Episode 18

Dr. Evan Nadler on the Future of Obesity Care & Why Hope Isn’t Lost (Part 3)

Published on: 17th November, 2025

In Part 3 of Sacha’s conversation with Dr. Evan Nadler — one of the nation’s leading pediatric bariatric surgeons — they explore the future of obesity treatment with clarity, honesty, and real hope.

Dr. Nadler breaks down why new medications aren’t just “stronger versions” of each other, how different receptor pathways may help people who don’t respond to certain GLP-1s, and why surgery and medication together will likely shape the next era of care. He and Sacha also talk through his telemedicine weight-management program, the crisis of access in pediatric obesity treatment, and how integrated care could finally bring support to families who’ve been overlooked.

If you’ve ever wondered what’s coming next in obesity care — and what it means for real people who are doing their best with the tools they have — this episode will help connect the dots.

🧭 In This Episode

  • Why “hope and science” actually work together in obesity treatment
  • What new medications are targeting — and why receptor variety matters
  • How early weight-loss patterns may predict long-term response
  • Why surgery + medications may be the strongest approach for many patients
  • The massive gap in pediatric access — and how telemedicine could change it
  • The risks and realities of compounded and gray-market medications
  • What a future integrated, one-stop weight-management system could look like

🪞 Key Takeaways

  • New meds don’t just “work better” — they target different biological pathways that may help non-responders.
  • Early weight-loss trends after surgery can signal who may need additional support.
  • Some patients who don’t respond to surgery also don’t respond well to certain medications — pointing to underlying biological drivers.
  • Access remains one of the biggest barriers in pediatric obesity care; many clinics literally cannot see the patients who need the most help.
  • Telemedicine may become a crucial entry point for kids and families shut out by geography, waitlists, or equipment limitations.
  • Compounded and gray-market medications come with risks — but patients often pursue them out of necessity, not preference.
  • The future of care may include integrated meal planning, wearables, coaching, exercise, and medical oversight in one single hub.

⚠️ Content Note

Includes discussion of obesity treatment, pediatric care, access barriers, medication sourcing (compounded/gray-market), and surgical outcomes.

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🏷 Keywords / Tags

Dr. Evan Nadler, pediatric obesity, childhood obesity, bariatric surgery, GLP-1, semaglutide, tirzepatide, retatrutide, obesity treatment, weight loss medications, telemedicine, access to care, compounded meds, obesity explained, bariatric science, hypothalamic set point, metabolic health

Next Time

🎧 Next up, I’m sitting down with Jessica Setnick, one of the most respected eating disorder and food-behavior experts in the country. We’re diving into why so many of us have complicated relationships with food even after bariatric surgery, how trauma shapes eating patterns, and why “willpower” has nothing to do with it.

Jessica breaks things down in a way that feels validating, eye-opening, and honestly… freeing. You’re absolutely going to walk away with language for things you’ve felt for years.

That three-part conversation starts Wednesday — don’t miss it.

👉 Make sure you’re subscribed to Life in the Bari Lane so you don’t miss our next ride.

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About the Podcast

Life in the Bari Lane
Come along for the ride — it's no fun going alone.
Life in the Bari Lane is your 30-minute dose of real talk about life after bariatric surgery — the good, the hard, the weird, and the “nobody warned me about this” moments. No fluff, no “just follow the plan” nonsense — just honest conversations about what it’s like to change your body, your habits, and your whole damn life.

This podcast is a space for the highs and lows of the weight loss journey. Because here’s the truth: bariatric surgery is a tool — not a magic fix. It’s still work. It’s still messy. And it’s still life — with a different GPS.

Whether you’re pre-op and researching, post-op and thriving, or somewhere in the “what the hell did I just do?” stage, you’re in the right lane. This show is about building community — the kind that gets it, supports you, and doesn’t sugarcoat the process.

I’m Sacha — a real-life bariatric patient navigating this wild ride — and I’m here to keep it honest, funny, and deeply human.

You’ll hear:
💥 Unfiltered talk about the hard days
🥗 Nutrition talk that’s actually realistic
🧠 Mental health, body image, and identity shifts
👯‍♀️ Support systems and “friendship fallout”
💪 Motivation that doesn’t suck
🙃 Oops moments, progress wins, and honest reflections

New episodes drop weekly — short enough to fit into your day, but packed with the good stuff to keep you going.

About your host

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Sacha Holder

Sacha Holder is a project manager, podcast host, and bariatric patient who’s not here to pretend it’s all perfect. With over a decade of professional experience and a whole lot of lived experience, she creates podcasts that tell the truth about what it means to live, heal, and grow — through chaos, and curveballs, while keeping it together (mostly).

She’s the voice behind Life in the Bari Lane, a bite-sized bariatric podcast for real people navigating post-op life, and The High-Functioning Disaster, a show about showing up even when everything feels like too much. Through humor, honesty, and zero judgment, Sacha builds community through conversation — because no one should have to figure it out alone.