WEBVTT - External Exam - Ozempic and Leaky Gut with Dr. Partha Nandi 0:00:04.720 --> 0:00:09.600 Mother Knows Death presents External Exams with Nicole and Jimmy. 0:00:16.840 --> 0:00:19.319 Over the past few weeks on Mother Knows Death, Maria 0:00:19.320 --> 0:00:21.880 and I have talked about a variety of news stories 0:00:21.960 --> 0:00:26.320 that involve the GI system and in particular the newest 0:00:26.560 --> 0:00:30.560 fad of weight loss with drugs like ozembic, and on 0:00:30.600 --> 0:00:33.559 today's External Exam, I thought it would be perfect if 0:00:33.600 --> 0:00:36.919 we spoke with a GI specialist, So I'd like to 0:00:37.040 --> 0:00:40.760 welcome doctor Partha Nandy. Hi, It's an honor to have 0:00:40.920 --> 0:00:41.320 you here. 0:00:42.040 --> 0:00:44.760 Well, thanks, Nicole. I like when people say external exam. 0:00:45.240 --> 0:00:47.639 When my patients say external exam, that only means one thing, 0:00:47.720 --> 0:00:50.479 so we're not doing that today, but absolutely pleasure. It's 0:00:50.520 --> 0:00:51.720 a pleasure to join me today. 0:00:52.520 --> 0:00:56.480 Thanks for being here. And doctor Nandy is a gastro 0:00:56.640 --> 0:01:00.640 enterlogist as well as a holistic health practitioner, and he 0:01:00.760 --> 0:01:02.880 as a host of his own TV show that is 0:01:02.880 --> 0:01:06.080 called Ask Doctor and Nandie tell us about that a 0:01:06.080 --> 0:01:08.720 little bit. What's up with your TV show? Yeah? 0:01:08.800 --> 0:01:12.720 You know what happened was my dad. He was my 0:01:13.080 --> 0:01:16.520 biggest hero when I was growing up and he got sick. 0:01:16.920 --> 0:01:20.200 When you know, how long has it been now, it's 0:01:20.240 --> 0:01:23.880 been about sixteen years ago he got He was very healthy, 0:01:24.040 --> 0:01:27.560 never never really had any time to was the hospital, 0:01:27.560 --> 0:01:31.200 but he got a devastating stroke. And what happened then, Nicole, 0:01:31.280 --> 0:01:32.640 is that I was I thought it was a pretty 0:01:32.680 --> 0:01:36.000 good doc. I thought I was empathetic. I thought I 0:01:36.080 --> 0:01:39.480 did a good job. But what I became the patient 0:01:40.520 --> 0:01:43.160 because of my dad and the advocate, I realized that 0:01:43.600 --> 0:01:45.479 there's a lot I didn't know. What I mean by 0:01:45.480 --> 0:01:48.840 that is how to be able to advocate for yourself 0:01:49.200 --> 0:01:51.960 what it feels like as a patient through our health system, 0:01:52.480 --> 0:01:56.040 and also how do I how do I as a patient, 0:01:56.160 --> 0:01:59.200 not as a doctor, to prevent what happened to my dad. So, 0:02:00.000 --> 0:02:02.760 you know, I thought about how to do it. I 0:02:02.800 --> 0:02:04.600 had a friend who was a producer in la and 0:02:04.640 --> 0:02:06.160 he he talked to me and said, you know, some 0:02:06.240 --> 0:02:09.480 of the things you talked to me about, doctor Dady, 0:02:09.560 --> 0:02:11.560 we could we could do television. So it certained a 0:02:11.600 --> 0:02:15.359 television show that basically talks about empowering you know, to 0:02:15.560 --> 0:02:18.000 yourself to be a healthier which is your own advocate 0:02:18.720 --> 0:02:22.040 for yourself and your family. And that's what began, and 0:02:22.080 --> 0:02:25.680 we started in one television station in Detroit. That's where 0:02:25.680 --> 0:02:28.560 I'm from and then now you know we're syndicated throughout 0:02:28.560 --> 0:02:30.600 the country in the world. It's because when I have 0:02:30.639 --> 0:02:34.280 a simple message, is that make your health and wellness 0:02:34.280 --> 0:02:36.720 your parody, which is a lot what you're doing. So 0:02:36.800 --> 0:02:39.040 that's kind of my that's our mission, our you know, 0:02:39.080 --> 0:02:42.040 our north star. And then we called the folks that 0:02:42.440 --> 0:02:45.200 believe in that health herold. We think everybody should be 0:02:45.240 --> 0:02:45.680 a health hero. 0:02:46.760 --> 0:02:50.200 So when you went to medical school, you became you 0:02:50.240 --> 0:02:52.960 specialized in GI. Is that have you done that since 0:02:52.960 --> 0:02:56.480 you graduated medical school and did a residency in GI 0:02:56.720 --> 0:02:58.160 you've been doing that this whole time? 0:02:58.360 --> 0:03:00.800 Yeah, So what happens is you do medical four years 0:03:00.800 --> 0:03:03.840 and you do residents you for three years in internal medicines. 0:03:03.880 --> 0:03:07.320 You become a specialized specialist in everything, right, which is 0:03:07.320 --> 0:03:10.000 internal medicine. And that's helpful for my show because I 0:03:10.000 --> 0:03:13.280 talk about everything. And so once you finish internal medicine, 0:03:13.280 --> 0:03:16.519 then you do three more years of being a sub specialist, 0:03:16.880 --> 0:03:20.239 which is a gastronogist. So that means diseases of the testine, 0:03:20.720 --> 0:03:25.720 the liver, the pancreas, the colon, the digestive issues. S. 0:03:27.040 --> 0:03:29.480 I liked it because you know, you get to talk 0:03:29.520 --> 0:03:32.160 to people and then be an expert. But you also 0:03:32.240 --> 0:03:34.720 get to do some procedures where you look inside the 0:03:34.760 --> 0:03:37.280 stomach with today, we had a patient that was bleeding. 0:03:37.320 --> 0:03:39.400 I was able to put a clip stop the bleeding. 0:03:39.760 --> 0:03:41.960 I think that's cool because you have a patient that's sick, 0:03:42.360 --> 0:03:44.720 you do something and they get better. That part of it. 0:03:44.760 --> 0:03:47.120 I like. I almost like counseling them for prevention. So 0:03:47.120 --> 0:03:48.480 that's why I like gastrorology. 0:03:49.200 --> 0:03:52.520 I get that GIG system is probably my favorite system too. 0:03:52.680 --> 0:03:56.280 I just I feel like I like it the most 0:03:56.280 --> 0:03:59.160 when I'm doing an autopsy or something, so I understand 0:03:59.160 --> 0:04:01.840 why you like it. So, seeing how long have you 0:04:01.920 --> 0:04:04.760 been a GI doctor for about decades? 0:04:04.760 --> 0:04:06.080 A couple of decades. 0:04:06.120 --> 0:04:09.800 Yeah, okay, so over the years you've probably seen since 0:04:09.840 --> 0:04:12.240 you deal with the GI system, you've probably seen some 0:04:13.760 --> 0:04:18.200 changes in weight loss trends. I would say, and I 0:04:18.240 --> 0:04:20.960 know some of this because I worked in surgical pathology 0:04:20.960 --> 0:04:24.640 for like twenty years, so I would say maybe ten 0:04:24.720 --> 0:04:27.280 years ago, like all the rage was sleeve gas jrectomy 0:04:27.440 --> 0:04:31.000 every day, getting multiple sleeve gas diractomies, and now it 0:04:31.080 --> 0:04:33.960 seems to be all the rage is like these weight 0:04:33.960 --> 0:04:38.840 loss drugs like ozempic, right, and now we have we 0:04:38.920 --> 0:04:41.400 have all these celebrities that have been losing weight over 0:04:41.480 --> 0:04:44.800 the past couple of years and now over the past 0:04:44.880 --> 0:04:48.960 couple of months, people like Oprah, Sharon Osbourne. They're all 0:04:48.960 --> 0:04:52.039 coming out and saying like, yeah, I use ozempic. So 0:04:52.160 --> 0:04:55.920 now it's that's the drug of choice right now. And 0:04:57.160 --> 0:05:00.760 can you explain to us exactly like what oze is 0:05:00.800 --> 0:05:02.880 and how does it help a person lose weight? 0:05:03.640 --> 0:05:06.400 Yeah, you're absolutely right, And to me, it's a revolution 0:05:06.560 --> 0:05:10.440 It's like it's a revolutionary drug because it's it's working 0:05:10.560 --> 0:05:12.919 in a way that people understand it. And you know, 0:05:12.960 --> 0:05:15.960 when people did gastric surgeries like the sleep gastrectomies like 0:05:15.960 --> 0:05:19.040 you're talking about. There are multiple ways for people who 0:05:19.080 --> 0:05:20.960 are listening watching is that you know how you can 0:05:21.320 --> 0:05:23.200 you can have weight loss. One of them is kind 0:05:23.200 --> 0:05:24.919 of part of the stomachs. You can't eat and you 0:05:25.000 --> 0:05:27.800 reroute it so you physically are not able to absorb 0:05:27.920 --> 0:05:31.719 nutrients and not eat. You can't eat enough and so 0:05:31.920 --> 0:05:35.440 you physically restrict it. This drug like you talked about 0:05:35.440 --> 0:05:39.680 a zempic and it's analogue with govy. Remember zempic is 0:05:39.880 --> 0:05:43.479 indicated for diabetes, right, and for people with diabetics. Its 0:05:43.520 --> 0:05:46.719 analogue with gov is indicated for for weight loss, but 0:05:46.720 --> 0:05:49.960 people use it interchangeably. So let's talk about just so zembic. 0:05:50.040 --> 0:05:52.400 It's there's a class. It's a class of medication called 0:05:52.680 --> 0:05:55.760 semi glue tide, and what it does is it kind 0:05:55.800 --> 0:05:58.479 of mimics it. It pretends like it's a it's a 0:05:58.520 --> 0:06:01.159 hormone that naturally occurs the body. And what that does 0:06:01.279 --> 0:06:05.640 is when that hormone kind of goes up, it goes 0:06:05.680 --> 0:06:08.679 to your brain and then the brain says, aha, I'm full. 0:06:09.000 --> 0:06:12.279 So you're not struggling. You just don't feel like eating, 0:06:12.600 --> 0:06:15.679 which is magnificent for people who are like, it's always 0:06:15.760 --> 0:06:18.480 hungry and I can't stop it, right, So it does 0:06:18.560 --> 0:06:22.600 that in addition to that, In addition, it slows down 0:06:22.640 --> 0:06:27.000 by digestion by increasing the amount of time it takes 0:06:27.000 --> 0:06:29.479 for food. So in boxing, it's like a one two 0:06:29.480 --> 0:06:33.280 punch because you're not only not feeling full or not 0:06:33.320 --> 0:06:35.800 feeling hungry, but you also feel full for a longer 0:06:35.839 --> 0:06:38.279 punt of time. And that's why it's so effective. Like 0:06:38.440 --> 0:06:40.720 a lot of people, especially when my colleagues are kind 0:06:40.720 --> 0:06:43.400 of like they pukou it. I think, I think it's 0:06:43.440 --> 0:06:46.400 not so bad. I think you've tried everything else and 0:06:46.440 --> 0:06:50.080 this is the big if. Right. I had a lady Nicole, 0:06:50.120 --> 0:06:54.960 it said, and she was not obese. She said, eh, doctor, nanny, 0:06:54.960 --> 0:06:57.320 can I do it? So it's ten to fifteen pounds. 0:06:57.400 --> 0:06:59.039 And it looked good in my bathing sit like it. 0:06:59.040 --> 0:07:02.159 It's not what this is or that's to me the key. 0:07:02.279 --> 0:07:05.760 You may see Oprah like melting away, or you know 0:07:05.839 --> 0:07:08.920 some other celebrity and you can tell they're like dramatic loss. Wait, 0:07:09.000 --> 0:07:11.400 that's one thing and they're doing it. But if you're 0:07:11.440 --> 0:07:14.000 not obese, first of all, I don't think you should 0:07:14.080 --> 0:07:17.120 do that. But secondly, you should couple it with the 0:07:17.160 --> 0:07:19.640 things we talk about by being you. On Healthy Ero, 0:07:19.760 --> 0:07:23.760 we talked about five pillers. It's purposeful living. Number two 0:07:23.880 --> 0:07:27.480 is not a diet, but getting the right foods in 0:07:27.520 --> 0:07:30.880 your body. Number three is movement with purpose. You gotta 0:07:30.920 --> 0:07:34.560 move and do things, have community and spirituality. I think 0:07:34.600 --> 0:07:38.320 you got to really have a holistic approach to doing this. 0:07:38.640 --> 0:07:40.920 Let's say you don't do all five, at least move 0:07:41.440 --> 0:07:44.240 and at least have healthy foods. It doesn't mean because 0:07:44.280 --> 0:07:47.400 I'm taking we go over your ozeen bake and now 0:07:47.840 --> 0:07:52.400 I can, you know, have a juicy you know, double cheese, whatever, 0:07:53.160 --> 0:07:55.760 burger concoction, only what I want to eat. So you've 0:07:55.800 --> 0:07:59.320 got to eat better, you gotta eat healthy and move 0:07:59.480 --> 0:08:03.040 along with this. But to me, it's gonna change things 0:08:03.120 --> 0:08:06.640 because I've already seen the demands. I do endoscopy, which 0:08:06.680 --> 0:08:09.960 is basically taking a little skill going into your mouth 0:08:09.960 --> 0:08:13.280 and neuroesophagus and stomach. I do that preoperatively, meaning that 0:08:13.760 --> 0:08:18.800 I tell the surgeons, hey, this patient can is okay 0:08:18.840 --> 0:08:22.280 to have a gastric bypass. Certainty that demand nicoll is 0:08:22.320 --> 0:08:25.560 way down already, not to mention what's gonna happen in 0:08:25.600 --> 0:08:27.360 the future as we get more and more in these drugs. 0:08:27.360 --> 0:08:31.520 So to me, the grain area is, hey, what's gonna 0:08:31.520 --> 0:08:33.720 happen long term? We're talking about a couple of months, 0:08:33.720 --> 0:08:35.840 three months, four months, five months, maybe even a year, 0:08:36.000 --> 0:08:38.280 But what happens five years down the road, you know, 0:08:38.320 --> 0:08:40.439 when you've taken this drugs, So I'd like to know 0:08:40.480 --> 0:08:42.880 what the long term side effects now. But I think 0:08:42.880 --> 0:08:46.000 it's another tool in our armamentarium to be able to 0:08:46.240 --> 0:08:49.400 fight obesity, which to me is the biggest epidemic in 0:08:49.440 --> 0:08:49.920 the planet. 0:08:50.720 --> 0:08:54.040 I agree with you, and I would say that a 0:08:54.120 --> 0:08:58.199 majority of the autopsies that I do, the patient has obesity, 0:08:58.320 --> 0:09:01.439 and younger people that are that are, you know, this 0:09:01.600 --> 0:09:05.400 prime age of women that I was seeing, especially between 0:09:05.440 --> 0:09:08.800 like fifty and sixty years old, way too young to die, 0:09:08.880 --> 0:09:13.000 but all obese and just I think it's really important 0:09:13.040 --> 0:09:16.400 that no matter how you lose it, you lose it 0:09:16.440 --> 0:09:22.000 because of the comorbidities associated with obesity. But it's funny 0:09:22.040 --> 0:09:24.880 that you mentioned that about the short term weight loss 0:09:24.920 --> 0:09:27.240 for people that like me, like I'm trying to lose 0:09:27.280 --> 0:09:30.880 like five or ten pounds, just oh, just take this medication. 0:09:31.000 --> 0:09:34.160 We had a story in the news actually of a 0:09:34.240 --> 0:09:37.560 woman that was given ozempic because she was trying to 0:09:37.600 --> 0:09:40.280 lose weight for her daughter's wedding to fit into the dress. 0:09:40.840 --> 0:09:44.640 So we're talking what ten to fifteen pounds max. And 0:09:44.800 --> 0:09:48.200 she ended up having a bowel obstruction and dying because 0:09:48.200 --> 0:09:52.640 of it. And so what are some of the negative 0:09:52.640 --> 0:09:55.440 effects that you see with this type of drug. 0:09:56.120 --> 0:10:00.280 Well, it's slowing down the intestinal motility. The movie of 0:10:00.360 --> 0:10:03.280 the of the food right, that's going through So people 0:10:03.320 --> 0:10:07.480 who already have problems with movement through your intestine can 0:10:07.480 --> 0:10:11.640 cause problems. You mentioned. You know, it's not common, it's rare. 0:10:11.760 --> 0:10:15.040 You could have problems with obstruction, which is a blockage 0:10:15.080 --> 0:10:17.400 I mean intestine. Let's say if you have a little 0:10:17.400 --> 0:10:19.280 bit of an area and then you slow things down 0:10:19.280 --> 0:10:21.959 even more, potentially you can you can make that worse. 0:10:22.160 --> 0:10:24.280 You can have problems with gall bladder problems. You could 0:10:24.280 --> 0:10:28.520 have problems with pagre titis. There's rare problems with infections. 0:10:28.559 --> 0:10:31.319 There's all kinds of you know, other side effects you 0:10:31.360 --> 0:10:34.680 can have, but the main ones are dealing with your 0:10:34.880 --> 0:10:37.880 food and your stomach not moving through, so you can 0:10:37.920 --> 0:10:41.560 have nausea, blow ding, abdominal discomforts. If you have any 0:10:41.600 --> 0:10:45.560 of those issues, don't forget to mention your doctor. People 0:10:45.920 --> 0:10:49.240 are so desperate to get this they don't They don't 0:10:49.240 --> 0:10:51.480 want to tell them anything about what's going on. Even 0:10:51.480 --> 0:10:55.280 if they know that there's possibility of this happening, they 0:10:55.280 --> 0:10:58.199 don't tell their doctor or their healthcare provider. It's important 0:10:58.240 --> 0:11:00.640 you let people know the street. If you have any 0:11:00.800 --> 0:11:04.440 yaspintestol issues, let your doctor figure that out. Any GI issues. 0:11:04.520 --> 0:11:07.120 What I mean is a nauseously the um bloating, you 0:11:07.160 --> 0:11:10.160 have discomfort, let them know, because this could make it worse. 0:11:10.480 --> 0:11:13.200 In some cases, it can make it significantly worse, leading 0:11:13.200 --> 0:11:16.360 to hospitalization. So again, it's not to be taken lightly. 0:11:16.360 --> 0:11:19.240 It's not just why eject myself and I'm gonna look great. 0:11:19.559 --> 0:11:22.679 It's more than that. And again again I'll say it 0:11:22.720 --> 0:11:26.040 has to be coupled with diet and having good food 0:11:26.120 --> 0:11:27.199 choices and exercise. 0:11:28.160 --> 0:11:30.920 Do you think that doctors that are prescribing this are 0:11:31.200 --> 0:11:35.000 giving that message because I personally have friends and family 0:11:35.000 --> 0:11:38.600 members that take these medications and they still eat like shit, 0:11:38.720 --> 0:11:43.280 they don't exercise. And one family member very close when 0:11:43.320 --> 0:11:48.880 I won't name her name in particular, had serious issues 0:11:48.880 --> 0:11:51.679 with motility, like almost had to go to the hospital, 0:11:52.520 --> 0:11:56.839 and she doesn't have great eating habits and had some 0:11:56.920 --> 0:12:00.880 kind of an obstruction, severe abdominal pain and up passing it, 0:12:00.920 --> 0:12:04.480 but then had bleeding and the rectum and everything because 0:12:04.520 --> 0:12:07.360 of it. And I don't I don't think that anyone 0:12:07.400 --> 0:12:09.680 ever really said to her, you need to change your 0:12:09.920 --> 0:12:13.000 your ways. So that concerns me. 0:12:13.600 --> 0:12:16.200 I think a lot of times, you know, we as 0:12:16.280 --> 0:12:20.000 doctors also want to keep our patients happy. It's easier 0:12:20.040 --> 0:12:22.400 just to write a strip right and have them go 0:12:22.440 --> 0:12:25.320 on their way than taking the time to say, hey, 0:12:25.360 --> 0:12:28.280 this is what's going to happen, because then comes up, oh, 0:12:28.679 --> 0:12:31.120 if so, do you think that I should do this 0:12:31.240 --> 0:12:34.040 or not? You see what I'm saying. It's harder to 0:12:34.400 --> 0:12:36.440 do that. So lots of people say, I think it'll 0:12:36.480 --> 0:12:38.959 be all right, say if your take it, because well, 0:12:38.960 --> 0:12:41.840 you've been to you've been to people like myself. You 0:12:41.880 --> 0:12:44.080 don't have a lot of time. I mean, you're in 0:12:44.160 --> 0:12:46.720 and out so quickly. And if it's just that you're 0:12:46.720 --> 0:12:49.320 here for the drug that you're looking for for weight 0:12:49.360 --> 0:12:52.600 loss or diabetes management, let's say, then you're you know, 0:12:52.679 --> 0:12:54.360 if you just write the prescription, you're on the way. 0:12:54.400 --> 0:12:57.360 So I think it's our responsibility, and this is for 0:12:57.400 --> 0:13:00.599 anybody who's healthcare professional to really let the patient. No, 0:13:01.120 --> 0:13:04.120 this is not a no brainer. It's like a nothing 0:13:04.160 --> 0:13:06.960 burner or something. It's not like taking it's not like 0:13:07.000 --> 0:13:11.800 taking something that is innocuous, right, It's something that's significant 0:13:11.840 --> 0:13:14.840 in your body that could could potentially harm it. So 0:13:14.880 --> 0:13:17.400 I think that people are not saying, hey, you know what, 0:13:17.520 --> 0:13:20.199 you could have your kidneys get damaged. Hey, you could 0:13:20.240 --> 0:13:24.120 have changes in your in your vision or worsening constipation, 0:13:24.800 --> 0:13:26.600 you know, like your pain group will get in played 0:13:26.600 --> 0:13:30.240 because I think that it's just it's just a much 0:13:30.240 --> 0:13:32.760 more involved conversation. And to be honest, some may not 0:13:32.840 --> 0:13:36.360 even know that. Some healthcare defessionals are ready, may not 0:13:36.440 --> 0:13:39.320 even know that there are these complications. So I think 0:13:39.320 --> 0:13:42.520 it's it's it's again be your and health theory. You're 0:13:42.559 --> 0:13:46.600 taking something, get to know yourself. We have resources now, 0:13:46.720 --> 0:13:48.719 get to know these side effects and see, hey, you 0:13:48.760 --> 0:13:50.360 know what. I'll go to my doctor and say I 0:13:50.400 --> 0:13:53.040 have these problems and you know the side effects. Can 0:13:53.200 --> 0:13:55.440 you think that's right for me? It's got to be 0:13:55.440 --> 0:13:57.920 a joint decision of partnership. It's not like I want 0:13:57.920 --> 0:14:01.720 to lose weight to take this all. It's a great 0:14:01.800 --> 0:14:04.880 drag and it can work. It can work, But I 0:14:04.920 --> 0:14:07.680 think that I don't think that it's something that should 0:14:07.720 --> 0:14:11.400 be taken lightly and should be taken with the direction 0:14:11.520 --> 0:14:14.240 of your healthcare provider, and you have to ask them, 0:14:15.320 --> 0:14:16.959 can something bad happen with this? 0:14:18.120 --> 0:14:20.480 I like that you mentioned about the long term side 0:14:20.520 --> 0:14:23.440 effects because obviously this drug hasn't been out too long 0:14:23.480 --> 0:14:27.280 to really know what is going to happen. In fifteen 0:14:27.400 --> 0:14:29.640 twenty years down the line with people that have been 0:14:29.680 --> 0:14:34.280 taking this medication long term. And obviously this medication isn't 0:14:34.560 --> 0:14:36.840 for people to take for the rest of their lives. 0:14:36.840 --> 0:14:39.880 It's supposed to be a correct I mean, if they're 0:14:39.880 --> 0:14:45.400 not taking it for diabetes management or something. So I 0:14:45.400 --> 0:14:48.520 don't know if you heard this, but recently a huge company, 0:14:48.560 --> 0:14:53.400 weight Watchers, has kind of gotten on the ozempic bandwagon 0:14:53.440 --> 0:14:56.520 and now they offer a subscription that you can get 0:14:56.760 --> 0:15:01.800 ozempic along with their weight loss pro which is good 0:15:01.880 --> 0:15:05.640 because they teach healthy eating habits and stuff. But do 0:15:05.720 --> 0:15:09.080 you feel like our culture is kind of like heavily 0:15:09.200 --> 0:15:12.560 going hard into this ozepic and giving up things like 0:15:13.600 --> 0:15:16.360 the regular way that you used to lose weight with, 0:15:16.440 --> 0:15:18.720 like caloric restriction and exercise. 0:15:19.200 --> 0:15:22.920 And I think that's you're absolute to me. You as 0:15:22.760 --> 0:15:25.760 a as a person prescribing, have to make it very important. 0:15:25.760 --> 0:15:29.360 Once you get your goal, you have to continue to 0:15:29.480 --> 0:15:32.520 do the other things besides the medication. Otherwise, I mean, 0:15:32.560 --> 0:15:34.680 there are studies right now that show that if you don't, 0:15:35.200 --> 0:15:37.600 if you continue to do what you're doing before these empic, 0:15:37.680 --> 0:15:41.280 you'll you'll gain the weight right back. It's not magical. Right, 0:15:41.360 --> 0:15:44.880 So once you take away the active substances that's making 0:15:44.920 --> 0:15:47.640 your brain feel like you're full and you're slowing down 0:15:47.840 --> 0:15:50.880 the speed of the stomach moving food through, you're going 0:15:50.960 --> 0:15:53.000 to gain the weight back. So it's really important to 0:15:53.080 --> 0:15:56.360 learn those habits while you're taking the drugs. If you 0:15:56.800 --> 0:15:59.880 don't have those habits, so you're absolutely right, and you know, 0:16:00.040 --> 0:16:02.560 it's not meant for them to just keep taking it forever. 0:16:02.600 --> 0:16:04.440 Some people will take it for a longer period of 0:16:04.440 --> 0:16:06.480 time because they may not get the weight loss, but 0:16:06.520 --> 0:16:08.560 it's not meant for people who are trying to have 0:16:08.600 --> 0:16:12.040 weight loss and not having diabetes. It's not forever. But 0:16:12.320 --> 0:16:15.360 again we have to let the patients know. You got 0:16:15.360 --> 0:16:17.800 to you've got to be able to understand the other 0:16:17.840 --> 0:16:21.280 two things that you do just movement, just exercise and 0:16:21.440 --> 0:16:24.200 eating well. And to be eating well, that doesn't mean 0:16:24.240 --> 0:16:26.680 that you know, you eat less. It means that when 0:16:26.680 --> 0:16:29.160 you eat the foods, make sure they're a whole, make 0:16:29.160 --> 0:16:30.680 sure they're nutritious. 0:16:30.320 --> 0:16:34.200 Make sure that they give you the nutrients you need 0:16:34.640 --> 0:16:38.160 and not just just looking at the taste and that's it. 0:16:38.440 --> 0:16:41.760 You know, like you have you know, cheeseburger for examples 0:16:42.120 --> 0:16:45.520 may taste good, but the nutrient value and the toxic 0:16:45.640 --> 0:16:48.760 value TAXX and load is huge. So you've got to 0:16:48.760 --> 0:16:50.920 be able to teach those. We have to be able 0:16:50.920 --> 0:16:53.360 to do that. Patients who come to you for this 0:16:53.880 --> 0:16:57.160 have clearly not learned this, most of them, because otherwise 0:16:57.200 --> 0:16:59.080 they would be asking you for that. So we have 0:16:59.160 --> 0:17:01.600 to be able to teach are our patients that to 0:17:01.640 --> 0:17:03.600 be able to do that, otherwise you're not how successful. 0:17:03.720 --> 0:17:05.639 It's gonna come again and again, or they're gonna be 0:17:05.640 --> 0:17:06.960 in the drug for a very long time. 0:17:13.520 --> 0:17:16.439 This episode is being brought to you today by my book, 0:17:16.680 --> 0:17:20.040 Nicole and Jemmy's Anatomy. If you didn't get what you 0:17:20.040 --> 0:17:23.360 wanted this holiday season, you're gonna want this book. It 0:17:23.440 --> 0:17:26.280 is a tour through the human body, starting with A 0:17:26.600 --> 0:17:29.360 through Z, and it tells you all the different things 0:17:29.400 --> 0:17:32.000 that could go wrong with your body. And a little 0:17:32.160 --> 0:17:35.000 unknown fact about this book is that there are multiple 0:17:35.040 --> 0:17:40.440 members of my family in this book, including my handsome husband, 0:17:41.359 --> 0:17:45.520 my dad, my aunt, and my sister in law. So 0:17:45.640 --> 0:17:49.200 check it out. You can go to thedoramatter dot com 0:17:49.200 --> 0:17:56.440 slash book and find where you can get this great book. Well, 0:17:56.440 --> 0:17:59.159 now that you're talking about toxic foods, this is a 0:17:59.200 --> 0:18:02.040 good time to get it to this subject. I worked 0:18:02.119 --> 0:18:06.639 years ago with a brilliant GI pathologist. She was awesome, 0:18:06.680 --> 0:18:09.080 and she was like very much into this, the new 0:18:09.160 --> 0:18:12.280 research of all this leaky gucks stuff we were talking about. 0:18:12.840 --> 0:18:15.960 And back when she was talking about this, this was 0:18:16.040 --> 0:18:19.960 like fifteen years ago, probably people were kind of thinking 0:18:20.000 --> 0:18:23.719 she was a quack for thinking, for believing in this stuff. 0:18:24.080 --> 0:18:26.960 And now all of this research is coming out that 0:18:27.080 --> 0:18:30.280 most people agree that leaky gut is is a thing. 0:18:31.240 --> 0:18:35.399 Could you please explain exactly what that is to our listeners? 0:18:35.760 --> 0:18:38.679 Yeah, absolutely, that's a great question. And so if you 0:18:38.800 --> 0:18:42.800 think about where blood and poop are separated, right, you 0:18:42.880 --> 0:18:46.600 think that it's a huge barrier. It's one cell layer thick. 0:18:46.840 --> 0:18:49.199 So let's say this is a cell. You know, my 0:18:49.280 --> 0:18:52.600 hand on this side is pooh, this side is blood. 0:18:52.920 --> 0:18:57.199 So your GI tractor, testinal tract, the cells have a 0:18:57.400 --> 0:19:01.159 huge job to be able to prove that stuff that's 0:19:01.200 --> 0:19:03.800 in your poop to go in your blood. And when 0:19:03.800 --> 0:19:08.400 it doesn't do that well, people who are very insightful, 0:19:08.560 --> 0:19:11.560 like your GeOI pathologists that you worked with, called it 0:19:11.600 --> 0:19:14.080 a leaky gut because it's happened. Your gut is leaky. 0:19:14.080 --> 0:19:17.880 Stuff comes true. But now we, like you said, there's 0:19:17.920 --> 0:19:20.600 there are studies that's showing that this works. We have 0:19:20.640 --> 0:19:24.240 a fancy or name for it. It's called intestinal permeability. 0:19:24.520 --> 0:19:27.359 So what happens is that in that one cell layer 0:19:27.359 --> 0:19:31.480 thic you know, barrier between poop and blood, you have 0:19:31.560 --> 0:19:35.199 these things called tight junctions which are like completely sealed 0:19:35.359 --> 0:19:39.600 tight and it's kind of like a very very sophisticated 0:19:39.680 --> 0:19:43.720 group of bouncers that will not let anything in or 0:19:43.800 --> 0:19:47.680 let anything out that doesn't belong. So once those those 0:19:47.720 --> 0:19:51.680 defense mechanisms of your of your intestinal track are not there, 0:19:52.080 --> 0:19:54.199 stuff can get through. And you think, you say, so 0:19:54.280 --> 0:19:56.240 what you know what if stuff gets true, Well, it 0:19:56.320 --> 0:19:58.560 won't be like big chunks of stool. We're not talking 0:19:58.560 --> 0:20:02.359 about that. On the microscope level, you're having little particles 0:20:02.560 --> 0:20:05.840 which are toxins, let's say, from above from a bacteria. 0:20:05.960 --> 0:20:08.440 One of them we know it's called LPs or light 0:20:08.480 --> 0:20:11.720 bulb polysachara. When that goes in the blood stream, here's 0:20:11.760 --> 0:20:15.400 what happened ago, your entire defense system goes, oh my gosh, 0:20:15.640 --> 0:20:19.920 something happened. So you're all of your your immune systems. 0:20:19.920 --> 0:20:22.879 So I call it kind of your almost your entire 0:20:23.000 --> 0:20:27.159 defense of your body. So your white cells come in, 0:20:27.240 --> 0:20:29.960 your natural killer cells, your lymphocide, everything comes through. It 0:20:30.000 --> 0:20:32.280 comes through. If you make the analogy in your in 0:20:32.320 --> 0:20:35.240 the in the country, you have the FBI, the CIA, 0:20:35.280 --> 0:20:38.359 and the army, the Navy. Everybody comes and says there 0:20:38.640 --> 0:20:42.720 is an attack. Something's come through, and it starts attacking 0:20:43.240 --> 0:20:46.359 because it thinks something's there in that reaction. If you 0:20:46.440 --> 0:20:49.320 haven't once in a while, won't matter. But if that 0:20:49.600 --> 0:20:53.320 leak continues and you have more stuff that comes through, 0:20:53.400 --> 0:20:58.560 that's the beginning of inflammation because then these cells continue 0:20:58.600 --> 0:21:02.040 to be activated trying to get rid of whatever this 0:21:02.160 --> 0:21:05.200 toxin that's coming through, and when it continues, it can 0:21:05.240 --> 0:21:09.080 cause inflammation. And inflammation is the beginning of all disease, 0:21:09.440 --> 0:21:11.760 whether it's of the heart, whether it's in the brain 0:21:12.080 --> 0:21:14.159 and long any part of it. That's why to me, 0:21:14.760 --> 0:21:17.679 the gut and you and I, you know, a realness 0:21:17.760 --> 0:21:20.119 is the gun is such an important part of your body. 0:21:20.160 --> 0:21:23.879 Why because it's the center. It's it's it's if you 0:21:23.960 --> 0:21:28.000 can fix the gut, not get leaky gut. Change what's 0:21:28.040 --> 0:21:31.000 called your microbiome, which is the trillions of bugs in 0:21:31.040 --> 0:21:34.600 your intestine system you can help prevent disease. I'm writing 0:21:34.600 --> 0:21:38.800 a book about comparing taking your gut health and optimizing 0:21:38.840 --> 0:21:41.360 it to prevent diseases of the brain like the one 0:21:41.400 --> 0:21:43.920 my dad had, And it's it's startling what you can 0:21:43.960 --> 0:21:45.520 do to your with your gut to be able to 0:21:45.520 --> 0:21:48.520 prevent that. But to answer your question, you know this, 0:21:48.520 --> 0:21:52.440