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Why are GLP-1 drugs exploding in sleep medicine, yet most patients still struggle to lose and keep off weight? Dr. Jonathan Lown breaks down why obesity is not a willpower problem, how GLP-1s change sleep apnea outcomes, and why dentists need to rethink how they talk about weight, airway, and treatment options. What We Discuss with Dr. Jonathan Lown: • GLP-1s in Sleep Medicine: Why tirzepatide and other GLP-1 drugs are a major shift in treating obstructive sleep apnea, not just obesity. • Why Weight Loss Fails Most Patients: The biology of weight regain, the SURMOUNT-4 data, and why maintenance is the real battle. • The Food Noise Problem: How appetite, reward systems, and evolution work against long-term dieting success. • CPAP, Oral Appliances, and Weight Loss: When patients lose weight, how treatment strategies shift and why oral appliances may become more viable. • The Uncomfortable Weight Conversation: How clinicians can discuss weight without shaming, while still being honest about health risks. • Muscle Loss, Protein, and Exercise: What actually happens to muscle during rapid weight loss and how to mitigate it. • Practical GLP-1 Tips: Bowel regularity, hydration, reflux timing, and why late-night eating matters more than people think. • The Future of Sleep Therapy: How GLP-1s may reshape Inspire, CPAP adherence, and dental sleep referrals. • And much more. Episode Summary For decades, sleep medicine has treated airway collapse while ignoring the weight conversation. That is no longer sustainable. In this episode, Dr. Jonathan Lown, internist, sleep physician, and sleep apnea patient, explains why GLP-1 medications represent a turning point for sleep apnea care. He shares his personal 50-pound weight loss journey, the clinical trial data behind tirzepatide, and why most patients fail at weight loss long-term despite multiple attempts. The hosts unpack the uncomfortable truth: obesity is biologically defended, weight regain is common, and lifestyle advice alone is often insufficient. They explore how weight loss changes CPAP tolerance, opens doors for oral appliance therapy, and may fundamentally change how dentists and physicians collaborate in airway care. If you treat sleep apnea, this conversation will change how you think about weight, compliance, and patient outcomes. Resources and References Mentioned • Featured Study Malhotra A, et al. Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity (SURMOUNT-OSA). New England Journal of Medicine, 2024. • Weight Maintenance Study SURMOUNT-4 Trial: Long-term data showing significant weight regain after stopping GLP-1 therapy. • Clinical Practice Guidelines 2015 AASM/AADSM Joint Guidelines for Oral Appliance Therapy.