GLP-1s vs Aggressive Dieting: What the Research Actually Shows

In this episode of Mastering Menopause, I follow through on a promise from my last episode and dive into the research comparing GLP-1 medications with aggressive dieting and the results surprised a lot of people.

This is not a GLP-1 bash. These medications absolutely have their place, especially in diabetes management. But when it comes to fat loss, inches lost, and momentum, the data tells a different story.

I reference and credit Not Another Nutrition Podcast, where Martin MacDonald breaks down this study in detail. Please give it a listen, it's way more in depth as Martin tackles common misconceptions like “GLP1s are the easy way out,” “Aggressive Diets require extreme willpower,” & “Pills do not change habits!” and explains why both GLP1s and Aggressive Diets remove food noise in different ways.

A 12-week study conducted at the University of Nottingham that directly compared:

• A GLP-1 group using semaglutide
• An aggressive diet group
• A combination of both

The results were clear.
The aggressive diet group lost more than double the weight, 29 pounds vs 13 pounds, with significantly greater fat loss, despite the appetite suppression effects of GLP-1s. Even more surprising, combining GLP-1s with aggressive dieting did not improve results at all. No extra fat loss. No better adherence. No added benefit.

I also talk about:

• Why aggressive dieting does not require more willpower when done correctly
• Why there were zero dropouts in the aggressive diet group
• How GLP-1 users often struggle to eat enough protein due to nausea
• Why muscle loss is a real concern for midlife women using GLP-1s
• Why aggressive dieting removes food noise, decision fatigue, and burnout

If you’re a woman in your  50s who’s been stuck eating 1,200 calories, frustrated by slow progress, or wondering whether GLP-1s are your only option, this episode will challenge what you’ve been told.

This conversation isn’t about extremes.
 It’s about choosing the right strategy, at the right time, for the right goal.

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