Julie Hittleman Returns: GLP-1s, AI Doctors, and Teaching Her Chat GPT to Fight Her

Episode 02. Fifty-six minutes, unscripted. Watch on YouTube · listen on the podcast feed.

Julie Hittleman was 265 pounds in the spring of 2020 when a doctor she had worked beside for ten years told her she was a hamburger shy of a heart attack. She released 120 pounds over the next eleven months. That is the short version, and it is not the point of this conversation. This one is about what six years of coaching other people since has taught her.

Julie is a metabolic health and wellness coach, a certified menopause health and fitness coach, and a registered nurse of 25 years who is not currently practicing as one. That last credential turns out to matter more than any of the others once the conversation gets to GLP-1 medications.

Why does the same hard truth land for one person and bounce off another?

Julie's answer starts with the dog on the porch. Two men are sitting there, an old dog is howling, and one asks the other why. His friend says the dog is lying on a nail. So why does not he get up? Because it does not hurt enough yet.

Most people know intellectually that the way they are eating is not working. Knowing is not what moves anyone. What moves someone is pain that has finally crossed a threshold, paired with an emotional reason to act on it. She told a story from a call with author Jim Kwik about a man who knew intellectually he needed to change his health, and felt nothing about it, until he came home from a business trip and his daughter would not stop crying because she had dreamed he died and never came home. That was not new information. It was the same fact wearing an emotion for the first time, and it is the difference between a person who understands a fact and a person who actually moves.

How does she actually train someone to become a coach?

She takes both ends of the spectrum: medical professionals who already know how to run an intake, and total beginners who have never coached anyone but want to serve people. Both go through the same apprentice model. Watch me do it. Do it with me. Now let me watch you do it.

She compares it to the first time anyone drove a car, talking themselves through every mirror check and pedal, versus twenty years later climbing in half asleep and being a mile down the road without a single conscious thought. That is the same arc she runs new coaches through, from not knowing what they do not know, to knowing they do not know it, to doing it deliberately, to doing it without thinking. It is also, she said, exactly how she learned to start an IV as a new nurse: someone talked her through it, she did pieces of it with a preceptor watching, and eventually she did it alone.

The part that surprised me: strangers often trust her coaching faster than people who have known her for years. Old friends still see the person she was, not the six years of track record since. She put it simply. Let me reintroduce myself to you, because who I was when we met is not who I am now. People who come to her with no history give her the authority she has actually earned. People who knew her before are still catching up to it.

What does a 25-year nurse actually think about GLP-1 drugs like Ozempic?

This is her opinion, built on what she taught, prescribed guidance for, and has seen firsthand, not medical advice for anyone reading this. She worked in endocrinology at UCLA and taught diabetics how to inject GLP-1 medications years before they became a household name. Back then they were used carefully, at lower doses, and titrated up slowly as bloodwork changed.

What worried her once the drugs went mainstream was the starting dose. She saw people begin at doses higher than what a diabetic patient would have been started on years earlier, often with no titration and no supervision of what else needed to change. The medication slows digestion and increases satiation, which is the mechanism, and it is also why the GI side effects show up. Slow it down too hard without prioritizing protein, and the body starts pulling amino acids from muscle instead, which is her explanation for the gaunt, deflated look some people get on these drugs. It is not the weight loss. It is what the body ate instead of food.

She also flagged something rarely discussed: the medication does not last forever in the body, and there is a tolerance curve. People come off it with the appetite they suppressed for months now roaring back, and nobody trained them for that part.

None of this means she is against the drugs. She works with clients who are on them and clients coming off them. Used as a tool alongside real structure, nutrition, and habit change, she has seen people succeed on them who could not on the drug alone. Used as a replacement for changing anything else, she has watched it fail the same people twice.

How does she actually use AI in her coaching practice?

Practically, and without pretending it replaces her judgment. Her clients use bioimpedance scales, the kind that read visceral fat, bone mass, skeletal muscle, and metabolic age instead of just a gravity number. She will feed last week's scan and this week's scan into an AI tool and ask for the changes and any warning signs, work that would take her twenty minutes by hand and takes two with the tool. Then she does the part AI cannot: deciding what it means for that specific client.

Her line for what that actually is: it is a calculator. You are not hunting for cosine and tangent on a scientific calculator's keypad, you are handing it numbers and getting numbers back. It never gets to make the call.

She is blunter about what happens when people skip the human and go straight to the machine for medical decisions. Her joke: the fitness industry used to run on doctors who trained thirteen years. Now half the internet is running on a medical degree from the University of Google, and the newest version of that is a future doctor who wrote his college essays with ChatGPT and is now using it to build his own workout program, before he treats you next year. A little bit of knowledge without discernment is not power. It can be destructive.

Her rule for her own AI use: she has spent a long time training her assistant on her exact parameters and voice, but she still challenges everything it gives back, because she refuses to let it become her voice instead of her own. Her actual worry is not that AI replaces coaches. It is that AI-fluent people who never learned to think without it start to sound like experts, using someone else's words with none of the judgment behind them, and their clients eventually notice the results are not there.

I told her about an odd habit of my own: I have caught my own AI assistant, mid-conversation about intermittent fasting, unprompted offer up the phone number for Overeaters Anonymous. Neither of us asked it to. It decided on its own that skipping a meal warranted a hotline. Julie's response was the whole argument in one line: that is exactly why the human still has to be in the loop, asking why the model said that instead of just taking the answer.

What is Broads Over 50?

Julie just launched a new podcast with two other metabolic health coaches, Tricia and Amber, called Broads Over 50, on Substack, YouTube, and Apple Podcasts. Menopause, midlife, hormones, and whatever else comes up, with nothing off limits. It is brand new, she said, so go easy on the early episodes and watch it get better.

How to reach Julie Hittleman

Practice: hittlemanhealth.com. New podcast: Broads Over 50 on Substack. She is also always looking for people who want to become coaches themselves, medical background or none at all. On Facebook and Instagram she is Julie Stern Hittleman.

This episode is a conversation, not medical advice. Julie's opinions on GLP-1 medications are her own professional perspective, not a recommendation for or against any treatment. Talk to your own physician before starting, stopping, or changing any medication.