Weight and Metabolism

You didn't decide to reach for your phone the moment you woke up. You didn't choose to pour that second cup of coffee on autopilot, take the same route to work, or find yourself halfway through a bag of chips before you even registered what you were eating. Your brain decided. And it did so in milliseconds, without consulting you at all. That's not a failure of awareness. That's a habit — and in P...

You finally get the thing you wanted. The meal, the moment, the reward you've been looking forward to all week. And for a brief, beautiful window — it's everything. And then it isn't. And then you want more. If that cycle feels familiar, this episode is going to explain exactly why. In Part 5 of this series, Dr. Deepti Sharma unpacks hedonic pleasure — one of the most powerful and least understood...

You are not broken. You are not lazy. You are not lacking discipline. You are, in fact, doing exactly what a hundred thousand years of human evolution designed you to do. In Part 4 of this series, Dr. Deepti Sharma introduces one of the most clarifying frameworks she brings into her clinical practice: the pleasure triad. The deeply biological drive to seek comfort, conserve energy, and avoid pain...

If you've ever reached for food when you weren't hungry, poured a drink to take the edge off, scrolled until midnight to avoid your own thoughts, socialized mindlessly, filling your time with plans that drain you or binge watched Netflix/OTT every day pushed yourself into exhaustion just to feel in control — this episode is not here to judge you. It's here to explain to you. In Part 3 of this seri...

Trauma doesn't just live in memory. It lives in the body — in a nervous system that never got the signal that it was safe to stand down.  You may have come to Dr. Deepti Sharma looking for answers about your weight, your energy, your hormones, or your metabolic health. But in Part 2 of this series, she's going to ask you to look a little further back. In this she picks up where the ACEs conversati...

In this foundational episode, Dr. Sharma — triple board-certified physician, certified Menopause Practitioner, and certified life coach — unpacks adverse childhood experiences from the ground up. What counts as an ACE. Why the metabolic consequences of early trauma can look like willpower problems, lifestyle failures, or "unexplained" disease — and why that framing is wrong. ACEs aren't just a chi...

In the next few episodes, I want to talk about the contributing factors or causes of obesity in detail. The number one thing is genetics. Genetic predisposition plays a foundational role, influencing metabolic processes, fat storage, and appetite regulation. However, genetics alone do not dictate outcomes. This introduces the concept of epigenetics, which refers to changes in gene expression due t...

Let's talk about what obesity actually does to your body — not to shame or scare you, but so you understand what's really at stake. In this episode, I walk through the hard science: obesity is an independent risk factor for sudden and premature death. All-cause mortality increases progressively with higher BMI, especially once you cross a BMI of 30. In the U.S. alone, obesity contributes to an est...

Let's talk about just how big this problem really is — because the stats are staggering. In 2022, 1 in 8 people globally were diagnosed with obesity. Adult obesity has more than doubled since 1990. Adolescent obesity? It's quadrupled . Here in the U.S., the numbers are even more alarming: more than 2 in 5 adults (42.4%) have obesity , and 1 in 11 adults have severe obesity. Among children and adol...

In this episode, let's talk about stress eating, also called emotional eating. It's when you eat in response to emotions rather than physical hunger. It's usually a way to cope with stress, anxiety, sadness, boredom, or even excitement. Why does it happen? Stress triggers the hormone cortisol in our body, which increases appetite and cravings, especially for sugary, salty, or high-fat foods. Eatin...

In this episode, I'm talking about glycemic index. The glycemic index is a system that ranks carbohydrate foods based on how quickly they raise your blood sugar levels after being eaten. The scale typically ranges from 0 to 100, with higher values indicating foods that cause a rapid increase in blood glucose. Imagine your body as a fireplace and food as the logs you throw in it. The glycemic index...

In this episode, Dr. Deepti Sharma sits down with Erica Rooney from Walk West to pull back the curtain on why this podcast exists — and what drives her work in obesity and lifestyle medicine. You'll hear Dr. Sharma get personal about the patient story that changed everything, the 30-year-old with undiagnosed diabetes who passed away suddenly, leaving behind young children. That moment shifted her...

In this episode, we're talking about metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO). These terms describe different metabolic profiles in people with obesity. Despite similar BMI, these two categories differ significantly in terms of their risk for developing obesity-related complications like cardiovascular disease, type 2 diabetes, and other metabolic disorders. In...

Diagnosing and treating obesity is really challenging due to a variety of barriers that can be broadly categorized into patient-related, healthcare provider-related, and systemic barriers. Let's break them down. Patient-related barriers include stigma and shame, which deter people from seeking help. Lack of awareness means some don't recognize they have obesity or underestimate the health risks. P...

Obesity is one of the most complicated diseases we face today. By the time people walk into my office, they've already tried multiple diets, cleanses, detoxes, and exercise programs, and they often feel frustrated or defeated. So how do we begin? Today, I'll walk you through how I approach the initial workup in my practice and why it matters. Every visit starts with the basics: weight, height, BMI...

So far in this series, we've explored the biology of obesity: genetics, hormones, the gut-brain axis, and set point theory. But biology isn't the whole story. The world we live in, our environment, our communities, and daily stresses shape health in very powerful ways. And if we want to change the story of obesity, we can't just focus on the individual. We have to focus on the environment. This is...

Meet Sarah. Over the last decade, she's tried everything: keto, intermittent fasting, juice cleanses, low-fat diets. Every time, the pattern is the same. She loses 20 pounds, and within months the weight creeps back. Sometimes she ends up even heavier than before. If you've ever felt like Sarah, you're not alone. This cycle of weight loss followed by weight regain is so common it has a name: yo-yo...

If you've ever lost weight on a diet only to see it creep back within months, you're not alone. Your experience reflects one of the most important theories in obesity science: the set point theory. Our bodies love balance, what scientists call homeostasis. Just like we regulate blood pH and body temperature very tightly, we also regulate fat mass. It's all about biology. The set point theory sugge...

Why is losing weight so hard and keeping it off nearly impossible? The answer lies in how our brain and gut are wired to protect fat mass, just like they protect red blood cells, bone, or muscle mass. Every nutrient we consume has receptors in the gut that signal to the brain, telling it how to regulate energy production, storage, and use. When you go on a calorie-restricted diet, your body interp...

Energy balance sounds simple: calories in versus calories out. But it's actually a delicate conversation between the gut and the brain, orchestrated by the hypothalamus. Your brain and gut are in constant dialogue through the gut-brain axis, and this is the "neuro" piece of neurohormonal regulation. For most of human history, diets were simple and unprocessed. Then came urbanization, industrial fo...

Our gut constantly talks to our brain through a symphony of hormones that control hunger, fullness, and energy balance. Some hormones rev up appetite, while others apply the brakes. In this episode, we explore the key players: ghrelin (the hunger hormone), GLP-1, GIP, PYY, and other satiety hormones that tell your brain when to stop eating. We also talk about the pancreatic hormones like glucagon,...

When people say "I'm doing everything right, but the weight won't come off," the answer often lies in insulin resistance . Insulin is the key that unlocks your cells so glucose can enter. Once inside, your body can burn it for energy, store it as glycogen, or convert it to fat. In a healthy system, this works seamlessly. But here's where things go wrong. Insulin Resistance: When you constantly eat...

In 1994, scientists discovered leptin, a hormone made by fat cells that tells your brain you've had enough to eat. They thought it was the cure for obesity. But here's the twist: most people with obesity don't have too little leptin. They have too much. Their brain just isn't listening. This is called leptin resistance. Leptin is your body's appetite thermostat. When it works, it regulates hunger...

Obesity isn't just about food and calories. It's about a highly complex network of hormones that tells you when to eat, when to stop, and how much energy to burn. When that system gets disrupted, everything changes. The Key Hormonal Players: Leptin tells your brain "we have enough energy, stop eating." But in obesity, the brain stops listening (leptin resistance), so you feel hungry even when you'...

In the last episode, we talked about how genetics play a huge role in obesity — shaping metabolism, appetite, and fat storage. But here's the catch: your genes aren't your destiny. Today, we're diving into epigenetics — the field that explains how your environment and lifestyle choices interact with your genes, deciding which ones get turned on or off. Think of it as the software that runs on your...