Episode 1: Welcome to Straight Shot

Dr. Clete Barrick is dual board-certified in internal medicine and obesity medicine, has treated thousands of GLP-1 patients going on five years, and has personally lost over 80 pounds on tirzepatide. In this premiere episode of Straight Shot, he tells the full story: how a Navy physician couldn't outrun his own biology, what changed when the food noise went quiet, and why he built this show.

He also breaks down the problem he sees every day: patients being mismanaged on GLP-1s by providers running one size fits all algorithms without understanding the clinical nuance. Patients told they're "maxed out" who have options nobody mentioned. Patients who think the medication failed when the care is what failed.

In this episode:

• Dr. Barrick's 80+ lbs. weight loss story on tirzepatide
• What "food noise" is and what it feels like when it stops
• Lessons from treating thousands of GLP-1 patients
• The Kevin story: told he was "maxed out," lost another 9%
• Why access to GLP-1s without expertise is failing patients
• What to expect from future episodes of Straight Shot

This is the show where an obesity medicine doctor who takes the medication himself gives you the information your doctor doesn't have time to explain. No hedging. No corporate script. Just the straight shot.

New episodes weekly. Visit barrickhealth.com for physician-led weight loss care.

Transcript

SPEAKER_00 0:03

Straight Shot. Welcome to Straight Shot. I'm Dr. Cleet Barrick, dual board certified in internal medicine and obesity medicine. I've treated thousands of patients on GLP1 medications, peptides, and medical weight loss therapy. This is Straight Shot, the science of weight loss, explained by a doctor who lives it. Quick note: everything on this show is for education only. It is not medical advice for your specific situation. Always talk to your prescribing physician before making any changes to your treatment plan. Welcome to Straight Shot. Here's something most doctors will never tell you. I take the same medication I prescribe. I'm a board-certified obesity medicine physician and treated thousands of patients on GLP1 medications, and I've personally lost over 80 pounds on terzepatide. I rotate my injection sites, manage the nausea, watched my body change in ways that years of discipline exercise and careful eating never achieved on their own. That's not the confession. The confession is this: I was an obesity medicine doctor who was obese. And I'm not ashamed of that. Because the fact that I couldn't do it on willpower alone is the entire point. This is the show where I give you the GLP1 information your doctor doesn't have the time to explain from a physician who's been on both sides of the prescription pad. This is episode one. And today I'm going to tell you who I am and why this show exists. I want to be honest with you about something before we go any further. There are a lot of people making content about GLP1 medications right now. Influencers, dietitians, coaches, uh, other physicians. Some of it is good. A lot of it is terrible. And almost none of it comes from someone who can say all three of these things at once. So I'm a dual board certified physician in internal medicine and obesity medicine. I've treated thousands of patients on these medications going on five years now, and I take the medication myself. That combination matters because it means I can read the clinical trial data and tell you what 3 a.m. nausea actually feels like. I can explain the pharmacology and tell you about the first time I drove past a fast food restaurant and felt absolutely nothing, which is completely life-changing, by the way. This was my Achilles heel. I know what the step trials say about average weight loss, and I know that my experience, your experience, every patient's experience is not an average. It's an N of one. I wrote an entire book about this. It's called the GLP1 Bible. Over 250,000 words, 800 plus references, 44 chapters. And I realized that most of the people who need this information are unlikely to read all of a book that size. They need someone to take the time and break it down. That's what this show is. I earned my medical degree from the University of Washington and I completed my residency with the Navy in Virginia. I spent eight years as an active duty naval officer, including two years with the Marines in Okinawa, Japan. I worked alongside some of the fittest people on the planet, Marines who could ruck for miles in body armor, do pull-ups until the bar bent, and operate on no sleep in some of the hardest conditions imaginable. And I was heavy the entire time. Not a little extra. I mean, I was heavy. I was the doc who would, you know, counsel patients on nutrition and exercise with genuine expertise, who understood the science in and out, and who still could not get his own weight under control. It sucked. I tried everything, and I don't mean that casually. I mean calorie counting, macro tracking, intermittent fasting, keto, you know, structured exercise programs that I designed myself because I literally have the credentials to do it. I could get the results for a while. I could lose, you know, 20, 30 pounds, uh, but then my body would inevitably fight me every inch of the way back up. The reason I'm telling you this is not for sympathy. I still mentally struggle with this saga of my life. I'll admit it was embarrassing, and even knowing the science, I still feel a level of shame about this. It's something that I'm working on still. I share this because if it sounds familiar to you, I want you to hear it from a physician. You are not failing. Your biology is working against you. Obesity is a chronic, relapsing disease driven by genetics, hormones, and neurochemistry. It is not a moral failure. The American Medical Association recognizes in 2013. The Endocrine Society agrees, the World Health Organization agrees as well. Your body has an internal thermostat, a set point that it defends. And when you lose weight through diet and exercise alone, your body fights back to get to that set point again. I knew all of this, I taught it to patients, I believed it, and I still blamed myself. So then I started to tie. And a few weeks in, you know, something changed that I was not prepared for, even you know, with all of my training. That was the food noise stopping. If you've experienced this, you know exactly what I'm talking about. That constant background hum of thinking about food, planning the next meal, negotiating with yourself about whether to eat the thing or not eat the thing. You know, at least 10% of my internal RAM seemed like it was always dedicated to food. Always. For me, it had been there so long, I didn't know really that it was there. It was like living next to a highway and forgetting the the traffic noise until someone actually closes the window. The medication closed that window. Now I've lost over 80 pounds uh and I'm in maintenance phase at this point. I'm healthier now than I've been my entire life. Now here's the other side. I don't just take this medication, I prescribe it every single day. I've watched a patient buy an entirely new wardrobe for the first time in a decade. I've sat across from someone who told me they went to the beach without feeling self-conscious for the first time since their teens. And I've had a grandmother describe riding a roller coaster with her grandchildren because she could finally fit in the seat. That one was particularly cool. Um, I've had a patient call me, say she, you know, boarded a flight without asking for a seatbelt expend extender for the first time in her adult life. I mean, how amazing is that? These medications give people the chance to become the person they've been working to become their entire lives. And from the first day I started caring for these patients, I haven't felt like I've worked a single day. But I've also seen the other side. I've seen patients come to me after being mismanaged, undertreated, over-treated, scared by bad information, or honestly neglected. I see patients who are told they were maxed out on semaglutide and they had never been offered terzepitide. I see patients whose providers escalate their dose on a rigid monthly schedule from the FDA titration charts because they don't know that there's a far better way to do things. I see patients who develop thyroid problems because nobody told them that semaglutide can change their how their thyroid medication is absorbed. I see patients who lose hair, lose energy, lose muscle. The list goes on and on. And I've seen far too many patients too who believe, uh, who've been told GLP medications don't work for them. When the medication really is working perfectly, it's the care that has failed. I'll say a patient I'll call Kevin came to me after about seven months on semaglutide. He lost about 14% of his body weight, a very solid result. And then he plateaued. His provider pushed the dose higher. Nausea got worse. Kevin started dreading injection day, pushing it back further and further, and but he was up at the highest dose, um, and the scale still wasn't moving, and he felt absolutely awful. Um Kevin's medication hadn't failed. You know, his dosing strategy had. So we ended up switching him to pterosepitide, um, built back up at a pace his body could actually tolerate, really individualized that dosing, and we found his sweet spot. Eight months later, he was down another 9% of his body weight. Uh, never needed the maximum dose, believe it or not. And his A1C dropped from 6.1% to 5.4%. So Kevin's story is not unusual. I'll grant that switching from semaglutide to TERZEPatide is not a complex tactic. That's kind of beginner-level stuff in my book. And this podcast isn't just going to stop at techniques you can pull off the front page of the TERS subreddit. We are going to discuss tactics, strategy, biology that your doctor either won't tell you or doesn't even really understand. Here's the uncomfortable truth about GLP1 medications in 2026. You know, access has exploded. Telehealth companies, compounding pharmacies, direct to consumer platforms. I mean, you can get a GLP1 prescription from your phone in under 15 minutes, start to finish. That access matters. You know, it matters enormously. Um, and it's honestly pretty cool to see how far the telehealth space has developed over the last few years. And a lot of people who couldn't afford or couldn't reach these medications can. Um, but access without expertise is a recipe for suboptimal outcomes. Many patients on GLP1s today are being managed by providers who see them, you know, for five minutes every couple of months. They run a one-size-fits-all algorithm on their patients without really understanding the clinical nuance. Uh, and they honestly just don't have the training or the time to manage the complex interplay of dosing, nutrition, exercise, sleep, stress, drug interactions, and psychology. It all determines whether a patient gets a decent result or an extraordinary one. I'm not pointing fingers, you know, the demand for these medications outstripped the supply of trained uh obesity medicine physicians years ago. There aren't enough of us, and most primary care doctors got maybe a couple hours of obesity medicine training in medical school, if that. So patients fill the gap the way modern humans fill every knowledge gap. They go to Google, they go to Reddit, they hop on TikTok, uh, they find a mix of genuinely helpful patient experiences, uh, dangerous misinformation, and everything in between. Uh a research team analyzed over almost 400,000 Reddit posts uh related to GLP1 medications. They found that uh patient-to-patient comparison was by far the most common topic. You know, people trying to figure out if their experience is normal, uh, using other people's anecdotes as their benchmark. That's where I come in. Before we keep going, I want to tell you about something I built for exactly this problem. Beric Health is my concierge telehealth practice. It exists because I got tired of watching patients get five-minute appointments, a prescription, and a C in a few months. That's not care. That's a vending machine. At Barrick Health, I work with patients one-on-one. Real appointments, real time. We go through your labs, your medications, your nutrition, your exercise, your sleep, every variable that affects your results. I build a plan around your body, not a soulless algorithm. If you've been on a GLP one and feel like something is off, if you've been told you're maxed out and you don't know what's next, if you want a physician who takes these medications himself and treats thousands of patients on them, check out www.baric health.com. I'll put the link in the show notes. Now, back to the show. Every week on Straight Shot, I'm gonna sit down and give you one focused topic. No guests, no panels, no fluff. Just me, the evidence and the clinical experience I've accumulated over years of eating, sleeping, and breathing GLP ones, as well as my own personal journey. We're gonna cover uh how these medications actually work. We're gonna talk about side effects, common ones, weird ones, uh, and the ones nobody warns you about. I'm gonna give you my complete dosing playbook, the same framework I use with my own patients. We'll talk about what to eat, how to exercise, why sleep matters more than you think, and what happens to your brain when the food noise goes quiet. We'll talk about stuff nobody else talks about, the emotional side of losing weight, what happens to your relationships, the identity crisis nobody really gives you the heads up about alcohol cravings that disappear, the insurance denial you shouldn't accept. And I'm gonna tell you about the future. Redatrutide, Cagri Semma, oral GLP1 pills, and what the next five years looks is gonna look like for this field. I'm gonna be honest with you on this show. When the evidence is strong, I'm gonna tell you. When it's uncertain, I'll tell you that too. I'm not gonna hedge everything into oblivion and give you a watered-down, liability-proof version that sounds like was written by a hospital legal department. I say, you deserve better than that. You deserve a doctor who tells you what he actually tells his patients. And that's what straight shot means. No chaser. Here's what I actually tell my patients on day one. You are not lazy. You are not weak. You did not fail at dieting because of a character flaw. You have a chronic disease with genetic, hormonal, and a neurological basis, and you now have access to the most effective treatment that has ever existed for it. But the medication is not a magic shot. It's a tool. It's the best tool we've ever had by far. And like any tool, it works better when someone who knows what they're doing helps you use it. And that's what I'm here for. If you're just starting, if you're stuck, if you're scared, if you're confused, if you've been told the medication stopped working and you don't know what to do next, you're in the right place. And if you don't just want education, if you want a physician who will actually sit with you, go through your numbers, build a plan that fits your life, that's Baric Health, concierge telehealth, real appointments, a doctor who's been where you are. So that's the first episode of Street Shot. Next week, we're getting into the science, how GLP1 medications actually work in your body. Explain in a way that makes sense without a medical degree. If this was helpful, subscribe so you don't miss it. Share it with someone you know who's on a GLP 1 medication or thinking about starting one. I'm Dr. Cleet Barrick. Thanks for being here. I'll see you next week.