Think you know everything about obesity, weight loss meds, and getting “healthy”?
Think again.
In this episode of Unfiltered Fit Life, I’m joined by Dr. Spencer Nadolsky, Board-Certified Obesity Medicine Physician and, yes, that Instagram Meme Doctor—for a raw, no-BS conversation that cuts through the internet noise and gets real about what’s actually going on with obesity, medications like Ozempic and Mounjaro, and the complex reality of weight loss in today’s world.
We’re breaking down the truths no one’s telling you, like why BMI is outdated (and kinda useless), how parenting and packed schedules totally shift your health priorities, and what you really need to know about meds like semaglutide and tirzepatide.
Forget the shame spirals, “health at every size” soundbites with zero nuance, and overnight weight loss promises. If you’ve ever felt judged, overwhelmed, or just plain confused about your health journey, you’re not alone, and this episode is for you.
Meet My Guest
Dr. Spencer Nadolsky brings over a decade of expertise in obesity medicine, with board certifications in obesity medicine and lipidology. Since becoming a doctor, he has helped 1000’s of patients lose weight and improve their quality of life through innovative healthcare delivery platforms. Dr. Spencer also has fun, educational social media content where you can laugh and learn at the same time. He resides in Michigan.
Here’s what we get into:
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What defines obesity (and why your BMI isn’t the whole picture)
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How genetics, environment, and mindset all play a role in weight gain
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The messy truth behind semaglutide, tirzepatide, and compounded meds
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Why calorie deficit still matters—but not in the way you’ve been told
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How to build a sustainable health plan without the food guilt or wearable obsession
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Where the system is failing, and what needs to change in healthcare, nutrition, and coaching
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Real talk for fitness pros, parents, and anyone tired of being shamed for their body
This one is packed with science-backed insight and hard truths—but also compassion, perspective, and zero judgment. Because at the end of the day? You deserve advice that respects your reality, not just your willpower.
These drugs work so well because they help normalize intuitive eating. They normalize the appetite centers so that people are like, "I don't need to eat the whole pizza. I can eat a slice." - Dr. Spencer Nadolsky
What’s one thing you thought you knew about obesity or weight loss that this convo flipped on its head? DM me on Instagram.
Related Episodes
Mentioned Links/Resources
American College of Lifestyle Medicine
Connect with Dr. Spencer Nadolsky
Connect with Nathalia
Get my favorite pre-workout HERE
Thanks for joining us on the Unfiltered Fit Life podcast! If you enjoyed this episode, please leave us a rating and review on Apple and Spotify to help us reach even more women ready to simplify their fitness journey so they can lose weight, regain their confidence, and feel sexy AF!
More about the Unfiltered Fit Life podcast
Ever wish you had a fit and straightforward BFF with over 15 years of experience to help you filter through all the information regarding fitness, nutrition, and life?
That’s exactly what you’ll get when you listen to the Unfiltered Fit Life Podcast.
Join Former Bikini Olympia Champion, mom of 2, and fitness coach Nathalia Melo each week as she shares fitness, nutrition, and life tips to help busy working moms simplify their fitness journey so they can learn easy and simple strategies on how to lose weight and feel sexy AF.
After helping over 5000 busy working moms, Nathalia has found the blueprint to fitness, nutrition, and life success, which she will be sharing in this podcast: actionable tips that will help busy working moms be more present at work and at home.
This show is for you if you realize that nothing good comes from your comfort zone and are ready to challenge yourself to achieve great things. Follow Unfiltered Fit Life wherever you are listening to join us each week for a splash of sass, humor, and a whole lotta truth.
The podcast transcript for this episode of the Unfiltered Fit Life podcast follows
Nathalia [00:00:00]:
Welcome back to another episode of the Unfiltered Fit Life podcast. I'm Nathalia Melo, your host, and today’s guest is someone I’ve been wanting to bring on for a long time. I was honestly a little nervous to ask because, well… he's kind of a big deal.
Dr. Spencer Nadolsky [00:00:19]:
Yeah, right.
Nathalia [00:00:21]:
Please welcome Dr. Spencer Nadolsky—Instagram’s unofficial meme doctor and an actual board-certified obesity medicine physician. He’s also certified in lipidology and has helped thousands of patients improve their health through innovative platforms. His content? Smart, funny, and science-backed. Oh, and he was a collegiate wrestler too.
Dr. Spencer Nadolsky [00:00:57]:
Yep, wrestled heavyweight for three years at UNC Chapel Hill.
Changing Perspectives on Obesity Medication
Nathalia [00:01:01]:
You’ve become increasingly vocal about medications like semaglutide and Ozempic—and I’ll admit, I was skeptical at first. But your explanations, paired with working with clients who fit this demographic, completely shifted my perspective. Thank you for educating coaches like me.
Dr. Spencer Nadolsky [00:01:50]:
I get it. I used to think the same way—“Why can’t people just put down the fork?” But the more I learned, the more it made sense.
Parenting and Shifting Fitness Priorities
Nathalia [00:02:35]:
You’re a dad of three and married to a fellow physician. Has parenthood changed your approach to fitness and nutrition?
Dr. Spencer Nadolsky [00:03:01]:
Absolutely. I used to lift four times a week—now I fit in two or three, sometimes with the kids biking next to me or in a stroller. My nutrition is efficient—protein shakes, fruit, whatever works. You gain a lot more empathy as a parent.
Unrealistic Expectations From Our Younger Selves
Nathalia [00:04:18]:
I see a lot of women trying to follow strategies they used in college—training for hours, eating next to nothing. But life looks very different now.
Dr. Spencer Nadolsky [00:04:55]:
Exactly. People romanticize their high school or college weight and think they need to get back there. But life, time, and bodies have changed.
Defining Obesity and Understanding the Epidemic
Nathalia [00:05:49]:
Let’s define obesity. What actually classifies someone as obese? And what’s fueling the epidemic in the U.S.?
Dr. Spencer Nadolsky [00:06:24]:
Traditionally, it’s defined as a BMI of 30 or higher. But BMI isn’t perfect—it’s a screening tool. True obesity is excess body fat that causes harm—things like insulin resistance, high blood pressure, sleep apnea. There’s even “preclinical obesity,” where the body has excess fat without current health issues.
Health at Every Size and Body Positivity: Helpful or Harmful?
Nathalia [00:09:48]:
How do you feel about the “Health at Every Size” movement? Is it possible?
Dr. Spencer Nadolsky [00:10:27]:
The message should be: promote health at any size—not claim everyone is healthy at every size. But some influencers deny the impact of excess fat altogether, which is dangerous. Weight stigma is harmful, yes—but excess adiposity causes harm regardless.
Is Obesity a Choice?
Nathalia [00:14:33]:
You’ve said obesity is not a choice. Can you clarify that—and address whether that belief risks removing a person’s agency?
Dr. Spencer Nadolsky [00:16:29]:
Obesity itself isn’t a conscious choice. People don’t choose to become obese—they grow into it through environment and biology. But people can choose to fight it, and many do. The problem is, the fight is relentless and often unsuccessful without help.
Genetics, Environment, and the Long Road to Obesity
Nathalia [00:20:40]:
So childhood environment, genetics, and early food habits all play a role?
Dr. Spencer Nadolsky [00:20:40]:
Absolutely. You’re seeing both nature and nurture at play. Appetite regulation, environment, and family modeling all influence outcomes—some kids are biologically more prone to overconsume.
Doctors and the Lifestyle “Blind Spot”
Nathalia [00:24:52]:
You’ve spoken about becoming cynical about the healthcare system. Why?
Dr. Spencer Nadolsky [00:25:19]:
Medical education is drug-heavy. Lifestyle is mentioned, but rarely taught. I was called a “lifestyle zealot” for trying to help patients change habits. Most doctors have no time or training in this area—it’s easier to prescribe.
Misinformation in the Medical Community
Nathalia [00:31:01]:
There’s so much conflicting info—some of it from doctors. How do we combat that?
Dr. Spencer Nadolsky [00:32:37]:
Teach critical thinking and how to evaluate research. Too many providers swing their degrees around and say inaccurate things with confidence. The public doesn’t know how to tell evidence-based from anecdotal nonsense.
On Fasting, Cortisol, and Misleading Science
Nathalia [00:35:19]:
I’ve had doctors tell me cortisol alone causes weight gain—without explaining how. Isn’t that misleading?
Dr. Spencer Nadolsky [00:36:39]:
Yes. You can’t gain mass from nothing. Cortisol may influence fat distribution, but you still need a calorie surplus. That’s a classic example of cherry-picked rodent studies being misapplied to humans.
Calories, Appetite, and Intuitive Eating
Nathalia [00:38:16]:
Can we talk about obesity without talking about calories?
Dr. Spencer Nadolsky [00:38:16]:
Calories are essential. I teach my patients the principle so they’re not misled. You can eat “intuitively” once your appetite is normalized—but many patients need structure first, especially after years of dysregulation.
Sugar Addiction and Glucose Trackers
Nathalia [00:42:53]:
Is sugar addictive?
Dr. Spencer Nadolsky [00:42:54]:
Not in the drug-addiction sense. It’s usually the combo of sugar, fat, salt, and texture that’s hyper-palatable—not sugar alone.
Nathalia [00:45:21]:
What about glucose monitors for healthy people?
Dr. Spencer Nadolsky [00:45:52]:
No clear evidence they help. Could be useful for behavior change with proper coaching—but they often cause confusion or anxiety without context.
Protein, Fad Diets, and Misinformed Messaging
Nathalia [00:53:44]:
Fasting is often touted as superior. Does it actually improve insulin sensitivity more than other approaches?
Dr. Spencer Nadolsky [00:53:44]:
Not inherently. Benefits from fasting often come from calorie reduction, not magical effects. Same goes for insulin sensitivity.
Nathalia [00:55:33]:
What about plant-based lifestyle medicine recommendations that avoid complete proteins?
Dr. Spencer Nadolsky [00:55:33]:
They can be effective if done right—but often ignore the need for adequate protein. It’s hard to get enough without planning or supplements.
Weight Loss Medications: The Good, The Bad, The Hype
Nathalia [01:00:03]:
Let’s talk about medications like semaglutide and tirzepatide. Are doctors getting paid to prescribe these?
Dr. Spencer Nadolsky [01:00:03]:
No. It’s illegal. There are advisory roles, but no direct payments for writing prescriptions.
Nathalia [01:03:30]:
Are these drugs being overprescribed?
Dr. Spencer Nadolsky [01:03:30]:
Yes—especially by telehealth clinics pushing them to people who don’t meet criteria. Some use compounded versions unethically.
Nathalia [01:06:43]:
Who’s a good candidate?
Dr. Spencer Nadolsky [01:06:43]:
People with clinical obesity or type 2 diabetes. Possibly those with high regain risk—but not small amounts of “vanity” weight loss.
Medications vs. Lifestyle: Can One Exist Without the Other?
Nathalia [01:11:14]:
How important is lifestyle alongside these medications?
Dr. Spencer Nadolsky [01:11:14]:
It’s crucial. Especially for muscle maintenance. The drugs help reduce hunger—but without movement or protein, quality of life and long-term success suffer.
Rebuilding a Better Healthcare Model
Nathalia [01:15:01]:
Can doctors do this well if they don’t have time, training, or referral systems in place?
Dr. Spencer Nadolsky [01:15:01]:
Not really. That’s why I left insurance-based care. Now I work in a direct-pay model where my patients get access to a doctor, dietitian, and strength coach. That’s how it should be.
Nathalia [01:17:06]:
Where can people find your work?
Dr. Spencer Nadolsky [01:17:06]:
Instagram @drnadolsky, my clinic is joinvineyard.com, and my podcast with my brother is Docs Who Lift.
Nathalia [01:17:15]:
Thanks for joining us, Spencer. This was incredible.
