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Extend Podcast with Darshan Shah, MD

Extend Podcast with Darshan Shah, MD

129. Ashley Koff: The GLP-1 Conversation Most People Are Missing

Jan 13, 2026 · 1h 2m

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About this episode

Most people think weight loss is about discipline, calories, or finding the right medication. But what if the real issue is that we've misunderstood how hormones, digestion, and recovery actually regulate metabolism in the first place? In this episode of Extend, we sit down with registered dietitian Ashley Koff to unpack what GLP-1 medications are really doing in the body and why bariatric surgery revealed metabolic changes long before significant weight loss ever occurred. We explore incretin hormones, vagus nerve signaling, and why appetite, blood sugar, and inflammation are part of a much larger hormonal ecosystem. We also dive into the often-missed pieces of the GLP-1 conversation,…