Do you find yourself thinking about food all day, even right after a meal? It’s called food noise, and it is not a character flaw. In part two of my CagriSema series, I walk you through a new study that used appetite testing, questionnaires and brain scans to see how this medication changes appetite, cravings and the brain's response to tempting foods, over a full year.

In this episode:

- The three systems that control eating, and why food noise happens
- How appetite and cravings changed, and why that held at one year
- Why eating a bit more at maintenance is a new steady state, not the medication wearing off
- The shift away from high-fat, sweet foods
- What changed in the brain, from reward to the brain's own "brakes"
- Side effects, study limitations, and my clinical pearls

Missed part one? Go back and listen to "Meet CagriSema" first.

This episode is for education only and isn't personal medical advice. Please speak with your own healthcare provider.

Reference: Abstract presented by Dr. Anthony P. Goldstone at EASD 2026. Effects of CagriSema on appetite, eating behaviour and food cue reactivity using functional MRI in adults with overweight or obesity. (V.F. Uhre et. al.)

WORK WITH ME
O​​ntario-Wide Virtual Obesity Management Clinic
https://www.highmetabolicclinic.com

Join my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight

Recover Strong for Binge Eating
https://www.sashahighmd.com/bed

Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide

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The New Kid on the block, coming 2027 (ish?), is CagriSema. Today, I’m giving you a clear, evidence-based introduction.

In this episode, I explain what amylin is, why combining it with semaglutide is a new approach, and what the REDEFINE trials actually showed.

In this episode:
- What amylin is, and how it differs from GLP-1 and GIP
- REDEFINE 1: about 20% average weight loss in people without diabetes
- REDEFINE 2: results in people living with type 2 diabetes
- REDEFINE 4: how CagriSema compared with tirzepatide, and how I interpret it
- Side effects, and practical ways to manage them
- Where approval stands, and why to avoid unapproved sources

Part 2, coming next week, goes inside the brain: what CagriSema does to appetite, cravings and food noise.

Resources:
- Garvey WT et al. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity (REDEFINE 1). N Engl J Med. 2025.
- Davies MJ et al. Cagrilintide–Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes (REDEFINE 2). N Engl J Med. 2025.
- Novo Nordisk company announcement on REDEFINE 4, February 23, 2026.

This episode is for education only and isn't personal medical advice. Please speak with your own healthcare provider.

WORK WITH ME
O​​ntario-Wide Virtual Obesity Management Clinic
https://www.highmetabolicclinic.com

Join my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight

Recover Strong for Binge Eating
https://www.sashahighmd.com/bed

Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide

FOLLOW SASHA
Instagram - https://www.instagram.com/sashahighmd/

In this episode, I’m joined by Dr. Ariel Dalfen, a psychiatrist and women’s mental health specialist, to explore the intersection of reproductive hormones, mental health, body image, eating disorders, and metabolic health.

We talk about why reproductive transitions—from the menstrual cycle to pregnancy, postpartum, perimenopause and menopause—can be particularly vulnerable times for mental health, and how clinicians can distinguish expected changes from symptoms that warrant treatment.

We also discuss:
- PMDD: what it is, how it differs from PMS, and why tracking symptoms across the menstrual cycle can be so helpful

- Mental health during perimenopause and menopause, including anxiety, depression, sleep disruption and emotional dysregulation

- How a history of PMDD, postpartum mental health concerns, or other psychiatric illness may influence risk during the menopause transition

- When menopause hormone therapy, psychiatric medication, or a combination may be appropriate

- How we should consider weight gain and metabolic health when choosing psychiatric medications

-The significant impact of menopause on body image and the risk of eating disorder relapse

- The growing pressure around food, exercise, protein, and body composition—and when healthy behaviours can become obsessive

- What we know, and what we still don't know, about the relationship between GLP-1 medications and mental health

- Why individualized, multidisciplinary care matters so much in women's mental health

Most importantly, we talk about the importance of listening to women, taking their symptoms seriously, and looking at the whole person rather than reducing complex experiences to either "just hormones" or a psychiatric diagnosis.

Dr. Dalfen is the CEO and co-founder of BRIA, a virtual women's mental health and hormone clinic. She is also an Assistant Professor of Psychiatry at the University of Toronto and previously led the perinatal mental health program at Mount Sinai Hospital in Toronto.

Learn more about BRIA at betterbria.com and BRIA Academy at briaacademy.com.

Follow BRIA on instagram: @bria.health