At her heaviest, Ali weighed 410 pounds. That's the last number she saw, because that's when she stopped getting on the scale.

WHAT WE GET INTO

How a spinal surgery and the treatment that followed led to 230 pounds of weight gain

The appointment that nearly ended her search for help, and why she still remembers the room

Why she chose a sleeve over a gastric bypass, and why Dr. Weiner pushed back at the time

What changed when GLP-1s arrived, and why a sleeve plus a GLP-1 now competes with a bypass

Why semaglutide did almost nothing for her and tirzepatide worked, and why nobody can predict which

Paying cash, stretching doses, and Dr. Weiner on why financial harm is harm too

What she actually eats, and why she got rid of her microwave

ONE-derland, loose skin, and why Dr. Weiner says she's already past her goal weight

Learn more about Pound of Cure Weight Loss: https://poundofcureweightloss.com

Weight loss therapist Lora Grabow, LMSW has spent 23 years working with medical and surgical weight loss patients, and she says the same piece is still missing from almost every treatment plan. She calls it headwork.

Mindset is about what you think. Headwork is about what to do with what you think, and that difference is the whole episode.

Lora joins Dr. Weiner and Zoe for a conversation that goes from the practical to the personal. She walks through her three-step "power of the pause" framework using a real scenario (it's 11pm, you're anxious about work tomorrow, and you're standing in the kitchen), explains why shame is the single biggest barrier to behavior change, and gets honest about her own decision to start a GLP-1 this past June after a hysterectomy and perimenopause left her doing everything right and getting nowhere.

That last part is the moment of the episode. Lora caught herself in the exact thinking she coaches patients out of every day, believing she had to earn help.

What we get into

• Headwork vs. mindset, and why "information only turns into transformation when you know what to do with it"
• The power of the pause, Lora's three tips for food noise: catch the thought, name the feeling, then choose how you respond
• Why we say "I'm feeling anxious," not "I'm anxious", because we are not our feelings
• Shame vs. guilt, through Brené Brown's framing: shame says I am a mistake, guilt says I made a mistake. One drives binge eating and isolation. The other drives change.
• Obesity is a disease, not a decision, and why Lora describes her role as a "shame lifter"
• Lora's GLP-1 story, from the menopause middle to the friend at breakfast who asked the question that stopped her in her tracks
• What actually got quiet for her, and it wasn't food noise, it was how hard she was being on herself
• Dr. Weiner's bell curve: roughly 15% of people do great on GLP-1s no matter what, roughly 15% won't respond at all, and the 70% in the middle almost never show up on your feed. That's where headwork, nutrition, and exercise decide the outcome.
• Numbing vs. coping through, and the lidocaine shot analogy that explains why food, phones, and doom scrolling all make the next round harder
• "Dead people goals", Dr. Susan David's line about the only people not feeling uncomfortable emotions
• Community is treatment, and the mic drop question Lora asks at the end of every support group

Free workshop from Lora:

What Happens After the Food Noise Gets Quiet? Tuesday, September 16 at 7:00pm Eastern. Completely free, no limit on attendance, and a replay goes out to everyone who registers.

Lora is walking through her brand new headwork framework and taking attendees through a live exercise on root cause work and patterns. If this conversation resonated, this is the deeper version of it.

👉 Register at loragrabow.com

Find Lora

• Website and Headwork Matters newsletter: loragrabow.com
• Instagram: @lora.grabow
• Facebook: Lora Grabow, LMSW
• Substack: https://substack.com/@lora809857

What does long-term success after bariatric surgery look like four years later, especially when GLP-1 medications, strength training, nutrition, and maintenance all become part of the journey?

In this episode, Zoe and Dr. Matthew Weiner are joined by Graham Hoffman, a Pound of Cure patient and peer leader, to talk about life four years after weight loss surgery. Graham shares how GLP-1 medications, strength training, walking, protein-forward nutrition, and long-term support helped him move beyond the number on the scale and build a healthier, more sustainable lifestyle.

They discuss why strength training can be more approachable than endless cardio, how building muscle supports metabolism after bariatric surgery, and why success is not just about reaching a goal weight. Graham also explains how GLP-1s helped reduce food noise, support maintenance, and make it easier to listen to hunger and fullness cues.

They also talk about real-life nutrition strategies after weight loss surgery, including protein coffee, blueberries for fiber, prepared meals, protein-forward snacks, roasted vegetables, planned indulgences, and learning how to leave food on the plate without guilt or shame.

Most importantly, Graham explains why long-term weight loss maintenance is not about being perfect. Sustainable success comes from consistency, support, strength, flexibility, and building habits that can actually last.