02/03/2026
Medical Case Mondays š§¬
Higher doses donāt fix the wrong problem.
This patient was on an extremely high GLP-1 dose and still battling constant food noise. Thatās your red flag. When appetite regulation fails at that level, the issue isnāt willpower or medication strengthā¦itās physiology.
Her labs told the real story:
⢠severely low testosterone
⢠significant anemia
That combination drives neuropeptide Y a powerful hunger signal in the brain that overrides GLP-1 therapy. Translation: the body is compensating for what itās missing.
Once we corrected the deficiencies, the food noise resolved.
Only then did GLP-1 therapy work at a much lower dose.
Data first. Dosing second.
This is why optimization without labs is guesswork.
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MJ. Gandon RN, MSN, FNPgandon .medical