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Speaker 1: It's going to be similar to I would say, like

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Speaker 1: mental health before it was taboo and people didn't understand,

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Speaker 1: and it's like just pull yourself up on your bootstraps

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Speaker 1: and put a smile on, just cheer up. It's going

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Speaker 1: to be the same with obesity. Instead of just like hey,

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Speaker 1: you need to put the fork down, they're going to

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Speaker 1: understand the biological underpinnings of it. And this doesn't mean

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Speaker 1: we shouldn't be working on our environment too. Yeah, we

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Speaker 1: should be working on the environment. We need to prevent

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Speaker 1: obesity before it occurs, but we also need tools to

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Speaker 1: help treat the obesity once it occurs too.

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Speaker 2: What is happening everyone, I'm only a body here.

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Speaker 3: You are listening to episode two hundred and seventy eight

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Speaker 3: of Hurdle, a wellness focused podcast reconnect with everyone from

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Speaker 3: your favorite athletes to top experts and industry CEOs about

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Speaker 3: their highest highs, toughest moments, and everything in between. We

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Speaker 3: all go through hurdles in life, and my goal through

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Speaker 3: these discussions is to empower you to better navigate yours

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Speaker 3: and move with intention so that you can stride towards

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Speaker 3: your own big potential and of course have some fun

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Speaker 3: along the way. First and foremost, I'll address my voice.

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Speaker 3: It's been better, but the show must go on. Literally,

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Speaker 3: So today I am bringing you my conversation with doctor

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Speaker 3: Spencer and Dadolski. He is the medical director of WW

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Speaker 3: and Sequence. He is also an obesity and lipid specialist physician.

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Speaker 3: Say that five times fast. Today we are talking all

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Speaker 3: about GLP one medications and extremely controversial topic, something that

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Speaker 3: we've been talking about now as a society for a

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Speaker 3: greater part of the past year. For those of you

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Speaker 3: that do not know, GLP one medications are what we

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Speaker 3: commonly hear to be zempic legovi medicines that are injected

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Speaker 3: and used as a tool for weight loss. As someone

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Speaker 3: who personally has a history of weight loss, and doctor

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Speaker 3: Nadolski and I talk about that in today's episode. It

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Speaker 3: was really interesting to me when these came on the scene.

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Speaker 3: I I'll just give you my stance. I feel like,

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Speaker 3: if you can speak with a physician you qualify every

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Speaker 3: one of these medications and it is something that you

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Speaker 3: are interested in going on, going on and using it in

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Speaker 3: a safe way, then you're entirely entitled to do whatever

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Speaker 3: you feel is right for you and your body. There

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Speaker 3: are two things that concern me. One that we don't

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Speaker 3: know the long standing effects of something like this because

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Speaker 3: they are so new to the market. And also when

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Speaker 3: individuals abuse these medications, maybe they obtained something like this

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Speaker 3: from a concierge doctor who may not always play by

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Speaker 3: the rules. So we talk about both of those things today,

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Speaker 3: and I really appreciate doctor Nadolski's expertise on the top.

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Speaker 3: We cover everything you need to know what these medications do,

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Speaker 3: what they are, how they interact with the body, what

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Speaker 3: the side.

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Speaker 2: Effects could be.

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Speaker 3: Who could be a good candidate to go on a

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Speaker 3: medication like this, Why it's important to be conscious of

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Speaker 3: your environment, whether or not you are interested in this

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Speaker 3: type of treatment if you are interested in weight loss,

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Speaker 3: And of course we talk about the controversy around these drugs,

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Speaker 3: and doctor Nadalski, as I mentioned, the medical director over

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Speaker 3: at Weight Watchers, talks about their decision to acquire Sequence

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Speaker 3: as well as they're first of its kind GLP one program,

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Speaker 3: which offers specialized behavioral support focusing on nutrition and activity

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Speaker 3: program formation to support those who are already on their

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Speaker 3: own GLP one journey. Like I've said before, it's so

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Speaker 3: important for me to have big conversations like this on

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Speaker 3: the show. So I hope that you find this insight

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Speaker 3: valuable and if you have any additional questions, feel free

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Speaker 3: to ask it by leaving me a voice message. The

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Speaker 3: link to do that is in the show notes at

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Speaker 3: Emily Abodi at Hurdle Podcast.

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Speaker 2: With that, let's get to hurtling today.

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Speaker 3: I'm sitting down with doctor Spencer Nadolski. He's a Board

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Speaker 3: certified family physician specializing in obesity, medicine, and lipidology. He's

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Speaker 3: also the medical director of WW and Sequence.

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Speaker 2: How are you doing today, Spencer doing great.

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Speaker 1: I'm in Michigan. It's getting cold here, but I went

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Speaker 1: for a run before this podcast. I'm good.

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Speaker 2: I know.

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Speaker 3: I need to make sure that we let the hurdlers

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Speaker 3: my audience what I call them in on the intel

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Speaker 3: that you also are a podcaster yourself. You have a

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Speaker 3: podcast with your brother called Docs Who Lift.

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Speaker 2: I love this.

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Speaker 1: Yeah, that's right. We promote exercises medicine, obviously lifting weights,

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Speaker 1: but you know we do a lot of aerobic training

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Speaker 1: as well.

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Speaker 3: Also, two doctors in the family have pretty fun for

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Speaker 3: your parents, I'm sure.

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Speaker 1: Yeah, yeah, they're proud of us. Of course.

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Speaker 2: Well, I'm so happy to have you on the show today.

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Speaker 3: We are getting together to talk about GLP one medication.

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Speaker 3: It's something that has certainly made its fair share of

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Speaker 3: headlines over the last three sixty five and beyond. Now,

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Speaker 3: before we get into all of the faqes, I want

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Speaker 3: to make sure that I learn a little bit about you,

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Speaker 3: especially because getting into the field of obesity medicine libidology

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Speaker 3: definitely a niche interest. So what inspired you to get

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Speaker 3: onto this side of medicine.

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Speaker 1: Yeah, I grew up in a very athletically and academically

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Speaker 1: minded family. Both parents were school teachers. My brothers obviously

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Speaker 1: into athletics and academics as well, and so got into

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Speaker 1: science to be good at athletics, did really well, and

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Speaker 1: to wrestle at UNC Chapel Hill. I was their heavyweight,

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Speaker 1: did pretty well there. And when I went into medical school,

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Speaker 1: everybody it's like, you're gonna be a sports medicine doctor.

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Speaker 1: You're going to help athletes get better. And I was like,

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Speaker 1: I don't want to help athletes get better. It's like,

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Speaker 1: to me, it's just kind of boring. I know. Sorry,

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Speaker 1: there's a lot of other people that liked doing that.

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Speaker 1: But what I thought was more fulfilling was actually helping

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Speaker 1: people become athletes, like people that didn't move at all,

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Speaker 1: people that were having type two diabetes and chronic disease,

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Speaker 1: and helping them either prevent those things from happening or

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Speaker 1: actually reversing or putting those things into remission, giving them

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Speaker 1: a fraction of the passion or the obsession I have

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Speaker 1: with diet and exercise, nutrition and exercise, just giving them

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Speaker 1: a little bit and preventing and treating those chronic diseases. So,

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Speaker 1: as I went through medical school, it was kind of

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Speaker 1: a specialty. Back then, there were some people doing it,

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Speaker 1: and they didn't have that greade of medicines back then,

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Speaker 1: and bioatric surgery is of course another thing. But as

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Speaker 1: I went through medical school and then residency, it was

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Speaker 1: starting to become these newer drugs and these newer technologies

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Speaker 1: were starting to come out, and the specialty really gained

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Speaker 1: some traction, and they actually created this Board of Obesity

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Speaker 1: Medicine right at the end of my residency, so I

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Speaker 1: was able to get that certification right after residency. So

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Speaker 1: for anybody listening, you go through four years of medical

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Speaker 1: school and then you do something called residency, which is

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Speaker 1: where you choose your specialty. I chose to do a

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Speaker 1: very broad one called family medicine. You can do internal medicine,

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Speaker 1: which is just adults, pediatrics, could do obgyn surgeries, all

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Speaker 1: sorts of different things. So I chose the broadest of

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Speaker 1: them all and then decided to specialize off of that.

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Speaker 1: So the other thing is I really think that our

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Speaker 1: current medical system is so archaic. So I was really

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Speaker 1: passionate about different ways of delivering healthcare that weren't the

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Speaker 1: same traditional fifteen minutes with a patient. I would do

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Speaker 1: Facebook lives at lunchtime, and I feel like I was

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Speaker 1: helping more people during my quick little live than I did,

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Speaker 1: like in a whole day of seeing people in the clinic.

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Speaker 1: It was really interesting. So that's kind of where I

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Speaker 1: got to today.

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Speaker 3: Yeah, you know, it's it's interesting, and I can relate

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Speaker 3: to that concept of feeling really fulfilled with your opportunity

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Speaker 3: to help people at a larger scale seeing those one

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Speaker 3: on one patients, there's so much value in that. But

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Speaker 3: when you can really utilize the knowledge that you have

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Speaker 3: to help a wider group of people, it's exciting.

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Speaker 1: Yeah, Yeah, that's exactly that's exactly. It. It was just

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Speaker 1: like and I felt like I was still getting that

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Speaker 1: deep meaningful help with them, not just superficial help, but

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Speaker 1: it was like deep, meaningful and wider, a larger net.

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Speaker 1: So that's why now that we're doing telemedicine and all

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Speaker 1: sorts of different ways of delivering care.

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Speaker 3: Yeah, so when it comes to we talked about obviously

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Speaker 3: the or you mentioned the four years of medical school

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Speaker 3: and the residency program. When it comes to then specializing

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Speaker 3: in the fields that you specialize, what does obtaining that

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Speaker 3: specialization look like.

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Speaker 1: Yeah, so currently, because it's so new, you just you

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Speaker 1: have to go get what's called the continuing medical education.

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Speaker 1: You have to go to conferences and things, and then

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Speaker 1: you take a board exam. What usually it ends up

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Speaker 1: is they you eventually have to take a one year

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Speaker 1: fellowship where you go from residency which is usually three

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Speaker 1: or so years, and then you go one more or

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Speaker 1: two more years in an actual setting where you keep

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Speaker 1: learning that right now, because it's so new, they they

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Speaker 1: have it set up to where you go to different

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Speaker 1: lectures and all these things. Then you take an exam

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Speaker 1: after about a year. But eventually that's that's that's the

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Speaker 1: idea of that's a lot of all this. A lot

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Speaker 1: of specialties have started that way and then moved over

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Speaker 1: into like a legit fellowship type of situation.

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Speaker 3: Okay, and then just a little bit more context before

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Speaker 3: we dive into the meat and potatoes of our discussion today.

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Speaker 3: Where along this journey for you in this specialization did

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Speaker 3: you come into connection with WW and sequence.

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Speaker 1: Yeah. So I graduated residency in twenty fourteen, got my

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Speaker 1: board certification obesity. Shortly after, went to private practice, worked

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Speaker 1: with a few different groups, actually jumped into a telemedicine

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Speaker 1: group in twenty sixteen and really started exploring these new

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Speaker 1: ways of delivering care, doing obesity medicine online, lipidology online,

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Speaker 1: and just lifestyle medicine online in general. And then in

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Speaker 1: twenty twenty one is when we go VI or some

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Speaker 1: maglutide was approved for obesity or weight management specifically. And

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Speaker 1: there were a couple of these engineers who found me

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Speaker 1: on Twitter and just said, hey, have you ever thought

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Speaker 1: about doing like an obesity medicine program online. I'm like, yeah,

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Speaker 1: That's what I've always wanted to do. I'm not a

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Speaker 1: startup guy, so if you guys are startup guys, let's

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Speaker 1: do it. And what we did is we these guys

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Speaker 1: were smart engineers. They developed a whole like electronic medical

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Speaker 1: records system kind of how I just told them to

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Speaker 1: do it based on what I think would be efficient

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Speaker 1: for both the provider, the doctor or nurse practitioner, whoever,

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Speaker 1: and then also for the patient, give them good care,

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Speaker 1: make them have a good experience, while also giving the

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Speaker 1: clinician a good experience. And I knew we were going

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Speaker 1: to do really well because other programs that were out there,

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Speaker 1: I didn't see them as much on social media and

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Speaker 1: I'm very good at social media. And we delivered great

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Speaker 1: care while also doing great job at marketing. And within

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Speaker 1: it was within a year we blew up. We had,

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Speaker 1: you know, thousands and thousands of patients started with just

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Speaker 1: me as the physician. Then we had I don't know

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Speaker 1: how many dozens of clinicians that were under me. And

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Speaker 1: what happened was Weight Watchers wanted me to be a

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Speaker 1: scientific advisor and they hadn't heard of our program yet,

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Speaker 1: but they were interested in getting into the clinical space,

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Speaker 1: and so we started talking YadA YadA YadA. They said, hey,

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Speaker 1: we want to add this clinical arm to our program.

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Speaker 1: When it was a perfect fit because they're you know,

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Speaker 1: the number, here's the number one behavioral commercial weight loss

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Speaker 1: program in the world, and we at the time, you know,

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Speaker 1: we're the top what I would consider the top telemedicine

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Speaker 1: obesity program. But you know still that that is in

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Speaker 1: its infancy, the whole you know, that whole niche is

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Speaker 1: in its infancy, but we're the top top ones, and

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Speaker 1: we're going to kind of combine and make this work

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Speaker 1: for everybody, kind of hit this whole what i'd call

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Speaker 1: the spectrum of what would call weight health. So there's

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Speaker 1: behavioral and then once people need more help than that,

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Speaker 1: they need to get into medical and even surgical tools

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Speaker 1: to help them with losing weight and keeping it off.

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Speaker 2: Got it.

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Speaker 3: So for those that aren't completely in the loop on Sequence,

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Speaker 3: you did just kind of give a rundown on how

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Speaker 3: it works.

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Speaker 2: But I do want to make sure that we really.

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Speaker 3: Dial into the specifics of how it works, because I

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Speaker 3: think there is a lot of questions around perhaps the

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Speaker 3: safety of something like this. So let's start first and

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Speaker 3: foremost with what it might look like for someone who

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Speaker 3: goes to SEQUENCE, which, as you mentioned, is a clinical

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Speaker 3: arm now of WW seeking perhaps a weight loss drug

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Speaker 3: like a semaglue tide, which we'll get into that in

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Speaker 3: just a second as well.

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Speaker 1: Yeah, so my biggest thing is I need to make

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Speaker 1: sure we are doing this safe. We cannot start giving

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Speaker 1: this medicine out to those who don't qualify. That was

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Speaker 1: like a big push of mine, because you know a

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Speaker 1: lot of people start these startup companies, and you know

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Speaker 1: you've seen these places in the media and all sorts

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Speaker 1: of all sorts of things are happening. So I wanted

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Speaker 1: to make sure it's safe. I want to make sure

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Speaker 1: we're doing appropriate prescribing. So the way we set it

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Speaker 1: up is basically you can't even get through the intake

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Speaker 1: quiz unless on paper you would qualify before you even

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Speaker 1: see a clinician. So you go through this intake quiz

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Speaker 1: that would make sure that sure you have a BMI

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Speaker 1: so that for anybody listening, these drugs are only approved

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Speaker 1: for those with it from an FDA guideline standpoint, for

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Speaker 1: those who have a BMI body mass index. And say

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Speaker 1: what you want about BMI, it's just it's what they

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Speaker 1: had to have at the time. Right now. It will

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Speaker 1: get better in the future with how to diagnose obesity,

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Speaker 1: but BMI of thirty and above or a BMI body

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Speaker 1: mass index of twenty seven and above plus what's called

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Speaker 1: a comorbidity. A comorbidity is anything related to obesity or

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Speaker 1: weight that is a medical problem. So think about hypertension,

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Speaker 1: high blood pressure, hyperglycemia, you know, pre diabetes, type two diabetes,

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Speaker 1: higher blood sugars, those types of things. Even things like

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Speaker 1: an obstructive sleepaptiam, maybe osteoarthritis in your knees, those types

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Speaker 1: of things. So if you have a thirty and above,

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Speaker 1: you technically qualified via FDA guidelines. If you have a

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Speaker 1: twenty seven plus one of these other weight related things,

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Speaker 1: you would also qualify. So you have to have that

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Speaker 1: at first. But then there's there's a there's a few

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Speaker 1: other things that you want to make sure that you're

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Speaker 1: not missing. You want to make sure people aren't pregnant, breastfeeding,

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Speaker 1: those types of things. These drugs you don't want to

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Speaker 1: use while people are pregnant or breastfeeding. There are some

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Speaker 1: other black box warnings like family history of medullary thyroid cancer.

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Speaker 1: It's a type of a very rare type of thyroid cancer.

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Speaker 1: But and we can get into why that is later.

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Speaker 1: And then you also want to see what medicines are on,

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Speaker 1: you know, do they have a primary care doctor, all

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Speaker 1: sorts of things. So you want to make sure that

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Speaker 1: these people are having a like should appropriately at least

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Speaker 1: get through because what you will see if you don't

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Speaker 1: have those things, and there's a lot of people wanting

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Speaker 1: to use these drugs just for vanity what i'd call

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Speaker 1: vanity weight loss. They don't have health problems. They're metabolically healthy.

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Speaker 1: You know, they may be in what's considered this normal

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Speaker 1: BMI range, which I don't like that term, but like

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Speaker 1: their weight, they're healthy for their weight, and they might

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Speaker 1: want to lose five to ten pounds and they want

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Speaker 1: these drugs, but like, not appropriate to prescribing these medicines

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Speaker 1: and those types of patients at least right now, and

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Speaker 1: it's not studied at this time, so we wanted to

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Speaker 1: stay away from that. And then once you get through

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Speaker 1: the intake quizz everything looks good, then you are then

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Speaker 1: evaluated by a clinician because then certain things you might

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Speaker 1: chat through the chat, they can do it what's it

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Speaker 1: called asynchronously, which may seem odd because people are used

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Speaker 1: to seeing somebody face to face when they see a doctor.

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Speaker 1: But because of scheduling and people people work, they don't

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Speaker 1: want to take an hour off of work to do

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Speaker 1: a telemedicine, so you might be able to chat back

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Speaker 1: and forth. There are some states that allow that. Some

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Speaker 1: states you have to be seen face to face synchronously

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Speaker 1: via video. But through that evaluation, then the clinician decides

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Speaker 1: whether that person is the right fit. And then after

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Speaker 1: that it's sounds more complicated than is, but there's what's

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Speaker 1: called a prior authorization, So then the insurance companies they

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Speaker 1: also want to make sure this is an appropriate patient.

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Speaker 1: So then we have a whole team, which is one

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Speaker 1: of the secret sauces we have is that we have

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Speaker 1: a whole team that does these prior authorizations. And it's

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Speaker 1: actually what's actually really a big reason why we do

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Speaker 1: well is because when you go to a primary care doctor,

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Speaker 1: they're inundated from patients wanting to get these medicine. These

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Speaker 1: medicines are in high demand, and the prior authorization process

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Speaker 1: and filling out it's a real pain. It's a burden

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Speaker 1: to the back office who's like they've already got a

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Speaker 1: lot of other stuff they got to do, and so

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Speaker 1: now they have to fill out this long prior authorization.

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Speaker 1: We have a whole team that does it for people.

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Speaker 1: In fact, I was just one with a patient who

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Speaker 1: specifically said, like, Hey, the reason we chose you is

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Speaker 1: because you guys are known to be good at these

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Speaker 1: prior authorizations. So for anybody listening, insurance, it's like, they

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Speaker 1: don't want to pay for these medicines. They want to

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Speaker 1: put you through hoops, and we help the patients jump

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Speaker 1: through those hoops basically to get the medicine.

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Speaker 3: Now, someone listening to this might add, Okay, why is

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Speaker 3: it that they want you to jump through these hoops?

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Speaker 2: Why do you think that that is?

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Speaker 1: Yeah, these medicines are expensive. They're extremely expensive, and there's

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Speaker 1: a whole list of reasons why that is. And you know,

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Speaker 1: we could get into big pharma, these PBMs and the

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Speaker 1: middlemen that start negotiating rates. But the gist is that

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Speaker 1: these medicines are expensive, insurances don't want to cover them,

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Speaker 1: and you know, I could understand that. I think in

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Speaker 1: the future of what we're going to see at the

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Speaker 1: prices are going to come down. There is only one

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Speaker 1: player in the market, one manufacturer. Now there are two

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Speaker 1: manufacturers in this world, and there's a whole list of

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Speaker 1: manufacturers seeing you know, i'd say dollar scigns if you

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Speaker 1: really want to see. But they're seeing like, hey, this

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Speaker 1: class of drug is somewhat miraculous and works extremely well.

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Speaker 1: And if we can prove that we have another similar

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Speaker 1: type of like peptides is what they are, these one

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Speaker 1: agonists we have, we can have one that's similar with

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Speaker 1: about similar efficacy amount of weight loss and safety and

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Speaker 1: improving health, then why not jump in and we can

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Speaker 1: make it cheaper. And then all of a sudden they

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Speaker 1: start competing a bunch of different options than the prices

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Speaker 1: should come down.

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Speaker 2: Got it?

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Speaker 3: Okay, so we've said these buzzwords a few times now.

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Speaker 3: Some of glue tides GLP one agonists. For those that

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Speaker 3: are really just diving into the shallow end and news

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Speaker 3: to understanding what we're even talking about here, why don't

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Speaker 3: we give a brief overview and set the table so

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Speaker 3: they can understand how some of glue tide interacts with

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Speaker 3: the body.

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Speaker 1: Yeah, so these are GLP one agonists glucagun like peptide one.

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Speaker 1: It's it's you don't need to know much more than that,

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Speaker 1: but GLP one agonists we have naturally occurring GLP one

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Speaker 1: that's released from our intestines. Now we may say, well then,

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Speaker 1: like do we have GLP one deficient? Is that why

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Speaker 1: we start gaining weights? It's no, that's not true at all.

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Speaker 1: We know as we gain weight, our GLP one works

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Speaker 1: quite well in our own body. The thing is is

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Speaker 1: that our own GLP one is broken down very quickly

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Speaker 1: within minutes, So we can't just even make natural GLP

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Speaker 1: one and start injecting it or find different foods to

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Speaker 1: hopefully boost our own GLP one. It's broken down so quickly.

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Speaker 1: So what these researchers, just brilliant researchers did back in

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Speaker 1: the late nineties early two thousands, they actually found a

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Speaker 1: little lizard and they're trying to find ways to mimic

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Speaker 1: this GLP one because they start seeing the actions of

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Speaker 1: it in the body. And they found ways to then

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Speaker 1: have this GLP one, a different type of GLP one,

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Speaker 1: not our own natural something similar that hit the receptors,

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Speaker 1: but that didn't break down as quickly. So the first

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Speaker 1: one was that exenotide or biatos, the brand name came

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Speaker 1: out in two thousand and five. So people thinking these

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Speaker 1: are brand new drugs and scary because we don't know

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Speaker 1: much about them. They're not they've been out for almost

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Speaker 1: two decades, not completely yet but definitely studied for two

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Speaker 1: decades now. But the first one was an injectable twice

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Speaker 1: a day. Then they got smarter researchers getting better at

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Speaker 1: making these little peptides since they found a once a

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Speaker 1: day more effective one. Then it got into then they

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Speaker 1: found they found ways to make it once a week.

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Speaker 1: They're a couple out back in the twenty tens. Then samaglutide,

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Speaker 1: So samaglutide was the newer one in twenty seventeen. That

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Speaker 1: was ozempic was is the name everybody hears about. That's

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Speaker 1: the type two diabetes branded version, somaglutide. Though then they

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Speaker 1: upped the dose because in ozempic it only went up

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Speaker 1: to one milligram at the time. It goes up to

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Speaker 1: two milligrams now, but they studied it in two point

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Speaker 1: four milligrams, a much higher dose, and they found it

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Speaker 1: this works extremely well for weight loss. In fact, older

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Speaker 1: drugs like we would the the standard of care was

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Speaker 1: looking at like if David look like can a lot

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Speaker 1: of people lose at least five percent of their weight

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Speaker 1: from a weight loss medicine or weight management medicine. The

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Speaker 1: reason they picked five percent is because that's where you

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Speaker 1: start seeing pretty good improvements in your health. But the

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Speaker 1: thing is, once you get to ten percent, fifteen, twenty percent,

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Speaker 1: you get many more and more massive improvements in your health.

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Speaker 1: You don't start seeing improvements in sleep apnea obstructive sleep

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Speaker 1: apnea until you hit like ten percent or more. But

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Speaker 1: the marker they used before was five percent. And so

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Speaker 1: the older drugs, you know that we had something called

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Speaker 1: cusimia that was okay, it combined fenturemine until piramide that

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Speaker 1: was around you know, ten percent, but some maglutide in

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Speaker 1: the dose of two point four milligrams off we govi.

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Speaker 1: That's when twenty one hit. This first study that came

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Speaker 1: out looking at obesity. In this one it was around

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Speaker 1: fifteen percent. So now all of a sudden, the average

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Speaker 1: weight loss jumped up from this five to ten percent

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Speaker 1: range now up to fifteen percent, which was massive. It

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Speaker 1: was a it was a you know what they said

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Speaker 1: said in the newspaper, a game changer. And you know,

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Speaker 1: why didn't the drug why didn't ozempic go crazy back

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Speaker 1: in twenty seventeen or you know, before the two thousand

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Speaker 1: and twenties. It's because nobody really knew about it. We

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Speaker 1: all knew as a clinician, we knew. I was like,

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Speaker 1: you know, we're prescribing it back then, but not until

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Speaker 1: this week GOV came out to where there's a big

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Speaker 1: study and then people are like, hey, this stuff really

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Speaker 1: works for for weight loss and losing weight, keeping it

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Speaker 1: off and it seems to be safe and those with

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Speaker 1: type two diabetes at the time of reducing risks of

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Speaker 1: heart attacks and all sorts of stuff like that.

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Speaker 3: And I know that the study that you're mentioning this

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Speaker 3: was during a time period that was a little bit

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Speaker 3: more than a year compared to you said that fifteen

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Speaker 3: percent ish baseline of weight loss versus people that were

435
00:23:47,080 --> 00:23:49,480
Speaker 3: using a placebo, which was closer to something like two

436
00:23:49,520 --> 00:23:53,199
Speaker 3: point four percent. So really big difference here when it

437
00:23:53,240 --> 00:23:57,680
Speaker 3: comes to assisted weight loss using the Semaglue tide versus

438
00:23:58,040 --> 00:23:59,200
Speaker 3: no Semaglue tide.

439
00:23:59,440 --> 00:24:01,639
Speaker 1: Yeah, that's that's the other thing. Because people are like, well,

440
00:24:01,960 --> 00:24:04,800
Speaker 1: of course they're injecting themselves. It's probably because the diet

441
00:24:04,800 --> 00:24:07,320
Speaker 1: and exercise. It's like, no, they had a placebo where

442
00:24:07,359 --> 00:24:11,160
Speaker 1: they gave the exact same lifestyle advice too, and they

443
00:24:11,160 --> 00:24:14,960
Speaker 1: only lost a few percent. So yeah, massive, massive improvements.

444
00:24:14,960 --> 00:24:18,840
Speaker 1: And then to jump on top of that research, the

445
00:24:18,880 --> 00:24:21,520
Speaker 1: technology is just getting better and better. The newest one,

446
00:24:22,040 --> 00:24:24,880
Speaker 1: which is called tur Zeppetide, is actually a gluca gun

447
00:24:24,960 --> 00:24:28,960
Speaker 1: like peptide one GLP one slash gip, what they call

448
00:24:28,960 --> 00:24:32,359
Speaker 1: a coagonist. It's hitting two different receptors in the body,

449
00:24:32,960 --> 00:24:35,840
Speaker 1: and that one is now hitting over twenty percent. So

450
00:24:35,880 --> 00:24:38,480
Speaker 1: we went from five to ten percent and then fifteen percent,

451
00:24:38,480 --> 00:24:40,480
Speaker 1: which is great. Now we're hitting over twenty percent and

452
00:24:40,520 --> 00:24:43,280
Speaker 1: maybe maybe the longer you take it, and we're getting

453
00:24:43,320 --> 00:24:46,760
Speaker 1: into twenty know, mid twenty percents, And then there's drugs

454
00:24:46,800 --> 00:24:49,119
Speaker 1: coming down the pipeline. They're not out yet, we're probably

455
00:24:49,119 --> 00:24:52,679
Speaker 1: going to hit that thirty percent range. And for people,

456
00:24:52,960 --> 00:24:55,359
Speaker 1: just to put that in perspective, bariatric surgery is that

457
00:24:55,440 --> 00:24:59,440
Speaker 1: thirty percent range. So we're now we're getting just massive

458
00:24:59,480 --> 00:25:03,520
Speaker 1: amounts of weight loss. And also to put into perspective,

459
00:25:03,760 --> 00:25:06,719
Speaker 1: because we start talking about a percentage of weight, it's like,

460
00:25:07,000 --> 00:25:08,520
Speaker 1: what does that even mean? I just want to lose

461
00:25:08,760 --> 00:25:10,919
Speaker 1: thirty pounds or what? You know what I mean? So

462
00:25:11,440 --> 00:25:13,879
Speaker 1: let's just say you are, you know, two hundred pounds.

463
00:25:13,960 --> 00:25:16,640
Speaker 1: Let's say you qualify for the medicine. You know, ten

464
00:25:16,720 --> 00:25:20,000
Speaker 1: percent would be twenty pounds, right of two hundred pounds.

465
00:25:20,160 --> 00:25:23,760
Speaker 1: Fifteen percent would would be you know, thirty thirty pounds,

466
00:25:23,760 --> 00:25:26,560
Speaker 1: and you know, and twenty percent would be forty pounds.

467
00:25:26,640 --> 00:25:30,720
Speaker 1: So that's average. By the way, you see a spectrum

468
00:25:30,720 --> 00:25:34,640
Speaker 1: of some people don't respond super well these medicines. That's rare,

469
00:25:34,720 --> 00:25:37,240
Speaker 1: but you do see it. And then some people are

470
00:25:37,280 --> 00:25:40,440
Speaker 1: what we call like hyper responders. They'll respond extremely well

471
00:25:40,480 --> 00:25:42,920
Speaker 1: to the medicine. So you see a big range. It's

472
00:25:42,920 --> 00:25:46,080
Speaker 1: just at that average fifteen percent for some magnetide and

473
00:25:46,119 --> 00:25:50,960
Speaker 1: twenty or so percent for zeppetide, the newest one. It's

474
00:25:51,000 --> 00:25:53,439
Speaker 1: pretty interesting to see.

475
00:25:52,920 --> 00:25:58,200
Speaker 3: For those that are on the semaglutide what happens within

476
00:25:58,240 --> 00:25:58,719
Speaker 3: the body.

477
00:25:59,359 --> 00:26:02,960
Speaker 1: Yeah, so how this drug works now, they made it

478
00:26:03,000 --> 00:26:05,760
Speaker 1: for type two diabetes originally because of the way that

479
00:26:05,800 --> 00:26:09,800
Speaker 1: it helped the pancreas release more insulin. It reduces another

480
00:26:10,720 --> 00:26:13,480
Speaker 1: hormone called glucagon, which it increases your blood sugar, so

481
00:26:13,480 --> 00:26:16,000
Speaker 1: it helps you lower your blood sugar, but over long run,

482
00:26:16,040 --> 00:26:18,359
Speaker 1: with your losing weight, it also improves your blood sugar.

483
00:26:18,720 --> 00:26:21,359
Speaker 1: The way this works for those without type two diabetes. Ooh,

484
00:26:21,840 --> 00:26:26,960
Speaker 1: and just for losing weight. These GLP one hits receptors

485
00:26:27,000 --> 00:26:31,280
Speaker 1: in the brain that helps with appetite, and you know,

486
00:26:31,359 --> 00:26:33,119
Speaker 1: it's like, oh, I don't need something to make me

487
00:26:33,240 --> 00:26:36,600
Speaker 1: less hungry. But like, people talk about this term called

488
00:26:36,640 --> 00:26:39,000
Speaker 1: food noise. I don't know if you've heard of this term,

489
00:26:39,040 --> 00:26:43,399
Speaker 1: but it's a pretty good term to describe intrusive thoughts

490
00:26:43,440 --> 00:26:46,439
Speaker 1: about food. So I always talk about it, like, you

491
00:26:46,520 --> 00:26:49,320
Speaker 1: might eat a super healthy meal just let's just be

492
00:26:49,560 --> 00:26:53,400
Speaker 1: like cliche, and you're like chicken breast and roccoli and

493
00:26:53,440 --> 00:26:57,400
Speaker 1: brown rice. You know, so like so cliche. But let's

494
00:26:57,440 --> 00:27:01,120
Speaker 1: just say you're eating a high volume of of low calorie,

495
00:27:01,359 --> 00:27:06,080
Speaker 1: high protein, high fiber healthy foods. Let's say, but afterwards,

496
00:27:06,119 --> 00:27:09,119
Speaker 1: you're like, I'm I feel full, but I'm not like

497
00:27:09,640 --> 00:27:13,320
Speaker 1: necessarily like you call satiated, So your stomach's kind of full,

498
00:27:13,320 --> 00:27:14,960
Speaker 1: and you're like, I should be full, but I'm like

499
00:27:15,000 --> 00:27:17,399
Speaker 1: I still want to I want to eat some potato chips.

500
00:27:17,400 --> 00:27:22,119
Speaker 1: I want to eat some pie, some cookies, some like those.

501
00:27:21,880 --> 00:27:24,400
Speaker 1: The food noise, you're still thinking about food. You're thinking

502
00:27:24,400 --> 00:27:27,120
Speaker 1: about your next meal, you're thinking about having another serving

503
00:27:27,160 --> 00:27:30,280
Speaker 1: despite like, you know, like I should be fine right now.

504
00:27:31,080 --> 00:27:34,840
Speaker 1: These medicines what the patients literally tell me, they say,

505
00:27:35,080 --> 00:27:38,080
Speaker 1: they make it make them feel like what someone who's

506
00:27:38,080 --> 00:27:40,040
Speaker 1: never had to worry about their weight must feel like

507
00:27:40,080 --> 00:27:43,080
Speaker 1: after a normal meal. It's that's about as It's about

508
00:27:43,080 --> 00:27:44,919
Speaker 1: as good of a description as you could give it,

509
00:27:44,960 --> 00:27:50,280
Speaker 1: because you know, you see people that they can apparently

510
00:27:50,280 --> 00:27:52,920
Speaker 1: eat whatever they want, and what happens in those cases,

511
00:27:52,920 --> 00:27:54,800
Speaker 1: people are like, oh, they must burn it off. It's like, well, no,

512
00:27:54,880 --> 00:27:57,320
Speaker 1: they're in those cases a lot of times, not all

513
00:27:57,320 --> 00:27:59,040
Speaker 1: the times, but in a lot of times they're actually

514
00:27:59,040 --> 00:28:01,520
Speaker 1: not eating as much throughout the day. They can eat

515
00:28:01,560 --> 00:28:05,520
Speaker 1: pizza and eat all these other things and their bodies satisfied,

516
00:28:06,320 --> 00:28:09,240
Speaker 1: while other people will eat that same food and their

517
00:28:09,320 --> 00:28:12,040
Speaker 1: their minds, the wires, I call them, like they're kind

518
00:28:12,040 --> 00:28:13,920
Speaker 1: of afraid. There might be some short circuits in the

519
00:28:14,240 --> 00:28:19,280
Speaker 1: brain and the appetite centers, they still will seek more food.

520
00:28:19,400 --> 00:28:22,520
Speaker 1: And these these were these drugs basically hit receptors in

521
00:28:22,560 --> 00:28:26,520
Speaker 1: the brain that dampen that signal to a point where

522
00:28:27,160 --> 00:28:30,200
Speaker 1: they say, like, I can't explain it, but I don't

523
00:28:30,200 --> 00:28:32,120
Speaker 1: I'm not thinking about food all the time. And in fact,

524
00:28:32,119 --> 00:28:37,160
Speaker 1: their anxiety and relationships with food all improve as well.

525
00:28:37,760 --> 00:28:40,560
Speaker 1: I can't say for everybody, but for most people that we.

526
00:28:40,600 --> 00:28:44,920
Speaker 3: See, someone hears these things reduced food noise, I get

527
00:28:44,960 --> 00:28:47,560
Speaker 3: to eat pizza and still lose weight, and they're like,

528
00:28:47,680 --> 00:28:52,400
Speaker 3: oh my god, this sounds awesome. But also I worry

529
00:28:52,560 --> 00:28:57,000
Speaker 3: about the concepts of I can eat all these things

530
00:28:57,080 --> 00:28:59,040
Speaker 3: and still lose weight and then get to a point

531
00:28:59,120 --> 00:29:01,640
Speaker 3: where maybe you go off of this medication and you've

532
00:29:01,720 --> 00:29:07,000
Speaker 3: learned actually nothing about nourishing yourself. What do you say

533
00:29:07,120 --> 00:29:10,920
Speaker 3: to people that are a little unsure on that front.

534
00:29:11,160 --> 00:29:13,480
Speaker 1: Yeah, this, I mean, this is where we step in

535
00:29:13,520 --> 00:29:17,080
Speaker 1: with our behavioral component because we also think the same way.

536
00:29:16,920 --> 00:29:19,719
Speaker 1: We want to make sure that people are nourishing their body,

537
00:29:19,760 --> 00:29:22,680
Speaker 1: and there's what I would say quality of weight loss.

538
00:29:22,720 --> 00:29:26,240
Speaker 1: And also it's not just about weight loss, it's about

539
00:29:26,440 --> 00:29:28,959
Speaker 1: the improvement of their health while they're doing it. So

540
00:29:29,600 --> 00:29:32,600
Speaker 1: anybody could just lose weight, like if we could just

541
00:29:32,640 --> 00:29:35,120
Speaker 1: give these medicines out like candy and people lose weight

542
00:29:35,160 --> 00:29:38,440
Speaker 1: and if their weight improves, their health could improve, but

543
00:29:38,480 --> 00:29:41,400
Speaker 1: there could be all there. It's not optimal. We want

544
00:29:41,440 --> 00:29:45,880
Speaker 1: to make sure people aren't just eating non nourishing foods

545
00:29:45,920 --> 00:29:48,520
Speaker 1: while just losing weight. Because as you said, some people

546
00:29:48,560 --> 00:29:50,920
Speaker 1: will come off the medicines. These medicines are meant to

547
00:29:50,920 --> 00:29:53,560
Speaker 1: be taken long term. I just want to mention that,

548
00:29:53,760 --> 00:29:55,920
Speaker 1: like we think of obesity as a chronic disease, just

549
00:29:55,960 --> 00:29:58,800
Speaker 1: like we think of type two diabetes or hypertension. And

550
00:29:58,840 --> 00:30:02,200
Speaker 1: in those cases like high pretension, people they're doing everything

551
00:30:02,240 --> 00:30:05,120
Speaker 1: they can from a lifestyle standpoint, and they'll have to

552
00:30:05,120 --> 00:30:06,920
Speaker 1: get on what's called like an ACE inhibitor or some

553
00:30:07,000 --> 00:30:09,680
Speaker 1: blood pressure medicine. Their blood pressure will go down and

554
00:30:09,720 --> 00:30:12,480
Speaker 1: get into a good range. It would be like stopping

555
00:30:12,520 --> 00:30:17,800
Speaker 1: that blood pressure medicine only to watch their blood pressure

556
00:30:17,880 --> 00:30:20,400
Speaker 1: jump back up. The same happens with obesity. Not everybody,

557
00:30:20,440 --> 00:30:23,760
Speaker 1: by the way, but most people. When you stop the medicine,

558
00:30:24,600 --> 00:30:27,160
Speaker 1: their weights start going out. Because we think of obesity

559
00:30:27,160 --> 00:30:32,600
Speaker 1: more of the chronic, relapsing, remitting type of disease. Now

560
00:30:33,400 --> 00:30:36,120
Speaker 1: in terms of like trying to help with behavior, because

561
00:30:36,160 --> 00:30:39,400
Speaker 1: these drugs work so well, that's where we jump in.

562
00:30:39,440 --> 00:30:43,240
Speaker 1: This is what our GLP one companion program does. We're

563
00:30:43,280 --> 00:30:45,840
Speaker 1: seeing this with people. If you don't give any behavior

564
00:30:45,880 --> 00:30:48,120
Speaker 1: with it, they'll lose weight. Like the medicine, they'll just

565
00:30:48,800 --> 00:30:51,480
Speaker 1: eat less of what they're doing, right, and if it's

566
00:30:51,480 --> 00:30:55,640
Speaker 1: pizza or whatever, they'll just eat less of it. However,

567
00:30:55,680 --> 00:30:58,240
Speaker 1: they could get side effects eating those types of things

568
00:30:58,280 --> 00:31:02,800
Speaker 1: because sometimes when you eat heavier, very fatty, kind of

569
00:31:02,800 --> 00:31:06,800
Speaker 1: greasy foods, it doesn't sit well. So what we are

570
00:31:06,840 --> 00:31:10,360
Speaker 1: doing is we're making sure that you're having some behavior

571
00:31:10,480 --> 00:31:14,160
Speaker 1: change and eating more of the nutrient dense types of foods,

572
00:31:14,160 --> 00:31:17,240
Speaker 1: getting enough protein. There's a worry of muscle loss with

573
00:31:17,280 --> 00:31:19,600
Speaker 1: these because people lose massive amounts of weight. If you

574
00:31:19,600 --> 00:31:22,840
Speaker 1: don't eat anything, you lose muscle. If you don't lift weights,

575
00:31:22,840 --> 00:31:25,320
Speaker 1: if you don't do any type of exercise, you can

576
00:31:25,360 --> 00:31:29,080
Speaker 1: lose muscle along with us. So we put a big

577
00:31:29,120 --> 00:31:32,720
Speaker 1: emphasis on making sure you're getting those micronutrients, the vitamins

578
00:31:32,720 --> 00:31:34,920
Speaker 1: and minerals that you should be getting, because if you're

579
00:31:34,960 --> 00:31:36,760
Speaker 1: not eating enough, you won't be getting enough of those.

580
00:31:36,760 --> 00:31:38,600
Speaker 1: So we want to make sure that people are getting those.

581
00:31:38,840 --> 00:31:40,840
Speaker 1: We want to make sure people are getting enough protein,

582
00:31:40,840 --> 00:31:42,720
Speaker 1: and we want to make sure people are getting enough

583
00:31:42,720 --> 00:31:46,040
Speaker 1: physical activity. And the truth is some people will want

584
00:31:46,080 --> 00:31:48,040
Speaker 1: to come up despite we call, you know, even if

585
00:31:48,080 --> 00:31:50,840
Speaker 1: we call obesity chronic disease, and these medicines are meant

586
00:31:50,880 --> 00:31:53,320
Speaker 1: to be taken long term. There will be people that

587
00:31:54,320 --> 00:31:56,880
Speaker 1: want to come off these medicines, and you do have

588
00:31:56,960 --> 00:32:01,160
Speaker 1: to give the behaviors that hopefully they can stain when

589
00:32:01,200 --> 00:32:04,479
Speaker 1: they come off. And then there will be people there

590
00:32:04,520 --> 00:32:06,800
Speaker 1: will be insurances that might not cover it long term

591
00:32:06,880 --> 00:32:09,520
Speaker 1: unfortunately too, and so we want to give them their

592
00:32:09,560 --> 00:32:11,840
Speaker 1: best shot at that. But ultimately we do want to

593
00:32:11,880 --> 00:32:16,760
Speaker 1: improve what we'd call non scale health measures because again,

594
00:32:17,560 --> 00:32:19,560
Speaker 1: you take somebody who has a what I call like

595
00:32:19,600 --> 00:32:22,920
Speaker 1: a poor quality diet versus someone who's exactly the same,

596
00:32:22,960 --> 00:32:25,120
Speaker 1: because there's just a twin. They have everything else the same,

597
00:32:25,200 --> 00:32:29,880
Speaker 1: except their quality of diet is more like the highly processed,

598
00:32:30,360 --> 00:32:34,960
Speaker 1: very low nutrient dense types of foods. And it's probable,

599
00:32:34,960 --> 00:32:37,360
Speaker 1: at least there's good evidence to say that the person

600
00:32:37,440 --> 00:32:40,560
Speaker 1: with the poor quality of diet is probably going to

601
00:32:40,600 --> 00:32:44,640
Speaker 1: have worse health outcomes over the long run. So regardless

602
00:32:44,640 --> 00:32:46,440
Speaker 1: of weight loss, we do want to make sure that

603
00:32:46,480 --> 00:32:49,840
Speaker 1: these people are improving their lifestyle.

604
00:32:55,440 --> 00:32:58,480
Speaker 3: Taking a break from today's episode to give some love

605
00:32:58,800 --> 00:33:03,080
Speaker 3: to something that it's been in my personal wellness toolbox

606
00:33:03,400 --> 00:33:08,280
Speaker 3: for years now, that is a g one it's my

607
00:33:08,520 --> 00:33:13,960
Speaker 3: all in one daily greens powder that's got seventy five vitamins, minerals,

608
00:33:14,000 --> 00:33:19,480
Speaker 3: and whole food sourced nutrients in one convenient daily serving,

609
00:33:19,840 --> 00:33:22,959
Speaker 3: with the anti accidant equivalent of twelve servings of fruits

610
00:33:22,960 --> 00:33:27,600
Speaker 3: and vegetables, as well as probiotics, probiotics, adaptagens, and superfoods.

611
00:33:27,880 --> 00:33:29,920
Speaker 3: It's hard for me to think about what my life

612
00:33:30,080 --> 00:33:33,960
Speaker 3: was like before I was regularly incorporating ag one into

613
00:33:33,960 --> 00:33:37,240
Speaker 3: my routine. No matter what is going on with my diet,

614
00:33:37,400 --> 00:33:40,520
Speaker 3: how often I'm eating out, especially with the holidays, this

615
00:33:40,560 --> 00:33:43,000
Speaker 3: can get a little bit nutty this time of year.

616
00:33:43,280 --> 00:33:45,440
Speaker 3: I know that beginning of my day with ag one

617
00:33:45,600 --> 00:33:48,840
Speaker 3: is me doing something really good and investing in my

618
00:33:48,960 --> 00:33:52,840
Speaker 3: own personal health and well being. With ag one, I

619
00:33:52,920 --> 00:33:56,120
Speaker 3: have notable benefits to my energy levels. I feel more

620
00:33:56,160 --> 00:34:00,360
Speaker 3: motivated and it actually tastes good. And I don't say

621
00:34:00,400 --> 00:34:03,400
Speaker 3: that like it tastes good for a greenspowder like I

622
00:34:03,520 --> 00:34:06,920
Speaker 3: look forward to drinking my AG one every single day

623
00:34:07,240 --> 00:34:11,360
Speaker 3: as a standalone product. Of course, ag one has a

624
00:34:11,400 --> 00:34:13,200
Speaker 3: deal for you if you want to get in on

625
00:34:13,280 --> 00:34:14,040
Speaker 3: the gang today.

626
00:34:14,280 --> 00:34:15,439
Speaker 2: Cannot recommend it enough.

627
00:34:15,440 --> 00:34:19,280
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628
00:34:19,560 --> 00:34:22,520
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629
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630
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631
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632
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633
00:34:35,560 --> 00:34:38,880
Speaker 2: Also got to give some love to my friends at Element.

634
00:34:39,320 --> 00:34:43,799
Speaker 3: Element makes no bs electrolytes with everything you need and

635
00:34:43,960 --> 00:34:45,080
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636
00:34:45,600 --> 00:34:47,560
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637
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638
00:34:51,960 --> 00:34:54,280
Speaker 3: are in a lot of those sports strengths you're reaching

639
00:34:54,320 --> 00:34:57,480
Speaker 3: for when you go to your bodega for your local market.

640
00:34:57,800 --> 00:35:01,320
Speaker 3: As much as I love drinking my Element before, during,

641
00:35:01,360 --> 00:35:05,520
Speaker 3: and after my workouts this time of year, I cannot

642
00:35:05,640 --> 00:35:09,839
Speaker 3: get enough of their chocolately flavors after dinner. That's why

643
00:35:09,960 --> 00:35:13,440
Speaker 3: Element is now my go to dessert. I make a

644
00:35:13,520 --> 00:35:16,400
Speaker 3: cup of hot water, I pour in a stick of

645
00:35:16,440 --> 00:35:17,960
Speaker 3: that chocolate caramel Element.

646
00:35:18,160 --> 00:35:20,080
Speaker 2: I top it with a little coconut.

647
00:35:19,600 --> 00:35:24,280
Speaker 3: Whip and wow, five calories, So delicious, and I'm taking

648
00:35:24,320 --> 00:35:28,560
Speaker 3: care of my body while seriously indulging. Talk about the

649
00:35:28,600 --> 00:35:31,200
Speaker 3: perfect stocking stuffer. I know right now we're trying to

650
00:35:31,200 --> 00:35:34,720
Speaker 3: think about what to get everyone on our holiday lists,

651
00:35:34,760 --> 00:35:37,880
Speaker 3: and I'd say that this is a safe bet. Of course,

652
00:35:38,000 --> 00:35:40,920
Speaker 3: we have an awesome deal for the hurdle listeners. Head

653
00:35:40,960 --> 00:35:43,840
Speaker 3: on over to drink Element dot com. That's drink l

654
00:35:44,000 --> 00:35:48,520
Speaker 3: mnt dot com slash hurdle to get a free Element

655
00:35:48,680 --> 00:35:52,319
Speaker 3: sample pack with your purchase today. Again that address to

656
00:35:52,360 --> 00:35:55,120
Speaker 3: get your freebies, head on over to Drink Element drink

657
00:35:55,239 --> 00:36:08,160
Speaker 3: lmnt dot com slash hurdle. What I'm hearing you say

658
00:36:08,360 --> 00:36:10,480
Speaker 3: is that a lot of the people that are on

659
00:36:11,080 --> 00:36:15,440
Speaker 3: a sea glue tide will basically eat the way that

660
00:36:15,920 --> 00:36:21,480
Speaker 3: they would or could eat on WW without the food noise.

661
00:36:21,800 --> 00:36:26,000
Speaker 3: So I'm likening this to my experience with WW. I

662
00:36:26,080 --> 00:36:29,319
Speaker 3: lost about seventy pounds back in college. At the time,

663
00:36:29,440 --> 00:36:32,600
Speaker 3: some of glue Tide was obviously not on my radar.

664
00:36:32,880 --> 00:36:38,080
Speaker 3: But it beckons the question for those individuals that maybe

665
00:36:38,440 --> 00:36:41,880
Speaker 3: in this higher BMI category as we spoke about, but

666
00:36:42,080 --> 00:36:46,560
Speaker 3: haven't tried a conventional weight loss program, what are the

667
00:36:46,600 --> 00:36:51,560
Speaker 3: pros versus the cons of then immediately jumping to something

668
00:36:51,880 --> 00:36:54,839
Speaker 3: like a Sema glue tide instead of simply trying to

669
00:36:54,880 --> 00:36:59,399
Speaker 3: follow something like WW or being more cognizant of portion, size,

670
00:36:59,400 --> 00:37:00,480
Speaker 3: what you're putting in your body.

671
00:37:00,520 --> 00:37:02,040
Speaker 2: More traditional weight loss methods.

672
00:37:02,280 --> 00:37:06,520
Speaker 1: Yeah, most people should. I mean most people usually try

673
00:37:06,600 --> 00:37:11,560
Speaker 1: to do some sort of weight loss diet and exercise before.

674
00:37:12,120 --> 00:37:15,200
Speaker 1: So a lot of my patients they have already done

675
00:37:15,200 --> 00:37:17,920
Speaker 1: some sort of behavioral program, but it's if they hadn't.

676
00:37:18,120 --> 00:37:20,720
Speaker 1: It basically helps people do what they know they should

677
00:37:20,800 --> 00:37:23,239
Speaker 1: do they just can't do. Does that make sense? So

678
00:37:23,400 --> 00:37:25,680
Speaker 1: like let's say they do Weight Watchers our core program

679
00:37:25,719 --> 00:37:28,759
Speaker 1: and they're like they have some success, and we see

680
00:37:28,760 --> 00:37:30,920
Speaker 1: it all the time. There's some people that would just

681
00:37:30,960 --> 00:37:32,600
Speaker 1: have success and it's like great, and they just keep

682
00:37:32,640 --> 00:37:35,040
Speaker 1: doing it and they keep the weight off. Great. But

683
00:37:35,080 --> 00:37:36,640
Speaker 1: there you know, there's going to be some people that

684
00:37:36,719 --> 00:37:39,640
Speaker 1: their body starts fighting back and they're going to feel it.

685
00:37:39,640 --> 00:37:42,960
Speaker 1: It's like it's the food noise, it's the appetite drivers,

686
00:37:43,000 --> 00:37:47,040
Speaker 1: it's the energy, and it's really difficult for a lot

687
00:37:47,080 --> 00:37:49,839
Speaker 1: of people to stick to that lifestyle. So basically, add

688
00:37:49,840 --> 00:37:52,799
Speaker 1: in these medicines boom boom hits these receptors in the brain.

689
00:37:52,880 --> 00:37:56,719
Speaker 1: It's like, oh, it helps them then calm down all

690
00:37:56,719 --> 00:37:59,600
Speaker 1: that food noise, calm all those other signals from their

691
00:37:59,640 --> 00:38:03,520
Speaker 1: body helps them basically do the lifestyle that we're recommending.

692
00:38:03,560 --> 00:38:05,640
Speaker 1: They just their body wouldn't allow them to do it,

693
00:38:05,680 --> 00:38:06,520
Speaker 1: if that makes sense.

694
00:38:07,000 --> 00:38:09,080
Speaker 3: I want to talk about side effects. You said this

695
00:38:09,120 --> 00:38:13,000
Speaker 3: buzzword early in our conversation. Definitely a concern for many

696
00:38:13,040 --> 00:38:15,879
Speaker 3: who are contemplating going the route of being on one

697
00:38:15,880 --> 00:38:17,040
Speaker 3: of these medications.

698
00:38:17,280 --> 00:38:18,399
Speaker 2: What do we know so far?

699
00:38:18,960 --> 00:38:23,000
Speaker 1: Yeah, most common side effect is nausea and GI side effects,

700
00:38:23,000 --> 00:38:27,760
Speaker 1: So nausea's number one. It's mild to moderate for most people,

701
00:38:28,320 --> 00:38:31,480
Speaker 1: and for most people it resolves over time. You'll see

702
00:38:31,480 --> 00:38:33,359
Speaker 1: it in the beginning when you start the medicine, and

703
00:38:33,400 --> 00:38:35,560
Speaker 1: you might see it every time what we call tit

704
00:38:35,600 --> 00:38:38,040
Speaker 1: trade up, go up in a dose, and then you

705
00:38:38,080 --> 00:38:40,960
Speaker 1: get to what's called your maintenance dose at some point,

706
00:38:41,520 --> 00:38:45,680
Speaker 1: and for most people, the side effect of nausea resolves.

707
00:38:46,680 --> 00:38:51,759
Speaker 1: One thing about our GLP one companion program. So this

708
00:38:51,800 --> 00:38:54,759
Speaker 1: is the program that you can do, whether you get

709
00:38:54,760 --> 00:38:58,239
Speaker 1: the medicine through our ww clinic versus getting it from

710
00:38:58,280 --> 00:39:04,320
Speaker 1: your primary care doctor. We've basically made the dietary changes

711
00:39:04,480 --> 00:39:09,080
Speaker 1: in a program like fashion too. Hopefully lesson now we

712
00:39:09,120 --> 00:39:12,000
Speaker 1: can't you know, we can't make that claim and whatever,

713
00:39:12,000 --> 00:39:13,600
Speaker 1: But it should. The way we set it up is

714
00:39:13,600 --> 00:39:17,360
Speaker 1: should decrease the risk of certain side effects because the

715
00:39:17,400 --> 00:39:20,319
Speaker 1: way you eat actually does. Like I said, if somebody

716
00:39:20,320 --> 00:39:23,000
Speaker 1: eats pizza, they'll know the next day, like I probably

717
00:39:23,040 --> 00:39:25,520
Speaker 1: shouldn't have done that because now I'm feeling really nauseous.

718
00:39:25,560 --> 00:39:28,880
Speaker 1: The food's kind of sitting in their stomach. So the

719
00:39:28,920 --> 00:39:32,040
Speaker 1: way you eat does have an effect there. But for

720
00:39:32,120 --> 00:39:35,040
Speaker 1: most people mild to moderate results. For most there will

721
00:39:35,080 --> 00:39:38,080
Speaker 1: be a subset of people that get more moderate to

722
00:39:38,200 --> 00:39:42,359
Speaker 1: severe nausea. It's a risk. You know, most people don't

723
00:39:42,400 --> 00:39:44,600
Speaker 1: start vomiting and have to go to the hospital, but

724
00:39:44,680 --> 00:39:47,399
Speaker 1: it does happen from time to time. The reason our

725
00:39:47,600 --> 00:39:50,520
Speaker 1: WW clinic, the reason I think is great as opposed

726
00:39:50,560 --> 00:39:52,640
Speaker 1: to like going to a primary care doctor or someone

727
00:39:52,680 --> 00:39:57,759
Speaker 1: you see once a month. We have very proactive care,

728
00:39:57,880 --> 00:40:01,480
Speaker 1: so like the doctor and our care teams always right there.

729
00:40:01,520 --> 00:40:03,319
Speaker 1: So if you start getting side effects, first of all,

730
00:40:03,320 --> 00:40:05,200
Speaker 1: we want to minimize we want to even prevent them

731
00:40:05,200 --> 00:40:08,080
Speaker 1: from happening. That's why we have our GLP one Companion

732
00:40:08,160 --> 00:40:11,640
Speaker 1: nutrition program and we have dietitians and to make sure

733
00:40:11,640 --> 00:40:13,759
Speaker 1: that hey eat in a way that we know is

734
00:40:13,800 --> 00:40:18,319
Speaker 1: going to reduce risk. Of side effects. However, not, there's

735
00:40:18,320 --> 00:40:19,880
Speaker 1: still going to be people that have side effects. So

736
00:40:19,960 --> 00:40:21,759
Speaker 1: what we do is jump in. We can jump in

737
00:40:21,800 --> 00:40:24,160
Speaker 1: with you know, does this person need to go to

738
00:40:24,200 --> 00:40:26,240
Speaker 1: the hospital. No, hopefully we can jump in with anti

739
00:40:26,360 --> 00:40:30,160
Speaker 1: nausea medicines. There are anti nausea medicines, and no, not

740
00:40:30,239 --> 00:40:33,480
Speaker 1: everybody should be taking these medicines to have nausea, only

741
00:40:33,520 --> 00:40:36,319
Speaker 1: to take another medicine to combat the nausea. And one

742
00:40:36,320 --> 00:40:38,240
Speaker 1: of the common questions that we get is like, Okay,

743
00:40:38,239 --> 00:40:39,960
Speaker 1: so people are just nauseous all the time and that's

744
00:40:40,280 --> 00:40:43,200
Speaker 1: why they're not eating. It's no, They've done studies on this.

745
00:40:43,480 --> 00:40:45,839
Speaker 1: It's not the nausea that makes people lose it. In fact,

746
00:40:45,880 --> 00:40:48,560
Speaker 1: the nausea resolves in the satiety and all that food

747
00:40:48,600 --> 00:40:51,719
Speaker 1: noise is down, so it's not the nausea. But unfortunately,

748
00:40:51,840 --> 00:40:54,319
Speaker 1: some people do still get nausea. But that's what I

749
00:40:54,360 --> 00:40:57,400
Speaker 1: really like about our proactive approach because we prevent it

750
00:40:57,440 --> 00:41:00,080
Speaker 1: and then we can jump in if we need to. You,

751
00:41:00,600 --> 00:41:03,439
Speaker 1: whereas other places it's I can't even get a hold

752
00:41:03,480 --> 00:41:05,120
Speaker 1: of my doctor. I'm gonna have to go to the

753
00:41:05,400 --> 00:41:08,200
Speaker 1: er and get some fluids to make sure that I

754
00:41:08,200 --> 00:41:10,360
Speaker 1: don't get dehydrated or some type of thing.

755
00:41:10,760 --> 00:41:14,920
Speaker 3: Outside of the nausea. What are other possible sidefacts constipation.

756
00:41:15,160 --> 00:41:18,080
Speaker 1: We see constipation. It slows down your GI track, so

757
00:41:18,600 --> 00:41:23,000
Speaker 1: you do see some constuppation. Again, being proactive in our program,

758
00:41:23,040 --> 00:41:26,360
Speaker 1: we make sure people are drinking enough fluid that obviously

759
00:41:26,360 --> 00:41:29,680
Speaker 1: helps with consumpation, enough fiber, and then physical activity even

760
00:41:29,760 --> 00:41:32,280
Speaker 1: just even just going for more walks and more steps

761
00:41:32,320 --> 00:41:35,600
Speaker 1: during the day should help your GI transit getting the

762
00:41:35,640 --> 00:41:40,160
Speaker 1: food through your system. So preventing the constipation is very important.

763
00:41:40,560 --> 00:41:42,040
Speaker 1: And then of course on top of that, you can

764
00:41:42,080 --> 00:41:45,400
Speaker 1: take cilium husk, you can do magnesium and other types

765
00:41:45,440 --> 00:41:50,880
Speaker 1: of things to improve the constipation. Sometimes we see diarrhea

766
00:41:51,120 --> 00:41:54,960
Speaker 1: resolves pretty quickly. Reflux is another thing because again you

767
00:41:55,040 --> 00:41:58,800
Speaker 1: slow down the gastric emptying how well your stomach releases

768
00:41:58,840 --> 00:42:03,200
Speaker 1: food through the intestine, and so sometimes we see people who,

769
00:42:03,280 --> 00:42:05,680
Speaker 1: especially if they have a history of reflux, it can

770
00:42:05,840 --> 00:42:09,280
Speaker 1: it can worsen acutely. But sometimes we do see fatigue

771
00:42:09,320 --> 00:42:12,279
Speaker 1: and people think that it's from not eating enough, but

772
00:42:12,360 --> 00:42:14,919
Speaker 1: there's something about the drug that may that we're saying

773
00:42:14,960 --> 00:42:18,960
Speaker 1: may cause fatigue. But again it resolves for anybody that

774
00:42:19,000 --> 00:42:22,200
Speaker 1: gets it. It resolves for pretty much everybody that gets that.

775
00:42:22,719 --> 00:42:26,239
Speaker 1: Other there's there's some other very rare side effects, but bye,

776
00:42:26,280 --> 00:42:29,960
Speaker 1: by far the most common one is nausea. Then there's

777
00:42:30,120 --> 00:42:33,600
Speaker 1: reflux and constipation.

778
00:42:33,160 --> 00:42:37,440
Speaker 3: And sometimes and what you mentioned about ramping up on

779
00:42:37,440 --> 00:42:40,400
Speaker 3: this medication, I would like in it maybe to ramping

780
00:42:40,480 --> 00:42:44,479
Speaker 3: up on some sort of anxiety medication. Right, what does

781
00:42:44,520 --> 00:42:47,000
Speaker 3: that process look like? Because you said that as a

782
00:42:47,000 --> 00:42:50,000
Speaker 3: byproduct of that ramp up, some of the side effects

783
00:42:50,040 --> 00:42:53,439
Speaker 3: that someone could experience with these may lessen over time

784
00:42:53,480 --> 00:42:55,000
Speaker 3: as the body gets used to it.

785
00:42:55,040 --> 00:42:56,400
Speaker 2: Is that the right language there?

786
00:42:56,840 --> 00:42:59,799
Speaker 1: Yeah? Yeah, So you know there's some patients that are like,

787
00:42:59,880 --> 00:43:02,239
Speaker 1: just throw me on the high dose, and it's like no.

788
00:43:02,400 --> 00:43:06,520
Speaker 1: You hear stories like that. Sometimes a pharmacist will dispense

789
00:43:06,600 --> 00:43:10,080
Speaker 1: the wrong medicine, unfortunately the wrong dose, and a lot

790
00:43:10,120 --> 00:43:12,440
Speaker 1: of those people end up in the hospital because it's

791
00:43:12,520 --> 00:43:14,399
Speaker 1: their body's not used to it and it comes as

792
00:43:14,440 --> 00:43:18,000
Speaker 1: a big shock. They're not used to to this type

793
00:43:18,000 --> 00:43:24,080
Speaker 1: of physiological effect or super physiological effect. I should say. So, yeah,

794
00:43:24,080 --> 00:43:26,319
Speaker 1: it's very important to start a low dose. Body gets

795
00:43:26,400 --> 00:43:28,719
Speaker 1: used to it. Okay, let's go up. Body gets used

796
00:43:28,719 --> 00:43:31,400
Speaker 1: to it. Okay, let's go up. And so for we

797
00:43:31,520 --> 00:43:35,120
Speaker 1: go V specifically, you start at point twenty five milligrams,

798
00:43:35,160 --> 00:43:37,080
Speaker 1: you go up too point five milligrams, and you go

799
00:43:37,120 --> 00:43:39,040
Speaker 1: to one milligrams, and you go to one point seven

800
00:43:39,080 --> 00:43:41,960
Speaker 1: then two point four. For the newest one called zep bound,

801
00:43:41,960 --> 00:43:44,640
Speaker 1: which is the ter zeppetide stuff, you start at two

802
00:43:44,680 --> 00:43:46,920
Speaker 1: point five milligrams, you go to five milligrams, and you

803
00:43:46,960 --> 00:43:48,600
Speaker 1: go to seven and a half, then ten, then twelve

804
00:43:48,640 --> 00:43:52,919
Speaker 1: and a half then fifteen right, and you know it's

805
00:43:53,280 --> 00:43:55,600
Speaker 1: because of the shortages that we saw on in a while.

806
00:43:55,880 --> 00:43:59,280
Speaker 1: It's possible that some people may skip around in doses,

807
00:43:59,320 --> 00:44:03,440
Speaker 1: but it that can increase your risk of getting these

808
00:44:03,480 --> 00:44:06,480
Speaker 1: side effects because when you jump up too quickly, too fast,

809
00:44:07,600 --> 00:44:11,040
Speaker 1: your body's not used to it. So that's exactly how

810
00:44:11,040 --> 00:44:11,440
Speaker 1: it works.

811
00:44:11,560 --> 00:44:13,120
Speaker 3: The other thing that I want to make sure that

812
00:44:13,160 --> 00:44:16,360
Speaker 3: we double click on is how we're making sure that

813
00:44:16,920 --> 00:44:20,640
Speaker 3: the right people are getting their hands on this. I

814
00:44:20,680 --> 00:44:23,600
Speaker 3: know you talked extensively about the vetting process for someone

815
00:44:23,960 --> 00:44:27,000
Speaker 3: to get this through sequence in the WW clinic, but

816
00:44:27,080 --> 00:44:30,680
Speaker 3: what's not to say that someone could give their phone

817
00:44:30,719 --> 00:44:33,719
Speaker 3: to someone else who's obese and have them put in

818
00:44:33,760 --> 00:44:37,560
Speaker 3: all their information and then end up with something harmful.

819
00:44:38,520 --> 00:44:41,239
Speaker 1: Yeah, it's you know, those things are really tough to

820
00:44:41,280 --> 00:44:43,399
Speaker 1: get by because like even in the clinic, you could

821
00:44:43,400 --> 00:44:46,560
Speaker 1: have your friend go in get them the prescription, and

822
00:44:46,600 --> 00:44:48,359
Speaker 1: then afterwards they can be like, all right, here you go,

823
00:44:48,440 --> 00:44:51,360
Speaker 1: here's the prescription for you. But we have some safeguards

824
00:44:51,400 --> 00:44:53,720
Speaker 1: in place. We make sure we have them take a picture.

825
00:44:54,320 --> 00:44:56,520
Speaker 1: We have them take a picture on a scale to

826
00:44:56,560 --> 00:45:00,799
Speaker 1: start off with, just to verify their weight. We get

827
00:45:00,840 --> 00:45:03,680
Speaker 1: medical records, we get labs and all these different things.

828
00:45:04,239 --> 00:45:07,120
Speaker 1: There's no you know, complete foolproof way to say like,

829
00:45:07,760 --> 00:45:11,520
Speaker 1: but I would say, out of anybody doing it out there,

830
00:45:11,520 --> 00:45:15,719
Speaker 1: I'm pretty sure I can say this. We're we have

831
00:45:15,760 --> 00:45:19,000
Speaker 1: to be one of the safe safest if not, that

832
00:45:19,120 --> 00:45:21,080
Speaker 1: was my thing. I want to make sure that we're

833
00:45:21,120 --> 00:45:23,680
Speaker 1: not putting this in the wrong hands. I mean, you know,

834
00:45:23,719 --> 00:45:27,520
Speaker 1: when we it's funny because some patient will flag and

835
00:45:27,640 --> 00:45:29,799
Speaker 1: we'll look at as a team like is this there's

836
00:45:29,800 --> 00:45:32,359
Speaker 1: something going on here? You know, and you'll see you'll

837
00:45:32,360 --> 00:45:34,440
Speaker 1: see all sorts of all sorts of things, and we

838
00:45:34,480 --> 00:45:37,040
Speaker 1: want to make sure that only the correct people are

839
00:45:37,440 --> 00:45:41,279
Speaker 1: are getting is. We're very serious about it. We don't

840
00:45:41,280 --> 00:45:45,080
Speaker 1: want to become known as someone who's just increasing diet

841
00:45:45,120 --> 00:45:49,120
Speaker 1: culture or doing this for just vanity weight loss purposes.

842
00:45:49,120 --> 00:45:51,959
Speaker 1: We want to do this for true health purposes from

843
00:45:51,960 --> 00:45:55,160
Speaker 1: a physician standpoint, like we really want to hone in

844
00:45:55,200 --> 00:45:58,560
Speaker 1: on improving health from a true indication of the medicine.

845
00:45:58,600 --> 00:46:00,560
Speaker 1: You want to make sure that we're doing this for

846
00:46:00,640 --> 00:46:03,000
Speaker 1: health purposes, not for just vanity purposes.

847
00:46:03,360 --> 00:46:05,920
Speaker 3: Yeah, and I want to reiterate that obviously, all this

848
00:46:06,080 --> 00:46:09,920
Speaker 3: is extremely interpretive, right, So one person may feel completely

849
00:46:09,960 --> 00:46:12,640
Speaker 3: happy in a place like where I was back in

850
00:46:12,680 --> 00:46:14,600
Speaker 3: college that I mentioned I lost a lot of weight,

851
00:46:14,640 --> 00:46:16,680
Speaker 3: and that's so fine, But I would be remiss if

852
00:46:16,680 --> 00:46:18,560
Speaker 3: I didn't say that there were things about me at

853
00:46:18,600 --> 00:46:21,840
Speaker 3: that time before the weight loss that were extremely unhealthy

854
00:46:21,840 --> 00:46:25,799
Speaker 3: biomarkers that I needed to be concerned about. You said

855
00:46:25,800 --> 00:46:28,200
Speaker 3: the words diet culture, So I do want to make

856
00:46:28,239 --> 00:46:31,520
Speaker 3: sure that we also talk a little bit about that. Clearly,

857
00:46:31,680 --> 00:46:36,480
Speaker 3: this whole Semaglue tie situation, there's been so many people

858
00:46:36,840 --> 00:46:40,280
Speaker 3: across the United States that have somehow gotten their hands

859
00:46:40,280 --> 00:46:44,360
Speaker 3: on this, and now people have a really big negative stereotype,

860
00:46:44,440 --> 00:46:49,400
Speaker 3: oftentimes with the buzzword ozebic, with the buzzword Wagov. I

861
00:46:49,480 --> 00:46:52,320
Speaker 3: want to know what your stance is on the people

862
00:46:52,400 --> 00:46:56,399
Speaker 3: that are maybe shaming others who have leaned into these

863
00:46:56,480 --> 00:47:00,799
Speaker 3: drugs because of the negativity that we've seen from Hollywood,

864
00:47:00,920 --> 00:47:02,160
Speaker 3: A listers, et cetera.

865
00:47:02,880 --> 00:47:05,239
Speaker 1: Yeah, I think that, you know, it's hard to get

866
00:47:05,280 --> 00:47:07,480
Speaker 1: around the people with a lot of money are going

867
00:47:07,560 --> 00:47:09,759
Speaker 1: to find a way to get these drug I mean,

868
00:47:09,800 --> 00:47:13,480
Speaker 1: whether it's their concierge doctor or they're they're going to

869
00:47:13,560 --> 00:47:16,040
Speaker 1: go get it from a compounding pharmacy, which we don't do.

870
00:47:16,120 --> 00:47:19,879
Speaker 1: We don't we only do FDA approved versions. But yeah,

871
00:47:19,920 --> 00:47:23,200
Speaker 1: you go to a concierge doctor, you're paying them thousands

872
00:47:23,239 --> 00:47:26,360
Speaker 1: of dollars a year. The concierge doctor is probably going

873
00:47:26,440 --> 00:47:30,239
Speaker 1: to follow what you what you want, unfor Unfortunately, you know,

874
00:47:30,239 --> 00:47:32,640
Speaker 1: people are like, but aren't doctors supposed to be? Yeah,

875
00:47:32,880 --> 00:47:35,960
Speaker 1: you know, we should, we should be prescribing it according

876
00:47:35,960 --> 00:47:37,879
Speaker 1: to the label, but you know, I don't know. People

877
00:47:37,920 --> 00:47:41,200
Speaker 1: are human, I guess. So it's it's just it's it's

878
00:47:41,239 --> 00:47:44,200
Speaker 1: really unfortunate about the whole Hollywood thing, but it's it's

879
00:47:44,200 --> 00:47:46,480
Speaker 1: hard to stop them from doing so. All I can

880
00:47:46,520 --> 00:47:50,520
Speaker 1: do my big messaging is like, forget the vanity weight

881
00:47:50,560 --> 00:47:55,600
Speaker 1: loss thing like, it's not I strongly strongly discourage that

882
00:47:55,800 --> 00:47:59,759
Speaker 1: use the people that are upset that people are you know,

883
00:47:59,800 --> 00:48:03,359
Speaker 1: take in this easy way out. It's it's a little

884
00:48:03,360 --> 00:48:05,600
Speaker 1: bit of ignorance. They don't understand what we call like

885
00:48:05,640 --> 00:48:10,520
Speaker 1: the pathophysiology of the disease of obesity. What they they

886
00:48:10,560 --> 00:48:13,440
Speaker 1: see in those who have obesity is a lack of

887
00:48:13,480 --> 00:48:16,120
Speaker 1: real power and discipline and they just can't stop eating,

888
00:48:16,200 --> 00:48:19,200
Speaker 1: like just push yourself away from the table, put your

889
00:48:19,280 --> 00:48:22,680
Speaker 1: fork down. And what they don't see are the internal

890
00:48:22,760 --> 00:48:26,440
Speaker 1: cues biological cues. Mind you, this isn't disciplined cues. It's

891
00:48:26,840 --> 00:48:30,239
Speaker 1: it's think of it as like an itch that that

892
00:48:30,400 --> 00:48:32,319
Speaker 1: like just don't just don't scratch it, and it's just

893
00:48:32,320 --> 00:48:36,520
Speaker 1: getting stronger and stronger and stronger. I have a I've

894
00:48:36,560 --> 00:48:38,600
Speaker 1: heard some other good analogies, like think of it like

895
00:48:38,920 --> 00:48:41,839
Speaker 1: you just didn't sleep last night, and somebody else had

896
00:48:41,840 --> 00:48:44,680
Speaker 1: the greatest sleep of their life, and the person wants

897
00:48:44,680 --> 00:48:47,120
Speaker 1: to fall asleep, it's like, just don't be tired. Well,

898
00:48:47,120 --> 00:48:50,400
Speaker 1: it's it's same as telling somebody with that pathophysiological disease

899
00:48:50,440 --> 00:48:54,160
Speaker 1: of obesity, like just stop eating so much. I don't understand,

900
00:48:54,200 --> 00:48:56,000
Speaker 1: why can't you just stop eating? And it's it's because

901
00:48:56,000 --> 00:48:59,759
Speaker 1: they just haven't felt it, this internal drive to just

902
00:48:59,800 --> 00:49:04,040
Speaker 1: like thinking about food. And so when someone is just like,

903
00:49:04,120 --> 00:49:06,279
Speaker 1: I don't understand, why don't you just use DIAGNEXTI I

904
00:49:06,320 --> 00:49:10,360
Speaker 1: posted a tweet yesterday about it. There's people always posting

905
00:49:10,360 --> 00:49:13,399
Speaker 1: about it. It's good, it's good fodder for social media

906
00:49:13,400 --> 00:49:16,279
Speaker 1: because it gives me a chance to talk about this.

907
00:49:16,480 --> 00:49:20,800
Speaker 1: But like, it shows ignorance and also a clear bias

908
00:49:20,840 --> 00:49:25,320
Speaker 1: and stigma against those with obesity, just a complete misunderstanding

909
00:49:25,360 --> 00:49:28,439
Speaker 1: of it. Because if if it were just a discipline issue,

910
00:49:28,480 --> 00:49:31,680
Speaker 1: then then you're telling me that every like most of

911
00:49:31,719 --> 00:49:36,520
Speaker 1: the population has a discipline issue, and it's just not true.

912
00:49:36,520 --> 00:49:38,440
Speaker 1: And then they're going to say, well, did you are

913
00:49:38,440 --> 00:49:40,920
Speaker 1: you saying genetics have changed? It's like, no, genetics are

914
00:49:40,920 --> 00:49:44,280
Speaker 1: a part of it, but obviously our environment has changed.

915
00:49:44,719 --> 00:49:47,319
Speaker 1: It's just that those who have a susceptibility and a

916
00:49:47,400 --> 00:49:52,600
Speaker 1: wiring to to eating more calories than we burn, it's

917
00:49:52,600 --> 00:49:56,440
Speaker 1: a it's a passive thing, despite despite their their frontal

918
00:49:56,480 --> 00:50:00,160
Speaker 1: cortex and them trying to fight against it, whereas like

919
00:50:00,200 --> 00:50:03,319
Speaker 1: someone like me, I'm naturally leaner, my body you know,

920
00:50:03,360 --> 00:50:05,840
Speaker 1: I can go eat whatever, and my body tends to

921
00:50:05,960 --> 00:50:10,840
Speaker 1: just stay leaner. And I understand that, and so I

922
00:50:10,880 --> 00:50:13,520
Speaker 1: think other people think that, like, well, if I can

923
00:50:13,560 --> 00:50:15,120
Speaker 1: do it, then other people should be able to do it.

924
00:50:15,160 --> 00:50:16,919
Speaker 1: But they don't know what's going on in that other

925
00:50:16,960 --> 00:50:19,520
Speaker 1: person's body. It's just that's that's all it is. It's

926
00:50:19,760 --> 00:50:22,120
Speaker 1: a lack of understanding. And so I used to get

927
00:50:22,160 --> 00:50:24,600
Speaker 1: really mad about it, and now I'm just like, well,

928
00:50:25,000 --> 00:50:26,440
Speaker 1: they don't get it, so let me see if I

929
00:50:26,480 --> 00:50:28,839
Speaker 1: can try to like teach them. And then if they

930
00:50:28,880 --> 00:50:32,239
Speaker 1: hear enough patient stories, and the stories are the same

931
00:50:32,440 --> 00:50:34,920
Speaker 1: over and over, they all say the same thing like

932
00:50:36,560 --> 00:50:38,680
Speaker 1: I just I can't I can't explain it when especially

933
00:50:38,680 --> 00:50:40,560
Speaker 1: when they start the medicine, they just all say, like

934
00:50:40,600 --> 00:50:44,120
Speaker 1: I feel what it must feel like to be someone

935
00:50:44,160 --> 00:50:45,319
Speaker 1: that doesn't struggle with weight.

936
00:50:45,800 --> 00:50:48,120
Speaker 2: Yeah, yeah, yeah.

937
00:50:48,280 --> 00:50:50,759
Speaker 3: So before when we were giving that example of a

938
00:50:50,760 --> 00:50:54,280
Speaker 3: two hundred pound person and maybe they'll lose fifteen percent,

939
00:50:54,360 --> 00:50:57,480
Speaker 3: maybe they'll lose up to thirty percent eventually using a

940
00:50:57,520 --> 00:51:02,640
Speaker 3: medication like this, who is to say via the medical

941
00:51:02,640 --> 00:51:06,480
Speaker 3: intervention when this person then comes off of this medication.

942
00:51:06,600 --> 00:51:09,480
Speaker 3: If someone loses something like forty to sixty pounds and

943
00:51:09,560 --> 00:51:12,920
Speaker 3: they're now in a normal quote unquote BMI range, although

944
00:51:12,960 --> 00:51:14,880
Speaker 3: you and I have already discussed the problems that come

945
00:51:14,920 --> 00:51:17,360
Speaker 3: hand in hand with that, but they're in a healthier

946
00:51:17,400 --> 00:51:19,600
Speaker 3: weight range. They're seeing a lot of the benefits that

947
00:51:19,640 --> 00:51:23,960
Speaker 3: come with that percentage of overall fat loss. Who's to

948
00:51:24,480 --> 00:51:27,239
Speaker 3: then modify that prescription? Should they need to come off

949
00:51:27,280 --> 00:51:29,080
Speaker 3: of it or is that something that they would just

950
00:51:29,160 --> 00:51:29,600
Speaker 3: stay on?

951
00:51:30,360 --> 00:51:33,840
Speaker 1: Yeah, great question. There's unfortunately a false I would call

952
00:51:33,920 --> 00:51:37,840
Speaker 1: it a false dichotomy that's occurring. So there's one group

953
00:51:37,840 --> 00:51:39,680
Speaker 1: of people who say these are a short term thing

954
00:51:39,719 --> 00:51:41,160
Speaker 1: to lose the weight and then they got to come off.

955
00:51:41,200 --> 00:51:44,680
Speaker 1: There's another group of mostly physicians, who are saying obese

956
00:51:44,800 --> 00:51:47,120
Speaker 1: is a chronic disease. They go on this medicine, why

957
00:51:47,160 --> 00:51:49,759
Speaker 1: would they ever stop? Well, the truth is is that

958
00:51:49,800 --> 00:51:54,239
Speaker 1: patients have autonomy, and we don't have autonomy over insurances

959
00:51:54,280 --> 00:51:59,320
Speaker 1: and whatnot either. But like there will be a subset

960
00:51:59,360 --> 00:52:01,600
Speaker 1: of patients, I will say most people will likely need

961
00:52:01,640 --> 00:52:05,960
Speaker 1: to take some form of fashion or fashion of a

962
00:52:06,280 --> 00:52:09,680
Speaker 1: therapy of biological therapy. It may not be a GLP one,

963
00:52:09,800 --> 00:52:11,400
Speaker 1: It may be a lower dose, it may be a

964
00:52:11,600 --> 00:52:16,200
Speaker 1: spread out like for example, let's just use let's use

965
00:52:16,440 --> 00:52:19,480
Speaker 1: URRs appetite zep bound as for an example. They may

966
00:52:19,480 --> 00:52:23,400
Speaker 1: get up to fifteen milligrams and they're they're like, they

967
00:52:23,520 --> 00:52:28,560
Speaker 1: lost one hundred pounds and they want they want to

968
00:52:28,560 --> 00:52:31,399
Speaker 1: wean off of it. So you start weaning them down.

969
00:52:31,760 --> 00:52:33,879
Speaker 1: You get them down to the lowest dose of two

970
00:52:33,920 --> 00:52:36,399
Speaker 1: and a half, and they're still keeping the weight off.

971
00:52:36,440 --> 00:52:38,680
Speaker 1: And now they go from every seven days to every

972
00:52:39,640 --> 00:52:42,239
Speaker 1: you know, twelve to fourteen days, like every other week,

973
00:52:42,280 --> 00:52:44,520
Speaker 1: and it's still keeping the weight off. And then they

974
00:52:44,520 --> 00:52:47,040
Speaker 1: stop and then they notice that their weight starts creeping up.

975
00:52:47,600 --> 00:52:49,440
Speaker 1: So those people may need to still stay on a

976
00:52:49,440 --> 00:52:51,799
Speaker 1: low dose, but a very low dose and spread out,

977
00:52:51,840 --> 00:52:56,400
Speaker 1: not even according to the package insert, which again, like

978
00:52:56,480 --> 00:52:58,360
Speaker 1: I just have to say, we're supposed to follow a

979
00:52:58,360 --> 00:53:01,000
Speaker 1: package insert, but patients. We're going to find that patients

980
00:53:01,000 --> 00:53:03,719
Speaker 1: respond so differently to these that we're going to start

981
00:53:03,760 --> 00:53:07,319
Speaker 1: having to really individualize, and that's what we do. Not

982
00:53:07,440 --> 00:53:10,439
Speaker 1: everybody needs to stay in the medicine long term. Most

983
00:53:10,480 --> 00:53:13,040
Speaker 1: people will have to be on some form or fashion

984
00:53:13,120 --> 00:53:15,000
Speaker 1: of it. But there are a subset of people that

985
00:53:15,080 --> 00:53:17,239
Speaker 1: will be able to come off of it and This

986
00:53:17,320 --> 00:53:20,040
Speaker 1: is kind of understanding that what we call the heterogeneity

987
00:53:20,440 --> 00:53:24,640
Speaker 1: of obesity, meaning that people are different. Different people are different.

988
00:53:24,640 --> 00:53:27,280
Speaker 1: We all have i don't know, different physiologies and different

989
00:53:28,280 --> 00:53:32,879
Speaker 1: environments and genetics, and so people need to have individualized care.

990
00:53:33,680 --> 00:53:39,080
Speaker 3: When someone gets a renewal for their prescription, would there

991
00:53:39,239 --> 00:53:43,080
Speaker 3: become a point if they're doing this through telehealth, that

992
00:53:44,000 --> 00:53:47,480
Speaker 3: someone would say, okay, you're at this weight now, which

993
00:53:47,520 --> 00:53:51,080
Speaker 3: means that we are going to lower the dose for you,

994
00:53:51,320 --> 00:53:54,040
Speaker 3: even if they want to maybe keep it at where

995
00:53:54,080 --> 00:53:54,520
Speaker 3: it's at.

996
00:53:55,520 --> 00:54:01,040
Speaker 1: We don't force people to come off. We offer We

997
00:54:01,080 --> 00:54:02,799
Speaker 1: offer it if they want, and we'll be there if

998
00:54:02,840 --> 00:54:07,360
Speaker 1: we want. But people are very sensitive to that because

999
00:54:08,520 --> 00:54:10,759
Speaker 1: other doctors in the past have forced people to come

1000
00:54:10,760 --> 00:54:13,680
Speaker 1: off and it can be quite triggering, like you don't

1001
00:54:13,760 --> 00:54:16,840
Speaker 1: understand I've done everything my whole life to try to

1002
00:54:16,880 --> 00:54:18,279
Speaker 1: lose weight and keep it off and this is the

1003
00:54:18,320 --> 00:54:23,279
Speaker 1: first time i feel free from that burden. And so like,

1004
00:54:23,960 --> 00:54:26,400
Speaker 1: we don't force it, we say, look, you're at a

1005
00:54:26,400 --> 00:54:28,799
Speaker 1: good weight. What we do have, though, we have a

1006
00:54:28,840 --> 00:54:33,640
Speaker 1: safety check in place like these newer metzepetite specifically zet bound.

1007
00:54:34,120 --> 00:54:38,279
Speaker 1: It is so powerful that some people will they'll keep

1008
00:54:38,320 --> 00:54:40,280
Speaker 1: losing weight, and if you keep them on the highest

1009
00:54:40,520 --> 00:54:43,279
Speaker 1: they'll go, they'll go into what I would consider a

1010
00:54:43,320 --> 00:54:46,520
Speaker 1: weight such a low weight that it's not healthy. So

1011
00:54:46,600 --> 00:54:49,520
Speaker 1: that becomes less about health and more about like this

1012
00:54:49,560 --> 00:54:52,440
Speaker 1: person's BMI. Like, so I set the cutoff of the

1013
00:54:52,440 --> 00:54:57,920
Speaker 1: BMI at twenty two. You know, eighteen eighteen is considered

1014
00:54:58,040 --> 00:55:02,040
Speaker 1: you know, underweight, but like really twenty two. If they're

1015
00:55:02,080 --> 00:55:05,279
Speaker 1: getting below twenty two, it's it comes. It's you're not

1016
00:55:05,320 --> 00:55:08,319
Speaker 1: going to get any health benefit below that, right, So.

1017
00:55:08,520 --> 00:55:10,880
Speaker 3: Yeah, I guess, but that was my that's my question

1018
00:55:11,000 --> 00:55:14,239
Speaker 3: or my concern really is that who's checking in to

1019
00:55:14,280 --> 00:55:18,319
Speaker 3: make sure that this isn't going to a dangerous place forals?

1020
00:55:18,440 --> 00:55:20,720
Speaker 1: So yeah, I set the protocol there to where basically

1021
00:55:20,760 --> 00:55:23,279
Speaker 1: it I call it like landing a plane. So like

1022
00:55:23,560 --> 00:55:26,640
Speaker 1: if they are rapidly losing weight and they're getting you know,

1023
00:55:26,800 --> 00:55:29,319
Speaker 1: under twenty five BMI they're getting, they're gonna they're gonna

1024
00:55:29,320 --> 00:55:31,680
Speaker 1: look like they're going to shoot past that twenty two BMI.

1025
00:55:32,080 --> 00:55:35,480
Speaker 1: Then we start rapidly, not rapidly, but we start titrating

1026
00:55:35,480 --> 00:55:38,080
Speaker 1: down the dose to make sure they don't shoot past that.

1027
00:55:38,239 --> 00:55:41,080
Speaker 1: So we're we're very careful there, and then that's kind

1028
00:55:41,080 --> 00:55:43,080
Speaker 1: of the basement BMI. We could go to twenty one

1029
00:55:43,200 --> 00:55:45,560
Speaker 1: or so if you know, some people lose weight just

1030
00:55:46,200 --> 00:55:49,799
Speaker 1: even if we didn't calculate it in their rate necessarily.

1031
00:55:49,800 --> 00:55:52,279
Speaker 1: But like we try not to go past that. We

1032
00:55:52,400 --> 00:55:54,440
Speaker 1: have that in our safety protocols.

1033
00:55:54,120 --> 00:55:56,879
Speaker 3: Right, And I again, I have an understanding that on

1034
00:55:56,920 --> 00:55:59,280
Speaker 3: your side, you do the best you can in this situation.

1035
00:55:59,480 --> 00:56:02,520
Speaker 3: Understanding that telehealth they're not actually there physically by their

1036
00:56:02,560 --> 00:56:04,799
Speaker 3: side all the time. I would assume there's also an

1037
00:56:04,800 --> 00:56:08,560
Speaker 3: instance where someone might not actually be accurately reporting their weight,

1038
00:56:09,239 --> 00:56:12,080
Speaker 3: which could bring other issues to the forefront.

1039
00:56:12,520 --> 00:56:16,680
Speaker 1: Yeah, it's it's very possible. We recognize that that's kind

1040
00:56:16,680 --> 00:56:20,040
Speaker 1: of one of the drawbacks of telemedicine as opposed to

1041
00:56:20,080 --> 00:56:23,640
Speaker 1: bringing them in person, looking at them right on the scale,

1042
00:56:23,719 --> 00:56:28,200
Speaker 1: making sure they're not holding a forty five pound weight

1043
00:56:28,719 --> 00:56:31,520
Speaker 1: on their chest or you know, something like something silly

1044
00:56:31,600 --> 00:56:35,560
Speaker 1: like that, so that you know those things are you know,

1045
00:56:35,920 --> 00:56:39,840
Speaker 1: are concerned and we find ways to minimize that type

1046
00:56:39,840 --> 00:56:43,279
Speaker 1: of situation. But I will say that tellymedicine, like the

1047
00:56:43,360 --> 00:56:47,400
Speaker 1: stigma around obese people have been traumatized from having to

1048
00:56:47,440 --> 00:56:51,480
Speaker 1: go in being sitting in chairs that weren't made for

1049
00:56:51,520 --> 00:56:54,640
Speaker 1: their bodies, around a bunch of other people that might

1050
00:56:54,680 --> 00:56:57,600
Speaker 1: be coughing and sputtering because they're because they're coming in

1051
00:56:57,640 --> 00:57:00,640
Speaker 1: for some cold or whatever. And then you're sitting around

1052
00:57:00,680 --> 00:57:02,680
Speaker 1: these other people, not in a comfortable chair to be

1053
00:57:02,680 --> 00:57:05,560
Speaker 1: brought in maybe weighed in in front of other people.

1054
00:57:06,040 --> 00:57:08,279
Speaker 1: It's it can be very traumatized. And then you sit

1055
00:57:08,360 --> 00:57:11,799
Speaker 1: there and the doctors behind a computer. The first thing

1056
00:57:11,800 --> 00:57:13,920
Speaker 1: he says is that like, hey, you know, you need

1057
00:57:13,960 --> 00:57:16,920
Speaker 1: to lose weight, right And they're not even looking at you.

1058
00:57:17,120 --> 00:57:19,800
Speaker 1: The person doesn't even realize that you lost fifty pounds

1059
00:57:19,840 --> 00:57:23,280
Speaker 1: despite your BMI being still in this kind of higher range.

1060
00:57:23,800 --> 00:57:25,680
Speaker 1: And I hear these stories all the time. The reason

1061
00:57:25,720 --> 00:57:27,720
Speaker 1: I bring this up. I hear these stories the trauma

1062
00:57:27,760 --> 00:57:31,760
Speaker 1: that's been done, and people just want to have a

1063
00:57:31,880 --> 00:57:38,160
Speaker 1: non stigmatizing, non biased type of weight health care visit.

1064
00:57:38,200 --> 00:57:40,439
Speaker 1: They just they just want to be heard. They don't

1065
00:57:40,440 --> 00:57:44,280
Speaker 1: want everything, including their cough and sickness to be attributed

1066
00:57:44,320 --> 00:57:47,240
Speaker 1: to their weight. They you know, if you hear about

1067
00:57:47,240 --> 00:57:50,479
Speaker 1: the person that had has obesity to have back pain,

1068
00:57:51,080 --> 00:57:53,160
Speaker 1: it's rare, but you see the doctor like it's just wait,

1069
00:57:53,200 --> 00:57:55,160
Speaker 1: go lose weight. They didn't even do the exam because

1070
00:57:55,160 --> 00:57:57,840
Speaker 1: they're they clearly have a bias. They just think everything's

1071
00:57:57,880 --> 00:57:59,680
Speaker 1: due to their weight. And the person had a tumor

1072
00:57:59,680 --> 00:58:02,439
Speaker 1: in their fine, again, it doesn't happen. That's that's rare.

1073
00:58:02,520 --> 00:58:06,240
Speaker 1: But those are like the cases you hear. So yeah,

1074
00:58:06,360 --> 00:58:10,760
Speaker 1: in terms of telemedicine, like removing that barrier of in

1075
00:58:10,800 --> 00:58:13,760
Speaker 1: the stigma away from it to where people feel comfortable

1076
00:58:13,840 --> 00:58:16,360
Speaker 1: to finally have those discussions where you don't have to

1077
00:58:16,400 --> 00:58:19,760
Speaker 1: go wige in front of a whole group of people

1078
00:58:21,000 --> 00:58:25,600
Speaker 1: and be kind of chastised by the system. Anyway, that's

1079
00:58:25,640 --> 00:58:27,600
Speaker 1: just my that's my little I'm going off on a

1080
00:58:27,680 --> 00:58:29,520
Speaker 1: thing because I've thought about it very much and I've

1081
00:58:29,560 --> 00:58:31,960
Speaker 1: talked with so many patients, thousands of patients, and they

1082
00:58:32,800 --> 00:58:34,960
Speaker 1: you know, some people do still prefer that in person,

1083
00:58:35,000 --> 00:58:37,360
Speaker 1: of course, and there is a strong role for that,

1084
00:58:37,560 --> 00:58:43,120
Speaker 1: and I agree there is. But like telemedicine especially, I

1085
00:58:43,160 --> 00:58:45,560
Speaker 1: would say, I say chronically monitoring. I was on Good

1086
00:58:45,560 --> 00:58:48,080
Speaker 1: Morning American, Like, can you say continuously and people don't

1087
00:58:48,080 --> 00:58:52,520
Speaker 1: know what chronically monitoring is, so continuously monitoring where it's

1088
00:58:52,520 --> 00:58:54,840
Speaker 1: like they can message in, they can have a team

1089
00:58:54,920 --> 00:58:58,800
Speaker 1: right then and there, proactively helping in between what you

1090
00:58:58,880 --> 00:59:01,400
Speaker 1: usually do or like month to month visits with like

1091
00:59:01,640 --> 00:59:04,280
Speaker 1: a normal doctor. But with us, it's like we're there

1092
00:59:04,360 --> 00:59:06,920
Speaker 1: all the time with you, with you on the journey.

1093
00:59:07,000 --> 00:59:08,240
Speaker 1: So anyway, sorry, I'm going off.

1094
00:59:08,440 --> 00:59:10,360
Speaker 2: Oh you are so fine. You are so fine.

1095
00:59:10,360 --> 00:59:13,520
Speaker 3: What would you say your hopes are for the future

1096
00:59:13,720 --> 00:59:15,240
Speaker 3: of this type of treatment?

1097
00:59:16,040 --> 00:59:18,880
Speaker 1: Yeah, so technology is just going to keep getting better

1098
00:59:18,920 --> 00:59:23,320
Speaker 1: and better. We need to keep improving our ways of

1099
00:59:24,720 --> 00:59:27,960
Speaker 1: delivering care through telemedicine. I think the future is going

1100
00:59:28,000 --> 00:59:30,240
Speaker 1: to be a hybrid though, of both. So we need

1101
00:59:30,280 --> 00:59:34,200
Speaker 1: to find ways to do good in person. We can't

1102
00:59:34,200 --> 00:59:35,600
Speaker 1: just get rid of in person. You need to be

1103
00:59:35,600 --> 00:59:38,240
Speaker 1: seen in person from time to time. Right now, we're

1104
00:59:38,360 --> 00:59:40,520
Speaker 1: you know, people still have their primary care doctors and

1105
00:59:40,520 --> 00:59:42,200
Speaker 1: they use us and we try to communicate with their

1106
00:59:42,240 --> 00:59:45,840
Speaker 1: primary care doctors. But I think eventually the future is

1107
00:59:45,880 --> 00:59:50,600
Speaker 1: a hybrid version of this. I think technology though online

1108
00:59:50,720 --> 00:59:52,960
Speaker 1: people have their people have their phones in their pocket

1109
00:59:53,000 --> 00:59:55,560
Speaker 1: at all time. Imagine having your care team in your

1110
00:59:55,600 --> 00:59:58,480
Speaker 1: pocket at all time, like a dietasan a strength coach.

1111
00:59:58,920 --> 01:00:01,919
Speaker 1: And then your apps. So for us, it's like our app,

1112
01:00:02,080 --> 01:00:04,160
Speaker 1: you know, you can't always have a person always there,

1113
01:00:04,280 --> 01:00:07,240
Speaker 1: you know, within minutes. But our app to help people

1114
01:00:07,280 --> 01:00:09,760
Speaker 1: through this journey to make sure they're eating the right things,

1115
01:00:09,760 --> 01:00:12,800
Speaker 1: to make sure they're doing the right physical activity. Even

1116
01:00:12,840 --> 01:00:14,800
Speaker 1: if you don't use us for a prescription, you can

1117
01:00:14,840 --> 01:00:17,480
Speaker 1: still use our app that helps you through this. So

1118
01:00:17,520 --> 01:00:20,480
Speaker 1: I think I think the future is making sure that

1119
01:00:20,520 --> 01:00:23,960
Speaker 1: people have a safe journey through it, a better quality

1120
01:00:24,000 --> 01:00:27,240
Speaker 1: of life through the journey. People stop the medicines. Oftentimes

1121
01:00:27,320 --> 01:00:29,560
Speaker 1: you see these articles like people don't even stay on

1122
01:00:29,600 --> 01:00:31,720
Speaker 1: these medicines because of the side effects. It's like, well,

1123
01:00:31,760 --> 01:00:33,840
Speaker 1: we have a good track record of keeping people on

1124
01:00:33,840 --> 01:00:36,000
Speaker 1: the medicines because if you minimize the side effects and

1125
01:00:36,000 --> 01:00:38,760
Speaker 1: make sure you're not increasing the dose when they're having

1126
01:00:38,800 --> 01:00:41,720
Speaker 1: side effects, because that's what you see in other instances though,

1127
01:00:41,960 --> 01:00:44,120
Speaker 1: they're going to be having side effects and like whatever,

1128
01:00:44,240 --> 01:00:46,040
Speaker 1: just keep going up on your dose. It's like, who, well,

1129
01:00:46,240 --> 01:00:47,919
Speaker 1: maybe not go up on the dose. Maybe you still

1130
01:00:47,960 --> 01:00:49,800
Speaker 1: got to get used to this. Maybe we need to

1131
01:00:49,840 --> 01:00:52,560
Speaker 1: adjust the way you're eating and that type of thing

1132
01:00:52,600 --> 01:00:55,080
Speaker 1: before we start thinking about going up in a dose.

1133
01:00:55,160 --> 01:01:01,280
Speaker 1: So I think the future is you really utilizing good technology,

1134
01:01:01,360 --> 01:01:05,400
Speaker 1: good programming to make sure people can safely use this

1135
01:01:05,440 --> 01:01:08,440
Speaker 1: new technological drug. And the drugs are just going to

1136
01:01:08,440 --> 01:01:11,200
Speaker 1: get better and better, like they're just the things that

1137
01:01:11,200 --> 01:01:15,439
Speaker 1: are coming out are just they're crazy people. People don't

1138
01:01:15,480 --> 01:01:17,800
Speaker 1: realize what's coming down the pipeline. It's it's going to

1139
01:01:17,840 --> 01:01:21,040
Speaker 1: be quite different in five to ten years of what

1140
01:01:21,080 --> 01:01:21,960
Speaker 1: we're going to see.

1141
01:01:22,280 --> 01:01:24,200
Speaker 2: What does better mean to you?

1142
01:01:24,960 --> 01:01:30,200
Speaker 1: So fewer side effects, better weight loss, fewer, fewer times

1143
01:01:30,200 --> 01:01:33,000
Speaker 1: you have to inject, like all the pain points that

1144
01:01:33,040 --> 01:01:35,200
Speaker 1: you see. So like before when I talked about it

1145
01:01:35,280 --> 01:01:36,880
Speaker 1: is like twice a day injection. Then it went to

1146
01:01:36,920 --> 01:01:38,480
Speaker 1: once a day, then it went to once a week,

1147
01:01:39,080 --> 01:01:42,400
Speaker 1: and then it went from this amount of weight loss

1148
01:01:42,480 --> 01:01:43,960
Speaker 1: up to this amount of weight loss. So we're going

1149
01:01:44,000 --> 01:01:45,600
Speaker 1: to see better weights and then and then there's a

1150
01:01:45,640 --> 01:01:48,480
Speaker 1: concern of like well how much of it's fat, how

1151
01:01:48,520 --> 01:01:51,240
Speaker 1: much of it's muscle and bone. There are gonna be

1152
01:01:51,280 --> 01:01:53,720
Speaker 1: ways where they're going to decrease the nausea. They're going

1153
01:01:53,760 --> 01:01:56,200
Speaker 1: to find ways to hit the receptors in the brain

1154
01:01:56,280 --> 01:01:58,560
Speaker 1: differently to where you don't cause nausea at all. Like

1155
01:01:58,600 --> 01:02:01,320
Speaker 1: there's think about that, Like all those little pain points

1156
01:02:01,320 --> 01:02:04,680
Speaker 1: are going to just be refined through the years, and

1157
01:02:04,760 --> 01:02:09,840
Speaker 1: I see our rule as just improving the journey while

1158
01:02:09,880 --> 01:02:13,200
Speaker 1: they take these medicines, because the medicines are inevitable unless

1159
01:02:13,200 --> 01:02:15,560
Speaker 1: there's a smoking gun that we don't know but we

1160
01:02:15,600 --> 01:02:18,320
Speaker 1: haven't seen it. There's just piles of data to show

1161
01:02:18,320 --> 01:02:21,160
Speaker 1: the safety of these medicines. I see our role as

1162
01:02:21,200 --> 01:02:24,680
Speaker 1: a facilitating the best quality of life and journey while

1163
01:02:24,680 --> 01:02:26,840
Speaker 1: people are taking these because I think there's going to

1164
01:02:26,840 --> 01:02:28,919
Speaker 1: be a lot of people taking these regardless.

1165
01:02:29,120 --> 01:02:32,600
Speaker 3: So yeah, I anticipate I'm curious to know your thoughts

1166
01:02:32,640 --> 01:02:36,080
Speaker 3: on this. I anticipate that as these quote unquote get

1167
01:02:36,120 --> 01:02:39,520
Speaker 3: better your words, more and more people are going to

1168
01:02:40,640 --> 01:02:45,400
Speaker 3: get onto a GLP one medication. Do you anticipate that

1169
01:02:45,480 --> 01:02:50,240
Speaker 3: there will be a wider acceptance of these medications as

1170
01:02:50,240 --> 01:02:53,400
Speaker 3: we move forward versus the kind of flack that they're

1171
01:02:53,400 --> 01:02:54,240
Speaker 3: getting now.

1172
01:02:54,440 --> 01:02:57,840
Speaker 1: Yeah, it's inevitable. And this is what I'm up against

1173
01:02:57,880 --> 01:03:01,560
Speaker 1: on social media all the time. And what's going to

1174
01:03:01,640 --> 01:03:03,840
Speaker 1: happen is that it's going to be similar to I

1175
01:03:03,880 --> 01:03:07,040
Speaker 1: would say, like mental health and things like that. Before

1176
01:03:07,080 --> 01:03:10,400
Speaker 1: it was you know, taboo and people didn't understand it.

1177
01:03:10,480 --> 01:03:14,400
Speaker 1: It's like, just pull yourself up in your bootstraps. You know, smile,

1178
01:03:14,480 --> 01:03:16,480
Speaker 1: put your smile on, you have depression, whatever, put a

1179
01:03:16,520 --> 01:03:18,760
Speaker 1: smile on, just cheer up. It's going to be the

1180
01:03:18,800 --> 01:03:21,440
Speaker 1: same with obesity. Instead of just like, hey, you need

1181
01:03:21,520 --> 01:03:23,160
Speaker 1: to put the fork down. They're going to understand the

1182
01:03:23,200 --> 01:03:26,640
Speaker 1: biological underpinnings of it. And this doesn't mean we shouldn't

1183
01:03:26,640 --> 01:03:30,680
Speaker 1: be working on our environment too. People I'll get chastise

1184
01:03:30,760 --> 01:03:33,960
Speaker 1: on Twitter with this kind of straw man false dichotomy,

1185
01:03:34,040 --> 01:03:35,760
Speaker 1: whatever you want to call it. They're like, but shouldn't

1186
01:03:35,760 --> 01:03:37,640
Speaker 1: we be working on the environment and not just working

1187
01:03:37,640 --> 01:03:39,320
Speaker 1: on these drugs? Is like, yeah, we should be working

1188
01:03:39,320 --> 01:03:42,800
Speaker 1: on the environment too. We need to prevent obesity before

1189
01:03:42,840 --> 01:03:46,520
Speaker 1: it occurs, but we also need tools to help treat

1190
01:03:46,520 --> 01:03:49,600
Speaker 1: the obesity once it occurs too. And by the way,

1191
01:03:49,640 --> 01:03:51,840
Speaker 1: there was just a press or release. There are companies,

1192
01:03:51,880 --> 01:03:54,080
Speaker 1: all sorts of companies working on how to prevent the

1193
01:03:54,120 --> 01:03:58,760
Speaker 1: obesity in the first place, because again, once people develop

1194
01:03:58,800 --> 01:04:02,640
Speaker 1: the obesity, that's where some physiological changes can happen in

1195
01:04:02,680 --> 01:04:05,600
Speaker 1: the brain, and that's where it's like the food noise,

1196
01:04:05,640 --> 01:04:09,160
Speaker 1: those biological drivers. It's really hard to just will power

1197
01:04:09,200 --> 01:04:10,040
Speaker 1: yourself out of that.

1198
01:04:10,680 --> 01:04:13,840
Speaker 3: Yeah, and you're really talking about what I think so

1199
01:04:13,920 --> 01:04:17,480
Speaker 3: many advocate now, it's what can we do from the

1200
01:04:17,520 --> 01:04:19,760
Speaker 3: get go, especially if you're in a position where you're

1201
01:04:19,840 --> 01:04:24,840
Speaker 3: raising children, to keep a healthier environment around because we

1202
01:04:24,960 --> 01:04:28,840
Speaker 3: are truly a product of our environment, and having important

1203
01:04:28,880 --> 01:04:32,440
Speaker 3: conversations about what eating well might look like, what you

1204
01:04:32,520 --> 01:04:35,440
Speaker 3: can do to move your body regularly, so many different

1205
01:04:35,440 --> 01:04:38,400
Speaker 3: things that we take on as a responsibility to hopefully

1206
01:04:38,480 --> 01:04:41,240
Speaker 3: live a healthier and happier life. And also be honest

1207
01:04:41,280 --> 01:04:43,520
Speaker 3: that there are going to be situations that feel as

1208
01:04:43,560 --> 01:04:46,240
Speaker 3: though they are beyond our control, and that just because

1209
01:04:46,240 --> 01:04:49,480
Speaker 3: someone may want to lose weight doesn't mean that they

1210
01:04:49,520 --> 01:04:52,959
Speaker 3: should be demonized for it. I think that's a really

1211
01:04:53,000 --> 01:04:55,800
Speaker 3: tough point point that we're at now in our society.

1212
01:04:55,960 --> 01:04:59,560
Speaker 3: I as someone who's lost weight herself, I know how

1213
01:04:59,600 --> 01:05:01,920
Speaker 3: difficult it can be to have other people have an

1214
01:05:01,920 --> 01:05:04,400
Speaker 3: opinion on your body. And when someone has an opinion

1215
01:05:04,440 --> 01:05:06,520
Speaker 3: on your body, when you know personally that you don't

1216
01:05:06,520 --> 01:05:08,800
Speaker 3: feel healthy in your body, it should be your decision

1217
01:05:08,800 --> 01:05:11,160
Speaker 3: on what you want to do moving forward, not the

1218
01:05:11,200 --> 01:05:12,320
Speaker 3: decision of the other.

1219
01:05:12,880 --> 01:05:15,520
Speaker 1: Yeah. Right, So you shouldn't feel forced to lose like that.

1220
01:05:15,640 --> 01:05:17,160
Speaker 1: That's the other So I I deal with a lot

1221
01:05:17,200 --> 01:05:19,920
Speaker 1: of those people online and it's like, look, I'm not

1222
01:05:19,960 --> 01:05:22,320
Speaker 1: going to tell you to lose like force you to

1223
01:05:22,320 --> 01:05:23,960
Speaker 1: lose weight. I'm not going to chastise you. If you

1224
01:05:24,000 --> 01:05:25,840
Speaker 1: want to lose weight or if you don't want to

1225
01:05:25,880 --> 01:05:30,920
Speaker 1: lose weight, the options there. You have autonomy over your body.

1226
01:05:31,760 --> 01:05:34,480
Speaker 1: But the thing is people are jerks. Like you know,

1227
01:05:34,520 --> 01:05:37,160
Speaker 1: people will say all sorts of things to me, mean

1228
01:05:38,040 --> 01:05:42,080
Speaker 1: from different angles. You. If you can't lose weight, you

1229
01:05:43,040 --> 01:05:46,280
Speaker 1: lack the discipline. If you lose weight using trying to

1230
01:05:46,440 --> 01:05:48,520
Speaker 1: do behavior, then you use the you know, one of

1231
01:05:48,560 --> 01:05:51,120
Speaker 1: these new medicines. Then you're taking the easy way out.

1232
01:05:51,160 --> 01:05:52,919
Speaker 1: It's like, just can I just like live my own

1233
01:05:52,960 --> 01:05:55,640
Speaker 1: life and do what I need to do now. Unfortunately,

1234
01:05:55,640 --> 01:05:58,280
Speaker 1: people are just not not nice people out there. But

1235
01:05:58,480 --> 01:06:02,600
Speaker 1: I think, I honestly think the perception, the paradigm will shift.

1236
01:06:02,680 --> 01:06:05,120
Speaker 1: We're at that turning point though, where I'd say, over

1237
01:06:05,160 --> 01:06:08,520
Speaker 1: the next decade or so, it's going to be thinking

1238
01:06:08,720 --> 01:06:09,840
Speaker 1: very differently about this.

1239
01:06:10,600 --> 01:06:13,200
Speaker 3: Well, Doctor Nandolski, I'm so happy that we are able

1240
01:06:13,280 --> 01:06:17,400
Speaker 3: to have this really in depth conversation about GLP one medication.

1241
01:06:17,560 --> 01:06:20,280
Speaker 3: I know that so many individuals are really trying to

1242
01:06:20,280 --> 01:06:23,120
Speaker 3: figure out what's right for them. And I just want

1243
01:06:23,160 --> 01:06:26,040
Speaker 3: to close this off by personally saying that no one

1244
01:06:26,040 --> 01:06:29,600
Speaker 3: should should you into what you do for your body.

1245
01:06:29,760 --> 01:06:32,080
Speaker 3: So make sure that if this is something that you're

1246
01:06:32,080 --> 01:06:34,960
Speaker 3: interested in, you really are taking ownership of your health.

1247
01:06:35,000 --> 01:06:37,920
Speaker 3: You're getting informed, You're not just listening to a podcast

1248
01:06:37,960 --> 01:06:40,080
Speaker 3: like this, but you're talking to an expert one on

1249
01:06:40,080 --> 01:06:42,880
Speaker 3: one to make decisions that are right for you and

1250
01:06:42,920 --> 01:06:45,920
Speaker 3: your body, knowing that those decisions and what's right might

1251
01:06:46,000 --> 01:06:49,200
Speaker 3: change over time. For those that want to follow up

1252
01:06:49,200 --> 01:06:51,000
Speaker 3: with you, that want to listen to more of what

1253
01:06:51,040 --> 01:06:52,520
Speaker 3: you have to say, keep up with you.

1254
01:06:52,720 --> 01:06:55,600
Speaker 2: How do they do that? Doctor Nadolski, Yeah, you.

1255
01:06:55,600 --> 01:06:58,800
Speaker 1: Can do it on so Instagram. I'm at doctor Nandolski,

1256
01:06:58,880 --> 01:07:03,080
Speaker 1: Dr nad oil Usky. I'm on TikTok at doctor Spencer,

1257
01:07:03,920 --> 01:07:07,760
Speaker 1: d R sp and c R at Doctor and Adult

1258
01:07:07,800 --> 01:07:11,360
Speaker 1: Scan Twitter and then doctor Spencer ADL Scan Facebook. You

1259
01:07:11,400 --> 01:07:13,840
Speaker 1: can listen to our docs who Lift podcast. It's me

1260
01:07:13,880 --> 01:07:16,120
Speaker 1: and my brother. We we get a little goofy on there,

1261
01:07:16,160 --> 01:07:18,520
Speaker 1: kind of giving each other, uh crap, but we go

1262
01:07:18,600 --> 01:07:21,080
Speaker 1: over all the new studies and all the new stuff

1263
01:07:21,080 --> 01:07:23,240
Speaker 1: to think about when it comes to these drugs or

1264
01:07:23,280 --> 01:07:26,240
Speaker 1: anything else related to obesity and health. And of course,

1265
01:07:26,400 --> 01:07:29,080
Speaker 1: like if you are interested in our whether you're on

1266
01:07:29,120 --> 01:07:31,120
Speaker 1: a GLP one and you you know from your own

1267
01:07:31,200 --> 01:07:33,920
Speaker 1: doctor you want to join our GLP one companion program

1268
01:07:33,960 --> 01:07:37,000
Speaker 1: through weight Watchers, we'd love to have you there. And

1269
01:07:37,080 --> 01:07:38,920
Speaker 1: if you are thinking about these new medicines and you

1270
01:07:38,920 --> 01:07:40,640
Speaker 1: don't want to go through your own doctor, we'd love

1271
01:07:40,680 --> 01:07:42,960
Speaker 1: to have you in our WW or weight Watchers clinic,

1272
01:07:43,760 --> 01:07:46,000
Speaker 1: so you can go to weight watchers dot com to

1273
01:07:46,360 --> 01:07:47,360
Speaker 1: get all that information.

1274
01:07:47,560 --> 01:07:49,920
Speaker 3: Beautiful, Thanks so much for your time today. I'm over

1275
01:07:50,000 --> 01:07:54,120
Speaker 3: at Emily a Body and at Hurdle Podcast another hurdle conquered.

1276
01:07:54,440 --> 01:07:55,439
Speaker 2: Catch you guys next time