Willpower Is B.S.: Food Noise, Healthspan, and What Actually Changed My Life

For decades, I started every New Year the same way.

In January, I promised myself this would be the year.

By February, I tried harder.

Every spring, I adjusted the plan.

And by summer or fall, the weight crept back.

That cycle repeated not because I lacked knowledge, discipline, or effort. Instead, it repeated because I misunderstood biology — at least when it came to myself.

This year is different.

For the first time since Ronald Reagan was first elected, weight loss is not at the top of my New Year’s resolution list. Not because I stopped caring, but because I lost 45 pounds with the help of Zepbound over the last year. More importantly, however, I learned something that reshaped how I think about obesity, healthspan, and shame.

Before anything else, let me be clear: this is not medical advice. This is a story. Anecdotes are not evidence, even when the anecdote is from a physician. Nevertheless, stories help us understand science when data alone fails to move us.

And this story matters.

I Had Willpower. That Wasn’t the Problem.

For years, people told me — and millions of others — the same thing: move more and eat less. At first glance, that advice sounds logical. After all, calories matter. Energy balance matters.

However, reality is more complicated.

To begin with, I am a surgeon. Surgical training requires extraordinary willpower. Moreover, I’ve logged food meticulously, cooked Mediterranean-style meals, exercised consistently, and followed every evidence-based recommendation I’ve ever given patients.

Meanwhile, Oprah has willpower. Olympic athletes have willpower. Yet obesity persists.

Sure, willpower works briefly. In fact, go on a liquid protein diet, and the weight will fall off quickly. Unfortunately, the food noise remains. Eventually, biology wins. Always.

In the same way you cannot positive-think your way out of hypertension, cholesterol, diabetes, cancer, or heart disease, you cannot willpower your way out of obesity. Obesity is a disease. It is not a moral failure.

Ironically, I knew this intellectually. Nevertheless, I failed to apply it to myself. We have a name for that: cognitive dissonance.

Food Noise Was the Missing Concept

The real turning point did not come from reading another study. Instead, it came from listening to people I trusted.

One colleague quietly lost weight on a GLP-1. Another friend told me something more striking: the food noise stopped. Alcohol lost its appeal. Smoking no longer called.

That phrase — food noise — suddenly explained decades of struggle.

To illustrate, think of sleeping near Lake Shore Drive in Chicago. At first, traffic noise dominates your awareness. Eventually, it fades into the background. Only when you leave the city do you realize how loud it was.

Food noise works the same way.

When GLP-1 therapy quieted that background signal, eating slowed naturally. Meals ended without effort. Desire changed without rules. Biology shifted.

Notably, calories did not lower my stress. Calories did not improve my sleep. Calories did not stop snoring. Biology did.

The Unexpected Early Benefits

Interestingly, weight loss was not the first change I noticed.

Sleep improved almost immediately. Stress dropped dramatically. Commutes that once registered hours of physiologic stress now barely registered minutes. Appetite normalized. Eating slowed.

These changes matter because sleep and stress directly affect inflammation, metabolic health, appetite signaling, and long-term disease risk. In other words, healthspan improved before the scale reflected anything meaningful.

That observation alone reframed the entire experience.

Why Support Groups Matter More Than Diet Rules

Along the way, something else happened.

Friends noticed.

Predictably, they asked the same question everyone asks: What diet is working? After I answered honestly, several started their own journeys.

Soon enough, we formed an informal support group. People texted. Others called. Questions surfaced: Is this normal? Should I eat this? Does this feeling pass?

Support did not mean coaching. Rather, support meant context. Shared experience reduced anxiety. Honest conversations prevented unnecessary panic.

Not surprisingly, patterns emerged. People still loved great food. Wine interest decreased naturally. Travel did not end. Joy remained intact.

Support mattered because isolation amplifies shame.

Vitamins, Bowels, and the Things No One Mentions

Equally important, practical realities surfaced.

Eating less means needing micronutrients, not fewer of them. Unfortunately, some vitamins fail when appetite drops. In fact, the only time I vomited was after taking a vitamin on an empty stomach. That lesson mirrored decades of bariatric follow-up experience.

For me, AG1 worked. No sponsorship exists here. Nevertheless, cost raises questions. With a background in culinary medicine, developing a better formulation makes sense. Thiamine deficiency, for example, causes devastating neurologic consequences. This is not theoretical.

Similarly, bowel habits change. Less intake means less output. Fewer bowel movements do not equal constipation. Fiber still matters. Mediterranean-style eating naturally solves most of this problem.

Understanding physiology prevents fear.

Why I’m Writing Another Book

At some point, frustration turned into obligation.

Recently, a physician who has never used a GLP-1 published a book about eating on GLP-1 therapy. That bothered me more than it should have.

Given my background — weight-loss surgery, culinary medicine, and lived experience — I realized I had to write this book. Not to sell diets, but to explain reality.

The working title?

Willpower Is B.S.

Subtlety has never been my strength.

This book will focus on biology, food ideas, micronutrients, behavior, and healthspan. Above all, it will remove shame from the conversation.

Incidentally, my literary agent retired long ago. Therefore, if you know someone who understands medicine, food, and honesty, I’m back in the market.

Why the Mediterranean Healthspan Cruise Exists

At the same time, conversations kept expanding beyond weight loss.

Healthspan matters more than thinness. Longevity depends on sleep, stress, nutrition, social connection, and movement. Accordingly, the Mediterranean Healthspan Cruise was born.

This is not a weight-loss cruise. Instead, it’s a learning experience. We will discuss food, medicine, science, and aging. Yes, there will be a GLP-1 support session. Equally, there will be conversations for everyone.

Learning works best in a community.

This Is Only Part One

As I write this, I’m preparing to inject my 7.5 mg dose of Zepbound. I still hate needles. Some things never change.

Nevertheless, this is only part one of the journey.

Science progresses when we admit what we got wrong.

This time, I listened.

References

1. Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, Kiyosue A, Zhang S, Liu B, Bunck MC, Stefanski A; SURMOUNT-1 Investigators. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022 Jul 21;387(3):205-216. doi: 10.1056/NEJMoa2206038. Epub 2022 Jun 4. PMID: 35658024.
2. Rubino F et al. Joint international consensus statement for ending stigma of obesity. Nature Medicine, 2020.

>> Dr. Terry Simpson: M Today is my coming out party. Today I'm coming

out. About me. Because this is the first new year

of my adult life where weight loss is not at the

top of my resolution list. And that's not because

I gave up. It's because over the last year, I have

lost 45 pounds with the help of Zephound, a GLP1

agonist. And today on 4Q, I'm finally ready to

tell you that story. Not as a success story, not

as advice, and certainly not as a moral lesson,

but as an honest account of what actually

happened. Why this wasn't willpower, why it wasn't

just eating better, and why this changed far more

than my weight. Some of you know I'm a weight loss

surgeon. Some of you know I'm trained in culinary

medicine. And some of you know I've spent my

career helping other people lose weight. What you

may not know is how much shame I carried doing all

that. So today I'm telling you my story. The

guilt, the biology, the food noise, and what this

last year has meant to me. Because if this story

resonates with you or someone you love, that

matters. This is the story of how science saved my

life. This is also the first new year where I

don't have weight loss as a resolution. In fact,

I've had weight loss as my New Year's resolution

since Ronald Reagan was first elected. Every year,

same promise, same guilt. And I don't think I ever

promised that more strongly than in 2010 when my

son JJ was born. I'm, um, one of those older

parents. I know it's hard to believe, but if there

was ever motivation, that was it. I was going to

lose weight. I was going to get healthier because

I had this little child that I wanted to spend a

lot of the rest of my life knowing. Some years the

promise was stronger. Some years it was better.

Every year until this last year, I might lose a

few, then gain it back. I know how to eat. I know

how to cook. Do you know that I almost set the

record for logging my daily food on Noom or over

2000 days? This was never about knowledge. This

was never about effort. I am your Chief Medical

Explanationist, Dr. Terri Simpson, and this is

Fork U Fork University, where we make sense of the

madness of weight loss, bust myths, and talk

honestly about food and medicine.

Let's talk talk about willpower. And let me start

with a confession. I've known the truth about

willpower for years. I just didn't believe it for

myself. I have willpower. I'm a surgeon, you don't

get through surgical training without willpower.

And you don't stand in an operating room for hours

making decisions that matter without willpower.

And let's be honest. Oprah has willpower. She has

discipline. She has access. She has resources. And

yet all the willpower in the world didn't allow me

or Oprah to lose weight and keep it off. Sure,

with enough willpower, you can lose weight for a

while. God knows I've done it. Liquid protein

diets, rigid eating, white knuckling my way

through, you'll lose the weight. I've done it more

than once. But you still hear the food noise.

Willpower doesn't quiet food noise. It doesn't

shut off the background pull toward food just

tells you to fight it all day, every day. And

eventually, food noise wins. Because biology beats

psychology every single time. You can't willpower

your way out of obesity any more than you can

positive think your way out of high blood pressure

or high cholesterol or diabetes or heart disease

or cancer. We don't tell people with hypertension

to believe harder yet with obesity, we pretend

willpower is the treatment. It isn't. And here's

where my shame lived. As a weight loss surgeon, I

told my patients this. I corrected people when

they said surgery was the easy way out. Because

surgery does not make the stomach smaller. It

changes gut hormones. It changes brain signaling.

It changes appetite regulation. It changes

biology. I believed that data fully for everyone

else, but not for me. I held myself to a different

standard. I gave everyone else grace, but I didn't

give it to myself. I didn't gain more willpower

from a needle. I'm not a better person because I

lost weight. I'm not morally superior because I

moved from obese to a normal weight. I didn't

become more disciplined. The biology changed.

That's it. I know this intellectually. I taught

it, I lived it through my patients, but I didn't

apply it to myself. You know, we have a name for

that, cognitive dissonance. Now, when I look back,

the turning point came down to two people and one

event before that. Let me say this clearly. This

wasn't ignorance. I'd known about GLP1 medications

for years. I'd read the trials. I understood the

mechanism. I prescribed them to my patients, and

my patients did well. But knowing the science and

believing it applies to you are two different

things. About seven years ago, a very good friend

of mine, an internist, was one of the

investigators setting GLP1 medications for weight

loss. She was stunned by the results and told me

that these medications are going to replace weight

loss surgery. Sure, I said. I wasn't impressed.

I'd seen other weight loss medications before, but

the data wasn't weak. Anyway, let's start with my

journey. It was a nurse that I worked with.

Nothing dramatic, nothing preachy. She just kept

losing weight quietly. And she mentioned her

experience on ozempic and would occasionally ask

me as a weight loss surgeon about ozempic. No

evangelism, um, no sales pitch. She felt better.

She did easier. The food noise was gone. Now, as a

surgeon, you learn to respect quiet results

because they are typically real. The second was a

person. Someone I work with in Alaska. In fact,

she and I grew up in the same town, Ketchikan.

Then she told me something that stopped me cold.

Yep, she had lost weight, but that wasn't the

headline. She said the food noise stopped. And

then she said something else. Her interest in

alcohol dropped. And she had stopped smoking. This

is when it stopped being about weight. That's when

about the biology of it became real. Then came the

event. Eli Lilly lowered the self pay price to

about $500 a month. Suddenly, this wasn't

theoretical. This was something I could budget. So

I called my friend, Dr. Michael Albert. Now,

Michael is a board certified obesity medicine

specialist. And that matters. If you're

considering this journey, Find someone who's

actually trained in obesity medicine, not someone

who says they are. Michael assumed I was calling

about a patient. I said, no, no Michael. I'm

calling about me. No judgment. Just one question.

What's your height and weight? That was 45 pounds

ago.

Let me tell you about the first injection. The

package derived from Eli Lilly. Inside were vials

of zepbound syringes, needles, alcohol, swabs. I

have a confession to make. Even though I got the

polio vaccine, even though I keep up with my

boosters, I hate needles. I. I hate them. I don't

like them. I don't like getting injections. I will

put off for any reason getting a booster, even

though I do it. So I did the appropriate thing. I

hydrated with Pedialyte in case there was some

nausea. And, um, finding subcutaneous fat for my

first injection. It just wasn't a problem. I mean,

a man with belly has options. So I put alcohol on

the vial. I put the air from the syringe into the

vial. I swiped my skin with alcohol, thinking, am

I really doing this? And I did it. I put the

needle in. I put the plunger down. In half A CC

was 2.5 milligrams of Zepbound subcutaneous. That

was it. I wondered if I needed a sucker. The next

morning, my partner said, that is the first time

you haven't snored in years. I checked my withing

sleep score. It was the best it had ever been. I

had hardly ever cracked 70 as a sleep score, and

all of a sudden, I was hitting the 80s. Let me

tell you about another change. Before I injected

myself, I did something very telling. I bought a

new blender. Because when you know you're going to

change your life or make a new habit, you prepare.

It's like when I decided to take up running again.

Before the first run, I, of course, bought new

shoes and a tracksuit. Matching, of course. Same

instinct. So I knew this change might mean more

smoothies. Not just as a diet trick, but as a

practical way to get nutrition in, you know, the

fruits, the ber, that good stuff. And my Vitamix

had been with me for 15 years. But it's a beast,

and I wanted something easier. After all, I was

going to inject myself. I deserved a simple

blender. And so I did the research. I saw

Wirecutter from the New York Times. I read

reviews. I looked at comparisons. I saw lots of

videos on TikTok, my favorite medium. And I bought

a Nutribullet. Amazon delivered it the day before

I started Zepboun. So I unpacked it, didn't read

the instructions, of course, and had all the parts

washed and ready to go. The next morning, after my

first injection, I wondered about my breakfast.

And I was traveling that day. So I made my usual

smoothie, which is kind of for me. Oat milk, a

banana, frozen blueberries, some egg protein. I'm

lactose intolerant, some peanut butter. And by the

way, if you want the recipe, it's on

terrysimpson.com now. You need to understand

something about me. If you've not known me. I am

known for eating fast. People notice it. I'm

usually the first one diet, always. And so that

morning, when I was traveling along in my commute,

which is about two hours at the time, that

smoothie wasn't guzzled. I would sip a little bit

and put it down normally with my smoothie. If I'm

traveling, that smoothie is gone, like a man who

found an oasis in the middle of desert. But this I

sipped, not consciously. It just happened. And

then that night, I made some salmon with broccoli

and chickpeas, one of my favorite recipes, and I

love salmon. And I ate it slowly and then I

stopped. I ate half the plate. Not because I was

uncomfortable, that was just done. Something had

stopped. Something went quiet and reminded me.

That's food noise. Do you know what it reminded me

of? Years ago, when I was at the University of

Chicago, I slept with the city noise. I lived by

Lakeshore Drive, There were trains in the

background, there was lots of cars going by 24

hours a day. And I would sleep to that. You never

noticed that background noise until I would go

home to catch canalaska at my parents house. And I

would take time to fall asleep because there

wasn't that background city noise. It was gone.

And that's what happened in my brain. Food noise

was gone. I didn't even know it was there. That's

what food noise was.

So things that changed first, before the scale

moved, that first night sleep, the second thing I

noticed was stress. Now sleep resets hormones,

lowers inflammation, recalibrates metabolism.

We've known this for years. And less sleep

actually increases appetite. Stress does. Does

too. So before this, you know, I commute a lot. I

live in the north LA central coast area and

commuting is just sort of a fact of life here. But

hours of commute meant a lot of physiologic

stress. And so when I would look at my Withings or

my whoop watch and you would see the amount of

stress I would have, if I had commuted two hours a

day, I'd have two hours of stress. Now I notice

the first week I might have five minutes of

stress. Calories didn't lower the stress, calories

didn't improve the sleep, the biology did. And

over time, friends started to notice. People

noticed. Now I have a few friends that were a

little more corpulent and they would always ask

when they would see me, hey, what diet are you on?

What are you doing, Terry? So finally I told them

different ones at different times. And one by one,

all of them began their own journey on zeppbound.

And without planning it, we formed our own little

support group. They would call me or text me when

they had an issue like, is this normal? What would

you do? Does this go away? And we would talk it

through, not as coaching, not as a program, just

people who understand. Let me tell you about one

of my friends. She travels constantly. If you were

to see her Instagram, if you follow her, it's full

of wonderful foods from wonderful restaurants

around the something like 50 plus countries she's

visited. I have traveled with her around the world

and we both love great food and oddly, we still

do. She still Loves great food. I still love great

food. When we go out to eat together, we get great

food. Interestingly, our desire for wine has kind

of completely gone, but we still enjoy great food.

Just small plates. Enjoy the taste, not the

volume. I have another buddy, he travels

constantly for work. Great guy. He has this

amazing workout regimen he does in every hotel

room, involving 100 push ups and calisthenics and

all of this stuff. And he was in shape, it was

just a round shape. So he asked me, what are you

doing, Terry? And I said, I'm doing Zepbound. I

gave him the number of my guy, Dr. Albert. He

called him up, he started it. You know, New Year's

is coming. And he said, he started laughing. He

said I had to buy a new tuxedo. Look at this. He

looks great. Then there's another friend of mine.

He's a fellow physician. I've known him for 25

years. We have gone and lectured together in

countries from New Zealand to Sweden and always go

out together at great restaurants. I've seen him

go up and down in weight over time. Oh, I'm on the

Paleo diet. I'm losing weight and then regaining

the weight. Now he's on Zepbound. And like me,

he'll say, what do you think? Should I increase in

dose? Anyway, I've always believed in support

groups, but now I understand them from the inside.

I'm not your coach, and I don't do this alone. I

work with a company called Accomplished Health.

No, they don't pay me, they don't sponsor the

podcast, but they practice real obesity medicine.

And maybe if they hear this, they'll send me a

coffee cup, which I would love. Here's a warning.

If you eat less, you still need micronutrients.

And that's not theoretical. Here's the thing, as a

weight loss surgeon, I've always told my patients,

you need to take a multivitamin. And I realized on

a GLP1, I need to take a multivitamin also. And

the first time I ever threw up, the only time I've

thrown up on this, was when I took a vitamin on an

empty stomach. Sip of coffee and boom, it wasn't

staying down. Now, I'd heard this for years from

weight loss surgery patients that some vitamins

just don't work. And I even tried some of these

fancy bariatric vitamins and they didn't work

either. And the one vitamin group that worked for

me was AG1. No, again, not a sponsorship. It's not

an ad. They don't pay me. This stuff is way too

expensive. Which made me think I should probably

develop a vitamin routine for people on empty

stomachs, because vitamins are critical,

especially thiamine, and the deficiency in

thiamine can be devastating. That's another reason

you really need someone to help you with this

journey.

Now let's talk bowel movements. Here's something

really simple. If you eat less, you're going to

have fewer bowel movements and that does not mean

constipation. Less in means less out. You don't

need to go to the bathroom every day. Fiber still

matters. Mediterranean diet helps naturally.

Vitamins, legumes, whole groups. This is about

understanding physiology and not panicking so why

am I going to write a book? I remember I was

disturbed when I saw a physician who's never been

on GL Pillar 1, never been on a wait list, but is

an obesity physician and fairly good and wrote a

book about how to eat on one. And I realized with

my background weight loss, surgery, culinary

medicine and living is I have to write a book and

I'm thinking of calling it Willpower Is bs. You

know me. Subtle. Now my book agent retired long

ago, so if any of you know or are a good literary

agent, hey, hit me up. I'm back in the market.

Anyway, this is just part one of this journey and

as I record this, I'm about to inject 7m.5mg dose

of Zeppelin and God I still hate needles. I'll

have more to share about the journey as we go, but

don't worry, this is not going to become a

zepbound podcast. I'm going to continue to bust

myths about food and medicine to make sense of the

madness. If you want to find out more, you can

read about it on the blog associated with

YourDoctorsOrders.com or ForkU.com and I am the

guy who researched and wrote this. I'm Dr. Terry

Simpson. I'm a board certified doctor but I am not

your doctor and before you make any changes to

your diet or if you get on zepbound, find a real

obesity physician like Dr. Albert or whomever. Dr.

Dalcy is a great one also in Michigan. Find them

and talk with them. All things audio are done by

my friends at Simpler media and the pod God

himself, Mr. Evo Terra. And by the way, while

weight loss isn't the big thing here, the big

thing is the medical changes that it has made By

Hemoglobin is A1C has gone down. It was normal but

it's better. My blood pressure is down. It was

normal. It was better. Lots of things are down.

They're normal but better. But the weight down is

good, because if I were to die tomorrow, then Mr.

Evo, Tara would probably be one of my pallbearers,

and at least he would have less to work with. All

right. Eat smarter, live better. Leave guilt out

of the kitchen. This is Dr. Simpson. Have a good

week. Hey, Evo. I know, uh, you may be a

pallbearer, but I'm gonna make an ash out of

myself and be cremated. I hope you're doing well,

buddy. How do you like this for true confessions?

Yeah, it's not every day you hear boomers being

all vulnerable and stuff, but I'm proud of you,

man. And also, while we're in the sharing mode, I,

too, have been on the shot for, gosh, about a year

now, doing much better. I love it this way.