Latest / Everyday Ancestral with James Barry / Fix Your Metabolism, Save Your Heart: Dr. Philip Ovadia on Preventing Disease the Natural Way

Transcript

Fix Your Metabolism, Save Your Heart: Dr. Philip Ovadia on Preventing Disease the Natural Way · Everyday Ancestral with James Barry

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If you're like me and you are scared of having a heart attack or having any cardiovascular
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health issue, then you're going to be very excited by my next guest.
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His book, Stay Off My Operating Table, yes I am speaking to Dr. Philip Ovidia.
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So conducting over 3,000 heart surgeries taught, Dr. Philip Ovidia, that good health comes
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from lifestyle and nutrition, not surgery and medication.
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Huh?
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It's very rare to hear this message from a person or a product of our medical industry.
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Sadly, many of his patients considered their heart attacks inevitable.
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He overcame a life long obesity and it's now his mission to help people stay off his
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operating table by teaching them how to never need a heart surgeon.
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Dr. Ovidia works as an independent cardiothoracic surgeon and he runs Ovidia Heart Health, a telehealth
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practice that focuses on the prevention of heart disease.
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Welcome to Every Day Ancestral, I'm your host James Berry.
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Please enjoy our guest, Dr. Philip Ovidia.
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It's such a pleasure to have you.
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Thank you so much for joining us here at Every Day Ancestral.
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Yeah, good to see you again, James.
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It's been a while since we've been together in person, but always nice to reconnect and
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have a great discussion with your audience.
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Yeah, well, it couldn't be more poignant, right?
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I mean, all the conversations right now with the maha talk, it's almost like it's finally
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on people's tongues.
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We got to make our health a priority, but I feel like there's just such an immense resistance
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going on.
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And I can't tell is it people with money or is it just the general public?
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What sense are you getting?
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I was actually fortunate enough to be up in Washington, DC for the inauguration, attended
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RFK's inaugural ball, very much the epicenter of the maha movement.
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And I'm certainly on board with it.
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This shouldn't be like a contentious political issue, right?
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Make America healthy again.
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It shouldn't even be political, right?
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Yeah, exactly.
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We should all want it.
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I'm excited to see that it's reaching that level now that there was a lot of energy
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around it and so many people that are committed to the movement.
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I think RFK can be a great leader for that.
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But in, I guess you could say there are many people that take issue with some of the things
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he talks about, but his overall message is, let's make America healthy again.
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He talks a lot about food quality and I think he has the right approach.
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And I think the controversial part around the pharmaceuticals and the vaccines, right?
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All he really says is, let's see the data, if these things work great, but we need to be
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more transparent around this and we need to be more scientific about what we are telling
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people to take and the stuff that doesn't work or the stuff that the science doesn't ultimately
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support.
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Yeah, we need to rein that back.
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We need to get some things, perhaps off of the market or just change the messaging around
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them at least.
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And that's all he's asking for is, let's look at the data.
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Let's get the data around these things and I think that makes a lot of sense when it comes
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to health.
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Now obviously, like you said, you know, there's opposition to that.
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There are people that are making a lot of money off the current system.
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One of the things I say about the healthcare system, right, today is, is working great
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for everyone except the patients and the doctors.
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And so there are a lot of people that really don't have any motivation to change the system.
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Those of us in this community have been shouting about this for a long time.
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Let's start looking at the food that's being put in front of us and that we're being told
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to eat.
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Let's acknowledge the fact that health is a major issue and it's moving in the wrong
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direction.
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You have personal experience, right?
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I mean, I would love to talk about the perspective of the doctor because you have that unique
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perspective, which is you are very much trained in Western medicine.
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You're a surgeon background and yet something wasn't working and you took the steps to
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change that.
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So can you kind of bring us back to what wasn't working?
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What were you taught and then what was the catalyst for change for you?
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Yeah.
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So again, you know, I've been a heart surgeon now for over 20 years.
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I've done over 3,000 heart surgeries quite frankly.
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I make a very good living as a heart surgeon and could continue doing so without trying
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to disrupt things, right?
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My incentives are not towards disrupting the healthcare system and making people healthier.
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But you know, on the flip side of things, I was very unhealthy.
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I was getting progressively more unhealthy, morbidly obese, prediabetic and I recognized
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that I was headed for my own operating table, so to speak.
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And I also recognized that the advice that I had been taught to give, it wasn't working
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for me and it wasn't working for my patients.
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At first, it was a matter of fixing my own health and I learned about low carbohydrate, eliminating
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processed food, ultimately have come to a mostly carnivore dietary approach, which
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I don't think is the only dietary approach that works, but it's what's been working for
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me now for many years.
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And along the way, I came to realize that what I thought I knew about heart disease, what
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I had been taught about heart disease was not correct.
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We're incorrect about what the primary cause of it is with the mainstream belief being
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that cholesterol is what causes this disease and it isn't.
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And we're incorrect more importantly on the fact that it is not preventable, not reversible
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and it is and that the way to do that is not through a pharmaceutical based approach.
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It's not with surgeries.
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It's with addressing diet and lifestyle first and foremost and we need to do a better
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job of that.
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You mentioned it's to your advantage to kind of follow the status quo.
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You make good money.
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You keep getting people on your table.
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Was the catalyst for change?
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Was it just you suddenly waking up one day and going, oh, I'm obese?
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What exactly happened that made you challenge or question what you had been taught?
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Yeah, like I said, the original catalyst was my health, right?
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And I was, you know, young father who wanted to be around to see his children grow up, right?
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I knew all too well what my future was because I saw it every day in the people that I was
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operating on.
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That's what opened my eyes initially and got me asking different questions and being open
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to this different information that I discovered.
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And what kind of response did you get once you started asking those questions?
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Because I imagine you first started asking your peers, right?
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The people that you're around.
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Really?
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That wasn't the first part, right?
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So the first part for me was first coming across this different information.
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And you know, the start for me was actually, ironically enough, I'm at a meeting of surgeons,
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the society of thoracic surgeons, right?
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And the guest speaker that year happened to be Gary Tobs.
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And you know, at that time, Gary had just written the case against sugar.
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And of course, prior to that, you know, he wrote good calories, bad calories and why we
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get fat.
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And you know, Gary was really the first person I heard some of these concepts from, right?
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This is not something I had learned in medical school about, you know, the effects of carbohydrate
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on insulin and insulin resistance and how that is what drives us to eat more and store
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more fat ultimately.
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That's how it started for me.
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Now, once I kind of learned about this and then I started talking to my colleagues about,
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why don't we know about this?
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Why weren't we taught this in school?
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Why aren't we telling our patients, you know, that this is a way that we can effectively
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manage not only obesity, but it turns out heart disease and much of the rest of the chronic
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disease that we face.
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And I got a lot of blank stairs back because the sad reality is is that most doctors never
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hear this information.
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They don't know about it.
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And they're just so programmed, right, with what we learned in school.
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And then they're so busy taking care of sick patients that they really don't have the
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time to stop and think, why are there so many sick patients?
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Consider myself blessed to have woken up to that fact and to now try and spread that word.
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And more and more other physicians are listening to this.
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I was just this past weekend at one of the low carb conferences and there were more
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physicians there than ever, more specialties of medicine represented by the physicians.
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And so I think this is growing.
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I think increasingly doctors are waking up to the fact that our medical system is failing
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and that we just have too many sick people to deal with.
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Where do you think it has to start, though?
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Do you think it has to start in the medical schools?
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Like do they have to shift and recognize, hey, people want more nutritional background?
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They want to understand how these different foods are affecting our bodies, anything like
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that, sugar, whatnot.
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Do you think it has to start there?
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Or is it just keep the status quo with the medical school?
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And then it's more about post-education.
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Yeah.
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So right now, I really think the best place to start is just more and more people doing
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this, right?
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And the more people that do this and get success with this, and then they go to their
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doctors, right?
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And their doctors start to see that.
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It's interesting.
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The physicians that were there at this conference this past weekend, right?
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They have one of two origin stories, how they got there.
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Either like me, they had personal health issues that they needed to deal with, or they
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had patients that woke them up.
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They had patients that did this and got better, which is something that doctors don't see
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a whole lot of, things like reversing type 2 diabetes.
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And thankfully, those doctors that were there were curious enough to follow up on that.
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A lot of doctors aren't.
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A lot of doctors just kind of shrug their shoulders and say, well, that's some anomaly and they
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just put their head back down and they keep plugging away the way they've been trained.
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But more and more, I think doctors are either being woken up by their patients or by their
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own health challenges.
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And I think that's really where it starts, you know, the problem right now is the medical
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education system is still largely captured by the pharmaceutical industry.
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And even, you know, if you said, okay, more nutrition in medical schools, the leading
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dogma around nutrition these days is still based on the food pyramid and low fat diets.
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And so getting more of that isn't really going to help.
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Right.
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So you get a lot of non fat, you'll play yogurt, you know, whatever, you get sponsorship
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very much true.
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So eventually, again, I hope going back to, you know, what we started talking about right
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from the politics down can come those policy changes that can then be implemented in the
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schools.
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But right now, I think the greater potential is the bottom up approach and that more patients,
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more people do this and that wakes more doctors up and then we can start to influence the
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system that way.
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I like that because you're really talking about, you know, it starts with the person in
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the mirror, right?
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That we have to start on ourselves and then it's progressively reaches, you know, eventually
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hopefully the institutions, the bigger businesses, big ag, whatever.
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I've heard that many times actually that, that it just takes that one person who even
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has some power sometimes within the system to make change, but you have to first believe
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it's possible.
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You have to believe in the modality, whatever it is we're talking about, you know.
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So you were surgeon, you had your big wake up call, you lost a lot of weight and you did
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it naturally, right?
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You did it with diet because ozemic wasn't going on back then.
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So you weren't doing it that way.
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So how is that shifted in how you deal with patients like or even how you initially interact
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with them?
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What's changed?
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Now as a heart surgeon, right, I can take a more holistic approach with my patients.
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Yes, unfortunately, by the time they get to me, they still usually need the surgery.
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That might not be avoidable, but I can be open with them, right?
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And I can explain to them that the surgery that I'm going to do isn't going to correct
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why you ended up here in the first place, why you need this surgery.
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And if we don't address that, ultimately, you're going to continue to have issues with
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heart disease.
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The sad reality is is that the majority of patients that undergo heart surgery or have
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a stent placed, for instance, or even have a heart attack, right?
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They still die of heart disease.
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Now yes, our treatments can prolong their life, can improve their life.
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But they still end up dying of heart disease because putting a stent in or doing bypass surgery
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like I do doesn't change the heart disease, right?
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It just is basically putting a band-aid on the problem.
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And so now I can, you know, explain to them about why they're actually here, what insulin
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resistance is and how it led to their heart disease.
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And then I can tell them we're going to do the surgery, but you can also do this other
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thing, right?
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You can change how you eat and change how you live and fix the underlying problem.
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And then you have a much better chance of heart disease not being what kills you.
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It's a much more complete approach in my role as a surgeon.
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Now I also have expanded how I practice these days and I have a preventative practice
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where I try and keep people off the operating table, I'm able to really start to attack
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this problem at all its different stages.
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I've always noticed in my 20 years in the health field that most people don't change their
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diet unless they get sick or someone they love gets sick.
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So how compliant are you finding people, not obviously the people that are coming to
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your telehealth because hopefully you're hitting them early, right?
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You're getting them a little earlier.
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But how compliant are you finding the people that do come to the surgery table?
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Is it a 100% success rate after they have the surgery of like, okay, I'm going to do
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it.
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Dr. Phil says, I'm in or do you still see resistance?
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Yeah, you know, they're, they're certainly still some resistance.
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Some people ultimately don't want to change, right?
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No matter what you tell them, right?
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They don't want to give up their habits and, you know what, I'm okay with that.
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This is an individual choice.
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I'm not here to force anyone to do this.
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I just want to be able to inform them.
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The sadder thing to me though is the situation I run into where the patient is enthusiastic
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right and they start doing it and they even start to see some good results from it.
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And then they have other doctors tell them that they can't continue doing this, that it's
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unhealthy for them because of those doctors and misunderstanding misconceptions, miseducation
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around what is really causing heart disease.
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A big part of my approach, right?
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I tell people to eat whole real food and mostly animal based foods, animal proteins.
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And of course, red meat is still widely considered to be a contributor to the development of heart
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disease.
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Now the science shows us otherwise and certainly the experience I'm having with lots and lots
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of patients and the bigger community that's out there around this shows us otherwise.
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But it is still a very deeply widely held belief that red meat is a driver of heart disease
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and therefore oftentimes, despite the success that patients are having, losing weight, improving
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their diabetes, getting off medicines, they get scared out of continuing it by their other
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doctors.
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Eggs are on that list as well, right?
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Egg yolks specifically and yet look at what's happening, finally, is it the USDA or FDA?
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They're finally saying, oh, eggs actually are health.
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They're finally kind of taking some ownership of what people have suspected for a long
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time that the data was incorrect and they're finally saying, oh, actually, these should
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be added to the healthy list.
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It hasn't happened long enough for us to truly see the ripple effect of that.
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But I do think it's, we're going to see a ripple effect and maybe, I don't know, 10 years
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or now, maybe finally we'll get people not splitting up the egg, you know, maybe.
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I agree with you.
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I think it is going to take quite a while.
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We see this all the time that the institutions, right?
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The systems like the healthcare system, they're very slow to change and unfortunately, right?
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This information doesn't really get communicated far and wide like it should.
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Something like, you know, ex or not bad for your health, right?
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That should be very widely communicated, but it's not.
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And a lot of people still just never hear that message for a lot of doctors, right?
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It's just too hard to change.
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When you tell a physician that most of what we understand around heart disease is wrong,
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that can be kind of jarring, that can be difficult.
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And a lot of doctors like a lot of people we talked about earlier, right?
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They just don't want to change and it's going to be hard to get them to change.
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I mean, I think still people are struggling with the fat is good for you, right?
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What was it that that devils food cookie came out?
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I think it was craft or something like that.
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It was in the 90s and it was fat free, but yet it was a cookie.
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I remember my mom was buying them all to everyone was freaking out thinking,
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oh, I can eat these because I'm not going to get fat on it.
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Not realizing that actually when you get access, sugar that converts into fat, of course, right?
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Like people didn't know this, which kind of begs the question of like we only know what we know.
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So as someone who is a product of the medical industry in terms of that,
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you were educated by the medical industry, but you're also a product of it
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where you've now had contrast of the industry and it's spun you in a different direction.
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So in many ways, you have the duality of you were educated by it,
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but you've also been reeducated by it, which is pretty cool.
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In my opinion, I guess the question is is that we only know what we know.
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And so if you now look back at the medical industry and go like, well, gosh,
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they've had so much wrong, how do you fully let what we're currently doing land as it being
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right when it also could be wrong? Do you know what I mean by the question?
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I understand that completely, right?
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And I'm not, I don't know what the right word is,
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egotistical enough, right? To say that, yeah, I know I'm absolutely right.
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I see more and more, right? I know how it's helped me.
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I see how it's helping the patients that I'm working with.
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I see, you know, all of the great health improvements that are going on within our community.
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And I also see that the old previous recommendations just did not work.
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And that's something that's very hard to ignore.
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The messaging around low fat cholesterol as the primary cause of heart disease, right?
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That's been our focus for 70 years now, right?
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Going back to the 1950s. And it's just not working.
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And so that's one of the other things that gives me the confidence to carry on with the message
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that I'm trying to bring and how we're trying to change that messaging.
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You're right. I might be wrong. We might all be wrong.
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But clearly, what was being done before was not the right approach and was not working.
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And so that's why I think it's time for us to change.
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What do you think we are getting right right now? Like, for example,
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seed oils, do you think they are as bad as, you know,
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social media influencers are telling us now? Are they probably the bigger culprit of inflammation
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than, you know, saturated fats, for example?
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Well, they're definitely a bigger problem than saturated fat is because saturated fat is not a
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problem when it comes to our health. The real question is, right? Are seed oils more harmful
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than sugar essentially, right? Or more harmful than refined carbohydrates? And the honest answer is
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I don't know the answer to that. I just know that processed food, which combines those two things,
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is very problematic. And so that's kind of the first focus that I hope to see, right? Let's
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eliminate the processed food. Let's get back to eating whole real food. I think that's where this
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starts with. Over time, I guess we can then work on the nuance of, you know, was it the seed oils
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or, you know, was it the sugar and the refined carbohydrates? But I don't think it matters. If you
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just get back to eating whole real food, the problem is fixed. And neither of those things are
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essential in our diet. And neither of those things are really necessary for us to be able to
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have enough food and good nutrition, right? And enough nutrients to sustain ourselves. So that's
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kind of where I start with. That is an area that I think we're making some headway in. I think
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people are truly waking up to the fact that, you know, all of this processed food is not good for us.
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And that's where I think we need to focus on and think we need to start.
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When you were at your heaviest before you started making your dietary changes, what were your,
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I don't know, your two or three crutch foods that you were kind of overindulging and then
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technically it's probably the same question is what did you cut out over the first few foods that
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you cut out as you started down this journey of weight loss? Yeah. So I was definitely, you know,
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very heavy on bread and pasta didn't think that was a problematic, right? You know, the candy,
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the cake, the cookies, right? We all know that that's not healthy for us, right? But bread, pasta,
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you know, this is the base of the pyramid, the food pyramid. And we think that's healthy for us.
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That's really what went first. My intro to this was low carbohydrate approach, right? And
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eliminating sugar. And like I said, I wasn't a real big sugar person. I didn't drink soda by
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the gallons. Like I know some people do. I was never want to put sugar in my coffee or anything
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like that. For me, the biggest thing that needed to go and, you know, did go and had big effects was
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things like the bread and the pasta that I thought was not harmful for my health.
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What did you find as you cut those out though? Because sometimes we, we eat to kind of numb any
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feelings going on. I think do you mind sharing like what came up for you as you cut out these
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comfort foods? Did your shadow side kind of rear its hits head and you're like, oh, I didn't,
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I didn't realize I was trying to keep this down or was it effortless for you?
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Yeah, I mean, I wouldn't say it was effortless, but I don't necessarily think I had that
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real strong element of sort of comfort eating food addiction, you know, and that is a real issue
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for many people. I was able to do it. I saw a pretty quick results, right? And that's kind of
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self reinforcing the flip side of this. And this is a lot of what I talked to people about, right?
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It's not even so much about restricting those things. It's reintroducing those other things
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like steak and ground beef that I would shy away from in the past and eggs, you know, another
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great example. And those are foods that I actually love to eat. So, you know, I guess in some
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ways I was able to replace with those and that kept me satisfied and satiated. And that was my
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experience. Now, yes, I acknowledge that many people, right? They have to deal with the emotional
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eating and the stress eating. Yes, if you're going to have long-term success, those issues do
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need to be addressed. What's most interesting to me that I noticed and many other people notice,
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right, is when you start getting metabolically healthy, it has a positive effect on your mental
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well-being in addition to the physical effects, right? And again, I'm not someone that had a
26:05
diagnosis of depression or anything like that. But I just noticed my mood being more stable,
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right? And so even the stress, listen, I'm a heart surgeon. I have a high stress life. By nature,
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I just deal with it better these days when I'm metabolically healthy. And I know a lot of other
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people have experienced similar changes in their mental well-being as well as their physical
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well-being. I love that you just brought up metabolic health. Let's dive into that a bit because
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I think that's a term that's being thrown around even more right now with the maha stuff.
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But let's pretend myself or anyone listening doesn't know what that means. Can you talk about
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what is metabolic health? Yeah. So, you know, the way that I refer to metabolic health is it
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simply refers to your body's ability to properly use the inputs that you're giving it, right? And
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the primary input we give our bodies is the food that we eat. Now, you can talk about, okay,
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how do we measure that? Because again, if you can't measure something, how do you improve it? How
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do you know where you stand? And so I always point people to start with to the five basic measures
27:20
of metabolic health. And those five measures are your waist circumference, your blood pressure,
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your fasting blood glucose level, your HDL cholesterol level, and your triglyceride level.
27:35
People can look up the numbers if people want to go to my website iFixHearts.com right on the
27:41
front page free. You can just go through the quiz, put in your numbers, and find out where you stand.
27:47
That's a very simple thing that everyone can and should do, right? Find out those five measures,
27:55
find out where you stand regarding your metabolic health. Because the shocking statistic is that
28:01
93% of the adults in the United States are not metabolically healthy. They don't meet those
28:09
five metrics of good metabolic health. And so chances are that you're not metabolically healthy,
28:18
and that can be the wake up call to get you start to working on, you know, making the changes.
28:24
Because when you're not metabolized, 93% and when you're not metabolically healthy, it means that
28:31
you're at increased risk of not only heart disease that I focus so much on, but cancer,
28:37
Alzheimer's disease, diabetes, all of these chronic diseases that are plaguing us today,
28:44
they basically all track back to metabolic health. What I like about your measurements too,
28:51
and I know of course you mentioned, you know, waistline, but it's not the only measurement,
28:56
and I think that's one thing that needs to be dispelled, and maybe you can even talk about it,
29:01
is that just being obese or not obese does not determine whether you're healthy.
29:07
Correct, you know, in that same study looking at metabolic health among US adults,
29:13
they looked at people specifically that were not obese. These were normal weight people,
29:19
and they still had 50% incidence of metabolic disease. So yes, not being obese is better than being
29:28
obese, but you can't assume that you're metabolically healthy just because you're not obese.
29:34
Let's talk about insulin resistance. I feel like I read somewhere that you find that one of the
29:38
root causes of heart disease is insulin resistance. So can you talk about that?
29:44
Insulin resistance is really the sort of biochemical manifestation of poor metabolic health.
29:51
And what insulin resistance means at the cellular level, right, is that your body isn't able to
29:57
properly process sugar and carbohydrates. And yes, this is a root cause of heart disease,
30:06
and yet the vast majority of doctors out there dealing with heart disease don't know that.
30:12
They don't know what insulin resistance is. They don't know how to evaluate for it,
30:17
and they don't know how to treat it, right? Because it's pretty intuitive. If you figure out
30:23
a patient has a problem with insulin resistance, and that means that they can't process
30:28
carbohydrates properly, the answer is pretty simple. Stop eating carbohydrates, stop putting
30:35
carbohydrates into the system, and that's how you fix the problem. But unfortunately the concept
30:43
of insulin resistance does not get talked about in the heart disease space. And so we missed the
30:50
root cause, right? We became focused on cholesterol, which is a downstream problem from the insulin
30:58
resistance. cholesterol is typically a buffer, right? It's trying to protect your body from the
31:04
inflammation that's going on, right? Exactly. It's trying to repair what the insulin resistance is
31:09
causing, right? The insulin resistance causes damage to the blood vessels. And it does that in a
31:15
couple of different ways, but high blood sugar being one and inflammation being the other.
31:21
And the cholesterol is supposed to repair that damage. What happens is, first of all,
31:28
you keep doing the damage, right? And the cholesterol has to keep coming and it sort of can't
31:34
keep up with the process, right? And it starts to build up on the vessel walls and form the plaque
31:40
that we talk about. And the other thing that happens is that the insulin resistance
31:47
damages the cholesterol itself. So when you have undamaged cholesterol, particles, cholesterol
31:54
carrying particles, the LDL that everyone focuses on, right? When those are undamaged and the marker
32:02
of them being undamaged is that they're large and fluffy, right? And so they go and they repair
32:09
some damage to your blood vessel wall. And then they're able to basically just kind of melt
32:14
away, right? They repair the wall and they disappear and we don't have any issues. However,
32:21
the insulin resistance damages those cholesterol particles and they become what we call small
32:28
dense particles. And now when they go to repair the wall, they actually set off more of an
32:35
inflammatory response because the body is reacting to this damaged particle and that compounds the
32:43
problem. And that's when again, when we start to see this build up of inflammation and the plaque
32:49
starts to form, but it's only when you have the damaged cholesterol carrying particles, the small
32:55
dense LDL in the presence of vascular damage that we see this. If you have healthy cholesterol,
33:03
large LDL cholesterol particles floating around in your bloodstream and you're not insulin resistant
33:10
and you're not damaging your blood vessels, cholesterol does not cause problems.
33:15
That was such a great explanation by the way, but it's so frustrating to me because as I mentioned,
33:20
I've been in this field 20 years as a chef, but in the health filter, I've been hearing about insulin
33:25
resistance from the beginning. So why the F is it taking the industry so freaking long to acknowledge
33:35
this? Is it because they're co-opted? Is it because their egos are so firmly entrenched in its
33:40
cholesterol? It's cholesterol. Like, what is going on, man? It's been 20 years plus.
33:46
You're exactly right, right? And I think back in the same way to, you know, why the first time I
33:52
hear these concepts, it came from, you know, a journalist and that is in no way a knock on Gary
33:59
Tobs. But, you know, why did I hear it from him first instead of, you know, the professors and
34:05
my colleagues? And you're right. Honestly, I do think ego is a big part of this, right? I think the
34:11
leaders of the field, the leaders that have been saying this for so long cholesterol for them to
34:19
admit that they were wrong, right? That's a big shift. And beyond the individual people,
34:25
they are right. It's the institutions that have been built around this, institutions like the
34:31
American Heart Association. And then, yes, you're right. We have to acknowledge the role that
34:38
funding from the pharmaceutical companies, funding from the food industry, play in all of this
34:45
as well. That is very real. People look at this in different ways and some people think it's a
34:51
grand conspiracy that may be started with one or two people. I don't think that's true. I just
34:58
think this is a kind of what we see in society, right? When institutions are built around a
35:03
certain concept, it is very hard to get that to change. But we're starting to see the cracks in
35:11
the foundation of this belief and of this system. And I am optimistic that we're going to be
35:18
able to make these real changes. And I'm very hopeful that 20 years from now, people aren't still
35:24
having this conversation. The conversation has become how did we ever think that cholesterol was
35:31
the primary problem or that a low fat diet was going to fix the problem? Well, it makes me think of
35:37
bloodletting, right? I remember reading a book that George Washington's doctors bloodlet him
35:43
because that was the modern medicine of the time of how to handle the sicknesses. And yet now,
35:48
when we look back, they realize, oh, he probably just had a common cold. Had they left him alone,
35:52
he would have survived. I've read that same story. And yes, we have many, many examples we can go
35:59
back to, right? And that's another thing that I think is problematic that these days. Because
36:05
all too often we think we know the answer. And we're not willing to change and consider
36:12
contrarian information. Medical history is littered with situations where what we were convinced
36:21
was true turned out not to be true. We do need to be more open-minded around medicine and not be
36:29
so dogmatic. And this unfortunately has showed up in many different ways, you know, in our recent
36:36
history. And it's very problematic. Oh, I love hearing you say that with your background. So
36:42
it's very encouraging, as we've already mentioned, that if one person can change, then many,
36:47
many others can as well. What's your whole take then on weight loss drugs like ozempic? Are
36:54
do you see those as a potential disaster? Or do you see those as like, well, the way
37:00
prozac was when it initially came out for people that were extremely depressed, you know, it gave
37:04
them the ability to just get their head above water so they could deal with some things because
37:09
some people are just drowning in, you know, weight or depression or whatever it may be.
37:15
Yeah, a little bit of both. So I do think these medications can be useful and can play a role.
37:22
But I do see an impending disaster because of the way that they're being used.
37:27
These medications do appear to be effective and I, you know, have seen effectiveness, right?
37:34
When they are used as a short term adjunct to making the diet and lifestyle changes, right? They
37:42
can help people that are really struggling at the beginning of this to be able to make some of
37:47
these changes more effectively. But you got to have an exit ramp. You got to be able to at some
37:53
point say, we don't need the medications any longer and the diet and lifestyle changes are now
37:59
firmly entrenched. And that's our long term plan. And unfortunately, that's not the way they're
38:05
being used. You know, they are being seen and used as this is the long term solution. And people
38:13
are just going to be on these medications for long periods of time at dosages that are
38:18
probably higher than they should be or need to be because people sort of build up tolerance to
38:24
these over time. And that is what I think is unfortunately going to lead to a wave of disaster
38:31
around these medications. What brings up what you mentioned earlier about how now you talk to
38:39
your patients, you know, a lot of times they're coming to you and they do need the surgery, but
38:43
then you're explaining to them, but this is how you don't come back. And I think about gastric
38:48
bypass, for example, so they that was the quick fix, but they still didn't deal with the emotional
38:54
and physical reason why these people were overeating. And so I think that the number of the
38:58
percentages is extremely high in terms of the people that eventually regressed right back to the
39:04
or higher that they were before the gastric bypass. So I have to assume that's the case as well
39:10
that if you're taking something like ozemic, you may not have actually been dealing with why
39:16
what caused you to be obese, right? You're not dealing with the reasons that you were feeling
39:20
motivated to overeat or to live a certain lifestyle, right? Yeah, definitely so. And you know,
39:27
it's interesting. These medications do seem to have some effects in the brain, right? They're
39:33
GLP1 receptors in the brain. We know and we're seeing that they seem to have effectiveness with
39:39
addiction disorders, right? And again, food addiction, like we said, is a big part of this,
39:45
but other things like alcohol addiction, they're showing promising results for the question
39:51
then becomes what's your exit strategy, right? You got to be addressing those underlying issues
39:58
ultimately or, you know, your only option is staying on these things life long and a,
40:05
we see waning effectiveness of these things over the long term and b, I think there are very good
40:14
reasons to be concerned about the long term usage of these medications and what effects that's
40:20
going to have. So like I said, I think they can be a good tool if they're used properly and they're
40:26
used as sort of a crutch as people are starting this journey, but I do have patients. I don't
40:33
personally prescribe them, but I have patients that come to me on them in my preventative practice.
40:39
The discussion we have is, okay, let's set a plan for getting you off of them and we have been
40:45
successful in doing that. They implement the right diet and lifestyle changes and then over a
40:52
period of time, we win them off of these medications and they're having success maintaining the
40:58
diet and lifestyle because we've addressed those underlying issues and we're giving them a
41:04
sustainable long term plan. So let's leave the audience with two or three diet and two or three
41:11
lifestyle changes. They can make right upon finishing this episode. You mentioned one diet, which
41:18
was just don't eat ultra-process foods, focus on real nutrient dense foods. So we got one of the
41:25
dietary changes. What would you say is another two for the diet? I would say another big one is
41:32
increase your protein, animal protein primarily that I think is a very powerful tool helping people
41:39
to avoid hunger and hunger is a big driver of why we eat poorly, eat real food, lots of animal
41:49
protein. That's kind of my basis of how we get people on a sustainable and successful dietary
41:58
approach. What would be a couple of lifestyle changes that you right off the bat would recommend
42:04
Yeah. So number one is just move more and that doesn't mean you need to go join a gym and spend
42:11
hours on the treadmill or on the bicycle. It just means move more. Just find those simple things
42:18
you can do throughout your day to get some extra movement. Take the steps instead of the elevator
42:24
when you can park further away for work or you're out shopping or just after you eat, take that
42:32
10 or 20 minute walk break and get some more activity in your day and the other one I would say
42:40
around lifestyle is to examine your sleep. I tell people better quality sleep, right? It's not
42:47
necessarily about more sleep. It's about better quality sleep. So be thinking about some of the things
42:54
you can do to make that happen. Something that have really helped me is like one make sure your
43:00
room is dark. Not a lot of light coming in. Try to limit screens or have zero screens before bed
43:07
and then even keeping lots of those electronic things out of the room like or even business.
43:12
Like my wife and I really try to keep that room sacred and so that we're not even talking business
43:17
there because we don't want our brains turning on you know when we're in the bedroom but more
43:23
getting ready for sleep. Before I let you go I do want to ask you because I don't know you well
43:29
enough to know this answer. How much does energy work or like less scientific stuff? The more
43:38
ethereal kind of stuff. Does that come into play for you and if so how? Yeah I mean I certainly make
43:45
efforts to you know get sunlight. That's a big one for me. I've played around with things like
43:53
cold plunging or I still still a little bit on the fence there but I think getting good sunlight
43:59
is definitely a priority. Trying to just get out in the fresh air. You know I'm fortunate to live
44:05
where I live in Florida by the beaches and so you know I always find it recharging to get to the beach
44:13
and I guess I'm doing grounding right and I'm in contact with nature in the water. I think that
44:18
stuff is important. Now what I tell people is if you're not getting the diet you know right and
44:26
you're not getting the lifestyle stuff I don't think you can overcome it by focusing only on
44:33
the energy stuff and their circadian stuff but I think it certainly is a powerful tool that can
44:40
help beyond the more typical diet and lifestyle stuff that we talk about. And what about meditation?
44:47
Have you do it that at all? Honestly I don't have tried it just it's not something that resonates
44:54
with me but you know I do do other things to just try and offload the stress right and I do have
45:01
other things that can help with that meditation I tried it and it doesn't mean it's not good
45:08
just never quite sunk in for me or resonated for me maybe maybe it will in the future and that can
45:14
make me even better. Yeah yeah well I'll be curious so what new practices you kind of discover
45:20
in 2025 that you start incorporating in your practices your book stay off my operating tables
45:28
available but will you please share how else people can find you how they might get connected with
45:34
your telehealth as well. Yeah definitely I fix hearts is really where to find me everywhere so
45:40
on all the socials at iFixHearts and then you can go to iFixHearts.com connect with my team
45:46
and I and like I said I have a telemedicine practice it's focused on prevention we see patients
45:52
throughout the US and even international patients the goal there is really like the book says to keep
46:00
people off the operating table we're happy to connect with people and figure out if working with
46:06
us is the right thing for you. Well thank you again Phil for showing up and sharing your gold with
46:11
us I look forward to seeing you at Hacker Health 2025 we saw each other in 2024 too that's a great
46:17
event and hopefully I'll see you at some other events as well it was joy meeting you last year
46:23
and getting to talk further with you today so thank you so much. Yeah and thank you for all the
46:27
great work you've been doing in the space James and you know you've been talking about it for a
46:32
long time as well and you bring you know such a unique aspect with your background as a chef
46:38
though so thank you for hosting this podcast and for all the work you're doing thank you and thank
46:44
you all for joining us on this episode make sure to share with your friends and stay curious.
46:52
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