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24. Semaglutide - Is It Worth the Hype? · Health Unscripted

• 0:03
  SPEAKER_00: Hey guys, what's up?
• 0:04
  SPEAKER_00: Welcome back to another episode of Health Unscripted.
• 0:08
  SPEAKER_00: Today I'm going to, and I'm going to admit messily.
• 0:11
  SPEAKER_00: So if you're watching the video version of this on YouTube or wherever, hi.
• 0:15
  SPEAKER_00: And I'm going to be clicking through my screens because I don't want to quote things wrong and memory is great, but maybe not that great.
• 0:23
  SPEAKER_00: But this week we're going to be talking about Symagnitude, which is like the newest weight loss craze, right?
• 0:29
  SPEAKER_00: If you don't know about it, I will be going into detail.
• 0:32
  SPEAKER_00: The name brands that it's under that people may be asking for if you're seeing this out there is Ozempic, Wagovi.
• 0:39
  SPEAKER_00: This is what I'm looking up because I'm like, wait, I'm a pharmacist and I don't remember the third one, Ribelsis.
• 0:46
  SPEAKER_00: I've been out for two years.
• 0:47
  SPEAKER_00: Okay.
• 0:48
  SPEAKER_00: There's been so many medications that's come out in two years that people ask me questions and I'm like, I don't know.
• 0:53
  SPEAKER_00: It's funny.
• 0:54
  SPEAKER_00: I always have this joke as a sidebar.
• 0:55
  SPEAKER_00: I always had this joke that retail pharmacy made me dumb because you forget all the clinical knowledge you learned in pharmacy school.
• 1:01
  SPEAKER_00: But we're not going to dive into that today.
• 1:03
  SPEAKER_00: Today we're going to focus on some magnitude for weight loss specifically.
• 1:08
  SPEAKER_00: Um, I'm also going to touch on some other pharmaceutical weight loss medications and just some other, you know, procedures and things that are done for rapid weight loss or for massive weight loss and my thoughts on those and kind of how to approach them moving forward.
• 1:24
  SPEAKER_00: So the reason I'm doing this Onozepic or Ragovi, Rebelsis, whatever name brand you want to put it under, we're going to be calling it the generic for this podcast, some magnitude, is because it is like the newest crazy trend.
• 1:37
  SPEAKER_00: Because I'm, I mean, I'm may ruffle some feathers in here too, but it's an easy button.
• 1:42
  SPEAKER_00: It is a, let me take this instead of doing lifestyle, you know, considerations, and I'll lose the weight.
• 1:50
  SPEAKER_00: Now, in the studies, I'm going to quote, they did do lifestyle interventions.
• 1:54
  SPEAKER_00: Some people still do lifestyle interventions.
• 1:56
  SPEAKER_00: But if you know anything about what I do and what we've been doing, sometimes you don't need a deficit.
• 2:01
  SPEAKER_00: Sometimes you need to take a break out of a deficit in order to lose weight.
• 2:03
  SPEAKER_00: We need to make hormones happy.
• 2:05
  SPEAKER_00: We need to eat the right type of nutrients and the right type of macros.
• 2:09
  SPEAKER_00: And most don't do that.
• 2:10
  SPEAKER_00: But for this episode, you know, a lot of people want to just take something and then see the results.
• 2:17
  SPEAKER_00: And I say this because I even have clients who are really working hard and have made super great success, but they have colleagues who work in the hospital or in healthcare too, who are taking these injections every week, seeing greater results in weight loss.
• 2:31
  SPEAKER_00: And they're like, well, I want to see that too.
• 2:33
  SPEAKER_00: How come I'm not seeing it that fast?
• 2:35
  SPEAKER_00: And I have to remind them that they're doing their due diligence and the hard work, which is going to pay off in the long run.
• 2:41
  SPEAKER_00: And that's what I'm going to talk about in this podcast.
• 2:43
  SPEAKER_00: Okay.
• 2:43
  SPEAKER_00: So all about some agtitude, what it is, the trials associated with it, my opinion on it, if I think it'll work, et cetera.
• 2:51
  SPEAKER_00: Okay.
• 2:51
  SPEAKER_00: So I am one of those pharmacists who quit pharmacy because I was tired of handing out band-aids and easy buttons.
• 2:57
  SPEAKER_00: All right.
• 2:57
  SPEAKER_00: And that's for most healthcare things.
• 2:59
  SPEAKER_00: Um, other medications that are out there for weight loss, like fentramine, I don't love, I think there's a lot of side effects, and it doesn't work once you get off of it.
• 3:07
  SPEAKER_00: It raises your heart rate and blood pressure, makes you anxious, don't love it.
• 3:10
  SPEAKER_00: It suppresses your appetite.
• 3:11
  SPEAKER_00: That's how fentramine works.
• 3:13
  SPEAKER_00: And sometimes we already, you know, have a suppressed appetite and we're not eating enough.
• 3:17
  SPEAKER_00: So if we're eating less, it's only going to make our hormones worse.
• 3:20
  SPEAKER_00: And this is primarily for women, too, with hormone control and stress and just what how that goes in the body.
• 3:27
  SPEAKER_00: So now that we have some magnitude, which, you know, is being studied for obesity.
• 3:33
  SPEAKER_00: It is a diabetic medication, but the weight loss effects were so great, they started studying it for obesity.
• 3:40
  SPEAKER_00: So, what some aglitude is, is a GLP1 analog.
• 3:45
  SPEAKER_00: Um, it's a glucagon-like peptide.
• 3:47
  SPEAKER_00: Okay, so what it does is it helps with insulin sensitivity and it also decretes appetite, it delays gastric emptying, so you're fuller longer, you don't eat as much.
• 3:57
  SPEAKER_00: Um, it does help weight loss in people with type 2 diabetes and adults who are obese.
• 4:03
  SPEAKER_00: And obese is defined as a BMI of greater than 30.
• 4:07
  SPEAKER_00: Um, for the trial I'll be speaking about, they also took participants who had a BMI of greater than 27 with at least one other cardio or metabolic issue.
• 4:17
  SPEAKER_00: Um, the people in the trial did not have diabetes.
• 4:19
  SPEAKER_00: So this is specifically studied for weight loss.
• 4:22
  SPEAKER_00: So is somagitude effective?
• 4:25
  SPEAKER_00: Absolutely.
• 4:26
  SPEAKER_00: So it's an injection.
• 4:27
  SPEAKER_00: You take it once a week.
• 4:28
  SPEAKER_00: The dose for weight loss is 2.4 milligrams once weekly, and they build you up to that dose.
• 4:34
  SPEAKER_00: Like they didn't just start participants on that because it does have side effects.
• 4:38
  SPEAKER_00: Nausea and gastrointestinal upset were the main factors in, you know, the main side effects reported.
• 4:44
  SPEAKER_00: Some people did stop taking the drug because of these side effects, but for those who continued versus placebo, both both groups uh were um susceptible or were made to do lifestyle changes, which included a 500 calorie a day deficit based on their energy output.
• 5:02
  SPEAKER_00: So kind of like a calculation.
• 5:04
  SPEAKER_00: And then 150 minutes of exercise per week, which could include just walking, right?
• 5:10
  SPEAKER_00: So, as a little aside on this, if you know one thing that helps with diabetes, insulin resistance, even more, is weight training.
• 5:19
  SPEAKER_00: Weight training is phenomenal.
• 5:21
  SPEAKER_00: So, not everyone in this study group did weight training, and I would get everyone lifting weights if I could.
• 5:26
  SPEAKER_00: It is so great for insulin resistance, increasing insulin sensitivity, and helping with overall weight loss in your metabolism.
• 5:33
  SPEAKER_00: But that was not, you know, one of the factors here.
• 5:36
  SPEAKER_00: It was just 150 minutes of exercise per week and a 500 calorie deficit.
• 5:40
  SPEAKER_00: This study was done, it is the step trials, by the way.
• 5:43
  SPEAKER_00: If you want to look it up, STEP STEP trials, 68 weeks.
• 5:47
  SPEAKER_00: So they were they were doing the study for 68 weeks, and there was a good amount of weight loss compared to placebo.
• 5:53
  SPEAKER_00: I want to say this is where I have the things pulled up because I'm like, I don't want to misquote it.
• 5:58
  SPEAKER_00: Um, where are the results?
• 6:01
  SPEAKER_00: Okay, so based on baseline to week 68, there was a 15% in the semaglita semagluta group.
• 6:09
  SPEAKER_00: I can't speak, compared with a 2.4% with placebo.
• 6:12
  SPEAKER_00: So 15% of body weight lost versus 2.4%.
• 6:15
  SPEAKER_00: Obviously, that is a really big deal.
• 6:17
  SPEAKER_00: Okay, that's a lot more weight.
• 6:19
  SPEAKER_00: I get it.
• 6:20
  SPEAKER_00: It worked.
• 6:20
  SPEAKER_00: Supposedly, they all did the lifestyle interventions and they were recorded in a diary.
• 6:25
  SPEAKER_00: They had like group setting therapy chats every four weeks to make sure everything was being recorded and they were doing the lifestyle changes.
• 6:33
  SPEAKER_00: But here's the thing: I have no doubt that it will work.
• 6:37
  SPEAKER_00: That's what the medication is for, that's what it does.
• 6:40
  SPEAKER_00: My issue with these medications is that can you keep that weight off?
• 6:46
  SPEAKER_00: What good is a program, a diet, a medication, or a supplement that you have to take or do forever to see results?
• 6:56
  SPEAKER_00: And that's kind of where I want to shift into listen, some magnitude is great.
• 7:00
  SPEAKER_00: It could be like a really good option for, you know, very obese patients who have really not having success otherwise.
• 7:09
  SPEAKER_00: Same as the gastric bypass or sleeve.
• 7:11
  SPEAKER_00: Um, did it is it was a gastric bypass, uh, the gastric sleeve or the bariatric surgery for weight loss where we reduce your stomach size, things like that.
• 7:22
  SPEAKER_00: All is fine and dandy and work super well while you're doing it or in the beginning, but it's after the fact where you see the regain and the plus the boomerang effect where you come back to gaining almost as much as you lost, or just, you know, more than you lost.
• 7:41
  SPEAKER_00: And it's because we didn't actually take the time to learn proper lifestyle changes.
• 7:47
  SPEAKER_00: Now, in a diet, a deficit and movement is great, but did they learn behavior changes to help them shift into a lifestyle transformation?
• 7:55
  SPEAKER_00: I'm gonna go with no.
• 7:57
  SPEAKER_00: And actually, I do have another article pulled up in the news of Medicine Matters where body weight rebounds after somagitude.
• 8:07
  SPEAKER_00: Why do I keep calling it smaglitude?
• 8:09
  SPEAKER_00: Symagletide withdrawal.
• 8:10
  SPEAKER_00: Sorry, guys, bear with me on this.
• 8:12
  SPEAKER_00: So body weight rebounds after cymaglatide withdrawal.
• 8:16
  SPEAKER_00: That does not surprise me at all.
• 8:18
  SPEAKER_00: If anything, if I would have bet$100 on every patient in the study whether they'd regain some weight, I would have done it.
• 8:24
  SPEAKER_00: I would do it because it's the behavior changes and the lifestyle shifts that actually make a difference.
• 8:29
  SPEAKER_00: So what happens is when they stop taking the medication, after a year, you know, there was a 52-week extension phase after stopping the randomized treatments.
• 8:39
  SPEAKER_00: Um, the average weight gain, average weight regain was 11.6 and 1.9 percentage points in the semaglotide and placebo groups.
• 8:48
  SPEAKER_00: So 11.6% regained weight of the 14.9% that lost, right?
• 8:54
  SPEAKER_00: And 1.9% of the placebo groups regained.
• 8:59
  SPEAKER_00: So not too much, but that's that's kind of negligible.
• 9:02
  SPEAKER_00: And they said in this article that two-thirds, they they gained regained two-thirds of the weight that they lost.
• 9:08
  SPEAKER_00: So yes, you might overall be down, and that's only after a year.
• 9:12
  SPEAKER_00: Um, it would be interesting to see a further extension study, like two years down the road, three years down the road, if you know they kept that weight off or what happened.
• 9:22
  SPEAKER_00: The one benefit that I do see from the article is that the cholesterol effects and the cardioprotective effects or the cardio effects did stay down and did have an improvement after the year, which is great, which you know, if you are suffering from co-founding uh comorbidities or metabolic factors, that could be a great, a great option for you.
• 9:43
  SPEAKER_00: But as far as weight loss in general, they saw the most rebound with those who lost the most weight, which does not surprise me either, because obviously to get to a certain weight, we have to have certain behaviors and habits.
• 10:00
  SPEAKER_00: And the quicker we lose that weight, that means it was either highly restrictive or something we did that wasn't sustainable.
• 10:07
  SPEAKER_00: So you're gonna see more weight regain in those clients because the factors and the lifestyle changes are still the same and it was done very much unsustainably.
• 10:17
  SPEAKER_00: So we couldn't keep it going.
• 10:19
  SPEAKER_00: So your answers here are if you're gonna do some aglatide or if you're debating getting on some aglatide, which I will say is not covered by insurance for obesity, or at least not yet, because technically, like they like to call it a cosmetic medication.
• 10:36
  SPEAKER_00: Um, it is being studied, that's what all these trials are for, but it's not covered by insurance.
• 10:41
  SPEAKER_00: Fentamine is usually not covered by insurance either, by the way.
• 10:44
  SPEAKER_00: It's very expensive.
• 10:45
  SPEAKER_00: Let me see if I can get a cash price really quick.
• 10:47
  SPEAKER_00: Um, I should have done that while I was on here.
• 10:50
  SPEAKER_00: Let's see.
• 10:50
  SPEAKER_00: Where's pricing?
• 10:52
  SPEAKER_00: So if we're gonna do Ozepic.
• 10:57
  SPEAKER_00: One carton, two pens of one milligram.
• 11:01
  SPEAKER_00: Well, you're gonna need 2.4 milligrams.
• 11:04
  SPEAKER_00: It's in the 800s, almost$900 cash price.
• 11:07
  SPEAKER_00: Now, maybe you can get some coupons of Good RX, but this says from Good Rx.
• 11:11
  SPEAKER_00: So I highly doubt it's gonna be cheaper than that.
• 11:13
  SPEAKER_00: But$800, and that looks like it could be monthly.
• 11:18
  SPEAKER_00: That's crazy.
• 11:19
  SPEAKER_00: So, super expensive.
• 11:22
  SPEAKER_00: So your options are if you're thinking about starting this, can you keep it up and do it forever?
• 11:27
  SPEAKER_00: Because that's what they're saying now, is like, oh, with the weight regain and the and the withdrawal period and the extension study, it seems that patients may need continued therapy.
• 11:38
  SPEAKER_00: Like, no shit, dude.
• 11:40
  SPEAKER_00: Like you're giving them an easy button, they're taking it, and then they regain after you're gonna need continued therapy.
• 11:45
  SPEAKER_00: So do I want to be on this forever?
• 11:47
  SPEAKER_00: Or will I commit the time and effort it takes to make behavior shifts so that I don't have to be on this medication forever and I can maybe take it for a little while and then get off of it?
• 11:59
  SPEAKER_00: Or can you just make the behavior changes and do the lifestyle changes and commit to that so that it is sustainable and you can have a lifelong, healthy habit and energy and all of that without having to spend$800 a month or wherever you can find it for cheaper if it's real, right?
• 12:15
  SPEAKER_00: Like maybe they're coming out of other countries on the black market.
• 12:18
  SPEAKER_00: I don't know, it's the magnetide on the magnetide on the black market.
• 12:22
  SPEAKER_00: Um, so what you can do if you are debating this and what I think they needed to add to this study to make it last long so there wasn't so much rebound effects.
• 12:35
  SPEAKER_00: And clients or anyone listening to this, the lifestyle behaviors that need to change are absolutely yes, getting out and moving, 150 minutes of exercise is um five days of 30 minutes walking, right?
• 12:49
  SPEAKER_00: Like you can walk, you can do whatever.
• 12:51
  SPEAKER_00: Um, I would say start weightlifting three to four times a week.
• 12:55
  SPEAKER_00: Strength training is gonna be the best.
• 12:56
  SPEAKER_00: And no, that doesn't mean hit exercises, that means actual strength training.
• 13:00
  SPEAKER_00: My nose is kind of running.
• 13:02
  SPEAKER_00: Sorry, guys.
• 13:02
  SPEAKER_00: If you're watching this video, sorry.
• 13:04
  SPEAKER_00: Uh movement is great, strength training is great.
• 13:08
  SPEAKER_00: Definitely want to start doing that and incorporating it into your day.
• 13:11
  SPEAKER_00: I will also differentiate exercise, which is going to be strength training, hit classes, things like that with walking.
• 13:17
  SPEAKER_00: Those are different and act on the body in a different way.
• 13:21
  SPEAKER_00: Neat, which is non-exercise activity thermogenesis, is walking, is fidgeting.
• 13:26
  SPEAKER_00: That is really, really good for the body as well and actually burns more calories over the extension of your total daily energy expenditure than exercise.
• 13:36
  SPEAKER_00: The exercise component, which would be strength training, is really great for longevity, for helping bone health, uh, metabolic health, insulin health, all of that.
• 13:47
  SPEAKER_00: So you want to do both.
• 13:49
  SPEAKER_00: So if I could really encourage you to do anything, it's start strength training, you know, even if you start at two days a week, start somewhere and then we build up.
• 13:56
  SPEAKER_00: But do do the strength training and then start walking.
• 14:00
  SPEAKER_00: For, you know, we like to have our clients do 10K steps a day.
• 14:04
  SPEAKER_00: But even if you're at zero K right now, start at 2,000, move up to 4,000, move up to 5,000, move up to 7,000, right?
• 14:11
  SPEAKER_00: All you need to do is walk.
• 14:12
  SPEAKER_00: And if you don't have a step counter, usually if you're walking at like four miles an hour, you can do a mile in 15 to 20 minutes, which is roughly 2,000 steps.
• 14:22
  SPEAKER_00: So maybe you go for walks for 40 minutes or you know, walk around at work during lunch in the morning at night, take your dog for a long walk.
• 14:30
  SPEAKER_00: I'm sure they'll enjoy it.
• 14:31
  SPEAKER_00: Anything to get more steps in, park farther back in the parking lot, right?
• 14:34
  SPEAKER_00: Like these are behavior changes that will ultimately help you be successful in the future.
• 14:39
  SPEAKER_00: Now, a dietary calorie deficit, like they did, a 500-calorie reduction is great for a diet phase.
• 14:45
  SPEAKER_00: But most of the women we see in our practice, and I call it a practice, uh, are clients who are already eating too low, that they actually need to give their metabolism a break, come back up, diet break, and then we could put them into a deficit later because hormones are happy, metabolism is now happy, we're burning on all cylinders.
• 15:04
  SPEAKER_00: It's great.
• 15:05
  SPEAKER_00: If we have someone who's 1200 calories and we put them 500 more calories in the gutter, which, you know, that's an extreme case, it's probably not happening, but I'm sure some of these people were eating 900 to 1000 calories.
• 15:17
  SPEAKER_00: And if you're a 200-pound person, that's an extreme deficit.
• 15:20
  SPEAKER_00: That is huge.
• 15:21
  SPEAKER_00: That's not sustainable.
• 15:23
  SPEAKER_00: It's a lot, okay?
• 15:24
  SPEAKER_00: Um, that's fine for maybe a short period of time for clients in this study, but overall it's not sustainable.
• 15:29
  SPEAKER_00: You're gonna need to learn how to get out of that diet.
• 15:32
  SPEAKER_00: And I don't believe these clients learned how to get out of that diet.
• 15:34
  SPEAKER_00: They ended the study and were like, whoa, I can go back to eating how I want to eat.
• 15:38
  SPEAKER_00: And that's exactly what they did.
• 15:40
  SPEAKER_00: Hence the two-thirds weight regain.
• 15:43
  SPEAKER_00: So, what I would say for lifestyle shifts as far as diet is related.
• 15:48
  SPEAKER_00: Look at how long you've already been in a diet.
• 15:50
  SPEAKER_00: Maybe you need to take some time off.
• 15:51
  SPEAKER_00: Maybe we need to reset that metabolism.
• 15:53
  SPEAKER_00: I'm not gonna say reset, restore because the metabolism is doing exactly what it's supposed to be doing.
• 15:58
  SPEAKER_00: It's adapting to a lower caloric intake because it is a machine and it's conserving energy.
• 16:04
  SPEAKER_00: So, what we need to do is give it the fuel it needs to actually do its job properly and do it well, and then it will be an even better asset to you in the future when we go into a diet phase.
• 16:14
  SPEAKER_00: So maybe that's step one.
• 16:16
  SPEAKER_00: Step two is including high-quality lean protein in every single meal that you have.
• 16:22
  SPEAKER_00: All right.
• 16:22
  SPEAKER_00: Breakfast, lunch, and dinner, make them 25 to 30 grams of protein minimum.
• 16:27
  SPEAKER_00: Minimum.
• 16:28
  SPEAKER_00: We do not eat enough protein as a society.
• 16:30
  SPEAKER_00: If you have kidney issues, liver issues, anything like that, check with your doctor first.
• 16:34
  SPEAKER_00: I don't recommend a super high protein diet for those with kidney issues.
• 16:37
  SPEAKER_00: But if you are not having kidney issues, obviously this is a disclaimer in general.
• 16:41
  SPEAKER_00: Always check with your doctor before starting anything.
• 16:43
  SPEAKER_00: You're gonna have to check with them before some aglatide anyway.
• 16:46
  SPEAKER_00: But protein in every single meal.
• 16:48
  SPEAKER_00: Protein is so, so, so important.
• 16:50
  SPEAKER_00: I would say, you know, aim for if you are in the realm of like 20% body fat to 25% body fat, you can likely do one gram of protein per pound of body weight.
• 17:03
  SPEAKER_00: If you are over 25% body fat to 30% body fat, maybe we back it down to 0.8.
• 17:09
  SPEAKER_00: And then when we get into like 35% body fat to 40% body fat, we may need to do 0.5 grams per pound of body weight, right?
• 17:16
  SPEAKER_00: Like if you are listening to this and you're 240 pounds, we're not gonna give you 240 grams of protein.
• 17:21
  SPEAKER_00: That would be insane.
• 17:22
  SPEAKER_00: It will likely fall somewhere between 130, you know, 135 if I'm doing it off the top of my head.
• 17:28
  SPEAKER_00: So those are the protein calculations you're gonna want to add those to your day.
• 17:32
  SPEAKER_00: Protein, love it.
• 17:34
  SPEAKER_00: Second is gonna be fiber.
• 17:36
  SPEAKER_00: Focus on fibrous foods.
• 17:38
  SPEAKER_00: Fiber is amazing.
• 17:39
  SPEAKER_00: I have a podcast called um, what is it, the magic ingredient for sustained weight loss.
• 17:44
  SPEAKER_00: It is fiber.
• 17:44
  SPEAKER_00: It is amazing.
• 17:45
  SPEAKER_00: And as Americans, we are under fibered.
• 17:47
  SPEAKER_00: I'm gonna do another episode on what we're missing in our diets uh for overall health, but fiber is essential.
• 17:54
  SPEAKER_00: You want 25 to 30 grams of fiber minimum each day.
• 17:58
  SPEAKER_00: The normal American gets in about 10.
• 18:00
  SPEAKER_00: That's terrible for our gut and for blood sugar regulation.
• 18:04
  SPEAKER_00: So, fiber, we want to add that too.
• 18:07
  SPEAKER_00: Um, more lifestyle changes are gonna be water.
• 18:10
  SPEAKER_00: Water is also gonna super help you.
• 18:12
  SPEAKER_00: So staying hydrated, half your body weight in ounces.
• 18:15
  SPEAKER_00: When you wake up in the morning, the first thing you should have is water.
• 18:18
  SPEAKER_00: The second thing you should have is breakfast.
• 18:20
  SPEAKER_00: So another lifestyle adjustment is no more skipping meals, no more, especially women.
• 18:24
  SPEAKER_00: If you're listening to this and you're in childbearing ages, please don't do intermittent fasting.
• 18:29
  SPEAKER_00: Please, please don't do it.
• 18:31
  SPEAKER_00: Um, start your day with a protein-packed breakfast, add some fiber.
• 18:34
  SPEAKER_00: Raspberries are my favorite for breakfast.
• 18:36
  SPEAKER_00: They're really high in fiber.
• 18:37
  SPEAKER_00: And then do coffee 60 to 90 minutes after waking and after eating.
• 18:42
  SPEAKER_00: We do not want to have caffeine on an empty stomach.
• 18:44
  SPEAKER_00: That goes for pre-workout, that goes for Celsius, whatever you're drinking, water, food, coffee.
• 18:50
  SPEAKER_00: This will super help with the cortisol response of the body and blood sugar regulation, which is what we want for overall weight loss and for overall health and longevity.
• 18:58
  SPEAKER_00: And then I don't have to say this, but I'm going to, but obviously, fruits and veggies are your friend.
• 19:01
  SPEAKER_00: Antioxidants and micronutrients are going to be amazing.
• 19:04
  SPEAKER_00: So the dietary recommendations, just to sum up, are going to be protein at every meal, fiber, focusing on fiber, 25 to 30 grams a day, water, water, water, water, and then the timing that you have your water meals and coffee and no skipping meals, no skipping breakfast, none of that.
• 19:23
  SPEAKER_00: We don't want it.
• 19:24
  SPEAKER_00: It's too stressful, especially for us women who are in our reproductive ages.
• 19:28
  SPEAKER_00: I don't like it.
• 19:29
  SPEAKER_00: So those overall things, plus the activity that we already spoke about, will do wonders for helping you.
• 19:36
  SPEAKER_00: The next best thing is going to be sleep.
• 19:38
  SPEAKER_00: Get seven to eight hours of sleep minimum per night, and you are set.
• 19:42
  SPEAKER_00: You don't need an$800 a month injection.
• 19:45
  SPEAKER_00: That doesn't sound fun anyway.
• 19:47
  SPEAKER_00: Um, if maybe we would have focused, like if I would have done the study, I would have maybe incorporated some of these behaviors.
• 19:55
  SPEAKER_00: We would also look at the insulin sensitivity, maybe raise some fat content.
• 19:58
  SPEAKER_00: Maybe I'd have them track macros and not just track calories, right?
• 20:02
  SPEAKER_00: Because they're totally different and we love macros more than we love empty calories.
• 20:07
  SPEAKER_00: So these are the things that you can start incorporating in your life now that I also went over in my fat loss podcast.
• 20:13
  SPEAKER_00: You guys are going to hear me say this a lot because it's so simple.
• 20:16
  SPEAKER_00: It's so simple and we tend to overcomplicate it.
• 20:18
  SPEAKER_00: And these are the things that we need to do to move forward to actually keep the weight off, have sustained weight loss, and be successful, not always injections or quick, easy fixes.
• 20:30
  SPEAKER_00: So I'd love to know your thoughts on this, like whether you think semaglitide is the drug of the future and it's gonna help everybody.
• 20:37
  SPEAKER_00: And I'm completely wrong if you think that.
• 20:42
  SPEAKER_00: If you think that it is also kind of like uh cool, it's gonna work for a little while, and then now what?
• 20:49
  SPEAKER_00: We can also chat about that.
• 20:50
  SPEAKER_00: I want to chat about that too.
• 20:52
  SPEAKER_00: But as a pharmacist, and you know, I get a lot of questions about these things, it's definitely my due diligence to talk about it.
• 20:59
  SPEAKER_00: So that's my opinion.
• 21:00
  SPEAKER_00: That's what it does.
• 21:01
  SPEAKER_00: If you guys have any questions, as always, reach out on Instagram at dr.dwyer at drdwyre.
• 21:08
  SPEAKER_00: I love chatting with you guys in there.
• 21:10
  SPEAKER_00: If you're watching this, screenshot the little Apple or Spotify emblem on there, the little graphic and tag me in it.
• 21:17
  SPEAKER_00: Let me know you're going for a walk or whatever you're doing.
• 21:20
  SPEAKER_00: Um, I do want to announce because by the time this comes out next week, or sorry, I'm recording it the week prior, but we will already be knee deep in our New Year Better You program.
• 21:32
  SPEAKER_00: So we do a program on New Year's.
• 21:34
  SPEAKER_00: Um, it's 16 weeks because New Year's resolutioners, we are all starting the new year with a new goal, feeling hella motivated.
• 21:41
  SPEAKER_00: We want to crush it.
• 21:42
  SPEAKER_00: And 50% of New Year's resolutions are weight-related, fitness related.
• 21:47
  SPEAKER_00: So how do we keep from falling off?
• 21:49
  SPEAKER_00: Because statistics show only 9% of all people who set resolutions, and no matter the category of what they set it for, whether it's saving money, stop biting your nails, et cetera, only 9% of people actually make it to the end of the year successful.
• 22:02
  SPEAKER_00: So, how do we make you one of those 9%?
• 22:05
  SPEAKER_00: And how do we get you to keep these lifestyle habits that we're gonna be teaching you in check, right?
• 22:09
  SPEAKER_00: Because it takes 66 days to make or break a habit, not 21, not 21.
• 22:13
  SPEAKER_00: So we're doing a 16-week nutrition and fitness program.
• 22:17
  SPEAKER_00: It will start January 2nd, highly discounted if you were gonna do this otherwise as a normal plan.
• 22:22
  SPEAKER_00: We don't even offer 16-week plans, it's usually 12-week or six-month.
• 22:26
  SPEAKER_00: So we're gonna give you six weeks, 16 weeks because we want it to, we want you to make it past the normal three-month mark where individuals usually fall off for the year.
• 22:34
  SPEAKER_00: We want you to do it for 16 weeks and make these real changes.
• 22:38
  SPEAKER_00: So if you are interested in this, you can also send me a DM on Instagram with the word new year and we'll talk about it.
• 22:45
  SPEAKER_00: We'll get you situated, we'll get you set up on a consultation call to see if this program is right.
• 22:49
  SPEAKER_00: It is a free consultation call and get you rolling.
• 22:53
  SPEAKER_00: So, yeah, guys, thanks so much.
• 22:54
  SPEAKER_00: I hope you have an amazing week and I'll talk to you next week.