Navigating the Modern Landscape of Medical Weight Loss

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[SPEAKER_00]: one of the things I put out recently was, can you buy a medical weight loss, drugs online?

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[SPEAKER_00]: Sure, but you can also buy sushi at a gas station.

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[SPEAKER_00]: Hi, I'm Kim Peters, welcome to the Illumine Podcast where we talk about women, women in business, their busy lives, hormones, weight loss, aesthetics, all the things that have to do with being a thriving woman in the United States of America.

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[SPEAKER_00]: So today we are going to be talking about a subject that is something

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[SPEAKER_00]: I love to talk about, all of it I love to talk about, but this one in particular is medical weight loss, huge subject right now, some controversy on whether it's good or bad, but we're going to dive in deep on what it's good for, what it's not good for, and probably give you an extra perspective on medical weight loss that maybe you haven't appreciated yet.

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[SPEAKER_00]: This podcast is going to be really good for two groups of people for both the provider and the medspot owner.

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[SPEAKER_00]: It's also going to be really good for the consumer for someone that maybe is looking into this or has experienced it.

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[SPEAKER_00]: Whether good or bad to gain another perspective and get some more education about what this medication can truly do for you.

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[SPEAKER_00]: All right, so medical weight loss, the most common thing that we hear is ozempic, wagovii, tersepotide, mongero, those are all common words that we hear of.

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[SPEAKER_00]: And a lot of us think of this as something that is new, and then it gets a little bit scary, because do we really know what goes on with that?

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[SPEAKER_00]: Are there any bad things that happen?

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[SPEAKER_00]: And we do hear about a few bad things, but we're really kind of kind of dice like that today.

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[SPEAKER_00]: First and foremost, I'd like to start with,

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[SPEAKER_00]: actually to take back before GLP ones were commonly used and talk about medications that were commonly used or traditionally used for medical weight loss prior to GPL1.

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[SPEAKER_00]: Hey, sorry to interrupt if you or someone you know is interested in building your confidence and feeling like you're best self both inside and out.

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[SPEAKER_00]: I encourage you to visit Horizon at Medspot and Wellness in Kansas City.

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[SPEAKER_00]: We have two locations in Shawnee and near the Kansas City Plaza.

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[SPEAKER_00]: We offer so many different things if you would like to check us out go to horizon medspot and wellness.com or you can see us on Instagram that horizon underscore medspot underscore wellness.

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[SPEAKER_00]: And now back to the show.

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[SPEAKER_00]: I'd like to start with actually to take back before GLP ones were commonly used and talk about medications that were commonly used or traditionally used for medical weight loss prior to GPL1.

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[SPEAKER_00]: So

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[SPEAKER_00]: First thing that we have is the brand name is called Contrave.

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[SPEAKER_00]: It is a mix of bueproprian and Naltruxone.

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[SPEAKER_00]: So, both of those medications are actually utilized in primarily patients who suffer or deal with some sort of addictive disorder.

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[SPEAKER_00]: People who have problems with smoking, a lot of times it will prescribe bueproprian to help them stop smoking.

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[SPEAKER_00]: Naltruxone is used in alcohol abuse disorder and so on and so forth.

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[SPEAKER_00]: The website for country of actually says the exact neurochemical effects of country of leading to the weight loss are not fully understood.

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[SPEAKER_00]: So that means we know that people are losing weight of this medication but we don't really have a good explanation of why.

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[SPEAKER_00]: From my perspective, I feel like this medication, the reason it works is it does help people who have maybe

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[SPEAKER_00]: addiction to food.

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[SPEAKER_00]: So I will often ask patients.

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[SPEAKER_00]: Do you feel like your eating habits are emotional?

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[SPEAKER_00]: You eat when you're sad, you eat when you're happy.

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[SPEAKER_00]: That might be a sign that it's more of addictive.

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[SPEAKER_00]: Overall, this medication has not been wildly successful.

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[SPEAKER_00]: 4 to 5% weight loss of their body weight in three to six months.

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[SPEAKER_00]: So if you're going to compare that,

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[SPEAKER_00]: about a 200-pound person, they can expect to lose maybe 10 pounds in three months.

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[SPEAKER_00]: And that is when combined with lifestyle changes, by the way.

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[SPEAKER_00]: In my opinion, that's not enough to convince me to take that medication consistently, knowing that there are side-effects to any medication, there's not enough benefit for me.

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[SPEAKER_00]: The next one is Toperamate, also known as Topermax.

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[SPEAKER_00]: Initially had its FDA approval for seizure prevention.

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[SPEAKER_00]: And we found that patients that were on this medication were losing weight, so it does work on the appetite center, so it decreases appetite.

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[SPEAKER_00]: Expective weight loss is about 5% in 6 months.

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[SPEAKER_00]: However, what I have found in patients is that they experience a lot of brain fog, fatigue, drowsiness.

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[SPEAKER_00]: They just feel like their brain is cloudy.

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[SPEAKER_00]: It is titrated.

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[SPEAKER_00]: They started a low dose and we titrate up.

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[SPEAKER_00]: Some people have even complained of memory impairment or trouble remembering things.

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[SPEAKER_00]: So compliance has been a big hindrance for me with patients.

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[SPEAKER_00]: It is effective, again, not one of my favorites.

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[SPEAKER_00]: Next, we've got his metformin, which is used for diabetes that helps with insulin resistance.

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[SPEAKER_00]: We know that high levels of insulin are linked to weight gain, and that's why we believe that metformin can help with managing weight.

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[SPEAKER_00]: However, in my experience as a practitioner when I gave this medicine to people, the most I would see in weight loss was maybe five pounds.

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[SPEAKER_00]: Metformin is still a good drug for people to be on.

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[SPEAKER_00]: There are some studies that show that there are some longevity benefits to this medication as well.

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[SPEAKER_00]: However, I don't think it would be a great medication to use for the goal of weight loss.

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[SPEAKER_00]: Expect a weight loss is 2 to 3% over several months to a year and some patients don't lose any weight at all.

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[SPEAKER_00]: All right, last but not least, on my list here, we have Centermine, very, very common medication used.

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[SPEAKER_00]: It was by far the most effective, before we were really using GLP1s.

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[SPEAKER_00]: However, the problem with this medication is that

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[SPEAKER_00]: patients would as soon as they stopped the medication, they would gain the weight back.

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[SPEAKER_00]: There was really no long-term benefit to this medication.

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[SPEAKER_00]: So it was kind of like your crash diet pill, so to speak.

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[SPEAKER_00]: The other downside of this medication is it's a controlled substance, so you could only get a month at a time.

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[SPEAKER_00]: And the reason it was controlled is because it was addictive and it's very dangerous for the heart.

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[SPEAKER_00]: So we found that some patients that had cardiac disorders or even any type of cardiac problem in general were at a higher risk of getting a heart attack and heart attacks have happened on this medication.

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[SPEAKER_00]: To me that's not worth it.

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[SPEAKER_00]: I have prescribed it in the past.

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[SPEAKER_00]: I was closely monitoring these patients and they could have it for up to three months and then they would have to be off of it for a complete month to kind of get that tolerance out of their system.

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[SPEAKER_00]: Again, it was our most effective and weight loss but I don't think any provider was really happy or proud or excited about perscribing this medication for any patient because there just wasn't a long-term benefit to it.

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[SPEAKER_00]: All right, so moving on to GLP ones, I think that we really want to talk about.

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[SPEAKER_00]: So, OZEMPIC, Wigobi, Tiersuppotide, Mongero, and these are brand names and generic names.

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[SPEAKER_00]: So, let's talk about GLP ones.

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[SPEAKER_00]: So, people think that a GLP one is, it's new, right?

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[SPEAKER_00]: So, we don't know what's going on with it.

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[SPEAKER_00]: We don't know if it's, you know, somebody's arm is going to fall off, or they're going to grow an extra ear, or they're going to die of a brain cancer, something like that, like we don't know if it's safe.

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[SPEAKER_00]: These are facts.

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[SPEAKER_00]: So a GLP-1 was initially approved for diabetes in 2005, so that was 21 years ago.

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[SPEAKER_00]: It was approved for weight loss in 2014, that is 12 years ago.

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[SPEAKER_00]: So that's a long time, so it went through rigorous studies before that, and then it was approved, and we have had patients on it for that long.

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[SPEAKER_00]: I think if there were hailing,

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[SPEAKER_00]: Horrible problems with this medication we would have found out, especially with the quantity of people that are on it.

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[SPEAKER_00]: I mean, there are so many people on this medication.

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[SPEAKER_00]: Since it's been brought into the market, there have been largely more positive outcomes than negative.

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[SPEAKER_00]: When compared to other weight loss medication, a GLP1 is safer.

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[SPEAKER_00]: There is a greater percentage of weight loss over the same duration.

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[SPEAKER_00]: GLP1s have the greatest long-term success rate, meaning patients are able to maintain their weight loss, which, in my opinion, is the bigger problem.

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[SPEAKER_00]: just about anybody can lose weight.

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[SPEAKER_00]: They can go through a diet, they can rev up their exercise plan, even take a medication like ventramine.

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[SPEAKER_00]: They can lose weight.

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[SPEAKER_00]: No patient has really come into my office saying I can never lose weight or I've never lost weight.

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[SPEAKER_00]: It's that I have never been able to maintain the weight loss that I achieved and that's really the big problem.

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[SPEAKER_00]: So this medication has been the most successful at achieving that and it's been the safest.

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[SPEAKER_00]: side effect profile is much lower and it has the best overall health benefit.

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[SPEAKER_00]: So the other side of GLP ones is we get really focused on how much it helps with weight loss and then there's this controversy whether you're cheating or not.

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[SPEAKER_00]: There are some really cool health benefits with GLP ones as well.

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[SPEAKER_00]: Okay, let's talk about how does a GLP1 work?

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[SPEAKER_00]: So how does it actually work?

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[SPEAKER_00]: And how is it causing us to lose weight?

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[SPEAKER_00]: So a GLP1 will increase insulin secretion.

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[SPEAKER_00]: So what insulin does is it grabs the glucose that's in our bloodstream that's not supposed to be there and pulls it into the body to be utilized for energy.

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[SPEAKER_00]: Diabetes is when sugar stays or glucose stays in the bloodstream too long causing problems.

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[SPEAKER_00]: So we increase insulin that takes the sugar out of the bloodstream.

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[SPEAKER_00]: We decrease glucose gone secretion.

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[SPEAKER_00]: So we are decreasing the amount of glucose that's being put into the bloodstream.

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[SPEAKER_00]: It also delays gastric emptying.

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[SPEAKER_00]: So that is delaying the amount of time it takes food to leave your stomach and go to your intestine.

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[SPEAKER_00]: So the result of that is you feel fuller faster and you feel

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[SPEAKER_00]: Things that you normally couldn't walk past, for example, for me, it was chips and caso.

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[SPEAKER_00]: I love chips and caso, so if I was trying to lose weight or be healthier, if somebody put a plate of chips salsa guacamole caso in front of me,

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[SPEAKER_00]: All bets off.

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[SPEAKER_00]: I don't care.

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[SPEAKER_00]: I'm not in a diet anymore.

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[SPEAKER_00]: I've earned this.

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[SPEAKER_00]: It's worth it.

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[SPEAKER_00]: I'm going to eat a ton of it.

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[SPEAKER_00]: Once I took a GLP one, I would still recognize that is something I like and I enjoy.

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[SPEAKER_00]: I would take a couple of bites and just be satisfied and be done.

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[SPEAKER_00]: And that, in my opinion, is beautiful.

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[SPEAKER_00]: wonderful because for those that are struggling or battling with that food noise of getting on the right track as far as controlling what they're eating and the quantity of what they're eating, that is a huge relief for them.

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[SPEAKER_00]: So that is what a GOP one does.

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[SPEAKER_00]: Now let's talk about the different types of GOP ones that are on the market.

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[SPEAKER_00]: So we have, and I'm just going to use the generic names for the purpose of this.

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[SPEAKER_00]: So we've got semi-glutide.

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[SPEAKER_00]: and then we have tears up a tide and then we have a new one read a true tide.

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[SPEAKER_00]: So read a true tide people haven't heard of this one as much.

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[SPEAKER_00]: That is because it has not passed all of the clinical trials for human use.

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[SPEAKER_00]: So it is in phase two of three.

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[SPEAKER_00]: Now what that means as far as an FDA approval, that means we have not found anything

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[SPEAKER_00]: Horrible about this medication.

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[SPEAKER_00]: We haven't found any bad side effects.

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[SPEAKER_00]: We haven't found anything that would stop the trial or keep us from recommending this medication.

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[SPEAKER_00]: However, it hasn't gone through the third phase for the FDA to put their stamp on it to say for sure this medication is safe.

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[SPEAKER_00]: We are okay with providers prescribing it.

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[SPEAKER_00]: Okay, so some of luteide tears up a tide.

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[SPEAKER_00]: Have an FDA approval.

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[SPEAKER_00]: Reditruteide does not quite yet.

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[SPEAKER_00]: It will soon.

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[SPEAKER_00]: I'm going to segue for just a minute.

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[SPEAKER_00]: I'm going to talk about an FDA approval.

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[SPEAKER_00]: So an FDA approval is a good thing, right?

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[SPEAKER_00]: So what an FDA approval does is we put a medication through extensive, extensive research to show that it's safe and effective.

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[SPEAKER_00]: However, to do this for a medication costs millions and millions and millions of dollars.

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[SPEAKER_00]: And a pharmaceutical company is only going to invest in that if they can profit off the medication and they only can only do that if they are establishing a patent.

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[SPEAKER_00]: So it can't already exist in the environment.

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[SPEAKER_00]: This is a good thing.

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[SPEAKER_00]: That's what keeps medications safe and effective for everybody.

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[SPEAKER_00]: However,

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[SPEAKER_00]: What I think gets missed is that people think that the FDA approval is everything.

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[SPEAKER_00]: There are things that we consume, and even as a provider that I prescribe to patients that are not FDA approved.

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[SPEAKER_00]: And it doesn't mean it's dangerous or unsafe or wrong.

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[SPEAKER_00]: It's just in a different category.

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[SPEAKER_00]: For example, vitamin D.

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[SPEAKER_00]: There's no FDA approval for Vitamin D-Y because it already exists in the environment.

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[SPEAKER_00]: Nobody is going to pay a bunch of money to study something that's already been established and they can't get a patent on it.

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[SPEAKER_00]: Vitamin B-12, we recommend that for people that are Vitamin B-12 deficient.

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[SPEAKER_00]: So just to keep in mind, FDA approvals are awesome and great.

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[SPEAKER_00]: They are not everything in a bag of chips.

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[SPEAKER_00]: Okay.

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[SPEAKER_00]: Some of Lutide works on one receptor, GLP-1, the one that we just talked about.

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[SPEAKER_00]: Tears Epitide works on GLP-1 and GIP, okay?

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[SPEAKER_00]: So what you're gonna get out of tears Epitide is you're gonna get enhanced insulin secretion improved fat metabolism, which is a little bit different from some of Lutide and better overall glycemic effects.

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[SPEAKER_00]: Now, with redotrytide, it's working on those two receptors plus another one.

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[SPEAKER_00]: And this one, what we're finding is that it's even more effective as far as weight loss.

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[SPEAKER_00]: and patients are noticing that they have more energy, and there's more fat burning, which is also another benefit of that.

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[SPEAKER_00]: So just to give it in comparison, semiglutide patients can typically expect about a 15% reduction in weight, tears up a tide 20 to 22%, rid a true tide 26 to 29%.

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[SPEAKER_00]: That's a big difference.

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[SPEAKER_00]: So

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[SPEAKER_00]: More isn't always better.

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[SPEAKER_00]: Semiglutite is fantastic.

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[SPEAKER_00]: And I have a lot of patients that come in and they say, well, I want to try tears up a tie because that's what my friend did.

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[SPEAKER_00]: And she says that tears up a tie does better.

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[SPEAKER_00]: Or I read that it's better and it's more effective.

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[SPEAKER_00]: It doesn't apply to everyone.

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[SPEAKER_00]: So Semiglutite is still a great medication.

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[SPEAKER_00]: And it's got this really lengthy titration, meaning there's a lot of little steps that we can go.

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[SPEAKER_00]: And so we can kind of tinker with the dose and adjust it.

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[SPEAKER_00]: Really easily to get that sweet spot for each patient.

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[SPEAKER_00]: And not everybody needs to lose 29% of their weight.

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[SPEAKER_00]: Sometimes just losing 10 or 15 or even 5% of their weight is gonna be really effective for them and bring them to a happy place.

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[SPEAKER_00]: And generally speaking, semi-glutide is a little bit more cost effective than tears up a tide.

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[SPEAKER_00]: Rediture tied.

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[SPEAKER_00]: It's so new.

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[SPEAKER_00]: I don't have a ton to say about that other than I can say that I've tried it and I do like it.

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[SPEAKER_00]: I do feel like there are less side effects.

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[SPEAKER_00]: I can take a lower dose and get the same benefit from it.

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[SPEAKER_00]: So I do like it.

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[SPEAKER_00]: However, I don't want people to think that more is better or that rediture tied is the best one or that tears up a tights the best one because it has the F2 approval.

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[SPEAKER_00]: It really applies to the patient's individual needs.

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[SPEAKER_00]: And

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[SPEAKER_00]: important to make sure that you're seeing a qualified provider that knows these medications well understands you as assessed you and can prescribe the right thing and make adjustments as needed.

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[SPEAKER_00]: So if you're scrolling through, let's say you're looking for you want to lose weight.

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[SPEAKER_00]: and you've heard about GLP1 so you heard about these weightless medications and you want to try it out so you start searching on your phone and then all of a sudden all these ads start popping up on your social media which we've all experienced that our phones are listening to us and you'll see advertising that you can get the medication online.

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[SPEAKER_00]: You don't have to visit a doctor.

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[SPEAKER_00]: You don't have to follow up.

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[SPEAKER_00]: It's shipped right to your house.

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[SPEAKER_00]: All these things that make it convenient right and they are selling it in a way that the convenience is what you really want.

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[SPEAKER_00]: I don't want to say that all online programs are bad because I don't know that.

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[SPEAKER_00]: There's no way for me to know that.

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[SPEAKER_00]: However, what I do know is that the lack of oversight and the lack of really diving into what is going on with each patient, as far as what's contributing to their barrier to losing weight or maintaining a healthy weight, a lot of that is lost.

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[SPEAKER_00]: when you're doing things online and you're not actually meeting with the qualified provider.

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[SPEAKER_00]: One of the things I put out recently was can you buy medical weight loss drugs online?

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[SPEAKER_00]: Sure, but you can also buy sushi at a gas station.

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[SPEAKER_00]: So I don't necessarily recommend doing that.

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[SPEAKER_00]: There is so much quality in

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[SPEAKER_00]: being taken care of.

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[SPEAKER_00]: And this is your body.

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[SPEAKER_00]: You're putting a liquid substance into your body.

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[SPEAKER_00]: That's going all over your body.

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[SPEAKER_00]: And it's going to affect your organs.

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[SPEAKER_00]: It's going to affect your energy level.

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[SPEAKER_00]: It's going to affect your skin.

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[SPEAKER_00]: All this different thing.

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[SPEAKER_00]: So I would think every person would want to make sure that they're seeing something that's qualified and reliable and safe and consistent.

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[SPEAKER_00]: And that might mean you pay a little bit more money than what you would get online.

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[SPEAKER_00]: It probably, that is probably exactly what's going to happen, but you're paying for that experience and that safety component, which in my opinion is incredibly valuable.

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[SPEAKER_00]: So there's a lot of things that can contribute to somebody's inability to lose weight.

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[SPEAKER_00]: So I'm going to go through a couple of them.

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[SPEAKER_00]: I always draw labs on everybody.

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[SPEAKER_00]: Now, when I draw a lab panel, I'm not necessarily looking for something that's going to prevent this patient from benefiting from a GLP1.

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[SPEAKER_00]: There's very little that I would find on a lab, unless the labs are really often, really something drastic is going on that I need to refer them to their primary care provider as specialist.

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[SPEAKER_00]: I'm not looking for something that's gonna keep me from starting them on one.

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[SPEAKER_00]: What I'm looking for in a lab panel is what's contributing to your symptomology and where you're at.

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[SPEAKER_00]: So a lot of people tell me I lack the motivation.

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[SPEAKER_00]: I'm still exercising and eating the way I did when I was able to maintain my weight really well.

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[SPEAKER_00]: And I'm not able to do that anymore.

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[SPEAKER_00]: I've noticed more abdominal fat.

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[SPEAKER_00]: I can't think.

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[SPEAKER_00]: I'm losing some of my memory.

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[SPEAKER_00]: I can't sleep through the night.

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[SPEAKER_00]: There's all these different things.

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[SPEAKER_00]: So we look at the lab panel.

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[SPEAKER_00]: We look at a complete blood count, which is looking at rub blood cells, white blood cells, and platelets.

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[SPEAKER_00]: That's going to tell me if there's some anemia that might contribute to your fatigue.

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[SPEAKER_00]: I'm going to look at a complete metabolic panel.

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[SPEAKER_00]: That's going to tell me how your liver, your kidney, is working.

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[SPEAKER_00]: It looks at your glucose.

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[SPEAKER_00]: and it looks like your electrolytes, although things are important to look at and get a general picture of how your health is in general, make sure that those are normal.

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[SPEAKER_00]: Vitamin B12, I check that because vitamin B12 is an essential ingredient for building hemoglobin in our blood and giving us energy, carrying oxygen through our body.

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[SPEAKER_00]: So that one's important if that one is low.

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[SPEAKER_00]: Then we want to make sure that we're replacing that.

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[SPEAKER_00]: CRP is another one that I check.

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[SPEAKER_00]: It looks to set tell me if there is some inflammation in the body in general.

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[SPEAKER_00]: If somebody inflamed, an inflammation has this kind of domino effect of causing a lot of problems through the body.

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[SPEAKER_00]: So I want to check that.

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[SPEAKER_00]: So here's the thing about CRP.

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[SPEAKER_00]: CRP is sensitive, but not specific.

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[SPEAKER_00]: And what that means is that if you have any inflammation for any reason, if you had a cold recently or you're dying of cancer, I know that's a large range, but I'm just saying in everything in between, if there's any inflammation,

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[SPEAKER_00]: It's going to be sensitive to pick up all that.

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[SPEAKER_00]: However, it's not specific, so it's not going to tell me exactly what it is.

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[SPEAKER_00]: So when I look at a CRP, I'm just looking, I'm following that number if it's high, let's work on some things to decrease inflammation, and then let's check that number again.

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[SPEAKER_00]: It's not something I get super concerned about if it's consistently high and increasing, then I'm going to do a deeper dive into what that causes.

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[SPEAKER_00]: But it's just giving me an overall look or glance at, is there inflammation going in their body?

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[SPEAKER_00]: thyroid super important, I a sub provider would check a thyroid and get just these basic numbers, a TSH, and if that was normal, then we're normal, we're moving on, and this is before I really understood the difference between

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[SPEAKER_00]: normal and optimal.

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[SPEAKER_00]: I always check a free T3 and I would like a free T3 to be around 3.5.

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[SPEAKER_00]: I find a lot of women less than 3, probably closer to 2.5 or lower than that.

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[SPEAKER_00]: It's still considered normal to be 3.5 and it's considered normal to be 2.

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[SPEAKER_00]: But I would like to be on the right side of that bell curve because I would like to, the benefits of T3, that is your metabolism, your energy, your feeling good, your hair's growing, your skin's nice and moisturized, your bowels are working, that plays a role in all of that.

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[SPEAKER_00]: So I will actually look at T3 because that might be contributing to some of your hindrance in losing weight or managing your weight.

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[SPEAKER_00]: It also plays, like I said, look with metabolism.

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[SPEAKER_00]: So I might give somebody a little bit of T3 if they need it.

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[SPEAKER_00]: Vitamin D, patients that are clinically symptomatic of vitamin D will experience low energy, depressed or anxious mood.

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[SPEAKER_00]: They will experience pain more, so they're increased sensitivity to pain, and there's some dysregulation of estrogen function with that one.

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[SPEAKER_00]: So that's another one, and it's common, so common for that to be low, and it's really easy to replace.

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[SPEAKER_00]: All right, check hormones, we check testosterone, free and total estrogen, follicular stimulating hormone, we check progesterone, all of those we can deep dive into that but you could go to our hormone podcast to talk about that but those are very, very important in metabolism, mood, energy, how people are sleeping at night so that makes a large contribution so we're looking at that as well.

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[SPEAKER_00]: All right, so when you're seeing a medical provider, what they should be doing is considering all of these things that could can be triviting to your inability to lose weight.

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[SPEAKER_00]: We kind of dove into that with the lab evaluation.

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[SPEAKER_00]: So we talk about hormone imbalance.

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[SPEAKER_00]: That's probably my number one to check into, especially in anyone over the age of 30.

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[SPEAKER_00]: I'm going to really dive into that.

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[SPEAKER_00]: Women particularly have what we call subclinical hypothyroidism, and what I mean by subclinical is that it's not going to show up red on the lab panel but it is if you've had a lot of experience with it and you work with that you'll find that hey we can optimize this We're on the left side of the bell curve.

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[SPEAKER_00]: We want to be on the right side.

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[SPEAKER_00]: We want to feel the best that we can and still stay within something that's clinically safe and normal.

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[SPEAKER_00]: We talk about gut health, gut health is huge.

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[SPEAKER_00]: How the gut is working and what's in our diet largely affects not just our hormones, but also our metabolism, which is kind of a domino effect.

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[SPEAKER_00]: A lot of times, if I have patients that are, let's say we've balanced their hormones, and we've optimized that.

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[SPEAKER_00]: We have been taking a GLP one and like it worked at first and it's kind of slowing down and we're kind of plateauing.

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[SPEAKER_00]: I will then look at somebody's gut health.

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[SPEAKER_00]: And if I can clean up that, which that's a whole other discussion about gut health, but we have some supplements and things that work really, really well that were backed by research, if I can get somebody's gut to reset, all of a sudden, their hormones work better, and they are starting to lose more weight more effectively, and they're feeling a lot better.

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[SPEAKER_00]: A lot of other maybe clingering symptoms that they've had are going away like brain fog.

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[SPEAKER_00]: So gut is another big one.

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[SPEAKER_00]: Looking into people's stress and cortisol levels,

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[SPEAKER_00]: The testing cortisol is tricky.

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[SPEAKER_00]: You can't just go in and say, like, can you just test my cortisol?

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[SPEAKER_00]: Cortisol is supposed to be on a curve, right?

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[SPEAKER_00]: Your cortisol is supposed to be higher in the morning and it gradually declines as you go through the day and it should be its lowest at night when you're going to sleep.

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[SPEAKER_00]: Checking cortisol shouldn't really infrequently just be one time during a day at a random part of the day.

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[SPEAKER_00]: So if you go in for your labs and say, hey, doctor, could you check my cortisol levels?

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[SPEAKER_00]: that information is not very valuable.

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[SPEAKER_00]: What's valuable is checking it actually four times so in the morning, four through the day, three quarters, and then at night, and then seeing what kind of curve that follows is actually going to give us a much, much

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[SPEAKER_00]: bigger picture and it's more useful information as far as seeing where we're at.

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[SPEAKER_00]: There are people that are what I call flatliners.

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[SPEAKER_00]: They're just flat lined the whole way.

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[SPEAKER_00]: Like their cortisol never comes.

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[SPEAKER_00]: If they have a hard time getting up in the morning, they're tired all day long, but they can go to sleep at night because they just don't have any cortisol that's waking them up.

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[SPEAKER_00]: Cortisol is our stress hormone, but it's also our wake-up hormone.

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[SPEAKER_00]: So it gets us awake in the morning.

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[SPEAKER_00]: And then we have people that are writing

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[SPEAKER_00]: Honestly, I'm pretty sure my cortisol is high all of the time because I have a hard time going to sleep a lot of that's better with things that I've balanced the message is Cortisol needs to be checked Through out the day not just one time and high cortisol isn't always a bad thing

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[SPEAKER_00]: you're supposed to have a high in the morning.

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[SPEAKER_00]: If people have trouble sleeping, if you are not getting good REM sleep, that does affect your metabolism significantly and also your brain function.

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[SPEAKER_00]: We look into whether people are depressed anxious if they have any type of mood disorder, what are their medications they're on, they might be affecting their ability to gain or lose weight, lifestyle.

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[SPEAKER_00]: That's a huge one.

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[SPEAKER_00]: I mean, I really dive into people's life that my questionnaire asks about their exercise, what kind of food they're eating, how often is it home cooked, how often is it convenient, are you an emotional eater, all those types of things.

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[SPEAKER_00]: So lifestyles a big component of it because we could talk about how great GOP ones are, but they're useless if you're not combining it with some changes.

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[SPEAKER_00]: And then just any other barriers or limitations, whether mental physical, financial, their schedule, just yesterday I saw a nurse, a night nurse, her barrier is because she works nights and she works three to four days a week.

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[SPEAKER_00]: Her schedule is very inconsistent in terms of her sleeping, her eating, and that has grossly effect her ability to get some exercise in, because she cannot find a consistent pattern.

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[SPEAKER_00]: So those are all really important things to consider.

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[SPEAKER_00]: Okay, so I want to talk about, I hear a lot of people kind of comment about how they feel that GLP ones are cheating.

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[SPEAKER_00]: I agree and disagree with this at the same time and here's why.

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[SPEAKER_00]: So when you are, I'm not at a weight that I like to be at.

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[SPEAKER_00]: I would like to lose weight.

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[SPEAKER_00]: The first thing that you're going to do is kind of see what you can adjust or change to get to that goal, right?

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[SPEAKER_00]: And maybe you have attempted those things on your own and you're not making it anywhere.

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[SPEAKER_00]: So then you go to the next where you're looking for a tool to help you get there.

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[SPEAKER_00]: So tools can be hiring a personal trainer or even just getting a gym membership, it can be signing up for some sort of meal plan.

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[SPEAKER_00]: I believe that seeking help from a qualified medical professional is still a tool just as those other what tools are.

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[SPEAKER_00]: How would GLP one should be used?

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[SPEAKER_00]: It should be looked at as a tool not as the ultimate solution to losing weight.

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[SPEAKER_00]: So can someone take this medication and do nothing else and lose weight?

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[SPEAKER_00]: Yes, that can happen.

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[SPEAKER_00]: We can all agree that that's not a good idea, and then that's not going to be a long-term solution for that patient.

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[SPEAKER_00]: And here's why.

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[SPEAKER_00]: So if you take a medication that suppresses your appetite, you are going to go into caloric deficit and you are going to lose weight.

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[SPEAKER_00]: However, if you do nothing to feed, grow, and maintain your muscle mass, you are going to lose muscle mass.

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[SPEAKER_00]: Semi-glutide turns up a tide is not a muscle-eating Pac-Man.

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[SPEAKER_00]: It's not like you take the medication and it's just going to eat up your muscles because I hear that a lot as well.

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[SPEAKER_00]: If you are in a caloric deficit period and of story, whether it's a bariatric surgery or your anorexic or you're just severely limiting your diet or you're doing keto, whatever it is.

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[SPEAKER_00]: And you're losing weight.

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[SPEAKER_00]: If you are not doing things to maintain your muscle mass, you're going to lose muscle mass.

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[SPEAKER_00]: So this whole thing about like ozempic but or ozempic face.

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[SPEAKER_00]: I don't think they should have that title with it because it's just a caloric deficit.

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[SPEAKER_00]: And somebody not appropriately using the medication as a tool rather than a solution is really the problem.

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[SPEAKER_00]: So it's the person's approach.

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[SPEAKER_00]: And this could be a lack of guidance from a provider like we've talked about already.

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[SPEAKER_00]: So like we've talked about how the medication works, right?

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[SPEAKER_00]: It slows gastric emptying.

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[SPEAKER_00]: You feel full or faster and full or longer.

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[SPEAKER_00]: You don't have the food noise anymore.

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[SPEAKER_00]: So food just doesn't talk to you anymore.

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[SPEAKER_00]: It is so much easier for you to stay on track on eating the things that you should and avoiding the things that you shouldn't.

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[SPEAKER_00]: It does not exercise for you and it does not pick your food for you.

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[SPEAKER_00]: so we do a lot of counseling on how patients need to stay focused on high nutritious items that they're eating.

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[SPEAKER_00]: So nuts, vegetables, fruits, lean protein, that's all still.

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[SPEAKER_00]: That information doesn't change.

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[SPEAKER_00]: It's just it's easier to do that.

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[SPEAKER_00]: You go to a restaurant and you're not quite as hungry.

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[SPEAKER_00]: So it's so much easier to order the grilled chicken in the broccoli because before when you were starving, even though you knew that was the better choice for you,

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[SPEAKER_00]: you went for the cheeseburger or the steak and gravy and mashed potatoes because you were starving and that was going to satisfy your hunger better.

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[SPEAKER_00]: That's where the difference lies.

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[SPEAKER_00]: You still have to do those things, but like I said, it's a tool and it's a freaking awesome tool to help people get to their goal.

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[SPEAKER_00]: I personally don't see it any different than using utilizing any other tools such as a personal trainer or a meal plan.

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[SPEAKER_00]: to get to your goal or to help you stay focused on what you need to to reach that goal.

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[SPEAKER_00]: I still have so much more than I want to talk about with this medication because I have been prescribing and managing patients on this medication before it was popular.

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[SPEAKER_00]: Even before it was approved, I was helping patients with losing weight with the GLP1.

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[SPEAKER_00]: So this is part one.

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[SPEAKER_00]: We are going to have a second part.

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[SPEAKER_00]: Possibly a third.

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[SPEAKER_00]: I don't know.

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[SPEAKER_00]: I just could just go on for days talking about medical weight loss and how it can help patients and to really understand how it works.

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[SPEAKER_00]: So that being said, if you are looking for a qualified provider, horizon medspon wellness, we have two locations where there's one in Shiny Kansas.

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[SPEAKER_00]: There's another one at the Country Club Plaza in Kansas City, Missouri.

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[SPEAKER_00]: We have qualified providers there that not only have the extensive experience, education,

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[SPEAKER_00]: To prescribe these medication, I can stand by that they have a genuine desire for their patients to be not only safe, but effectively attain their goals as far as their weight management, and we do write ourselves in taking a very comprehensive approach to medical weight loss.

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[SPEAKER_00]: The links for that are in the description.

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[SPEAKER_00]: Thank you for joining me again today.

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[SPEAKER_00]: I want you guys to all have a great day.

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[SPEAKER_00]: We'll see you next time.