Latest / Fork U with Dr. Terry Simpson / GLP-1 Guide to Healthy Habits and Success

Transcript

GLP-1 Guide to Healthy Habits and Success · Fork U with Dr. Terry Simpson

0:00
>> Dr. Terry Simpson: Hey. Today's podcast is about navigating the
0:02
GLP1 medications. But it turns
0:05
out a lot of this advice is for anyone in the
0:08
new year who wants to develop better eating and a
0:11
better relationship with food. So even if you aren't
0:14
on these medications but want to eat a little better,
0:16
maybe give a listen. All right, on to the show.
0:19
M
0:23
Today we're digging into GLP1
0:26
medications like Ozempic, Zepbound and
0:29
others. They're revolutionary, but
0:32
even the best tools need proper
0:34
handling. As a weight loss surgeon,
0:37
I've spent years teaching people how to eat better
0:40
after surgery. Surprisingly,
0:43
the common things we teach people after surgery who have a
0:46
smaller stomach is the same thing
0:49
we teach people after GLP1 medications
0:52
begin. We also know things that
0:55
don't work well. What we know doesn't work well
0:58
is telling people to eat less and move more.
1:01
Another bit of advice that doesn't work well is telling people
1:04
to just eat less than what you've been doing.
1:07
The most important advice enabled
1:10
by surgery or weight loss GLP medications is
1:13
the opportunity to repair the relationship
1:16
with food and repair the trauma
1:18
from years of diet culture. And
1:21
while these drugs curb that relentless
1:24
food noise in your brain that tells you to eat even when you're not
1:27
hungry, these drugs do have common side
1:30
effects. So on today's pod, we'll go through some
1:33
of those side effects and teach you how to navigate this
1:35
incredible journey.
1:40
I'm Dr. Terry Simpson, your chief medical
1:42
explanationist and this is Fork
1:45
U Fork University, where we make sense of
1:48
the madness, bust a few myths, and teach you a little bit
1:51
about food and medicine.
1:56
Let's start with diet culture.
1:59
Diet culture refers to those societal norms and
2:02
beliefs that value thinness, appearance and weight
2:05
over health and well being. It often promotes
2:08
restrictive eating, obsessive exercise and
2:11
guilt around food choices, perpetuating
2:14
harmful body image, weird
2:16
ideals and disordered eating habits.
2:20
For someone using GLP1 receptor agonists like
2:23
Ozempic or Zeppbound for weight management and other health
2:25
concerns, addressing diet culture
2:28
is critical for fostering a healthy relationship with food
2:31
and body. So here's how we want to remove some of those
2:34
diet culture elements.
2:37
First, shift the focus to health
2:40
and functionality. Meaning we want you to emphasize
2:43
overall health, energy levels, metabolic improvements rather
2:46
than weight or appearance. Celebrate non scale
2:49
victories such as better blood sugar control, improved
2:52
mobility, reduce blood pressure, maybe make your
2:54
goal this year doing the splits. Okay, maybe not the splits. I
2:57
did them when I was 10 years old. I've never done them since. But maybe
3:00
this year I'll do some better yoga moves. We want you to
3:03
redefine the idea of good and bad foods, removing
3:06
those moral labels from foods. Because all foods can fit into
3:09
a balanced diet in moderation. Except death cap
3:12
mushrooms. A uh, gram of them will kill you faster than almost
3:15
anything. But encouraging mindful eating to recognize
3:18
hunger and fullness cues without judgment. Let me give
3:21
you an example. The power you have
3:23
over food with the GLP1 medications
3:26
is can eat a small amount of
3:29
food, sense the feeling of fullness
3:32
and walk away. You will
3:34
notice you don't need to get it again.
3:37
You now have power over the food. Where before
3:40
you'd have that sense of fullness walk away, but you'd be
3:43
back or you'd eat more later. Now you
3:46
have a tool that will help you that, that
3:48
encourages more mindful eating, slowing
3:51
down, taking your time, sensing
3:54
fullness so you don't get overstuffed.
3:58
Setting individual goals beyond weight loss is important
4:01
too. So we want you to focus on
4:03
sustainable habits like eating nutrient
4:06
dense meals, regular physical activity, stress
4:09
management that doesn't involve alcohol or drugs,
4:12
and personalized goals to align with those intrinsic
4:15
measurements like feeling stronger or improving
4:18
sleep quality. For God's sake, buy a new
4:20
mattress. Maybe I'm talking to me.
4:24
It's really hard to unlearn
4:27
harmful messaging that has been placed by diet
4:30
culture. Especially this time of year when you will
4:33
see supermodels who are anorectic
4:36
going on bikini clad or
4:39
whatever clad as an ideal body image.
4:41
They're not understanding that
4:44
medication as a tool for health management rather than purely for
4:47
weight loss is key and
4:50
reinforcing that. Its purpose is to support overall
4:53
metabolic health, meaning your body's metabolism, its
4:56
health not confined to societal pressure.
5:00
But as anyone who's been on any weight loss journey might have a
5:03
bit of trauma from the absolutes of the diet. These
5:06
new medications will help you get that better
5:09
relationship with food. But we have to
5:12
balance that with this caveat.
5:14
There are some foods you may need to be careful about on these
5:17
medications. You've probably all heard about the side
5:20
effects of GLP1 medications. Nausea, vomiting,
5:23
reflux, constipation. They're pretty common. So let's start
5:26
from the bottom up.
5:28
Constipation. Typically it's a lack
5:31
of water and a lack of fiber.
5:34
Fiber is a key ingredient. It's even considered
5:37
an essential nutrient for your gut. It feeds the healthy
5:40
bacteria in your gut or the microbiome and they produce a
5:43
lot of incredible things to thank you. Everything from
5:45
dopamine to your own endogenous
5:48
GLP1. Yep, you make it in your gut. And
5:51
some anti cancer agents that keep your colon happy and
5:54
healthy and keeps things moving along.
5:56
It's astonishing that only 10% of Americans get the fiber
5:59
they need from their diet. And if you find yourself consuming
6:02
less fiber because you're consuming less food, you
6:05
might develop constipation. Now some
6:08
of this can be helped with fiber supplements like citrusyl
6:10
metamucil, etc. But those are a supplement, they
6:13
are not a solution.
6:15
Instead focus on finding and
6:18
incorporating fiber rich foods and
6:21
making them a part of your routine. You want some example
6:24
fiber rich foods? Whole grains like
6:27
whole grain bread and whole grain pasta.
6:29
Another one are legumes, beans,
6:32
lentils, chickpeas, tofu, etc. Most
6:35
people when they think of fiber, think about fruits and vegetables. And while
6:38
those should be a part of your diet,
6:41
they're not a big source of fiber like the powerhouses of
6:44
whole grains and legumes. Now
6:47
there are plenty of you who've been indoctrinated into that low
6:50
carb mantra of all grains are evil.
6:53
Lets be clear, from a scientific point of view,
6:56
grains are not evil. People
6:59
who consume whole grains, not refined grains,
7:02
have less obesity, less heart disease, less
7:05
cancer, live longer. Not bad, huh?
7:08
Uh, nothing like whole grains or brown rice,
7:10
quinoa or even oats. Adding them to your diet
7:13
to not only get fiber, but a lot of other benefits of whole
7:16
grains. Legumes are another great source of
7:19
fiber. Legumes are things like beans, chickpeas,
7:22
lentils, even peanuts. Let me give you an
7:24
example. Beans are great for
7:27
breakfast. One of my favorite breakfasts when
7:30
I go to breakfast houses is getting
7:33
huevos rancheros. But I'm not such a huevo
7:36
fan. But I like the beans and having those
7:38
beans with a little bit of hot sauce is great.
7:41
Soups you can add beans to, you can add chickpeas
7:44
to, you can have hummus as a dip. You can add
7:46
beans to salads, they're delicious.
7:49
And lentils the same way. I have a great recipe for
7:52
dal in my website. Beans are not
7:55
only fiber rich, but a great source of
7:58
protein and low in fat.
8:01
Fiber is just one half of the equation for constipation. The
8:04
other half is hydration. And hydration is something if you're
8:07
on a GLP1 or if you've had weight loss surgery you hear a
8:10
lot about. Let me help you to avoid a
8:13
scam. There are lots of
8:16
hydration packs or IV hydration packs
8:19
for sale and most of them aren't
8:21
terribly useful. Why? Because Many of them
8:24
advertise themselves as sugar free, part of diet
8:27
culture. You want to be sugar free, but here's the
8:31
need glucose in those hydration packs, otherwise you don't get
8:34
the full benefits of the hydration of the salts in
8:37
that pack, including magnesium, potassium and sodium.
8:40
Without glucose, you lose the best
8:43
way to get electrolytes in your
8:46
body. How do I know? Did you know
8:49
there are 92 million kids today who are
8:52
alive because of a simple hydration formula
8:54
involving a 6 to 1 ratio of glucose to salt in
8:57
a liter of water? 92
9:00
million kids. They didn't just give them salt and
9:03
water, they didn't just give them water. But
9:05
true dehydration from diarrheal viruses,
9:08
cholera, rotaviruses, et cetera. You
9:11
need true hydration uses that formula. So what
9:14
do I recommend? In almost any pharmacy, you can get
9:17
what's called Pedialyte packages. These are the things we give to kids
9:20
who are dehydrated, but they're fine for adults.
9:23
They're available in every pharmacy. They're easy to carry with you.
9:26
And the Pedialyte even has popsicles, so you can make them up.
9:29
So if you're feeling nauseous, licking
9:32
a popsicle is one of the great things you can do to get some good
9:34
rehydration. And here's a tip.
9:37
If you are taking a GLP1 medication and you
9:40
notice that after you get the shot,
9:43
you have some nausea, we think
9:46
you should take a full packet of hydration
9:49
about an hour before you take your GLP1
9:52
medication. Why? Because that way we know you're
9:55
going to be pretty well hydrated before going in it. So if
9:58
you have any adverse reactions, at least you've got that
10:00
down. And finally, let's talk about this.
10:03
If you're eating less, you're going to have fewer trips to
10:06
the bathroom. That's normal. That
10:09
is not constipation. Let's talk about
10:12
nausea and reflux. High
10:15
fat foods delay digestion
10:18
in normal people, in everybody, and
10:21
they worsen nausea. And if you're on a
10:24
GLP1 medication, like Ozempic or
10:26
Mounjaro, your stomach is not going to
10:29
empty as fast as it normally does. Things will
10:32
sit in there. So that means that,
10:35
I mean, I love Popeye's chicken. Who doesn't?
10:38
But if you have too much of that delicious crust that
10:41
will sit in your stomach, delay emptying. Your stomach
10:44
will get more and more gastric juices become more and more
10:46
bloated, and you won't like the result. Greasy
10:49
and fatty Foods delay stomach emptying. The technical reasons,
10:52
fat in food stimulates the release of a hormone called
10:55
cholecystokinin, which releases in the duodenum
10:58
and that inhibits distal stomach motility.
11:00
That's our way of saying the food stays in your stomach longer. And that,
11:03
combined with the medications GLP1s means the food's gonna
11:06
sit there for a while. It also stimulates
11:09
pyloric tone. Alright, what is that? At the end of your stomach is a
11:12
sphincter called the pylorus that opens to empty
11:15
the stomach. But
11:17
greasy foods and GLP1s
11:20
cause that sphincter, uh, to be
11:23
tight. If food sits in the
11:25
stomach longer, you get bloating,
11:27
distension, reflux, nausea,
11:30
and even vomiting. Have you ever had food poisoning?
11:34
Food poisoning is when your body keeps food in your stomach
11:36
longer until you get bloated, nausea and you vomit. It's trying to keep
11:39
the bacteria from entering into your gut.
11:43
That's why it's not a bad thing to vomit if you have food
11:45
poisoning. Well, GLP1
11:48
medicines are sort of like that. They keep food in your stomach
11:51
longer. Now, if you eat too much or if you
11:54
eat on top of being full, you're going to have more
11:56
nausea. But grease isn't the only
11:59
thing that causes food to sit in your stomach
12:02
longer. Here's a few other things. Foods with a lot of
12:05
added sugar, sugar sits in your stomach, breaks
12:08
down, causing more acid to hit the stomach, leading to more bloating,
12:10
more discomfort. Typically, these are high
12:13
sugary drinks like fruit juice, southern
12:16
sweet tea, soda. So instead those are
12:19
things to be minimized. Alcohol with
12:22
GLP1 drugs presents its own unique
12:25
set of issues. Now, in general,
12:27
we are working hard to tell America and the
12:30
world that there isn't a safe level of
12:32
alcohol. And if you can stop consuming it, you will have better
12:35
health for it. This is in contrast to what we
12:38
believe for many years, science advances. Sorry to take
12:41
away your favorite afternoon drink, but alcohol
12:44
is not good. And a combination of dehydration and
12:47
increased alcohol can lead to pancreatitis in some
12:50
people. So if you're dehydrated and are drinking alcohol, which
12:53
leads to more dehydration, you can develop
12:56
pancreatitis. So best to avoid alcohol on
12:59
GLP1 medications or limit it to one
13:01
glass. Many people actually find when they
13:04
start GLP1 medications, they lose their taste for alcohol
13:07
altogether. It might be a social thing. They're used to grabbing a beer or
13:10
glass of wine, but. But otherwise, when they start tasting it, it just
13:13
doesn't taste the same. It's
13:15
okay. Remember the other thing. Because you're not eating
13:18
that much, you don't have food quantity which absorbs some of the
13:21
alcohol. So you're going to get a little bit tipsy a little
13:24
bit faster. Here's a tip for restaurant
13:27
use. When you go to a restaurant,
13:30
if you're like the rest of us, you want to finish what's on your
13:32
plate. Get a To go box immediately.
13:36
We use this tip all the time for our weight loss surgery patients who have
13:39
smaller stomachs. But think take
13:42
that immediately. Get the to go box. Put the food in
13:44
there. And if you don't want your friends to know that you're eating less
13:47
quizzes of GLP1. They don't care. Really, they
13:50
don't care. You can tell them you had a late lunch. You can tell them
13:53
you want to save some for your friends. You can tell them you want some for
13:56
tomorrow for breakfast. Doesn't matter. Make whatever excuse you
13:58
want. But it's a great tip for eating less, even for your
14:01
friends who are going out and want to lose a little weight, which most
14:04
of America does. How about fast
14:07
food? Well, aside from avoiding greasy things, the kid's
14:10
menu is going to be your best friend. And
14:13
hey, you might even get a toy with your meal.
14:15
I mean, who doesn't want a toy? So, like, if you go to Chick Fil a, get
14:18
the grilled chicken, please. Your stomach will thank you for it.
14:21
But most nausea happens when people overeat,
14:23
right? Overeating feels like
14:26
overstuffing a suitcase. Just because you can zip it closed
14:29
doesn't mean it won't burst open later. So for nausea,
14:32
take a walk, take some ginger or peppermint
14:35
tea, and if it's overdone, you start feeling the
14:38
reflux but have to go to bed. A wedge pillow will help
14:40
a lot. Here's another one. You're going to hear a
14:43
lot of people who've had GLP1 say, oh, you got to have a lot of
14:46
protein. Well, protein is a key, but don't overdo
14:49
it. Beans, Greek yogurt, simple shakes
14:52
can keep you balanced. There's no need to overthink it.
14:54
We want habits that last a lifetime. And
14:57
eating more protein can lead to people eating more
15:00
greasy things like steaks or sausages, which we
15:03
don't think are great overall nutrient
15:05
balances in a healthy diet. More
15:08
importantly, adding too much protein at the expense of
15:11
other parts of your diet can lead to more constipation and other
15:14
issues. Finally, be patient with
15:16
yourself okay. Initial weight loss
15:19
is often due to water and glycogen. So what's that? It's
15:22
dramatic but temporary weight loss. Glycogen is how
15:25
your body stores extra glucose. It's stored in your muscle.
15:28
You need it for times when you're exercising, sleeping, fasting,
15:31
just in everyday life. Many people who are overweight have a
15:34
lot of excess glycogen stored in their muscles and they lose
15:37
the glycogen as they burn through it when they go through eating
15:40
less. And for every pound of glycogen you
15:42
burn, you will lose 2 pounds of water.
15:45
Hence, early weight loss is often rapid.
15:49
Sometimes people even think they're losing muscle because they'll see muscle go down
15:51
on some of these fancy scales. But you're actually losing glycogen from
15:54
muscle. You are going to lose fat in the
15:57
background and you will see fat loss
16:00
come, but in a far more stepwise fashion. But here's
16:03
the other thing. You need to liberate your scale.
16:06
If your day is going to be ruined by a number on a scale, it's time
16:08
to let it go. You don't need it. The
16:11
medication allows you to listen to your body, to eat smaller
16:14
portions. That will take care of the weight loss.
16:18
And isn't it a great feeling to know that you can have a smaller
16:21
portion? Feel satisfied. Walk away
16:24
knowing you're not going to be starving later. Knowing you're not going to be called back to the
16:27
refrigerator. Taking time
16:30
to learn about good things to eat, learning
16:32
new recipes for the new year, that should be your
16:35
goal. So you can forget the scale.
16:38
You can celebrate wins, like fitting into old
16:41
clothes that were too tight or treating yourself to new ones.
16:44
You deserve it. But there are plenty of you
16:46
out there who really like to track your weight. And that's great. Just
16:49
don't let those few pounds here or there ruin your
16:52
day.
16:53
And trust in in the process,
16:55
you are going to need a daily vitamin. And there are a lot
16:59
of choices out there. Oh my gosh. So before you buy
17:01
the fancy AG1 for 80 to 100 bucks a
17:04
month, try a few different vitamins. See how they settle on your
17:07
stomach. You might find that children's chewable
17:10
a couple a day work just as well. And they're pretty
17:12
inexpensive. But if you want to be a little
17:15
bourgeois and like the expensive vitamins,
17:18
that's fine. I have a simple key for
17:21
you. Your body doesn't care how much the vitamin
17:23
costs. Your vitamin comes from whether
17:26
it's a rose hip or a synthesized in a lab. Your body doesn't care.
17:29
It will utilize them. And when you see
17:32
all this extra stuff on the label, like I take
17:35
a little AG1 and it has all this extra stuff.
17:38
But the key on the label is the
17:41
little disclaimer where it says, the FDA has not verified
17:44
these claims. Meaning,
17:47
don't listen to what we're saying. Prenatal
17:50
vitamins are great too, by the way. If you want to buy the expensive
17:53
juices, go ahead and buy it. So I want you to think
17:56
about this. GLP1s are a lifelong medication to treat
17:59
the disease of obesity. They give you
18:01
the tool, you'll be able to use it. Your
18:04
goal is to eat better and not get trapped
18:07
into absolutisms. The ice cream you
18:10
ate won't ruin you. You can enjoy
18:13
it. You can enjoy a little bit of everything.
18:16
You truly can moderate and eat
18:18
almost anything and enjoy it. So listen to your
18:21
stomach, mostly eat well, mostly
18:24
plants. And yep, new medicines are coming.
18:27
You may be transitioning to one of the new medications that are in pill
18:30
form later on, but until then,
18:33
your goal is great food, delicious food,
18:37
healthy and enjoyable food.
18:40
Well, that's a wrap. Remember, GLP1
18:42
medications are tools, not magic. But
18:46
I would always recommend that you go with an obesity
18:48
specialist who are trained in GLP1s and know how
18:51
to help and walk you through and guide the process.
18:55
Not a, uh, coach, not a life
18:57
coach, not a gym bro. This
19:00
podcast was written and researched by me, Dr. Terry Simpson. And while I
19:03
am a doctor, I am not you your doctor.
19:06
I do want you to consult a real western trained
19:09
physician and a good registered
19:11
dietitian. Not some alternative medicine practitioner,
19:14
eastern thing, chiropractor. They don't know about GLP1
19:17
medications. Do check out the blog associated with the
19:20
podcast at YourDoctorsOrders.com and 4Q.com
19:23
4Q is distributed by our friends at Simpler
19:25
Media who also help with the editing of the
19:28
sound and make me sound better than I am.
19:31
Special thanks to the pod God, Mr. Evotera.
19:34
And until next time, keep your fork
19:37
on the road to health.
19:44
Hey EVO, these new GLP1
19:47
medications are frigging amazing.
19:50
They have actually flattened the obesity curve in the United
19:53
States for the first time in 30 years.
19:56
I am thinking that there are going to be a large population
19:59
of America that's going to be using them. Maybe they'll even listen to
20:02
this podcast.
20:05
>> Speaker B: You totally missed a great opportunity for a
20:08
much less large population.
20:11
Choke. But no.
20:14
Still good tips. I could use
20:17
them. Cheers. Oh, and uh, happy New Year.