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E106
November 18, 2025
GLP-1s and Midlife Metabolism, Part 2: Dr. Rocio Salas-Whalen Breaks Down the Science of Weight Loss and Menopause
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What happens after you lose the weight? Few are focused on this important question about GLP-1 medications. In Part 2 of this conversation on GLP-1s and Midlife Metabolism, triple board-certified endocrinologist Dr. Rocio Salas-Whalen continues her discussion with Dr. Mary Claire Haver, going deeper into what happens after weight loss, including the physical and emotional changes no one prepares you for, and what the future of these medications looks like.

Dr. Salas-Whalen, founder of New York Endocrinology and author of the upcoming book Weightless, tackles the questions women are actually asking: How do I know if I'm getting good care? What about compounding pharmacies? Will I need therapy? And what comes next in obesity medication?

The conversation addresses the psychological shifts that happen when you reach your goal weight for the first time in your life. Dr. Salas-Whalen shares what she's learned from following patients long-term and why the maintenance phase is actually the most important part of treatment.

Dr. Salas-Whalen also addresses the cost and accessibility crisis around Ozempic, Wegovy, and Mounjaro, the environmental impact of single-use injection pens, and why direct-from-manufacturer vials (like Eli Lilly's Zepbound vials) are making treatment more affordable. She shares her standard of care for obesity treatment and explains exactly what questions to ask before starting GLP-1 therapy.

For women experiencing perimenopause and menopause weight gain, this episode provides useful information about what to expect beyond initial weight loss, how to maintain results long-term, and why proper medical supervision with body composition monitoring is essential for protecting muscle mass and metabolic health.

Guest links:

Books:

This episode covers:

  • The emotional reality of rapid weight loss and body image adaptation after GLP-1 treatment
  • Why some patients need mental health support alongside GLP-1 medications
  • How weight loss affects relationships and marriages as well as the "Ozempic divorce" phenomenon
  • The truth about compounding pharmacies: safety concerns, FDA regulations, and red flags to watch for
  • Why GLP-1 medications combined with menopause hormone therapy show superior weight loss results
  • Green flags and red flags when choosing a provider for GLP-1 treatment
  • The future of obesity medication: triple incretin drugs (retatrutide), oral GLP-1 options, and monthly injections
  • Protein requirements to preserve muscle mass during weight loss: why 100 grams daily matters
  • Physical changes after significant weight loss: cold intolerance, excess skin, and medical considerations
  • How to support a loved one on GLP-1 medications without triggering guilt or shame
  • Who should NOT take GLP-1 medications: contraindications and safety considerations
  • Finding an obesity medicine specialist: how to locate qualified providers

Articles:

Other Resources:

Chapters

01:38 – Part 2 Begins: GLP-1s, Menopause & Women’s Health
03:27 – Stigma, Shame & the Menopause/GLP-1 Parallel
07:46 – Putting Out the “Menopause Fire” Before Weight Loss
08:54 – Why Body Composition Matters More Than the Scale
10:16 – Strength Training, Balance & Avoiding Falls
12:23 – Serena Williams, GLP-1s & Public Judgment
15:24 – Telehealth & Access to GLP-1 Medications
17:23 – Protein Needs on GLP-1s & Preserving Muscle
20:47 – Sponsor Break: MIDI, Headley & Bennett, HelloFresh
23:59 – GLP-1s & Eating Disorders: What the Data Shows
24:32 – The Emotional Impact of Rapid Weight Loss
27:17 – Physical Changes After Weight Loss: Cold, Skin & More
29:02 – Visibility, Attention & Social Shifts After Weight Loss
31:05 – Relationship Strain & the “Ozempic Divorce”
34:33 – Menopause Hormone Therapy + GLP-1s: Better Together
35:54 – Cost, Access & “You’re Not Fat, You’re Just Poor”
38:51 – Compounded GLP-1s: Safety Risks & Red Flags
41:29 – The Future Pipeline: Twin & Triple Incretins
44:39 – Oral GLP-1s & Their Role in Maintenance
49:32 – How to Find the Right GLP-1 Doctor
51:31 – Rethinking the Standard of Obesity Care
52:03 – How Loved Ones Can Be Truly Supportive
53:47 – Who Should Not Take GLP-1s
55:24 – Dr. Salas-Whalen’s Midlife Transformation
58:36 – Outro & Where to Find Dr. Salas-Whalen

About the guest

Dr. Rocio Salas-Whalen

Dr. Rocío Salas-Whalen is a board-certified Endocrinologist and Obesity Medicine specialist, widely recognized as one of the earliest adopters of GLP-1 therapies in the United States. With over 15 years of experience treating thousands of patients, she has helped redefine obesity care—moving the conversation from willpower to science, and from stigma to empowerment.
She is the author of the upcoming book Weightless, a comprehensive guide to the new era of GLP-1 medications, designed to support individuals before, during, and after weight-loss therapy. Weightless goes beyond medication—it addresses the psychological, social, cultural, and metabolic changes patients face, and offers the tools needed for lasting success.
In practice, Dr. Salas-Whalen combines cutting-edge metabolic science with compassionate, individualized care. Her expertise spans perimenopause and menopause, where she leads a modern “menopause redo,” empowering women to navigate midlife with strength, clarity, and vitality through evidence-based hormone therapy, metabolic optimization, and lifestyle tools.
Outside the clinic, she is a leading voice on social media (@drsalaswhalen), educating and inspiring millions by making complex medical science accessible and actionable. She is also the founder of StrengthMD and The Dry Revolution, initiatives focused on metabolic wellness, muscle health, and supporting alcohol-free living.
An immigrant from Mexico who came to the United States to pursue her dream of becoming a physician, Dr. Salas-Whalen now leads a thriving practice on New York’s Upper East Side. Her mission is to transform lives and rewrite the future of women’s health—by addressing root causes, honoring lived experiences, and delivering science-driven care with unwavering empathy.