Are GLP-1s Helping Us Avoid the Real Problem?

19 Oct Are GLP-1s Helping Us Avoid the Real Problem?

By Shanti Pappas

What if there’s something you’re actually enjoying about being stuck?

I know that sounds strange, especially if you’ve spent years frustrated with your weight, trying different diets, and telling yourself that this time you’re finally going to change.

Photo by Alena Darmel

But stay with me.

I’ve worked with women for over 15 years, and I’ve noticed something interesting. Many of the women who struggle most with making changes already know a tremendous amount about nutrition.

They know what they should be eating. They know they need to sleep more, move their bodies, and stop reaching for food every time they’re stressed.

So why don’t they?

I don’t think the answer is always a lack of discipline.

I think sometimes there’s something we’re getting out of staying exactly where we are.

Maybe food is the one thing you look forward to after a long day of taking care of everyone else.

Maybe staying up late watching television is the only time you feel like nobody needs anything from you.

Maybe you’ve been talking about losing the same 20 pounds for years, and as frustrating as that is, the struggle itself has become familiar.

The Idea of Secondary Gain

There’s a psychological concept called secondary gain. It refers to the benefits we sometimes receive from situations or behaviors we consciously want to change.

We may not like the consequences, but there’s something about the behavior that’s working for us.

I find this fascinating because it changes the conversation.

Instead of asking someone why she can’t stop snacking at night, I might ask what she enjoys about that time.

Is she hungry? Is she bored? Is she finally relaxing? Is eating the only thing she’s done for herself all day?

Those answers matter.

If food is providing comfort, pleasure, or relief, simply telling someone to stop eating it doesn’t address what she was getting from it.

And if we don’t address that, she’s likely to keep going back to the same behavior.

When the Plan Is Right but Follow-Through Isn’t

Of course, there are very real physiological reasons people struggle with weight. Insulin resistance, hormonal changes, poor sleep, medications, and appetite regulation all play a role. I spend a great deal of time working with clients on these issues.

But I’ve also learned that we can get someone’s nutrition dialed in, improve her sleep, and create a perfectly reasonable plan, and she can still have trouble following through.

That’s when I get curious.

What happens right before she abandons the plan? What is she feeling? What does she get to avoid by going back to the familiar routine?

And what would she have to give up if she actually made the change?

Sometimes we say we want something without fully considering what getting it might require of us.

Maybe it means setting boundaries with family. Maybe it means making time for ourselves instead of always putting everyone else first. Maybe it means finding a different way to manage uncomfortable feelings.

Those changes can be much harder than knowing what to eat for breakfast.

Understanding Instead of Shame

I don’t believe people need to be pushed, shamed, or held accountable for every bite they take. Most of the women I work with are already incredibly hard on themselves.

What they often need is an opportunity to understand themselves a little better.

To recognize what they’re doing, why they’re doing it, and whether it’s still serving them.

And sometimes that means being willing to admit something uncomfortable.

There may be a part of you that doesn’t want to give up the very thing you’re complaining about.

That doesn’t mean you don’t want to lose weight. And it certainly doesn’t mean you’re responsible for every obstacle you’re facing.

It just means there’s more to changing a behavior than knowing it’s bad for you.

If you’ve spent years starting and stopping diets, perhaps the next question isn’t what you should be eating.

Maybe it’s what you’re getting out of continuing to do what you’ve always done.

For a broader overview of weight management research, see this MedicalResearch.com overview of weight issues.

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Last Updated on October 19, 2026 by Marie Benz MD FAAD