The GLP-1 Problem No One Is Talking About: A New Metabolic Approach

GLP-1 receptor agonists have transformed weight loss and metabolic health—but what are we overlooking? In this episode of New Frontiers in Functional Medicine, Dr. Kara Fitzgerald is joined by Dr. Sanjay Bhojraj and Dr. Alexis Gonzales to explore the clinical tradeoffs of GLP-1 therapy, including lean muscle preservation, nutrient status, weight regain, and long-term metabolic health.

The conversation also examines SiPore, an engineered silica-based intervention that works locally in the GI tract to slow the breakdown and absorption of carbohydrates and fats. Dr. Fitzgerald and her guests discuss findings from the randomized, double-blind, placebo-controlled SHINE trial, including outcomes related to A1c, visceral fat, waist circumference, cholesterol, and lean mass.

They also explore how CGMs can reveal post-meal glucose patterns, why muscle preservation matters during weight loss, and how clinicians can support patients transitioning off GLP-1 medications—including those preparing for pregnancy, IVF, or surgery.

Full show notes + references: https://www.drkarafitzgerald.com/fxmed-podcast/

GUEST DETAILS

Sanjay Bhojraj, MD, FACC is an interventional cardiologist and Fellow of the American Academy of Anti-Aging Medicine specializing in cardiometabolic health, longevity medicine, and precision cardiovascular prevention.

He’s the founder of the Laguna Institute of Functional Medicine. His programs focus on reversing metabolic dysfunction, improving resilience, and reducing cardiovascular risk through lifestyle optimization and advanced diagnostic testing.

Dr. Alexis Gonzales ("Dr. G") is OvationLab’s Senior Clinical Implementation and AI Specialist, translating breakthrough research into practical clinical workflows, and holds advanced degrees in biochemistry (Saint Mary’s), biotechnology (Johns Hopkins), and naturopathic medicine (Bastyr).

She provides concierge functional-medicine care at her private practice in California—focusing on endometriosis, fertility, PCOS, and menopause—while distilling emerging research into practical frameworks at conferences to make integrative solutions accessible.

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