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Appetite on Pause: Weight Loss, Culture, and the Rise of GLP-1 Drugs
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The Science, Trade-Offs, and Long-Term Questions Behind GLP-1 Weight-Loss Drugs
GLP-1 medications like Ozempic, Wegovy, Mounjaro, and Zepbound have transformed the conversation around weight loss.
For many people, these medications reduce hunger, quiet food noise, and make weight loss feel possible for the first time. But beyond the dramatic before-and-after photos lies a more important question: What happens to your hormones, appetite, and overall health along the way?
In Appetite on Pause, health educator Tierra Duncan offers a balanced, evidence-based exploration of the science and culture behind GLP-1 drugs. This book moves past the hype and fear to help you understand how these medications work, what they may change in the body, and the trade-offs worth considering before starting—or while continuing—treatment.
Inside, you’ll learn:
-How GLP-1 medications affect appetite, cravings, and food noise.
-How the body adapts to weight loss and why those changes matter.
-Why body composition is about more than the number on the scale.
-Common side effects and important unanswered questions.
-What often happens when the medication is stopped.
Whether you are considering a GLP-1 medication, currently taking one, or trying to understand the broader implications, Appetite on Pause will help you ask better questions and make more informed decisions about your health—because weight loss is only part of the story.
GLP-1 medications like Ozempic, Wegovy, Mounjaro, and Zepbound have transformed the conversation around weight loss.
For many people, these medications reduce hunger, quiet food noise, and make weight loss feel possible for the first time. But beyond the dramatic before-and-after photos lies a more important question: What happens to your hormones, appetite, and overall health along the way?
In Appetite on Pause, health educator Tierra Duncan offers a balanced, evidence-based exploration of the science and culture behind GLP-1 drugs. This book moves past the hype and fear to help you understand how these medications work, what they may change in the body, and the trade-offs worth considering before starting—or while continuing—treatment.
Inside, you’ll learn:
-How GLP-1 medications affect appetite, cravings, and food noise.
-How the body adapts to weight loss and why those changes matter.
-Why body composition is about more than the number on the scale.
-Common side effects and important unanswered questions.
-What often happens when the medication is stopped.
Whether you are considering a GLP-1 medication, currently taking one, or trying to understand the broader implications, Appetite on Pause will help you ask better questions and make more informed decisions about your health—because weight loss is only part of the story.
- GenresHealth
241 pages, Kindle Edition
Expected publication October 14, 2026
About the author
Tierra Duncan
2 books9 followersTierra Duncan is a women’s health educator, author, and longtime coach dedicated to helping women understand their hormones, their bodies, and the health choices that shape their lives. Known for blending science, compassion, and straight talk, Tierra makes complex health topics clear, approachable, and grounded in real life.
With more than a decade of experience working with clients to improve their fitness and nutrition, Tierra expanded her work to include women’s hormone health. Through years of coaching—and through her own journey with birth control, pregnancy, and postpartum recovery—she saw how little women are often taught about their hormones, cycles, and long-term health. Her mission is to close that education gap by giving women evidence-based information they can actually use, so they can ask better questions, advocate for themselves, and make informed choices with confidence.
Tierra is the founder of Duncan Milam LLC, an independent publishing company dedicated to creating research-driven books and resources that support women’s health education. She is the author of The Birth Control Illusion: Reclaiming Hormones, Health, and Your Cycle and continues to write about the intersections of hormones, weight, reproductive health, fitness, and medical decision-making. Her work has been featured in conversations across women’s health and wellness media, including Bloom TV, the Integrative Women’s Health Podcast, and Authority Magazine.
She also shares honest, evidence-based health conversations through her YouTube channel, @tierraduncanauthor, and her monthly newsletter. Based in Maryland, Tierra is a wife, mom to a spirited daughter, and a lifelong athlete. When she is not writing or creating health education resources, you can find her coaching CrossFit classes, training for fitness events, enjoying strong coffee, or soaking up quiet mornings with her family.
To learn more about Tierra’s work, access free resources, and join her growing community of women seeking clear, grounded health education, visit tierraduncan.com or follow her on Instagram and YouTube at @tierraduncanauthor.
With more than a decade of experience working with clients to improve their fitness and nutrition, Tierra expanded her work to include women’s hormone health. Through years of coaching—and through her own journey with birth control, pregnancy, and postpartum recovery—she saw how little women are often taught about their hormones, cycles, and long-term health. Her mission is to close that education gap by giving women evidence-based information they can actually use, so they can ask better questions, advocate for themselves, and make informed choices with confidence.
Tierra is the founder of Duncan Milam LLC, an independent publishing company dedicated to creating research-driven books and resources that support women’s health education. She is the author of The Birth Control Illusion: Reclaiming Hormones, Health, and Your Cycle and continues to write about the intersections of hormones, weight, reproductive health, fitness, and medical decision-making. Her work has been featured in conversations across women’s health and wellness media, including Bloom TV, the Integrative Women’s Health Podcast, and Authority Magazine.
She also shares honest, evidence-based health conversations through her YouTube channel, @tierraduncanauthor, and her monthly newsletter. Based in Maryland, Tierra is a wife, mom to a spirited daughter, and a lifelong athlete. When she is not writing or creating health education resources, you can find her coaching CrossFit classes, training for fitness events, enjoying strong coffee, or soaking up quiet mornings with her family.
To learn more about Tierra’s work, access free resources, and join her growing community of women seeking clear, grounded health education, visit tierraduncan.com or follow her on Instagram and YouTube at @tierraduncanauthor.
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Displaying 1 - 5 of 5 reviews
Review of advance copy received from NetGalley
In a cultural conversation crowded with miracle claims, horror stories, and moral judgment, Tierra Duncan’s Appetite on Pause offers something rarer: a serious invitation to slow down and ask better questions.
GLP-1 medications have become one of the defining medical stories of the decade—and for good reason. For thousands of people, they have meant lower blood pressure, improved cholesterol, quieter “food noise,” and real protection against diabetes, heart attacks, and the long-term toll of obesity. Given how quickly this conversation has moved, I wanted to understand the science before forming an opinion, and Duncan’s book turned out to be exactly the kind of grounded, science-first resource I was looking for.
Duncan opens with the basics and does so without condescension. GLP-1, or glucagon-like peptide-1, is a hormone the body already produces. She describes it as the body’s traffic controller for energy: It prompts the pancreas to release insulin, slows digestion, and signals fullness. The catch is that natural GLP-1 breaks down within minutes. GLP-1 agonist drugs were engineered to mimic that effect while lasting far longer, transforming what was once a niche metabolic therapy into what Duncan calls a cultural movement. She is careful not to frame that shift as inherently good or bad, presenting it instead as a predictable response to an obesity epidemic that costs health-care systems billions.
Before reading Duncan, I understood GLP-1s primarily as appetite-suppressing drugs. Her discussion of the hypothalamus and the gut-brain axis made me see them instead as medications that intervene in a much larger system of motivation, pleasure, and self-regulation. The most compelling section of the book, for me, is Duncan’s argument that GLP-1’s most profound effects may occur not in the gut but in the brain—specifically, the hypothalamus, the body’s command center for appetite and energy regulation. This is where food noise gets quieted and overeating gets curbed; food begins to register as fuel rather than comfort.
Duncan traces this process further into the gut-brain axis, explaining how GLP-1 signals travel along the vagus nerve—the communication line between the stomach and the brain—to register satiety. It is here that the book earns its subtitle, A Thoughtful Consideration: Duncan does not stop at explaining how these drugs suppress appetite; she also asks what else might be touched along the way. Because GLP-1 interacts with dopamine and serotonin pathways, some people experience it as simply turning down cravings, while others find that it changes how they experience pleasure altogether. If food has been a source of comfort, she notes, having that response interrupted can be genuinely destabilizing—not only physically, but emotionally.
Duncan’s greatest stylistic strength is her ability to move between biology and lived experience without making either one feel secondary. Appetite on Pause is grounded in science, but it never loses sight of the patients living inside that science—their fears, hopes, frustrations, and complicated relationships with food and their bodies. That balance feels especially important at a moment when the “heroin chic” aesthetic of the early 2000s has resurfaced and the cultural pressure to become thinner has once again been repackaged as aspiration. Against that backdrop, the popularity of GLP-1 medications can seem like more than a medical development; it becomes part of a broader cultural demand to lose weight, often quickly and at almost any cost.
To her credit, Duncan does not bury the caveats. She covers mood changes, electrolyte imbalances, and dehydration as real possibilities, and dedicates space to tirzepatide, a dual agonist that acts on both GLP-1 and GIP rather than on a single pathway. Her point is nuanced: Dual-action mechanisms may improve efficacy, but they may also add to the body’s overall biological burden. She is equally direct about dosing. The same mechanism that quiets binge or emotional eating can, if pushed too far, dull the drive to eat at all—a survival instinct worth taking seriously.
Duncan also addresses concerns about changes in body composition, noting that weight loss can include both fat and lean mass. Her emphasis on resistance or strength training and adequate nutrition is one of the book’s most practical contributions. She also stresses that what you eat still matters. Her discussion of ultra-processed foods examines the way they overstimulate the brain’s reward circuitry, making the case that GLP-1 medications alone cannot undo a food environment engineered to encourage overconsumption.
The book is strongest when explaining the science and asking ethical questions. It is somewhat less definitive when it moves from established evidence into broader claims about pleasure, emotional eating, and the psychological effects of appetite suppression. But even where Duncan raises questions she cannot fully answer, she does something valuable: She makes uncertainty part of the conversation rather than hiding it behind easy conclusions.
What makes Appetite on Pause more than a science primer is its recurring, almost interview-style question: Why are you taking this? Duncan presents GLP-1 use as a confluence of medicine, media, and morality, and she pushes readers to sit with the implications. Is the goal aesthetic or medical? What else has been tried? What is the root cause? What are the actual health risks of not losing weight? Her implicit litmus test is simple: If you and your medical team have already had these conversations, you are likely approaching the decision thoughtfully.
Ultimately, Appetite on Pause is less interested in telling readers what to do than in asking whether they understand what they are asking a medication to change. Duncan does not reduce GLP-1 use to either personal choice or cultural coercion; she shows how the two can exist together. That makes the book valuable not only as an introduction to GLP-1s, but also as a thoughtful examination of what our desire to lose weight reveals about the moment we are living through.
I recommend it to anyone weighing GLP-1 therapy, clinicians looking for a patient-friendly explainer, and readers who want to understand the “why” behind the headlines.
Note: This review reflects a reading of the book’s content and general GLP-1 science. It is not medical advice. Decisions about these medications should be made with a doctor who knows your health history.
GLP-1 medications have become one of the defining medical stories of the decade—and for good reason. For thousands of people, they have meant lower blood pressure, improved cholesterol, quieter “food noise,” and real protection against diabetes, heart attacks, and the long-term toll of obesity. Given how quickly this conversation has moved, I wanted to understand the science before forming an opinion, and Duncan’s book turned out to be exactly the kind of grounded, science-first resource I was looking for.
Duncan opens with the basics and does so without condescension. GLP-1, or glucagon-like peptide-1, is a hormone the body already produces. She describes it as the body’s traffic controller for energy: It prompts the pancreas to release insulin, slows digestion, and signals fullness. The catch is that natural GLP-1 breaks down within minutes. GLP-1 agonist drugs were engineered to mimic that effect while lasting far longer, transforming what was once a niche metabolic therapy into what Duncan calls a cultural movement. She is careful not to frame that shift as inherently good or bad, presenting it instead as a predictable response to an obesity epidemic that costs health-care systems billions.
Before reading Duncan, I understood GLP-1s primarily as appetite-suppressing drugs. Her discussion of the hypothalamus and the gut-brain axis made me see them instead as medications that intervene in a much larger system of motivation, pleasure, and self-regulation. The most compelling section of the book, for me, is Duncan’s argument that GLP-1’s most profound effects may occur not in the gut but in the brain—specifically, the hypothalamus, the body’s command center for appetite and energy regulation. This is where food noise gets quieted and overeating gets curbed; food begins to register as fuel rather than comfort.
Duncan traces this process further into the gut-brain axis, explaining how GLP-1 signals travel along the vagus nerve—the communication line between the stomach and the brain—to register satiety. It is here that the book earns its subtitle, A Thoughtful Consideration: Duncan does not stop at explaining how these drugs suppress appetite; she also asks what else might be touched along the way. Because GLP-1 interacts with dopamine and serotonin pathways, some people experience it as simply turning down cravings, while others find that it changes how they experience pleasure altogether. If food has been a source of comfort, she notes, having that response interrupted can be genuinely destabilizing—not only physically, but emotionally.
Duncan’s greatest stylistic strength is her ability to move between biology and lived experience without making either one feel secondary. Appetite on Pause is grounded in science, but it never loses sight of the patients living inside that science—their fears, hopes, frustrations, and complicated relationships with food and their bodies. That balance feels especially important at a moment when the “heroin chic” aesthetic of the early 2000s has resurfaced and the cultural pressure to become thinner has once again been repackaged as aspiration. Against that backdrop, the popularity of GLP-1 medications can seem like more than a medical development; it becomes part of a broader cultural demand to lose weight, often quickly and at almost any cost.
To her credit, Duncan does not bury the caveats. She covers mood changes, electrolyte imbalances, and dehydration as real possibilities, and dedicates space to tirzepatide, a dual agonist that acts on both GLP-1 and GIP rather than on a single pathway. Her point is nuanced: Dual-action mechanisms may improve efficacy, but they may also add to the body’s overall biological burden. She is equally direct about dosing. The same mechanism that quiets binge or emotional eating can, if pushed too far, dull the drive to eat at all—a survival instinct worth taking seriously.
Duncan also addresses concerns about changes in body composition, noting that weight loss can include both fat and lean mass. Her emphasis on resistance or strength training and adequate nutrition is one of the book’s most practical contributions. She also stresses that what you eat still matters. Her discussion of ultra-processed foods examines the way they overstimulate the brain’s reward circuitry, making the case that GLP-1 medications alone cannot undo a food environment engineered to encourage overconsumption.
The book is strongest when explaining the science and asking ethical questions. It is somewhat less definitive when it moves from established evidence into broader claims about pleasure, emotional eating, and the psychological effects of appetite suppression. But even where Duncan raises questions she cannot fully answer, she does something valuable: She makes uncertainty part of the conversation rather than hiding it behind easy conclusions.
What makes Appetite on Pause more than a science primer is its recurring, almost interview-style question: Why are you taking this? Duncan presents GLP-1 use as a confluence of medicine, media, and morality, and she pushes readers to sit with the implications. Is the goal aesthetic or medical? What else has been tried? What is the root cause? What are the actual health risks of not losing weight? Her implicit litmus test is simple: If you and your medical team have already had these conversations, you are likely approaching the decision thoughtfully.
Ultimately, Appetite on Pause is less interested in telling readers what to do than in asking whether they understand what they are asking a medication to change. Duncan does not reduce GLP-1 use to either personal choice or cultural coercion; she shows how the two can exist together. That makes the book valuable not only as an introduction to GLP-1s, but also as a thoughtful examination of what our desire to lose weight reveals about the moment we are living through.
I recommend it to anyone weighing GLP-1 therapy, clinicians looking for a patient-friendly explainer, and readers who want to understand the “why” behind the headlines.
Note: This review reflects a reading of the book’s content and general GLP-1 science. It is not medical advice. Decisions about these medications should be made with a doctor who knows your health history.
Review of advance copy received from NetGalley
Appetite on Pause offers a clear, timely, and engaging introduction to GLP-1 medications. I especially enjoyed the author’s conversational tone and her talent for breaking down complex topics without making them feel dry or overwhelming.
I would have liked more detail on suggested eating plans and ways to maximize results while taking these medications, but overall, this is an approachable and informative resource. It’s an excellent starting point for anyone considering GLP-1s—or hoping to avoid common pitfalls and get the best possible results.
I received an advance review copy from the publisher through NetGalley. All opinions are my own.
I would have liked more detail on suggested eating plans and ways to maximize results while taking these medications, but overall, this is an approachable and informative resource. It’s an excellent starting point for anyone considering GLP-1s—or hoping to avoid common pitfalls and get the best possible results.
I received an advance review copy from the publisher through NetGalley. All opinions are my own.
Review of advance copy received from NetGalley
As someone who is currently taking GLP1, I was excited to read this. I liked the tone of the writing, it didn't feel like a science textbook, but did lay out a researched and in depth informational study. I feel like I now know more about what's going on in my body. Highly recommended.
Review of advance copy received from NetGalley
This was such an informative and well-researched book, and honestly, I think it is an incredibly valuable read given how popular GLP-1 medications have become.
What I appreciated most was how Duncan breaks down the science behind GLP-1 medications in a way that is actually understandable. She explains what these medications are doing in the body, how they affect appetite and hunger, and the changes that can happen with weight loss and body composition without making the information feel overly complicated.
I also really appreciated that this book doesn't approach GLP-1s as simply a good thing or a bad thing. Instead, it gives you information so you can understand what you're actually getting into. With medications like Ozempic, Wegovy, Mounjaro, and Zepbound becoming such a huge part of the weight-loss conversation, I think it's incredibly important that people understand the science, potential side effects, nutritional considerations, and what can happen when treatment is stopped.
We live in a culture where everyone seems to be looking for the next “miracle cure” for weight loss, and I think that's exactly why a book like this is so important. Before jumping on the latest trend, people should have the information they need to make an educated decision about their own health.
Duncan does a great job making a complicated and sometimes controversial topic approachable. I finished this book feeling like I had a much better understanding of GLP-1s and the bigger picture surrounding them not just the number on the scale.
Definitely a book I would recommend to anyone considering a GLP-1, currently taking one, or simply wanting to understand what all the hype is about.
What I appreciated most was how Duncan breaks down the science behind GLP-1 medications in a way that is actually understandable. She explains what these medications are doing in the body, how they affect appetite and hunger, and the changes that can happen with weight loss and body composition without making the information feel overly complicated.
I also really appreciated that this book doesn't approach GLP-1s as simply a good thing or a bad thing. Instead, it gives you information so you can understand what you're actually getting into. With medications like Ozempic, Wegovy, Mounjaro, and Zepbound becoming such a huge part of the weight-loss conversation, I think it's incredibly important that people understand the science, potential side effects, nutritional considerations, and what can happen when treatment is stopped.
We live in a culture where everyone seems to be looking for the next “miracle cure” for weight loss, and I think that's exactly why a book like this is so important. Before jumping on the latest trend, people should have the information they need to make an educated decision about their own health.
Duncan does a great job making a complicated and sometimes controversial topic approachable. I finished this book feeling like I had a much better understanding of GLP-1s and the bigger picture surrounding them not just the number on the scale.
Definitely a book I would recommend to anyone considering a GLP-1, currently taking one, or simply wanting to understand what all the hype is about.
Review of advance copy received from NetGalley
Appetite on Pause: Weight Loss, Culture, and the Rise of GLP-1 Drugs by Tierra Duncan is a valuable resource for anyone taking, considering, or preparing to stop a GLP-1—which feels like 75% of America these days. We all know someone using one, yet most of us know very little about how these medications actually work.
Are they safe? Are they helpful or harmful? How do you successfully stop taking them? The answers are complicated, and there is no one-size-fits-all solution. What this book does is arm readers with the information needed to better understand GLP-1 medications and perhaps have a fighting chance of maintaining their benefits long after stopping them.
There is no doubt that these drugs have been life-changing for many people by helping them address serious weight-related health concerns. But at the end of the day, they are still medications—and nothing comes without potential consequences.
I found this book incredibly enlightening. It answered many of my questions about what GLP-1 medications actually do, how they affect other functions of the body, and why they are so effective at quieting food noise and reducing cravings. This is an excellent resource for anyone using a GLP-1 who wants to better understand both its benefits and concerns.
Thank you so much to Tierra Duncan, Duncan Milam LLC, and NetGalley for the ARC.
Are they safe? Are they helpful or harmful? How do you successfully stop taking them? The answers are complicated, and there is no one-size-fits-all solution. What this book does is arm readers with the information needed to better understand GLP-1 medications and perhaps have a fighting chance of maintaining their benefits long after stopping them.
There is no doubt that these drugs have been life-changing for many people by helping them address serious weight-related health concerns. But at the end of the day, they are still medications—and nothing comes without potential consequences.
I found this book incredibly enlightening. It answered many of my questions about what GLP-1 medications actually do, how they affect other functions of the body, and why they are so effective at quieting food noise and reducing cravings. This is an excellent resource for anyone using a GLP-1 who wants to better understand both its benefits and concerns.
Thank you so much to Tierra Duncan, Duncan Milam LLC, and NetGalley for the ARC.
Displaying 1 - 5 of 5 reviews