Your Best Shot: The Truth About GLP-1s and Natural Weight Health Hormones

Ashley Koff

Episode Description:

Registered dietitian Ashley Koff joins Dr. Pedram Shojai to unpack the truth about GLP-1 medications like Ozempic and Wegovy. While these drugs mimic hormones our bodies naturally produce, they don’t solve the root cause of why our own weight-health hormones aren’t functioning properly. Ashley explains how gut health, the vagus nerve, stress, and digestive function all play crucial roles in our body’s natural hormone production. She shares her personal journey from childhood obesity to understanding that healing weight health isn’t about what you eat or avoid—it’s about optimizing your body’s operating system. Whether you’re considering GLP-1s or looking for natural alternatives, this conversation reveals the foundational work needed for sustainable weight health and the critical role of digestion, hydration, and lifestyle in supporting your body’s innate wisdom.

Listen to the episode on Spotify here or on your favorite podcast platform and check out the Urban Monk Academy here.

Podcast show notes:

[00:00:00] Introduction to GLP-1s and Gateway to Health

• Dr. Shojai introduces the topic of GLP-1 medications and their impact on hormones
• Setting the stage for understanding whether these shots are right for you

[00:02:00] GLP-1s Aren’t New—Your Body Already Makes These Hormones

• Understanding that pharmaceutical companies are leveraging chemistry already happening in our bodies
• The body naturally produces weight-health hormones: GLP-1, GIP, PYY, CCK, GLP-2

[00:03:00] The Difference Between Biosimilar and Bioidentical

• Natural hormones work for 2-5 minutes before deactivation
• GLP-1 medications stay active 24/7 for about a week
• These are hormone replacement therapies, not solving the root problem
• Why aren’t our own hormones reaching their receptor sites?

[00:05:00] Root Cause vs. Symptom Management

• The inconvenient truth about lifestyle, food production, and eating habits
• Moving beyond the “Advil after tequila” approach to health
• Understanding why these hormones aren’t being produced or circulating properly

[00:07:00] The Epidemic of Suboptimal Weight-Health Hormone Function

• Two key reasons for hormone dysfunction: digestive system damage and modern environmental cues
• Pre-industrialization motion detectors vs. modern need for a “force field”
• The role of vagus nerve, brain inflammation, and digestive health

[00:08:00] The Microbiome and Gut Lining Connection

• Weight-health hormones are made in the digestive tract lining and secreted through alan kay cells
• Impact of stress, toxins, and food on the gut lining
• The metabolically active mucosal layer and its crucial role

[00:09:00] Beyond the Tube: Understanding the Gut Lining

• Short-chain fatty acids and beneficial bacteria like Akkermansia
• How signals from the vagus nerve trigger hormone secretion
• Hormones travel via bloodstream or vagus nerve to receptor sites throughout the body

[00:10:00] The Downstream Effects of Gut Dysfunction

• Appetite dysregulation, blood sugar issues, and fat allocation
• Muscle, bone, and hydration all regulated by these hormones
• Impact on cognitive function and heart health

[00:11:00] The Traffic Jam Analogy

• Inflammatory cascades and cytokine activation blocking hormone delivery
• The importance of harmony in digestion
• Testing for food sensitivities (IgG, IgA) to identify inflammatory triggers

[00:12:00] The Inconvenient Truth About Food Sensitivities

• Drug companies promise easy solutions without lifestyle changes
• The challenge of implementing dietary restrictions
• Why pharmaceutical messaging can be problematic

[00:13:00] Choline, Supplementation, and Nutrient Optimization

• When food restrictions create nutrient gaps
• The role of choline in methylation and metabolic function
• Why prenatal nutrients matter throughout life

[00:14:00] Glutamine and Gut Repair

• Lessons from the burn unit about tissue regeneration
• “Really Dumb Amounts” (RDAs) vs. optimal nutrition
• Why we need more than minimum requirements

[00:15:00] The Magnesium Myth

• DRIs established in 1997 based on outdated assumptions
• Why women actually need more magnesium than recommendations suggest
• Optimal resourcing vs. minimum requirements

[00:16:00] Ashley’s Personal Journey

• From childhood antibiotics and chronic infections to obesity
• Twenty years of dieting and restriction without understanding root cause
• The seven-day goat’s milk cleanse that didn’t work

[00:17:00] The Gastroenterologist Who Changed Everything

• “It’s not what you’re eating or not eating—your digestive system doesn’t have what it needs”
• This single insight transformed Ashley’s approach to weight health
• Focusing on resourcing the digestive system vs. restriction

[00:18:00] The Operating System Problem

• Every diet focuses on what to eat, missing the underlying operating system
• GLP-1s slow digestion and delay gastric emptying for 24 hours
• These medications can exacerbate underlying digestive issues

[00:19:00] No Free Lunch with GLP-1s

• Every medication has a story about side effects and what happens when stopping
• The promise of “easy” always comes with complications
• Simplifying what sounds complicated for sustainable success

[00:20:00] Using GLP-1s as a Tool, Not a Solution

• Ashley uses and recommends these medications strategically
• The reality of food noise and trauma from failed attempts
• Importance of supporting the body regardless of medication choice

[00:21:00] The Three-Hour Pit Stop Strategy

• Moving beyond “30 minutes of exercise per day” recommendations
• Your body is meant to be active, not sedentary with brief exercise bursts
• Breathing, movement, and stress management throughout the day

[00:22:00] Recognizing Your Stress Signals

• Ashley’s personal stress indicators: talking fast, raised shoulders
• On a 1-10 scale, digestion shuts down at 7 or above
• Even superfoods won’t help if you’re not absorbing nutrients

[00:23:00] The Race Car Pit Stop Analogy

• Every 3 hours: breathing, bathroom, movement, nutrient-balanced meal, mental reset
• Stop thinking in daily totals, start thinking in consistent intervals
• 10 ounces of water every few hours vs. massive daily intake

[00:24:00] Protein Distribution Throughout the Day

• 15-40 grams of protein per pit stop vs. total daily amounts
• Breaking up with incorrect nutrition messages
• Chapter One of the book: “Shit to Unlearn”

[00:25:00] The Gut Test Recommendation

• Dr. Shojai’s discount for listeners on comprehensive gut testing
• Understanding what’s causing inflammation before spending $1200/month on shots
• Testing reveals easily solvable problems

[00:26:00] Listening to Internal Signals

• Interoception vs. exteroception
• The vagus nerve as a two-way communication highway
• Regaining agency over your body’s wisdom

[00:27:00] The Problem with Digital Health and Lab Testing

• Over-reliance on data collection without understanding context
• “It was the almonds!” oversimplification
• Lab results don’t tell you what’s actually going on

[00:28:00] Low Iron Example: 15 Different Causes

• Testing doesn’t reveal root cause
• The fiber-for-constipation mistake, especially with GLP-1s
• First two days post-injection: focus on motility, not fiber

[00:29:00] Gamifying Body Assessment

• Sweet taste bud test: bite into an apple, rate sweetness 1-10
• This reveals if you’re overusing non-nutritive sweeteners
• Assessment tools instead of just prescriptive advice

[00:30:00] Hose vs. Sponge: The Hydration Assessment

• If you drink water and pee within 2 hours, you’re a “hose”
• Water needs to be absorbed to bring nutrients into cells
• Comprehensive digestive assessment: breath, gas, skin, energy, fullness

[00:31:00] The Proton Pump Inhibitor Problem

• Most people prescribed PPIs actually have low acid, not high
• Low stomach acid = poor protein breakdown and nutrient absorption
• Creating downstream problems with B12, calcium, and inflammatory undigested protein

[00:32:00] Beyond One-Time Assessments

• Doctors and dietitians often assess only once
• Ongoing questions reveal patterns: hair loss, tinnitus, satiety signals
• Ashley never felt full as a child due to destroyed hormones

[00:33:00] The Limits of DIY Testing

• Don’t buy tests and self-prescribe supplements
• Lab data alone won’t guide you to better health
• The analog gold: wisdom, relationships, listening

[00:34:00] The Protein Paradox

• Functional medicine’s 1 gram per pound recommendation
• Many people lack the enzymes or HCL to handle that amount
• Then they fail, feel bad, and turn to GLP-1s

[00:35:00] Protein Going Into Body ≠ Protein to Muscle

• Excess undigested protein causes inflammation
• GLP-1s delay gastric emptying, further impairing protein breakdown
• Focus on what your body can absorb, not arbitrary amounts

[00:36:00] Breaking Down Protein Throughout the Day

• Above 150g daily requires optimal digestion
• Distribute protein across pit stops for better absorption
• The boss analogy: 5 hours of work dropped at once vs. spread throughout the day

[00:37:00] Amino Acid Diversity Matters

• Creatine requires three different amino acids
• Eating only chicken and eggs misses crucial amino acids
• 200-pound person: 150g split into 3-5 pit stops

[00:38:00] Signals Over Numbers

• Body composition, workout recovery, hair/skin/nails
• Energy and mood reveal if protein intake is optimal
• Strategic amino acid optimization for different body types

[00:40:00] The Chicken-Only Diet Problem

• Eating one protein repeatedly with leaky gut creates antibodies
• Six months later: you can’t eat chicken anymore
• Orthorexic patterns lead to limited food options and eventual failure

[00:41:00] Reframing Your Relationship with Food

• The tantalizing promise of fitting into that dress
• How to hack your own hormones naturally

[00:42:00] The Pizza-Making Analogy

• Crust = digestion and hydration
• Sauce = nutrition (quantity, quality, timing, balance)
• Cheese = lifestyle (joy, stress, breathing, sleep, movement)
• Toppings = supplements and medications (including GLP-1s)

[00:43:00] GLP-1 Agonists vs. Future Medications

• Second-generation (semiglutide, tirzepatide) are biosimilar to our hormones
• Future generations may not be biosimilar—concerning parallel to Cox-2 inhibitors and statins
• The body receives biosimilar hormones as its own

[00:44:00] GLP-1 Activators: The Alternative

• Amarasate (hops from New Zealand) increases GLP-1 and PYY by 600%
• Case study: 42-year-old perimenopausal patient avoiding agonists
• Used activator as bridge to implement full optimization plan

[00:45:00] When Trauma Prevents Implementation

• Decades of dieting create body trauma
• Post-bariatric surgery complications
• The topping on a pizza: great topping on bad pizza = bad pizza

[00:46:00] Fix the Root Cause, Everything Else Follows

• Weight loss, better skin, improved appearance
• People spend money on peripheral promises
• The solution is always the same: fix digestion and gut health

[00:47:00] Ashley’s Vulnerability and Your Best Shot Book

• Writing books is hard work, especially being vulnerable
• Rags-to-riches health story helps others
• Patient stories included throughout

[00:48:00] The Ongoing Journey at 52

• Not rags to riches—it takes intentional effort
• Hormone shifts at 45-46 required totally new approach
• Getting traumatized by belly fat returning

[00:49:00] The Fasting Mistake

• Trying every tool: fasting, CGMs, ProLon
• Friend’s insight: “You need to eat, and eat on waking”
• Doubling down on digestive work during hormonal transitions

[00:50:00] Creating Generational Weight Health

• Sex hormones (testosterone decline, perimenopause) impact digestion
• Using GLP-1s right could help create healthier future generations
• Shifting DNA and generational challenges by addressing root causes

Key Takeaways:

• GLP-1 medications are biosimilar hormone replacements, not solutions to root causes
• Your body naturally produces these weight-health hormones when digestion is optimized
• Gut lining health, vagus nerve function, and microbiome diversity are foundational
• Think in 3-hour pit stops instead of daily totals for food, water, movement, and stress management
• Protein absorption matters more than protein consumption
• Lab tests and data don’t replace understanding your body’s signals
• Whether using GLP-1s or not, you must optimize your body’s operating system
• Fix digestion first, and weight loss, energy, and appearance follow naturally

Resources Mentioned:

• Ashley Koff’s book: “Your Best Shot”
• Gut testing (discounted for listeners)
• Amarasate (GLP-1 activator)

Guest Information: Ashley Koff, RD – Registered Dietitian specializing in weight health and digestive optimizationg

This episode is for educational purposes only and not intended as medical advice. Consult with qualified healthcare practitioners for personalized guidance.

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