Unlock The Power Of Diet In Diabetes Management

Cyrus Khambatta, PhD

Yes. Thank you so much. I appreciate the invitation to be here today. Beverly.

Beverly Yates, ND

Absolutely. Tell us a little bit about your background, and we’re going to take it away.

Cyrus Khambatta, PhD

A quick background: I was diagnosed with three autoimmune conditions in 2002. That was effectively 21 years ago. I was at the end of college. I was a senior, and I was trying to graduate and move on with my life. I was studying mechanical engineering at the time, and all of a sudden I got diagnosed with type 1 diabetes, Hashimoto’s, hypothyroidism, and alopecia, which is total hair loss. The doctors at the time could not explain exactly why I had developed three autoimmune conditions within six months, and they kind of left me leaving the hospital saying, Hey, here’s a book about carbohydrate counting, here’s some insulin, here’s some syringes, and here’s a blood glucose meter. See you later. I was like, Wait, what is happening to me? This doesn’t make any sense. I’ve always been an athletic guy. I’ve always been of normal weight, and as a result of that, when I got diagnosed with type 1 diabetes in particular, I was just scratching my head because I didn’t get it. What am I missing? What did I do wrong?  

That set me on a journey to try and figure out how to get an answer to that question. Did I cause this? Did something else cause this? Is this a virus? Is it environmental or chemical? Is it something in my genetics? Is it some combination of all of that together? I don’t know. The first year, I ended up transitioning to a low-carbohydrate diet because that’s what the doctors told me was the right thing to do. I didn’t know anything about human biology at that point. I thought, Okay, I’m just going to listen to what these authoritative figures have to tell me. I ate a low-carbohydrate diet that had somewhere around 75, maybe a maximum of 125 grams of carbohydrates per day, which is not a ketogenic diet. Just for clarity. This is a low-carbohydrate, general-low-carbohydrate diet. The promise was that it would keep my glucose down, it would keep my glucose controlled, and it would keep my insulin use from increasing over time. Neither one of those is to happen. My glucose was very erratic. On any given day, my glucose could be anywhere from as low as 40 to as high as 400. It was just kind of bouncing all over the place. I didn’t have any control over what the number was going to be at any given moment in time. 

I was a good boy. I was a good patient. I was exercising frequently. I was drinking lots of water. I was keeping my stress low. I got rid of alcohol consumption, and I was eating a low-carb diet exactly as they described. But yet, my insulin use was also creeping up. It had doubled in the first year, and my glucose was all over the place. I knew that this just wasn’t the thing for me. I switched over to eating a plant-based diet because a friend of mine nudged me in that direction and said, Hey, this might be a good option for you. I switched over to eating a plant-based diet under the supervision of a gentleman named Dr. Doug Graham. He went on to write a book called The 80/10/10 Diet, which is a diet that teaches people how to use a raw food approach to combating chronic diseases and just living their best life. Under his supervision, I ended up making this transition to eating a fully plant-based diet. My Lord, in the first week of making that transition, my glucose felt like a rock. Rather than being very erratic at high most of the day, it came down, was very low, and was very consistent. In addition to that, because my glucose was so low and because it was so predictable, I was able to reduce my use of insulin, my insulin had crept up to about 45 minutes per day, and it went from 45 down to 42, down to 37, down to 31. Before I knew it, I was down to 23 units per day. But here’s the kicker: I was doing it while consuming 600 to 700 grams of carbohydrates per day. The reason why this is important is because the narrative in the world of diabetes is that carbohydrates cause you to use more insulin. Carbohydrates cause insulin resistance. Carbohydrates cause your pancreas to work harder, and carbohydrates make your pancreas secrete more insulin.

But what I was doing was eating not 125 grams of carbohydrates a day—600 to 700 grams of carbs per day. Yet, despite that, my insulin use went down, getting cut down by about half. I knew that something was fascinating that was happening behind the scenes, and I just couldn’t explain it using words. Long story short, I ended up going back to school to get a Ph.D. in nutritional biochemistry because I was thirsty for knowledge. I wanted to understand what was happening inside of this biological machine. How could I explain what I was just experiencing? then, in addition to that, how could I extrapolate that to be able to help other people living with type 1 diabetes, type 2 diabetes, gestational diabetes, and beyond? That led to the development of mastering diabetes with my partner, Robbie Barbero, who also has type 1. The two of us have created a platform that teaches people how to transition towards a plant-focused diet. In the process of doing so, they can significantly improve their health while combating the underlying condition. That seems to be the topic of every YouTube video in the world now, which is insulin resistance. We’ve developed a method that can not just manage insulin resistance but reverse it at its core. As a result of that, we have people all across the world from all walks of life who are lowering their glucose, lowering their body weight, and feeling a million bucks. It’s just fun. It’s a fun thing to do.

Beverly Yates, ND

Absolutely. It’s great to be able to help others and help them unravel the mysterious things. It sounds like a key part of the process for users is that you got curious, you got to work, you had an open mind, and you were finding out what was going to work for you for a while. Individual response, and then you were able to scale it. There are plenty of other people for whom that blueprint is effective, and they will need support, guidance, and help along the way. One of the things I’ve always been kind of annoyed and puzzled by is that often in the world of medicine and health, people do get into these narratives that it has to be one way, as if nutrition is about one size fits all. I have to say, with 30+ years of experience, I have not seen that be true. I appreciate that you unpack both your journey, what’s happened for your community, and the keys to the science behind all of this so that it makes sense and is repeatable.

Cyrus Khambatta, PhD

You got it. You nailed it on the head. I mean, if you go into the scientific world, you’ve been involved in science for a long period, and you’ve studied it for endless hours. Similarly, I did the same thing when I was doing my Ph.D., and one of the things you find out is that you can’t build a scientific story off of one observation or off of one anecdotal experience. You can’t build it off of two. You can’t build it off of five. That might be a hypothesis-generating thing, but then you have to go and test it and make sure that it applies to larger populations in many different circumstances. The long story short is that there’s an overwhelming amount of scientific data that demonstrates just what you’re saying. Number one, there is a strong bioindividuality among people. People of different shapes, colors, sizes, and disease backgrounds may not have the same response to the same food on their plate. that’s okay. That’s part of the process: trying to figure out what’s ideal for you. But we have also seen that the research has demonstrated that eating more plants and eating a stronger diet with a plant-based focus tends to be a very powerful solution for a wide majority of all people living with diabetes. Is it the number one solution for anybody living with diabetes? No, that’s not the case. But the truth is that it works for an overwhelming majority of people. That unto itself is reason enough to give it a lot of attention.

Beverly Yates, ND

Absolutely. You’ve got to do what works, and what’s effective. if you’re an outcomes-based, results-based person, whether you’re the one living with the illness or you’re someone who’s an advocate or supporter of it, or if you’re here on the summit because you’re a fellow health professional,? We know that about 80% of our audience is the general public. That 20% is health professionals. Whatever your reason for being here, please understand that it is critical to meet people where they are and help them get to where they need to go. That is the journey.

Cyrus Khambatta, PhD

Okay, you’ve nailed it.

Beverly Yates, ND

Perfect. As we’re talking here in the first part of our interview about insulin resistance, what are some of the myths along the way that people don’t get? There’s a lot of misinformation out there now, and it almost makes it seem like if you just think good thoughts and sprinkle glitter on yourself, the resistance will go away. You and I both know that’s not that simple.

Cyrus Khambatta, PhD

You’re going to have to use a lot of glitter. That’s the truth.

Beverly Yates, ND

Some unicorns and rainbows.

Cyrus Khambatta, PhD

They help. Okay. The common narrative in the world of diabetes is that a low-carbohydrate diet is the solution. Regardless of the type of diabetes you live with, whether it’s type 1 insulin-dependent or type 2 diabetes, carbohydrates are the enemy. Carbs are bad for you. Carbs will make you fat. Carbs will make your pancreas work harder. Carbs will make you secrete more insulin. Carbs will make you more insulin-resistant. You see this everywhere you go. Just go into Google, go into Instagram, go to YouTube—you name it—and just type in diet for diabetes, and boom, you’ll see this anti-carbohydrate propaganda. I do use the word propaganda in particular because it is not always factually based. You can see this all over the freaking place. The reason that it exists in the first place is because when you lower your carbohydrate intake, many positive things can happen in the short term. What people will experience is that they’ll say, What, I’m eating a low-carb diet. In reality, what they’ve done is cut out most of the processed food from their diet. When people say low carb diet, what they should be saying is that I’m eating a low refined carbohydrate diet, which means low cookies, crackers, chips, pastas, sodas, pretzels, donuts,  and beyond. If you get rid of most of that stuff, well, then it’s not a surprise that your health is going to improve.

It’s not a surprise that you’re going to lose weight. It’s not a surprise that your glucose will come down, your A1C will come down, your blood pressure will come down, your total cholesterol will come down, and your triglycerides will come down. That is a very good thing. People will make this change, and they’ll see all these positive benefits, and they’ll be, a low-carbohydrate diet is the solution. But what they are sort of doing is, I think, what this world of a low-carbohydrate diet is doing, unfortunately, is making people believe that all carbohydrates are the same and all carbohydrate-rich food is created equal. You see this all over the place where people will say, Don’t eat bananas because bananas contain sugar, and sugar is bad for you. Sugar will make your blood sugar go up. It’s a very simplistic argument, but it has no factual basis. People will always confuse whole carbohydrate-rich foods like fruits, starchy vegetables, potatoes, or squashes with whole grains like quinoa, barley, and farro. They’ll say those are also bad for you because fruits contain sugar and potatoes contain starch, which breaks down into sugar.

This term sugar just gets planted in people’s heads, and people go, anything that’s carbohydrate-rich is bad for me because carbs equal sugar. High. The problem with that is that it’s factually incorrect. The refined carbohydrates, which we talked about earlier, the cookies, crackers, chips, pasta, bread, sodas, all that stuff. Get it out of your diet. Regardless of who you talk to, whether it’s a plant-strong individual like myself, whether it’s a ketogenic expert, whether it’s a paleo expert, or whether it’s a low-carbohydrate diet, every single one of us is saying the same thing: Get those processed foods out of your diet because they have no place. It’s just literally a dietary napalm. Just be done with them. But the confusion is all about whether or not eating fruits, potatoes, and whole grains is healthy or unhealthy. The carnivore in the low-carbohydrate world wants you to believe that they’re unhealthy, but the plant-based world knows that they are healthy for you. Now, why is that the case? The reason that’s the case is those whole carbohydrate-rich foods, which are foods that are grown in nature and either come from a bush, a tree, or the ground, or unprocessed, meaning you can just pick them off of a plant and eat them, or you can minimally process them by picking them off of the plant and maybe boiling them or heat treating them in some way. You can still eat it in its whole state without having to refine it and separate it into individual parts. 

When you consume those foods. What the research has shown over and over again is that those foods are beneficial for human health; they’re beneficial for longevity; they’re beneficial for chronic disease reduction, whether it’s diabetes, heart disease, cancer, autoimmune diseases, or beyond. The reason for that is that whole-grain foods contain many classes of nutrients that go well beyond just the carbohydrate world. They contain carbohydrates, fat, and protein, which are your three macronutrients. In addition to that, they also contain vitamins and minerals, fiber, water, antioxidants, and phytochemicals. Nine classes of nutrients are present in every single whole food that you can think of. Just think in your head. Give me five examples of whole foods.  

I’ll give you a banana, I’ll give you chickpeas, I’ll give you purple potatoes, I’ll give you quinoa, and I will also give you black beans, every single one of those, no matter what other whole food that you can think of, whether it’s some obscure berry that grows in the middle of the Amazon rainforest or whether it’s wheat that comes from a large industrial farm in the middle of Ohio. 

Regardless of what it is, every single whole food contains carbohydrates, fat, and protein, plus vitamins, minerals, fiber, water, antioxidants, and phytochemicals. It’s the presence of all nine of these macro- and micronutrients that do the nutritional magic. The macronutrients are what give you energy. That energy can be translated into ATP, which is useful for your brain, your muscles, your heart, your blood vessels, your liver, your kidneys, and beyond. But the micronutrients are the disease-fighting powerhouses that help, number one, reduce your cholesterol, number two, reduce your blood pressure, create elasticity inside of blood vessels, and prevent platelet aggregation. They’re vasodilators and beyond. All of these disease-fighting micronutrients are critical for human health, both in the short term and in the long term. When you eat a low-carbohydrate diet, simply thinking that eliminating all carbohydrate-rich foods from your diet is the solution, what you inadvertently do is also eliminate the micronutrients. It ends up becoming a micronutrient-deficient diet, which in the long term is going to cause significant organ damage to your brain, your eyes, your liver, your kidneys, your heart, your blood vessels, your muscle tissue, and beyond. I want people to understand that it’s not just about the carbs. We have to get beyond the carb and understand that there are two different types of carbohydrates and that the whole carbohydrate comes prepackaged with a whole bunch of micronutrients. Those micronutrients are the keys to understanding how to live an optimal life long into the future.

Beverly Yates, ND

Well said. I agree with you 100% about this. Another way you would say to look at this is with the two kinds of carbs. The beneficial, helpful health, preserving carbs, and the ones that are the thieves of health are, in my opinion, the highly refined, highly processed stuff. Those are nutrient-deficient and set people up for a whole host of problems, including blood sugar problems.

Cyrus Khambatta, PhD

100% blood glucose. Irregular dysregulation is just one of many things that can happen when you’re eating a micronutrient-deficient diet. Your cholesterol is likely to go up, your blood pressure is likely to go up, and your blood glucose is likely to go up. Cholesterol deposition inside blood vessels is likely to go up. Atherosclerosis is likely to go up. You increase your risk for dementia, Alzheimer’s disease, fatty liver disease, and chronic kidney disease, and the list goes on. You’re right. You nailed it.

Beverly Yates, ND

Alright, cool. We’re all going to be advocates of whole foods, real foods, and nutrient-dense options. In that, when we’re talking about insulin resistance, it’s been so interesting to see over the last, I’d say, 7 to 9 years, so much more emphasis on demonizing food groups and foods. I don’t quite get what that’s about because we need to eat and nourish ourselves. It’s fundamental before we’re even born; when we’re a fetus in the womb and we’re attached to the placenta, we’re being nourished. Why should that end when we leave our mother’s body? What is the journey that people go through where they need to understand where there might be some speed bumps or cautionary moments where people will try and tell you one thing, but the other thing is actually what’s accurate and what’s their lived experience?

Cyrus Khambatta, PhD

Yes, for sure. I mean, it’s all over the place. In today’s world, there’s so much misinformation, regardless of where you go. Any social media platform—Google, WebMD—it’s just a quagmire. It’s hard to understand what is true and how to separate fact from fiction in today’s world. I’ve seen, during the COVID pandemic—I mean, it got really bad. All of a sudden, there was so much information specifically about COVID, what it is, and how it can be treated and beyond. It just got to a point where I had to turn off the Internet, and I don’t even know what to believe anymore. This is weird. I feel like I’m living in some dystopian, post-Armageddon world where I’m; I don’t even know what I’m supposed to believe. Which is kind of strange. Long story short, it can be very easy to fall prey to misinformation, or, I should say, scientific information. That’s what it boils down to. Go ahead.

Beverly Yates, ND

No, no, no. I’m affirming. Unscientific. I agree. Go ahead.

Cyrus Khambatta, PhD

Yes. unscientific. When people refer to scientific information, we’re referring to all of the papers and scientific publications that have been created since the beginning of time that are put into this thing called PubMed. PubMed is a search engine. It’s the Google search engine for scientific papers. Most people don’t spend any time searching PubMed because why would you? It’s a bunch of esoteric information. It’s hard to understand. It’s hard to read, and, quite honestly, it’s just freaking boring. But people like you and me, who are super nerds, doctors, researchers, and beyond, love going into PubMed because that’s our source of truth now. Even within PubMed, there are a lot of conflicts, and you can look up the term insulin resistance to try and figure out what causes it. Even within the scientific papers themselves, there’s a lot of confusion. Then it becomes, well, now wait a minute, even though the science’s messed up and the science is confusing. How is the general public supposed to understand what’s the right thing to do?

What I would say is that, going back to what you were saying, what we don’t want to do is demonize any one particular food group or any one particular nutrient. That’s all. That’s what happens a lot on social media, where people will tell you that fiber is toxic for you. Don’t eat fiber; don’t eat carbs; carbs are bad for you; don’t eat fat. All that’s bad for you. Eat as much protein as you possibly can. Proteins. Great. You just see these sound bites, which make it seem believable. But in reality, it’s all just kind of a fragmented picture of a very complex master puzzle. I’ve spent a lot of time thinking. And, when we wrote the book Mastering Diabetes, Robin and I had to spend thousands of hours trying to figure out, How are we going to craft an argument that was going to help people understand that this complex world of nutrition is not that complex. But you have to apply some very fundamental principles first. one of those fundamental principles. Go ahead.

Beverly Yates, ND

Now, I was going to say you’re applying those fundamental principles first and consistently. Go ahead.

Cyrus Khambatta, PhD

Consistently. Exactly. What you have to do is ask yourself some pretty darn basic and general questions first, and then build upon those questions to make them more complicated. One of the first basic concept questions you can ask yourself is: What is the ideal macronutrient ratio for human health? Is there a single macronutrient ratio that is optimal for human health?  What I mean by macronutrient ratio is the distribution of carbohydrate versus fat versus protein that has been consistently shown to lead to positive health outcomes. Is it 33% carbohydrate, 33% protein, 33% fat, or 20% carbohydrate, 60% fat, and 20% protein? We’ve spent a lot of time trying to figure out the answer to that.

Here’s the answer already. There is no answer. The answer is that there is no answer. But the answer is that, again, if you look at the specific types of studies that are called randomized controlled trials, RCT. These are considered the gold standard in the world of nutritional research because they’re designed to follow a design that enables you to split subjects into two different groups and randomize them so they don’t know exactly which group they’re going into. Then you feed group one a specific protocol, you feed group two a specific protocol, and then you measure the differences over time. That’s how you’re supposed to do very good scientific research. Then you can get one step even further than that, and you can say, All right, let’s perform a meta-analysis of randomized controlled trials, which is a way of saying, All right, we have these 50 randomized controlled trials in front of us, and each one of them has a slightly different conclusion. Well, let’s pool all the data together into one giant conglomerate of data, and then let’s try and figure out what all of these papers say that doesn’t have a coherent story. That’s when you get to another level of trying to understand what the overall research has to say about a given topic. 

When you look at the meta-analyses and the systematic reviews of many randomized controlled trials, there’s a common theme that seems to be bubbling to the surface over the last 10 or 15 years. That common theme is exactly what I said earlier, which is that more plant-based material in your diet can lead to more positive health outcomes. Do you have to eat a strictly plant-based diet? No, not. If you want to, you can’t. But if you were to incorporate a larger amount of plant material into your diet in substitution for number one plant-processed foods and number two, animal-based foods, then you’re doing yourself a huge service from a cardio-metabolic perspective. By incorporating cardiovascular foods early, you’re lowering your risk for heart disease. Number two, all metabolic functions, whether that’s inside of your gut or inside of your liver, your kidney, your brain, you name it. All of that tends to improve. If you were to ask me, well, fine. Cyrus, what’s the ideal macronutrient ratio? My answer to you is somewhere between 70% carbohydrate, 15% fat, and 15% protein, somewhere in that range, between 70, 15, 15, and 80,10, 10. In both of those scenarios, we’re talking about an overwhelmingly large component of the diet that comes from carbohydrate-rich foods, only from whole sources, and the remainder is split relatively evenly between fat and protein. Again, it’s 70% carbohydrate split, 15/15 for fat and sodium, then carbohydrate, and then 15 fat, 15 protein, or 80% carbohydrate, 10 fat, 10 body. If you move in that general direction, then what you’re likely to find is that number one, your total fat intake has come down to a physiologically relevant amount—a physiologically normal amount. 

The standard American diet contains, on average, 42 to 45% fat, which is, technically speaking, a very high fat intake. A decent amount of that fat can come from saturated fat. Now, saturated fat is if I had to do a rank-ordered list of the worst offenders and two best offenders. Saturated fat would be my number one worst offender. Again, I’m not trying to say all saturated fat is bad for you, but saturated fat seems to be the one type of molecule, the one class of molecule that leads to more metabolic dysfunction than any other molecule. A high-fat diet, as well as a high-saturated-fat diet, can cause many problems from a cardiovascular perspective and an insulin resistance perspective. If you move from a diet that contains approximately 42 to 45% of your diet in fat and bring it down to somewhere between 10 and 15% there, that one change can have massive positive influences on your ability to utilize glucose as a fuel.

Glucose is a molecule that comes from the carbohydrate world. Let me say this one other way: fatty acids and carbohydrates compete for world dominance. The two of them do not know each other. The two of them do not want to coexist. When you consume a diet that is high in fat and a diet that is high in carbohydrates at the same time, many problems ensue. If you choose to follow my recommendations, what I suggest you do is lower your fat intake to between 10 and 15% of all calories and raise your whole carbohydrate intake. In that world, what that means is that the small amount of fat that you are consuming does not interfere with your ability to metabolize carbohydrates from whole foods. That is a good thing. That means you can eat whole foods, you can get a lot of carbohydrate energy, you can efficiently process that carbohydrate energy and that leads to the usage of glucose as a fuel, and that leads to optimal insulin signaling inside of your liver and inside of your muscle. Exactly the way human beings were designed—in fact, exactly the way most mammals were designed. The truth be told.

Beverly Yates, ND

Now that metabolic flexibility. It’s important.

Cyrus Khambatta, PhD

Exactly. Now. I just describe a situation where you go low-fat but high-carbohydrate, and again, the fat does not interfere with carbohydrate utilization or carbohydrate metabolism. Now, if we were to go and flip it in the exact opposite direction and say, What if you decided to eat a very high-fat diet, consuming 70 or 80% of your calories as fast as you would in the low-carbohydrate world or the ketogenic world, and then bring your carbohydrate intake down to something like 10 to 15 to 20%? What would happen in that scenario? Well, in that scenario, what you’re likely to find is exactly what the rest of the low-carbohydrate world finds: you get some very positive benefits that would come along for the ride. You get lower blood pressure, lower total cholesterol, lower triglycerides, lower fasting blood glucose, and you lose a lot of weight.

But what’s important to understand is that those results are short-term results. Those results are likely to happen within the first six months, maybe 12 months or so. But if you look at the data and the scientific research, what you’ll find is that people who experience positive benefits in the short term, oftentimes if you extrapolate into the future, go two years in the future, three years, sometimes even five years in the future, A1C values begin to rise once again, back up to the Type 2 diabetes level of greater than 6.4%. Blood pressure tends to come back up. LDL cholesterol is always high in that setting, and that’s not a good thing because your heart health is significantly compromised. It’s important to understand that if you play the game where you’re doing high-fat, low-carbohydrate, you will see a positive impact in the short term. But there is a strong likelihood that over a year, two years, or three years, you’re increasing the amount of insulin resistance in your liver and muscle. Much that you’re creating other problems, and they’re going to come back to bite you in the future.

Beverly Yates, ND

Cyrus, now, as we continue this interview, let’s talk about the Ozempic, the Mounjaro, Wegovy, and the GLP-1 drugs, and the opportunities they present for people.

Cyrus Khambatta, PhD

Okay. Phenomenal. There’s a whole class of drugs that are called GLP-1 receptor agonists. That’s just a long-winded, super-nerdy scientific way of saying drugs will help you do two primary things. Number one: lower your blood glucose. Number two, lose weight rapidly. GLP-1 receptor agonists were originally developed by the pharmaceutical industry to help combat type 2 diabetes and lower blood glucose in people living with type 2 diabetes. But what they found out was that when you interfere with the GLP-1 signaling pathway, you can end up generating a drug that makes rapid weight loss happen. As a result of that, GLP-1 receptor agonists are now more popular in the weight loss world than they are in the diabetes world. There are people all over the place who are non-diabetics, and they do not have diabetes in any way, shape, or form, but their doctors are prescribing them, GLP-1 receptor agonists named Ozempic, Wegovy, or Mounjaro, and are using these medications to lose weight. Guess what? It works like wildfire. 

I’m going to share my screen and show you a couple of different interesting things that can happen when you start using a GOP-1 receptor agonist. This is a study that was published in the New England Journal of Medicine, and it demonstrates what can happen to people who use a GLP-1 receptor agonist throughout a 68-week period, which is just over a year called a year and a quarter. What that means is that these individuals, the people from the study, were placed into one of two groups. Group number one was fed a placebo pill. They were told that they were taking some type of medication, but they didn’t know what it was. The group number two was given what’s called semaglutide. Semaglutide is the generic version of Ozempic, and Wegovy. Group number two was given some semaglutide, and again, they were not told what they were being fed, but basically, both groups went into this blindly. The first group throughout those 68 weeks ended up losing approximately 2% of their body weight over, of course, a year and a half or a year and a quarter versus the group that was fed semaglutide. They ended up losing, as you can see on this graph, 15% of their body weight throughout 68 weeks. A 15% body weight drop is a massive change. This is what makes this drug so attractive for doctors and so attractive for people who are overweight because as long as you’re taking it, you’re likely to lose a significant amount of weight. We’re not talking about just a couple of kilograms here and there. We’re talking about 15% of your total body weight. 

Now, this is given as a once-weekly injection. What that means is that you are prescribed a medication that you have to inject. The side effects of these injections can mount over time. This is what makes taking these drugs relatively uncomfortable. You can see on the screen here that the most common side effects of Ozempic include a lot of GI dysfunction because GLP-1 is a hormone that is secreted inside your digestive system. These drugs intercept and scramble the message that comes from GLP 1, which then causes your brain to interpret information differently. As a result of that, a lot of the side effects happen inside your digestive tract because that’s where GLP-1 functions. These side effects include nausea, abdominal pain, constipation, diarrhea, and vomiting. If somebody has taken either Ozempic, Wegovy, or Mounjaro, just go ask them. Say, Hey, were you nauseous? Did you vomit? What happened to your appetite? Did you get any GI dysfunction? 

Most people will tell you, yes, that was uncomfortable. It worked. My appetite just literally disappeared, but it did not feel good. I didn’t appreciate those side effects. The reason that these side effects are happening again is because GLP-1 is a hormone that is secreted by your small intestine, but GLP-1 sends signals to your brain, and your brain is where the bulk of the magic happens. If you can stretch your small intestine and stretch it to make it think that there’s food inside of it, which is exactly what these drugs do, then what’s going to happen is that your small intestine is going to pick up a phone and go call your brain via a neurological pathway and say, Hey, hypothalamus, can you not be as hungry? If you’re not as hungry, then you’re going to take on less food, and then you’re going to go into a negative calorie balance and lose weight. That’s what happens: these drugs make your digestive tract think that there is food inside of it when in reality there is nothing. As a result of that, your brain says, Oh, wait a minute, let me shut off my hunger signal, and then you are not hungry. If you don’t eat food, you begin to lose weight. That is the primary mechanism by which it works. It is very, very effective. 

There was another trial that’s called the Step Four trial that was published in 2021. In this trial, they took individuals, and they did something very interesting with them. They were trying to ask the question, What happens if you stop taking Semaglutide after taking it for 20 weeks? Does the weight loss that you experience while taking it stay or does it go away once you stop using it? What they did was take individuals and randomly assign them to one of two groups. Group number one was fed or given semaglutide for 20 weeks. then they continued to give them magnetite for the remainder of the time up to week 68. The second group, which is the placebo group, was also given some appetite for the first 20 weeks, and then they discontinued semaglutide from weeks 20 to 68. Effectively, both groups got it for 20 weeks, and then Group One continued, and Group One discontinued. What they found was that those who did continue ended up losing another 38% of their body weight after that first 20-week marker.

Those who discontinued ended up gaining 7% of their body weight back. The actual difference between those two groups at the end of 68 weeks means that there was about a 15 percentage point difference between whether or not you decided to keep using it or not using it. Why is this important? Well, I’ll tell you why, because this drug or these drugs only work when you use them. If you decide that you want to start using one of these medications, but yet, as Beverly states, you don’t make lifestyle modifications simultaneously, you are not increasing your intake of plant-based foods, reducing your intake of processed foods, reducing your intake of animal-based foods, reducing your intake of saturated fat, increasing your energy expenditure via exercise, developing, hydrating yourself, living a lower-stress lifestyle, getting a significant amount of sleep, and applying all the lifestyle principles that we know to work. If you’re not doing that in the background and you’re just taking an injection and you’re saying, I’m just going to let this injection do all the hard work for me, well, guess what? When you decide that paying $900 a month for that injection is no longer worth it, your weight is going to skyrocket. You go back to where you started, or more. But if you use it as a temporary stopgap to help start the weight loss process and then start making lifestyle changes after lifestyle changes after lifestyle changes, then when you decide that you’re going to stop taking the medication, the weight loss can persist into the future.

Beverly Yates, ND

That’s the Ozempic ticket. I always feel that these kinds of medications buy people time. I think it’s beautiful that it turns off that food noise that some people have. It just obsessively makes them eat even though they don’t even want to. They’re still doing it. Anything to help people be healthier, I’m all for it. But I know that you still have to do the lifestyle side. I want to see that message get out there. I think it is unfair to tell people, Hey, take this injection; it’s going to solve all your problems. Then, just as you said, it’s the second they discontinue that injection; for whatever reason, they don’t have the money. They decide that it’s not worth it. They don’t; they’re not. The side effects become overwhelming, whatever they might be. They’re back where they were. It’s okay, now what? The time you may have bought yourself to make those lifestyle changes, it’s a missed opportunity for real healing. I feel it’s part of the conversation. We all know these drugs are relatively new, and I’m hopeful, that our fellow health professionals will join in on making sure people get fully supported on what they need to do on the lifestyle side so that people can continue to be successful with these things. Because a lot of the people who turn to these classic drugs never got full lifestyle support to begin with.

Cyrus Khambatta, PhD

I fully agree. There’s just a large lack there. There’s a huge, what’s the word I’m looking for? There’s a huge problem: doctors are not trained to teach their patients how to adopt lifestyle changes. Dr. Yates is given instructions on how to prescribe them medications. so they use it as their first line of defense, rather than teaching them how to apply lifestyle principles that have plenty of research and evidence to demonstrate that they’re very powerful. If we can get to a point where our medical professionals have more knowledge and better tools, we will be in a much better place as a society and as a country.

Beverly Yates, ND

Agree. Now we’ve got pockets of people who might be naturopathic doctors like myself. They could be functional medicine doctors, etc. who may be understanding this deeply and supporting people. But there’s nowhere near enough of us. We need the conventional medical world to join us here to make that difference for most people because that’s what people typically have more access to.

Cyrus Khambatta, PhD

I couldn’t agree with you more. 

Beverly Yates, ND

Okay, great. As we go to wrap this up, do you have any parting thoughts to share with people? I hope you give them a little news to get going. Yes, for sure. I need that encouragement. They need the inspiration.

Cyrus Khambatta, PhD

Yes, absolutely. It’s funny; I was just talking with a gentleman yesterday that I met for the first time. As we were sitting down to eat some food as a group, he mentioned that he is living with type 2 diabetes. My wife and I turn to him. We’re like, How long have you been living with type 2 diabetes? We got curious and started to understand. Well, what do you eat and do? You move your body, and you name it. He painted the perfect picture of type 2 diabetes. I don’t exercise because it hurts. I’m too heavy now. It used to be 225 pounds. Now I’m 233 pounds. I want to be able to exercise, but I just can’t do it now. It’s just too uncomfortable. I said, Well, what do you eat for breakfast? He goes, Well, I’m eating a ham and cheese sandwich for breakfast. Sometimes I eat some eggs, and then I might have a couple of fruits later, but then I’ll have some chicken or some tacos for dinner. Okay, you just literally described the perfect recipe for type 2 diabetes.

The recipe is perfect; an even more perfect recipe would be that you’re consuming a lot of alcohol, which he didn’t say anything about. We then went down the path of trying to educate him and explain to him why eating a more plant-based, strong diet and lower-fat diet was going to make a positive impact. The light bulbs in his brain just went off, and he was, Wait, what are you talking about? Well, what about this? What about this? What about this? He got curious and started to ask questions. Within the course of a 30-minute conversation with him, he was completely transformed from the inside out. He’s holding on. Let me take a picture with you. This is my before picture, starting now. I’m starting on this, and I’m going to make it happen. Trust me, two months from now, you’re not even going to recognize me anymore. I was like, The light bulb in his head just turned on, and he now knows to give him the nudge to start making changes for himself because I can’t do it for him, and neither can my wife. But he’s going to have to do it for himself. It was it’s that same idea that everybody has within them the power to succeed. Every single person. You just have to decide whether or not you care enough. Do you care enough about yourself? Do you care enough about the people that you live with? Do you care enough about your friends and your family to be able to be here on this planet for a long period and have exceptional health in the future? If you do, then you’re going to do whatever you can to live an incredible life and do whatever you can to try and get your health under control. 

My suggestion for you would be that if you believe in it and if you believe that you’re good enough, and honestly, I believe that you’re good enough, then I would strongly recommend taking this information from this summit and the plant-based world in general and incorporating it into your lifestyle piece by piece. It is not a sprint. It is a marathon. If you start to incorporate tiny little pieces over time, which you are likely to find, so many things about you will change: your glucose will come down, your blood pressure will come down, your cholesterol will come down, and you will start to lose weight. Great. But in addition to that, your thoughts will change. You’ll become a happier person. Literally. You will have a happier brain. Your digestive process will become better, your skin will become clearer, you’ll have more energy, you’ll sleep better, and you’ll have better interpersonal relationships with friends in your life and with family members. Everything about you will change because you are improving from the inside out. If you resonate with that message and you’re sitting there thinking to yourself, man, I got to get started. I know I should, I should do this. I should do that. There are no shoulds in life. Stop saying the word should. I’m going to do it. Just put it into play and start making tiny little microscopic changes and compounding them on themselves over time, and just watch as you completely transform from the inside out. But you have to trust the process. If you can trust the process, I guarantee you it’s going to work.

Beverly Yates, ND

Bravo. Way to bring it home. As we wrap up this interview, please tell us where people can connect with you if they want to learn more.

Cyrus Khambatta, PhD

If you want to connect with us, just go to any platform. Just look up the words @MasteringDiabetes, Instagram, TikTok, Facebook, YouTube, podcast, and website. Masteringdiabetes.org or type, mastering diabetes, knowing where those platforms are, and yes. We are producing lots of content all day long, every single day. If anything I’ve said, even one tiny, microscopic little thing that I said resonated with you. Go learn more information and get involved. We have a coaching program. Our coaching program has touched the lives of thousands of people and continues to transform lives every single day. The stories that I read that come out of this program bring me to tears, literally bring me to tears, where people are transforming from the inside out and getting a new lease on life. If you want a new lease on life, if you want to feel your best if you want to look your best, and if you want to transform yourself from the inside out, you have the power, you have the tools, and you just have to get started. I guarantee you, it’s going to work.

Beverly Yates, ND

Absolutely. Live long and live well. You address these root causes, and it makes it possible for people to unlock their code and enjoy the health that everyone deserves. We just need support, and we need to know how.

Cyrus Khambatta, PhD

You got it. You nailed it.

Beverly Yates, ND

Beautiful. Thank you so much for being a partner with me here at the summit. I love always interviewing you, the information and energy that you bring, and your lived experience. It makes this even more real. Friends, please share this summit with anyone you know, who either has Type 2 diabetes or pre-diabetes, any kind of blood sugar dysregulation, or people who work with them—health professionals and people who advocate for them—me, family members, neighbors, colleagues, friends, whatever people’s emotional and social world matters. Please share this so we can reach as many people as possible. I still have that goal, and I’m getting closer to helping 3 million people or more around the world get a hold of this blood sugar issue and make it different and better for themselves going forward. Thank you for tuning in.