Full Transcript Introduction and guest background 0:02 Hello, my name is Adriana Merino and I 0:02 Hello, my name is Adriana Merino and I am host and producer of Bend into 0:04 am host and producer of Bend into 0:04 am host and producer of Bend into Balance powered by the source. Today I'm 0:07 Balance powered by the source. Today I'm 0:07 Balance powered by the source. Today I'm very happy to be accompanied by Dr. 0:09 very happy to be accompanied by Dr. 0:09 very happy to be accompanied by Dr. Kevin Jones. Dr. Jones began in 0:12 Kevin Jones. Dr. Jones began in 0:12 Kevin Jones. Dr. Jones began in emergency medicine before starting Flow 0:15 emergency medicine before starting Flow 0:15 emergency medicine before starting Flow Wellness here in Bend 3 years ago. Can
Origins of Ozempic and GLP-1 drugs 0:18 Wellness here in Bend 3 years ago. Can 0:18 Wellness here in Bend 3 years ago. Can you tell us a little bit about Ozempic 0:20 you tell us a little bit about Ozempic 0:20 you tell us a little bit about Ozempic and the GLP-1s in general, how they 0:22 and the GLP-1s in general, how they 0:22 and the GLP-1s in general, how they began, how long they've been in the 0:23 began, how long they've been in the 0:23 began, how long they've been in the market because many of us think Ozempic 0:26 market because many of us think Ozempic 0:26 market because many of us think Ozempic is a household name like it just in the 0:27 is a household name like it just in the 0:27 is a household name like it just in the couple years ago but it's actually been 0:29 couple years ago but it's actually been 0:29 couple years ago but it's actually been around since 2005 if I'm not mistaken or 0:32 around since 2005 if I'm not mistaken or 0:32 around since 2005 if I'm not mistaken or these type of drugs at least. 0:34 these type of drugs at least. 0:34 these type of drugs at least. >> Correct. Yeah, they were first developed 0:35 >> Correct. Yeah, they were first developed 0:35 >> Correct. Yeah, they were first developed for diabetics to help manage blood sugar 0:38 for diabetics to help manage blood sugar 0:38 for diabetics to help manage blood sugar which is something that Ozempic does do. 0:40 which is something that Ozempic does do. 0:40 which is something that Ozempic does do. And it was a really a incidental side 0:42 And it was a really a incidental side 0:42 And it was a really a incidental side effect that people were losing weight 0:44 effect that people were losing weight 0:44 effect that people were losing weight while taking this medication. And the 0:46 while taking this medication. And the 0:46 while taking this medication. And the initial drugs, the one that were around 0:47 initial drugs, the one that were around 0:47 initial drugs, the one that were around in the early 2000s, you had to take 0:49 in the early 2000s, you had to take 0:49 in the early 2000s, you had to take either once or twice a day. And so for 0:51 either once or twice a day. And so for 0:51 either once or twice a day. And so for weight loss that's not a very appealing 0:53 weight loss that's not a very appealing 0:53 weight loss that's not a very appealing thing but for diabetics who rely on 0:54 thing but for diabetics who rely on 0:54 thing but for diabetics who rely on insulin, they're used to doing daily 0:56 insulin, they're used to doing daily 0:56 insulin, they're used to doing daily shots so it wasn't a big thing for them 0:58 shots so it wasn't a big thing for them 0:58 shots so it wasn't a big thing for them to take those medications. 0:59 to take those medications. 0:59 to take those medications. >> Uh-huh. 1:00 >> Uh-huh. 1:00 >> Uh-huh. >> And what really changes when they were 1:01 >> And what really changes when they were 1:01 >> And what really changes when they were able to make the medication last longer 1:04 able to make the medication last longer 1:04 able to make the medication last longer from daily to weekly and then start 1:07 from daily to weekly and then start 1:07 from daily to weekly and then start looking at it just for the sole purpose 1:08 looking at it just for the sole purpose 1:08 looking at it just for the sole purpose of weight loss. And and the original 1:10 of weight loss. And and the original 1:10 of weight loss. And and the original medicine for that was called semaglutide 1:12 medicine for that was called semaglutide 1:12 medicine for that was called semaglutide or semaglutide also known as Ozempic.
How GLP-1s evolved for weight loss 1:14 or semaglutide also known as Ozempic. 1:15 or semaglutide also known as Ozempic. >> Okay. 1:15 >> Okay. 1:15 >> Okay. >> And then that just you know it just hit 1:17 >> And then that just you know it just hit 1:17 >> And then that just you know it just hit a tipping point where people realized it 1:19 a tipping point where people realized it 1:19 a tipping point where people realized it was effective and for the most part safe 1:22 was effective and for the most part safe 1:22 was effective and for the most part safe with you know not there are some side 1:24 with you know not there are some side 1:24 with you know not there are some side effects but most people can manage them. 1:26 effects but most people can manage them. 1:26 effects but most people can manage them. And now there's newer medications like 1:27 And now there's newer medications like 1:27 And now there's newer medications like tirzepatide which is also called 1:29 tirzepatide which is also called 1:29 tirzepatide which is also called Mounjaro or Zepbound. There's pills now 1:31 Mounjaro or Zepbound. There's pills now 1:31 Mounjaro or Zepbound. There's pills now available where you don't even have to 1:33 available where you don't even have to 1:33 available where you don't even have to do the shots. And then there's even 1:35 do the shots. And then there's even 1:35 do the shots. And then there's even newer medicines out there that are 1:36 newer medicines out there that are 1:36 newer medicines out there that are approaching like what the level of 1:38 approaching like what the level of 1:38 approaching like what the level of bariatric surgery is for weight loss. 1:40 bariatric surgery is for weight loss. 1:40 bariatric surgery is for weight loss. And so it's just a real exciting field 1:41 And so it's just a real exciting field 1:41 And so it's just a real exciting field to be part of and and see where it's 1:43 to be part of and and see where it's 1:43 to be part of and and see where it's going. 1:44 going. 1:44 going. >> Wow, it's really grown fast in such 1:46 >> Wow, it's really grown fast in such 1:46 >> Wow, it's really grown fast in such little time. 1:48 little time. 1:48 little time. >> Yeah, I mean the the the tragedy with 1:49 >> Yeah, I mean the the the tragedy with 1:49 >> Yeah, I mean the the the tragedy with obesity is that affects so many parts of 1:52 obesity is that affects so many parts of 1:52 obesity is that affects so many parts of people's lives. You know, it's linked 1:53 people's lives. You know, it's linked 1:53 people's lives. You know, it's linked with higher risk of heart disease, 1:54 with higher risk of heart disease, 1:54 with higher risk of heart disease, cancer, stroke, longevity. And there 1:57 cancer, stroke, longevity. And there 1:57 cancer, stroke, longevity. And there just wasn't wasn't a treatment for it. 1:59 just wasn't wasn't a treatment for it. 1:59 just wasn't wasn't a treatment for it. You know, we would I mean, not so much 2:00 You know, we would I mean, not so much 2:00 You know, we would I mean, not so much in the ER, but primary care doctors 2:02 in the ER, but primary care doctors 2:02 in the ER, but primary care doctors would say, "Well, you know, exercise 2:04 would say, "Well, you know, exercise 2:04 would say, "Well, you know, exercise more and eat better." But, you know, 2:05 more and eat better." But, you know, 2:05 more and eat better." But, you know, that that only gets you to a point, and 2:07 that that only gets you to a point, and 2:07 that that only gets you to a point, and then with ultra-processed food, it's 2:09 then with ultra-processed food, it's 2:09 then with ultra-processed food, it's pretty hard to monitor calorie intake. 2:12 pretty hard to monitor calorie intake. 2:12 pretty hard to monitor calorie intake. And so, we were you know, even though 2:13 And so, we were you know, even though 2:13 And so, we were you know, even though people were trying, this is what I hear 2:14 people were trying, this is what I hear 2:14 people were trying, this is what I hear from a lot of the patients that I've 2:15 from a lot of the patients that I've 2:15 from a lot of the patients that I've treated, you know, they're doing their 2:17 treated, you know, they're doing their 2:17 treated, you know, they're doing their best, but just not getting where they 2:19 best, but just not getting where they 2:19 best, but just not getting where they want to go. 2:20 want to go. 2:20 want to go. And also, just middle age and getting 2:22 And also, just middle age and getting 2:22 And also, just middle age and getting older, you know, your body slows down.
Obesity, treatment gaps, and patient eligibility 2:24 older, you know, your body slows down. 2:24 older, you know, your body slows down. So, for a lot of people that were at a 2:25 So, for a lot of people that were at a 2:25 So, for a lot of people that were at a healthy weight, that changes over time. 2:28 healthy weight, that changes over time. 2:28 healthy weight, that changes over time. And And now, we have this medication 2:29 And And now, we have this medication 2:30 And And now, we have this medication that can help people get to where they 2:32 that can help people get to where they 2:32 that can help people get to where they want to be and feel like themselves 2:33 want to be and feel like themselves 2:33 want to be and feel like themselves again. It's really phenomenal. 2:34 again. It's really phenomenal. 2:34 again. It's really phenomenal. >> Yeah. This reminds me of in my past, I 2:37 >> Yeah. This reminds me of in my past, I 2:37 >> Yeah. This reminds me of in my past, I was a filmmaker, and I did a one-hour 2:39 was a filmmaker, and I did a one-hour 2:40 was a filmmaker, and I did a one-hour special for National Geographic on 2:41 special for National Geographic on 2:41 special for National Geographic on obesity, and I went to Monterrey, 2:43 obesity, and I went to Monterrey, 2:43 obesity, and I went to Monterrey, Mexico, and I met that that time the 2:45 Mexico, and I met that that time the 2:45 Mexico, and I met that that time the world's largest man. 2:47 world's largest man. 2:47 world's largest man. >> Oh, yeah. 2:48 >> Oh, yeah. 2:48 >> Oh, yeah. >> His name was Uribe, uh Miguel Uribe, and 2:51 >> His name was Uribe, uh Miguel Uribe, and 2:51 >> His name was Uribe, uh Miguel Uribe, and he got the Guinness Book of He got the 2:53 he got the Guinness Book of He got the 2:53 he got the Guinness Book of He got the Guinness record of being the heaviest 2:55 Guinness record of being the heaviest 2:55 Guinness record of being the heaviest man, and he was at almost 600 kilos, 2:58 man, and he was at almost 600 kilos, 2:58 man, and he was at almost 600 kilos, which is 2:59 which is 2:59 which is close I would have to do the math, but I 3:01 close I would have to do the math, but I 3:01 close I would have to do the math, but I think that's over 1,200 lb. And when I 3:04 think that's over 1,200 lb. And when I 3:04 think that's over 1,200 lb. And when I met him, he had been living 3:06 met him, he had been living 3:06 met him, he had been living on a mattress for the last 13 years. And 3:09 on a mattress for the last 13 years. And 3:09 on a mattress for the last 13 years. And on that mattress, he had to do 3:10 on that mattress, he had to do 3:10 on that mattress, he had to do everything, all his bodily functions. He 3:12 everything, all his bodily functions. He 3:12 everything, all his bodily functions. He could not get up from that mattress. And 3:15 could not get up from that mattress. And 3:15 could not get up from that mattress. And he had been literally bedridden for 13 3:17 he had been literally bedridden for 13 3:17 he had been literally bedridden for 13 years. And if you wanted to see the sun 3:18 years. And if you wanted to see the sun 3:18 years. And if you wanted to see the sun and get out, they had to transfer that 3:21 and get out, they had to transfer that 3:21 and get out, they had to transfer that mattress to the back of a pickup truck, 3:23 mattress to the back of a pickup truck, 3:24 mattress to the back of a pickup truck, and then they would drive him through 3:25 and then they would drive him through 3:25 and then they would drive him through town, and he would just kind of be 3:27 town, and he would just kind of be 3:27 town, and he would just kind of be exposed to the sun and you know, of 3:28 exposed to the sun and you know, of 3:28 exposed to the sun and you know, of course, to the city. He was obviously 3:30 course, to the city. He was obviously 3:30 course, to the city. He was obviously well known, you know, a lot of people 3:31 well known, you know, a lot of people 3:31 well known, you know, a lot of people went to go visit him. Anyways, he sadly 3:34 went to go visit him. Anyways, he sadly 3:34 went to go visit him. Anyways, he sadly passed away a couple of years later, but 3:35 passed away a couple of years later, but 3:36 passed away a couple of years later, but I don't think he reached 3:37 I don't think he reached 3:38 I don't think he reached I think he died around close to 40, if 3:39 I think he died around close to 40, if 3:39 I think he died around close to 40, if I'm not mistaken. He was probably in his 3:41 I'm not mistaken. He was probably in his 3:41 I'm not mistaken. He was probably in his late 30s when I met him. But, it was a 3:43 late 30s when I met him. But, it was a 3:43 late 30s when I met him. But, it was a very impactful experience to see him 3:46 very impactful experience to see him 3:46 very impactful experience to see him just really glued to that mattress, and 3:49 just really glued to that mattress, and 3:49 just really glued to that mattress, and knowing that he had been there for 13 3:51 knowing that he had been there for 13 3:51 knowing that he had been there for 13 years It very hard to conceive. So, that 3:53 years It very hard to conceive. So, that 3:53 years It very hard to conceive. So, that brings me, you know, to the need of why 3:56 brings me, you know, to the need of why 3:56 brings me, you know, to the need of why these drugs could be useful 3:58 these drugs could be useful 3:58 these drugs could be useful because he was unable to lose any 3:59 because he was unable to lose any 3:59 because he was unable to lose any weight. 4:01 weight. 4:01 weight. Can you tell us, you know, when you a 4:02 Can you tell us, you know, when you a 4:02 Can you tell us, you know, when you a patient comes to you, like what are the 4:04 patient comes to you, like what are the 4:04 patient comes to you, like what are the factors that you're keeping in 4:05 factors that you're keeping in 4:05 factors that you're keeping in consideration as to as to why this 4:08 consideration as to as to why this 4:08 consideration as to as to why this patient should be eligible or not to 4:10 patient should be eligible or not to 4:10 patient should be eligible or not to take these new medications? 4:13 take these new medications? 4:13 take these new medications? >> Uh yeah, it's a great question. There 4:14 >> Uh yeah, it's a great question. There 4:14 >> Uh yeah, it's a great question. There are criteria which we base off of the
Non-traditional uses and patient profiles 4:16 are criteria which we base off of the 4:16 are criteria which we base off of the body mass index, which is a calculation 4:18 body mass index, which is a calculation 4:18 body mass index, which is a calculation based on your height and weight. 4:20 based on your height and weight. 4:20 based on your height and weight. >> Mhm. 4:20 >> Mhm. 4:20 >> Mhm. >> And then also factoring in other risk 4:22 >> And then also factoring in other risk 4:22 >> And then also factoring in other risk factors, mainly for heart disease, like 4:24 factors, mainly for heart disease, like 4:24 factors, mainly for heart disease, like does that person have diabetes or high 4:26 does that person have diabetes or high 4:26 does that person have diabetes or high blood pressure or bad cholesterol or a 4:28 blood pressure or bad cholesterol or a 4:28 blood pressure or bad cholesterol or a family history of heart disease. 4:30 family history of heart disease. 4:30 family history of heart disease. And so, those are the kind of 4:31 And so, those are the kind of 4:31 And so, those are the kind of traditional things that we look at for 4:32 traditional things that we look at for 4:32 traditional things that we look at for GLP-1 medications. We are seeing it use 4:35 GLP-1 medications. We are seeing it use 4:35 GLP-1 medications. We are seeing it use a lot more commonly now for other 4:36 a lot more commonly now for other 4:36 a lot more commonly now for other conditions, mainly in the longevity 4:39 conditions, mainly in the longevity 4:39 conditions, mainly in the longevity space. There was a large study that 4:41 space. There was a large study that 4:41 space. There was a large study that showed semaglutide, which is the 4:43 showed semaglutide, which is the 4:43 showed semaglutide, which is the original weight loss medication, had a 4:45 original weight loss medication, had a 4:45 original weight loss medication, had a 15% drop in all-cause mortality for 4:48 15% drop in all-cause mortality for 4:48 15% drop in all-cause mortality for people who took it over a study period. 4:51 people who took it over a study period. 4:51 people who took it over a study period. And so, people are looking at this and 4:52 And so, people are looking at this and 4:52 And so, people are looking at this and say, "Hey, I can actually use this 4:53 say, "Hey, I can actually use this 4:53 say, "Hey, I can actually use this medication help live longer." There was 4:56 medication help live longer." There was 4:56 medication help live longer." There was a large study looking at it for 4:57 a large study looking at it for 4:57 a large study looking at it for dementia, which it didn't really pan 4:59 dementia, which it didn't really pan 4:59 dementia, which it didn't really pan out, so that's still up in the air. 5:01 out, so that's still up in the air. 5:01 out, so that's still up in the air. >> Okay. 5:02 >> Okay. 5:02 >> Okay. >> We've also had patients use it for 5:03 >> We've also had patients use it for 5:03 >> We've also had patients use it for inflammation. 5:04 inflammation. 5:04 inflammation. >> Uh-huh. 5:04 >> Uh-huh. 5:04 >> Uh-huh. >> Like pro-inflammatory states of the 5:06 >> Like pro-inflammatory states of the 5:06 >> Like pro-inflammatory states of the body, and you know, fat cells are 5:09 body, and you know, fat cells are 5:09 body, and you know, fat cells are pro-inflammatory. And so, if you can 5:10 pro-inflammatory. And so, if you can 5:10 pro-inflammatory. And so, if you can lose weight, you can decrease that 5:12 lose weight, you can decrease that 5:12 lose weight, you can decrease that inflammation. 5:12 inflammation. 5:12 inflammation. >> Sure. 5:13 >> Sure. 5:13 >> Sure. >> And so, we have we are we have the 5:15 >> And so, we have we are we have the 5:15 >> And so, we have we are we have the traditional things, which is just truly 5:17 traditional things, which is just truly 5:17 traditional things, which is just truly excess weight. Like a BMI over 30, 5:19 excess weight. Like a BMI over 30, 5:20 excess weight. Like a BMI over 30, whereas over 25 is considered obese. 5:22 whereas over 25 is considered obese. 5:22 whereas over 25 is considered obese. >> Right. 5:22 >> Right. 5:22 >> Right. >> Or over 25 is considered overweight, 5:24 >> Or over 25 is considered overweight, 5:24 >> Or over 25 is considered overweight, over 30 is obese. And then also folks 5:26 over 30 is obese. And then also folks 5:26 over 30 is obese. And then also folks that are looking at it for kind of what 5:28 that are looking at it for kind of what 5:28 that are looking at it for kind of what we consider like non-traditional 5:29 we consider like non-traditional 5:29 we consider like non-traditional treatments as well. 5:31 treatments as well. 5:31 treatments as well. >> Okay. And non-traditional treatments 5:33 >> Okay. And non-traditional treatments 5:33 >> Okay. And non-traditional treatments would be like what? 5:34 would be like what? 5:34 would be like what? >> Like the inflammation component, uh 5:36 >> Like the inflammation component, uh 5:36 >> Like the inflammation component, uh fertility, like we've had folks become 5:39 fertility, like we've had folks become 5:39 fertility, like we've had folks become pregnant after losing weight because, 5:40 pregnant after losing weight because, 5:40 pregnant after losing weight because, you know, being overweight is not the 5:42 you know, being overweight is not the 5:42 you know, being overweight is not the the doesn't put your body in the 5:43 the doesn't put your body in the 5:43 the doesn't put your body in the healthiest state to have children. 5:45 healthiest state to have children. 5:45 healthiest state to have children. >> Uh-huh. 5:46 >> Uh-huh. 5:46 >> Uh-huh. >> Mhm. 5:47 >> Mhm. 5:47 >> Mhm. Yeah, I and there is a recent New York 5:49 Yeah, I and there is a recent New York 5:49 Yeah, I and there is a recent New York Times article about someone using it for 5:51 Times article about someone using it for 5:51 Times article about someone using it for a head injury, which is a new to me. I 5:53 a head injury, which is a new to me. I 5:53 a head injury, which is a new to me. I hadn't heard of that, but she had a 5:54 hadn't heard of that, but she had a 5:54 hadn't heard of that, but she had a severe concussion and actually found 5:55 severe concussion and actually found 5:55 severe concussion and actually found getting on a GLP-1 medication helped 5:58 getting on a GLP-1 medication helped 5:58 getting on a GLP-1 medication helped their concussion symptoms. So, it's in 6:00 their concussion symptoms. So, it's in 6:00 their concussion symptoms. So, it's in the news right now. There's just a 6:01 the news right now. There's just a 6:01 the news right now. There's just a little bit of everything that you're 6:02 little bit of everything that you're 6:02 little bit of everything that you're hearing about that how GLP-1s can help 6:04 hearing about that how GLP-1s can help 6:04 hearing about that how GLP-1s can help and maybe not all of that is 100% 6:06 and maybe not all of that is 100% 6:06 and maybe not all of that is 100% accurate is going to be backed up by 6:08 accurate is going to be backed up by 6:08 accurate is going to be backed up by study data, but we are seeing a lot of 6:10 study data, but we are seeing a lot of 6:10 study data, but we are seeing a lot of benefit for things that we didn't even 6:11 benefit for things that we didn't even 6:11 benefit for things that we didn't even know about. 6:12 know about. 6:12 know about. >> Okay. And the patients that come to see 6:14 >> Okay. And the patients that come to see 6:14 >> Okay. And the patients that come to see you here, in general, what are in what 6:18 you here, in general, what are in what 6:18 you here, in general, what are in what category do they fall in? Like the 6:19 category do they fall in? Like the 6:19 category do they fall in? Like the non-traditional or more just weight
Consultation process and screening 6:21 non-traditional or more just weight 6:21 non-traditional or more just weight loss, looking for longevity 6:24 loss, looking for longevity 6:24 loss, looking for longevity benefits? What What do you 6:25 benefits? What What do you 6:25 benefits? What What do you >> It's really a mix of both. I would say 6:27 >> It's really a mix of both. I would say 6:27 >> It's really a mix of both. I would say on average an older population for the 6:29 on average an older population for the 6:29 on average an older population for the most part. We're mostly seeing people 6:30 most part. We're mostly seeing people 6:30 most part. We're mostly seeing people 40s, 50s, and even a handful of 60s, 6:33 40s, 50s, and even a handful of 60s, 6:33 40s, 50s, and even a handful of 60s, 70s. 6:35 70s. 6:35 70s. The middle-aged folks are really what I 6:37 The middle-aged folks are really what I 6:37 The middle-aged folks are really what I hear over and over again is I was doing 6:38 hear over and over again is I was doing 6:38 hear over and over again is I was doing fine. I'm eating right. I'm exercising, 6:40 fine. I'm eating right. I'm exercising, 6:40 fine. I'm eating right. I'm exercising, you know, they I live in Bend. I get 6:41 you know, they I live in Bend. I get 6:41 you know, they I live in Bend. I get out. That sort of thing. But I I just 6:44 out. That sort of thing. But I I just 6:44 out. That sort of thing. But I I just the pounds just keep on getting adding 6:46 the pounds just keep on getting adding 6:46 the pounds just keep on getting adding on. And that's so true. I mean, it's 6:48 on. And that's so true. I mean, it's 6:48 on. And that's so true. I mean, it's statistically shown you know, people in 6:49 statistically shown you know, people in 6:49 statistically shown you know, people in middle age people gain on average, you 6:51 middle age people gain on average, you 6:51 middle age people gain on average, you know, roughly a pound a year. What no 6:53 know, roughly a pound a year. What no 6:53 know, roughly a pound a year. What no matter how hard you're trying is your 6:54 matter how hard you're trying is your 6:54 matter how hard you're trying is your body's just slowing down. And you know, 6:56 body's just slowing down. And you know, 6:56 body's just slowing down. And you know, eventually it gets that affects people 6:58 eventually it gets that affects people 6:58 eventually it gets that affects people either their exercise tolerance goes 7:00 either their exercise tolerance goes 7:00 either their exercise tolerance goes down. They have a health concern. Maybe 7:02 down. They have a health concern. Maybe 7:02 down. They have a health concern. Maybe you know, that health scare of some sort 7:04 you know, that health scare of some sort 7:04 you know, that health scare of some sort and they want to get healthier. And so, 7:06 and they want to get healthier. And so, 7:06 and they want to get healthier. And so, what we're seeing is folks that, you 7:07 what we're seeing is folks that, you 7:07 what we're seeing is folks that, you know, are are hitting that point where 7:09 know, are are hitting that point where 7:09 know, are are hitting that point where like I've heard of this treatment. I I 7:11 like I've heard of this treatment. I I 7:11 like I've heard of this treatment. I I know I'm getting worse. I've done 7:13 know I'm getting worse. I've done 7:13 know I'm getting worse. I've done everything I can to get better. Like 7:15 everything I can to get better. Like 7:15 everything I can to get better. Like would this work for me? 7:16 would this work for me? 7:17 would this work for me? >> Sure. Are there any red flags that you 7:19 >> Sure. Are there any red flags that you 7:19 >> Sure. Are there any red flags that you look for where you think that the drug 7:21 look for where you think that the drug 7:21 look for where you think that the drug is not 7:23 is not 7:23 is not compatible for that person? 7:25 compatible for that person? 7:26 compatible for that person? >> I mean, that the biggest thing we'd 7:26 >> I mean, that the biggest thing we'd 7:27 >> I mean, that the biggest thing we'd screen for is something called body 7:28 screen for is something called body 7:28 screen for is something called body dysmorphic disorder, which is you know, 7:30 dysmorphic disorder, which is you know, 7:30 dysmorphic disorder, which is you know, people who are already very thin who 7:31 people who are already very thin who 7:31 people who are already very thin who want to become more thin. 7:32 want to become more thin. 7:32 want to become more thin. >> Sure. 7:33 >> Sure. 7:33 >> Sure. >> And and that's pretty obvious when they 7:34 >> And and that's pretty obvious when they 7:34 >> And and that's pretty obvious when they walk in the door and that they don't 7:36 walk in the door and that they don't 7:36 walk in the door and that they don't >> Or what you know, their BMI is. 7:38 >> Or what you know, their BMI is. 7:38 >> Or what you know, their BMI is. >> And surprisingly, that's very uncommon. 7:40 >> And surprisingly, that's very uncommon. 7:40 >> And surprisingly, that's very uncommon. Like I I can count on one hand how many 7:42 Like I I can count on one hand how many 7:42 Like I I can count on one hand how many people I've seen personally that I you 7:44 people I've seen personally that I you 7:44 people I've seen personally that I you know I'm just like this isn't a healthy 7:46 know I'm just like this isn't a healthy 7:46 know I'm just like this isn't a healthy situation for you. 7:47 situation for you. 7:47 situation for you. >> Yeah. 7:48 >> Yeah. 7:48 >> Yeah. >> And we do have to be careful with folks 7:49 >> And we do have to be careful with folks 7:49 >> And we do have to be careful with folks looking at like the inflammation 7:50 looking at like the inflammation 7:50 looking at like the inflammation benefits that they don't lose too much 7:52 benefits that they don't lose too much 7:52 benefits that they don't lose too much weight cuz if we're treating something 7:53 weight cuz if we're treating something 7:54 weight cuz if we're treating something else, but the main effect is weight loss 7:55 else, but the main effect is weight loss 7:55 else, but the main effect is weight loss and we don't want them to get unhealthy. 7:57 and we don't want them to get unhealthy. 7:57 and we don't want them to get unhealthy. And that's something we actually track 7:59 And that's something we actually track 7:59 And that's something we actually track with the body composition scans so we 8:00 with the body composition scans so we 8:00 with the body composition scans so we can look at their muscle mass, their fat 8:02 can look at their muscle mass, their fat 8:02 can look at their muscle mass, their fat mass. You know, a big buzzword right now 8:04 mass. You know, a big buzzword right now 8:04 mass. You know, a big buzzword right now in health is visceral fat, the fat 8:06 in health is visceral fat, the fat 8:06 in health is visceral fat, the fat that's around your organs cuz that's um 8:08 that's around your organs cuz that's um 8:08 that's around your organs cuz that's um considered more dangerous for heart 8:10 considered more dangerous for heart 8:10 considered more dangerous for heart disease and so we can track that and see 8:12 disease and so we can track that and see 8:12 disease and so we can track that and see if it's getting better. And so people 8:14 if it's getting better. And so people 8:14 if it's getting better. And so people are looking at that, well how do I 8:15 are looking at that, well how do I 8:15 are looking at that, well how do I improve my visceral fat? Whether that's 8:17 improve my visceral fat? Whether that's 8:17 improve my visceral fat? Whether that's with GLP-1 or something else. 8:19 with GLP-1 or something else. 8:19 with GLP-1 or something else. >> Okay. So tell me a little bit of the
Risks, side effects, and dosing 8:21 >> Okay. So tell me a little bit of the 8:21 >> Okay. So tell me a little bit of the process. A patient comes to you and you 8:23 process. A patient comes to you and you 8:23 process. A patient comes to you and you filter them, you ask the necessary 8:25 filter them, you ask the necessary 8:25 filter them, you ask the necessary questions, you understand that you know 8:27 questions, you understand that you know 8:27 questions, you understand that you know they're 8:28 they're 8:28 they're eligible I guess for the medication. 8:31 eligible I guess for the medication. 8:31 eligible I guess for the medication. What does it process look like? Like 8:34 What does it process look like? Like 8:34 What does it process look like? Like >> Yeah, so first they meet with the 8:35 >> Yeah, so first they meet with the 8:35 >> Yeah, so first they meet with the provider. If it's an in-person visit we 8:37 provider. If it's an in-person visit we 8:37 provider. If it's an in-person visit we do a body composition scan. And when we 8:39 do a body composition scan. And when we 8:39 do a body composition scan. And when we meet with them you know we're going to 8:40 meet with them you know we're going to 8:40 meet with them you know we're going to talk about like you know what their what 8:41 talk about like you know what their what 8:42 talk about like you know what their what their journey has been. Like everyone 8:43 their journey has been. Like everyone 8:43 their journey has been. Like everyone has a you know like when did 8:45 has a you know like when did 8:45 has a you know like when did it comes out pretty naturally like when 8:46 it comes out pretty naturally like when 8:46 it comes out pretty naturally like when did you feel like at a healthy weight? 8:48 did you feel like at a healthy weight? 8:48 did you feel like at a healthy weight? When did that change and what do you 8:49 When did that change and what do you 8:49 When did that change and what do you think changed and how's your diet? How's 8:51 think changed and how's your diet? How's 8:51 think changed and how's your diet? How's your exercise? 8:53 your exercise? 8:53 your exercise? And and usually there's sometimes 8:54 And and usually there's sometimes 8:54 And and usually there's sometimes there's a trigger like you know someone 8:56 there's a trigger like you know someone 8:56 there's a trigger like you know someone I talked with today had an injury and 8:57 I talked with today had an injury and 8:57 I talked with today had an injury and they were gaining weight because they 8:59 they were gaining weight because they 8:59 they were gaining weight because they couldn't exercise again and they're 9:00 couldn't exercise again and they're 9:00 couldn't exercise again and they're waiting surgery. 9:01 waiting surgery. 9:01 waiting surgery. >> Uh-huh. 9:02 >> Uh-huh. 9:02 >> Uh-huh. >> You know, other folks it's just that 9:03 >> You know, other folks it's just that 9:03 >> You know, other folks it's just that middle age factor. And then you know 9:05 middle age factor. And then you know 9:05 middle age factor. And then you know then we spend a lot of time but most of 9:07 then we spend a lot of time but most of 9:07 then we spend a lot of time but most of the conversation is really about you 9:08 the conversation is really about you 9:08 the conversation is really about you know the risks and benefits of the 9:09 know the risks and benefits of the 9:09 know the risks and benefits of the medication cuz there are important 9:11 medication cuz there are important 9:11 medication cuz there are important things to know. 9:12 things to know. 9:12 things to know. >> For example, can you tell us a little 9:14 >> For example, can you tell us a little 9:14 >> For example, can you tell us a little bit about the risks and 9:16 bit about the risks and 9:16 bit about the risks and >> Yeah, the the biggest thing is these 9:17 >> Yeah, the the biggest thing is these 9:17 >> Yeah, the the biggest thing is these medicines do have side effects and so 9:19 medicines do have side effects and so 9:20 medicines do have side effects and so the most common being nausea. 9:22 the most common being nausea. 9:22 the most common being nausea. And so we want to warn people about 9:23 And so we want to warn people about 9:23 And so we want to warn people about that. 9:24 that. 9:24 that. And so you know not eating too much at 9:26 And so you know not eating too much at 9:26 And so you know not eating too much at once and then you know being taking your 9:29 once and then you know being taking your 9:29 once and then you know being taking your time starting the medication, you know, 9:31 time starting the medication, you know, 9:31 time starting the medication, you know, we we also want people to lose weight in 9:33 we we also want people to lose weight in 9:33 we we also want people to lose weight in a healthy way. You know, we don't want 9:34 a healthy way. You know, we don't want 9:34 a healthy way. You know, we don't want them just shedding pounds by the week 9:36 them just shedding pounds by the week 9:36 them just shedding pounds by the week because that puts you in a starvation 9:38 because that puts you in a starvation 9:38 because that puts you in a starvation state and you start losing muscle. 9:40 state and you start losing muscle. 9:40 state and you start losing muscle. >> Yeah. 9:40 >> Yeah. 9:41 >> Yeah. >> Also, you know, the way the medication 9:42 >> Also, you know, the way the medication 9:42 >> Also, you know, the way the medication works is it really just slows down your 9:44 works is it really just slows down your 9:44 works is it really just slows down your whole GI system and so constipation is 9:46 whole GI system and so constipation is 9:47 whole GI system and so constipation is very common. So, we want to talk with 9:48 very common. So, we want to talk with 9:48 very common. So, we want to talk with people about that. 9:49 people about that. 9:49 people about that. >> Okay. 9:50 >> Okay. 9:50 >> Okay. >> Sometimes people paradoxically also get 9:51 >> Sometimes people paradoxically also get 9:51 >> Sometimes people paradoxically also get diarrhea. So, it basically just affects 9:53 diarrhea. So, it basically just affects 9:53 diarrhea. So, it basically just affects your guts. Um and there are more rare 9:55 your guts. Um and there are more rare 9:55 your guts. Um and there are more rare side effects, mainly more attributed to 9:57 side effects, mainly more attributed to 9:57 side effects, mainly more attributed to weight loss, but for instance, you know, 9:59 weight loss, but for instance, you know, 9:59 weight loss, but for instance, you know, if you lose weight, that can increase 10:00 if you lose weight, that can increase 10:00 if you lose weight, that can increase your risk of gallstones, which can lead 10:02 your risk of gallstones, which can lead 10:02 your risk of gallstones, which can lead to a gallbladder infection, which can 10:04 to a gallbladder infection, which can 10:04 to a gallbladder infection, which can lead to surgery. 10:05 lead to surgery. 10:05 lead to surgery. >> Uh-huh. 10:05 >> Uh-huh. 10:05 >> Uh-huh. >> And we've had had some patients need to 10:07 >> And we've had had some patients need to 10:07 >> And we've had had some patients need to get their gallbladders taken out. But, 10:09 get their gallbladders taken out. But, 10:09 get their gallbladders taken out. But, you know, the gallstones are composed of 10:11 you know, the gallstones are composed of 10:11 you know, the gallstones are composed of what's in fat cells. So, as you those 10:13 what's in fat cells. So, as you those 10:13 what's in fat cells. So, as you those fat cells start breaking down and into 10:15 fat cells start breaking down and into 10:15 fat cells start breaking down and into the bloodstream, they can lodge in the 10:16 the bloodstream, they can lodge in the 10:16 the bloodstream, they can lodge in the gallbladder. 10:18 gallbladder. 10:18 gallbladder. And there are more serious uh side 10:19 And there are more serious uh side 10:19 And there are more serious uh side effects, which we've really hardly seen 10:21 effects, which we've really hardly seen 10:21 effects, which we've really hardly seen any of, but like pancreatitis, like any 10:23 any of, but like pancreatitis, like any 10:23 any of, but like pancreatitis, like any medication can cause inflammation of the 10:25 medication can cause inflammation of the 10:25 medication can cause inflammation of the pancreas, which can be life-threatening. 10:27 pancreas, which can be life-threatening. 10:27 pancreas, which can be life-threatening. >> Oh, wow. 10:28 >> Oh, wow. 10:28 >> Oh, wow. >> There's a theoretical risk of a a very 10:30 >> There's a theoretical risk of a a very 10:30 >> There's a theoretical risk of a a very rare type of thyroid cancer that that 10:32 rare type of thyroid cancer that that 10:32 rare type of thyroid cancer that that was seen in rat studies. It hasn't been 10:34 was seen in rat studies. It hasn't been 10:34 was seen in rat studies. It hasn't been demonstrated in humans, but there is a 10:36 demonstrated in humans, but there is a 10:36 demonstrated in humans, but there is a warning on the drug label, so we do talk 10:38 warning on the drug label, so we do talk 10:38 warning on the drug label, so we do talk with people about that. 10:39 with people about that. 10:39 with people about that. >> Sure. 10:40 >> Sure. 10:40 >> Sure. >> And those are those are the main things 10:41 >> And those are those are the main things 10:41 >> And those are those are the main things in terms of like what we what we warn 10:43 in terms of like what we what we warn 10:43 in terms of like what we what we warn people about. Then of course, we just 10:44 people about. Then of course, we just 10:44 people about. Then of course, we just talk about, you know, dosing and like, 10:46 talk about, you know, dosing and like, 10:46 talk about, you know, dosing and like, you know, what what a healthy weight 10:48 you know, what what a healthy weight 10:48 you know, what what a healthy weight loss target is. 10:50 loss target is. 10:50 loss target is. Um and you know, then [clears throat] we 10:51 Um and you know, then [clears throat] we 10:51 Um and you know, then [clears throat] we we follow our patients pretty closely. 10:53 we follow our patients pretty closely. 10:53 we follow our patients pretty closely. We want to see how they're doing and 10:54 We want to see how they're doing and 10:54 We want to see how they're doing and adjust their dose as needed. 10:56 adjust their dose as needed. 10:56 adjust their dose as needed. >> Yeah, that's what I was curious about. 10:58 >> Yeah, that's what I was curious about. 10:58 >> Yeah, that's what I was curious about. Like the following, the continue, you 11:00 Like the following, the continue, you 11:00 Like the following, the continue, you know, how the how the care is provided 11:02 know, how the how the care is provided 11:02 know, how the how the care is provided for a while they're taking the drug. 11:04 for a while they're taking the drug. 11:04 for a while they're taking the drug. Like with what frequency will you see 11:06 Like with what frequency will you see 11:06 Like with what frequency will you see the patients? 11:08 the patients? 11:08 the patients? What is an appropriate weight loss per 11:10 What is an appropriate weight loss per 11:10 What is an appropriate weight loss per week? I mean, does that really depend on 11:11 week? I mean, does that really depend on 11:11 week? I mean, does that really depend on what the their initial weight is? 11:14 what the their initial weight is? 11:14 what the their initial weight is? >> It does. I mean, on average, we're you 11:15 >> It does. I mean, on average, we're you 11:15 >> It does. I mean, on average, we're you know, 1 to 3 lb is considered a healthy
Long-term use, maintenance, and food noise 11:17 know, 1 to 3 lb is considered a healthy 11:17 know, 1 to 3 lb is considered a healthy weight. On on tirzepatide, the stronger 11:20 weight. On on tirzepatide, the stronger 11:20 weight. On on tirzepatide, the stronger medicine, we do have some people who say 11:22 medicine, we do have some people who say 11:22 medicine, we do have some people who say have like 50 plus pounds to lose and 11:23 have like 50 plus pounds to lose and 11:23 have like 50 plus pounds to lose and they'll drop like 10 or 20 lb the first 11:25 they'll drop like 10 or 20 lb the first 11:25 they'll drop like 10 or 20 lb the first month just really fast. We don't want 11:28 month just really fast. We don't want 11:28 month just really fast. We don't want that to be sustained. 11:29 that to be sustained. 11:29 that to be sustained. >> Yeah. 11:29 >> Yeah. 11:29 >> Yeah. >> But that can happen. 11:31 >> But that can happen. 11:31 >> But that can happen. But yeah, so we just don't want to up 11:32 But yeah, so we just don't want to up 11:32 But yeah, so we just don't want to up people's dose too fast. But most people 11:34 people's dose too fast. But most people 11:34 people's dose too fast. But most people don't want that cuz if if you're you're 11:36 don't want that cuz if if you're you're 11:36 don't want that cuz if if you're you're going to feel pretty miserable. 11:37 going to feel pretty miserable. 11:37 going to feel pretty miserable. >> Sure. 11:38 >> Sure. 11:38 >> Sure. >> Like if if you're not able to eat at 11:39 >> Like if if you're not able to eat at 11:39 >> Like if if you're not able to eat at all, you're you're just not going to 11:40 all, you're you're just not going to 11:40 all, you're you're just not going to feel good. So, you know, we we tend to 11:43 feel good. So, you know, we we tend to 11:43 feel good. So, you know, we we tend to it's it's just standard in medicine you 11:44 it's it's just standard in medicine you 11:44 it's it's just standard in medicine you start low and go slow and I just warn 11:46 start low and go slow and I just warn 11:46 start low and go slow and I just warn people that this is a process. It is a 11:48 people that this is a process. It is a 11:48 people that this is a process. It is a journey. You know, you're not going to 11:50 journey. You know, you're not going to 11:50 journey. You know, you're not going to get to your goal weight in a month. And 11:52 get to your goal weight in a month. And 11:52 get to your goal weight in a month. And then it's a long-term commitment to 11:54 then it's a long-term commitment to 11:54 then it's a long-term commitment to this. And you know, whether it's you 11:56 this. And you know, whether it's you 11:56 this. And you know, whether it's you know, if you reach your weight in 3 11:57 know, if you reach your weight in 3 11:57 know, if you reach your weight in 3 months or 9 months or a year, you know, 11:59 months or 9 months or a year, you know, 11:59 months or 9 months or a year, you know, this the where this drug was studied was 12:01 this the where this drug was studied was 12:01 this the where this drug was studied was actually 17 months of study periods. 12:04 actually 17 months of study periods. 12:04 actually 17 months of study periods. They they were planning on over a year 12:05 They they were planning on over a year 12:05 They they were planning on over a year to look at this. 12:06 to look at this. 12:06 to look at this. >> Uh-huh. 12:07 >> Uh-huh. 12:07 >> Uh-huh. >> And and then also to the big thing too 12:09 >> And and then also to the big thing too 12:09 >> And and then also to the big thing too is to talk about what happens when you 12:10 is to talk about what happens when you 12:10 is to talk about what happens when you get to your goal. What do you want to do 12:12 get to your goal. What do you want to do 12:12 get to your goal. What do you want to do next? Cuz if people stop these 12:14 next? Cuz if people stop these 12:14 next? Cuz if people stop these medications, statistically they are 12:16 medications, statistically they are 12:16 medications, statistically they are going to regain weight. 12:18 going to regain weight. 12:18 going to regain weight. >> Yeah, I read that normally half 12:21 >> Yeah, I read that normally half 12:21 >> Yeah, I read that normally half the patient will regain the weight back. 12:23 the patient will regain the weight back. 12:23 the patient will regain the weight back. >> Yeah, it happens very slowly. And a lot 12:25 >> Yeah, it happens very slowly. And a lot 12:25 >> Yeah, it happens very slowly. And a lot of times people will still wind up under 12:27 of times people will still wind up under 12:27 of times people will still wind up under where they were before. 12:28 where they were before. 12:28 where they were before. >> Uh-huh. 12:29 >> Uh-huh. 12:29 >> Uh-huh. >> And so we want to warn people that, you 12:30 >> And so we want to warn people that, you 12:30 >> And so we want to warn people that, you know, it's not just like anything else, 12:32 know, it's not just like anything else, 12:32 know, it's not just like anything else, there's no permanent fix, there's no 12:33 there's no permanent fix, there's no 12:33 there's no permanent fix, there's no magic bullet. 12:34 magic bullet. 12:34 magic bullet. >> Yes. 12:35 >> Yes. 12:35 >> Yes. >> We I would say it it breaks down. We do 12:37 >> We I would say it it breaks down. We do 12:37 >> We I would say it it breaks down. We do have some people that get to their goal 12:39 have some people that get to their goal 12:39 have some people that get to their goal weight and then get back to their 12:40 weight and then get back to their 12:40 weight and then get back to their healthy habits and stay there. I mean, 12:42 healthy habits and stay there. I mean, 12:42 healthy habits and stay there. I mean, that's probably the biggest minority. We 12:44 that's probably the biggest minority. We 12:44 that's probably the biggest minority. We do have some people that get to their 12:46 do have some people that get to their 12:46 do have some people that get to their goal weight, they do well for a period 12:47 goal weight, they do well for a period 12:47 goal weight, they do well for a period of time and then something comes up in 12:49 of time and then something comes up in 12:49 of time and then something comes up in their life, whether it's an illness or a 12:50 their life, whether it's an illness or a 12:50 their life, whether it's an illness or a family stressor or life stressor, and 12:53 family stressor or life stressor, and 12:53 family stressor or life stressor, and they'll they'll call us back and be 12:54 they'll they'll call us back and be 12:54 they'll they'll call us back and be like, "Hey, you know, I was I was doing 12:55 like, "Hey, you know, I was I was doing 12:55 like, "Hey, you know, I was I was doing great for 3 months, but can I get back 12:57 great for 3 months, but can I get back 12:57 great for 3 months, but can I get back on for a month or two?" 12:58 on for a month or two?" 12:58 on for a month or two?" >> Uh-huh. 12:59 >> Uh-huh. 12:59 >> Uh-huh. >> And so they cycle a little bit, which is 13:00 >> And so they cycle a little bit, which is 13:00 >> And so they cycle a little bit, which is fine. And then other people just really 13:02 fine. And then other people just really 13:02 fine. And then other people just really feel so much better on the medication 13:04 feel so much better on the medication 13:04 feel so much better on the medication that they just want to stay on it and 13:06 that they just want to stay on it and 13:06 that they just want to stay on it and then we just work them to a a 13:07 then we just work them to a a 13:07 then we just work them to a a maintenance dose, like a lower dose, 13:09 maintenance dose, like a lower dose, 13:09 maintenance dose, like a lower dose, maybe a more affordable medication. 13:11 maybe a more affordable medication. 13:11 maybe a more affordable medication. And what what people really find that 13:13 And what what people really find that 13:13 And what what people really find that the benefit is, that's hard to explain 13:15 the benefit is, that's hard to explain 13:15 the benefit is, that's hard to explain it to you if you've experienced it, is 13:16 it to you if you've experienced it, is 13:16 it to you if you've experienced it, is the the lack of food noise or cravings. 13:19 the the lack of food noise or cravings. 13:19 the the lack of food noise or cravings. >> Yeah. 13:19 >> Yeah. 13:19 >> Yeah. >> Cuz when you're living that life all the 13:21 >> Cuz when you're living that life all the 13:22 >> Cuz when you're living that life all the time, you don't think about it, but 13:23 time, you don't think about it, but 13:23 time, you don't think about it, but people get very food stressed. I know 13:25 people get very food stressed. I know 13:25 people get very food stressed. I know that was an issue for me when I was 13:26 that was an issue for me when I was 13:26 that was an issue for me when I was working night shifts in the ER. I 13:28 working night shifts in the ER. I 13:28 working night shifts in the ER. I thought I'd always feel hungry cuz I was 13:29 thought I'd always feel hungry cuz I was 13:29 thought I'd always feel hungry cuz I was you know, using calories to get some 13:31 you know, using calories to get some 13:31 you know, using calories to get some energy. 13:31 energy. 13:31 energy. >> Sure. 13:32 >> Sure. 13:32 >> Sure. >> And and when I started I personally take 13:34 >> And and when I started I personally take 13:34 >> And and when I started I personally take the medication and when I started I did 13:35 the medication and when I started I did 13:35 the medication and when I started I did that that noise just went away and I was 13:37 that that noise just went away and I was 13:37 that that noise just went away and I was like, "Wow, that was really like a big 13:38 like, "Wow, that was really like a big 13:38 like, "Wow, that was really like a big part of the background thinking in my 13:40 part of the background thinking in my 13:40 part of the background thinking in my life." And now it's gone and it's really 13:42 life." And now it's gone and it's really 13:42 life." And now it's gone and it's really nice. 13:43 nice. 13:43 nice. >> Yeah. 13:43 >> Yeah. 13:43 >> Yeah. >> And so and that helps with other things 13:45 >> And so and that helps with other things 13:45 >> And so and that helps with other things beyond food, too. People have used it to 13:47 beyond food, too. People have used it to 13:47 beyond food, too. People have used it to cut back on alcohol use. That's being 13:48 cut back on alcohol use. That's being 13:48 cut back on alcohol use. That's being studied. 13:49 studied. 13:49 studied. >> That's fascinating. 13:50 >> That's fascinating. 13:50 >> That's fascinating. >> Yeah, and so I don't I don't think 13:52 >> Yeah, and so I don't I don't think 13:52 >> Yeah, and so I don't I don't think there'll ever be a true like just take 13:54 there'll ever be a true like just take 13:54 there'll ever be a true like just take this pill or shot to get get off booze, 13:57 this pill or shot to get get off booze, 13:57 this pill or shot to get get off booze, but we do have people that cut way back 13:59 but we do have people that cut way back 13:59 but we do have people that cut way back on their alcohol use and part of it is 14:01 on their alcohol use and part of it is 14:01 on their alcohol use and part of it is the mental craving and part of it is the 14:02 the mental craving and part of it is the 14:03 the mental craving and part of it is the physical amount that you just can't 14:04 physical amount that you just can't 14:04 physical amount that you just can't drink a bottle of wine on a GLP-1 cuz 14:07 drink a bottle of wine on a GLP-1 cuz 14:07 drink a bottle of wine on a GLP-1 cuz your stomach's going to you're going to 14:08 your stomach's going to you're going to 14:08 your stomach's going to you're going to feel terrible. 14:09 feel terrible. 14:09 feel terrible. >> Wow. 14:10 >> Wow. 14:10 >> Wow. Now that you're talking about, you know, 14:12 Now that you're talking about, you know, 14:12 Now that you're talking about, you know, all these, you know, the psychological 14:15 all these, you know, the psychological 14:15 all these, you know, the psychological benefits of not feeling that noise that
Lifestyle support and follow-up care 14:17 benefits of not feeling that noise that 14:17 benefits of not feeling that noise that food that food noise and the fact that 14:20 food that food noise and the fact that 14:20 food that food noise and the fact that it can help with people who have 14:21 it can help with people who have 14:21 it can help with people who have addiction to alcohol, can you tell us a 14:23 addiction to alcohol, can you tell us a 14:23 addiction to alcohol, can you tell us a little bit about how they work? I think 14:25 little bit about how they work? I think 14:25 little bit about how they work? I think I find it fascinating. 14:27 I find it fascinating. 14:27 I find it fascinating. What's going on metabolically in our in 14:29 What's going on metabolically in our in 14:29 What's going on metabolically in our in our body when we take these drugs? 14:31 our body when we take these drugs? 14:31 our body when we take these drugs? What's going on? 14:32 What's going on? 14:32 What's going on? >> Yeah, so the GLP stands for 14:34 >> Yeah, so the GLP stands for 14:34 >> Yeah, so the GLP stands for glucagon-like peptide and it's mimicking 14:37 glucagon-like peptide and it's mimicking 14:37 glucagon-like peptide and it's mimicking a natural hormone or peptide, I'm sorry, 14:40 a natural hormone or peptide, I'm sorry, 14:40 a natural hormone or peptide, I'm sorry, that your body produces. So every time 14:41 that your body produces. So every time 14:41 that your body produces. So every time you eat in your small intestine you 14:43 you eat in your small intestine you 14:43 you eat in your small intestine you release GLP-1. And that's basically 14:45 release GLP-1. And that's basically 14:45 release GLP-1. And that's basically telling your body that you're full. So 14:47 telling your body that you're full. So 14:47 telling your body that you're full. So it it signals to your stomach, "Hey, 14:49 it it signals to your stomach, "Hey, 14:49 it it signals to your stomach, "Hey, slow down. We're good." Signals to your 14:50 slow down. We're good." Signals to your 14:51 slow down. We're good." Signals to your brain, "We don't need any more food." 14:53 brain, "We don't need any more food." 14:53 brain, "We don't need any more food." Unfortunately, that that peptide, the 14:55 Unfortunately, that that peptide, the 14:55 Unfortunately, that that peptide, the naturally occurring one, only lasts for 14:56 naturally occurring one, only lasts for 14:56 naturally occurring one, only lasts for a few minutes. So what's there's kind of 14:59 a few minutes. So what's there's kind of 14:59 a few minutes. So what's there's kind of some fun trivia about the GLP-1s that it 15:01 some fun trivia about the GLP-1s that it 15:01 some fun trivia about the GLP-1s that it was actually derived from Gila monster 15:03 was actually derived from Gila monster 15:03 was actually derived from Gila monster um 15:04 um 15:04 um GLP-1. And so Gila monsters are these 15:06 GLP-1. And so Gila monsters are these 15:06 GLP-1. And so Gila monsters are these like lizard creatures that live in this 15:08 like lizard creatures that live in this 15:08 like lizard creatures that live in this American Southwest. 15:09 American Southwest. 15:09 American Southwest. >> Uh-huh. 15:10 >> Uh-huh. 15:10 >> Uh-huh. >> And they only eat, you know, once or 15:11 >> And they only eat, you know, once or 15:11 >> And they only eat, you know, once or twice a month. So they have a GLP-1 that 15:13 twice a month. So they have a GLP-1 that 15:14 twice a month. So they have a GLP-1 that lasts a lot longer. 15:15 lasts a lot longer. 15:15 lasts a lot longer. And so it the 15:17 And so it the 15:17 And so it the the the molecule that was isolated is 15:20 the the molecule that was isolated is 15:20 the the molecule that was isolated is called exenatide exenatide. I may be 15:22 called exenatide exenatide. I may be 15:23 called exenatide exenatide. I may be saying it wrong. And that turned into 15:24 saying it wrong. And that turned into 15:24 saying it wrong. And that turned into exenatide, which was the first GLP-1 15:27 exenatide, which was the first GLP-1 15:27 exenatide, which was the first GLP-1 that was released in 2005. So, it's a 15:29 that was released in 2005. So, it's a 15:29 that was released in 2005. So, it's a derivative of this Gila monster GLP-1. 15:32 derivative of this Gila monster GLP-1. 15:32 derivative of this Gila monster GLP-1. And so, that they found a way to make it 15:34 And so, that they found a way to make it 15:34 And so, that they found a way to make it last longer. 15:35 last longer. 15:35 last longer. >> Oh, interesting. 15:36 >> Oh, interesting. 15:36 >> Oh, interesting. >> And so, what when you do this, it's not 15:37 >> And so, what when you do this, it's not 15:37 >> And so, what when you do this, it's not a natural thing that you're taking. 15:39 a natural thing that you're taking. 15:39 a natural thing that you're taking. Like, tirzepatide is not something your 15:40 Like, tirzepatide is not something your 15:40 Like, tirzepatide is not something your body naturally makes. It's it's a 15:42 body naturally makes. It's it's a 15:42 body naturally makes. It's it's a synthetic version of your natural GLP-1 15:44 synthetic version of your natural GLP-1 15:44 synthetic version of your natural GLP-1 that's designed to last longer in your 15:46 that's designed to last longer in your 15:46 that's designed to last longer in your body. So, it resists getting broken down 15:48 body. So, it resists getting broken down 15:48 body. So, it resists getting broken down by other proteins. 15:50 by other proteins. 15:50 by other proteins. And so, that's why that feeling of full 15:52 And so, that's why that feeling of full 15:52 And so, that's why that feeling of full fullness like lasts longer than a few 15:54 fullness like lasts longer than a few 15:54 fullness like lasts longer than a few minutes. Like, it 15:55 minutes. Like, it 15:55 minutes. Like, it >> I see. 15:56 >> I see. 15:56 >> I see. And how long can that last then? I guess 15:58 And how long can that last then? I guess 15:58 And how long can that last then? I guess it depends on the doses, but 16:00 it depends on the doses, but 16:00 it depends on the doses, but >> Yeah, I mean, well, for these weekly 16:01 >> Yeah, I mean, well, for these weekly 16:01 >> Yeah, I mean, well, for these weekly medications, you know, the half-life is 16:03 medications, you know, the half-life is 16:03 medications, you know, the half-life is between 5 and 7 days. So, you take the 16:05 between 5 and 7 days. So, you take the 16:05 between 5 and 7 days. So, you take the medication, you have a kind of lower 16:07 medication, you have a kind of lower 16:07 medication, you have a kind of lower level of GLP-1 that's circulating. So, I 16:10 level of GLP-1 that's circulating. So, I 16:10 level of GLP-1 that's circulating. So, I I think that's where people also don't 16:11 I think that's where people also don't 16:11 I think that's where people also don't get those food noises cuz their brain's 16:13 get those food noises cuz their brain's 16:13 get those food noises cuz their brain's being told, "Hey, it's okay. It's okay." 16:16 being told, "Hey, it's okay. It's okay." 16:16 being told, "Hey, it's okay. It's okay." And one of the big misconceptions with 16:17 And one of the big misconceptions with 16:17 And one of the big misconceptions with GLP-1s is you you can still eat and 16:19 GLP-1s is you you can still eat and 16:19 GLP-1s is you you can still eat and enjoy food. It doesn't affect taste or, 16:21 enjoy food. It doesn't affect taste or, 16:21 enjoy food. It doesn't affect taste or, you know, going out with friends or 16:23 you know, going out with friends or 16:23 you know, going out with friends or having a glass of wine. Like, those 16:24 having a glass of wine. Like, those 16:24 having a glass of wine. Like, those things are all 16:25 things are all 16:25 things are all totally back to normal. You're just not 16:27 totally back to normal. You're just not 16:27 totally back to normal. You're just not going to have as much. Like, what I 16:29 going to have as much. Like, what I 16:29 going to have as much. Like, what I often tell patients is you're going to 16:30 often tell patients is you're going to 16:30 often tell patients is you're going to start bringing take-home bags from a 16:32 start bringing take-home bags from a 16:32 start bringing take-home bags from a restaurant or maybe you just split an 16:33 restaurant or maybe you just split an 16:33 restaurant or maybe you just split an entree with your spouse. You just don't 16:35 entree with your spouse. You just don't 16:35 entree with your spouse. You just don't need as much to feel full. 16:38 need as much to feel full. 16:38 need as much to feel full. And that's the biggest change. And and 16:39 And that's the biggest change. And and 16:39 And that's the biggest change. And and and it's it's just really simple. I 16:40 and it's it's just really simple. I 16:41 and it's it's just really simple. I mean, if you're taking in half as much 16:42 mean, if you're taking in half as much 16:42 mean, if you're taking in half as much calories, you know, to use a rough 16:43 calories, you know, to use a rough 16:43 calories, you know, to use a rough number, then you're going to on average 16:45 number, then you're going to on average 16:45 number, then you're going to on average lose weight. 16:46 lose weight. 16:46 lose weight. >> Sure, of course. 16:48 >> Sure, of course. 16:48 >> Sure, of course. Now, when someone begins these the this 16:51 Now, when someone begins these the this 16:51 Now, when someone begins these the this medication, what are some lifestyle 16:54 medication, what are some lifestyle 16:54 medication, what are some lifestyle interventions that should be maintained? 16:56 interventions that should be maintained? 16:56 interventions that should be maintained? I mean, for example, exercise, 16:59 I mean, for example, exercise, 16:59 I mean, for example, exercise, proper hydration, you know, managing 17:01 proper hydration, you know, managing 17:01 proper hydration, you know, managing stress, sleep. Like, where I mean, as a 17:03 stress, sleep. Like, where I mean, as a 17:04 stress, sleep. Like, where I mean, as a health and wellness coach, you know, I 17:05 health and wellness coach, you know, I 17:05 health and wellness coach, you know, I cannot not wonder about, you know, what 17:07 cannot not wonder about, you know, what 17:07 cannot not wonder about, you know, what are these other how these other 17:08 are these other how these other 17:08 are these other how these other interventions come into play just to 17:10 interventions come into play just to 17:10 interventions come into play just to make sure that, you know, health and 17:11 make sure that, you know, health and 17:11 make sure that, you know, health and wellness is maintained and we're just 17:13 wellness is maintained and we're just 17:13 wellness is maintained and we're just not relying on a you know, as you say, a 17:15 not relying on a you know, as you say, a 17:15 not relying on a you know, as you say, a magic pill pill, a miracle drug to kind 17:18 magic pill pill, a miracle drug to kind 17:18 magic pill pill, a miracle drug to kind of do all the work for us. Like what's 17:19 of do all the work for us. Like what's 17:19 of do all the work for us. Like what's the work that the patient still should 17:21 the work that the patient still should 17:21 the work that the patient still should do? 17:22 do? 17:22 do? >> Yeah, absolutely. I mean those are 17:23 >> Yeah, absolutely. I mean those are 17:23 >> Yeah, absolutely. I mean those are really important things for, you know, 17:25 really important things for, you know, 17:25 really important things for, you know, body weight and as well as long-term 17:27 body weight and as well as long-term 17:27 body weight and as well as long-term health. We we do offer nutritionists 17:30 health. We we do offer nutritionists 17:30 health. We we do offer nutritionists people want to work on their nutrition 17:32 people want to work on their nutrition 17:32 people want to work on their nutrition cuz you know, for some people that might 17:33 cuz you know, for some people that might 17:33 cuz you know, for some people that might be their weakness is just I just don't 17:34 be their weakness is just I just don't 17:34 be their weakness is just I just don't eat healthy. I need some planning on 17:36 eat healthy. I need some planning on 17:36 eat healthy. I need some planning on that. The biggest thing that we worry 17:38 that. The biggest thing that we worry 17:38 that. The biggest thing that we worry about with the medication is that as 17:40 about with the medication is that as 17:40 about with the medication is that as you're losing weight you can lose muscle 17:42 you're losing weight you can lose muscle 17:42 you're losing weight you can lose muscle because your body is if it needs 17:43 because your body is if it needs 17:43 because your body is if it needs calories it's going to scrounge wherever 17:44 calories it's going to scrounge wherever 17:45 calories it's going to scrounge wherever it can get. And so, you know, obviously 17:46 it can get. And so, you know, obviously 17:46 it can get. And so, you know, obviously it'll start with body fat but it's also 17:48 it'll start with body fat but it's also 17:48 it'll start with body fat but it's also going to pull 17:49 going to pull 17:49 going to pull >> lean muscle mass 17:50 >> lean muscle mass 17:50 >> lean muscle mass >> Yes. And so, that's something we can 17:51 >> Yes. And so, that's something we can 17:51 >> Yes. And so, that's something we can track and then we also really encourage 17:54 track and then we also really encourage 17:54 track and then we also really encourage our patients to start, you know, 17:55 our patients to start, you know, 17:55 our patients to start, you know, exercising if they aren't already. The 17:57 exercising if they aren't already. The 17:57 exercising if they aren't already. The nice thing is naturally as people start 17:58 nice thing is naturally as people start 17:58 nice thing is naturally as people start to feel better they start moving more 18:01 to feel better they start moving more 18:01 to feel better they start moving more which is a great benefit of the 18:02 which is a great benefit of the 18:02 which is a great benefit of the medication. It's like, you know, if say 18:03 medication. It's like, you know, if say 18:03 medication. It's like, you know, if say someone who's, you know, very large like 18:05 someone who's, you know, very large like 18:05 someone who's, you know, very large like they just every time they get off the 18:07 they just every time they get off the 18:07 they just every time they get off the couch it hurts. Like it's physically 18:08 couch it hurts. Like it's physically 18:09 couch it hurts. Like it's physically painful for them and that pain's going 18:11 painful for them and that pain's going 18:11 painful for them and that pain's going to go down, you know, as as they lose 18:13 to go down, you know, as as they lose 18:13 to go down, you know, as as they lose weight. In fact, the medication's being 18:15 weight. In fact, the medication's being 18:15 weight. In fact, the medication's being studied for like osteoarthritis, that 18:17 studied for like osteoarthritis, that 18:17 studied for like osteoarthritis, that sort of thing to help with that benefit. 18:20 sort of thing to help with that benefit. 18:20 sort of thing to help with that benefit. And so, people do want to do that but we 18:21 And so, people do want to do that but we 18:21 And so, people do want to do that but we obviously encourage them and and we have 18:23 obviously encourage them and and we have 18:23 obviously encourage them and and we have an education program we use at our 18:25 an education program we use at our 18:25 an education program we use at our clinic but, you know, it's like here's 18:27 clinic but, you know, it's like here's 18:27 clinic but, you know, it's like here's straight some strength exercises and 18:29 straight some strength exercises and 18:29 straight some strength exercises and here's what you need for your long-term 18:30 here's what you need for your long-term 18:30 here's what you need for your long-term health. Sleep is obviously is important. 18:32 health. Sleep is obviously is important. 18:32 health. Sleep is obviously is important. I mean that's like the most underrated 18:34 I mean that's like the most underrated 18:34 I mean that's like the most underrated thing for anything I think in longevity 18:35 thing for anything I think in longevity 18:36 thing for anything I think in longevity is just getting sleep and it's so hard 18:37 is just getting sleep and it's so hard 18:37 is just getting sleep and it's so hard right now with social media and, you 18:39 right now with social media and, you 18:40 right now with social media and, you know, the world and doom scrolling and 18:41 know, the world and doom scrolling and 18:41 know, the world and doom scrolling and stress and something I struggle with a 18:43 stress and something I struggle with a 18:43 stress and something I struggle with a lot. 18:44 lot. 18:44 lot. >> Yeah, it's something I most coach on is 18:45 >> Yeah, it's something I most coach on is 18:45 >> Yeah, it's something I most coach on is a Yeah, it's very common just to suffer 18:48 a Yeah, it's very common just to suffer 18:48 a Yeah, it's very common just to suffer from lack of sleep. Yeah. So, there's a 18:50 from lack of sleep. Yeah. So, there's a 18:50 from lack of sleep. Yeah. So, there's a lot of things that you're recommending 18:52 lot of things that you're recommending 18:52 lot of things that you're recommending your patients to do. 18:54 your patients to do. 18:54 your patients to do. >> Yeah, and we check in with them monthly. 18:56 >> Yeah, and we check in with them monthly. 18:56 >> Yeah, and we check in with them monthly. I mean 18:56 I mean 18:56 I mean >> monthly 18:56 >> monthly 18:56 >> monthly >> We're at slightly different model, you 18:58 >> We're at slightly different model, you 18:58 >> We're at slightly different model, you know, where it's a concierge level so 19:00 know, where it's a concierge level so 19:00 know, where it's a concierge level so it's we want to hear from our people. Um 19:03 it's we want to hear from our people. Um 19:03 it's we want to hear from our people. Um you know, every place does a little bit 19:04 you know, every place does a little bit 19:04 you know, every place does a little bit differently but 19:06 differently but 19:06 differently but you know, it's it's 19:07 you know, it's it's 19:07 you know, it's it's it's a journey so it's going to take 19:09 it's a journey so it's going to take 19:09 it's a journey so it's going to take time. It's going to take adjustments. 19:11 time. It's going to take adjustments. 19:11 time. It's going to take adjustments. What I I say in the in this community 19:13 What I I say in the in this community 19:13 What I I say in the in this community that people tend to know what they need 19:14 that people tend to know what they need 19:14 that people tend to know what they need to do. You know, it's they know where 19:16 to do. You know, it's they know where 19:16 to do. You know, it's they know where they slipped up and and so it's it's 19:19 they slipped up and and so it's it's 19:19 they slipped up and and so it's it's less of an issue that thought, but it's 19:20 less of an issue that thought, but it's 19:20 less of an issue that thought, but it's always good to remind folks, you know, 19:21 always good to remind folks, you know, 19:21 always good to remind folks, you know, it it takes sometimes it takes a little 19:23 it it takes sometimes it takes a little 19:23 it it takes sometimes it takes a little like push to hey, just all right, how 19:24 like push to hey, just all right, how 19:24 like push to hey, just all right, how are you doing with this or looks like 19:26 are you doing with this or looks like 19:26 are you doing with this or looks like you lost some muscle mass. How can we 19:28 you lost some muscle mass. How can we 19:28 you lost some muscle mass. How can we work on that? You know, we want to keep 19:29 work on that? You know, we want to keep 19:29 work on that? You know, we want to keep you healthy. You know, the last thing
Stopping treatment and weight regain 19:30 you healthy. You know, the last thing 19:30 you healthy. You know, the last thing you want to do is 19:32 you want to do is 19:32 you want to do is feel great and be back to your, you 19:33 feel great and be back to your, you 19:33 feel great and be back to your, you know, regular clothes that fit, but be 19:35 know, regular clothes that fit, but be 19:35 know, regular clothes that fit, but be an unhealthy person. We don't want that. 19:37 an unhealthy person. We don't want that. 19:37 an unhealthy person. We don't want that. >> Sure. 19:42 Is there any kind of counseling that 19:42 Is there any kind of counseling that goes on with these patients? Just like I 19:46 goes on with these patients? Just like I 19:46 goes on with these patients? Just like I don't know, psychological counseling 19:47 don't know, psychological counseling 19:47 don't know, psychological counseling about body image, about body weight. 19:49 about body image, about body weight. 19:49 about body image, about body weight. Does that tend to accompany this process 19:52 Does that tend to accompany this process 19:52 Does that tend to accompany this process at all? For those who have suffered for 19:54 at all? For those who have suffered for 19:54 at all? For those who have suffered for being overweight or obese? 19:56 being overweight or obese? 19:56 being overweight or obese? >> Well, you hear a lot about how it 19:57 >> Well, you hear a lot about how it 19:57 >> Well, you hear a lot about how it affects marriages. 19:58 affects marriages. 19:58 affects marriages. As one person gets healthy, it really 20:00 As one person gets healthy, it really 20:00 As one person gets healthy, it really changes the dynamic. In fact, we have a 20:01 changes the dynamic. In fact, we have a 20:02 changes the dynamic. In fact, we have a lot of people that come in that will 20:03 lot of people that come in that will 20:03 lot of people that come in that will start with us and then bring their 20:04 start with us and then bring their 20:04 start with us and then bring their spouse in like 3 to 6 months later. 20:06 spouse in like 3 to 6 months later. 20:06 spouse in like 3 to 6 months later. >> Oh, interesting. 20:07 >> Oh, interesting. 20:07 >> Oh, interesting. >> Cuz I mean, you know, if for folks that 20:08 >> Cuz I mean, you know, if for folks that 20:08 >> Cuz I mean, you know, if for folks that really struggle with obesity, I mean, it 20:10 really struggle with obesity, I mean, it 20:10 really struggle with obesity, I mean, it really affects every aspect of their 20:11 really affects every aspect of their 20:11 really affects every aspect of their life and when when those things get 20:13 life and when when those things get 20:13 life and when when those things get changed, like they're obviously going to 20:15 changed, like they're obviously going to 20:15 changed, like they're obviously going to feel a lot better and want to change 20:16 feel a lot better and want to change 20:16 feel a lot better and want to change other things in their in their life. 20:18 other things in their in their life. 20:18 other things in their in their life. >> Uh-huh. 20:19 >> Uh-huh. 20:19 >> Uh-huh. Can you think of any, you know, 20:21 Can you think of any, you know, 20:21 Can you think of any, you know, obviously without any names, but like 20:23 obviously without any names, but like 20:23 obviously without any names, but like any stories that have really inspired 20:25 any stories that have really inspired 20:25 any stories that have really inspired you or that have really shown like the 20:26 you or that have really shown like the 20:26 you or that have really shown like the power of these drip this medication of 20:29 power of these drip this medication of 20:29 power of these drip this medication of how it can really transform a life? 20:32 how it can really transform a life? 20:32 how it can really transform a life? >> There's been a couple. I mean, one that 20:34 >> There's been a couple. I mean, one that 20:34 >> There's been a couple. I mean, one that comes up repeatedly is for like one of 20:35 comes up repeatedly is for like one of 20:35 comes up repeatedly is for like one of my first patients had a hip injury and 20:37 my first patients had a hip injury and 20:37 my first patients had a hip injury and it gained a fair bit of weight. She was 20:39 it gained a fair bit of weight. She was 20:39 it gained a fair bit of weight. She was younger 20:40 younger 20:40 younger and and she couldn't get her surgery cuz 20:42 and and she couldn't get her surgery cuz 20:42 and and she couldn't get her surgery cuz she was too overweight and she's like, 20:43 she was too overweight and she's like, 20:43 she was too overweight and she's like, I'm in this catch-22 where I want to 20:45 I'm in this catch-22 where I want to 20:45 I'm in this catch-22 where I want to exercise, but it's painful. I can't. And 20:48 exercise, but it's painful. I can't. And 20:48 exercise, but it's painful. I can't. And I can't get this fixed that I need cuz 20:49 I can't get this fixed that I need cuz 20:49 I can't get this fixed that I need cuz I'm too heavy now. And so she she was 20:52 I'm too heavy now. And so she she was 20:52 I'm too heavy now. And so she she was successful getting back to the weight 20:53 successful getting back to the weight 20:54 successful getting back to the weight that she needed to do to get her surgery 20:55 that she needed to do to get her surgery 20:55 that she needed to do to get her surgery and and then was fine afterwards and 20:57 and and then was fine afterwards and 20:57 and and then was fine afterwards and now, you know, she's not on the 20:58 now, you know, she's not on the 20:58 now, you know, she's not on the medication anymore. 21:00 medication anymore. 21:00 medication anymore. >> She's not on it. 21:01 >> She's not on it. 21:01 >> She's not on it. >> And I had a consult today with the same 21:03 >> And I had a consult today with the same 21:03 >> And I had a consult today with the same story, an older patient who's in the 21:04 story, an older patient who's in the 21:04 story, an older patient who's in the same situation. I've just, you know, 21:06 same situation. I've just, you know, 21:06 same situation. I've just, you know, injury, can't, you know, if you think 21:08 injury, can't, you know, if you think 21:08 injury, can't, you know, if you think about it, if you hurt your knee or hip, 21:10 about it, if you hurt your knee or hip, 21:10 about it, if you hurt your knee or hip, it's usually the hips that I hear a lot 21:11 it's usually the hips that I hear a lot 21:11 it's usually the hips that I hear a lot about. You can't, you know, aside from 21:13 about. You can't, you know, aside from 21:13 about. You can't, you know, aside from swimming, you're pretty limited on what 21:14 swimming, you're pretty limited on what 21:14 swimming, you're pretty limited on what you can do for cardiovascular activity, 21:17 you can do for cardiovascular activity, 21:17 you can do for cardiovascular activity, and and getting back down is is a goal 21:19 and and getting back down is is a goal 21:19 and and getting back down is is a goal for them. 21:21 for them. 21:21 for them. >> And um so, once they get down to that 21:24 >> And um so, once they get down to that 21:24 >> And um so, once they get down to that weight that they need in order to get 21:25 weight that they need in order to get 21:25 weight that they need in order to get that surgery in order to, you know, 21:27 that surgery in order to, you know, 21:27 that surgery in order to, you know, enhance that mobility again, do they 21:29 enhance that mobility again, do they 21:29 enhance that mobility again, do they stay off the drug? What usually happens 21:31 stay off the drug? What usually happens 21:31 stay off the drug? What usually happens afterwards? 21:32 afterwards? 21:32 afterwards? >> It's it's really individualized when 21:33 >> It's it's really individualized when 21:33 >> It's it's really individualized when people get to their goal. Yeah, that's 21:35 people get to their goal. Yeah, that's 21:35 people get to their goal. Yeah, that's like 21:36 like 21:36 like we want to talk want to talk with people 21:38 we want to talk want to talk with people 21:38 we want to talk want to talk with people about like what they're what how they're 21:39 about like what they're what how they're 21:39 about like what they're what how they're feeling, what they want to try. I mean, 21:41 feeling, what they want to try. I mean, 21:42 feeling, what they want to try. I mean, I always encourage people if they're up 21:43 I always encourage people if they're up 21:43 I always encourage people if they're up for it to try 21:44 for it to try 21:44 for it to try weaning off the medication and see how 21:46 weaning off the medication and see how 21:46 weaning off the medication and see how they feel. 21:47 they feel. 21:47 they feel. >> Uh-huh. 21:47 >> Uh-huh. 21:47 >> Uh-huh. >> Um cuz if you don't need it, then you 21:48 >> Um cuz if you don't need it, then you 21:49 >> Um cuz if you don't need it, then you don't need it. 21:49 don't need it. 21:49 don't need it. >> Yeah. 21:50 >> Yeah. 21:50 >> Yeah. >> And it but I I mean, it's hard to know 21:52 >> And it but I I mean, it's hard to know 21:52 >> And it but I I mean, it's hard to know exactly, but I I I've sort of split it 21:54 exactly, but I I I've sort of split it 21:54 exactly, but I I I've sort of split it up into thirds. Like when I tell people 21:55 up into thirds. Like when I tell people 21:55 up into thirds. Like when I tell people this, like a third of people will stop 21:57 this, like a third of people will stop 21:57 this, like a third of people will stop and stay off of it, a third of people 21:58 and stay off of it, a third of people 21:58 and stay off of it, a third of people will cycle, a third of people will stay 22:01 will cycle, a third of people will stay 22:01 will cycle, a third of people will stay on it. I think that's probably a little 22:02 on it. I think that's probably a little 22:02 on it. I think that's probably a little bit higher that than a third that people 22:03 bit higher that than a third that people 22:03 bit higher that than a third that people will want to stay on it just as 22:04 will want to stay on it just as 22:05 will want to stay on it just as >> maintenance. 22:05 >> maintenance. 22:05 >> maintenance. >> Sure. 22:06 >> Sure. 22:06 >> Sure. >> Just cuz they're feeling better, you 22:07 >> Just cuz they're feeling better, you 22:07 >> Just cuz they're feeling better, you know, they they've gotten to where they 22:08 know, they they've gotten to where they 22:08 know, they they've gotten to where they want to be. Maybe they tried stopping it 22:10 want to be. Maybe they tried stopping it 22:10 want to be. Maybe they tried stopping it for a month and those food cravings came 22:12 for a month and those food cravings came 22:12 for a month and those food cravings came back and they started gaining weight 22:13 back and they started gaining weight 22:13 back and they started gaining weight again. 22:15 again. 22:15 again. >> Yeah. 22:16 >> Yeah. 22:16 >> Yeah. And for those who are able to who who 22:18 And for those who are able to who who 22:18 And for those who are able to who who are in that third that are able to stop 22:21 are in that third that are able to stop 22:21 are in that third that are able to stop the taking the drug altogether, like 22:23 the taking the drug altogether, like 22:23 the taking the drug altogether, like what are they doing in their time in 22:25 what are they doing in their time in 22:25 what are they doing in their time in terms of their lifestyle in order to 22:28 terms of their lifestyle in order to 22:28 terms of their lifestyle in order to keep that weight off and not need the 22:29 keep that weight off and not need the 22:29 keep that weight off and not need the drug anymore? 22:31 drug anymore? 22:31 drug anymore? >> Um that's a good question. You know, I I 22:32 >> Um that's a good question. You know, I I 22:32 >> Um that's a good question. You know, I I I don't hear from them that often cuz 22:34 I don't hear from them that often cuz 22:34 I don't hear from them that often cuz cuz you have to miss it. 22:35 cuz you have to miss it. 22:35 cuz you have to miss it. >> Yes. 22:35 >> Yes. 22:36 >> Yes. >> But I think I mean, what I think they're 22:37 >> But I think I mean, what I think they're 22:37 >> But I think I mean, what I think they're doing is just getting back to where they 22:38 doing is just getting back to where they 22:38 doing is just getting back to where they were like in terms of activity level. I
Metabolic health, inflammation, and future outlook 22:40 were like in terms of activity level. I 22:40 were like in terms of activity level. I mean, I hear from a lot of patients, I 22:41 mean, I hear from a lot of patients, I 22:41 mean, I hear from a lot of patients, I just need a boost. I need a kick-start 22:43 just need a boost. I need a kick-start 22:43 just need a boost. I need a kick-start to get where I want to be. And that's 22:44 to get where I want to be. And that's 22:44 to get where I want to be. And that's part of your body's, you know, how it 22:46 part of your body's, you know, how it 22:46 part of your body's, you know, how it functions at homeostasis where it wants 22:48 functions at homeostasis where it wants 22:48 functions at homeostasis where it wants to stay the same. And that's been looked 22:50 to stay the same. And that's been looked 22:50 to stay the same. And that's been looked at like in the the biggest loser TV 22:52 at like in the the biggest loser TV 22:52 at like in the the biggest loser TV show, they did a big trial or big study 22:54 show, they did a big trial or big study 22:54 show, they did a big trial or big study and they looked at those folks that lost 22:56 and they looked at those folks that lost 22:56 and they looked at those folks that lost like tremendous amount of weight, but 22:57 like tremendous amount of weight, but 22:57 like tremendous amount of weight, but their body's metabolism really slowed 22:59 their body's metabolism really slowed 22:59 their body's metabolism really slowed down and it wasn't reversible. And so, 23:02 down and it wasn't reversible. And so, 23:02 down and it wasn't reversible. And so, it becomes really hard, especially as 23:03 it becomes really hard, especially as 23:03 it becomes really hard, especially as you're cycling between overweight and 23:05 you're cycling between overweight and 23:05 you're cycling between overweight and regular weight, your your metabolism is 23:07 regular weight, your your metabolism is 23:07 regular weight, your your metabolism is always keeping score of that. And so it 23:09 always keeping score of that. And so it 23:09 always keeping score of that. And so it does take some time to reset that if 23:11 does take some time to reset that if 23:11 does take some time to reset that if that's even possible. 23:13 that's even possible. 23:13 that's even possible. And so, you know, it takes a lot of 23:14 And so, you know, it takes a lot of 23:14 And so, you know, it takes a lot of discipline. I tell people it's easy to 23:16 discipline. I tell people it's easy to 23:16 discipline. I tell people it's easy to lose weight on this medication, it's 23:17 lose weight on this medication, it's 23:17 lose weight on this medication, it's hard to stop and keep it off, but you 23:19 hard to stop and keep it off, but you 23:19 hard to stop and keep it off, but you should know that going in cuz, you know, 23:21 should know that going in cuz, you know, 23:21 should know that going in cuz, you know, we'll be having this conversation in, 23:23 we'll be having this conversation in, 23:23 we'll be having this conversation in, you know, 3 months, 6 months, a year. 23:25 you know, 3 months, 6 months, a year. 23:25 you know, 3 months, 6 months, a year. This is that, you know, what do you want 23:26 This is that, you know, what do you want 23:26 This is that, you know, what do you want to do now, but knowing that the if you 23:29 to do now, but knowing that the if you 23:29 to do now, but knowing that the if you want to stop and get off of it, all all 23:30 want to stop and get off of it, all all 23:30 want to stop and get off of it, all all those benefits of the mental and and the 23:33 those benefits of the mental and and the 23:33 those benefits of the mental and and the gut systems slowing down are going to 23:35 gut systems slowing down are going to 23:35 gut systems slowing down are going to are going to go away. 23:36 are going to go away. 23:36 are going to go away. But I think with a lot of I mean, there 23:38 But I think with a lot of I mean, there 23:38 But I think with a lot of I mean, there are 23:38 are 23:38 are a subset of people that are super 23:40 a subset of people that are super 23:40 a subset of people that are super disciplined and they get that kickstart 23:41 disciplined and they get that kickstart 23:41 disciplined and they get that kickstart that they need and then they can move 23:43 that they need and then they can move 23:43 that they need and then they can move forward with it. 23:44 forward with it. 23:44 forward with it. >> Yeah. 23:45 >> Yeah. 23:45 >> Yeah. What do you see the future of these 23:47 What do you see the future of these 23:47 What do you see the future of these drugs? Do you think they're going to 23:48 drugs? Do you think they're going to 23:48 drugs? Do you think they're going to become more mainstream? Do you think 23:50 become more mainstream? Do you think 23:50 become more mainstream? Do you think they're going to be held back? How do 23:52 they're going to be held back? How do 23:52 they're going to be held back? How do you see them evolving to? 23:55 you see them evolving to? 23:55 you see them evolving to? >> Yeah, for a while I was worried that 23:56 >> Yeah, for a while I was worried that 23:56 >> Yeah, for a while I was worried that there was some like unknown side effect 23:58 there was some like unknown side effect 23:58 there was some like unknown side effect that was going to come out, you know, 24:00 that was going to come out, you know, 24:00 that was going to come out, you know, cuz there's been diet drugs in the past 24:01 cuz there's been diet drugs in the past 24:02 cuz there's been diet drugs in the past that have later turned out to be 24:02 that have later turned out to be 24:03 that have later turned out to be dangerous like fen-phen. 24:04 dangerous like fen-phen. 24:04 dangerous like fen-phen. But now that we've had, you know, over 24:06 But now that we've had, you know, over 24:06 But now that we've had, you know, over two decades of this type of medication 24:08 two decades of this type of medication 24:08 two decades of this type of medication being out and available and plus just, 24:11 being out and available and plus just, 24:11 being out and available and plus just, you know, tens of millions of people 24:12 you know, tens of millions of people 24:12 you know, tens of millions of people taking the medication, I really don't 24:14 taking the medication, I really don't 24:14 taking the medication, I really don't think there's going to be one overall 24:16 think there's going to be one overall 24:16 think there's going to be one overall bad thing that's going to happen. There 24:18 bad thing that's going to happen. There 24:18 bad thing that's going to happen. There could be more future side effects that 24:19 could be more future side effects that 24:19 could be more future side effects that we don't know about. It's always hard to 24:21 we don't know about. It's always hard to 24:21 we don't know about. It's always hard to tell with any any treatment. 24:22 tell with any any treatment. 24:23 tell with any any treatment. >> Yeah. 24:23 >> Yeah. 24:23 >> Yeah. >> I do think that I mean, the biggest 24:24 >> I do think that I mean, the biggest 24:25 >> I do think that I mean, the biggest issue for right now for a lot of people 24:26 issue for right now for a lot of people 24:26 issue for right now for a lot of people is price because insurance typically 24:28 is price because insurance typically 24:28 is price because insurance typically doesn't cover this medication until 24:30 doesn't cover this medication until 24:30 doesn't cover this medication until you're a diabetic, which is frustrating 24:32 you're a diabetic, which is frustrating 24:32 you're a diabetic, which is frustrating cuz you have to wait to get the illness 24:34 cuz you have to wait to get the illness 24:34 cuz you have to wait to get the illness that is caused by being overweight for 24:36 that is caused by being overweight for 24:36 that is caused by being overweight for to get treated for it. And 24:38 to get treated for it. And 24:38 to get treated for it. And unfortunately, that's just, you know, 24:39 unfortunately, that's just, you know, 24:39 unfortunately, that's just, you know, how American insurance work. It's more 24:41 how American insurance work. It's more 24:41 how American insurance work. It's more for sick care rather than health care. 24:42 for sick care rather than health care. 24:43 for sick care rather than health care. >> Yeah. 24:43 >> Yeah. 24:43 >> Yeah. >> And so, you know, these medicines are 24:45 >> And so, you know, these medicines are 24:45 >> And so, you know, these medicines are are expensive out of pocket. The cost 24:47 are expensive out of pocket. The cost 24:47 are expensive out of pocket. The cost has gone down tremendously. Like when I 24:48 has gone down tremendously. Like when I 24:48 has gone down tremendously. Like when I first started doing this 3 years ago, it 24:50 first started doing this 3 years ago, it 24:51 first started doing this 3 years ago, it was over $1,000 a month. And now either 24:53 was over $1,000 a month. And now either 24:53 was over $1,000 a month. And now either with compounded medication or brand new 24:55 with compounded medication or brand new 24:55 with compounded medication or brand new medication, you can get the medication 24:57 medication, you can get the medication 24:57 medication, you can get the medication for, you know, $300 to $500 a month. 24:59 for, you know, $300 to $500 a month. 24:59 for, you know, $300 to $500 a month. >> Okay. 25:00 >> Okay. 25:00 >> Okay. >> So, quite a bit less, but still for 25:01 >> So, quite a bit less, but still for 25:01 >> So, quite a bit less, but still for that's still a lot of money. 25:02 that's still a lot of money. 25:02 that's still a lot of money. >> Sure. 25:03 >> Sure. 25:03 >> Sure. >> I I do think the cost will keep going 25:04 >> I I do think the cost will keep going 25:04 >> I I do think the cost will keep going down as there's more medications out 25:06 down as there's more medications out 25:06 down as there's more medications out there. I mean, I think every drug 25:07 there. I mean, I think every drug 25:08 there. I mean, I think every drug company right now is seeing this as 25:09 company right now is seeing this as 25:09 company right now is seeing this as something that they want to get into. 25:11 something that they want to get into. 25:11 something that they want to get into. >> I've heard a lot of farmers into this 25:12 >> I've heard a lot of farmers into this 25:13 >> I've heard a lot of farmers into this now. Yeah. 25:14 now. Yeah. 25:14 now. Yeah. >> Yeah, I mean, just to have a fix for 25:15 >> Yeah, I mean, just to have a fix for 25:15 >> Yeah, I mean, just to have a fix for really the most common medical problem 25:17 really the most common medical problem 25:17 really the most common medical problem in the United States, I mean, it's, you 25:19 in the United States, I mean, it's, you 25:19 in the United States, I mean, it's, you know, over 60 70% of American adults are 25:21 know, over 60 70% of American adults are 25:21 know, over 60 70% of American adults are obese, so being able to have an 25:23 obese, so being able to have an 25:23 obese, so being able to have an effective treatment for that is really 25:25 effective treatment for that is really 25:25 effective treatment for that is really revolutionary, and I think it's going to 25:27 revolutionary, and I think it's going to 25:27 revolutionary, and I think it's going to as a whole help our whole country, you 25:29 as a whole help our whole country, you 25:29 as a whole help our whole country, you know, live healthier, live longer. It's 25:31 know, live healthier, live longer. It's 25:31 know, live healthier, live longer. It's because there's so many consequences of 25:33 because there's so many consequences of 25:33 because there's so many consequences of having excess weight. 25:36 having excess weight. 25:36 having excess weight. >> Yeah. 25:37 >> Yeah. 25:37 >> Yeah. What are those biggest consequences? 25:38 What are those biggest consequences? 25:38 What are those biggest consequences? Because, I mean, we're getting into the 25:40 Because, I mean, we're getting into the 25:40 Because, I mean, we're getting into the issue of like metabolic health, which is 25:42 issue of like metabolic health, which is 25:42 issue of like metabolic health, which is definitely a big driver 25:44 definitely a big driver 25:44 definitely a big driver of a, you know, a lot of disease that we 25:46 of a, you know, a lot of disease that we 25:46 of a, you know, a lot of disease that we see here in the United States. 25:48 see here in the United States. 25:48 see here in the United States. >> Yeah, I mean, I mean, I mean, it affects 25:50 >> Yeah, I mean, I mean, I mean, it affects 25:50 >> Yeah, I mean, I mean, I mean, it affects all levels. I mean, the number one, you 25:51 all levels. I mean, the number one, you 25:51 all levels. I mean, the number one, you know, disease that kills people is 25:53 know, disease that kills people is 25:53 know, disease that kills people is cardiovascular disease, and certainly 25:55 cardiovascular disease, and certainly 25:55 cardiovascular disease, and certainly being overweight is a contributor to 25:56 being overweight is a contributor to 25:56 being overweight is a contributor to that. You know, it's going to Yeah, 25:58 that. You know, it's going to Yeah, 25:59 that. You know, it's going to Yeah, associate with high 26:00 associate with high 26:00 associate with high high cholesterol, lead to high blood 26:02 high cholesterol, lead to high blood 26:02 high cholesterol, lead to high blood pressure, all those risk factors for 26:04 pressure, all those risk factors for 26:04 pressure, all those risk factors for stroke and heart disease. A big one that 26:06 stroke and heart disease. A big one that 26:06 stroke and heart disease. A big one that I I feel like is becoming more common is 26:08 I I feel like is becoming more common is 26:08 I I feel like is becoming more common is just the cancer element, you know, like 26:10 just the cancer element, you know, like 26:10 just the cancer element, you know, like obesity is linked to, believe it's over 26:12 obesity is linked to, believe it's over 26:12 obesity is linked to, believe it's over 20 different types of cancers, 26:13 20 different types of cancers, 26:13 20 different types of cancers, particularly breast cancer. 26:14 particularly breast cancer. 26:14 particularly breast cancer. >> Wow. 26:15 >> Wow. 26:15 >> Wow. >> And so, all, you know, with those 26:17 >> And so, all, you know, with those 26:17 >> And so, all, you know, with those adiposes fat cells being so 26:18 adiposes fat cells being so 26:18 adiposes fat cells being so pro-inflammatory, it's just kind of 26:20 pro-inflammatory, it's just kind of 26:20 pro-inflammatory, it's just kind of wrecking havoc in your body. We're 26:21 wrecking havoc in your body. We're 26:21 wrecking havoc in your body. We're seeing a lot more young people with 26:23 seeing a lot more young people with 26:23 seeing a lot more young people with cancer nowadays. I'm sure there's more 26:25 cancer nowadays. I'm sure there's more 26:25 cancer nowadays. I'm sure there's more to it than just body weight, but that 26:26 to it than just body weight, but that 26:26 to it than just body weight, but that undoubtedly is a component. 26:29 undoubtedly is a component. 26:29 undoubtedly is a component. >> Wow. Can Can you explain to me why, you 26:32 >> Wow. Can Can you explain to me why, you 26:32 >> Wow. Can Can you explain to me why, you know, you mentioned inflammation a lot, 26:34 know, you mentioned inflammation a lot, 26:34 know, you mentioned inflammation a lot, and 26:35 and 26:35 and you know, inflammation is definitely a 26:37 you know, inflammation is definitely a 26:37 you know, inflammation is definitely a more common word, you know, as that 26:39 more common word, you know, as that 26:39 more common word, you know, as that silent killer behind so many of these 26:41 silent killer behind so many of these 26:41 silent killer behind so many of these chronic diseases. 26:43 chronic diseases. 26:43 chronic diseases. How does the GLP-1s work in being an 26:46 How does the GLP-1s work in being an 26:46 How does the GLP-1s work in being an anti-inflammatory? 26:48 anti-inflammatory? 26:48 anti-inflammatory? >> I don't think the full extent of it 26:49 >> I don't think the full extent of it 26:49 >> I don't think the full extent of it isn't honestly known, but I I I, you 26:51 isn't honestly known, but I I I, you 26:51 isn't honestly known, but I I I, you know, as you decrease fat cells, that 26:53 know, as you decrease fat cells, that 26:53 know, as you decrease fat cells, that that those are the ones that are 26:54 that those are the ones that are 26:54 that those are the ones that are producing a lot of inflammatory signals 26:56 producing a lot of inflammatory signals 26:56 producing a lot of inflammatory signals in the body. Obviously, it's more 26:57 in the body. Obviously, it's more 26:57 in the body. Obviously, it's more complicated than that. But, that was a 26:59 complicated than that. But, that was a 26:59 complicated than that. But, that was a benefit like a lot of people didn't even 27:00 benefit like a lot of people didn't even 27:00 benefit like a lot of people didn't even realize that you know, especially like 27:03 realize that you know, especially like 27:03 realize that you know, especially like inflammatory conditions can be hard to 27:05 inflammatory conditions can be hard to 27:05 inflammatory conditions can be hard to treat cuz there's not like an easy fix. 27:06 treat cuz there's not like an easy fix. 27:06 treat cuz there's not like an easy fix. And and we were seeing people with like 27:09 And and we were seeing people with like 27:09 And and we were seeing people with like like, you know, endometriosis, irritable 27:11 like, you know, endometriosis, irritable 27:11 like, you know, endometriosis, irritable bowel disease, polycystic ovarian 27:13 bowel disease, polycystic ovarian 27:13 bowel disease, polycystic ovarian disease, like things that just didn't 27:14 disease, like things that just didn't 27:15 disease, like things that just didn't have good treatments that were 27:16 have good treatments that were 27:16 have good treatments that were really affecting people's lives in in a 27:18 really affecting people's lives in in a 27:18 really affecting people's lives in in a non-specific like very ill way, and 27:21 non-specific like very ill way, and 27:21 non-specific like very ill way, and they're getting better. And I mean, I I 27:23 they're getting better. And I mean, I I 27:23 they're getting better. And I mean, I I think it's mostly through weight. There 27:24 think it's mostly through weight. There 27:24 think it's mostly through weight. There might be other mechanisms too. There the 27:26 might be other mechanisms too. There the 27:26 might be other mechanisms too. There the GLP-1 receptors are all over the body, 27:29 GLP-1 receptors are all over the body, 27:29 GLP-1 receptors are all over the body, and so there's probably things that are 27:30 and so there's probably things that are 27:30 and so there's probably things that are still yet to be discovered for that. 27:32 still yet to be discovered for that. 27:32 still yet to be discovered for that. >> Wow. 27:33 >> Wow. 27:33 >> Wow. It's interesting to see how 27:36 It's interesting to see how 27:36 It's interesting to see how much this, you know, this is growing, 27:40 much this, you know, this is growing, 27:40 much this, you know, this is growing, and at the same time the the industry 27:42 and at the same time the the industry 27:42 and at the same time the the industry and the, you know, is still discovering 27:45 and the, you know, is still discovering 27:45 and the, you know, is still discovering all its benefits and possible outcomes 27:47 all its benefits and possible outcomes 27:47 all its benefits and possible outcomes at the same time. It's like, you know, 27:49 at the same time. It's like, you know, 27:49 at the same time. It's like, you know, there's a lot known still, but a lot of 27:51 there's a lot known still, but a lot of 27:51 there's a lot known still, but a lot of interesting things that are coming out 27:53 interesting things that are coming out 27:53 interesting things that are coming out as people are more and more taking these 27:55 as people are more and more taking these 27:55 as people are more and more taking these drugs. 27:56 drugs. 27:56 drugs. >> Yeah, and I I think I think they'll be, 27:57 >> Yeah, and I I think I think they'll be, 27:57 >> Yeah, and I I think I think they'll be, you know, as we get more targeted with, 27:59 you know, as we get more targeted with, 27:59 you know, as we get more targeted with, you know, AI and all these things like 28:00 you know, AI and all these things like 28:00 you know, AI and all these things like the medical therapies just going to keep 28:01 the medical therapies just going to keep 28:02 the medical therapies just going to keep on getting better in that regard. I 28:03 on getting better in that regard. I 28:03 on getting better in that regard. I mean, there'll always be an issue of 28:04 mean, there'll always be an issue of 28:04 mean, there'll always be an issue of affordability and access. 28:06 affordability and access. 28:06 affordability and access. >> Sure. 28:06 >> Sure. 28:06 >> Sure. >> But, this is I think the tip of the 28:08 >> But, this is I think the tip of the 28:08 >> But, this is I think the tip of the iceberg of what what's possible down the 28:10 iceberg of what what's possible down the 28:10 iceberg of what what's possible down the road. 28:10 road. 28:10 road. >> Yeah. 28:12 >> Yeah. 28:12 >> Yeah. So, in terms of wellness, how have you 28:14 So, in terms of wellness, how have you 28:14 So, in terms of wellness, how have you seen that these drugs have helped your 28:16 seen that these drugs have helped your 28:16 seen that these drugs have helped your patients in general? Like, besides the 28:18 patients in general? Like, besides the 28:18 patients in general? Like, besides the weight loss, what else is happening for 28:20 weight loss, what else is happening for 28:20 weight loss, what else is happening for them? 28:21 them? 28:21 them? >> You know, I I always think of it like 28:22 >> You know, I I always think of it like 28:22 >> You know, I I always think of it like they feel like yourself again. You know, 28:24 they feel like yourself again. You know, 28:24 they feel like yourself again. You know, everyone has that memory of when we were 28:25 everyone has that memory of when we were 28:25 everyone has that memory of when we were young and healthy, and we want to aspire 28:27 young and healthy, and we want to aspire 28:27 young and healthy, and we want to aspire to get back to that point, which is 28:29 to get back to that point, which is 28:29 to get back to that point, which is always a hard thing to do, but it help 28:32 always a hard thing to do, but it help 28:32 always a hard thing to do, but it help it helps put you on that path. 28:34 it helps put you on that path. 28:34 it helps put you on that path. You know, just you know, if you can wake 28:36 You know, just you know, if you can wake 28:36 You know, just you know, if you can wake up and be, you know, pain-free, moving 28:39 up and be, you know, pain-free, moving 28:39 up and be, you know, pain-free, moving throughout your day, or doing activities 28:40 throughout your day, or doing activities 28:40 throughout your day, or doing activities that you like, 28:41 that you like, 28:41 that you like, >> Yeah. 28:42 >> Yeah. 28:42 >> Yeah. >> I'm you know, fitting into clothes that 28:43 >> I'm you know, fitting into clothes that 28:43 >> I'm you know, fitting into clothes that make you feel comfortable again, those 28:45 make you feel comfortable again, those 28:45 make you feel comfortable again, those sort of things. I think it's really a 28:46 sort of things. I think it's really a 28:46 sort of things. I think it's really a big self-confidence booster. 28:48 big self-confidence booster. 28:48 big self-confidence booster. >> For sure. 28:49 >> For sure. 28:49 >> For sure. And changes a little bit dynamics in 28:51 And changes a little bit dynamics in 28:51 And changes a little bit dynamics in relationships as you mentioned. 28:53 relationships as you mentioned. 28:53 relationships as you mentioned. >> Yeah, absolutely. 28:54 >> Yeah, absolutely. 28:54 >> Yeah, absolutely. >> Yeah. For you personally, you mentioned 28:57 >> Yeah. For you personally, you mentioned 28:57 >> Yeah. For you personally, you mentioned that it has helped you kind of eliminate 28:58 that it has helped you kind of eliminate 28:58 that it has helped you kind of eliminate that food noise that you were hearing 29:00 that food noise that you were hearing 29:00 that food noise that you were hearing before. What other benefits have you 29:02 before. What other benefits have you 29:02 before. What other benefits have you experienced? 29:04 experienced? 29:04 experienced? >> Well, I think I think for me one of the 29:05 >> Well, I think I think for me one of the 29:05 >> Well, I think I think for me one of the most striking things is how well my 29:06 most striking things is how well my 29:06 most striking things is how well my athletic performance got better cuz I 29:08 athletic performance got better cuz I 29:08 athletic performance got better cuz I like to ski a lot, but I was, you know, 29:09 like to ski a lot, but I was, you know, 29:09 like to ski a lot, but I was, you know, always the slow guy. 29:11 always the slow guy. 29:11 always the slow guy. >> Yeah. 29:11 >> Yeah. 29:11 >> Yeah. >> And I was like, well, maybe I just, you 29:12 >> And I was like, well, maybe I just, you 29:12 >> And I was like, well, maybe I just, you know, this is just me, but as I lost 29:14 know, this is just me, but as I lost 29:14 know, this is just me, but as I lost weight, I was like, "Oh, wow, like I'm 29:15 weight, I was like, "Oh, wow, like I'm 29:15 weight, I was like, "Oh, wow, like I'm actually I feel much more athletic. I'm 29:17 actually I feel much more athletic. I'm 29:17 actually I feel much more athletic. I'm moving better." 29:18 moving better." 29:18 moving better." >> Uh-huh. 29:19 >> Uh-huh. 29:19 >> Uh-huh. >> Um and that was a nice side effect that 29:20 >> Um and that was a nice side effect that 29:20 >> Um and that was a nice side effect that I didn't really anticipate. Um you know, 29:23 I didn't really anticipate. Um you know, 29:23 I didn't really anticipate. Um you know, I think I think by not having that food 29:25 I think I think by not having that food 29:25 I think I think by not having that food noise, you can also eat healthier cuz 29:27 noise, you can also eat healthier cuz 29:27 noise, you can also eat healthier cuz you're just not eating whatever's right 29:28 you're just not eating whatever's right 29:28 you're just not eating whatever's right in front of you, so you can be more 29:29 in front of you, so you can be more 29:29 in front of you, so you can be more intentional. 29:30 intentional. 29:30 intentional. >> That's a good point. 29:31 >> That's a good point. 29:31 >> That's a good point. >> And so, you know, I used that as a 29:32 >> And so, you know, I used that as a 29:32 >> And so, you know, I used that as a springboard for that element. You know, 29:35 springboard for that element. You know, 29:35 springboard for that element. You know, I think it 29:36 I think it 29:36 I think it I think it's it just makes you feel more 29:37 I think it's it just makes you feel more 29:37 I think it's it just makes you feel more confident, I would say. Like that's been 29:39 confident, I would say. Like that's been 29:39 confident, I would say. Like that's been a big thing.
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