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Dave Knapp – Decoding GLP-1 · Vox Novus with Victor Fuhrman

0:05
Speaker 1: Vox Novus, the New Voice, Vox Novus, the new Dimension,
0:14
Speaker 1: Vox Novus thought and movement leaders who will share from
0:19
Speaker 1: their experience and offer tools to help us navigate our
0:23
Speaker 1: rapidly changing world. My name is Victor Furman. Welcome to
0:29
Speaker 1: vox Novus, the New Voice. Having just undertaken my own
0:37
Speaker 1: weight loss journey with a GLP one drug, I was
0:41
Speaker 1: fascinated to learn of the work of Dave Knapp and
0:44
Speaker 1: his organization on the Pen. Calling upon his personal experience
0:49
Speaker 1: with GLP one, Dave recognized the need for a source
0:53
Speaker 1: of comprehensive information as well as advocacy for those challenged
0:58
Speaker 1: with obesity and type two diabetes. His website is ondepen
1:03
Speaker 1: dot com, and he joins me this week to share
1:06
Speaker 1: his personal journey and book that answers many of the
1:09
Speaker 1: questions surrounding these drugs, Decoding GLP one, a guide for
1:15
Speaker 1: friends and family of those on the Pen. Please join
1:20
Speaker 1: me in welcoming to Vox Novis. Dave Knapp, Welcome, Dave.
1:25
Speaker 2: Thank you, Victor. It's a pleasure to be here. Thank
1:27
Speaker 2: you for having me.
1:28
Speaker 1: Dave, please share with us your personal journey and the
1:32
Speaker 1: emotional challenges you had to face.
1:35
Speaker 3: Yeah, I always appreciate the chance to share my story
1:39
Speaker 3: because I think it echoes so many other stories that
1:42
Speaker 3: are out there for people who have lived with obesity.
1:44
Speaker 3: I started to experience, at least noticing that I was
1:48
Speaker 3: a little bit different than my siblings and my peers
1:51
Speaker 3: at a pretty young age, probably early adolescence. I noticed
1:55
Speaker 3: that I was a little heftier around the midsection than
1:59
Speaker 3: some of my friends were. And it was the first
2:03
Speaker 3: time I really started to notice that I that I had,
2:06
Speaker 3: you know, something that was different about me. It wasn't
2:10
Speaker 3: completely abnormal, because on either side of my family, I've
2:15
Speaker 3: got aunts and uncles and grandparents that have struggled with
2:20
Speaker 3: their weight and some with obesity and type two diabetes
2:23
Speaker 3: as well, but in my immediate family it was it
2:26
Speaker 3: was kind of rare, and so I felt a little
2:28
Speaker 3: bit like a fish out of water at a young age,
2:32
Speaker 3: and you know, that just sort of progressed until high school,
2:36
Speaker 3: where you know, I tried to tried to always kind
2:39
Speaker 3: of watch what I eat, and you know, I had
2:42
Speaker 3: people in my life too that were trying to encourage
2:45
Speaker 3: me to watch what I eat and always reminding me
2:48
Speaker 3: that heart disease ran in the family and all those
2:50
Speaker 3: things that obesity can impact all well meaning things. But
2:54
Speaker 3: definitely that's a lot of pressure to feel at that
2:56
Speaker 3: age when you're already you know, kind of feeling a
2:58
Speaker 3: little bit different and as things sort of progressed. Victor,
3:05
Speaker 3: I discovered late in high school. This say is around
3:08
Speaker 3: the two thousand and two two thousand and three timeframe.
3:11
Speaker 3: I discovered the Atkins diet, and that will ring a
3:14
Speaker 3: bell with many of your listeners.
3:15
Speaker 2: I'm sure.
3:17
Speaker 3: And I embarked on, you know, just kind of controlling
3:21
Speaker 3: my weight with that, and the thing about it, in hindsight,
3:24
Speaker 3: the bad thing about.
3:26
Speaker 2: It was that it worked. It worked really well. At
3:30
Speaker 2: that age.
3:31
Speaker 3: I was coupling it with a lot of strenuous exercise
3:34
Speaker 3: as well, you know, running miles and miles a day.
3:38
Speaker 3: I had. You can imagine what the what you know,
3:41
Speaker 3: in that time frame two thousand and two, two thousand
3:44
Speaker 3: and three, I had friends that were enrolling and listing
3:49
Speaker 3: in the military, and so I had friends that would
3:51
Speaker 3: run with me that were in the military to train.
3:53
Speaker 3: So I was I was doing a lot to control
3:55
Speaker 3: my weight, and it was it was working well. I
3:57
Speaker 3: was I was down I think at my heavy I
4:00
Speaker 3: was around two hundred and twenty pounds on a five
4:02
Speaker 3: to eleven frame, and I got down right around graduation
4:07
Speaker 3: time to my lowest weight of about one hundred and seventy pounds,
4:11
Speaker 3: and I was able to keep that up until I wasn't.
4:15
Speaker 3: Until I wasn't. It just wasn't a long term sustainable lifestyle,
4:20
Speaker 3: both in terms of how much I was exercising and
4:24
Speaker 3: the restriction of food that I was eating, and so
4:29
Speaker 3: really to kind of encapsulate the next around seventeen years
4:35
Speaker 3: of my life, I sort of chased that success with
4:39
Speaker 3: that Atkins diet. For about three to five months out
4:42
Speaker 3: of every year, I would go hard on some form
4:46
Speaker 3: of a low carbohydrate diet and I would usually be
4:49
Speaker 3: able to lose about twenty five pounds, but on the upswing,
4:52
Speaker 3: I'd gained thirty or thirty five pounds. And this ultimately
4:56
Speaker 3: led to age thirty seven, where I was diagnosed with
5:02
Speaker 3: type two diabetes. And at that time I weighed in
5:06
Speaker 3: at three hundred and nineteen pounds, and so not only
5:11
Speaker 3: was I no, no, not only was I you know, overweight,
5:16
Speaker 3: and you know having these early early issues with you know,
5:20
Speaker 3: some elevated blood pressure a little bit of high heart rate.
5:23
Speaker 3: But I was diagnosed with type two diabetes, and it
5:27
Speaker 3: was at that moment that my doctor said, Dave, what
5:30
Speaker 3: do you want to do?
5:32
Speaker 2: At this point? I have four kids, and.
5:34
Speaker 3: I really, really am, you know, convinced in my mind
5:39
Speaker 3: that I'm going to do this with more hard work
5:43
Speaker 3: and grit and determination, and I was just going to
5:46
Speaker 3: buckle down. He said, well, if you want to stay
5:47
Speaker 3: off medication, there's basically one thing you can do, Dave.
5:50
Speaker 3: You can eat low carbohydrate. And so I explained that
5:55
Speaker 3: I had basically lived that lifestyle off and on, never
6:00
Speaker 3: been able to sustain it for long periods of time
6:03
Speaker 3: my entire adult life. But I was willing to with
6:05
Speaker 3: this type two diabetes diagnosis do whatever I could. Grip
6:09
Speaker 3: my teeth and do whatever I could to stay off medicine.
6:11
Speaker 3: And so for the next year, I embarked on a
6:14
Speaker 3: extremely restrictive car low carbohydrate diet. I wore a continuous
6:18
Speaker 3: glucose monitor that fed back to my doctor so he
6:21
Speaker 3: could always see, you know, if I was minding my
6:23
Speaker 3: p's and q's. Of course, as a diabetic, if you
6:25
Speaker 3: eat carbohydrates, it's pretty noticeable when you are managing when
6:29
Speaker 3: you are having your blood glucose monitored in real time
6:31
Speaker 3: twenty four hours a day. And so I was doing
6:34
Speaker 3: everything I needed to do. But after one year, I
6:37
Speaker 3: sat in the doctor's office with a completely normal A
6:40
Speaker 3: one C, but my weight had only gone from three
6:43
Speaker 3: hundred and nineteen pounds to three hundred and twelve pounds.
6:47
Speaker 3: This was, as you can imagine, Victor, quite quite I'm
6:56
Speaker 3: struggling to even find the word. I mean, I was defeated,
6:59
Speaker 3: for sure, but that seems to come up short for.
7:01
Speaker 2: What I felt. I was crushed.
7:04
Speaker 3: By those results, or lack thereof. And it was at
7:09
Speaker 3: that point that the doctor said, well, we've got two
7:12
Speaker 3: ways we can go with this. One, you're a candidate
7:15
Speaker 3: for bariatric surgery since you're non responsive to this program.
7:20
Speaker 3: Or two, there's basically a new class of medications that
7:26
Speaker 3: are starting to mimic hormonally what happens to people when
7:29
Speaker 3: they have bariatric surgery. And I was my curiosity was piqued.
7:34
Speaker 3: At thirty eight years old, I wasn't too keen on
7:37
Speaker 3: the idea of getting my biology rearranged to fight the
7:45
Speaker 3: disease of obesity. I thought a medication sounded maybe preferable
7:49
Speaker 3: to that, and he said, you know, what they've learned
7:51
Speaker 3: about these surgeries is that you know, everybody thinks that
7:55
Speaker 3: they that people lose weight because ultimately they're just eating less,
8:00
Speaker 3: they have a smaller stomach, etc. And he said, certainly,
8:02
Speaker 3: that's part of it to begin with, but really what's
8:04
Speaker 3: happening is there's a restoration of these gut hormones that
8:08
Speaker 3: are responsible for things like satiety and helping your pancreas
8:14
Speaker 3: release insulin efficiently, and it's just restoring sort of this homeostasis.
8:20
Speaker 3: Even on the operating table, they're able to measure some
8:24
Speaker 3: of these hormones, and now they have medications that can
8:28
Speaker 3: mimic sort of some of those hormonal effects of bariatric surgery.
8:32
Speaker 3: And that, Victor, is when I was introduced to the
8:35
Speaker 3: idea of GLP one medications.
8:38
Speaker 1: Your story is very similar to my story, except I'm
8:42
Speaker 1: a bit older and GLP one came into my life
8:46
Speaker 1: much later. But I'm going to share this with you
8:49
Speaker 1: really quickly. As a kid, I grew up in a
8:52
Speaker 1: family where food was considered a reward, and even though
8:57
Speaker 1: I have a younger brother and sister who did not
9:00
Speaker 1: become obese, I became obese, especially at a young age.
9:04
Speaker 1: In nineteen seventy three, I went into the Air Force
9:08
Speaker 1: and I weighed about two hundred pounds at the time
9:10
Speaker 1: five 'ot nine and a half and the training I
9:15
Speaker 1: had to go through special training to lose weight so
9:17
Speaker 1: that I could pursue the career in the Air Force
9:20
Speaker 1: or the enlistment that I had in the Air Force.
9:23
Speaker 1: I did that. I got down to the way that
9:25
Speaker 1: they wanted me to be, and I was in the
9:27
Speaker 1: Air Force, and actually I carried that way pretty well
9:30
Speaker 1: until I got out of the Air Force in nineteen
9:32
Speaker 1: seventy nine. When I got out in nineteen seventy nine,
9:36
Speaker 1: I was weighing one hundred and seventy pounds. As my
9:39
Speaker 1: life ensued, the weight came back to the extent that
9:44
Speaker 1: in nineteen and sorry in twenty ten, at the age
9:47
Speaker 1: of fifty seven, I was weighing close to four hundred
9:50
Speaker 1: pounds and I had an issue. I had to have
9:53
Speaker 1: stence put into my heart. I was blessed that I
9:55
Speaker 1: did not have diabetes, but I had to have stints
9:57
Speaker 1: put in my heart, and my cardiologist said to me,
10:01
Speaker 1: you really need to get this weight off of you.
10:04
Speaker 1: And at that time, the only opportunity I had was
10:06
Speaker 1: to go under the bariatric surgery, and I had what
10:10
Speaker 1: they call a sleeve gas strict to me, where they
10:13
Speaker 1: basically remove most of your stomach and have a little
10:15
Speaker 1: sleeve shaped stomach left over. I think you've probably heard
10:18
Speaker 1: of that. And they did that, and I started losing weight,
10:22
Speaker 1: and I'm feeling better and losing weight, and I got
10:24
Speaker 1: down to all I leveled off at about two hundred
10:26
Speaker 1: and forty pounds, and I just couldn't go beyond that,
10:29
Speaker 1: even though my weight of my food intake was much less.
10:33
Speaker 1: But I guess for some reason, was stuck at that.
10:36
Speaker 1: And then I'll share later on my GLP one experience
10:39
Speaker 1: with you, but I will say, and very happily say
10:43
Speaker 1: that after that experience, I'm now down to one hundred
10:45
Speaker 1: and seventy pounds, the same weight I was when I
10:48
Speaker 1: left the Air Force in nineteen seventy nine, for which
10:50
Speaker 1: I am grateful.
10:52
Speaker 3: Wow, that is an amazing story. And what I find
10:55
Speaker 3: most fascinating about what you know your whole story there,
10:58
Speaker 3: and there's probably a lot to unpass, but you struggled
11:03
Speaker 3: with your weight all the way up until you got
11:06
Speaker 3: into the military, and then it was as if the
11:10
Speaker 3: physical demands of a military career were the only thing
11:16
Speaker 3: that could really keep your weight in check. And I
11:18
Speaker 3: think that really encapsulates I think the experience that a
11:22
Speaker 3: lot of people living with the disease of obesity. And
11:24
Speaker 3: I do say disease. I know some people will struggle
11:27
Speaker 3: with that, and I'd love to get into that topic
11:29
Speaker 3: more if you'd like to, But for purposes of this conversation,
11:34
Speaker 3: I think that that is the big takeaway, because I
11:37
Speaker 3: think that's what people don't understand. I think that people
11:40
Speaker 3: living with overweight or obesity are always just lacking willpower,
11:44
Speaker 3: lacking the ability to just put the fork down right,
11:48
Speaker 3: put the fork down and move more. And if all
11:50
Speaker 3: things were created equal, that would be the case. But
11:53
Speaker 3: that's the big misconception about obesity. Some people simply have
11:57
Speaker 3: genetic factors that are working against them. They've been exposed
12:00
Speaker 3: to perhaps different toxins or different you know, foods that
12:05
Speaker 3: have destroyed their gut microbiome. And really, you know, when
12:09
Speaker 3: we talk about g LP one, it's not GLP one
12:12
Speaker 3: is not the name of a drug. GLP one is
12:14
Speaker 3: the name of a hormone that your body makes in
12:17
Speaker 3: response to taking in nutrients, and this is one of
12:20
Speaker 3: the hormones that becomes dysregulated in people living with disease
12:24
Speaker 3: like obesity.
12:24
Speaker 2: And type two diabetes.
12:25
Speaker 3: So I just find that fascinating that it was it
12:28
Speaker 3: took that amount a military career, that amount of physical
12:32
Speaker 3: activity for someone like you to be able to control
12:35
Speaker 3: your weight absolutely.
12:37
Speaker 1: And I'll share my GLP one experience with you later
12:39
Speaker 1: on in the interview. What inspired you to write Decoding
12:42
Speaker 1: GLP one and share your personal experiences?
12:47
Speaker 3: Get that question a lot, and really the the the
12:51
Speaker 3: answer to that question is the fact that I started
12:54
Speaker 3: to document my journey, ID document a different weight loss,
12:58
Speaker 3: you know, pinpoints of my journey, so to speak, on YouTube,
13:02
Speaker 3: and I felt like, you know, I'm not going to
13:06
Speaker 3: start this medication without knowing everything I can know about
13:10
Speaker 3: this medication. Like I said, I was a little hesitant
13:12
Speaker 3: to take any medication right away right and so before
13:15
Speaker 3: I was going to inject myself with the medication, I
13:17
Speaker 3: was going to learn everything there was to learn. But
13:19
Speaker 3: at that time, back in the fall of twenty twenty two,
13:22
Speaker 3: there was just not a lot out there in terms
13:25
Speaker 3: of information about GLP one medications. What they were, where
13:29
Speaker 3: they came from, how they work in the body, et cetera.
13:32
Speaker 3: And to be honest with you, at that point, I
13:33
Speaker 3: didn't even buy into the idea that obesity was a disease,
13:37
Speaker 3: and so I just started to learn. And as I learned,
13:39
Speaker 3: I started to share on YouTube. And as I started
13:42
Speaker 3: to share on YouTube, a community started to develop around
13:45
Speaker 3: around the YouTube channel. And so as that community grew,
13:51
Speaker 3: what I found is a lot of people would reach
13:53
Speaker 3: out to me and tell me that I was courageous
13:57
Speaker 3: or perhaps in their mind, heroic for sharing that I
14:02
Speaker 3: was on a GLP one, and I simply couldn't understand
14:05
Speaker 3: that sentiment. It did not track with me that how
14:09
Speaker 3: could somebody find that element of what I'm doing courageous?
14:15
Speaker 3: It's just naturally what I do. I like to If
14:17
Speaker 3: I find something I believe in and am passionate about,
14:19
Speaker 3: I share about it. But what I quickly found is
14:22
Speaker 3: that so many people have so much shame and guilt
14:25
Speaker 3: wrapped up in living with the disease of obesity because culture, society,
14:29
Speaker 3: family loved ones have placed on us this moral inadequacy
14:34
Speaker 3: that really cuts to the core I think of where
14:36
Speaker 3: people find their value and self worth and what I
14:40
Speaker 3: found is that most my story was uncommon in that
14:44
Speaker 3: I was willing to share, and more commonly, people did
14:46
Speaker 3: not want to share that they were on medication. They
14:49
Speaker 3: did not want to share that they were getting treatment,
14:51
Speaker 3: and that really impacted me on a personal level. As
14:57
Speaker 3: a content creator, you have to kind of disassociate sometimes
15:00
Speaker 3: times from comments and things people say, or things can
15:03
Speaker 3: be hurtful. But that's one of the things that really
15:06
Speaker 3: stuck out to me. I just read comment after comment,
15:08
Speaker 3: and I was personally impacted by the fact that so
15:12
Speaker 3: many people just felt like they couldn't share this part
15:15
Speaker 3: of their journey. And I thought one of the things
15:18
Speaker 3: that I have the ability to do is articulate big
15:21
Speaker 3: concepts and boil them down into little, bite sized chunks
15:24
Speaker 3: that people can digest and understand. And I wanted to
15:28
Speaker 3: take everything that I was learning about glpe's by this point,
15:31
Speaker 3: by the time I wrote the book, which was last year,
15:34
Speaker 3: around this time, I was writing the book this time
15:36
Speaker 3: last year, this summertime of twenty twenty four. By that time,
15:39
Speaker 3: I had been introduced to some of the most renowned
15:44
Speaker 3: obesity specialists in the world because my YouTube channel had
15:48
Speaker 3: grown from me sharing little stories about my injections to
15:52
Speaker 3: interviewing people, and the community had really grown because really
15:57
Speaker 3: what we were doing was pioneering a whole genre of
16:01
Speaker 3: social media content that didn't exist prior to On the Pen,
16:05
Speaker 3: And so we gave it a name On the Pen,
16:07
Speaker 3: which is, you know, obviously a play on words, because
16:10
Speaker 3: these medications primarily come in inject injector pens, so we
16:14
Speaker 3: call it on the Pen. But the book itself was
16:18
Speaker 3: written to just simply be a cliffs Notes to GLP one,
16:22
Speaker 3: something that somebody could pass along to a loved one
16:25
Speaker 3: and say, hey, I'm on this medication and you know,
16:27
Speaker 3: it's kind of awkward for me to talk about, but
16:29
Speaker 3: if you just read this book, you're going to get
16:31
Speaker 3: everything you need to know. There's a little bit about,
16:34
Speaker 3: you know, what it's like to live with obesity, all
16:36
Speaker 3: the way to you know, sort of some of the
16:38
Speaker 3: ins and outs of the history of the medication and
16:40
Speaker 3: the future of these medications. And I just wanted it
16:43
Speaker 3: to be a tool that would open up conversations between
16:47
Speaker 3: people and their loved ones and so they didn't feel
16:50
Speaker 3: like they had to hide.
16:51
Speaker 2: Under under a rock anymore.
16:53
Speaker 3: And in terms of the treatment that they were seeking
16:56
Speaker 3: out for their obesity.
16:58
Speaker 1: You touched upon this before, but can you break down
17:01
Speaker 1: for our listeners, Uh, the science behind GOLP desh one medications.
17:08
Speaker 2: Yes, I'd love to so.
17:10
Speaker 3: As I mentioned before, g LP one stands for glucagon
17:13
Speaker 3: like peptide ones, just a long science y word for
17:17
Speaker 3: a hormone that is produced in your gut and in
17:20
Speaker 3: your brain in response to nutrient intakes. So these are
17:22
Speaker 3: often referred to as nutrient stimulated hormones. In other words,
17:26
Speaker 3: they're hormones that your body releases in response to nutrient intake.
17:31
Speaker 3: And the GLP one falls under a specific class of
17:34
Speaker 3: medication not to lose people, but they're called encritin mimetics
17:37
Speaker 3: and in cretin hormones fall under this idea of nutrients
17:41
Speaker 3: stimulated hormones, and GLP one happens to be the most prominent.
17:45
Speaker 3: Now the the there's some lore and we share this
17:48
Speaker 3: in the book a little bit. There's some lore around
17:50
Speaker 3: how they came up with g LP one. I mean, obviously,
17:54
Speaker 3: the hormone in the body was discovered long ago, but
17:57
Speaker 3: in terms of mimic it, mimicking it in a pharmaceutical drug,
18:01
Speaker 3: they were looking at HeLa monster venom, which contained a
18:06
Speaker 3: peptide in it that it when isolated, brought down blood
18:09
Speaker 3: sugars in humans, and so they isolated this peptide. It's
18:15
Speaker 3: called extendant four, and Exendin four would later become the
18:20
Speaker 3: first GLP one to hit the market, called exendotide, and
18:23
Speaker 3: the brand name was Baieta. And simply what it did
18:26
Speaker 3: was it mimic this GLP one hormone, this hormone that
18:29
Speaker 3: when you eat, your body makes it and it helps
18:31
Speaker 3: you to feel full in your brain. It helps to
18:34
Speaker 3: regulate the insulin release in your pancreas, so it actually
18:39
Speaker 3: acts on the beta cells in your pancreas to say, hey,
18:41
Speaker 3: there's these types of nutrients, specifically glucose, and you need
18:46
Speaker 3: to release insulin now so that we can maintain our homeostasis.
18:49
Speaker 3: And what they had learned previously is that a lot
18:51
Speaker 3: of times these GLP one, this GLP one signaling the
18:55
Speaker 3: GLP one levels in the body were disrupted or dysregulated
18:59
Speaker 3: in the bodies of specifically type two diabetics. And in fact,
19:04
Speaker 3: one of the medications that came out before GLP one
19:10
Speaker 3: receptor agonists or GLP one mimetics were called DPP four inhibitors.
19:15
Speaker 3: And again I'm saying a lot of sciencey things, so
19:17
Speaker 3: I don't want to lose anybody. But basically, in your gut,
19:20
Speaker 3: you have bacteria, right, everybody knows that, And there's byproducts
19:24
Speaker 3: of these bacteria, right, there's waste that they excrete. And
19:27
Speaker 3: one of the byproducts of some specific gut bacteria is
19:31
Speaker 3: this DPP four enzyme, which basically lives to destroy GLP
19:36
Speaker 3: one in similar hormones. And what they found is that
19:40
Speaker 3: in the guts, in the intestines, in the digestive tract
19:44
Speaker 3: of people living with type two diabetes, the gut bacteria
19:48
Speaker 3: that produces DPP four was orders of magnitude higher than
19:52
Speaker 3: it was in people with let's say a healthy gut.
19:55
Speaker 3: And so DPP four came around, inhibitors came around as
19:59
Speaker 3: a treatment for two two diabetes to help your body
20:02
Speaker 3: preserve that natural GLP one that your body creates, and
20:06
Speaker 3: that sort of led to this discovery of GLP one analogs,
20:10
Speaker 3: which just have a much longer half life and they're
20:12
Speaker 3: sort of impervious. They can't be destroyed as easily by
20:16
Speaker 3: this DPP four enzyme in your gut, and so you
20:19
Speaker 3: get that signaling restored for satiation, for insulin release, and
20:25
Speaker 3: sort of this homeostasis is sort of brought back to
20:28
Speaker 3: that signaling between your gut and your brain.
20:31
Speaker 1: Now there can't be an hour that goes by without
20:34
Speaker 1: a commercial home television for Ozebic or Truelicity or Munjaro
20:38
Speaker 1: or Victoza. Are there any differences between these?
20:42
Speaker 3: Yeah, So, as I talked earlier, the first GLP one
20:47
Speaker 3: receptor agonist was Baieta. That was the one that was
20:51
Speaker 3: sort of derived from this peptide in helo monster venom.
20:55
Speaker 2: That evolved right.
20:57
Speaker 3: That was a twice daily shot and this all sort
20:59
Speaker 3: of relates to the half life of the medication. So
21:02
Speaker 3: with Bayeta, you have a GLP one receptor agonist that
21:07
Speaker 3: lasts a few hours. Well, the drug companies got to
21:10
Speaker 3: work and they say, how can we make this last
21:11
Speaker 3: longer so that people maybe only have to take it
21:14
Speaker 3: once a day? And then you know, the drug companies
21:17
Speaker 3: came up with a once a day shot that was
21:19
Speaker 3: that was Victosa, which became the second GLP one to
21:24
Speaker 3: hit the market for type two diabetes. Then they realized
21:26
Speaker 3: there was actually some overlap and people were losing weight
21:29
Speaker 3: on these medications and Victosa was approved then for obesity
21:33
Speaker 3: management and it was called sex sendas. So that was
21:36
Speaker 3: the first once daily and you know, I don't want
21:38
Speaker 3: to go through the whole evolution of it, but then
21:40
Speaker 3: you get to your once weekly. That was Trulyicity from
21:43
Speaker 3: Eli Lilly to manage diabetes. And then after Trulyicity came
21:47
Speaker 3: another once weekly, a more powerful medication called Ozepic from
21:52
Speaker 3: Novo Nordisk, and Ozempic was then approved for obesity management
21:57
Speaker 3: and it's called we go V and that led to
22:01
Speaker 3: now targeting multiple incrytin hormones. As we talked about earlier.
22:06
Speaker 3: You have the GLP one, but there are multiple incrton hormones,
22:10
Speaker 3: and so Eli Lilly brought one to market that not
22:12
Speaker 3: only focuses on GLP one receptors, but also GIP which
22:16
Speaker 3: is another incretin hormone and has become a more even
22:19
Speaker 3: powerful drug yet for both controlling A one C which
22:23
Speaker 3: is the marker that they determine type two diabetes and
22:26
Speaker 3: measure type two diabetes with and in obesity, so it
22:31
Speaker 3: has a more powerful potential for weight loss as well.
22:34
Speaker 1: My guest is Dave Knapp. His book is called Decoding
22:38
Speaker 1: GLP Dash one a guide for friends and family of
22:42
Speaker 1: those on the Pen. Dave, please share with our listeners
22:45
Speaker 1: where they can get your book and find out more
22:47
Speaker 1: about you and your work.
22:49
Speaker 3: Yes, so the book is available on Amazon. If you
22:52
Speaker 3: just search on the pen or decoding GLP one, you'll
22:55
Speaker 3: be able to find it there. But the gateway to
22:58
Speaker 3: sort of every thing lives at our website on thepen
23:03
Speaker 3: dot com. And really where our focus is these days
23:08
Speaker 3: is we are creating a obesity medicine news platform. All
23:13
Speaker 3: the information that flows about these medications, you're either going
23:16
Speaker 3: to get it from the media, and it's basically the
23:20
Speaker 3: media puts out information about these medications that is designed
23:23
Speaker 3: for one of two people. It's either designed for doctors
23:26
Speaker 3: because it came from maybe clinical trials, or it's designed
23:30
Speaker 3: for investors because there's a lot of money to be
23:32
Speaker 3: made in treating obesity, a problem that affects an estimated
23:36
Speaker 3: one hundred million people in the US alone. So there's
23:39
Speaker 3: there's investor news, and then there's doctor news, and we
23:43
Speaker 3: seek to bring patients the news that affects them and
23:47
Speaker 3: empowers them to have better conversations with their doctor and
23:50
Speaker 3: so on. The pen dot com is the best gateway
23:53
Speaker 3: to get information about GLP one from the patient perspective,
23:58
Speaker 3: and we have a podcast, we have have all the
24:00
Speaker 3: social media channels, and we have interviews with all of
24:05
Speaker 3: the obesity specialists around the country CEOs of companies that
24:09
Speaker 3: are working on future medication. So anything you would need
24:12
Speaker 3: to learn more about these medication is going to be
24:14
Speaker 3: available there.
24:15
Speaker 1: Thank you for your advocacy, sir, Thank you, I appreciate it,
24:20
Speaker 1: and we'll be back with more of Dave after these
24:23
Speaker 1: words on the Own Times Radio network.
24:26
Speaker 4: The cutting edge of conscious radio Home Times Radio IOMFM.
24:31
Speaker 4: Home Times Magazine is one of the leading online content
24:34
Speaker 4: providers of positivity, wellness and personal empowerment. A philanthropic organization,
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24:58
Speaker 1: Imagine yourself being transported to India, to the banks of
25:02
Speaker 1: the Ganga and an ashram in Rishikesh. Visualize that you
25:07
Speaker 1: were welcome to Satsan with an American Sanyasi who shares
25:11
Speaker 1: the wisdom of her Guru. Your visualization has manifested. Joined
25:16
Speaker 1: Satfi Bagawati Saraswati for inspiration and transformation. Every Thursday at
25:22
Speaker 1: eleven a m. Eastern on Old Times Radio back on
25:27
Speaker 1: vox Novis. My guest this week is Dave Knapp. We're
25:30
Speaker 1: talking about his book Decoding GLP one, a guide for
25:35
Speaker 1: friends and family of those on the pen. Dave, what
25:39
Speaker 1: are some of the common myths and misconceptions surrounding these treatments.
25:45
Speaker 3: Oh, I don't know that we have enough time to
25:47
Speaker 3: unpack all that, but you've seen the headlines ozepic, face, ozempic, butt, ozempic.
25:54
Speaker 2: You name it.
25:55
Speaker 3: There's a lot of sensational headlines out there, to be sure,
25:59
Speaker 3: But I think to be serious about it because hopefully
26:03
Speaker 3: people understand that whenever you lose weight rapidly, there are
26:07
Speaker 3: a host of issues that can come with losing weight rapidly,
26:11
Speaker 3: And of course those sort of side effects are associated
26:15
Speaker 3: with the medication. But oftentimes the side effects that people
26:18
Speaker 3: feel on these medications or may experience that become sensational
26:21
Speaker 3: headlines are more a result of rapid weight loss than
26:24
Speaker 3: anything else. But let's talk about maybe the biggest concern
26:28
Speaker 3: that people have these with these medications that I think
26:30
Speaker 3: is completely warranted. So all GLP one medications or anchorton
26:34
Speaker 3: memetics come with a black box warning, which is a
26:37
Speaker 3: warning for medullary thyroid cancer. And so this is the
26:40
Speaker 3: one that I get the most from people who look
26:43
Speaker 3: at taking these medications, is like, there's a warning about
26:45
Speaker 3: thyroid cancer on here, should I be concerned? And We've
26:48
Speaker 3: interviewed doctors and specialists around the country. We've interviewed scientists
26:52
Speaker 3: and researchers, and here is the rub on the black
26:57
Speaker 3: box warning on GLP once. So when rod are given
27:01
Speaker 3: an exorbitantly high amount of these medications, they have had
27:07
Speaker 3: rodents in rodent models, they've seen a specific type of
27:11
Speaker 3: thyroid cancer called medullary thyroid cancer, and so what they've
27:15
Speaker 3: seen is an increase, and so they put that warning
27:18
Speaker 3: on the medication because they've seen it in rodents. It
27:20
Speaker 3: has yet to be seen or shown in these medications
27:25
Speaker 3: that it actually causes this same thing in humans. A
27:28
Speaker 3: couple of really great studies have been done in the
27:32
Speaker 3: recent past, including one just a couple of weeks ago
27:34
Speaker 3: that came out and forgive me, I don't have it
27:36
Speaker 3: in front of me, but you can look it up.
27:38
Speaker 3: You can find it at obesity dot News, which is
27:40
Speaker 3: our sub stack. We do articles on this stuff all
27:42
Speaker 3: the time. But type obesity period news into your browser
27:45
Speaker 3: and use the search tool. But basically what they've done
27:48
Speaker 3: is they've done post marketing studies. So everybody knows about
27:51
Speaker 3: clinical trials.
27:52
Speaker 2: You have a phase.
27:53
Speaker 3: One which is usually in animals, and then if it's safe,
27:56
Speaker 3: and they'll move it to phase two, phase three and
27:58
Speaker 3: then it's approved. But phase four trials are less talked about.
28:01
Speaker 3: And these are the studies that they look at using
28:04
Speaker 3: electronic medical records, so they're able to aggregate data from
28:07
Speaker 3: millions and millions of patients and cross reference data about
28:11
Speaker 3: patients who are on GLP ones versus patients who are
28:14
Speaker 3: not and basically say, you know, is there an increased
28:17
Speaker 3: risk of medullary thyroid cancer. And they've looked specifically at
28:20
Speaker 3: diabetics and the most recent study was looking at diabetics
28:23
Speaker 3: who were taking a GLP one receptor agonist versus any
28:27
Speaker 3: other of the frontline treatments for diabetes. And there was
28:31
Speaker 3: after I believe it was a they looked at a
28:33
Speaker 3: four year window. There was no increased risk over any
28:37
Speaker 3: other diabetes medication for developing medullary thyroid cancer than with
28:43
Speaker 3: the GLP one receptor agonists versus any other diabetes medication.
28:46
Speaker 3: And so that was a really long study and it
28:49
Speaker 3: was looking at millions of patients, and so you can
28:53
Speaker 3: you're hard pressed to come up with better data than
28:55
Speaker 3: that in a post marketing study. And so it's just
28:58
Speaker 3: it's yet to be own or proven that this exists
29:01
Speaker 3: in humans the way that it does in mice. But
29:05
Speaker 3: I think that's the biggest one that people sort of
29:08
Speaker 3: flinch when they when they see that black box warning.
29:10
Speaker 3: But it's good to put it in perspective of what
29:13
Speaker 3: we've actually seen in the real world.
29:15
Speaker 1: There was a point when there were news reports of
29:18
Speaker 1: shortages of GLP one medications.
29:22
Speaker 3: Yeah, the obviously, as one can imagine, when you have
29:26
Speaker 3: a problem facing the United States, and actually obese has.
29:30
Speaker 2: Become a global problem.
29:33
Speaker 3: The demand for these drugs because of their effectiveness is exponential,
29:39
Speaker 3: and people are willing to pay a very high price
29:41
Speaker 3: tag to get these medications. So even though for obesity
29:44
Speaker 3: there's a very low insurance adoption rate as of current
29:49
Speaker 3: people are willing to pay the sticker price to get
29:52
Speaker 3: effective treatment. And because that's the case, these medications have
29:58
Speaker 3: been in shortage because the drug manufacturers have been unable
30:02
Speaker 3: to keep up with demand. Novo Nordisk had the first
30:06
Speaker 3: really effective obesity drug when we talk about Saxenda.
30:12
Speaker 2: But Saxenda I believe was around nine.
30:16
Speaker 3: Percent body weight loss over the over the clinical trial,
30:19
Speaker 3: and that was that was a game changer. But we Govi,
30:23
Speaker 3: which is the obesite version of ozepic, hit the market
30:26
Speaker 3: at almost sixteen percent fifteen percent and change weight loss.
30:30
Speaker 2: Over sixty eight weeks.
30:32
Speaker 3: That is an exponentially larger jump from Saxenda even and
30:36
Speaker 3: then when ter zeppetide, Munjaro and zep bound hit the market,
30:40
Speaker 3: it got all the way up to twenty two percent.
30:42
Speaker 3: So they've become very effective medications for treating obesity, and
30:48
Speaker 3: you've basically got two companies that make them. You have
30:51
Speaker 3: Novo Nordisk and Eli Lilly. Now both have scrambled to
30:56
Speaker 3: increase their manufacturing capacity. In fact, last year, at the
30:59
Speaker 3: end of the year year a deal was consummated between
31:02
Speaker 3: Novo Nordisk or Novo Holdings, the parent company, which is
31:05
Speaker 3: one of the largest companies in the world, and a
31:07
Speaker 3: company called Catalan, which was once the law once one
31:10
Speaker 3: of the largest generics manufacturer in the world, and Novo
31:14
Speaker 3: Nordis acquired them and acquired all their finish and fill
31:17
Speaker 3: capacity to be able to convert that basically to GLP
31:20
Speaker 3: one manufacturing. ELI Lilly, for their part of it, have
31:24
Speaker 3: invested almost thirty billion dollars in the last five years
31:28
Speaker 3: in expanding manufacturing capacity in these drugs in the United States,
31:33
Speaker 3: so they have scrambled to increase capacity to meet demand,
31:38
Speaker 3: and only recently have they really been able to catch up.
31:40
Speaker 3: So these were very hard to find. It actually impacted
31:43
Speaker 3: my own journey early on. There's a titration, a very
31:46
Speaker 3: specific titration process to starting these medications and getting up
31:51
Speaker 3: to the highest dose, which is the most effective dose
31:54
Speaker 3: in the clinical trials, and I had to skip several
31:56
Speaker 3: of them because they just weren't anywhere to be found
32:00
Speaker 3: during the early days of being on these medications.
32:03
Speaker 1: How many patients and their families best navigate this complex
32:07
Speaker 1: world of GLP one medications.
32:10
Speaker 3: Well, it obviously starts with great open conversations with your
32:15
Speaker 3: medical provider. These providers are becoming more aware and more
32:18
Speaker 3: educated on the topic of GLP one medication, certainly much
32:21
Speaker 3: more so than two years ago or three years ago
32:24
Speaker 3: when we started making content about this. So start with
32:28
Speaker 3: your primary care doctor, and I would really encourage folks.
32:31
Speaker 3: If your primary care doctor has reservations about these medications,
32:37
Speaker 3: try to speak to an obesity specialist, right because they're
32:40
Speaker 3: certainly going to be well versed in all of the
32:43
Speaker 3: areas of not only how these medications work, how they
32:46
Speaker 3: might benefit you, but also the insurance side of it,
32:49
Speaker 3: because again, obtaining these medications is extremely expensive, especially if
32:52
Speaker 3: you're taking them for obesity management. Diabetes has a great
32:56
Speaker 3: adoption rate from the insurance company. So if you have diabetes,
32:59
Speaker 3: if you have the good for of being a type
33:00
Speaker 3: two diabetic like myself, they're rather easy to get through
33:04
Speaker 3: through commercial insurance. But if you're treating obesity with them,
33:08
Speaker 3: as I mentioned earlier, the insurance adoption rates are terrible
33:11
Speaker 3: on OBCC medicine right now, and we're working on that
33:14
Speaker 3: and working with organizations and working on Capitol Hill to
33:18
Speaker 3: change that. But start with your primary care if they're
33:22
Speaker 3: not open to it or uneducated on this topic, speak
33:26
Speaker 3: to an obesity specialist and honestly, going to ondipin dot
33:31
Speaker 3: com going to obesity dot News, one of.
33:33
Speaker 2: Our resources out there.
33:34
Speaker 3: We talk all the time about different ways that you
33:38
Speaker 3: can get these medications covered. Manufacture savings cards are a
33:42
Speaker 3: big topic of conversations because if your insurance doesn't cover
33:47
Speaker 3: these drug, companies provide a way for you to get
33:50
Speaker 3: them more affordably. You have a list price, and then
33:52
Speaker 3: they'll have a savings card that'll bring that list price
33:55
Speaker 3: down almost in half. There are direct options now through
34:00
Speaker 3: both Eli Lilly and novo Ortics through their own pharmacies
34:02
Speaker 3: to do a cash pay version that circumvents the insurance altogether,
34:06
Speaker 3: which allows you to get these medications for less money
34:09
Speaker 3: than the sticker price. And so there are options out there,
34:12
Speaker 3: and we cover all of that on the PEN.
34:15
Speaker 2: It's a huge topic that we.
34:16
Speaker 1: Cover without mentioning any names. There are many organizations companies
34:21
Speaker 1: that you see advertising on television that are offering a
34:25
Speaker 1: free consultation by phone to determine your need and then
34:30
Speaker 1: issuing these medications to you under their brand. Are these reliable?
34:37
Speaker 3: Yeah, So I believe you're speaking about telehealth companies. Telehealth
34:41
Speaker 3: companies which would essentially provide a stable of providers that
34:45
Speaker 3: they'll connect you with that you can visit for an
34:48
Speaker 3: appointment and get these medications prescribed when medically necessary. I
34:53
Speaker 3: would say buyer beware always applies. Right. Not all of
34:58
Speaker 3: these companies are going to be created equal there. You
35:02
Speaker 3: want to do your homework and your due diligence on
35:05
Speaker 3: what company you're working with. Because, as we alluded to
35:08
Speaker 3: the idea of shortages earlier, this sort of spawned this
35:11
Speaker 3: whole industry of what's called compounded medications. In other words,
35:16
Speaker 3: when a drug is in shortage, patents sort of go
35:20
Speaker 3: by the wayside for a little bit, and generics I'm
35:24
Speaker 3: using the term loosely, but copies of these medications are
35:27
Speaker 3: allowed to be made by pharmacies that hold the property designation.
35:31
Speaker 3: Now that has spawned a whole industry of basically knockoff
35:34
Speaker 3: versions of these medications that are sold and prescribed by
35:38
Speaker 3: these telehealth companies. So understanding the differences between both the
35:43
Speaker 3: branded medications and compounded medications are very important a topic
35:47
Speaker 3: that we cover in the book. It's a topic that
35:49
Speaker 3: we cover online quite frequently. Basically, they're not FDA regulated
35:55
Speaker 3: when they're compounded. Are these compound pharmacies have FDA oversight
35:59
Speaker 3: to some degree, But these are going to be copies
36:02
Speaker 3: that are made in times of shortage. Now that the
36:04
Speaker 3: shortage is over, things have moved to this idea of
36:07
Speaker 3: a personalized medication, sort of a legal loophole that allows
36:10
Speaker 3: them to continue to offer these at scale. But definitely
36:15
Speaker 3: it's a buyer beware situation, and you want to follow
36:18
Speaker 3: good people online, good resources like on the pen where
36:22
Speaker 3: we can point you to reputable organizations that can help
36:25
Speaker 3: you get access to safe medication.
36:28
Speaker 1: In your book, you share how well intended family and
36:32
Speaker 1: friends may actually say things to those using GLP one
36:36
Speaker 1: that are inappropriate. Please share some examples of this and
36:40
Speaker 1: how we can address the stigma surrounding obesity and diabetes.
36:45
Speaker 3: I appreciate the question because I think this is one
36:47
Speaker 3: of the most universal experiences that people living with obesity have,
36:51
Speaker 3: and that's these people in our lives, whether well intentioned
36:55
Speaker 3: or malicious intent, we hear things and things are said
36:59
Speaker 3: to us about our weight or about the way that
37:01
Speaker 3: we try to manage our weight, and even well meaning
37:05
Speaker 3: comments for example like hey, you're looking good, have you
37:09
Speaker 3: lost weight? Oftentimes somebody living with obesity hears that, and
37:14
Speaker 3: for some they might find it and take that for
37:17
Speaker 3: what it's worth.
37:18
Speaker 2: Hey, I guess I'm looking good. That's great. That makes
37:20
Speaker 2: me feel good.
37:21
Speaker 3: But for many others, myself included, when I hear that,
37:25
Speaker 3: I start to consciously or subconsciously ascribe my value with
37:31
Speaker 3: that person being based upon how my physical appearance looks,
37:36
Speaker 3: and that can drive all sorts of behaviors because because
37:39
Speaker 3: thoughts lead to behaviors, and when these kind of ideas
37:44
Speaker 3: of our self worth get wrapped up in our weight
37:47
Speaker 3: or the size of pants or shirt that we wear,
37:50
Speaker 3: I can be a very dangerous and slippery slope and
37:53
Speaker 3: lead to some behaviors that may not be great for
37:56
Speaker 3: that person. So I would always one of the things
37:59
Speaker 3: that we do in our books is towards the backside
38:01
Speaker 3: of it. We give some ideas about how you might
38:04
Speaker 3: start a conversation with somebody that you love about being
38:08
Speaker 3: on a weight loss journey, and you know some of
38:11
Speaker 3: the things that you can do to start that conversation.
38:14
Speaker 3: But also conversely, on the other side of it, if
38:16
Speaker 3: you love someone who may benefit from a GLP one
38:20
Speaker 3: or you just love someone who lives with obesity and
38:22
Speaker 3: want to understand them more, there's some tips for how
38:25
Speaker 3: to support them and how to avoid comments about their appearance,
38:31
Speaker 3: how to acknowledge the complexity of obesity as a disease
38:36
Speaker 3: and not a choice that somebody has chosen for themselves.
38:39
Speaker 3: Offers support without judgment or advice. So there's some good
38:42
Speaker 3: tips and tricks towards the back of just knowing how
38:45
Speaker 3: to maybe gently approach those conversations in a way that
38:50
Speaker 3: is not going to be harmful for the person that
38:52
Speaker 3: you love.
38:53
Speaker 1: In the beginning, I started sharing my personal journey, and
38:56
Speaker 1: I had mentioned that in twenty ten I had a
38:58
Speaker 1: sleeve guts strictomy. I eventually settled down to a weight
39:01
Speaker 1: of about two hundred and forty pounds, which was still
39:03
Speaker 1: too heavy for my physical size of five foot nine
39:05
Speaker 1: and a half. I do have a wide frame. In
39:07
Speaker 1: twenty twenty four, my orthopedic surgeon said it's time to
39:12
Speaker 1: replace your left me and I was having a great
39:15
Speaker 1: deal of difficulty walk and couldn't navigate steps for more
39:18
Speaker 1: than a couple of steps, And in preparation for that,
39:21
Speaker 1: he worked with my primary physician prescribing me one of
39:26
Speaker 1: the GLP one drugs, and by the time I had
39:29
Speaker 1: the surgery in September, I had actually lost twenty five
39:34
Speaker 1: pounds and subsequent to the surgery, staying on the GLP one,
39:41
Speaker 1: I am now down to one hundred and seventy pounds.
39:44
Speaker 1: And remember this journey in the second part of my
39:46
Speaker 1: life started at four hundred pounds, so I had lost
39:49
Speaker 1: a tremendous amount of weight. I'm grateful for this because
39:54
Speaker 1: at seventy two years of age, right now my energy
39:56
Speaker 1: level is like through the roof, and I can go
39:59
Speaker 1: out and do things that I hadn't been able to
40:01
Speaker 1: do in years. I can run, I can do many
40:03
Speaker 1: many things. By the way, if anyone else has a
40:05
Speaker 1: knee replacement, if you want to run, talk to your
40:07
Speaker 1: doctor first. I'm not going to say go out and
40:09
Speaker 1: run right away. But in my case I can, and
40:11
Speaker 1: I feel very blessed in that way, and I'm just
40:14
Speaker 1: grateful for the entire process. The one thing, the one
40:17
Speaker 1: hitch for me was that when the prescription, I'm on Medicare.
40:22
Speaker 1: I have been on Medicare for several years. When the
40:24
Speaker 1: prescription was issued, Medicare and my supplemental insurance covered it
40:29
Speaker 1: until this year, until January of this year, and then
40:32
Speaker 1: they said because I didn't have diabetes, they couldn't cover me. Anymore. So,
40:37
Speaker 1: I was actually paying out of pocket on a monthly
40:39
Speaker 1: basis for this, and you, as you alluded to, the
40:42
Speaker 1: expense on this can be rather extensive. I find that
40:45
Speaker 1: I truly want to do that now that I'm at
40:47
Speaker 1: my settled weight of one seventy. I'm having another appointment
40:50
Speaker 1: with my primary at the end of this month to
40:52
Speaker 1: see whether or not he thinks I should continue, and
40:55
Speaker 1: we'll talk talk about that in the next segment. But
40:58
Speaker 1: I'm very grateful for everything that happened this process.
41:02
Speaker 3: Yeah, that's an amazing that's an amazing story.
41:05
Speaker 2: I'm glad.
41:05
Speaker 3: You're very fortunate being on Medicare to have gotten coverage
41:09
Speaker 3: for these GLP one medications without a type two diabetes diagnosis,
41:13
Speaker 3: especially given that you've been taking them for some time.
41:16
Speaker 3: Because going back, that's the whole the whole thing about
41:19
Speaker 3: Medicare is what people don't understand is that it's actually illegal.
41:24
Speaker 2: I'm not saying that wrong.
41:25
Speaker 3: It's illegal. It's against the law for Medicare to cover
41:29
Speaker 3: obesity medicine. Now, this stems back to some legislation that
41:33
Speaker 3: was designed to protect the elderly population from previous generations
41:38
Speaker 3: of OBEs. Medications that were stimulants. Obviously, the older population
41:46
Speaker 3: is at risk for more, you know, typically core morbidities
41:49
Speaker 3: associated with heart and they didn't want to go around
41:53
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41:57
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42:01
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42:04
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42:07
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42:09
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42:12
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42:14
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42:20
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42:23
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42:26
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42:31
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42:34
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42:37
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42:42
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42:45
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46:02
Speaker 1: Back on Box Novis, my guest this week is Dave Knapp.
46:05
Speaker 1: We've been talking about his book Decoding GLP Dash one,
46:09
Speaker 1: a guide for friends and family of those on the pen. Dave,
46:14
Speaker 1: do people taking these medicines require constant maintenance even after
46:19
Speaker 1: their weight loss goal is achieved.
46:22
Speaker 3: It's a great question and one that many people weigh
46:26
Speaker 3: out before they start these medications.
46:29
Speaker 2: So the first thing that I think.
46:30
Speaker 3: That we have to understand is that obesity is a
46:34
Speaker 3: chronic relapsing disease. So if you've ever lived with obesity
46:38
Speaker 3: and tried to treat it with let's just use the
46:42
Speaker 3: word that gets thrown around a lot, the natural way, right.
46:47
Speaker 3: Most of us have lived that experience where we have
46:49
Speaker 3: gone down and gone up and gone down and gone
46:51
Speaker 3: up and gone down and gone up and gone down.
46:52
Speaker 3: Very few people have better gone down or very few
46:56
Speaker 3: people are able to go down and stay down for
46:58
Speaker 3: their whole entire life because those living with obesity, including
47:03
Speaker 3: some of the metabolic disfunction that goes along with that,
47:05
Speaker 3: some of the dysregulation of these hormones, if you stop
47:08
Speaker 3: treating it, you stop getting the advantages of treating it.
47:11
Speaker 3: Much similar to the way that you would treat high
47:14
Speaker 3: blood pressure. Most people don't expect to take a blood
47:18
Speaker 3: pressure medication, get their blood pressure down, and say, Okay,
47:20
Speaker 3: we're good, we're coming off of it. Obesity medicines are
47:23
Speaker 3: no different because it is a chronic relapsing disease, and
47:27
Speaker 3: the clinical trials for both some of glue tide, the
47:29
Speaker 3: select trials, the surmount trials. Forture Zeppetite is the main
47:34
Speaker 3: two drugs that are out there right now. Both have
47:38
Speaker 3: pretty good clinical evidence that once the medication is stopped,
47:42
Speaker 3: the benefit goes away and the weight does come back.
47:46
Speaker 3: Not all the weight in all the cases, but for
47:50
Speaker 3: most people going off the treatment will experience some form.
47:55
Speaker 2: Of weight regain. A maintenance dose is typically what the
47:59
Speaker 2: goal is.
48:00
Speaker 3: When people get to a goal weight and they're done
48:03
Speaker 3: with their losing weight, they want to be able to
48:05
Speaker 3: then maintain that weight loss with the lowest amount of
48:08
Speaker 3: medication possible. And that's really going to be a back
48:13
Speaker 3: and forth with you and your provider to try to
48:16
Speaker 3: find what is that ideal dose.
48:17
Speaker 4: Now.
48:18
Speaker 3: For some of the people in the community, that may
48:20
Speaker 3: mean taking the same dose they're on today less frequently.
48:24
Speaker 3: So for some people that may be appealing because then
48:28
Speaker 3: you don't have to buy as much medication. For others,
48:31
Speaker 3: that may be just reducing the dose. Maybe you're on
48:33
Speaker 3: five milligrams now and you're still losing a little bit
48:37
Speaker 3: of weight. You want to slow the weight loss down,
48:38
Speaker 3: and you move down to two point five milligrams. That
48:41
Speaker 3: typically seems to be the track that people in the
48:43
Speaker 3: community follow, But the data definitely does show us that
48:47
Speaker 3: there is a pretty significant amount of weight regain when
48:50
Speaker 3: the treatment is removed.
48:52
Speaker 1: What are your thoughts on the future of GLP one
48:55
Speaker 1: research and its potential impact?
48:58
Speaker 3: As one of the questions, Victor, that I love answering
49:02
Speaker 3: the most. I really am hopeful for the future of
49:07
Speaker 3: obesity medication because, as we talked about early on in
49:10
Speaker 3: our discussion, GLP one is one of many incretin hormones.
49:17
Speaker 3: And now what they're doing with these future medications in
49:20
Speaker 3: early stage and some in late stage clinical trials, is
49:23
Speaker 3: they're combining these hormones. So where we had again their
49:27
Speaker 3: early stage GLP ones and then when Manjaro chrezeppetide zet bound,
49:32
Speaker 3: those are all interchangeable, right. Trezepetide the active ingredient in
49:36
Speaker 3: Manjaro the diabetes medication, terzepetide the active ingredient in zet Bound,
49:40
Speaker 3: the obese medicine. They targeted two hormones. Now Eli Lilly's
49:46
Speaker 3: next project that they'll release in a once weekly shot
49:51
Speaker 3: is called retatratide. And Retatratide is a GLP one hormone agonist,
49:57
Speaker 3: it's a GP hormone agonist, and it's a glucagon hormone agonists,
50:01
Speaker 3: and so you've got three targeted there. In what early
50:05
Speaker 3: stage clinical trials they're showing us everything from best in
50:10
Speaker 3: class weight loss twenty five plus percent weight loss over
50:14
Speaker 3: seventy two weeks or sorry, those are some of the
50:17
Speaker 3: earlier clinical trials, predicted to be about between twenty five
50:21
Speaker 3: and thirty when that data drops later this year. Perhaps
50:26
Speaker 3: that data drops late next year or early next year,
50:29
Speaker 3: I can't remember the exact timeline, but soon that data drops,
50:34
Speaker 3: expected to be between twenty five and thirty percent weight loss,
50:36
Speaker 3: It eviscerates liver fat, it reverses liver fibrosis, it's being
50:41
Speaker 3: shown to shrink tumors. There's all sorts of data that
50:44
Speaker 3: will be coming fast and furious, and so targeting multiple
50:47
Speaker 3: hormones because there's likely dysregulation in many hormones where there's
50:51
Speaker 3: dysregulation with one, if you're talking about a gut that's
50:55
Speaker 3: out of whack and out of balance. The future this medication,
50:59
Speaker 3: these medications is bright. I think it's really going to
51:01
Speaker 3: change the way that we look at things like bariatric
51:04
Speaker 3: surgery and medicine. You're going to see a blend of two.
51:07
Speaker 3: One of the things I'm most excited about is a
51:09
Speaker 3: company called Fractal Health, and we've interviewed their CEO on
51:12
Speaker 3: on the pen but they they've been looking at more
51:14
Speaker 3: of like root cause, why does your body become dysregulated
51:18
Speaker 3: in GLP one, Why does the nutrient sensing get dysregulated?
51:23
Speaker 3: And so they actually have like minor outpatient endoscopic procedures
51:27
Speaker 3: that you know, perform like a small oblation on the
51:31
Speaker 3: surface of your gut lining and it helps to restore
51:34
Speaker 3: the sensitivity to the nutrients that you take and so
51:37
Speaker 3: you're endogenous or naturally occurring hormones are rebalanced and reset.
51:44
Speaker 3: And so they're looking at trials where they get people
51:46
Speaker 3: down to their ideal weight with a drug like terzepetide
51:51
Speaker 3: or semaglutide and then they have this procedure done and
51:55
Speaker 3: then they maintain their weight loss with that procedure instead
51:58
Speaker 3: of more medication.
51:59
Speaker 2: And so.
52:01
Speaker 3: I'm just very very encouraged. The more I learn, the
52:03
Speaker 3: more I believe that we will see perhaps in my lifetime,
52:08
Speaker 3: this idea of disease as a very treatable, curable, preventable
52:13
Speaker 3: disease and all of the cascading comorbidities that go along
52:16
Speaker 3: with it, whether we're talking about heart health, cardiac health,
52:20
Speaker 3: whether we're talking about cancer, where you know there are
52:23
Speaker 3: thirteen different cancers associated with obesity alone. Imagine if we
52:26
Speaker 3: can can get to the bottom of this obesity problem,
52:29
Speaker 3: we solve a lot of the cancer problems that we have,
52:31
Speaker 3: We solve a.
52:31
Speaker 2: Lot of the heart issues that we have.
52:33
Speaker 3: And So while people look at these medications and the
52:36
Speaker 3: current price tag of them and say this is going
52:38
Speaker 3: to bankrupt our healthcare system, I look at it and say,
52:40
Speaker 3: these medications are going to save our healthcare system.
52:44
Speaker 1: How may individuals and organizations support GLP one advocacy and
52:50
Speaker 1: education efforts.
52:52
Speaker 3: There are a whole host of them out there that
52:55
Speaker 3: support the advocacy for these and things like to treat
52:59
Speaker 3: and reduce obesiae. The act we talked about four I
53:01
Speaker 3: would point a couple to a couple of them. The
53:04
Speaker 3: first would be the Obese Action Coalition. Now, this is
53:08
Speaker 3: a sort of like a trade organization. Is how how
53:11
Speaker 3: it operates. The you know, they do like the industry
53:16
Speaker 3: trade shows, and they have you know, some pharmaceutical backing,
53:19
Speaker 3: et cetera. But it's really designed to be patient centric.
53:23
Speaker 3: I'll be actually attending a Your Weight Matters conference just
53:27
Speaker 3: next week in Washington, d C. And people will be
53:30
Speaker 3: learning how to you know, talk to their representatives and
53:33
Speaker 3: advocate for obesc treatment. So the Obese the Action Coalition
53:36
Speaker 3: is one and the Obese Medicine Association would be another
53:39
Speaker 3: one that I would point people in the direction of
53:42
Speaker 3: just some great advocacy groups helping to rewrite the narrative
53:46
Speaker 3: about obesity in this country and helping people get access
53:49
Speaker 3: to care.
53:50
Speaker 1: What would you like readers to take away from Decoding
53:52
Speaker 1: g LP One.
53:55
Speaker 3: I would just like to see more people feeling like
53:58
Speaker 3: they can have an intelligent conversation with a loved one,
54:01
Speaker 3: to educate them and to just have a more open relationship.
54:04
Speaker 3: At the end of the day, this book wasn't designed
54:07
Speaker 3: to do the work of getting people to understand everything
54:11
Speaker 3: there is to understand about these medications. It was designed
54:14
Speaker 3: as a conversation starter's starter to allow people to have
54:17
Speaker 3: better conversations with the people they love in their life,
54:20
Speaker 3: so that they didn't feel like they had to hide
54:22
Speaker 3: this part of their life. Now, imagine Victor being somebody
54:24
Speaker 3: who had gone from four hundred pounds to one hundred
54:27
Speaker 3: and seventy pounds and never saying a word about how
54:30
Speaker 3: you did it to your mom, to your dad, to
54:33
Speaker 3: your even some folks in the community don't share with
54:37
Speaker 3: their spouse that they're on these medications. So imagine the
54:41
Speaker 3: shame that is wrapped up in living with obesity for
54:44
Speaker 3: somebody who is not sharing with their spouse that they're
54:46
Speaker 3: on a medication to treat their disease. My hope and
54:48
Speaker 3: prayer for this book is that it opens up conversations
54:51
Speaker 3: for people to just have better conversations with their loved ones.
54:55
Speaker 1: Absolutely. My guest Dave Knapp his book Decoding golp one,
55:00
Speaker 1: a guide for friends and family of those on the pen. Dave,
55:05
Speaker 1: one more time, please share with our listeners where they
55:07
Speaker 1: can get your wonderful book and find out more about
55:09
Speaker 1: you and your organization.
55:11
Speaker 3: Thank you, Victor on theepen. Dot com is the gateway
55:14
Speaker 3: to all the things, whether you're looking for social media connection,
55:18
Speaker 3: whether you're looking for a podcast, if you're looking for
55:22
Speaker 3: news like a newsletter. A lot of people just like, hey,
55:25
Speaker 3: I don't like to watch videos, but I do like
55:28
Speaker 3: to read. If that is more what you prefer. We
55:31
Speaker 3: have a new domain called obesity dot news. So people
55:34
Speaker 3: are used to typing in dot com, but if you
55:36
Speaker 3: just type in your browser obesity period news, it's going
55:39
Speaker 3: to take you to our substack, which is what our
55:41
Speaker 3: newsletter is, and so you just put your email in,
55:44
Speaker 3: you'll sign up there and directly to your inbox. Just
55:47
Speaker 3: about every day, you're going to get a new update
55:49
Speaker 3: on virtually every topic that we talked about today and
55:53
Speaker 3: then some.
55:54
Speaker 1: Dave, thank you so much for joining us and sharing
55:57
Speaker 1: this amazing and valuable information with our listeners.
56:01
Speaker 2: My pleasure. Thank you for having me Victor.
56:03
Speaker 1: And thank you for joining us on Vox Novus. I'm
56:06
Speaker 1: Victor the Voice Ferman. Have a wonderful week.