For our first Weight Watchers Book Club, listen in on GLP-1 real talk from an obesity medicine specialist who literally wrote the book on it.

By Weight Watchers

Last updated January 21, 2026

In early 2026, Weight Watchers started a book club series where authors, doctors, thought leaders, and social media influencers lead members through a discussion that’s informative, thoughtful, helpful — and a good time. Our first one in the series was about the book Weightless: A Doctor’s Guide to GLP-1 Medications, Sustainable Weight Loss, and the Health You Deserve, by Rocio Salas-Whalen, M.D., a board-certified endocrinologist specializing in obesity medicine.

In front of a live audience (also livestreamed to members at home) at Weight Watchers HQ, Dr. Salas-Whalen spoke with Julie Rice, our chief experience officer. “ Weightless is like a handbook for people on a GLP-1 journey, a companion and a guide that everyone needs,” said Rice.

Read on for a full recap of why and what they discussed. To tune into the next book club event in real time, follow Weight Watchers on Instagram so you can get access to RSVP links as soon as they’re live.

On first getting interested in obesity medicine

Dr. Salas-Whalen: I grew up in Mexico, where type 2 diabetes [and its complications] is the second-leading cause of death, and it affects nearly every family. I knew that that’s what I wanted to treat and work on. In medical school, I learned that diabetes goes hand-in-hand with obesity, and we cannot treat diabetes without treating obesity — and vice versa. How do we prevent type 2 diabetes? By treating obesity first. Eventually I opened my own practice in New York City.

On reframing obesity

Julie Rice: We know at Weight Watchers that obesity is not a matter of willpower; it’s actually a chronic condition. Can you talk more about that?

Dr. Salas-Whalen: That’s what made me want to write this book. I heard patient after patient telling me, ‘I’m doing what they’re recommending, I’m eating 1,000 calories, I’m exercising.’ I couldn’t believe what I was hearing. It was completely contrary to how I was trained as an endocrinologist, and even as an obesity specialist. Obesity is not a willpower problem. It’s not that somebody’s not trying. In fact, I have yet to meet a patient that hasn’t tried hard to lose weight. I haven’t met that patient that wants to have obesity. That patient does not exist, or at least I have not met that person. The [World Health Organization] categorized obesity as a disease back in the 1940s, but it wasn’t until 2013 that the American Medical Association actually officially recognized it as a  disease. Today’s guidelines say we need to stop seeing obesity as a risk factor for other issues and more as a true disease of its own.

Julie Rice: So what is going on in our bodies that is causing weight gain? How much is lifestyle and choices and how much is just biological?

Dr. Salas-Whalen: Obesity is multifactorial. Transgenerational obesity is documented in papers and serious journals where we go back three or four generations. Things that could impact somebody’s weight like trauma, famine, poverty, marginalization, child abuse, sexual abuse can lead to obesity, and we were blaming it on that one person at that one moment in time, when probably, genetically, we’re already predisposed to develop obesity, struggle with weight, or have difficulty with losing weight.

On menopausal weight gain

Julie Rice: I’m the perfect example of midlife weight gain for women. I’m the co-founder of SoulCycle. My whole life, I’ve eaten the right things, exercised, and then all of a sudden, I woke up one day at 50 years old, and the same things didn’t work anymore. I’d lose one pound, gain two back. It’s the first time I needed the help of a GLP-1. What causes this?

Dr. Salas-Whalen: I see this a lot in my office. I have women coming in who tell me, ‘I’m even exercising more. I’m even eating even healthier. And I don’t recognize my body. This is not the way it used to be.’ This is because of the hormonal chaos of perimenopause, and that’s in our early 40s, or for some women in our late 30s. The fat in our fertile years went to our hips, our thighs, our breasts. The dropping of estrogen in midlife promotes changes in our body composition, so we tend to store more body fat centrally. That’s why there’s more risk of type 2 diabetes in menopause, because of that gain of central visceral fat.

We, in midlife, also confront so many difficult situations. It could be the loss of our parents, or parents aging and we’re taking care of them. It could be a divorce. It could be our children growing up. It could be success in our jobs, not sleeping, or traveling for work. There are so many different things that really are against us in midlife that it explains why, at this age, it’s easier to gain weight and harder to lose weight.

But it’s a good time to be in midlife right now, because more than ever, we have tools that our mothers didn’t have — that even 10 years ago weren’t available.

On changing the language to let go of blame, shame, and stigma

Julie Rice: With GLP-1 prescription medications, we’re right in the beginning, so there’s still stigma and still shame in using them for some people. When I first started, I didn’t know if I was going to tell people or not. Sometimes I go to lunch with six of my friends, and I know we’re all taking those drugs, but not everyone will admit to that or talk about it. But talking about it allows people to have honest conversations and say, ‘This is not my fault. This is not that I’m not doing something right. This is about my biology, this is a condition. And this is about me taking charge and figuring out how I’m gonna handle it so that I can be healthier, happier, and more confident.’

Dr. Salas-Whalen: People struggling with their weight need so much empathy from others. I see this in my patients in their 60s, 70s, 80s, that they’ve struggled with weight since they’re 10 and spent a lifetime carrying this shame, trauma, guilt, and bullying for literally decades. When we say ‘the obese person’ or ‘the obesity patient,’ we’re actually putting the disease in front of the person. But a person is not their disease. By saying ‘the cancer patient,’ rather than ‘the patient with cancer,’ we’re forgetting about the human, and it’s the same with obesity. If someone says, ‘the obese person,’ you’re disregarding the person as a whole, as a human, and you’re already putting the disease in front of them. We need to be using person-first language in medicine. Patients with obesity really deserve to take a break from feeling guilty or that they’re causing their disease. So even by that small thing of changing to saying, ‘the person with obesity,’ it changes everything in our perspective.

On the origins of GLP-1s

Julie Rice: What is a GLP-1 and how does it actually work in our bodies?

Dr. Salas-Whalen: I want people to make an informed, educated decision, not one based on fear. The first thing that everybody needs to know is that these are not new medications. This has been FDA approved since 2005 for management of type 2 diabetes, which means it goes through a very rigorous testing. We have clinical data of safety beyond the 20 years.

Also, the GLP-1 hormone was discovered by a female scientist. She found this hormone is made in our gut, in our small intestine, and it’s released by the passage of food. So you eat food, and then it goes through digestion, and then this hormone is released. The hormone has many benefits, including stimulating the production of insulin when your glucose goes up. It was found that it can also control appetite and cause weight loss. I want to make clear here there isn’t a GLP-1 deficiency; it’s not that people with obesity have less GLP-1 than somebody who is lean. The problem with our own GLP-1 is that it’s broken down within two to four minutes of when it’s produced, so it’s very, very short-lived. Commercial GLP-1 medications are engineered to be long-acting versions of our own body’s GLP-1.

On busting common myths

Julie Rice: What are the myths that are out there that you’re hearing when patients come to you?

Dr. Salas-Whalen: One that really upsets me — because I can see the loss for someone who could potentially benefit from this medication — is the idea of thinking that you have to suck it up to deal with the worst side effects to get the benefits of the medication, that you have to be vomiting, that you have to be feeling nauseated, that you have to be feeling sick. That’s unfortunately due to the poor experience with whoever is guiding you with this medication; the medication itself is very noble if it’s managed the right way. You don’t have to suck it up for the benefits of weight loss. [While a small number of individuals may not be able to take these medications due to side effects], many people can and experience minimal to no side effects if they take the right steps to prevent those side effects. So, you can have a good quality of life while you’re on a GLP-1.

Another misconception is that you’re never going to enjoy food anymore. That’s not true. You’re hungry, you eat, you enjoy it, then you’re physically satisfied and you’re not thinking of food for the next four or five hours. For many patients, they say ‘Wow, this is how people normally eat.’

The other common myth is that once you’re on this medication, you just can sit back, do nothing, and watch the fat melt.

Julie Rice: The theory was that people wouldn’t be going to the gym because they’re on a GLP-1, but actually what’s happening is that gyms are actually busier than ever. People are feeling a little bit more confident, a little better in their body, so they can take the first step.

Dr. Salas-Whalen: I’ve seen this through the years of my practice. When you remove the stress of weight loss with exercise, it flips a switch and changes completely. The switch here is ‘I have to go to the gym to lose weight’ to ‘I’m gonna go to build muscle.’ The medication is taking care of your fat loss, so it just liberates you. You start exercising for health, not expecting weight loss — since we told them that was how to lose weight — and being disappointed that it’s not happening. When I tell my patients, ‘Don’t exercise for weight loss. Don’t go to the gym thinking that you’re going to lose more weight,’ they look at me like I’m talking Russian. But they start coming back to me saying they love going to the gym, they hiked a mountain, and now they want to see what else their bodies can do beyond the treadmill.

On who’s a good candidate for a GLP-1

Dr. Salas-Whalen: We can go by your BMI, which is what the insurance uses. We can go by what I use, which is percentage body fat. But I think the easiest way for somebody who’s questioning if this will benefit them or not is: If you feel that losing weight or maintaining your current weight is a full-time job, then you are a candidate for that medication. Because it should never feel like a full-time job — that tells me you’re trying to overcome certain factors that promote weight gain.

Julie Rice: Wow. I can think about years of my life where weight dominated my life: waking up, thinking about what I was gonna consume when, how I was gonna go work off certain things — it’s a job.

Dr. Salas-Whalen: This is something that I learned from my patients, that every time a plate is in front of them, it triggers something. ‘Am I going to feel guilty? Am I going to feel shame? Do I have to work out even more? Will I be able to eat less later, or tomorrow?’ To me, that was the most shocking thing: to learn that people were struggling with this three times a day, seven days a week. For some, that’s been happening since childhood — seven, eight, ten years old. I ask patients, ‘At what age were you conscious, or made conscious, of your weight?’ And might say, ‘My mom put me on a diet at 10.’ We have to be very careful of how we talk to children, because they carry that.

On life without food noise

Julie Rice: For me, reducing food noise has actually been one of the most amazing things about being on a GLP-1. As somebody who really has thought about my weight my whole life, I find that mental freedom is really the benefit. I’m thrilled that I’ve lost some weight, but I could raise a third child or run another company with all the brain space I have! I’ve never had so much free time in my whole life by not debating what I was gonna eat for dinner starting at 2 o’clock in the afternoon.

Dr. Salas-Whalen: I’m extremely simplifying it, but a GLP-1 targets the two reasons we eat as humans. One, we eat for survival — meaning fuel, energy — and two, we also eat for a reward, or anticipating a reward. For the fuel part, GLP-1s act as satiety signals the moment that you start eating, so you start feeling fuller with half of what you normally would eat, or maybe a third for some people. Then in between meals, the medication makes it so your body keeps food longer in your stomach, sending the signal of fullness, so in between meals, it suppresses your hunger hormones. For the majority of patients, they feel physically content eating two small meals a day.

In our amygdala, the reward center of our brain, a dopamine release is happening from you even thinking of a food — my grandmother’s lasagna or that chocolate cake when I go to that restaurant. You’re already anticipating, even without seeing the food in front of you, that reward you’re gonna have. The GLP-1 is going to block it. So, when you’re on medication, you see that lasagna and you’re gonna try it, because the behavior is there. But then there’s no dopamine release, so your behavior changes.

On losing fat and preserving muscle on a GLP-1

Dr. Salas-Whalen: I always recommend if you’re going to start a GLP-1 to invest in a body composition scanner at home; they run from $30 to $300 versions. [Editor’s Note: Weight Watchers has an in-app body composition scanner.] It will always be better than the regular scale. If you’re going into this journey, do it the right way. You need to track so you’ll be quicker to notice changes in a good way or in a negative way.

If you’re losing two or three pounds per week, you are losing muscle. I have never seen a single patient lose three pounds of fat in a week. Slow weight loss means most likely you’re preserving your muscle. Also with consuming enough protein in your diet — for women, 1 gram of protein per kg of weight per day — you’re not losing a significant amount of muscle.

On the new Wegovy pill

Dr. Salas-Whalen: We’ve actually had an oral semaglutide since 2019 for type 2 diabetes named Rybelsus. The reason we didn’t use it off-label for weight loss is because at the doses available, we didn’t see weight loss that was comparable to the injectable. The highest dose is 14 milligrams, and the new Wegovy pill goes up to 25 milligrams; at that dose, they are seeing comparable results with the injectable.

In my clinical experience, an oral GLP-1 was a little bit harder to tolerate for patients than the injectable, with more gastric side effects, so we still have to be cautious. I do like that they have a new lowest dose. Rybelsus starts at 3mg, and the Wegovy pill starts at 1.5 milligram, so maybe that is going to allow patients to slowly grow tolerance to any possible side effects.

An upside is that the pill is less expensive than the injectable. A downside is that it’s a daily pill and you have to take it on an empty stomach and wait 30 minutes before you eat. Meanwhile, the injection is once a week and there’s no timing specifications. I can see maybe once people reach their goal with the injectable they might transfer to the oral drug. It’s just good that we have more options.

On long-term GLP-1 use

Dr. Salas-Whalen: What causes weight gain could be genetics, menopause, perimenopause, aging, hormones, environment, trauma, and a GLP-1 medication is not fixing that. When you go off, those things will still be there promoting weight gain or difficulty in weight loss. That’s why these medications were never designed for short-term use. They’re designed to work while you take it. When patients ask me, ‘Am I going to be on it long-term?’ I say that it depends all on the reason of what’s bringing you to need the medication in the first place. I’m gonna use myself as an example. I never struggled with weight, my family doesn’t struggle with weight, I got pregnant at 38, 39, I had two kids under two, I hit perimenopause, I divorced. On the medication, I lost 30 pounds in seven months, and then I could stop it, because I didn’t have those factors that were promoting weight gain. But if I had struggled with weight, or my family struggled with weight, then most likely I would still need to be on the medication.

For the first time in medicine, we have a medication that actually helps you maintain weight loss. That was the holy grail, because any crazy diet can make you lose weight. For the first time, we actually have something that takes you there and can keep you there. My goal for my patients is always the lowest dose long-term.

On reducing inflammation

Dr. Salas-Whalen: Most of the data that we have of improvement of many symptoms is only in patients with obesity and/or type 2 diabetes. We don’t have the data of using a GLP-1 on a metabolically healthy patient. Visceral fat is pro-inflammatory and puts your body in chronic inflammation. Low muscle mass is pro-inflammatory and puts your body in chronic inflammation. So, if you have somebody with overweight or obesity, and they have high visceral fat and low muscle mass, they have inflammation. We see that with cancer cells: When your immune system is preoccupied with chronic inflammation, it’s leaving the door open for tumor cells to grow; autoimmune diseases can also get worse. So somebody who is normal weight, if their body composition is more muscle mass and low visceral fat, they’re already getting that protection of somebody on a GLP-1.

On GLP-1s and mental health

Dr. Salas-Whalen: Obesity has a huge burden on mental health. All that thinking about food, the guilt, of wondering how to lose weight — it consumes people. So when you remove that, everything relaxes.