more.” Hunger, habit, emotional distress, oversized portions, and an environment packed with calorie-dense food can shape how much a person eats. Yet the booming weight loss drug market often presents appetite suppression as the answer to a problem that may run deeper.
The Physicians Committee is a doctor’s group known for its YouTube channel and podcast, The Exam Room. In a new episode, the group addresses the negative health effects of the trendy weight loss drugs that an increasing number of people are using to tackle obesity and excess weight. The Physicians Committee also presents an alternative way to lose weight, which it frames as both healthier and more sustainable.
Read more: Why Eating Earlier May Be Better For Your Health
In the new video, The Exam Room host Chuck Carroll interviews Dr Vanita Rahman, an internal medicine and lifestyle medicine physician, certified nutritionist, and personal trainer. Rahman examines the rapid rise of GLP-1 medications, their costs and limitations, and the psychological and environmental factors that can drive people to eat when they are not physically hungry.
Her central argument is that obesity cannot be fully addressed by suppressing appetite. Sustainable weight management, she says, requires people to understand what is driving their eating and to change the type of food on their plates.
The billion-dollar weight loss drug boom
You’ll find more plant-based health and nutrition videos on the Physicians Committee YouTube channel.
Weight loss medications have become one of the pharmaceutical industry’s biggest commercial opportunities, in large part because they target an enormous potential market. Rahman says more than 42 percent of American adults are living with obesity, while more than 74 percent are either overweight or obese.
Only around one in four adults has a body mass index (BMI) in the normal range. Those figures help explain why drugs such as semaglutide, sold under brand names including Ozempic and Wegovy, have attracted so much attention. Semaglutide became the top-selling drug in the United States in 2023, according to figures discussed in the video, generating USD $13.8 billion in net sales.
“It certainly is an enormous amount of money,” Rahman says. “Imagine if we could invest that money into nutrition and lifestyle. We could help people make changes not just temporarily, but long-term.”
GLP-1 drugs work partly by suppressing appetite and slowing gastric emptying. This means that food remains in the stomach for longer. As a result, users tend to eat less. Research discussed in the video suggests that semaglutide can produce average weight loss of around 16 percent of a person’s starting body weight. Tirzepatide, sold under brand names including Mounjaro and Zepbound, may produce losses of around 16 to 23 percent.
But Rahman argues that these figures do not tell the whole story. Semaglutide can cost more than $1,600 a month, she says, while tirzepatide can cost more than $1,200. Possible side effects include nausea, vomiting, diarrhea, severe constipation, gallbladder disease, inflammation of the pancreas, and kidney dysfunction. Researchers are also investigating other potential long-term risks.
Weight loss may also plateau. In one trial discussed by Rahman, only 12 percent of medication users reached a normal BMI after approximately two years. Around 45 percent remained in the overweight category, while 43 percent remained in the obese category.
Stopping the drugs presents another problem. Studies highlighted in the interview show that participants commonly regain weight after discontinuing treatment. Improvements in blood pressure, blood sugar, and cholesterol may also be reversed. Rahman cites research indicating that 65 percent of people who begin taking a GLP-1 drug discontinue it within 12 months. Within two years, that figure rises to 84 percent. Expense, side effects, and limited results may all play a role.
Who funds the research?
Rahman also raises concerns about the financial relationship between drug manufacturers and the research used to assess their products. Novo Nordisk, which manufactures semaglutide, has funded the majority of its clinical trials, she says. The company has also played a role in data collection, data analysis, and decisions about submitting research for publication. Eli Lilly, the manufacturer of tirzepatide, has similarly funded much of the research into its drug and participated in gathering and analyzing data.
Industry funding does not necessarily mean a study’s conclusions are false. However, it can create conflicts of interest, particularly when the company paying for the research stands to earn billions of dollars from positive findings.
Rahman argues that greater independent and long-term research is needed. This is especially important because these medications are relatively new and may be prescribed for years or even for life.
Why people binge or eat under stress
Weight gain results when people consistently consume more energy than their bodies use. The harder question, Rahman says, is why people eat beyond their energy needs.
There is no single answer. People may overeat because they have become extremely hungry, developed a habit of eating late at night, or grown accustomed to larger portions. Cultural traditions can also encourage eating during holidays and celebrations, even when someone is not physically hungry.
Environmental factors matter, too. Rahman points to calorie-dense foods, oversized restaurant servings, and distractions as factors that can influence eating habits. Liquid calories, as well as the sight and smell of food, can also prompt people to eat more than their bodies need. A coffee drink, for example, can contain 500 or 600 calories, she notes.
Portion sizes have also changed dramatically. Rahman says the size of the average US burger has grown by 223 percent since the 1950s, while the average soda is now around five times larger. Dinner plates have expanded from about nine inches to 11 or even 13 inches. As a result, what was once considered an adult-sized serving is now sometimes treated as a children’s portion.
Rahman also notes that humans begin life as intuitive eaters. Babies typically stop eating when they are satisfied. Adults, often with good intentions, may encourage children to take another bite or finish what is on their plates. Over time, she says, people can learn to pay less attention to their own hunger and fullness signals.
Binge and emotional eating can add another layer of difficulty. Rahman describes them as common issues that may leave people feeling ashamed, frightened, or hopeless.
“So many people deal with it. And if you are dealing with it, you almost always know you are, but maybe you’re ashamed or scared or feeling hopeless,” Rahman says.
Her broader point is that overeating is shaped by hunger, habits, emotions, portion sizes, and the surrounding food environment. Weight loss drugs may reduce appetite, but they do not address those underlying influences.
“The new medications are not addressing any of these factors,” Rahman says. “They are simply suppressing our appetite.”
Read more: What Is The Sugar Diet? The Truth Behind The Trend
A whole-food, plant-based approach
Rahman recommends a diet centered on fruits, vegetables, legumes and whole grains. These foods tend to be rich in fiber and nutrients while being lower in caloric density than many animal products and ultra-processed foods. That combination allows people to eat satisfying portions without consuming the same concentration of calories.
In one plant-based diet study highlighted in the video, participants lost an average of 12 kilograms, or roughly 26 pounds, over 12 months. Their cholesterol and blood sugar levels also fell, without the medication costs or adverse effects discussed elsewhere in the interview.
Rahman points out that the average American consumes fewer than one serving of fruit and fewer than two servings of vegetables a day. Whole grains and legumes, including beans, lentils and tofu, also remain scarce on many plates. Refined grains, added sugars and excessive sodium are far more common.
A whole-food, plant-based diet is not simply another plan based on eating smaller quantities. It changes what makes up the meal, prioritizing foods that offer bulk, fiber, and nutrients with fewer calories.
Rahman does not suggest that dietary changes alone will resolve every case of binge or emotional eating. Some people will require counseling, medical care, or other forms of support. But she argues that lasting weight management is more likely when people address the root causes of overeating and build eating patterns they can maintain without expensive injections.
The approach may lack the headline-grabbing promise of a weekly drug. But unlike appetite suppression alone, it aims to change the conditions that caused the weight gain in the first place.
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