BMI limitations and better metrics for risk

Today, Dr. Priya Jaisinghani joins us to cut through the headlines. We move beyond the "cheating" narrative and explore the biology of obesity as a chronic disease. We discuss the phenomenon of "Food Noise"—the constant mental static about eating—and why silencing it is a matter of brain chemistry, not willpower.

We get into the weeds of patient selection, explaining why BMI is a broken metric (especially for South Asian populations) and why being "skinny" doesn't mean you’re metabolically healthy. We also tackle the serious risks: the "muscle crisis" (sarcopenia), the dangers of unregulated compounding pharmacies, and what happens when you stop these drugs.

What We Discuss:

• The "Food Noise" Phenomenon

• Patient Selection & The Broken BMI

• The Muscle Crisis: Quality vs. Quantity

• Safety, Side Effects & The Compounding Trap

• The Future of Metabolic Medicine

Resources & Links:

Connect with Dr. Jaisinghani:

• NYU Langone Profile: Dr. Priya Jaisinghani

• Instagram: @DrJ_NYU

• LinkedIn: Priya Jaisinghani, MD

Studies & Literature Mentioned:

• SURPASS-3 MRI Sub-study: Reduction in Liver Fat and Muscle Fat with Tirzepatide

• SELECT Trial: Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (The "MACE" reduction data)

• FLOW Trial: Semaglutide in Patients with Type 2 Diabetes and Chronic Kidney Disease

• GRAMS Trial (Upcoming): GLP-1s and Musculoskeletal Outcomes

• Medscape Article: Do GLP-1s Have Deleterious Effects on Muscle?

Podcasts & Videos Mentioned:

• Podcast: Drug Story by Thomas Goetz (Episode on GLP-1s)

• TEDx Talk: Dr. Melanie Jay: Weight Bias in Medicine

Concepts & People:

• Dr. Gabrielle Lyon: Muscle-Centric Medicine

• Dr. Spencer Nadolski: Lipidologist & Obesity Physician

Want to work with Dr. Raja?

• Refining Health & Performance is opening a limited number of founding member spots for the telemedicine practice. We focus on health span, longevity, and performance using a Medicine 3.0 approach. Apply at RefiningHealthRx.com.

Guest Bio:

Dr. Priya Jaisinghani is a triple-board certified physician in Internal Medicine, Endocrinology, and Obesity Medicine, and currently serves as a Clinical Assistant Professor at NYU Grossman School of Medicine.

She completed her training at Weill Cornell and New York-Presbyterian Hospital before becoming a key architect at NYU Langone, where she helped build their official obesity clinical care pathway.

Dr. Jaisinghani is a leading voice in the cardiometabolic space, specializing in the intersection of hormonal health and metabolic dysfunction. She is deeply passionate about treating obesity as a chronic, complex disease rather than a willpower failure.

Beyond her clinical practice, she is a dedicated educator who has secured grant funding to develop tools that teach residents how to dismantle weight bias in the exam room. She serves as a vital bridge between endocrinology, bariatric surgery, and sports medicine to treat the whole patient.