Evolution of Medicine Podcast · Functional Forum

Your Best Shot: Holistic Approach to GLP-1

·36 min·2 clips

Koff says GLP-1s are an “inflection point” for creating “generational weight health” in children and adults.

Ashley Koff, a dietician with decades in functional medicine, joins the show to talk about GLP-1s. She frames the medication conversation around her book Your Best Shot and around the bigger question of how practitioners, patients, and the wider care ecosystem can use these drugs well. The episode starts from a simple premise. GLP-1s are not just a headline; they are a chance to rethink weight health, function, and the systems that have not been working. Koff keeps returning to the idea that this is an inflection point. If medications are being used, the opportunity is to use them in a way that helps rebuild suboptimal systems instead of just covering them up. That frame extends to children and adolescents. She notes that these medications are now being approved for age 10 and up, and age 15 and up, which makes the developmental stakes impossible to ignore. The conversation then widens into practice design. It spends time on the role of the dietician in a modern practice and on what it takes to turn medical intent into follow-through. Koff uses a patient example to make the point concrete. A woman whose day was overloaded with work, home, and personal demands needed help that started with food tweaks and gut repair rather than a reflexive medication decision. The episode names a five-R approach. It also points to specific supports such as stepping off daily NSAIDs, using pro-resolving mediators, and trying New Zealand hops before a meal. Those changes are presented as practical tools. They are part of a bigger effort to help someone actually carry out choices in real life. Koff also makes room for low-dose agonist use when the body and behavior need that support. In that case, she uses a similar protocol and aims to restore enough function that the person can later come off the medication. The episode keeps returning to the same boundary. The medication can help, but the system that made it necessary still has to be addressed.

As heard by us

A grounded GLP-1 discussion about medication, food, and the care system around both.

GLP-1s may be the headline, but the larger argument here is about rebuilding weight care around food, gut repair, and the ability to act on advice.

Read the full review in PlayNext →

Why you'd press play

Want a practical GLP-1 take that treats the shot as one tool, not the whole story?

Read the full recommendation in PlayNext →

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