Metabolic Mind

How can clinicians use real-world patient data to personalize metabolic health care? In this episode of Metabolic Mind, Dr. Bret Scher speaks with Dr. Jeff Pua, an internal medicine and obesity medicine physician, about obesity medicine, metabolic syndrome, nutritional ketosis, and what clinicians can learn from patient outcomes in everyday practice.
Dr. Pua shares how his approach has evolved from relying only on broad research categories to also paying close attention to individual patient experiments, blood tests, and lived experience. In his practice, he sees patients improve not only in weight and metabolic markers, but also in mood, mindset, mental sharpness, and confidence as they begin to see measurable changes in their own health.
They cover:
How obesity medicine is evolving beyond the number on the scale
Why metabolic syndrome is a major focus in Dr. Pua’s practice
How N-of-1 patient data can help clinicians personalize care
What blood tests can reveal about real-world metabolic improvement
Why nutritional ketosis can be a helpful benchmark for some patients
How nutrition, physical activity, and behavior change work together
Why exercise may become more accessible once metabolic health improves

This conversation offers a clinician’s view of how metabolic health care can become more personalized, measurable, and empowering for patients.
👉 Want to stay up to date with the latest research on metabolic health and metabolic psychiatry? Sign up for our newsletter to stay informed: metabolicmind.org/about-us/newsletter/
🔎 Have questions about how to apply metabolic therapies effectively? Submit them at metabolicmind.org/questions to be featured in a future Metabolic Mailbag episode.
#MetabolicMind #KetogenicTherapy #ObesityMedicine

Expert Featured:
Dr. Jeffrey Pua
https://www.drjeffreypuamd.com/
https://www.instagram.com/drjeffreypuamd/
http://linkedin.com/in/jeffrey-pua-a15627317

Free CME Clinician Trainings:
Are you a clinician who would like to learn more about the science behind these therapies and how to implement them in practice? Earn CME with our growing library of courses from some of the top experts in the field including Dr. Chris Palmer, Dr. Georgia Ede, Dr. Matthew Bernstein, Dr. Mariela Glandt, Dr. Deanna Kelly, Dr. Julie Milder, Dr. Zoltan Sarnyai, and Dr. Bret Scher with more coming soon.
Our courses have been made FREE by grants from Baszucki Group, so we can spread these powerful therapies as widely as possible. Earn CME/CNE credits:
https://www.metabolicmind.org/for-clinicians/trainings-courses/?utm_medium=organic-social&utm_source=youtube&utm_campaign=cme-yt

Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.
Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/

About us:
Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.
Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

Can chronic stress undermine metabolic health, even when nutrition, sleep, and exercise are in place?
In this episode of Metabolic Mind, Dr. Bret Scher explains why stress recovery is an important part of metabolic health and how chronic cortisol and adrenaline activation may affect insulin resistance, blood pressure, inflammation, sleep, and long-term cardiometabolic health.
Dr. Scher breaks down the difference between short-term stress that helps us respond to challenges and chronic stress that keeps the body’s alarm system switched on. He also shares why stress recovery doesn’t have to mean an hour of meditation or a weekend nature retreat. Even brief, consistent practices like 10 minutes outside, a short walk, sunlight exposure, calming music, or nature sounds may help the nervous system reset.
In the episode, Dr. Scher covers:
How chronic stress can affect blood sugar, insulin resistance, and blood pressure
Why cortisol and adrenaline are helpful short term but harmful when constantly elevated
How stress can disrupt sleep, cognition, inflammation, and metabolic health
Why meditation works for some people, and why consistency matters more than duration
How nature exposure, sunlight, and natural sounds may support stress recovery
Why recognizing early stress signals can help prevent bigger health consequences
How small daily recovery practices can support cardiovascular, metabolic, and brain health

Regular recovery practices give your stress response somewhere to land. A few minutes of meditation, a walk outside, sunlight, music, or even nature sounds can help support steadier blood sugar, better sleep, and a brain and body that aren’t constantly running on high alert.
👉 Ready to build your own metabolic mental health plan? Explore THINK+SMART, our free, evidence-informed program designed to help you work with your care team and take practical steps toward supporting metabolic and mental health: metabolicmind.org/thinksmart/
🔎 Have questions about how to apply metabolic therapies effectively? Submit them at metabolicmind.org/questions to be featured in a future Metabolic Mailbag episode.
#MetabolicMind #KetogenicTherapy #NationalWellnessMonth

Expert Featured:
Bret Scher, MD - Baszucki Group Medical Director & Host of the Metabolic Mind Podcast
https://www.linkedin.com/in/bret-scher-08baaa102/
https://www.instagram.com/drscher858/?hl=en
https://x.com/bschermd

Free CME Clinician Trainings:
Are you a clinician who would like to learn more about the science behind these therapies and how to implement them in practice? Earn CME with our growing library of courses from some of the top experts in the field including Dr. Chris Palmer, Dr. Georgia Ede, Dr. Matthew Bernstein, Dr. Mariela Glandt, Dr. Deanna Kelly, Dr. Julie Milder, Dr. Zoltan Sarnyai, and Dr. Bret Scher with more coming soon.
Our courses have been made FREE by grants from Baszucki Group, so we can spread these powerful therapies as widely as possible. Earn CME/CNE credits:
https://www.metabolicmind.org/for-clinicians/trainings-courses/?utm_medium=organic-social&utm_source=youtube&utm_campaign=cme-yt

Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.
Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/

About us:
Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.
Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

Could GLP-1 medications play a role in treating bulimia or binge eating disorder? In this episode of Metabolic Mind, Dr. Bret Scher speaks with Paige Gordon and psychiatrist Dr. Michael Lutter about Paige’s personal experience using a GLP-1 medication for treatment-resistant bulimia, and why researchers are beginning to explore the neurobiology of binge eating.
Paige shares how years of therapy and medication never quieted the overwhelming binge urges that drove her bulimia. After hearing someone describe their experience on a podcast, she began exploring GLP-1 medication and saw a profound change in her urges and eating patterns. Dr. Lutter adds the scientific context, including genetic findings that may help explain why some people with binge eating or bulimia respond strongly to GLP-1 medications.
They cover:
How Paige’s bulimia began and why standard treatments didn’t fully help
What “food noise” felt like in her lived experience
Why GLP-1 medications may affect appetite, reward pathways, and binge urges
How genetics may help identify who responds to GLP-1s
Why eating disorder treatment needs more precision-focused research
The risks of using GLP-1 medications in people with restrictive eating disorders
Why stigma keeps many people from discussing this treatment openly

This conversation explores an emerging area of eating disorder research with hope, caution, and a clear need for larger clinical trials.
👉 Want to stay up to date with the latest research on metabolic health and metabolic psychiatry? Sign up for our newsletter to stay informed: metabolicmind.org/about-us/newsletter/
🔎 Have questions about how to apply metabolic therapies effectively? Submit them at metabolicmind.org/questions to be featured in a future Metabolic Mailbag episode.
#MetabolicMind #GLP1 #EatingDisorderTreatment

Expert Featured:
Paige Gordon
https://paigegordonauthor.com/
https://www.instagram.com/paigegordonauthor/
https://www.linkedin.com/in/paigegordon/
https://www.tiktok.com/@paigegordonauthor

Dr. Michael Lutter
https://precision-psychiatry.com/
https://www.linkedin.com/in/michaelluttermd/
https://www.youtube.com/@precisionpsychiatry

Free CME Clinician Trainings:
Are you a clinician who would like to learn more about the science behind these therapies and how to implement them in practice? Earn CME with our growing library of courses from some of the top experts in the field including Dr. Chris Palmer, Dr. Georgia Ede, Dr. Matthew Bernstein, Dr. Mariela Glandt, Dr. Deanna Kelly, Dr. Julie Milder, Dr. Zoltan Sarnyai, and Dr. Bret Scher with more coming soon.
Our courses have been made FREE by grants from Baszucki Group, so we can spread these powerful therapies as widely as possible. Earn CME/CNE credits:
https://www.metabolicmind.org/for-clinicians/trainings-courses/?utm_medium=organic-social&utm_source=youtube&utm_campaign=cme-yt

Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.
Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/

About us:
Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.
Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

Can ketogenic therapy improve symptoms, cognition, and metabolic health in people living with serious mental illness?
In this episode of Metabolic Mind, Dr. Bret Scher speaks with Dr. Judy Ford, Juliette Kyner (previously Juliette Ward), and Dr. Shebani Sethi about the first-ever randomized controlled trial of a ketogenic diet intervention in individuals living with schizophrenia spectrum disorder or bipolar I disorder with psychotic features.
The conversation explores what made this trial possible, from prepared meals and coaching to the structured support that helped participants stay engaged. It also highlights encouraging four-month findings across metabolic health, cognition, depressive symptoms, and both positive and negative psychiatric symptoms.
They discuss:
Why this trial is an important step for metabolic psychiatry
How participants adhered to a ketogenic diet with structured support
What changed in metabolic health markers like BMI, A1C, and HOMA-IR
Why cognitive improvements were especially meaningful
How positive symptoms, negative symptoms, and depressive symptoms changed over time
What family members noticed as participants re-engaged with daily life
Why future studies may need to be longer, larger, and more mechanistic

This trial marks an important step for metabolic psychiatry and points to the need for larger, longer, fully controlled studies that can better clarify how ketogenic interventions may affect metabolic, cognitive, and psychiatric outcomes.
👉 Learn more about this trial on our study page: First-Ever Randomized Controlled Trial of Ketogenic Diet in Schizophrenia-Spectrum and Bipolar I Disorder
🔎 Have questions about how to apply metabolic therapies effectively? Submit them at metabolicmind.org/questions to be featured in a future Metabolic Mailbag episode.
#MetabolicMind #KetogenicTherapy #Schizophrenia #BipolarDisorder

Expert Featured:
Dr. Judy Ford
https://bbrfoundation.org/about/people/judith-m-ford-phd

Juliette Kyner, Research Assistant at UCSF
https://www.linkedin.com/in/juliette-marie-kyner/

Dr. Shebani Sethi
https://www.metabolicpsychiatry.com/team
https://www.linkedin.com/in/drsethi/
https://x.com/ShebaniMD

Resources Mentioned:
Metabolic Improvements with a Ketogenic Diet Correlate with Symptom Improvement in Psychosis: A Randomized Controlled Trial
https://doi.org/10.1093/schbul/sbag082

Free CME Clinician Trainings:
Are you a clinician who would like to learn more about the science behind these therapies and how to implement them in practice? Earn CME with our growing library of courses from some of the top experts in the field including Dr. Chris Palmer, Dr. Georgia Ede, Dr. Matthew Bernstein, Dr. Mariela Glandt, Dr. Deanna Kelly, Dr. Julie Milder, Dr. Zoltan Sarnyai, and Dr. Bret Scher with more coming soon.
Our courses have been made FREE by grants from Baszucki Group, so we can spread these powerful therapies as widely as possible. Earn CME/CNE credits:
https://www.metabolicmind.org/for-clinicians/trainings-courses/?utm_medium=organic-social&utm_source=youtube&utm_campaign=cme-yt

Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.
Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/

About us:
Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.
Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

Do GLP-1 medications improve metabolic health as much as they support weight loss? A new observational study in the Annals of Internal Medicine raises an important question about semaglutide, insulin discontinuation, type 2 diabetes, and what meaningful metabolic improvement may require.
In this episode of Metabolic Mind, Dr. Bret Scher breaks down a real-world study of more than 9,000 veterans with type 2 diabetes who were using insulin and then added either a GLP-1 receptor agonist, SGLT2 inhibitor, or DPP4 inhibitor. Despite semaglutide’s stronger association with weight loss, the study found similar insulin discontinuation rates across all three groups over three years.
Dr. Scher covers:
Why weight loss and metabolic health improvements may not always move together
What insulin discontinuation can reveal about insulin resistance and beta cell function
Why semaglutide did not outperform older diabetes medications in this study
The limitations of observational research and real-world medication data
How GLP-1 medications and therapeutic carbohydrate reduction may work through complementary mechanisms
Why combining GLP-1s with therapeutic carbohydrate reduction may be an important area for future research and clinical practice

This conversation takes a closer look at what metabolic health means, and why the path from weight loss to insulin independence may be more complex than the scale alone can show.
👉 Want to stay up to date with the latest research on metabolic health and metabolic psychiatry? Sign up for our newsletter to stay informed: metabolicmind.org/about-us/newsletter/
🔎 Have questions about how to apply metabolic therapies effectively? Submit them at metabolicmind.org/questions to be featured in a future Metabolic Mailbag episode.
#MetabolicMind #KetogenicTherapy #GLP1

Expert Featured:
Bret Scher, MD - Baszucki Group Medical Director & Host of the Metabolic Mind Podcast
https://www.linkedin.com/in/bret-scher-08baaa102/
https://www.instagram.com/drscher858/?hl=en
https://x.com/bschermd

Resources Mentioned:
Comparative Effectiveness of Glucagon-like Peptide-1 Receptor Agonists Versus Oral Agents for Insulin Discontinuation in Type 2 Diabetes : A Target Trial Emulation
https://www.acpjournals.org/doi/10.7326/ANNALS-25-05216

Free CME Clinician Trainings:
Are you a clinician who would like to learn more about the science behind these therapies and how to implement them in practice? Earn CME with our growing library of courses from some of the top experts in the field including Dr. Chris Palmer, Dr. Georgia Ede, Dr. Matthew Bernstein, Dr. Mariela Glandt, Dr. Deanna Kelly, Dr. Julie Milder, Dr. Zoltan Sarnyai, and Dr. Bret Scher with more coming soon.
Our courses have been made FREE by grants from Baszucki Group, so we can spread these powerful therapies as widely as possible. Earn CME/CNE credits:
https://www.metabolicmind.org/for-clinicians/trainings-courses/?utm_medium=organic-social&utm_source=youtube&utm_campaign=cme-yt

Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.
Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/

About us:
Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.
Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.