193. The GLP-1 Revolution: Food Noise, Muscle Loss & The Future of Metabolic Medicine | Priya Jaisinghani, MD

Feb 2, 2026

Priya Jaisinghani, MD, triple-board endocrinologist and obesity medicine specialist at NYU, discusses the biology of obesity and modern metabolic care. She breaks down the “food noise” phenomenon and when GLP-1 therapies are appropriate. Conversations cover BMI limitations, muscle preservation during weight loss, safety concerns with compounding, and the evolving future of metabolic medicine.

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INSIGHT

Medication And Surgery Are Complementary

Bariatric surgery remains appropriate for patients needing very large weight loss or with functional impairment.
There's a continuum: lifestyle, medication, and surgery can be combined when necessary.

ADVICE

Plan Pauses And Restarts With A Clinician

If GLP-1s are paused >2 weeks (procedures, etc.), restart at the lowest dose and titrate up with clinician guidance.
Coordinate perioperative plans with both the operating team and prescribing clinician to avoid abrupt issues.

INSIGHT

Chronic Use Is The Default For Obesity

Current data support chronic use of GLP-1s for obesity; no official de‑prescribing protocol exists yet.
Expect weight regain if therapy stops and plan maintenance strategies proactively.

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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?

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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.