[SPEAKER_02]: Hey, it's Elizabeth McGand, the holistic GLP1 podcast.
[SPEAKER_02]: That would do it.
[SPEAKER_01]: Physical activity is a cornerstone for weight loss maintenance.
[SPEAKER_01]: Not for losing weight.
[SPEAKER_01]: You can be very successful and lose body fat and not increase your physical activity, not increase your movement.
[SPEAKER_01]: But when we look at the data of people who are successful at doing this, do a certain amount of physical activity.
[SPEAKER_01]: It's almost like there's a threshold, almost like there is a amount of energy that
[SPEAKER_01]: Oh, that's interesting.
[SPEAKER_01]: And when you get to that level of energy through, and you're eating and you're burning, right?
[SPEAKER_01]: So you're matching.
[SPEAKER_01]: You want to match how many calories come in to how many calories you burn.
[SPEAKER_01]: That's the key to weight loss maintenance, not to be out of balance, but to be in balance.
[SPEAKER_01]: There seems to be something about a certain amount of energy through the system that allows your body to do this naturally.
[SPEAKER_01]: Ah, naturally.
[SPEAKER_01]: And we call it metabolic flexibility.
[SPEAKER_02]: Oh, no, we do it.
[SPEAKER_02]: Today's episode is about one of the biggest questions I hear from women using GLP1 medications.
[SPEAKER_02]: Not how to lose the weight, but what happens once you reach your goal?
[SPEAKER_02]: And I see this every day with the women we support inside our holistic GLP1 programs, when GLP1s are used thoughtfully with a medical provider alongside nutrition, strength training, and real metabolic healing, weight loss becomes easier, and women start to feel like themselves again.
[SPEAKER_02]: But then a new fear shows up.
[SPEAKER_02]: Do I have to stay on this forever?
[SPEAKER_02]: What happens if I stop?
[SPEAKER_02]: Today's conversation answers that question.
[SPEAKER_02]: I'm joined by Dr. Holly Wyatt, an endocrinologist and obesity medicine physician who has spent decades studying not just weight loss, but what actually helps people keep it off long-term.
[SPEAKER_02]: Her new book, Losing the Weight Loss Meds focuses on something that hasn't been talked about enough.
[SPEAKER_02]: How to transition off of GLP-1 medications without regaining the weight.
[SPEAKER_02]: What I love about this conversation is how naturally her work fits into what we teach inside our holistic gelp1 coaching programs that medication can be incredibly helpful, but it's not the destination.
[SPEAKER_02]: Freedom is.
[SPEAKER_02]: In this episode, we talk about why weight regain happens.
[SPEAKER_02]: What the body needs to transition successfully off of the medication and how food, movement, muscle, and mind state all come together to create lasting results.
[SPEAKER_02]: Let's get into it.
[SPEAKER_02]: Good work.
[SPEAKER_02]: I'm excited.
[SPEAKER_02]: Dr. Holly Wyatt, thank you for being here.
[SPEAKER_02]: I'm excited too.
[SPEAKER_02]: Thanks for inviting me.
[SPEAKER_02]: Oh gosh, it's cool.
[SPEAKER_02]: Your work is awesome and I'm really looking forward to getting into some cool stuff.
[SPEAKER_02]: And I wanted to just get right into it.
[SPEAKER_02]: You've spent decades studying weight loss and weight management maintenance.
[SPEAKER_02]: What was happening in your clinical work that made you realize that we needed an entire book just on getting off of weight loss medications.
[SPEAKER_01]: Well, I think it's for the very first time, people were asking me about weight loss maintenance.
[SPEAKER_01]: I've been doing weight loss maintenance for 30 years, but no one really wanted to talk about it.
[SPEAKER_01]: I would always kind of hide it in weight loss.
[SPEAKER_01]: They would love to talk about weight loss.
[SPEAKER_01]: I could do a talk on weight loss.
[SPEAKER_01]: It would be, you know, people would be standing in the back row.
[SPEAKER_01]: If I was to say, let's go talk about weight loss maintenance, you know, crickets, no one would come.
[SPEAKER_01]: Because no one was really ready.
[SPEAKER_01]: to talk about weight loss means they always wanted to lose more weight.
[SPEAKER_01]: We did have tools that produced a large enough amount of weight loss that people really were ready to graduate to the next phase.
[SPEAKER_01]: Yeah.
[SPEAKER_01]: So for the first time in my career, I was like, yes, it's time.
[SPEAKER_01]: You know, yeah, this is what I studied my whole career.
[SPEAKER_01]: Now I can help people because they're finally ready to talk about what it takes for weight loss maintenance.
[SPEAKER_01]: That's what really set this book up.
[SPEAKER_01]: The GLP-1 medications made that possible.
[SPEAKER_02]: Yes, and I think there's this big fear and it's being propagated by very well-meaning physicians that you're gonna have to be on these medications for life.
[SPEAKER_02]: And maybe there's some truth to that.
[SPEAKER_02]: And maybe also there's a way to do it better.
[SPEAKER_02]: And that's why your book, everyone's got to get it.
[SPEAKER_02]: So many people talk to me about their fear of like, oh man, is this a life sentence?
[SPEAKER_02]: You'll have to be on these for life.
[SPEAKER_02]: And I'm just wondering what your thoughts are on that.
[SPEAKER_02]: Why does it happen?
[SPEAKER_02]: Why do people gain the way back?
[SPEAKER_01]: Well, first of all, I like to say, it's a choice.
[SPEAKER_01]: You can beyond the medications long term.
[SPEAKER_01]: I think we'll learn maybe how to do that even better.
[SPEAKER_01]: But you don't have to.
[SPEAKER_01]: The book was really written as a choice.
[SPEAKER_01]: So if you don't want to stay in a long term, some people don't feel great on the medications.
[SPEAKER_01]: Some people do.
[SPEAKER_01]: And there's just all these different reasons.
[SPEAKER_01]: So as written as a choice, this is what you have to do, but this is a possibility.
[SPEAKER_01]: And we do know about weight loss maintenance.
[SPEAKER_01]: We do have science that can help people succeed.
[SPEAKER_01]: But we weren't getting it out there.
[SPEAKER_01]: So the book was saying, let's get it out there.
[SPEAKER_01]: So people have that option if it makes sense for them.
[SPEAKER_02]: Yeah.
[SPEAKER_02]: And what are you noticing when people do follow people on JLP ones?
[SPEAKER_02]: Do you have a sample set of people where they have gone off of them and you've been able to kind of observe how they do off of the medications completely?
[SPEAKER_01]: So I've followed a lot of people in weight loss maintenance.
[SPEAKER_01]: We have the National Weight Control Registry plus just all of my, you know, clinic and program patients.
[SPEAKER_01]: I've followed them in weight loss maintenance for many, many, many years.
[SPEAKER_01]: Obviously, the population for the GLP ones is much smaller because it's just happened.
[SPEAKER_00]: Yes.
[SPEAKER_01]: We are starting to see more examples of what people are is working, what it's not working.
[SPEAKER_01]: So we're just starting to kind of get all that real world data in.
[SPEAKER_01]: But before we get all that real-world data in, we do have some things we know work.
[SPEAKER_01]: That's why I don't think we want to wait.
[SPEAKER_01]: I think we want to get this information out here now.
[SPEAKER_01]: And I know there are some strategies that work for people to keep the weight off.
[SPEAKER_02]: Yeah, and it's very similar to the best practices for how to be on a GLP one.
[SPEAKER_02]: I like to talk about in the work that I coach with people that
[SPEAKER_02]: GLP ones can be training wheels, training wheels for the right behavior, and what will set you up for success off of a GLP one is really how you approach the actual weight loss journey.
[SPEAKER_02]: Can you speak to that more?
[SPEAKER_02]: It seems like we're aligned there.
[SPEAKER_01]: Absolutely.
[SPEAKER_01]: I would say begin with the end in mind.
[SPEAKER_01]: While you're on the GLP one is the perfect time where you have some protected time because your appetite is being controlled by the medication is being, you know,
[SPEAKER_01]: is at a lower level than it would ever will be.
[SPEAKER_01]: So you can practice some things that you may need skills you could need in the future.
[SPEAKER_01]: And it's the perfect time to do that.
[SPEAKER_01]: So don't just go on the medicine and just focus on losing the weight, focus on that.
[SPEAKER_01]: But also think about the future.
[SPEAKER_01]: Begin with the end of mind and say, what skills, what strategies, what changes to my environment, do I want to put in place?
[SPEAKER_01]: So when or if I go off the medication,
[SPEAKER_02]: Yeah, and what are those best practices?
[SPEAKER_02]: Let's talk about nutrition.
[SPEAKER_02]: I love about you as a physician.
[SPEAKER_02]: You're an endocrinologist.
[SPEAKER_02]: So awesome, and you understand nutrition, as well as lifestyle and sustainability, it's unique in physicians.
[SPEAKER_02]: And I really applaud you for really going so deep into this work.
[SPEAKER_02]: What are the best practices that people could train, behavior change that they could do when they're on a GOP one, so they can get off of it.
[SPEAKER_01]: Yeah, so there's there's there's multiple, but I kind of think of them.
[SPEAKER_01]: There's some food things they can do.
[SPEAKER_01]: There's some physical activity.
[SPEAKER_01]: Things they can be preparing for and there's some mind or mind state things and I think you're going to love that, right?
[SPEAKER_01]: Yes, they can do to start preparing.
[SPEAKER_01]: In addition to those three big buckets, I always talk about, let's get your environment set up to support the new you, the new body weight.
[SPEAKER_01]: What's your environment?
[SPEAKER_01]: How is that gonna help you?
[SPEAKER_01]: And put some new routines and rituals in place.
[SPEAKER_01]: If you want to stay at this new body weight, after the medication is gone, you need an environment that's different.
[SPEAKER_01]: If you go back to the same environment, guess what?
[SPEAKER_01]: You go back to the same weight.
[SPEAKER_01]: If you go back to the same routines and rituals, you have a tendency to go back to the same weight.
[SPEAKER_01]: But if you change those, that can be just as powerful as the physiology.
[SPEAKER_01]: One of the things, biologies involve physiologies involved, there's no doubt.
[SPEAKER_01]: And the medications change that while you're on them.
[SPEAKER_01]: If you go off the medication, your physiology is going to come back.
[SPEAKER_01]: But the environment is just as powerful.
[SPEAKER_01]: And that's the message a lot of people don't understand.
[SPEAKER_01]: The environment's what's causing your body weight, the obesity epidemic, just as much as that physiology equal.
[SPEAKER_01]: So let's work on that so that if you do need to or want to stop the medication, you have something already in place that can really help you maintain.
[SPEAKER_02]: Yeah, and I want to talk about changing the environment, curious what that is for you.
[SPEAKER_02]: I also just want to also add that if people are, it just makes common sense that if you're taking a GLP1 and you're letting the GLP1 do all the work and you change nothing else, then it's not going to go very well when you come off of it because you're relying 100% on the medication.
[SPEAKER_02]: And if the medication goes away, of course you're going to gain the weight back.
[SPEAKER_01]: it makes sense.
[SPEAKER_01]: It that's how the medications working.
[SPEAKER_01]: If you're only relying on the medication, it's like a blood pressure pill.
[SPEAKER_01]: You stop the blood pressure pill.
[SPEAKER_01]: Your blood pressure goes back up.
[SPEAKER_01]: It's not a failure.
[SPEAKER_01]: It's just how it works.
[SPEAKER_01]: Right.
[SPEAKER_01]: That part makes sense.
[SPEAKER_01]: And I would say you need to work on this while you're on the meds.
[SPEAKER_01]: Or if for some people, they're saying, well, I'm already off of them.
[SPEAKER_01]: Okay, you can transition.
[SPEAKER_01]: You can still, the key is to have a plan to have some type of here's what I'm going to do to try to replace the impact the medication was having.
[SPEAKER_02]: Well, let's talk, let's go right into that.
[SPEAKER_02]: Cause you're an endocrinologist.
[SPEAKER_02]: So you understand blood glucose levels.
[SPEAKER_02]: Do you work with diabetics?
[SPEAKER_02]: Oh, yes.
[SPEAKER_02]: Okay.
[SPEAKER_02]: So diabetics, it's a blood glucose issue without going to into the weeds of all the biochemistry.
[SPEAKER_02]: This is a lay audience that just wants to hear it in a way that will really make sense.
[SPEAKER_02]: When these were originally diabetes drugs and they make your blood glucose, it would look more normal.
[SPEAKER_02]: If you were wearing a CGM, the continuous glucose monitor, or you were to test your blood glucose, it would go to a more normal range, right?
[SPEAKER_01]: On these drugs.
[SPEAKER_01]: And that helps you get more normal, probably less ups and downs, right?
[SPEAKER_02]: And by doing that, it gives you these effects of less hunger, more fat burning.
[SPEAKER_02]: It's easier to lose weight.
[SPEAKER_01]: Well, it has those effects on glucose.
[SPEAKER_01]: It probably has separate effects.
[SPEAKER_01]: So that is helping.
[SPEAKER_01]: That definitely helps with diabetes, and it also may help with some weight loss because of the patterning.
[SPEAKER_01]: But there's also some separate effects that these drugs do in terms of satiety and the brain, and some other things going on.
[SPEAKER_01]: So these receptors, these GLP-1 receptors are all over the body.
[SPEAKER_01]: So they're having, you can see this having a lot of different effects and different different organ systems.
[SPEAKER_01]: And we don't even understand them all yet.
[SPEAKER_01]: We know there's an effect on glucose and for diabetes, we know there's effect on body weight for obesity.
[SPEAKER_01]: And we know there's effect on cardiovascular risk and improving cardiovascular status.
[SPEAKER_01]: And that's probably a different pathway too.
[SPEAKER_01]: So there's lots of moving parts when we talk about these GLP ones.
[SPEAKER_02]: lots of moving parts, but let's go right into the metabolic aspect of it, the blood glucose aspect, because if we look at that, it is possible for someone who's pre-diabetic or even diabetic, type two, someone who's dipped into that range through diet and lifestyle alone, to reverse maybe the wrong word, but to get it back into a healthier range.
[SPEAKER_02]: It's possible to do that
[SPEAKER_01]: Absolutely, we have studies that have proven that.
[SPEAKER_01]: The diabetes prevention study, we've had look ahead studies, we've had big huge studies that have proven diet and activity, lifestyle, can do that to diabetes, reverse it, prevent it, all just what you said.
[SPEAKER_01]: And improves your glucose.
[SPEAKER_02]: Yes, that's right.
[SPEAKER_02]: So wouldn't it make sense that if you learned how to do that,
[SPEAKER_02]: as part if that was part that could be part of your maintenance if you could learn how to eat and move your body in a way where your glucose was managed and if you were and if you were using the peptide the JLP1 to do it and you want to come off of it is there a way to do that in maintenance where you're managing your glucose similarly.
[SPEAKER_01]: Does that make sense?
[SPEAKER_01]: That's what you're going to try to do.
[SPEAKER_01]: You're going to try to do it similarly.
[SPEAKER_01]: Realize though, their physiology does play a role too.
[SPEAKER_01]: It's your managing it, but for some people, the physiology makes that management more difficult.
[SPEAKER_01]: than for others.
[SPEAKER_01]: And so the drug kind of comes in.
[SPEAKER_01]: Let's you, like you said, practice the training wheel analogy.
[SPEAKER_01]: I think is great.
[SPEAKER_01]: Lots of data to show what we do in that lifestyle period that can produce similar types of results.
[SPEAKER_02]: What do we do?
[SPEAKER_02]: How do we do that?
[SPEAKER_02]: I'm all ears.
[SPEAKER_02]: And I know people are taking notes.
[SPEAKER_01]: Yeah, so when we, you know, I said, there's just three buckets.
[SPEAKER_01]: I think the food, and this is where it's a little bit different.
[SPEAKER_01]: I think when you're on the medication, you need to be thinking more about the quality of the weight loss, not just the quantity, so you may be eating a little bit different.
[SPEAKER_01]: The medication might be doing the heavy lifting of keeping that appetite low.
[SPEAKER_01]: When you come off the meds, you need to change the food where it's going to help with satiety.
[SPEAKER_01]: Obviously, we want to reset your appetite.
[SPEAKER_01]: Not as low as probably the medications can do because they're really lowering that appetite for a lot of people.
[SPEAKER_01]: But we don't want it to go up to where it was.
[SPEAKER_01]: It's high as it was before.
[SPEAKER_01]: How do we do that?
[SPEAKER_01]: Yeah, with food, you can do some things.
[SPEAKER_01]: And you've talked about that glucose pattern, there's something to do with that.
[SPEAKER_01]: You can do several things to help decrease it, reset it.
[SPEAKER_01]: A little bit lower than it was, probably not as low as on the medicine, but not as high as it was before the medicine.
[SPEAKER_01]: Things like, and these were, we have certain principles in the books we talk about.
[SPEAKER_01]: It's not just one thing.
[SPEAKER_01]: I always get on these shows and they're like, tell me the magic, I'll lay in.
[SPEAKER_01]: I'm like, I would.
[SPEAKER_01]: I would.
[SPEAKER_01]: I promise you I would.
[SPEAKER_01]: If it was just one thing, but there's not.
[SPEAKER_01]: There's several things you do.
[SPEAKER_01]: And some people may be more sensitive to some of them than others.
[SPEAKER_01]: And that's why we wrote a playbook because you need to go in and figure out which of these food plays work for you.
[SPEAKER_01]: But for instance, one of the food plays is always combining a protein and a carbohydrate, not eating a carbohydrate by itself, always making sure your meals when you're in maintenance is a combination.
[SPEAKER_01]: So I'm not going to be telling you what to eat in this book, because that doesn't work.
[SPEAKER_01]: If you eat this, you'll eat it for a certain amount of time and then you won't eat it.
[SPEAKER_01]: You won't be able to eat it forever.
[SPEAKER_01]: And we're talking about forever.
[SPEAKER_01]: when it comes to weight loss maintenance.
[SPEAKER_01]: So these are more principles, uh, we have something called an appetite reset meal, which has really been helpful for people.
[SPEAKER_01]: Uh, tell me more.
[SPEAKER_02]: I love that appetite reset meal.
[SPEAKER_01]: Yeah.
[SPEAKER_01]: So it's your first meal of the day and I don't once again don't tell you you've got to eat.
[SPEAKER_01]: Greek yogurt or you've got to eat egg whites because that just doesn't work but there's parameters.
[SPEAKER_01]: It has a meal that has at least 15 grams of fiber, at least 25 grams of protein.
[SPEAKER_01]: We limit the carbohydrates to under 45, so we're getting a balance there, try to limit sugar to less than 10, so there's some parameters that we kind of set up.
[SPEAKER_01]: You can decide what you put together.
[SPEAKER_01]: But the object of this meal is to keep your appetite more steady throughout the day.
[SPEAKER_01]: To start you off, where you're not just getting a big insulin spike and then the glucose going down and to allow you then for what you eat the rest of the day, you be in a better place to control it, to decide how much, to not be fighting it, to not be using as much willpower, to reset
[SPEAKER_01]: your appetite for that day.
[SPEAKER_01]: And I think the first meal of the day is a great time to do that.
[SPEAKER_02]: 100%.
[SPEAKER_02]: I find if you need a sugary breakfast, the standard American breakfast, you get a big spike of glucose in the rest of the day.
[SPEAKER_02]: Some people are more sensitive than others.
[SPEAKER_02]: You're chasing that next hit.
[SPEAKER_02]: Like almost like a drug addict.
[SPEAKER_02]: You have a sugary cereal like two hours later, you're looking for like your hungry.
[SPEAKER_02]: And it's the up and downness.
[SPEAKER_02]: To your point, if it's a really
[SPEAKER_02]: You're, you're, it's so much easier to go throughout the day.
[SPEAKER_01]: And what I love that you said is some people are more sensitive than others.
[SPEAKER_01]: Yeah.
[SPEAKER_01]: I'm very sensitive, so that's one that I worked really, really well for me.
[SPEAKER_01]: I have a good friend who's like, that one didn't seem to be the best play for me, but this other play, it does seem to really work for me.
[SPEAKER_01]: And that's the hard part and writing this book, but also I think the key is not to make this dogmatic.
[SPEAKER_01]: Here are the 10 rules you've got to do, because that doesn't work.
[SPEAKER_01]: Here are the plays.
[SPEAKER_01]: The idea is to go in and pick the ones you need to help control your appetite off these medications.
[SPEAKER_01]: What's another play?
[SPEAKER_01]: So we also have something called a satiety snack.
[SPEAKER_01]: So the appetite reset meal is you start.
[SPEAKER_01]: It's like taking a medication first thing in the morning.
[SPEAKER_01]: you do it every day.
[SPEAKER_01]: You can pick the foods.
[SPEAKER_01]: That's what people get confused.
[SPEAKER_01]: Oh, you're going to make me eat this meal every day.
[SPEAKER_01]: No, I'm going to allow you to pick the foods, but I want the parameters to set it up, so it's going to help reset your appetite.
[SPEAKER_01]: But that is a daily dose, like a medicine you take every morning.
[SPEAKER_01]: And it's protein fiber and lower carbohydrate.
[SPEAKER_01]: Lower carbohydrates, watch the sugar.
[SPEAKER_01]: We even watched the fat in that first meal, just to set up.
[SPEAKER_01]: And I'll be honest with you.
[SPEAKER_01]: I think there's a mind state part to it, too.
[SPEAKER_02]: Yeah, tell me more.
[SPEAKER_01]: Well, you're doing this.
[SPEAKER_01]: You're eating it when you eat it mindful.
[SPEAKER_01]: You're like, okay, I'm setting myself up for success.
[SPEAKER_01]: You believe in that, you remember it, you remember what's important for you?
[SPEAKER_01]: I mean, we're combining it.
[SPEAKER_01]: I think the fiber and the protein in the carbs and in the combination that we're doing is very important for the physiology, but I think mine state needs to be in everything we do.
[SPEAKER_01]: And so that fits perfectly.
[SPEAKER_02]: I love that.
[SPEAKER_01]: The satiety snack is what I call PRN, which means take as needed, a medication we say is PRN is if you only take it when you need it.
[SPEAKER_01]: So a satiety snack is something you have ready to go, and we have certain parameters kind of around it too, and it needs to be what you tend to crave.
[SPEAKER_01]: If you're a chocolate craving, let's make the satiety snack about chocolate.
[SPEAKER_01]: If you're savory, let's make it about savory, or maybe you're both, so you got to have a chocolate one in a savory one ready to go, depending on what might come your way.
[SPEAKER_01]: You know, you go for that snack that's already been kind of prepared, just like a medication.
[SPEAKER_01]: Oh, I'm feeling this PRN.
[SPEAKER_01]: I need this.
[SPEAKER_01]: I take it as I need it.
[SPEAKER_01]: So that's another play for people.
[SPEAKER_01]: And like I said, some people said, yes, this is me.
[SPEAKER_01]: I'm really one of those.
[SPEAKER_01]: I crave something and I think about it and that food noise is so loud about it.
[SPEAKER_01]: I need something to do.
[SPEAKER_01]: And some people say, not really my thing.
[SPEAKER_01]: Wow.
[SPEAKER_02]: I love that.
[SPEAKER_02]: Give me more.
[SPEAKER_02]: Leave your whole book and people who have to get this book.
[SPEAKER_02]: What's another strategy?
[SPEAKER_01]: So then, well, let's move to physical activity because then, all just about the food.
[SPEAKER_01]: And I think that's really important.
[SPEAKER_01]: We tend to focus everything on the food.
[SPEAKER_01]: And very important part of the three, the three things, the three big buckets, but alone probably would not make you successful.
[SPEAKER_01]: If you just focused on the food.
[SPEAKER_01]: Yeah.
[SPEAKER_01]: Physical activity, we've known for many, many, many years, is a cornerstone for weight loss maintenance, not for losing weight.
[SPEAKER_01]: You can be very successful and lose body fat and not increase your physical activity, not increase your movement.
[SPEAKER_01]: But when we look at the data of people who have been successful keeping weight off, one of the things that comes out time and time and time again is that people who are successful at doing this do a certain amount of physical activity.
[SPEAKER_01]: There's almost like there is a amount of energy that needs to move through your system.
[SPEAKER_01]: Oh, that's interesting.
[SPEAKER_01]: And when your body, when you get to that level of energy through, and you're eating, and you're burning, right?
[SPEAKER_01]: So you're matching for weight loss maintenance.
[SPEAKER_01]: You want to match how many calories come in to how many calories you burn.
[SPEAKER_01]: That's the key to weight loss maintenance, not to be out of balance, but to be in balance.
[SPEAKER_01]: And there seems to be something about a certain amount of energy through the system that allows your body
[SPEAKER_02]: Ah, naturally, and we call it metabolic flexibility.
[SPEAKER_02]: Ooh, yes, what does that mean exactly?
[SPEAKER_02]: Metabolic flexibility.
[SPEAKER_01]: It means when you decide to have a little bit more calories or eat a piece of birthday cake or have some pizza, which we all are going to do at some point your body can adjust.
[SPEAKER_01]: Okay.
[SPEAKER_01]: I think about the people who's waiting ever changes.
[SPEAKER_01]: There's people out there, I used to say I hate them because they don't have to do things.
[SPEAKER_01]: They don't think about it.
[SPEAKER_01]: And I'm like, how do you keep your weight exactly two pounds?
[SPEAKER_01]: You know, how do you do that?
[SPEAKER_01]: Are you writing down what you're eating?
[SPEAKER_01]: Cause if, you know, and they're not, their body is helping them do that.
[SPEAKER_01]: And your body can help you do that when you have a certain amount of energy through the system.
[SPEAKER_01]: But that's that metabolic flexibility.
[SPEAKER_01]: You want that, that's easy.
[SPEAKER_01]: It's like you don't have to think about it.
[SPEAKER_02]: And there's something about movement.
[SPEAKER_02]: There's a certain amount of energy that wants to move through the body through activity that just makes that easier.
[SPEAKER_02]: It gives that flexibility.
[SPEAKER_01]: Think about a car idling, and I'm not a good car analogy, but apparently when a car idles higher, it can adjust quicker versus kind of low and sluggish, it doesn't respond.
[SPEAKER_01]: Ah.
[SPEAKER_01]: Think about your metabolism responding, and you need a certain amount of energy through it for it to be able to respond to what you're eating and burn.
[SPEAKER_01]: If you don't want extra fat, we want it to be able to burn that extra fat, burn that extra carbohydrate.
[SPEAKER_02]: And is it true?
[SPEAKER_02]: And I want to hear this from endocrinologist that when you're spiking an insulin is released, it's harder to burn fat.
[SPEAKER_01]: I don't know that it's harder to burn fat, but definitely I think it's related to some of the satiety and thinking about food and the patterning.
[SPEAKER_01]: I think we're gonna have some data, I think in the future that's gonna show the patterns, more than the absolute amounts, may be important for the appetite regulation.
[SPEAKER_01]: So I think that may be more important than the other, but you could be right.
[SPEAKER_01]: There's lots of different things we don't understand yet.
[SPEAKER_02]: Well, when you eat sugar, an insulin's released, doesn't that tell the body to store the glucose that's coming into the system as fat?
[SPEAKER_01]: Sure, insulin is storage, there are 10 to stay store, but you really have to look at it average down over time.
[SPEAKER_01]: Okay.
[SPEAKER_01]: To kind of get to the final part.
[SPEAKER_01]: So it's hard to study.
[SPEAKER_01]: You got to study people for a long time.
[SPEAKER_01]: You can't just study them for a short period of time to really get the real answer.
[SPEAKER_01]: But I do think trying to control that in some way, not have the big spikes.
[SPEAKER_01]: I do agree with you is very helpful for some people.
[SPEAKER_02]: And movement, they say after you eat a meal and you walk or you move, it burns off some of that excess glucose.
[SPEAKER_01]: I think it's helpful.
[SPEAKER_01]: I think it's helpful for maybe that reason.
[SPEAKER_01]: I also think it's helpful for my behavioral routine and ritual standpoint.
[SPEAKER_01]: I think there's multiple things.
[SPEAKER_01]: One of the plays in the book for physical activity is something called the supper club.
[SPEAKER_01]: Ooh.
[SPEAKER_01]: And this is where you go in and you do some physical activity either before or after you eat.
[SPEAKER_01]: very specifically and you start to make that a routine or ritual and we have some specifics about how to do that and you know take to get that going but but the idea that's a play and for some people that has been critical they're like okay I can and you don't have to be a 60 minute walk.
[SPEAKER_01]: It can be 10 or 15 minutes, but you start putting that movement in around the supper time.
[SPEAKER_01]: And it even can become a family or routine that the family thinks about or does together.
[SPEAKER_01]: And you start to kind of also chunk that physical activity you need.
[SPEAKER_01]: It doesn't have to be all at once.
[SPEAKER_01]: You can do it in bite size parts.
[SPEAKER_01]: Most people say, OK, I can go do something for 15 minutes.
[SPEAKER_01]: I can move for 15 minutes, and so the separate club is one of the plays that's in the book.
[SPEAKER_02]: There's so many plays, and I like to say that most people are doing GLP ones wrong, and it's a fun thing to say, but just observing people, relying overly relying on the medication, not doing the behavioral change, and if people are fundamentally relating to a GLP one, not as well as they could, with some of the tips that you're giving us,
[SPEAKER_02]: What would it make sense that when they come off of it, they're also going to be making mistakes?
[SPEAKER_02]: In your experience, what are the most common mistakes that people make when they stop GLP ones that almost guarantee weight regain?
[SPEAKER_01]: Well, the number one mistake is they don't have a plan.
[SPEAKER_01]: They say, I'm just going to see how it goes.
[SPEAKER_01]: And I don't know how many people, let me just see, I, and I do think they believe they're going to be able to control their appetite without the medication.
[SPEAKER_01]: A lot of times they've been on it for a while and they've almost forgotten, I think that's normal.
[SPEAKER_01]: You, you've had the medication on board.
[SPEAKER_01]: You, you have been working to try to eat reasonable portions.
[SPEAKER_01]: You know, you have worked with the medication that way, and you don't remember or don't truly understand how much the medication has been helping to keep that appetite low, which has been helping to do that behavior.
[SPEAKER_01]: And so you think I'll just wing it.
[SPEAKER_01]: Or I'll just see how it goes, which to me is the same as not having a plan, which means to me you're setting yourself up probably for weight regain.
[SPEAKER_01]: So that's the number one.
[SPEAKER_01]: I don't think there's just one plan.
[SPEAKER_01]: I think the book is great, but I'm not going to say it's the only way to go because that wouldn't be true.
[SPEAKER_01]: But not to have a plan at all, that would be my number one mistake and make so much sense.
[SPEAKER_02]: And so you're in the world, you're around a lot of physicians.
[SPEAKER_02]: Are you noticing that the conversation is you're going to need to be on these medications for life?
[SPEAKER_02]: Are people resistant to the idea that you can come off of them?
[SPEAKER_01]: the physicians attend to be a little bit resistant to that.
[SPEAKER_01]: I even have physicians who say, I'm not prescribing the drugs, Holly, because I know my patients won't stay on them or a large portion and I know they're going to regain the weight when they come off.
[SPEAKER_01]: And I'm like, whoa, wait a minute, let's, let's really look at this.
[SPEAKER_01]: The idea that weight loss is separate from weight loss maintenance.
[SPEAKER_01]: That is the key concept we need to get out there with the healthcare professionals.
[SPEAKER_02]: Yes, say that again, that is, that is so profound.
[SPEAKER_01]: Yeah, so we used to think about you would lose the weight and just kind of do whatever for the long term.
[SPEAKER_01]: We put it all together as one weight loss is one phase.
[SPEAKER_01]: The key, I think, for physicians to think about or healthcare providers to think about is weight loss is separate.
[SPEAKER_01]: What we do to lose the weight is different than what we do to maintain it.
[SPEAKER_01]: And so we can have tools that are really good at weight loss.
[SPEAKER_01]: And you won't lose weight forever.
[SPEAKER_01]: Weight loss tends to be fine.
[SPEAKER_01]: You do it for a certain period of time.
[SPEAKER_01]: And then you don't lose any more weight.
[SPEAKER_01]: And then weight loss maintenance tends to be forever.
[SPEAKER_01]: And the tools and strategies that work for weight loss maintenance are different.
[SPEAKER_01]: So when you get confused about, well, it had the tools for weight loss won't work in weight loss maintenance.
[SPEAKER_01]: Then you're you're mudding the waters.
[SPEAKER_01]: We need to think about them separately.
[SPEAKER_01]: What tools work for weight loss?
[SPEAKER_01]: What tools work for weight loss maintenance?
[SPEAKER_01]: How can I help my patients transition between the two?
[SPEAKER_02]: Yeah.
[SPEAKER_02]: And it also being a continuum that they might be different phases, but one informs the other.
[SPEAKER_02]: Correct.
[SPEAKER_01]: They flow into each other.
[SPEAKER_01]: Yeah.
[SPEAKER_01]: But tools.
[SPEAKER_01]: It's like having always, I tell my patients, let's have a tool belt on.
[SPEAKER_01]: And we're going to go up there and we found those.
[SPEAKER_01]: We need a hammer.
[SPEAKER_01]: And let's use the hammer.
[SPEAKER_01]: But then when we suddenly need, you know, a saw, let's also be able to put the hammer up and get the saw out to be able to do what we need to do later.
[SPEAKER_02]: Yeah, let me make so much sense.
[SPEAKER_02]: Man, there's so many things we could talk about.
[SPEAKER_02]: So many things.
[SPEAKER_02]: And you know, your book lays out a 10 week transition plan.
[SPEAKER_02]: It's 10 weeks.
[SPEAKER_01]: It is, you know, you're gonna go into maintenance it's gonna be forever.
[SPEAKER_01]: But if I said the forever plan, people probably wouldn't buy the book.
[SPEAKER_01]: So, you know, 10 weeks, if you're coming off the drugs, is long enough to get some of these plays in place to really set yourself up for success.
[SPEAKER_02]: And so let's also talk about something that again, as a physician, I'm noticing that because the standard of care, the way that the pharmaceutical industry puts out the drugs, there's a standard dosing strategy, and then there's thoughts on how you would stay on them for life.
[SPEAKER_02]: And you don't hear a lot about lower doses or non-standard doses or even what's so popular.
[SPEAKER_02]: I'm out here in Los Angeles where for three years, really, people, everyone's microdosing.
[SPEAKER_02]: And they're having great results.
[SPEAKER_02]: And again, I want to say this non-diabetics, people that probably are more metabolically healthy, but getting great results.
[SPEAKER_02]: And wanting to microdose into maintenance and whatever that does, whatever microdosing means, how much are you, I feel like you're more tapped into the standard of care, because you're a physician and you do it by the book, right?
[SPEAKER_02]: That's how it's done.
[SPEAKER_02]: What do you think of microdose?
[SPEAKER_02]: I'm just curious.
[SPEAKER_01]: What does that even mean to you?
[SPEAKER_01]: I think we're gonna understand it better in the future.
[SPEAKER_01]: And so it's interesting to hear people having good results, but those are anecdotal.
[SPEAKER_01]: When we look at the science, when we look at what's been published, we don't know the best way to do that.
[SPEAKER_01]: We don't know what impact it's having.
[SPEAKER_01]: For instance, we know the GLP ones improve cardiovascular risk.
[SPEAKER_01]: Does a micro dose do that?
[SPEAKER_01]: I don't know.
[SPEAKER_01]: Okay, so we don't really understand that.
[SPEAKER_01]: That doesn't mean it won't,
[SPEAKER_01]: We've turned out to be true.
[SPEAKER_01]: It doesn't mean we, you know, science evolves and changes.
[SPEAKER_01]: And I think there are studies right now out there looking at some of those things.
[SPEAKER_01]: So we'll have some more data.
[SPEAKER_01]: So right now we don't know.
[SPEAKER_01]: I can't tell you, yes, this is the perfect micro dose.
[SPEAKER_01]: We don't even have a definition for what a micro dose is.
[SPEAKER_02]: So I think the definition at least anecdotally is that it's less than the standard dose.
[SPEAKER_02]: So I'm more familiar with Tersepatide, that she'll be one.
[SPEAKER_02]: And so I can speak to just the numbers that I hear, the doctors that I work with, talk about.
[SPEAKER_02]: And you know, 2.5 milligrams of Tersepatide, which is Monjaro, I think it's also Zepound, is the lowest standard dose.
[SPEAKER_02]: And so a microdose would be less than that.
[SPEAKER_02]: And we don't only be able to do that if you got it in the vial form or you got it compounded.
[SPEAKER_02]: And I think they are, I think Zepound now does create a vial that with your doctor, you could pull up one milligram, 1.5 milligrams, 1.75 milligrams, and find what that lower dose is and keep it in maintenance.
[SPEAKER_02]: So it's not just all the way up or all the way down.
[SPEAKER_02]: Does that make sense?
[SPEAKER_01]: It makes sense and that maybe a path for success for some people, you know, maybe it makes sense that in maintenance, you might not need as much some people, but we just don't know.
[SPEAKER_01]: And
[SPEAKER_01]: You know, I assume that maybe that lower dose people are doing it because they don't have as many side effects or the cost or there's some, you know, reason behind their motivation to do a lesser dose.
[SPEAKER_01]: I think it's the side effects.
[SPEAKER_02]: I like to say side effects are optional.
[SPEAKER_02]: And but that's only if you're on lower doses, but I'm curious, what are best practices with side effects?
[SPEAKER_02]: Because I know that, you know,
[SPEAKER_02]: people can have really nasty side effects.
[SPEAKER_02]: And so from a medical lens, how do you interpret side effects?
[SPEAKER_02]: How do you interpret them and what do you do to mitigate them?
[SPEAKER_01]: Well, side effects, there's a spectrum.
[SPEAKER_01]: Some people have zero side effects.
[SPEAKER_01]: They lose weight, but they're saying, I don't feel any different at all.
[SPEAKER_01]: I don't have anything.
[SPEAKER_01]: And then there's people who have such severe side effects, they can't stay on the medication.
[SPEAKER_01]: It's just they have nausea and vomiting.
[SPEAKER_01]: They feel terrible.
[SPEAKER_01]: Maybe they have severe constipation where they, or,
[SPEAKER_01]: have severe reflux.
[SPEAKER_01]: I mean, there's just everywhere in between.
[SPEAKER_01]: So it really is an individual type situation.
[SPEAKER_01]: And that's why I believe that you need to be plugged into a healthcare provider.
[SPEAKER_01]: Yeah, because there are things you can do to make it better.
[SPEAKER_01]: There are.
[SPEAKER_01]: symptomatic things you can add that you might not have to add forever but you add for a little while that can make it helpful.
[SPEAKER_01]: And if some of the really dangerous side effects occur, people have ended up in the hospital.
[SPEAKER_01]: There's no doubt about that.
[SPEAKER_01]: You have a health care provided that hopefully prevent that that can help you.
[SPEAKER_01]: So my biggest thing on that is you need someone who understands your your medical history, you know, if you have a predisposition to constipation, if you've had problems with that before and you're going on these drugs,
[SPEAKER_01]: I'm going to there may be some constipation issues with that.
[SPEAKER_01]: I'm not saying that means you can't go on the medications But you need to be dialed into that and you might want to start some treatment for that before you even start or be on top of it Right at the beginning at the lower doses if you start to kind of notice that So it's really very individual and I wish I could say, you know, here's what you should do
[SPEAKER_01]: But that really wouldn't be fair.
[SPEAKER_01]: And it wouldn't work for each individual out there.
[SPEAKER_01]: And that's why this is a medication.
[SPEAKER_01]: That's why you have to have a prescription.
[SPEAKER_01]: And I know people think, oh, just, you know, give it out.
[SPEAKER_01]: And I'm like, no, no, no, no.
[SPEAKER_01]: I've seen some serious stuff from this.
[SPEAKER_01]: You don't want that you want to be plugged in.
[SPEAKER_01]: 100% yes, thank you for that.
[SPEAKER_02]: And
[SPEAKER_02]: I'm really curious about the distransition plan.
[SPEAKER_02]: I just know that it's such a great book that you wrote.
[SPEAKER_02]: I think that's the missing link really for getting people off of these.
[SPEAKER_02]: I feel like freedom is really the goal that we're looking for and using JLP1s is a tool for behavior change and then to be able to get off of them.
[SPEAKER_02]: So what would a 10 week transition plan look like for someone?
[SPEAKER_01]: So in the book, we have three different types of transition plans you can do.
[SPEAKER_01]: If you need to do focus, so you're like, okay, I really want to focus on the food aspect.
[SPEAKER_01]: Or there's more of a intensive plan.
[SPEAKER_01]: There's more of what I call the all-acart plan for people who really want to mix it up because one plan doesn't fit all.
[SPEAKER_01]: So, you can use, you read the book, you kind of decide which one we talk about profiles.
[SPEAKER_01]: We ask, you know, or you kind of more what we call a non-stop food seeker, we have the sedentary sitters, we have the, the cyclers, the kind of the people who kind of cycle a lot.
[SPEAKER_01]: So, we have these profiles that may help you decide what plan you want to go on, which fits you better?
[SPEAKER_01]: So you get to choose.
[SPEAKER_01]: That's whole plan.
[SPEAKER_01]: My first book State of Slim was more.
[SPEAKER_01]: This is what you need to do to lose the weight and keep it off.
[SPEAKER_01]: And that's what I believe in.
[SPEAKER_01]: It was good science.
[SPEAKER_01]: What has evolved in the next last 13 years since that book came out was we need options.
[SPEAKER_01]: You don't just say this is the plan.
[SPEAKER_01]: Let me hand it to you and do it.
[SPEAKER_01]: You need to be able to make it fit you.
[SPEAKER_01]: I always, I say it's like those good pair of jeans.
[SPEAKER_01]: You put on that just fit you perfectly and you don't know why, but when you put them on, you're like, yeah, it fits me.
[SPEAKER_01]: You need a plan that fits you and you feel that good about.
[SPEAKER_02]: And it's not a one-size-fits-all.
[SPEAKER_02]: never.
[SPEAKER_02]: And so the options, you give options, I love that.
[SPEAKER_02]: And within that, you know, microdosing aside in what I'm hearing you say is that, and I love that about you and physicians in general is that you want to see the data, you want to see the studies, but we don't have the study yet.
[SPEAKER_02]: Correct.
[SPEAKER_02]: We don't have the study.
[SPEAKER_02]: So we don't quite know.
[SPEAKER_02]: So but for someone who wants to do it more by the book and of is they're working with a physician that doesn't think micro dosing is for them.
[SPEAKER_02]: Could they?
[SPEAKER_02]: Can you do the transition plan and just maybe lower your standard dose?
[SPEAKER_02]: So if you're at five milligrams or you're at seven milligrams, you're all the way up.
[SPEAKER_02]: You can start stepping down.
[SPEAKER_02]: Is that part of it?
[SPEAKER_02]: And then maintaining on the lowest dose?
[SPEAKER_01]: So I think that's what you want to talk to your doctor about, make sure that works for you.
[SPEAKER_01]: But I do think there's different ways to do what success looks like.
[SPEAKER_01]: And for some people success might be in part of the plan might be backing down on the dose with their physician.
[SPEAKER_01]: You know, and getting that guidance for some people it might not look like that.
[SPEAKER_01]: But that
[SPEAKER_01]: We don't know the, and you know what, even when we have the data, that's going to be one way that worked.
[SPEAKER_01]: The art of medicine, that's what doctors do.
[SPEAKER_01]: You know, we have the science, and then we have the art.
[SPEAKER_01]: And what you're talking about is the art.
[SPEAKER_02]: I love it.
[SPEAKER_02]: The art, yes, art, the arts and sciences.
[SPEAKER_02]: It is an art.
[SPEAKER_02]: And I think it's often not practiced that way though.
[SPEAKER_01]: Yes, I agree, but doctors may practice that way and not realize when they get some experience and more experience than they're they usually start to kind of say, okay, I know in this type of patient I've seen this work and I might do it this way and if you look at blood pressure pills, we now have so many different blood pressure pills.
[SPEAKER_01]: And doctors are really good at mixing and matching and saying, okay, I'm going to put this patient on here.
[SPEAKER_01]: We have science behind it, but an end of one, one person, doesn't necessarily fit the science where there's an average.
[SPEAKER_01]: It's a mean.
[SPEAKER_01]: They could be an outlier.
[SPEAKER_01]: They have different situations.
[SPEAKER_01]: So when you get more experience, doctors do start to use their anecdotal experience too.
[SPEAKER_01]: use the science, but change it a little bit to fit that individual person.
[SPEAKER_01]: And that really is the art.
[SPEAKER_01]: And I do think doctors do that.
[SPEAKER_01]: Some probably better than others.
[SPEAKER_02]: Yes.
[SPEAKER_02]: And so, people are on this medication.
[SPEAKER_02]: It's working so well.
[SPEAKER_02]: It works so well that maybe they might even be tempted to do nothing else.
[SPEAKER_02]: Just let the medication do all the heavy lifting and maybe not make any changes.
[SPEAKER_02]: A lot of people are doing it that way.
[SPEAKER_02]: But that's not what we're suggesting.
[SPEAKER_01]: Well, I think it's up to them.
[SPEAKER_01]: I'm not here to tell anybody what they should or shouldn't do.
[SPEAKER_01]: If that's working for them, a lot of people, this is the first time in their life that they're not thinking about food.
[SPEAKER_01]: This is the first time that they've been able to lose weight.
[SPEAKER_01]: This is the first time that they're kind of like taking an exhale and saying, oh my goodness, this is something so new for me.
[SPEAKER_01]: I, you know, and that is okay.
[SPEAKER_01]: how other aspects of their life were going.
[SPEAKER_01]: You know, it's not just weight when it comes to health.
[SPEAKER_01]: Mm.
[SPEAKER_01]: Weight is a part of it.
[SPEAKER_01]: Yes.
[SPEAKER_01]: And that may be something you've struggled with for a long time.
[SPEAKER_01]: But weight alone does not is not the whole, you know, enchilada.
[SPEAKER_01]: There's a lot of other things that go into being healthy.
[SPEAKER_01]: And so think about that.
[SPEAKER_01]: Also think about is, you know, are you living your best life?
[SPEAKER_01]: And thinking about how you may put some other behaviors in, making that come into the picture, too.
[SPEAKER_01]: Because for some people, they've said, when I lose weight, I'm gonna be happy.
[SPEAKER_01]: And you can understand that having extra body weight can limit some things in their life that they may wanna do, that really bring them happiness, being able to play with their kids, being able to go climb a mountain, and so, and you can understand how that's related,
[SPEAKER_01]: But also, sometimes they lose the weight and that wasn't the issue, right?
[SPEAKER_01]: And so that's where the complexity of it comes in.
[SPEAKER_01]: And it doesn't necessarily guarantee happiness.
[SPEAKER_01]: And so looking at that becomes important, too.
[SPEAKER_02]: 100% I love that you're taking us there.
[SPEAKER_02]: Yes, people think that when I get to this goal, I'll be happy.
[SPEAKER_02]: But if you haven't figured out how to be happy along the way, you often get to the goal and wonder why you're not happy.
[SPEAKER_01]: Oh my gosh, so that is a huge thread throughout the book.
[SPEAKER_01]: Is we're not waiting for the outcome to live our lives, to celebrate, to, it is part, part, one of the things we learn for people who are successful is they don't do that.
[SPEAKER_01]: They start celebrating and living their life as they're doing it and that actually helps them get to the outcome.
[SPEAKER_01]: It's not that you're gonna give up on the outcome.
[SPEAKER_01]: People used to say, well, Holly, I'm gonna lose weight.
[SPEAKER_01]: And if you tell me to enjoy the journey, you're telling me not to focus on the weight loss.
[SPEAKER_01]: know you can focus on the weight loss.
[SPEAKER_01]: I'm not going to take that goal away from me.
[SPEAKER_01]: You can lose the weight.
[SPEAKER_01]: This is an AND situation.
[SPEAKER_01]: It's actually how you get to the weight loss successfully, not keeping you from.
[SPEAKER_01]: You can want that goal.
[SPEAKER_01]: You can say that is my goal.
[SPEAKER_01]: Let's go for it.
[SPEAKER_01]: But let's make sure we're enjoying the process as we get there as a way to get there quicker, as a way to get there better, as a tool to actually get there.
[SPEAKER_02]: I love that so much, yes.
[SPEAKER_02]: And often, I work with a lot of people that helping them lose weight.
[SPEAKER_02]: And it's an honor and a privilege to coach them through that with their physician.
[SPEAKER_02]: And if they're not using the medication without their physician, however, I'm coaching them.
[SPEAKER_02]: And one of the things that I've noticed is that the people that struggle the most often have almost an addictive relationship with food.
[SPEAKER_02]: And having studied addiction recovery, one of the things that we notice
[SPEAKER_02]: If, whether it was alcohol or it's food, if that's how you enjoy your life only, if that's how you celebrate, if that's what you use for comfort, if that's if food is or a drug is taking up all the space in your life, it would make sense that it's gonna be hard to eat less of it and do the things you need to do to release weight.
[SPEAKER_02]: But if you start to bring all the aspects of your life up that you enjoy, your home, your family or creativity or spirituality, all the things, food doesn't have to take up that whole role
[SPEAKER_02]: It's easier.
[SPEAKER_02]: Is that part of someone's maintenance that you emphasize of living a full life?
[SPEAKER_01]: Yes.
[SPEAKER_01]: It's in the mind as medicine part.
[SPEAKER_01]: So we food as medicine, physical activities as medicine, and then the mind as medicine.
[SPEAKER_01]: Huge part.
[SPEAKER_01]: I talk about living large.
[SPEAKER_01]: And that's the kind of the phrase I use, we're decreasing our body, what we're living large.
[SPEAKER_01]: And while you're on the medication, it's the perfect time to be putting that in place.
[SPEAKER_01]: Because the food, the appetite is kind of, you can't eat a lot.
[SPEAKER_01]: So you've taken that out of the picture.
[SPEAKER_01]: You need to be developing other tools and strategies, other things that bring you joy.
[SPEAKER_01]: Like you're talking about,
[SPEAKER_01]: So when the appetite comes back, if you go off the drug and curve ball comes, life comes and throws you something, you have other strategies and tools and things that bring you joy, they're in place.
[SPEAKER_01]: So it's a huge part of all success.
[SPEAKER_02]: I love this about you.
[SPEAKER_02]: So I love you.
[SPEAKER_02]: You call it mind state.
[SPEAKER_02]: I love that term as well.
[SPEAKER_02]: You often hear mind set and mind state are those are those interchangeable for you or is mind state something more than mind set.
[SPEAKER_02]: How would you define that?
[SPEAKER_02]: It's something more.
[SPEAKER_01]: So mindset is part of mindset, but mind state is about the mindset and then how you live life that the engagement part of it, you know, let's I like to kind of say it's mindset is what you believe in mindset is how you live.
[SPEAKER_01]: And what you believe is part of how you live, but it's a little bit more than just the thinking part, it's really embodying it.
[SPEAKER_01]: It's what you think, but then embodying the life, the identity.
[SPEAKER_01]: Identity is so important in keeping weight off.
[SPEAKER_02]: Let's talk about that.
[SPEAKER_02]: It's so important.
[SPEAKER_02]: Why is identity so important in keeping the weight off?
[SPEAKER_01]: Because you, it, it, it, it makes the forever part of this journey what you're going to do for a long period of time, which is what's required in weight loss maintenance.
[SPEAKER_01]: part of who you are.
[SPEAKER_01]: It's not something you do because I've got to keep my way it off.
[SPEAKER_01]: That didn't work.
[SPEAKER_01]: Yeah.
[SPEAKER_01]: It becomes part of, yes, I may do some of these lifestyles in the life I'm living helps me keep my way off, but it's more now who I am, what I do, how I live.
[SPEAKER_01]: People used to say I'm not someone who exercises
[SPEAKER_01]: And then their dynidious, I say, yeah, I am.
[SPEAKER_01]: I'm someone who goes out there and works out.
[SPEAKER_01]: I'm somebody who eats vegetables.
[SPEAKER_01]: Oh my gosh, I'm somebody who has all the, it's, I'm a different identity.
[SPEAKER_01]: And I wouldn't even say a dynidia.
[SPEAKER_01]: A lot of times it's just realigning with what's already there.
[SPEAKER_02]: hundred percent identity shifting it works so well and I work with a lot of women in Perry menopause and midlife and you know there's a big conversation nowadays about meant to even talking about menopause or Perry menopause when I was younger you would you people would whisper it like oh gosh you know
[SPEAKER_02]: You know, it was, it was, there was a stigma and there was a shame around it.
[SPEAKER_02]: What did, what do you noticing with weight loss?
[SPEAKER_02]: What biological realities even do you want women in mid-life to understand is they, if they're transitioning off the medication?
[SPEAKER_02]: And would it be better, the, does the medication help?
[SPEAKER_02]: Would they want to stay on it?
[SPEAKER_02]: More if they're menopausal or post-menopausal?
[SPEAKER_01]: I don't think that matters.
[SPEAKER_01]: I think the individual, you have to figure that out.
[SPEAKER_01]: But I wouldn't say if you're a menopausal, you need to stay on the medication or anything like that.
[SPEAKER_01]: The message is, I like to give to women who are going through.
[SPEAKER_01]: That is, you can still lose weight and keep it off.
[SPEAKER_01]: A lot of times they've been saying, well, I'm going through menopaus or I'm in menopaus and my actual just write this off.
[SPEAKER_01]: And I'm like, no!
[SPEAKER_01]: I would never take that possibility away from you.
[SPEAKER_01]: And it doesn't need to be taken away from you.
[SPEAKER_01]: And doctors who say that sometimes OB-GYNs say, well, you might as well just give up on your weight because you're in menopause.
[SPEAKER_01]: And I'm like, no, not ever.
[SPEAKER_01]: To me, that's some of the best times.
[SPEAKER_01]: Yeah.
[SPEAKER_01]: Because you're really kind of discovering yourself.
[SPEAKER_01]: You're going through a transformation anyway.
[SPEAKER_01]: Let's set yourself up and a really good place.
[SPEAKER_01]: Let's use that time to say, what's important to me?
[SPEAKER_01]: Why do I want to accomplish?
[SPEAKER_01]: How do I want to be?
[SPEAKER_01]: A lot of times that's at a time when people's lives where they're thinking about that stuff, just in the timing aspect of their life that can be the perfect time to go through some of this transformation, identity shifts, all of that.
[SPEAKER_02]: Yes.
[SPEAKER_02]: And really not just, oh, I'm just going to put myself out to pasture.
[SPEAKER_02]: I'm resigned to lose weight.
[SPEAKER_02]: I'm going to have all these symptoms.
[SPEAKER_02]: I am noticing that women when they are on a GLP one, they'll notice that some of their hormonal symptoms are better.
[SPEAKER_02]: And I'm wondering from an endocrinology, your perspective, what's happening there, what's.
[SPEAKER_02]: What is it about a GLP1 that makes it less pain, less bloating, less ups and downs?
[SPEAKER_02]: What do you suppose is happening there?
[SPEAKER_01]: I don't know that I can hook it to the hormones.
[SPEAKER_01]: And maybe it is.
[SPEAKER_01]: Like I said, there's these receptors everywhere.
[SPEAKER_01]: We don't know everything that these drugs do.
[SPEAKER_01]: So I'm not saying that's not going on.
[SPEAKER_01]: I don't know that I can say this is exactly what's happening to estrogen or anything like that.
[SPEAKER_01]: Or it helps them kind of become more aware on their body.
[SPEAKER_01]: It helps them choose certain foods.
[SPEAKER_01]: So maybe they're choosing foods that are better choices for them, that may be some of them are.
[SPEAKER_01]: But maybe they are.
[SPEAKER_01]: Maybe they're taking care of themselves a little bit.
[SPEAKER_01]: Maybe they're getting some more activity in.
[SPEAKER_01]: And that's helping.
[SPEAKER_01]: Maybe they're working on, you know.
[SPEAKER_01]: So there's lots of things.
[SPEAKER_01]: I think anytime we're going through a transformation or we're changing, and people are losing weight and people like to lose weight.
[SPEAKER_01]: It feels good to lose weight.
[SPEAKER_01]: Oh yeah.
[SPEAKER_01]: And they believe in, you know, the confidence is coming back.
[SPEAKER_01]: Some people who've never been in the gym are like, I'm going into gym, you know?
[SPEAKER_01]: And that is powerful.
[SPEAKER_01]: Just as powerful is hormonal changes.
[SPEAKER_01]: 100%.
[SPEAKER_02]: reclaiming trust in your body.
[SPEAKER_02]: I feel like if someone, here this a lot in our work, if someone's listening and they feel scared that they're never will be able to trust their body without the medication.
[SPEAKER_02]: It's been such a game changer for them, that maybe they don't have a doctor that understands behavior changes much as you do.
[SPEAKER_02]: And all the things you've shared with us, and thank you for sharing that.
[SPEAKER_02]: What would you want them to know?
[SPEAKER_01]: I would say if they're scared that it's not going to work.
[SPEAKER_01]: To simply, for a second, turn around and say, what if it does?
[SPEAKER_01]: And if it doesn't, if this makes some feel bad, if it doesn't, you can go back on the drug.
[SPEAKER_01]: But what if it does?
[SPEAKER_01]: What if I can make some of these changes and I feel even better?
[SPEAKER_01]: What if, maybe I need less of a dose?
[SPEAKER_01]: What if making some of these behavioral change that I'm now set up to be in the perfect place to do that?
[SPEAKER_01]: And if it doesn't work, there's no harm, it's not failure.
[SPEAKER_01]: People, I had to go back on the drug.
[SPEAKER_01]: I'm like, no, you'll learn a lot.
[SPEAKER_01]: You go back on the drug, that's fine.
[SPEAKER_01]: You can try again, or you can stay on the drug.
[SPEAKER_01]: You're not taking away the option, and it's not failure.
[SPEAKER_01]: So let's, I would say, let's not focus on the fear-based aspect of it.
[SPEAKER_01]: Let's focus on the possibility because it just feels so much better and that's where I think you can move forward and I believe anyone can succeed.
[SPEAKER_02]: Yes, and the science of that even, like you test it out, get some data, optimize, try a new thing.
[SPEAKER_01]: So what I love, I love that you said that is, I'm like, let's collect our own data.
[SPEAKER_01]: When I do group classes or do I do an energized group every week Saturday mornings, I'm like, okay, I can tell you the data that's out there, but you know the most powerful data is your own.
[SPEAKER_01]: So this week, let's collect some data.
[SPEAKER_01]: Let's do this and let's see how it feels, a works or what, how hard it is or how easy it is.
[SPEAKER_01]: Let's collect your own data for this.
[SPEAKER_01]: That's the powerful stuff.
[SPEAKER_02]: 100% gosh, thank you for being here and sharing this.
[SPEAKER_02]: It's really inspiring.
[SPEAKER_02]: And people are going to want to know more about your work, what you're excited about, what you want to share, how can they find you, tell us more?
[SPEAKER_01]: So I've tried to put everything in one place, because I was kind of all over the world, I had status limit, so everything, I've tried to put everything under a brand called Weight Wisdom or a website called Weight Wisdom, so just www.weightwisdom.com.
[SPEAKER_01]: And that's a one place you can go and see everything I'm going to start doing a weekly news email kind of newsletter just with some tips and tricks maybe new plays you can sign up for that there you can get the book there obviously any kind of master classes we have we're going to put there we want to hear what you need there but trying to make that be where everything is in one place.
[SPEAKER_02]: I love it.
[SPEAKER_02]: I love your podcast too.
[SPEAKER_02]: It's really fun.
[SPEAKER_02]: Really fun with that.
[SPEAKER_02]: Well, we need to have you on.
[SPEAKER_02]: Oh, I love it.
[SPEAKER_02]: Sure.
[SPEAKER_02]: I'm here.
[SPEAKER_02]: And I'd love to have you back on.
[SPEAKER_02]: Oh, I would love, this has been great.
[SPEAKER_01]: This is the fact.
[SPEAKER_02]: I feel like this conversation is definitely an evolving one in terms of the studies, in terms of the data, what people are, how they're using them and it's so interesting.
[SPEAKER_02]: So I would love to have you back and we can keep talking about what you're noticing as this comes up.
[SPEAKER_01]: I would love to be back on.
[SPEAKER_02]: Yeah, awesome.
[SPEAKER_02]: All right, really good.
[SPEAKER_02]: Well, what do we say goodbye for now?
[SPEAKER_02]: And just thank you so much.
[SPEAKER_02]: Thank you.