The BariNation Foundation Podcast

Weight recurrence after bariatric surgery or GLP-1 treatment isn't a personal failure, it's often a natural part of treating the chronic disease of obesity. In this episode of the BariNation Foundation Podcast, April welcomes bariatric surgeon and obesity medicine specialist Dr. Saniea Majid to discuss her groundbreaking research on weight recurrence, why the medical community is moving away from the term "weight regain," and how ongoing, individualized care can improve long-term outcomes. Together, they explore the importance of eliminating shame, redefining success beyond the number on the scale, staying connected with your clinical care team, and empowering patients with practical strategies to navigate obesity treatment for life.

What You Will Learn in this Episode:
✅ Why weight recurrence after bariatric surgery is expected and why the word "failure" needs to be stricken from the conversation
✅ The three categories of response (partial, non, and clinically significant) and why each needs its own plan
✅ How consistent follow-up care and multidisciplinary care help prevent or reverse recurrence
✅ Practical ways to shift from shame to action while protecting metabolic wellness

This episode of the BariNation Podcast is produced by the BariNation Foundation, a 501 (c) (3) dedicated to advancing metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. Funding is provided by the generous donations to the BariNation Foundation from listeners and viewers like you, Johnson & Johnson, and the Texas Center for Bariatrics & Advanced Surgery, led by Dr. Joe Cribbins.

TIMESTAMPS:
00:00 Dr. Saniea Majid discusses weight recurrence after treatment and her research regarding standardizing terminology and data sets
04:42 Why patients avoid follow-up care after bariatric surgery
10:01 The wide range of reported weight recurrence after bariatric surgery rates
15:18 Health benefits that remain even with weight recurrence
24:19 The importance of follow-up care
29:15 Why the word failure is banned in modern obesity care
34:44 Recommended definitions for partial response and non-response
45:08 Advice for a listener stuck at limited weight loss two years later
50:32 Dr. Majid answers rapid fire questions related to obesity
01:00:57 Final thoughts on seeking the right team for lifelong care

KEY TAKEAWAYS:
💎 Weight recurrence signals the chronic nature of obesity and calls for more treatment, not self-blame
💎 Regular follow-up care with the right multidisciplinary team is the strongest tool against progression
💎 Revisional surgery and GLP-1 medications are part of continuum care, not last resorts
💎 Patients retain meaningful health gains even when some weight returns

ABOUT THE GUEST:
Dr. Saniea Majid is a board-certified bariatric surgeon and obesity medicine specialist, founder and Medical Director of the Weight Loss and Wellness Center in northern New Jersey. She has built multiple accredited metabolic and bariatric programs and was the first surgeon in the state to perform the SPATZ adjustable gastric balloon and endoscopic sleeve gastroplasty.
A national leader in the field, she just completed a 2 year term of the ASMBS Foundation TREO (Treatment, Research and Education to End Obesity), sits on the ASMBS Board of Directors, and is committed to comprehensive, compassionate care for patients of all ages, including adolescents.
Meet Dr. Majid – Award-Winning Weight Loss Doctor NJ | WLWC
Proposed Definitions and Clinical Recommendations for the Management of Weight Recurrence Following Bariatric Surgery

RESOURCES MENTIONED:
BariNation Community - $19 a month
BariNation Website
BariNation - Email
BariNation’s How to Find an Obesity Specialist Guide
Sign up for BariNation’s Newsletters
J&JMedTech

BariNation, Bariatric Surgery, NSVS, GLP-1, VSG, Vertical Sleeve Gastrectomy, Lapband, Roux-en-Y, Gastric Bypass, Sadi-S, Weight Regain After Bariatric Surgery, Weight Recurrence, Bariatric Surgery, Obesity Treatment, Metabolic Wellness, Follow Up Care, Chronic Disease, Multidisciplinary Care, Bariatric support, Bariatric patient education, Clinically Significant Weight Recurrence, Revisional Surgery, GLP 1 Medications, ASMBS, Shame And Blame, Weight Fluctuations, Surgical Success, Long-term weight loss maintenance

What if the biggest obstacle to getting the help you need isn't your body, but the belief that you have to earn it?

Even therapists struggle with shame, self-doubt, and asking for help. In this episode of the BariNation Foundation Podcast, April sits down with longtime therapist and BariNation supporter Lora Grabow, who shares her own journey through menopause, unexpected health changes, and the difficult decision to begin GLP-1 treatment. Despite decades of helping others heal their relationship with food, Lora discovered she had been holding herself to a different standard, believing she needed to "work harder" before deserving treatment. Together, April and Lora discuss the damaging myths surrounding obesity, menopause, self-worth, and medical care while exploring why community, self-compassion, and evidence-based treatment are essential for lasting health.

This conversation is a powerful reminder that you don't have to suffer in silence, you don't have to earn help, and hope begins the moment you allow yourself to receive the support you deserve.

What You Will Learn in this Episode:
Why obesity is a chronic disease, not a personal failing, and why that reframe lifts shame around GLP-1 weight loss
How menopause weight gain can stall even the healthiest habits, and why biology, not effort, is often the real barrier
Why self-compassion, not self-criticism, is the tool that actually leads to lasting behavior change
How community support helps people move past the belief that they must earn help before accepting it

This episode of the BariNation Podcast is produced by the BariNation Foundation, a 501 (c) (3) dedicated to advancing metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. Funding is provided by the generous donations to the BariNation Foundation from listeners and viewers like you, Johnson & Johnson, and the Texas Center for Bariatrics & Advanced Surgery, led by Dr. Joe Cribbins.

TIMESTAMPS:
00:00 Lora Grabow discusses her two decades in weight management and therapy
06:16 April sets the stage: doing everything right without results
07:48 Lora explains obesity as a chronic disease, not a decision
08:17 Lora shares her menopause weight gain and hormone therapy story
12:17 The friend who asked why Lora wasn't starting a GLP-1
17:15 Unpacking the belief that you must earn help before treatment and the power of community
26:48 Finding safe support in virtual spaces; April shares a personal story
31:20 How are we talking to ourselves and having self-compassion
41:57 Lora reflects on hope, healing, and life after starting Zepbound
46:04 Why it took Lora so long to go on a GLP-1, the many benefits of the drug

KEY TAKEAWAYS:
Shame keeps people stuck. Self-compassion is what actually opens the door to change.
Obesity is a chronic relapsing disease, and no one should have to manage it alone.
GLP-1 medications, like other metabolic wellness tools, aren't something you have to "earn."

ABOUT THE GUEST:
Lora Grabow, LMSW, is an obesity medicine therapist, coach, and professional speaker with over 20 years of experience working with patients in obesity medicine. Lora helps patients discover the missing piece of their treatment plan: A piece she calls Headwork™.
She is the owner of a thriving private practice serving patients affected by obesity. Her expertise includes providing individual therapy and 1:1 coaching, facilitating support groups, and engaging patients in her online course, Foundations in Headwork for Healthy Weight Loss. She is an active leader in the American Society for Metabolic and Bariatric Surgery. (ASMBS) She is a sought-after podcast guest and speaker at national provider and patient obesity medicine conferences.
Lora Grabow Instagram
Lora Grabow - Website

RESOURCES MENTIONED:
BariNation Community - $19 a month
BariNation Website
BariNation - Email
BariNation’s How to Find an Obesity Specialist Guide
Sign up for BariNation’s Newsletters
J&JMedTech

Episode 287: What if everything you believed about obesity was wrong? Bariatric surgeon Dr. Eric Smith joins the BariNation Foundation Podcast to launch a six-part series on Mastering Metabolic Health and Weight Management. Today's episode is about the first lever: Beyond the Scale...Obesity as a Chronic Disease. He explains why only 0.5 to 2% of people can lose enough weight through diet alone to no longer be classified as obese and what the hormones ghrelin and leptin have to do with it. Mental health therapist, bariatric patient and BariNation Foundation Board, Community member, and licensed expert, Melanie Lindell adds the emotional truth: accepting obesity as a chronic disease is not giving up; it is finally getting honest. This conversation will shift how you think about your body, your habits, and your future. Join us for this six-part series, Mastering Your Metabolic Health and Weight Management.

What You Will Learn in this Episode:
Why obesity as a chronic disease cannot be resolved through willpower alone, and what the actual success rates of diet and exercise reveal about the biology working against you
How the hormones ghrelin and leptin resistance change the way your body responds to calorie deficits, making sustainable weight loss far more complex than simply eating less
Why bariatric surgery and GLP-1 medications create the conditions for change but cannot replace the controllable habits that determine long-term metabolic health outcomes
How building consistent habits around sleep, whole food nutrition, and movement forms the true foundation of lasting obesity treatment success

This episode of the BariNation Podcast is produced by the BariNation Foundation, a 501c3 dedicated to advancing metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. Funding is provided by the generous donations to the BariNation Foundation from listeners and viewers like you, Johnson & Johnson, the Texas Center for Bariatrics & Advanced Surgery, led by Dr. Joe Cribbins.

TIMESTAMPS:
00:00 The psychology of results and why visible change drives obesity treatment commitment
04:00 Dr. Eric Smith and Melanie Lindell introduce themselves and the bariatric surgery series
08:04 The six levers of metabolic health and weight management are introduced
09:18 Why diet and exercise alone fail: success rates as low as 0.5% for obesity as a chronic disease
11:56 How triggering life events lead to obesity and why reversing behavior is not enough
23:44 The hormonal science of ghrelin and leptin resistance and their role in weight loss, and why the body fights back against calorie deficits
33:00 The golf analogy: why patients become complacent and stop applying controllable health habits
38:30 The danger of removing friction and how easy access to GLP-1 medications can backfire, and leaning into the idea that obesity is a lifelong disease
44:13 Sleep consistency as a lever: the real science behind sleep and weight loss, and the mental health part of finding joy in yourself
53:08 April's personal gut check and the honest conversation about stalled weight management
1:00:12 How KBI redesigned its entire approach to treating obesity as a chronic disease

KEY TAKEAWAYS:
Obesity as a chronic disease has a biological basis. With success rates of 0.5 to 2% for diet and exercise alone, this is not a failure of character but a failure of biology working against patients without proper obesity treatment.
Surgery and GLP-1 medications provide the spark, but they are not the solution on their own. Without the controllable levers such as whole-food nutrition, sleep, and movement, results will stall or reverse.
Leptin resistance and rising ghrelin levels mean that the longer someone has lived with obesity, the harder the body fights against weight loss, making medical intervention and habit-building both essential.
Goals bring short-term motivation, but habits create lifelong results. Celebrating the consistency of controllable health habits rather than only the scale is what sustains metabolic health over time.

ABOUT THE GUEST:
Eric F. Smith, DO, FASMBS, CAQ-MBS
Dr. Smith is a board-certified general, bariatric and robotic surgeon who has been in practice since 2006.
Kentucky Bariatric Institute - Website
Dr. Eric Smith - Instagram
RESOURCES MENTIONED:
BariNation Community- $19 a month
BariNation Website
BariNation - Email
BariNation’s How to Find an Obesity Specialist Guide
Sign up for BariNation’s newsletters
J&JMedTech

Summer is here, and so is every barbecue, pool party, and 4th of July spread your family could throw at you. No judgment. We're gonna talk about all of it.
April and Nat are back together for a real one, a summer celebration episode built around the four BariNation pillars: movement, mindset, metabolic wellness, and community. They're sharing how they personally live these pillars when routines go out the window, the weather gets hot, and the paper plates get absolutely massive.
This one is for you whether you're six weeks post-op or six years out. Because bariatric life doesn't take a summer break, but it absolutely can feel like a party.
What we get into:
MOVEMENT: Why movement does not have to mean the gym, and how painting rocks, kayaking for the first time, and water balloon fights with your niece absolutely count. Nat shares how she's getting back to exploring outdoors after a really hard school year, and April talks about finally being able to show up at the lake without dreading every moment.
MINDSET: The brain gremlins don't stop just because it's summer. Nat (almost six years post-op!) gets real about still dealing with "what are people thinking about my plate" anxiety at social events. April walks through the "catch it, check it, change it" tool, a practical mindset skill from BariNation's licensed mental health support groups, and why the goal is never to stop having these thoughts, just to get better at catching them.
METABOLIC WELLNESS: Summer food is protein city if you think about it — burgers, ribs, brats. You're already set up. April and Nat talk about the plate size swap that changed everything at Nat's 4th of July prime rib dinner (yes, really), how to set up a buffet table so you naturally eat in the right order, and why 10 BBQ meals out of 400 summer eating occasions is not the thing that derails you.
COMMUNITY: Why the BariNation membership community is becoming both April and Nat's go-to over social media feeds packed with ads and AI content. Real humans, zero algorithm, no one selling you something. Plus, April is launching a summer Whole Food Learning series in the community every Tuesday night with experts and registered dietitians.
AND THE BIG NEWS: BariNation is officially becoming the BariNation Foundation, a 501(c)(3) nonprofit, as of July 1, 2026. That means the podcast is now a foundation production, your support is 100% tax-deductible, AND the BariNation membership community is dropping from $39/month to $19/month. Less than a dollar a day. We are not calm about this.
Links:
Join the BariNation Community: https://barination.mn.co/plans/1983996?bundle_token=403d003e4d6e5c649341e4319c80a3d8&utm_source=manual
BariNation Community Calender: https://calendar.google.com/calendar/embed?src=cqvlhco5fdmkk0lsuasl7ggdu88emhuc%40import.calendar.google.com&ctz=America%2FLos_Angeles
Donate to the BariNation Foundation: https://barination.givecloud.co/fundraising/forms/8NDR96EK
Follow April: @actively_april
Follow Natalie: @breakingbari_ers
Follow BariNation on Instagram: @bari.nation
Follow BariNation on Facebook: @barination
Get our weekly newsletter: https://lp.constantcontactpages.com/sl/O2S7vlT
Visit our website: www.barination.org

Your metabolism is not broken. It just might need a new strategy.
If you've had bariatric surgery (or started a GLP-1 medication like Ozempic or Mounjaro) and you've hit a wall, struggled with cravings, felt like you can't go more than two hours without eating, or watched the scale stop moving entirely, this episode is for you.
Registered dietitian and certified personal trainer Kayla Girgen, RD, CPT is back, and she's here to explain one of the most talked-about, least understood topics in the metabolic health space: metabolic flexibility. What it is, why it matters after weight loss surgery, and what you can actually do about it starting today.
In this episode, we cover:
What metabolic flexibility actually means (in plain, real-person language)
The interstate traffic analogy that makes insulin resistance finally make sense
Why insulin resistance can make it nearly impossible to lose weight and how the disease of obesity is directly connected
The difference between being metabolically flexible vs. stuck in what researchers call "metabolic gridlock"
How movement, even a short walk after a meal, can bypass insulin resistance and get your metabolism moving again
Why sleep is one of the most unsexy, underrated tools for improving metabolic health
Whether a CGM (continuous glucose monitor) is worth it, and what you can do to balance your blood sugar if one isn't in your budget
A real community member question about reactive hypoglycemia, weight gain on GLP-1s, and what strength training might do to help

Kayla leads live meetups and classes inside the BariNation community every other month. Drop your questions in the comments or send us an email at hello@barination.org.
Find Kayla at @KaylaGirgenRD on Instagram or at KaylaGirgenRD.com.
BariNation is a 501(c)(3) nonprofit. Learn more and join the community at barination.org.