Full Transcript Intro and GLP-1 Genetics Overview 0:00 So a patient with active alcohol use or compulsive eating patterns may get far more clinical benefit from a GLP-1 than just the weight alone. 0:07 So their genetics can really tell you in advance. 0:09 And here's what I will tell. 0:11 For me, this was so true because I used to like to have a glass of wine or two in the evenings. 0:16 Once I use the GLp-I, I completely lost that craving for it. 0:19 I'm like, ''I don't even want to touch it.'' I don''t want it, so it's really interesting what genetics could tell and how beneficial it can be above and 0:26 beyond weight loss. 0:27 Welcome to Beyond the Scale, where real health gets deeper than just the numbers. 0:32 I'm Dr. 0:33 Darren Dubiak. 0:34 And I am Alexandra Dubyak, and we are not only partners in life, but also passionate partners and integrative care. 0:40 Blending safe, family, functional wellness, And a little life with our dogs. 0:45 Because true healing happens beyond the scale. 0:52 This podcast does not contain any medical or health related diagnosis or treatment advice. 0:56 Content provided on this podcast is for informational purposes only. 1:00 For any health or medical related advice, please consult with a physician or other health care professionals. 1:05 Further, information about specific products or treatments within this Podcast are not to diagnose, treat, cure, or prevent disease. 1:14 Hey guys, how are you? 1:16 Again, I have Dr. 1:17 Piper Gibson. 1:18 Dr Gibson, thanks for joining us again today. 1:20 Thank you for having me. 1:22 You're welcome. 1:22 So guys we're doing this series on the Aimprint. 1:26 And if you guys are following us since the first episode, this is our fourth or fifth episode. 1:32 We saved I think one of the best things for last on this. 1:35 And that is the genetics of weight loss medications, right? 1:41 Because how awesome would it be if I told you Piper that I could wave a magic wand and say, you're going to do good on a GLP if you are not? 1:50 Well, I am waging here is the magic one because that is The Aimprint, right? 1:56 And it's so neat because I'm seeing it even in practice, because we have obviously a very large weight loss practice here in Pittsburgh. 2:03 And we see our patients on GLP, some do magnificent and some don't do well. 2:10 No matter how much elaborate blood work we order, we saw that, wow, there's something else and that something is definitely genetics. 2:17 That's what we're going to get into today, aren't we? 2:19 We are, and I will tell you, I'm so excited. 2:22 I think this is an amazing, juicy topic. 2:25 And it's something I usually talk about in my own practice. 2:27 So to be able to sit down and nerd out with you on this, i'm, so, excited, absolutely. 2:33 She's not BSing us because I got two emails on a phone call of how excited she is today. 2:38 By the way, it makes me feel excited that you're excited because to me, Today's video is one of the coolest topics we'll go over in all seriousness, 2:48 guys. 2:49 It's going to be very, very educational. 2:51 And again, Piper, thanks for coming on. 2:53 So I want to get right into it. 2:54 We're going talk about a GLP receptor sensitivity medication selection. 3:00 You know, because you have all these things, somaglutide, terzepatide and all this, right? 3:05 So first and foremost, What does the GLP1R tell us about medication response? 3:13 So, by the way, guys, that GLp1r is the gene that we test on the imprint, right? 3:21 And Piper, you know this. 3:23 You were very instrumental in helping us develop it. 3:25 So yes, we can test how a GL p drug will do on you. 3:31 Again, what's it tell about us, please?
GLP-1 Receptor Sensitivity and Drug Choice 3:34 So as we start to look at GLP1R, GLp1r encodes the receptor for a GL p1. 3:42 So medications like semiglutide and what they actually bind to. 3:47 If that receptor is less functional genetically, the medication has less to work with. 3:54 So we looked at a couple of your patient's reports. 3:58 And so if you have a patient who has both of the genes that you're looking at in the green, it indicates normal receptor sensitivity for blood sugar reduction 4:08 and body weight response, respectively. 4:11 So before investing in expensive medications with significant side effects, knowing those receptor sensitivities is really clinically responsible because 4:21 the patient is genetically primed to respond, which changes the cost benefit conversation entirely. 4:27 It truly does. 4:28 And you know this just by being a practitioner, how many people are buying these weight loss medications online, right? 4:35 And it's really a crap shoot. 4:36 Like, hey, one, is it going to work? 4:39 Right? 4:39 Two, should I be on semiglutide or terzepatide? 4:43 Which one would work best? 4:46 I know that's my next question I'm going ask you, but The genetic testing and name print right there in that paragraph, Dr. 4:53 Gibson, you would agree is, that's paramount. 4:55 Everyone should have it done to test this darn gene to see how well you do. 5:00 So like you said, instead of spending and investing all this time and money on a medication that may not work for you, get the damn test done. 5:08 Right. 5:08 And not only that, your test is going to tell you so much more above and beyond just your response to a GLP-1. 5:15 This is where you start to build that roadmap. 5:17 Absolutely. 5:18 So again, guys, as we go through this today, we're going to break down GLP ones first, and then we'll get into some other things. 5:25 Let's go on that question I was going ask you. 5:28 Does it matter genetically which GL P1 medication someone is on? 5:34 Yeah, so this to me is one of the least discussed and most important questions in clinical practice right now. 5:39 So terzepatide hits two receptors, a GLP1R and a GIPR, the receptor for a glp, which is a completely separate gut hormone. 5:50 So GIPR genetic variants determine how well someone responds to that second mechanism. 5:57 So a patient with a strong GLP1R sensitivity but a poor G.I.P.R signaling will respond differently to terzepotide than to semiglutide. 6:09 And the genetics can actually inform which drug is the better first choice. 6:14 Right now, most prescribers are choosing medications based on availability and insurance. 6:20 But the genetics, in my opinion, should really be driving that decision because practitioners who understand this are going to have so much more meaningful 6:30 and better outcomes. 6:32 And really, that is the edge that the imprint creates. 6:35 And a grin, I agree. 6:37 And I see that just with our practitioners in recommending the right GLP for the person, when our patients have that test done from the imprint, 6:49 and we follow up on them, obviously, right? 6:51 Because they're working with health coaches, they are working on us, the results are pretty profound. 6:56 Pretty neat stuff. 6:57 I want to get into a couple of the other genes on the test we have. 7:02 So, especially the hunger signaling genes, right? 7:04 So if Sayadee genes are blunt, do GLP-1 drugs really even work then? 7:12 Yeah, and I think this is a great question. 7:14 So GLP-1 medications enhance satiety signals. 7:18 However, those signals still need functional downstream receptors to land. 7:24 For example, one of the reports we looked at with one your patients was they had a leptin receptor and an HTR2C both in the red. 7:33 So, meaning that the downstream reception for these drugs is compromised.
Satiety Genes and Hunger Signaling 7:37 So the medication may produce less perceived fullness than expected in this patient, explaining why some people on GLP-1s actually describe still feeling 7:47 hungry even when they're on a therapeutic dose. 7:50 So what's the fix? 7:51 The fixes with this person, we would layer in high protein, high fiber and structured meal timing to provide independent satiety input while the medication 8:01 works on the appetite hormone side. 8:02 So the genetics are telling you exactly what to stack. 8:06 Yeah, exactly. 8:07 And you know, having all of our health coaches, our certified health, coaches and working with our patients, because again, 8:14 Piper, this is another issue we're seeing in the United States. 8:16 People just taking this medication and just thinking it's a cure all end all. 8:20 They're not working what their food, they have no idea what they're should be eating, right? 8:24 Right. 8:25 So working a certified practitioner and helping you through the food components, because it's still daunting to me how some people still to this day don't 8:36 know what a protein is. 8:37 Don't what carbohydrate is, right? 8:39 But education is paramount with these people. 8:42 Dopamine, the reward eating and addiction wild card. 8:48 You know and that's a title that i that we had for this next series of questioning but, you know one of the big jeans that you and i really get geeked 8:57 out on as we say is that calm variant right and how it interacts with glp so the c o m t variance how did they interact with the g l p medications. 9:09 Yeah, this one for me was huge because this is me in a nutshell and how I felt with a GLP-1 and it is because of my COMT function. 9:18 So GLp-2 medications are thought to reduce food reward signals in the brain, but not just suppress hunger,but dampen the drive to seek out pleasurable foods. 9:30 So this is part of why some patients lose interest in things like alcohol or highly palatable foods on these medications, 9:38 which is very, very true for me. 9:40 So for a patient with intermediate COMT clearance, dopamine lingers. 9:45 They're slightly longer than normal. 9:47 It keeps the food reward signals a little bit elevated. 9:51 The GLP-1 medication may be partially counteracting this, Which could explain why COMt intermediate patients are often particularly good responders. 10:00 However, when we start to look at some of the other factors, maybe your dopamine receptor or your DDC genes, is we can see if you're going to be predisposed 10:10 to binge eating or overeating. 10:12 And so for this person that we were looking at, both of their genes for binge-eating and overeat came back normal, which is really a favorable finding, 10:19 and it really makes that dopamine component here really manageable. 10:23 Yeah. 10:23 And just like Dr. 10:24 Gibson said, guys, you know, it's really amazing when you're asking patients, Hey, do you have any alcohol cravings now? 10:31 And by the way, I have full transparency. 10:33 I, i have tried GLP drugs as well and medications and they've worked wonderfully. 10:38 and it is funny. 10:39 Sometimes doc, my craving really didn't go away. 10:43 But let's say if I had a bite of pizza, I was good with the one. 10:46 It's like I really never had to have the two, the three, or the four other pieces. 10:50 You know what I mean? 10:51 But that comp gene makes sense now since I have my own imprint done on myself.
Reward Pathways, Alcohol Cravings, and COMT 10:58 Why do some patients on GLP suddenly stop drinking or lose interest in some of these behaviors, right? 11:06 Is it genetic? 11:07 is that something we can tell them on the imprint? 11:10 So when we start to take a look at it, this is one of the most fascinating emerging areas for GLP-1 medications because they appear to dampen the general 11:21 reward response. 11:21 So not just to food, but to alcohol, nicotine, compulsive behaviors. 11:26 The mechanism runs through the same dopamine pathways that drive that food reward. 11:30 So when we're looking at something like the AimPrint and we are looking COMT and DRD2 and ANKK1 variants, they start to determine that dopamine receptor 11:40 density and clearance rate and predicts who gets cross-addiction benefit most strongly. 11:45 So patients with, like we said, that intermediate COmT who already have that elevated dopamine tone are the ones most likely to notice those reduced alcohol 11:54 cravings and side effects. 11:55 It's just so fascinating to me. 11:57 I'm sorry to interrupt. 11:59 It's just literally mind-blowing how this works genetically. 12:03 I love it. 12:03 Yeah. 12:04 So this matters because it changes the informed consent conversation you're having. 12:09 A patient with active alcohol use or compulsive eating patterns may get far more clinical benefit from a GLP-1 than just the weight alone. 12:17 Their genetics can really tell you in advance and here's what I will tell you, for me this was so true because I used to like to have a glass of wine or 12:24 two in the evenings and once I use the GLP-1 I completely lost that craving for it. 12:28 I'm like I don't even want to touch it, I dont want it so it's really interesting what genetics can tell and how beneficial it can be above and beyond 12:36 weight loss. 12:37 A hundred percent. 12:38 I mean, if we're reading the current literature and even just the news right now, a lot of big pharmas looking how to have these GLPs utilized for people 12:48 addicted to alcohol and other things. 12:51 And again, I think you have the best population of people right. 12:55 Now just ask them of, Hey, how much have your cravings declined? 12:59 And they really have, you know, even myself when I was on them, I maybe, like you said, have a drink or two. 13:05 I was like, no, I'm good. 13:06 You know, you just didn't want it. 13:09 And moving forward, Like you've said it's getting away from just weight loss, even a body by aim, it, its longevity, right? 13:18 It's how can this aim print be so significant to help me on other facets of life? 13:24 Again, other than just wait. 13:27 But today, again, I really am glad we're focusing on these very sensitive genes and specific genes talking about the medication. 13:36 I want to talk about insulin resistant genes because I definitely have some insulin resistance, unfortunately. 13:45 Which genes most clearly predict insulin-resistance on this panel? 13:51 Yeah, and you know, I think this is something that's so critical for so many people in the world right now is this insulin resistance effect. 13:58 And so everybody that is listening to this podcast, yes, we are giving out some names for genes and they're usually like little code words, 14:06 but Darren can guide you through all of that. 14:08 So when we're looking at insulin-resistance genes, TCF7L2 and CDKN2A are two genes that really lend to either a representation of elevated type 2 diabetes 14:23 genetic risk or not. 14:25 And so when we're looking at, you know, a certain report, we can see that this individual actually has this elevated risk. 14:30 But you also want to layer that with mitochondrial findings because mitochondria, right? 14:36 They're the energy in your cell, they're your workhorse. 14:40 So you look at several variants. 14:41 You look UCP variants and a TFAM variant. 14:45 These people have a genetic profile where Energy can be stored more readily, and we can look at mitochondrial efficiency. 14:54 So the urgency here is really real. 14:56 It isn't lifestyle optimization conversations. 14:58 it's really about metabolic disease prevention and genetics. 15:01 And we could look these genes and say, see how well people are going to use and burn energy, or see well how people will handle that insulin resistance. 15:10 Above and beyond the GLP-1, this panel does incredible things. 15:15 Now, I appreciate you saying that because again, just even my passion, my family history, but even with our patent pending and our pattern hopefully being approved, 15:23 coming out with and treating diabetics with the AIM method of how to circumvent some of these things of being insulin resistant. 15:32 You know, one of the items that happened the other day, and I know this is going to be our next topic to talk about. 15:37 I want to get into this next is, The whole skinny fat skinny looking emaciated version of that person right like you know it's coming now to a point where
Insulin Resistance and Metabolic Risk Genes 15:51 we're saying oh that personal must be on the shot right. 15:54 You know even yourself you may be guilty of saying how they're on it you now. 15:59 The muscle loss problem that no one is talking about is what I want to get into next. 16:05 Why do some people come off a GLP looking so depleted instead of lean? 16:12 Yes, and this, since day one, has been something that I have said about GLP-1s. 16:17 And so muscle is so critically important for everybody, especially women over 40, muscle. 16:24 But GLp-one medications don't selectively burn fat. 16:28 They're not like, oh, you have a big butt, we're going to burn right here. 16:31 Uh-uh, not how it happens. 16:33 So, you know what? 16:34 Say that whole thing, Piper, again, because it's that important. 16:37 GLP medications don't what again? 16:39 GLp-1 medications. 16:41 Don't selectively burn fat. 16:44 You got it. 16:45 That's right. 16:46 People don' t get it, people don t understand that. 16:48 Yeah. 16:49 They don''t get. 16:50 It''s going to, burn the fat off your face, it'''s gonna burn. 16:52 The fat of your legs and your arms, and it' s not gonna selectly burn it off. 16:56 Your booty, where you probably have a good bunch of it right? 16:59 Yeah. 17:00 So research shows a significant portion of weight loss on a GLP-1 is lean mass. 17:06 That means your muscle, everybody. 17:07 And that percentage gets worse without intentional intervention. 17:14 going on, lifting weights, building muscle, eating protein. 17:18 Variants in the TRHR, which is a thyroid hormone receptor, and your IGF2, an insulin-like growth factor, on the imprint directly govern how well someone 17:30 preserves muscle during caloric deficit. 17:32 So people with red variants here mean a genetic predisposition toward muscle catabolism when eating less, so your body basically eating up your own muscle. 17:42 And what the clinical implication really means is that muscle preservation risk has to drive protein targets and resistance training recommendations before 17:52 the medication even starts. 17:54 This is a conversation most prescribers are not having, and it's why some people look worse at their goal weight than they did when they were heavier. 18:01 They lost all of their lean muscle body weight. 18:05 I really have to be honest with you. 18:07 I don't know any practitioners in my area or anyone I've even spoken to of any practitioner is talking about this stuff, 18:15 right? 18:16 Everyone is so focused on that goal of losing weight, but no one knows what's going to happen and what that person is going look like after. 18:23 You know, we mandate some of our patients being on at least a creatine, a collagen, something where protein is going to be readily available to atleast 18:35 build protein, right? 18:37 Because, like you said, the number one thing, Piper, for females, especially over the age of 50, We talk about bone loss. 18:45 We talked about muscle loss, and then you have that whole downward spiral. 18:50 of osteopenia, breaking the hip and the story, right? 18:53 So I'm all for these medications done properly, but the nutritional aspects have to be there too, you know?
Muscle Loss and Nutrient Depletion on GLP-1s 19:01 100%. So the side effect of certain things, meaning, and you and I just talked about this before we went on air. 19:11 Who gets nauseated? 19:15 Who doesn't? 19:16 who's going to have diarrhea. 19:17 Who's gonna be constipated, right? 19:19 So can genetics honestly predict who is going have miserable experiences on GLPs? 19:25 Yeah, nausea, vomiting, and gastroparesis risk with GLP-1 medications. 19:30 It really isn't random. 19:32 So that GLp-2 receptor that we talked about in the beginning, these receptors are expressed heavily in your gut and the vagus nerve. 19:41 it governs that gastric emptying. 19:43 Your gut sends about 10 signals to your brain and your brains send about one signal to you gut. 19:48 So your gut is extremely bossy. 19:51 In variants that affect vagal tone and GI motility pathways influence how severe GI response will be to these. 19:59 We talked about COMT previously, but COMT variants are relevant here too. 20:04 So slower catecholamine clearance affects gut motility directly. 20:09 Intermediate or slow COMTs patients may have more pronounced GI side effects because the signaling pathway stays activated longer. 20:18 Knowing this in advance changes the titration conversation, so how much you're going to increase over a period of time, right? 20:24 It's not a reason to avoid the medication. 20:25 It is actually a reasons to start lower, go slower, and have a specific plan. 20:30 Most patients My mom being one of them who abandoned GLP ones in the first 30 days because of the GI side effects. 20:37 And there's really a gentler way to approach it when we know your genetics. 20:42 Yeah, 100%. And like you said, even with us, Piper, like your mother, the number one reason people quit these GI GLPs is because GI issues, 20:52 right? 20:53 Or some sort of something. 20:55 I just didn't feel well. 20:57 So again, guys, I'm going to continually saying this on this episode. 21:01 Before you start spending money on GLP's you have the imprint on and know what you're up against and like Piper said, there's so many different genomes 21:11 we're talking about. 21:12 COMT, TKRM, you know, it sounds like a bunch of code words, right? 21:18 but that's why there's practitioners like us to go over it and talk about it. 21:22 Piper, a lot of people don't know we already have GLP sensors in our body, right? 21:27 You know, the GLPs sensor only last five or 10 seconds, but we have it, so your gut's already making GLp. 21:36 Can we optimize it? 21:38 Can someone actually boost their body's own GL p production? 21:43 Yeah, the human body is the coolest. 21:46 The gut, like you said, produces GLP-1 naturally from the L cells in your small intestine. 21:52 And those are triggered by fiber, protein, and fermented foods. 21:56 So, FUT2 secretor status matters. 21:59 Let me just tell you real quick what F-U-T-2 is for people that are listening. 22:03 FUT2, is your fucosal sugars in you gut. 22:05 You make these little sticky fuchosals sugars, in the gut that actually the probiotics that bacteria like to stick to and then proliferate, 22:13 you want them to grow. 22:15 If you have an FUT2 variant that kind of you don't secrete these sugars as well, things like probiotic, your microbiome really may have a less favorable environment. 22:26 So, F-U-T-2 secretor status matters and that shows up in that gut microbiom work we're doing. 22:32 It directly influences the microbial environment that drives this production of GLP-1s. 22:39 So non-secretors of FUT2 variants have a less diverse microbiome and produce less short-chain fatty acids that then in turn stimulate natural GLP-1 release. 22:51 They are starting from this compromised baseline before the medication even enters the picture. 22:57 And really that practical application would be FUT2 variants informed targeted probiotic and prebiotic strategies that can meaningfully boost endogenous GLP1. 23:08 It's part of why two people on the same dose have totally different outcomes and why the full genomic picture matters before you even write the prescription. 23:17 Yeah, and you know, it's funny, even in the same family, I see people reacting differently, right? 23:23 Sisters, mother, daughters, still acting differently. 23:26 Right? 23:27 And that genetic testing, the genome looking at the FUT2 genes is pretty profound. 23:33 It's so fascinating and the science behind it right now is just, like I said, it's just so exciting. 23:37 I'm just excited about it. 23:41 You know, there's times in medicine where you're on the forefront of certain things and there are times where we're really seeing, 23:49 not categories, I see people falling into different categories and it is really neat guiding them on different aspects of this. 23:58 You know, even one of the things, as you know and it leads me to this, is a lot of what we do here is even with our custom IVs, 24:06 right? 24:06 Remember, when I have all this blood work, Piper, and I this gene testing, our IV's are able to be made custom for you when you're in the office. 24:14 So, are there nutrient deficiencies practitioners should really be worried about on long-term GLPs? 24:20 Like, do you have a top two or three that we should talk about? 24:24 Yeah, I do. 24:24 And I think this is another great conversation because it is one that is not being had. 24:29 GLP-1 medications, yeah, they reduce food intake, which sounds obvious, but the nutrients lost aren't distributed evenly. 24:38 So reduced protein intake accelerates muscle loss. 24:42 We went back to that TRHR and that IGF2 that we looked at. 24:47 But reduced animal product intake is going to deplete B12. 24:51 And so if you have someone who has a TCN2 variant that is compromised, they are going have issues with B-12 transport. 24:59 So you're already getting less B 12 and they already have an issue transporting this B twelve. 25:04 We also have to look at vitamin D production and how it falls because less dietary fat means less absorption of fat soluble vitamins. 25:13 I don't know if anyone's ever told you, but if you're going to take a fat-soluble vitamin, take it with something that has fat in it. 25:19 So when we start to looks at this and we look the imprint, you are looking at three different variants in the vitamin-D pathway, 25:25 which can be critical to know, hey, is this person already in a hole before we started this medication? 25:31 So the genetic panel isn't just telling you what to supplement. 25:34 It's telling which depletions will happen faster and hit harder in a specific person on this specific medication.
GI Side Effects and Titration Strategy 25:42 This to me is really proactive care. 25:45 That's what prevents people from feeling great for six months and then just completely crashing. 25:50 I agree. 25:51 Not only crashing, it's how about gaining weight after they get off these things, right? 25:56 Yeah. 25:56 I mean, I will tell you this much. 25:59 Hi, am seeing not our patients, but patients coming from other clinics coming in who had no nutritional guidance, who just took a shot. 26:06 They didn't talk about nutrition, supplementation, anything like that. 26:10 Is that rebound effect? 26:11 And I'm going to tell, you guys, holy moly, is that a real thing? 26:15 I think the number one fear with GLPs is regaining all the weight. 26:20 is that fear genetic you think yeah you know some of that really can be so when the medication stops the biological landscape it was masking snaps right 26:31 back into shape if you have an fto or a leptin receptor or an htr2 that are in the red the drug compensates for those variants. 26:39 It's not correcting them. 26:40 You still have those variance. 26:42 They still are doing the same things in your body. 26:44 The drug is just kind of masking that. 26:46 So people, for example, who have the heaviest satiety burden, you know, stacked across like the leptin receptor and the HTR2C, 26:55 they have this steepest rebound risk because they were the most dependent on the medication to feel full at all. 27:02 This is something families and patients deserve to know before they start. 27:05 The argument is for building the full protocol during the medication phase, not after. 27:10 So you use the appetite suppression window to rewire the eating patterns, establish that circadian structure, and address those nutrient depletions. 27:19 The genetics are going to tell you what needs to be in place before anyone considers tapering them off. 27:25 These are things that you need to know. 27:27 I don't think there's enough push for patients to know or education wise that letting people know, Hey, when you go up on some of these higher doses and 27:36 you stop cold Turkey, you're going to have a problem, right? 27:40 You're. 27:41 Going to gain weight back. 27:42 And it's almost like, You know when people were on certain SSRIs and certain doses on you and I both know this. 27:50 If you do not just tie trade down and you just completely take yourself off of or stop, there's going to be hell to pay. 27:58 Right? 27:59 Yeah. 28:00 Yeah, you're not going feel so hot. 28:01 No, not at all. 28:03 And, and it's just not only that it I've seen people have gained weight back like I'd never seen before when they're no tie trading down correctly. 28:14 All right. 28:15 Lastly, the whole body by aim, that the entire way we built this company is customization and accountability. 28:25 When we talk about stacking genetics with medication and coaching, I believe that's, That's the win-win here body buy aim. 28:33 So I want to hear it from you, Dr. 28:35 Gibson. 28:36 Why do some people lose 40 pounds on this?
Boosting Natural GLP-1 and Gut Health 28:40 stuff and some people lose eight. 28:42 Yeah. 28:43 And wouldn't you like to know this before you go into taking this medication and you take it for months and then you're like, 28:48 I only lost eight pounds, like I would love to notice prior to that. 28:53 So a 40 pound responder typically have good receptors sensitivity to these drugs, which the person that we were looking at really does. 29:04 They have manageable satiety genetics. 29:06 And you have this clinical team that personalizes the surrounding protocols. 29:11 So we know they have the good genes going into it, and you the genes to build that roadmap and that plan. 29:17 But when we look at someone like an eight pound responder, they are often fighting their genetics without knowing it. 29:24 Maybe they have late chronotype circadian disruption, which can undermine medication benefits and metabolic benefits. 29:32 So, you know, what is their eating schedule like? 29:34 What is there sleep schedule? 29:35 Like it can be blunted and those satiety receptors that were supposed to reduce fullness, maybe they don't mitochondrial inefficiency and limiting how 29:44 much energy they can actually burn. 29:46 Right? 29:46 So when we look at the medication, you can't just look it as a standalone. 29:51 The medication is one lever on a 10 lever system. 29:55 Pulling only one level while the others work against you explains the wildly variable outcomes that we're seeing and why data on GLP ones is so inconsistent 30:05 in the literature. 30:06 Yeah. 30:07 And it truly, truly truly is, what does a truly personalized protocol look to you? 30:14 What's it look like to Yeah, that's really how I've built my business, too, is this personalization, this individualization. 30:21 And so when we are looking at specific patients, GLP-1 medications where they have a good receptor sensitivity, you can assist them with a low-carb diet 30:31 structure when you start to look at their FTO genes or their UCP genes. 30:35 We know that maybe they need more morning light or a consistent sleep schedule maintenance. 30:39 They need targeted supplementation based on their genes. 30:42 For example, we talked about the D3 and the methylated B12. 30:46 And maybe, they needs some mitochondrial support.
Rebound Weight Gain and Long-Term Planning 30:48 So, you know, looking at that, it's not just one thing. 30:51 It is multiple factors built around, hey, know these genetic results. 30:55 That aim print gives you the blueprint. 30:57 Without it, You're just prescribing to the average patient. 31:00 With it you are prescribing to a specific person. 31:05 Agreed. 31:05 So tell me what you believe is the single most important insight providers miss though when prescribing this stuff. 31:13 The medication operates inside a biological system shaped by dozens of genetic variants. 31:21 Prescribing without understanding those variants is like tuning an engine without knowing what model the car is. 31:29 The genetics tell you what medication will hit, what it won't hit. 31:33 What it needs to be addressed through diet, sleep, stress management, lifestyle, environment, and supplementation to make the medication work as well as 31:42 it possibly can. 31:43 So, you know, one of the benefits is the way that you approach it. 31:49 This is that differentiator. 31:51 And it's the reason that have better, more meaningful outcomes. 31:55 Well, thank you. 31:56 Thank you, and I mean, that's what we pride ourselves on, right? 31:59 And having this aim print has been such a game changer in my practice. 32:04 I thought ordering over 80 biomarkers was huge. 32:07 When you have that genetic factors and those genetics in front of you got it. 32:12 You know, I'll give you an instance. 32:14 So Ali was like, well, you respond so well. 32:17 One of the things guys we talked about was the fasting genes and we'll do that in another episode. 32:22 And I am fantastic when I fast right I was all green funny enough when i do fast I feel fantastic alley coincidentally genetics. 32:35 doesn't do well, son of a gun, when Allie tries to fast like I do, she does horribly, right? 32:41 Even worse outcomes, headaches, not feeling well. 32:45 Really lethargic. 32:47 On the other hand, I'm ready to rock and roll, Right? 32:49 I like food. 32:50 What food? 32:51 Like I am that good. 32:52 I want to thank you for today. 32:54 I know we made this again, the genetics of weight loss medications, but like Dr.
Personalized Protocols and Closing Thoughts 32:59 Gibson said, guys, this can go in so many different variants. 33:02 And we said a lot of different gene variants today as well. 33:06 It sounds confusing. 33:08 Trust me, until I really got involved in genetics and neutral genomics, some of the stuff was confusing to me. 33:14 But it's amazing. 33:15 Dr Gibson, I appreciate your professionalism and your knowingness of all this. 33:20 It is how amazing we can streamline a person by having their genes. 33:25 It's period. 33:27 And it really, it's really is life changing, right? 33:30 People say that nonchalantly. 33:32 Oh, no, this really it is. 33:34 I mean, I always say it on all my advertisements and every time I talk with a patient, the aim print is just not giving you data. 33:42 it Is absolutely giving a direction. 33:45 on which way to take that information, right? 33:48 And to prevent those certain things. 33:50 I want to thank you again. 33:51 This isn't going to be the last time we hear from you on the Aimprint. 33:55 Thank you for doing this initial series with me. 33:59 Guys, again, beyond the scale, like us, share us with people who love this stuff. 34:06 The TikTok, as you could see, behind Dr. 34:09 Gibson is a great book that you wrote. 34:12 When did that come out? 34:13 Can I ask you that? 34:15 Oh, 2022. 2022, so guys, please also look up Dr. 34:20 Piper Gibson. 34:21 She's a genius in the world of what she does. 34:24 And I'm always humbled that you're saying yes to coming on to the show. 34:28 So thank you so much. 34:29 You are welcome. 34:30 Thank you for being my really nerdy genetic bestie. 34:34 Your welcome, this is what we talk about as we're talking about genes. 34:38 It's really neat stuff. 34:40 Again, thank Thanks for spending time with us on Beyond the Scale. 34:46 If today's episode helped you see your health differently, like the show, share it, and we'll see you next time on beyond the scale.
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