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Speaker 1: Doctor Archinasadu is our guest. She's an indochronologist board certified

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Speaker 1: that means hormones, and she specializes in diabetes. She is

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Speaker 1: the director of the system Diabetes Program at Houston Methodist.

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Speaker 1: And we're talking about ozimpic, something that keeps coming up

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Speaker 1: in conversation after conversation as I talk to people who

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Speaker 1: you compliment you look great, you've lost weight, and they

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Speaker 1: say ozimpic or some variation of that drug class. Doctor Sadu,

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Speaker 1: I want to go back to you gave three items.

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Speaker 1: Number three was appetite suppression. Number two was raising the

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Speaker 1: ability of the pancreas to secrete insulin. The first was,

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Speaker 1: as I understood it, delaying the food vacating in your stomach.

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Speaker 1: Does that mean it's holding the food longer in your

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Speaker 1: stomach so that you feel full and you don't have

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Speaker 1: a need to refill that. I want to make sure

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Speaker 1: I understand that exactly.

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Speaker 2: Yeah, So it is delaying the emptying process of the stomach,

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Speaker 2: and so the gastric content whatever you've eaten or sitting

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Speaker 2: in the stomach a little bit longer. The stomach wall

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Speaker 2: is stretched out a little bit more, and so that

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Speaker 2: in and of self signals your brain to stop eating

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Speaker 2: as much because obviously you don't want to. Normally you

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Speaker 2: don't want to overeat the stomach volume. So it's called

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Speaker 2: delayed gas string emptying. It's the well known effect of

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Speaker 2: the drug that we actually desire because one it makes

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Speaker 2: you eat less. Two it allows your body to handle

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Speaker 2: the nutrients more slowly and efficiently.

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Speaker 1: And our body can't do that on its own.

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Speaker 2: Well, we normally do. And as I mentioned, this hormone

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Speaker 2: is in all of us, but there may be different

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Speaker 2: levels for different people, and that could be genetic, that

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Speaker 2: could be environmental, that could be we don't know all

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Speaker 2: the different reasons why some people who may overeat may

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Speaker 2: not have enough of GLP one that is active, and

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Speaker 2: so these drugs are used to enhance those effects multifold

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Speaker 2: than what we normally have in our own natural eating process.

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Speaker 1: Let's go to item number two. It raises the pancreas's

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Speaker 1: ability to secrete insulin. My father is a very brittle diabetic.

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Speaker 1: He was released honorably, discharged honorably from the Coastguard sixty

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Speaker 1: three years ago because diabetes. They thought they didn't think

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Speaker 1: he would live, and he didn't have I've talked to

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Speaker 1: There was the head of the diabetes program at Johns

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Speaker 1: Hopkins was flying back from Africa on a flight next

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Speaker 1: to me years ago, and he said, your dad knows

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Speaker 1: as much about diabetes as any doctor, because he's kept

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Speaker 1: all his fingers toes and vision for all these years

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Speaker 1: with diabetes. Because our knowledge is relatively recent. When we

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Speaker 1: talk about the pancreas secreting insulin, talk a little bit

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Speaker 1: about what that does and why some people, particularly diabetics,

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Speaker 1: pancreas doesn't seem to function.

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Speaker 2: So I want to first make a distinction in the

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Speaker 2: type of diabetes, which I'm not sure which one your

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Speaker 2: father had, but there is type one and type two,

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Speaker 2: just to be very simplistic. So in type one diabetes

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Speaker 2: that pancreas, the problem is those cells don't make any insulin,

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Speaker 2: so these drugs are not used for that type of diabetes.

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Speaker 2: They're solely for type two diabetes. So the underlying problem

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Speaker 2: with type two diabetes is not that the pancreas doesn't

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Speaker 2: make insulin. It does, but it has to make multifold

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Speaker 2: of a normal person without diabetes to overcome insulin resistance

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Speaker 2: throughout the body. So insulin resistance means that even though

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Speaker 2: your celves are seeing insulin, it's not working as efficiently

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Speaker 2: to get the job done. And that insulin resistance can

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Speaker 2: come from sedentary lifestyles, poor diets, being over weight, OBEs,

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Speaker 2: and genetic factors. So what this drug is. It helped

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Speaker 2: at the level of the cells that make insulin in

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Speaker 2: the pancreas. It helps them be more efficient. And it's

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Speaker 2: not only insulin. It actually affects another hormone in the

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Speaker 2: pancreas called glucagon that normally raises our blood sugars. It

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Speaker 2: suppresses that hormone and enhances the effectiveness and secretion of insulin.

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Speaker 2: So by doing those two modulations in the pancreas, the

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Speaker 2: patient will experience more even blood sugar control. And this

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Speaker 2: is what you know. Time and time again, patients come

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Speaker 2: back telling us I feel like my blood sugars are

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Speaker 2: more even more controlled, And then when we actually have

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Speaker 2: measurements to back that up, we can see that it

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Speaker 2: really stabilizes the blood sugars, particularly after eating meals when

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Speaker 2: it's most active.

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Speaker 1: Yeah, the variations, the spikes and drops or gets my

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Speaker 1: dad in trouble. He was a five in one shot

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Speaker 1: today again, now he's on a pump, but the pumps

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Speaker 1: don't always function well and it's a constant stressor. But

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Speaker 1: how well does ozempic treat the type two diabetic which

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Speaker 1: he is, I should tell you how well does ozempic

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Speaker 1: treat that?

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Speaker 2: So not just ozempic, but all of these in these

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Speaker 2: classes have just been remarkable. They've been such a valuable

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Speaker 2: tool for those of us who have been managing diabetes

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Speaker 2: type two diabetes for decades. We've really not had anything

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Speaker 2: as effective as this class of drugs. We are seeing

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Speaker 2: patients almost normalize their blood sugars on these drugs, especially

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Speaker 2: if you add on the weight loss and healthy lifestyle interventions,

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Speaker 2: get them a non regular exercise programs. I've been able

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Speaker 2: to take patients off insulin that they've been on for many,

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Speaker 2: many years, as well as other diabetes drugs, and it's

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Speaker 2: just been a great tool for us, really rewarding not

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Speaker 2: only in the scientific data but in real life life

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Speaker 2: with patients. And that's the reason for its popularity because

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Speaker 2: it's very effective for our patients with diabetes. Now we

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Speaker 2: can talk about the weight loss indication separately, but it's

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Speaker 2: just been a very effective class of drugs for us.

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Speaker 1: And how difficult is it for your patients to find

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Speaker 1: ozimpic today? Because I have my dad's not on ozmpic,

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Speaker 1: but my niece's husband is, and this is an issue

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Speaker 1: that I care about. And he talks about the difficulty

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Speaker 1: in getting ozempic or something in that class of drugs.

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Speaker 1: How difficult has that become.

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Speaker 2: So this is a first in my career where a

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Speaker 2: diabetes drug has been in shortage like this. And really

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Speaker 2: what happened is when semaglue tide was approved for diabetes

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Speaker 2: and we were using it, you know, using it as

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Speaker 2: much as we could to help our patients, and then

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Speaker 2: it got the approval for weight loss and is the

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Speaker 2: same drug. What happened was the demand for weight loss

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Speaker 2: went up tremendously, and as I understand, there was also

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Speaker 2: some supply production problems with the company and the manufacturing plants,

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Speaker 2: so that there was not as much drug available to

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Speaker 2: meet the demand. So even if you're using it for

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Speaker 2: weight loss, and when that drug with govy was not available,

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Speaker 2: people just switched over to the diabetes version ozempic. And

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Speaker 2: again it's the same drug, so you get the same effect.

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Speaker 2: And that really domino effect in terms of supply chain

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Speaker 2: and for the last year, we have seen unprecedented demands

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Speaker 2: for this drug, lack of supply and disruptions in our

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Speaker 2: care for patients with diabetes who relied on it. Really

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Speaker 2: for the Blachergar control, so tons of phone calls as

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Speaker 2: soon as this tragedy started from patients, my sugars are

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Speaker 2: out of control, I need something else. We had to

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Speaker 2: get patients immediately on insulin who weren't on insulin, or

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Speaker 2: if they were on insulin as well, just bring up

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Speaker 2: the doses much higher than they were. And of course

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Speaker 2: insulin has a lot more side effects that we don't want,

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Speaker 2: particularly low blood sugars. So this has really been a

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Speaker 2: scramble situation for those of us who manage diabetes when

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Speaker 2: all of a sudden this drug is withdrawn and we

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Speaker 2: have to substitute and come up with other treatment plans

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Speaker 2: immediately and even resulted in hospitalizations.

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Speaker 1: Doctor Archinal Sadhu is our guest. She is a diabetes

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Speaker 1: expert and she runs a system diabetes program at Houston Methodist.

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Speaker 1: More with her coming out the Michael Berry.

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Speaker 3: Joe Hi, as you doing, Hanna, This is his Miss

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Speaker 3: Sherley Q liquor. You know Michael Berry has had a

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Speaker 3: love affair with Losianna forever and ever. He was born

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Speaker 3: right down on the Sabine River. That boy been eating

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Speaker 3: scrimps and a two and boot and baut his whole life, honey,

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Speaker 3: And now he gonna be right there with you. On

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Speaker 3: News talk Radio ninety eight per five The Talk of Acadiana,

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Speaker 3: The barometric pressure of one hundred percent ignass fixing to

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Speaker 3: hit Lefayette hard, Honey listener Michael Barrys show every weekday

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Speaker 3: from four to seven pm. Right here on the Talk

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Speaker 3: of Acadiana Honey ninety eight per five.

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Speaker 1: Doctor Archino Sadu is our guest. She is a board

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Speaker 1: certified indo chronologist that means hormones, and she is a

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Speaker 1: diabetes expert. She is the director of the System Diabetes

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Speaker 1: Program at Houston Methodist. And we're talking specifically about ozembic

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Speaker 1: and drugs in that category, both in treating diabetes and

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Speaker 1: in the wider issue as a weight loss drug. You know,

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Speaker 1: when you doctor Southu, over the years, a number of

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Speaker 1: my friend's wives when they lose weight, and I'll comment, oh,

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Speaker 1: you know, Susie looks great, she's lost how much she lost?

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Speaker 1: You know, twenty pounds? That's a lot for a woman,

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Speaker 1: right if she was one forty and she's won twenty,

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Speaker 1: you really see a difference. And there was a class

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Speaker 1: of drugs I remember, I can't remember their names, but

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Speaker 1: Vivance was one of them. There were several, but it

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Speaker 1: sounded like they were really just amped up speed and

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Speaker 1: that made that made women sort of jittery. It made

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Speaker 1: them it couldn't sleep. It was in a class of drugs.

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Speaker 1: Is this a Can you compare those two because that

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Speaker 1: seems to have kind of gone away in favor of

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Speaker 1: this and people seem to really prefer ozempic in this

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Speaker 1: class of drugs.

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Speaker 2: Yeah. So, you know, it's interesting the timeline of obesity

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Speaker 2: drugs and how many were introduced and approved by FDA

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Speaker 2: and withdrawn over the years. And you're talking about more

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Speaker 2: of the amphetamine based drugs. Fen Fen is another one.

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Speaker 2: So they were all popular for some time but subsequently

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Speaker 2: found to have pretty unacceptable side effects for patients, and

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Speaker 2: exactly cardiovascular side effects heart racing, high blood pressure were

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Speaker 2: just not worth the effectiveness of the drug, which really

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Speaker 2: is nowhere near these drugs we're talking about now. So

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Speaker 2: at that time and any FDA approval criteria for a

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Speaker 2: weight loss drug was you should lose at least five

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Speaker 2: percent of your body weight and of course have acceptable

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Speaker 2: side effects. But these drugs, the Regovi and the Manjaro,

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Speaker 2: they're up to twenty percent of your baseline body weight.

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Speaker 2: Between twelve to twenty percent is where the studies are showing,

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Speaker 2: So it's three fourfold the basic criteria of the old drugs.

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Speaker 2: So for that reason, there's no really driving force to

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Speaker 2: use any of the previous obesity drugs, not to mention

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Speaker 2: the fact that they have had really detrimental side effects,

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Speaker 2: including suicides and suicidal ideations. And these drugs do have

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Speaker 2: side effects, don't get me wrong. They are there, and

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Speaker 2: everyone who's taking them should be aware of them and

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Speaker 2: make sure that their risk to benefit ratio is in

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Speaker 2: their favor to use the drugs.

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Speaker 1: Let's talk about those, because that was my next round

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Speaker 1: of questions. What are some of the risk factors to

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Speaker 1: this drug, to ozembic and drugs in that category.

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Speaker 2: So the side effects commonly are gastrointestinal because that's where

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Speaker 2: the drug is working. So as you can imagine, if

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Speaker 2: you're emptying your stomach lower at a lower rate, you're

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Speaker 2: going to have a little bit more nausea, maybe even

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Speaker 2: vomiting sometimes causes diarrhea, other times constipation a reflux of

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Speaker 2: food is a really common issue. And then abdominal cramping

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Speaker 2: and abdominal pain. So those are common and have been

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Speaker 2: found in the studies and are found in real life.

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Speaker 2: And to mitigate those, we really recommend a very slow

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Speaker 2: titration on the doses and that that schedule has been

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Speaker 2: you know, on the drug label. But the more serious

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Speaker 2: side effects really are a pancreatitis and that can even

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Speaker 2: be deadly, an acritizing pancreatitis where the pancreast becomes so enflamed,

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Speaker 2: and other things include gallstones or acute gall bladder attacks.

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Speaker 2: We've seen many cases of that and that's been shown.

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Speaker 2: It also does elevate the heart rate a little bit,

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Speaker 2: usually not to a degree where it's causing any problems,

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Speaker 2: but you can have a higher heart rate. And then

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Speaker 2: the very serious side effect is in a thy special

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Speaker 2: thyroid cancer or rare thyrowid cancer called medullary tyrowid cancer,

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Speaker 2: and that is an absolute contra indication if you have

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Speaker 2: a family history or personal history of that kind of

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Speaker 2: thyroid cancer.

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Speaker 1: Our guest is the director of the system Diabetes program

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Speaker 1: at Houston Methodist doctor Archi and us said, when we

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Speaker 1: hear doctor said, when we hear these risk factors, you know,

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Speaker 1: at the end of it's been within the last you know,

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Speaker 1: not that many years that pharmaceutical companies were able to

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Speaker 1: advertise on television and now they're one of the biggest

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Speaker 1: class of advertisers. And after you hear all the wonderful

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Speaker 1: things that can do and all the pretty people, whether

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Speaker 1: they're about to have sex in a tub, out on

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Speaker 1: the beach, or they're old and now all of a

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Speaker 1: sudden they can see their grand children playing ball, or

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Speaker 1: they've fallen in love, or all these wonderful things these

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Speaker 1: drugs can do for you. And at the end it says,

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Speaker 1: you know, your eyeballs could fall out, your throat could

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Speaker 1: cave in. When you talk about risk factors, I think

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Speaker 1: we sort of block those out, which was not the point.

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Speaker 1: How often are we seeing significant side effects? You know,

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Speaker 1: even to the point of some of the more serious

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Speaker 1: stuff there and I mean beyond nausea. I got that,

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Speaker 1: But how like is it one in a thousand, is

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Speaker 1: it one in a million?

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Speaker 2: It's somewhere in between. It's really not as common as

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Speaker 2: it's not so common that it would prohibit people from

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Speaker 2: using the drug, and I think that's where the demand comes.

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Speaker 2: I don't recall the exact statistics, but for instance, the

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Speaker 2: medullary thyroid cancer that has not been found in humans necessarily,

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Speaker 2: but in the rap studies it was much higher than placebo,

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Speaker 2: so it's on the label as a potential risk. But

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Speaker 2: a recent study in humans done in Europe, actually in France,

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Speaker 2: looking at their database of patients who've used these drugs,

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Speaker 2: they are seeing up to a threefold more incidents than

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Speaker 2: diagnosis of syroid cancers for patients on the drug compared

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Speaker 2: to those not on the drug. Now, this is a

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Speaker 2: retrospective study, so it's not entirely controlled for everything, so

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Speaker 2: we don't put as much stock in in the results

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Speaker 2: of a retrospective study as a randomized control study, but

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Speaker 2: it is showing some kind of signal there that maybe

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Speaker 2: we should be looking at this more. Other things that

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Speaker 2: have come up. In fact, recently there's been in Europe

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Speaker 2: again some reports have increased suicide for patients taking this drug.

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Speaker 2: So the EUAY, their version of our FBA, is actually

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Speaker 2: looking into these kind of reports to see if there's

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Speaker 2: any merit to this and if we should be looking

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Speaker 2: at it even more closely, especially because now it's being

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Speaker 2: used so widely. So all of the randomized control trials

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Speaker 2: are not popular this big populations, and they're not forever.

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Speaker 2: They're limited usually around two years or last. So we're

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Speaker 2: starting to see things in the real world that maybe

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Speaker 2: we need to pay more attention to and study more.

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Speaker 1: Doctor Archinal Sado hold right there. We'll talk more with her.

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Speaker 1: We'll get to the big issue which everyone wants to

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Speaker 1: know about, is the appetite suppression. Imagine if you didn't

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Speaker 1: have all these cravings, how skinny you would be coming out.

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Speaker 3: We're gonna add a little bit about these warhouses I

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Speaker 3: know all about.

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Speaker 1: Ramon wants to know what around the world is.

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Speaker 4: Whistling bungholes, spleen splitters, whisker biscuits, honkey riders, whoskerdoos, whosker don'ts,

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Speaker 4: nips and dazers, whether without the scooter stick or one

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Speaker 4: single whistling kiddy Jason.

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Speaker 1: Doctor Archino Sadhu is our guest. She is a board

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Speaker 1: certified indo chronologist that means hormones, and she is a

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Speaker 1: diabetes expert. She is the director of the system diabetes

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Speaker 1: program at Houston Methodists, and we're talking specifically about ozempic

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Speaker 1: and drugs in that category, both in treating diabetes and

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Speaker 1: in the wider issue as a weight loss drug. You know,

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Speaker 1: when you doctor SAIDU. Over the years, a number of

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Speaker 1: my friend's wives when they lose weight, and I'll comment, oh,

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Speaker 1: you know, Susie looks great, she's lost how much she lost?

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Speaker 1: You know, twenty pounds. That's a lot for a woman,

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Speaker 1: right if she was one forty and she's won twenty.

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Speaker 1: You really see a difference. And there was a class

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Speaker 1: of drugs I remember, I can't remember their names, but

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Speaker 1: Vivance was one of them. There were several, but it

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Speaker 1: sounded like they were really just amped up speed and

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Speaker 1: that made women sort of jittery. It made them it

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Speaker 1: couldn't sleep. It was in a class of drugs. Is

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Speaker 1: this a Can you compare those two because that seems

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Speaker 1: to have kind of gone away in favor of this

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Speaker 1: and people seem to really prefer ozempic in this class

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Speaker 1: of drugs.

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Speaker 2: Yeah. So you know, it's interesting the timeline of obesity

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Speaker 2: drugs and how many were introduced and approved by FDA

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Speaker 2: and then withdrawn over the years, and you're talking about

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Speaker 2: more of the amphetamine based drugs. Fen Fen is another one.

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Speaker 2: So they were all popular for some time, but subsequently

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Speaker 2: found to have pretty unacceptable side effects for patients, and

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Speaker 2: exactly cardiovascular side effects heart racing, high blood pressure were

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Speaker 2: just not worth the effectiveness of the drug, which really

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Speaker 2: is nowhere near these drugs we're talking about now. So

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Speaker 2: at that time and any FDA approval criteria for a

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Speaker 2: weight loss drug was you should lose at least five

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Speaker 2: percent of your body weight and of course have acceptable

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Speaker 2: side effects. But these drugs, the Wagov and the Manjaro,

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Speaker 2: they're up to twenty percent of your baseline body weight.

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Speaker 2: Between twelve to twenty percent is where the studies are showing,

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Speaker 2: so it's three fourfold the basic criteria of the old drugs.

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Speaker 2: So for that reason, there's no really driving force to

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Speaker 2: use any of the previous obesity drugs, not to mention

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Speaker 2: the fact that they have had really detrimental side effects,

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Speaker 2: including suicides and suicidal ideations. And these drugs do have

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Speaker 2: side effects, don't get me wrong. They are there, and

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Speaker 2: everyone who's taking them should be aware of them and

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Speaker 2: make sure that their risk to benefit ratio is in

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Speaker 2: their favor to use the drugs.

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Speaker 1: Let's talk about those, because that was my next round

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Speaker 1: of questions. What are some of the risk factors to

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Speaker 1: this drug, to ozembic and drugs in that category.

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Speaker 2: So the side effects commonly are gastrointestinal because that's where

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Speaker 2: the drug is working. So as you can imagine, if

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Speaker 2: you're empten your stomach lower at a lower rate, you're

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Speaker 2: going to have a little bit more nausea, maybe even vomiting.

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Speaker 2: Sometimes it causes diarrhea, other times constipation a reflux of

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Speaker 2: food is a really common issue. And then abdominal cramping

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Speaker 2: and abdominal pain. So those are common and have been

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Speaker 2: found in the studies and are found in real life.

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Speaker 2: And to mitigate those, we really recommend a very slow

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Speaker 2: titration on the doses and that that schedule has been

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Speaker 2: you know, on the drug label. But the more serious

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Speaker 2: side effects really are a pancreatitis and that can even

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Speaker 2: be deadly, an adcvertizing pancreatitis where the pancreast becomes so enflamed.

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Speaker 2: And other things include gallstones or acute gall bladder attacks.

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Speaker 2: We've seen many cases of that and that's been shown.

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Speaker 2: It also does elevate the heart rate a little bit,

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Speaker 2: usually not to a degree where it's causing any problems,

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Speaker 2: but you can have a higher heart rate. And then

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Speaker 2: the very serious side effect is in a special thyroid cancer,

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Speaker 2: a rare thyrowoid cancer called medullary tyrowid cancer, and that

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Speaker 2: is an absolute contra indication if you have a family

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Speaker 2: history or personal history of that kind of tyroid cancer.

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Speaker 1: Our guest is the director of the System Diabetes program

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Speaker 1: at Houston Methodist doctor Archi and Us said, when we hear,

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Speaker 1: doctor said, when we hear these risk factors, you know,

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Speaker 1: at the end of it's been within the last you know,

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Speaker 1: not that many years that pharmaceutical companies were able to

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Speaker 1: advertise on television, and now they're one of the biggest

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Speaker 1: class of advertisers. And after you hear all the wonderful

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Speaker 1: things it can do and all the pretty people, whether

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Speaker 1: they're about to have sex in a tub out on

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Speaker 1: the beach, or they're old and now all of a

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Speaker 1: sudden they can see their grand children playing ball, or

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Speaker 1: they've fallen in love, or all these wonderful things that

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Speaker 1: these drugs can do for you. And at the end,

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Speaker 1: it says, you know, your eyeballs could fall out your

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Speaker 1: throat could cave in. When you talk about risk factors,

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Speaker 1: I think we sort of block those out, which was

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Speaker 1: not the point. How often are we seeing significant side effects,

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Speaker 1: you know, even to the point of some of the

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Speaker 1: more serious stuff there, and I mean beyond nausea. I

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Speaker 1: got that, But how like is it one in a thousand,

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Speaker 1: is it one in a million?

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Speaker 2: It's somewhere in between. It's really not as common as

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Speaker 2: it's not so common that it would prohibit people from

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Speaker 2: using the drug. And I think that's where the demand comes.

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Speaker 2: I don't recall the exact statistics, but for instance, the

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Speaker 2: medullary thyroid cancer that has not been found in humans necessarily,

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Speaker 2: but in the rat studies it was much higher than placebo,

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Speaker 2: so it's on the label as a potential risk. But

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Speaker 2: a recent study in humans done in Europe, actually in France,

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Speaker 2: looking at their database of patients who's used these drugs,

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Speaker 2: they are seeing up to a threefold more incidents than

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Speaker 2: diagnosis of thyroid cancers for patients on the drug compared

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Speaker 2: to those not on the drug. Now, this is a

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Speaker 2: retrospective study, so it's not entirely controlled for everything, so

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Speaker 2: we don't put as much stock in the results of

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Speaker 2: a retrospective study as a randomized control study, but it

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Speaker 2: is showing some kind of signal there that maybe we

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Speaker 2: should be looking at this more. Other things that have

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Speaker 2: come up. In fact, recently there's been in Europe again

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Speaker 2: some reports have increased suicide for patients taking these drug

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Speaker 2: So the EUA, their version of our FBA, is actually

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Speaker 2: looking into these kind of reports to see if there's

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Speaker 2: any merit to this and if we should be looking

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Speaker 2: at it even more closely, especially because now it's being

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Speaker 2: used so widely. So all of the randomized control trials

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Speaker 2: are not popular this big populations, and they're not forever.

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Speaker 2: They're limited usually around two years or less. So we're

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Speaker 2: starting to see things in the real world that maybe

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Speaker 2: we need to pay more attention to you and study more.

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Speaker 1: Doctor archinal sod hold right there, we'll talk more with her.

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Speaker 1: We'll get to the big issue which everyone wants to

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Speaker 1: know about, is the appetite suppression. Imagine if you didn't

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Speaker 1: have all these cravings, how skinny you would be. It's

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Speaker 1: easy and out the world as we know it. The

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Speaker 1: Michael Berry Show, Ends of the World coming up.

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Speaker 3: Nine meal five.

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Speaker 1: Doctor Archina Saudu is our guest. She's an endochronologist, board certified.

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Speaker 1: It's amazing to me how I lost seventy pounds about

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Speaker 1: two years ago. And yeah, it's amazing to me how

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Speaker 1: as I lost weight, I wanted to work out more.

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Speaker 1: And the more I worked out, I didn't want to

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Speaker 1: eat bad foods. I want to eat all day. The

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Speaker 1: intermittent fasting made it almost, I don't want to say easy.

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Speaker 1: But once I changed that behavior, the thinner I got,

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Speaker 1: the more I wanted to work out, the less I

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Speaker 1: wanted to drink, the less I wanted to stay up

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Speaker 1: all night. It sort of went hand in hand. So

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Speaker 1: it's sort of getting jump started that becomes that difficult thing.

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Speaker 1: And to me, that's the hope that one of these drugs,

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Speaker 1: or veriatric surgery or all those sorts of things can

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Speaker 1: play into. But doctor Souther, let me conclude with this.

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Speaker 1: We talk a lot about avoidance of things that we

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Speaker 1: either enjoy or they're convenient. Fast food, food out of

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Speaker 1: a box, processed food, you know, these processed starches and carbs.

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Speaker 1: What are some of the things that we should encourage.

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Speaker 1: My wife grew up on a very different diet than

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Speaker 1: I did, and growing up in India. She grew up

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Speaker 1: on a very healthy diet, not that every Indian does,

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Speaker 1: but she doesn't eat sweets naturally. She eats vegetables instead

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Speaker 1: of French fries. And when you talk about the things

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Speaker 1: that if you're giving people, hey focus on these things

432
00:26:55,920 --> 00:26:58,080
Speaker 1: and learn to crave these because you will in time.

433
00:26:58,320 --> 00:27:00,520
Speaker 1: What are some of those really good things we can do?

434
00:27:01,960 --> 00:27:05,560
Speaker 2: So I always tell my patients make sure what you're

435
00:27:05,600 --> 00:27:10,000
Speaker 2: eating is coming from the earth and as less touched

436
00:27:10,040 --> 00:27:14,320
Speaker 2: by man as possible. So fresh fruits and vegetables that

437
00:27:14,400 --> 00:27:17,639
Speaker 2: are not covered in a sauce or you know, some

438
00:27:17,760 --> 00:27:21,640
Speaker 2: type of heavy salad dressing, which will then just negate

439
00:27:21,720 --> 00:27:25,160
Speaker 2: the effects of the fresh vegetables you're trying to consume.

440
00:27:25,520 --> 00:27:31,560
Speaker 2: So grilling is really a very light and minimally disruptive

441
00:27:31,600 --> 00:27:36,240
Speaker 2: way to have your food. And most importantly, though, is

442
00:27:36,520 --> 00:27:39,280
Speaker 2: know what's in what you're eating. And the only way

443
00:27:39,280 --> 00:27:41,760
Speaker 2: you will know is if you've prepared it. And this

444
00:27:41,880 --> 00:27:45,000
Speaker 2: is where the convenience and time factor comes in. We

445
00:27:45,080 --> 00:27:47,760
Speaker 2: often go out to eat, We often get fast food

446
00:27:47,960 --> 00:27:53,960
Speaker 2: because we prioritize other things in our schedule and sacrifice

447
00:27:54,000 --> 00:27:56,199
Speaker 2: the nutrition of our food. But you don't know what

448
00:27:56,320 --> 00:27:59,440
Speaker 2: it is when you're picking this up prepared by somebody else,

449
00:27:59,480 --> 00:28:03,240
Speaker 2: and it could being labeled as a healthy item, or

450
00:28:03,280 --> 00:28:05,920
Speaker 2: you perceive it as a healthy item, but there's hidden

451
00:28:06,080 --> 00:28:09,760
Speaker 2: ingredients that really are not that healthy and raise the

452
00:28:09,800 --> 00:28:14,919
Speaker 2: caloric content of that food. So keep it home cooked

453
00:28:14,920 --> 00:28:18,159
Speaker 2: as much as possible, and do as little to it

454
00:28:18,200 --> 00:28:21,360
Speaker 2: as possible, and just enjoy the flavor of the actual

455
00:28:21,600 --> 00:28:26,840
Speaker 2: ingredient that's coming from a fresh source, rather than trying

456
00:28:26,880 --> 00:28:31,240
Speaker 2: to cover it with sauces and other condiments that'll just

457
00:28:31,320 --> 00:28:35,920
Speaker 2: make it very unhealthy. And that's really how our body

458
00:28:36,119 --> 00:28:39,440
Speaker 2: was designed to process food. So we just have to

459
00:28:39,520 --> 00:28:42,160
Speaker 2: match our habits to how our body was designed. We

460
00:28:42,160 --> 00:28:45,400
Speaker 2: were not designed for donuts and big Max. That's not

461
00:28:45,440 --> 00:28:48,840
Speaker 2: how our digestive truck works. That's not how our metabolism

462
00:28:48,960 --> 00:28:52,200
Speaker 2: was created to work. And that's where the problem is. Now.

463
00:28:52,240 --> 00:28:56,120
Speaker 2: We're having all these processed, high calorie foods that our

464
00:28:56,160 --> 00:28:59,960
Speaker 2: bodies cannot handle, and we're going awry. That's why obesity

465
00:29:00,080 --> 00:29:02,400
Speaker 2: is on the rise. I have been on the rise.

466
00:29:02,680 --> 00:29:05,440
Speaker 1: I will speak from my own experience, not anyone else's,

467
00:29:05,960 --> 00:29:09,720
Speaker 1: But I will tell you that I was raised able

468
00:29:09,760 --> 00:29:13,000
Speaker 1: to list every president from the first to the present

469
00:29:13,600 --> 00:29:19,320
Speaker 1: without understanding you know that good nutrition, which foods are

470
00:29:19,320 --> 00:29:21,640
Speaker 1: good for me, which are bad? What the effects of

471
00:29:21,960 --> 00:29:24,800
Speaker 1: those foods have. Basic finance is important. I mean when

472
00:29:24,840 --> 00:29:27,680
Speaker 1: you talk about your basic life skills, this is the

473
00:29:27,720 --> 00:29:31,720
Speaker 1: sort of thing eating is an afterthought. And I also

474
00:29:31,840 --> 00:29:34,720
Speaker 1: think that a big result and the reason you have

475
00:29:34,800 --> 00:29:37,600
Speaker 1: so many diabetics in these programs coming to you for

476
00:29:37,680 --> 00:29:41,960
Speaker 1: help is that we don't plan ahead. We have become

477
00:29:42,080 --> 00:29:45,600
Speaker 1: so much busier, We do so many more things for

478
00:29:45,720 --> 00:29:48,200
Speaker 1: longer that take more of our time. We're stuck in

479
00:29:48,240 --> 00:29:51,320
Speaker 1: the car longer, the kids do more activities. That food

480
00:29:51,480 --> 00:29:55,240
Speaker 1: becomes or eating food becomes this sort of afterthought, and

481
00:29:55,320 --> 00:29:59,720
Speaker 1: there is this convenience of the fast food that's relatively affordable,

482
00:30:00,960 --> 00:30:03,800
Speaker 1: that is fast, that is delicious. I love fast food.

483
00:30:04,200 --> 00:30:06,160
Speaker 1: And the other thing I would say, and I'd ask

484
00:30:06,200 --> 00:30:07,720
Speaker 1: you to speak to that. But the other thing I

485
00:30:07,760 --> 00:30:10,960
Speaker 1: would say is I will often post of me eating

486
00:30:11,040 --> 00:30:13,920
Speaker 1: a bowl of ice cream or eating a bad you know,

487
00:30:14,080 --> 00:30:16,560
Speaker 1: a food that's atypical that I might eat once every

488
00:30:16,560 --> 00:30:19,120
Speaker 1: two weeks, and people will say, I thought you were

489
00:30:19,120 --> 00:30:21,239
Speaker 1: eating right now. I thought you And I think there

490
00:30:21,320 --> 00:30:23,480
Speaker 1: is a lack of understanding and my wife really taught

491
00:30:23,480 --> 00:30:26,000
Speaker 1: me this. You can't deny yourself one hundred percent of

492
00:30:26,040 --> 00:30:28,600
Speaker 1: the time. Look forward to a bowl of ice cream

493
00:30:28,760 --> 00:30:32,360
Speaker 1: and eat it once a month, as opposed to, well,

494
00:30:32,400 --> 00:30:34,360
Speaker 1: if I'm eating bad, I'm eating bad all the time,

495
00:30:34,680 --> 00:30:37,120
Speaker 1: and if I'm eating well, I'm eating well all the time.

496
00:30:37,160 --> 00:30:40,200
Speaker 1: And I think you never have any real rewards. Does

497
00:30:40,200 --> 00:30:40,800
Speaker 1: that make sense?

498
00:30:41,600 --> 00:30:45,200
Speaker 2: Absolutely, you've hit the nail on the head. We're not

499
00:30:45,320 --> 00:30:48,320
Speaker 2: saying that everything that goes into your mouth must be

500
00:30:48,400 --> 00:30:53,880
Speaker 2: of maximal nutritional value and no pleasure, but we've tipped

501
00:30:53,880 --> 00:30:58,600
Speaker 2: the balance. Now it's been all about taste and convenience

502
00:30:58,840 --> 00:31:03,640
Speaker 2: at the expense of obesity, diabetes, heart disease, kidney disease,

503
00:31:03,720 --> 00:31:07,080
Speaker 2: liver disease. So we've really got to move that balance back.

504
00:31:07,400 --> 00:31:11,640
Speaker 2: And what you said about not teaching our children how

505
00:31:11,680 --> 00:31:15,200
Speaker 2: to eat, that is such a failure of our society

506
00:31:15,560 --> 00:31:18,680
Speaker 2: and even our medical community. You know, we are now

507
00:31:18,720 --> 00:31:21,520
Speaker 2: just putting band aids on the problem that's been going

508
00:31:21,560 --> 00:31:25,000
Speaker 2: on for thirty years or more. When you look at

509
00:31:25,000 --> 00:31:28,840
Speaker 2: the data on the increase in obesity just in the

510
00:31:28,920 --> 00:31:35,440
Speaker 2: last twelve years, it's so remarkable, and it really coincides

511
00:31:35,520 --> 00:31:40,400
Speaker 2: with industrialization, I think it started back then when food

512
00:31:40,440 --> 00:31:45,080
Speaker 2: became so much more easy to manufacture and consume. But definitely,

513
00:31:45,360 --> 00:31:49,440
Speaker 2: how we are living our daily lives, we're not prioritizing

514
00:31:49,520 --> 00:31:52,320
Speaker 2: that planning or what am I going to eat today?

515
00:31:52,720 --> 00:31:55,200
Speaker 2: Can I make sure it's healthy? When am I going

516
00:31:55,240 --> 00:32:00,960
Speaker 2: to have some fiscal activity today? And that's really resulted

517
00:32:01,040 --> 00:32:04,360
Speaker 2: in very grave consequences for our society and our future

518
00:32:04,400 --> 00:32:08,720
Speaker 2: health and more importantly for future generations. And yeah, you

519
00:32:08,800 --> 00:32:11,880
Speaker 2: can have cheat days for a cheat meal, that's very

520
00:32:12,880 --> 00:32:16,480
Speaker 2: acceptable as long as eighty percent of the time you're

521
00:32:16,520 --> 00:32:19,040
Speaker 2: doing everything else right. Your body can handle that one

522
00:32:19,080 --> 00:32:21,160
Speaker 2: meal or that one treat.

523
00:32:21,800 --> 00:32:24,240
Speaker 1: But if it's and you know what I find, doctor Southey,

524
00:32:24,520 --> 00:32:29,200
Speaker 1: is this idea of celibacy for sinful food, this idea

525
00:32:29,240 --> 00:32:32,680
Speaker 1: that well, I'll never get to eat anything other than

526
00:32:33,000 --> 00:32:35,400
Speaker 1: you know, leafy vegetables for the rest of my life.

527
00:32:35,760 --> 00:32:38,680
Speaker 1: It creates this sort of crash and then it creates

528
00:32:38,680 --> 00:32:40,959
Speaker 1: this binge behavior. And I know I've been guilty of it.

529
00:32:41,240 --> 00:32:42,960
Speaker 1: If I can never have ice cream again in my

530
00:32:43,000 --> 00:32:45,440
Speaker 1: life because I've cleared it out of the house. So

531
00:32:45,520 --> 00:32:47,200
Speaker 1: what I do is I don't keep bad things in

532
00:32:47,240 --> 00:32:50,880
Speaker 1: the house. So ice cream is a on the way somewhere.

533
00:32:50,880 --> 00:32:52,800
Speaker 1: I haven't done anything bad. We've got an extra hour

534
00:32:52,840 --> 00:32:55,640
Speaker 1: to kill. Hey, kids, let's go to Marble Slab. I

535
00:32:55,720 --> 00:32:58,360
Speaker 1: do it there. And you know, I've known of people

536
00:32:58,360 --> 00:33:00,760
Speaker 1: to quit drinking by they don't drink get home, so

537
00:33:00,760 --> 00:33:02,760
Speaker 1: they can only drink out and they limit their you know,

538
00:33:02,920 --> 00:33:05,640
Speaker 1: going out. These are the sorts of things that require

539
00:33:05,640 --> 00:33:08,520
Speaker 1: a strategy though, And that's I talk about this with

540
00:33:08,920 --> 00:33:12,520
Speaker 1: with personal finance, with building your business, with building your friendships,

541
00:33:12,560 --> 00:33:15,080
Speaker 1: with managing your time. You have to have a strategy

542
00:33:15,120 --> 00:33:16,480
Speaker 1: for when I'm going to eat and what I'm going

543
00:33:16,560 --> 00:33:18,880
Speaker 1: to eat. It can't just be I'm really hungry, because

544
00:33:18,920 --> 00:33:21,280
Speaker 1: you make bad decisions when you get to that point.

545
00:33:21,560 --> 00:33:25,880
Speaker 2: Exactly. These little behavioral modifications can go a long way.

546
00:33:26,440 --> 00:33:29,880
Speaker 2: If you have a food is that is very pleasurable

547
00:33:29,920 --> 00:33:32,680
Speaker 2: to you, you put it in a context where it's

548
00:33:32,720 --> 00:33:35,760
Speaker 2: not very frequent, and you allow yourself to have that pleasure.

549
00:33:36,160 --> 00:33:38,800
Speaker 2: But it's not frequent, though, it won't be as harmful.

550
00:33:39,120 --> 00:33:41,360
Speaker 1: I promised you I would get you out on time.

551
00:33:41,440 --> 00:33:45,520
Speaker 1: Doctor Argini Sadu sa Dhu. You can find her online.

552
00:33:45,640 --> 00:33:49,280
Speaker 1: She specializes in diabetes. She's the director of the system

553
00:33:49,360 --> 00:33:53,600
Speaker 1: diabetes program at Houston Methodist. You're wonderful. Thanks for coming

554
00:33:53,640 --> 00:33:55,520
Speaker 1: on and explaining this to us.

555
00:33:55,560 --> 00:33:56,200
Speaker 2: My pleasure,