Tuesday, January 13, 2026

Book Review: Diet, Drugs And Dopamine

Next up for review is Diet, Drugs And Dopamine by David Kessler, MD. The author is the former Commissioner of the Food and Drug Administration and is a graduate of Harvard Medical School.

Introduction

The main focus of this book is the new class of weight loss drugs; the GLP-1 agonists such as Wegovy and Zepbound. It contains chapters on the use of these drugs, side effects, our current food environment and weight maintenance when you get off the medication. The book is 385 pages. It is very well-written and I enjoyed reading it.

3 Things I Really Liked About Diet, Drugs And Dopamine

1) I really like how this book presents the advice of multiple experts and not just the author’s opinions.  Dr. Kessler includes quotes from many of the world’s foremost clinicians and researchers in weight loss medicine. This adds a lot to the book.

2) The author stresses that doctors are not providing the proper nutrition support for patients on the GLP-1 agonists. I couldn’t agree more. Most patients are eating between 500 and 800 calories a day on these medications. This is similar to what an anorexic patient eats in a day. There has been widespread signs of malnutrition in these patients and one expert even reported a case of scurvy in his office. Scurvy, in 2025! 

3) The author also points out that up to 40% of weight lost by these patients is muscle mass. This can cause a host of problems and I like that the author stresses resistance training as an essential part of the program for these patients.

3 Things I Didn’t Agree With In Diet, Drugs And Dopamine

1) I feel like the book was a little longer than it needed to be. If it was a bit more focused on the GLP-1 medicines, it would have been an easier read. Sections on the history of food labels and nutritional biochemistry, for example, were not really necessary in my opinion.

2) The author repeatedly states that lifestyle changes always fail for those trying to lose weight. I strongly disagree here. I have seen clients lose weight and keep it off for well over 20 years. Just because weight loss is not easy or quick does not mean it is not possible.

3) I wish the references were cited numerically in the text instead of just lumped together in the back of the book. I am sure most readers won’t notice or care about this, but as a nutrition researcher, I often will find a reference I want to download and it is much harder to find them this way.

Is Diet, Drugs And Dopamine Worth Reading?

Absolutely! The GLP-1 agonist meds have hit our world like a ton of bricks and a lot is not known about them. This book provided a wealth of information about how these drugs work, known and potential side effects and some strategies about what to do when you go off of them. This is really important, as up to 90% of patients stop taking them after 1 year (according to one of the experts in the book).

I would strongly recommend this book to anyone taking these meds, thinking about taking them or any health care clinician working with these patients.

No comments: