5HT #114: The identity drug

Back in my early Greatist days, I read The Power of Habit by Charles Duhigg and used it to finally build a meditation practice. Now, I always joke I have a very simple habit chain: I wake up, I pee, and I meditate. May or may not put it on a T-shirt. 😆

For years, I was someone who wanted to meditate. Then, somewhere along the way, I became a meditator. And once that flipped, everything downstream got easier—I was better at work, better to my now-wife, slower to react, faster to recover. 

That’s when my brain started to think about it differently. Meditation stopped being a "healthy" thing I did, and it started feeling like a superpower.

So when the folks at Noom—who just brought Duhigg on as an advisor focused exactly on this intersection—connected us for a sit-down (cue fanboy moment 😅), I knew what I wanted to talk about.

Because I don't think GLP-1s are just a catalyst for healthier decisions. 

I think they're a catalyst for the same identity flip.

Duhigg has been on a GLP-1 for over a year. So have I. (Are we the same???) 

Longtime readers know my version: I grew up a big kid with a ton of food noise—I just didn’t have a word for it. Orrrr any clue mine ran louder than most people’s, until microdosing GLP-1s showed me what my head sounded like without it. 

I even tapered off at one point, hated how loud everything got, and went back on at a tiny maintenance dose. That quiet has been one of the most meaningfully positive changes in my life—not just around food, but in what I have room to notice about everything else.

And Duhigg explained the mechanism better than anyone I've heard.

Your brain tracks two kinds of preferences:

1️⃣ Stated preferences: I want to lose weight. 
2️⃣ Revealed preferences: I say I want to lose weight, but every time I go to the cafeteria, I get a Cinnabon.

Your brain 🧠 watches both 👀—and builds a subconscious self-image out of the gap. If I keep saying I want to lose weight and keep eating Cinnabons, my brain is calling BS.

The identity that forms in the deeper parts of my brain: I’m someone with good intentions and no follow-through. I have weak willpower. And, unfortunately, that becomes its own habit. I feel bad about myself. That makes it even easier to ignore my stated preference: I already had the Cinnabon, why not ice cream too?

The fix, per Duhigg, is to create moments where stated and revealed preferences align. Prove to yourself you’re the kind of person who walks past the Cinnabon.

And that’s what GLP-1s actually do. They don’t lose weight for you. They quiet the food noise and make walking past the Cinnabon easy enough that you actually do it. Over and over 🔁. Which is exactly the evidence your brain needs to stop calling BS.

The default story about weight is that it's a willpower problem. Duhigg thinks the story has the science backward ⏮️.

Willpower is finite. If you're spending all of it fighting food noise, there's nothing left over to cook, exercise, or take that post-dinner stroll. GLP-1s free up your budget, and the willpower you were burning on resisting gets reallocated to building. 

That's when the identity rewrite starts. 

You go from "I'm on a diet" (which is about denying yourself, btw) to:

Statements your brain actually believes—because now your revealed preferences back them up. And when your brain believes the identity, it goes on autopilot. Same thing that happened to me with meditation: "I want to meditate" never worked. "I'm a meditator" 🧘‍♂️ runs itself.

One thing Duhigg was emphatic about: GLP-1s open a habit-change window 🪟, but windows close. The medication is the catalyst, not the system.

The system is whatever forces you to pay attention. 

The National Weight Control Registry—which tracks people who’ve kept significant weight off long-term—consistently finds self-monitoring, especially food journaling, among the strongest predictors of maintenance. Not because journaling is magic 🪄. Because noticing is. (FWIW I'm an enormous journaling guy, and it's still the single best tool I've found for noticing things about myself.)

Plus, as Duhigg points out, rewards are more rewarding when we notice them—and every small win you observe is more evidence your new identity is real.

This is the entire bet Noom is making, by the way. Their new report—surveying nearly 5K GLP-1 users found more than 90% (!!) said the medication helped them adopt healthier habits. Duhigg is also building a “Habit School” for Noom members, designed to make the habits outlive the prescription.

So, get the system right, and the medication matters less over time. Not because you white-knuckled your way off of it. Because the behavior change already happened, and habits, once they shift, run in the background. That’s why plenty of people won’t need to be on these drugs forever.

This is also why the "GLP-1s are cheating" narrative drives me a little crazy 😵‍💫. 

We've assigned a moral failing to a biological process. Some people's brains are simply louder about food than others 📢. That doesn't make anyone better or worse—it makes it a biological problem. And biological problems deserve biological solutions.

Meditation gave me a superpower by adding capacity. GLP-1s gave me one by removing friction. Different mechanisms, same destination: you stop being someone trying to get healthier.

You just become someone who is.

👋 Who are you again? I’m Derek Flanzraich—founder of two venture-backed startups in Greatist (👍) and Ness (👎). I’ve worked with brands like GoodRx, Parsley, Midi, Ro, NOCD, and Peloton. I now run Healthyish Content, a premium health content & SEO agency (among other things).

Every Thursday (and now Sunday!), I share healthyish things I feel strongly about. (Disclaimer: I’m more your friend with health benefits. None of this is medical advice.) Also some links are affiliate links, but they influence my decisions zero.

Oh, you also feel strongly about some health things? Hit reply—I’d love to hear it.