In this critical and timely episode, Dr. Cristina Castagnini is joined by Melainie Rogers, Founder and CEO of BALANCE Eating Disorder Treatment Center, to navigate the chaotic "wild west" of the current weight loss landscape. As GLP-1 medications like Ozempic and Wegovy saturate the market, Melainie pulls back the curtain on the alarming side effects that are often swept under the rug—from significant muscle atrophy to "medically induced anorexia." This conversation challenges the pervasive myth that thinness equals health, exposing how the lack of informed consent and the rise of med-spa prescriptions are setting the stage for a future of metabolic damage and disordered eating.

Melainie Rogers is the CEO and founder of BALANCE Eating Disorder Treatment Center in New York City. She is a registered dietitian known for her leadership in the field of eating disorder treatment and her advocacy for weight-inclusive, evidence-based care. Under her direction, BALANCE offers comprehensive treatment services, including both Partial Hospitalization (PHP) and Intensive Outpatient (IOP) programs. Rogers is also recognized for her work in professional education and her contributions to advancing non-diet, recovery-focused approaches. She frequently speaks, writes, and consults on best practices for treating eating disorders across diverse populations.      

KEY TOPICS DISCUSSED:

  • Why the "health" promised by weight loss drugs may actually be damaging your metabolism and body composition long-term.
  • The shocking statistic regarding muscle mass loss versus fat loss when using semaglutide medications.
  • How the current wave of weight loss prescriptions mirrors the dangers of past diet trends like liquid diets and bariatric surgery.
  • The connection between rapid weight loss, brain atrophy, and increased anxiety, drawing parallels to the Minnesota Starvation Study.
  • Why a BMI between 24 and 27 is statistically associated with greater longevity, debunking the "thinner is better" narrative.

KEY TAKEAWAYS:

  • The Muscle Atrophy Danger: Melainie explains that unlike natural weight fluctuation, GLP-1 drugs cause a rapid loss of lean muscle mass. When weight is regained (which is common upon cessation), it returns as adipose tissue, permanently lowering the body's metabolic rate.
  • Medically Induced Anorexia: A powerful concept discussed in the episode, highlighting how these drugs mimic the physiological and psychological effects of starvation—including brain atrophy and rigid thinking—regardless of the body's starting size.
  • Informed Consent Gap: A major conflict identified is the lack of education provided to patients. Many are unaware that these are lifetime medications or of the severe long-term risks to their GI tract, pancreas, and bone density.
  • The Med Spa Loophole: Dr. Castagnini and Melainie discuss the ethical grey area of obtaining these potent drugs via Groupon deals and med spas without ever seeing a doctor in person.

IMPORTANT TIMECODES FROM THIS EPISODE:

  • [00:00] The Muscle Loss Reality: A startling look at the 39% muscle loss associated with Ozempic.
  • [03:40] Melainie’s Origins: How an internship at the Obesity Research Center changed her perspective on eating disorders.
  • [09:30] Building BALANCE: The struggle to open a much-needed treatment facility during the Great Recession.
  • [15:00] The "Family Health Kick": The disturbing trend of parents sharing weight loss prescriptions with their college-aged children.
  • [20:00] Off-Label Use: Clarifying the difference between diabetic treatment and aesthetic weight loss.
  • [27:12] The Metabolic Cost: Why regaining weight after stopping these drugs leaves you with more fat and less muscle.
  • [36:00] The "Wild West" of Prescriptions: The lack of screening and the rise of compounding pharmacies and med spas.
  • [40:40] Starvation and the Brain: How severe caloric restriction impacts mental health and cognitive function.
  • [44:40] "Medically Induced Anorexia": A new term describing the severe impact of these medications.
  • [45:30] Longevity & BMI: What the data actually says about optimal weight and health.

CONNECT WITH MELAINIE ROGERS:

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Part of the Los Angeles Tribune Podcast Network, produced by the Tweaky Tales.

**Disclaimer:**

The content of this podcast episode is for informational and educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. The views and experiences shared by guests are their own and do not necessarily reflect those of the host or affiliated organizations. If you have any medical or mental health concerns, please consult a qualified healthcare provider. Listener discretion is advised, especially for those sensitive to topics related to body image, weight stigma, and eating disorders.