Latest / Fork U with Dr. Terry Simpson / Willpower Is B.S.: A Surgeon on Zepbound

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Willpower Is B.S.: A Surgeon on Zepbound · Fork U with Dr. Terry Simpson

0:03
>> Dr. Terry Simpson: M Today is my coming out party. Today I'm coming
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out. About me. Because this is the first new year
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of my adult life where weight loss is not at the
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top of my resolution list. And that's not because
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I gave up. It's because over the last year, I have
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lost 45 pounds with the help of Zephound, a GLP1
0:23
agonist. And today on 4Q, I'm finally ready to
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tell you that story. Not as a success story, not
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as advice, and certainly not as a moral lesson,
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but as an honest account of what actually
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happened. Why this wasn't willpower, why it wasn't
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just eating better, and why this changed far more
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than my weight. Some of you know I'm a weight loss
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surgeon. Some of you know I'm trained in culinary
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medicine. And some of you know I've spent my
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career helping other people lose weight. What you
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may not know is how much shame I carried doing all
1:00
that. So today I'm telling you my story. The
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guilt, the biology, the food noise, and what this
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last year has meant to me. Because if this story
1:11
resonates with you or someone you love, that
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matters. This is the story of how science saved my
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life. This is also the first new year where I
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don't have weight loss as a resolution. In fact,
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I've had weight loss as my New Year's resolution
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since Ronald Reagan was first elected. Every year,
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same promise, same guilt. And I don't think I ever
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promised that more strongly than in 2010 when my
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son JJ was born. I'm, um, one of those older
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parents. I know it's hard to believe, but if there
1:46
was ever motivation, that was it. I was going to
1:50
lose weight. I was going to get healthier because
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I had this little child that I wanted to spend a
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lot of the rest of my life knowing. Some years the
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promise was stronger. Some years it was better.
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Every year until this last year, I might lose a
2:04
few, then gain it back. I know how to eat. I know
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how to cook. Do you know that I almost set the
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record for logging my daily food on Noom or over
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2000 days? This was never about knowledge. This
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was never about effort. I am your Chief Medical
2:24
Explanationist, Dr. Terri Simpson, and this is
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Fork U Fork University, where we make sense of the
2:31
madness of weight loss, bust myths, and talk
2:34
honestly about food and medicine.
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Let's talk talk about willpower. And let me start
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with a confession. I've known the truth about
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willpower for years. I just didn't believe it for
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myself. I have willpower. I'm a surgeon, you don't
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get through surgical training without willpower.
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And you don't stand in an operating room for hours
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making decisions that matter without willpower.
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And let's be honest. Oprah has willpower. She has
3:05
discipline. She has access. She has resources. And
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yet all the willpower in the world didn't allow me
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or Oprah to lose weight and keep it off. Sure,
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with enough willpower, you can lose weight for a
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while. God knows I've done it. Liquid protein
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diets, rigid eating, white knuckling my way
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through, you'll lose the weight. I've done it more
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than once. But you still hear the food noise.
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Willpower doesn't quiet food noise. It doesn't
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shut off the background pull toward food just
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tells you to fight it all day, every day. And
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eventually, food noise wins. Because biology beats
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psychology every single time. You can't willpower
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your way out of obesity any more than you can
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positive think your way out of high blood pressure
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or high cholesterol or diabetes or heart disease
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or cancer. We don't tell people with hypertension
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to believe harder yet with obesity, we pretend
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willpower is the treatment. It isn't. And here's
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where my shame lived. As a weight loss surgeon, I
4:11
told my patients this. I corrected people when
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they said surgery was the easy way out. Because
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surgery does not make the stomach smaller. It
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changes gut hormones. It changes brain signaling.
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It changes appetite regulation. It changes
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biology. I believed that data fully for everyone
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else, but not for me. I held myself to a different
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standard. I gave everyone else grace, but I didn't
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give it to myself. I didn't gain more willpower
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from a needle. I'm not a better person because I
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lost weight. I'm not morally superior because I
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moved from obese to a normal weight. I didn't
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become more disciplined. The biology changed.
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That's it. I know this intellectually. I taught
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it, I lived it through my patients, but I didn't
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apply it to myself. You know, we have a name for
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that, cognitive dissonance. Now, when I look back,
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the turning point came down to two people and one
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event before that. Let me say this clearly. This
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wasn't ignorance. I'd known about GLP1 medications
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for years. I'd read the trials. I understood the
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mechanism. I prescribed them to my patients, and
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my patients did well. But knowing the science and
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believing it applies to you are two different
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things. About seven years ago, a very good friend
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of mine, an internist, was one of the
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investigators setting GLP1 medications for weight
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loss. She was stunned by the results and told me
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that these medications are going to replace weight
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loss surgery. Sure, I said. I wasn't impressed.
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I'd seen other weight loss medications before, but
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the data wasn't weak. Anyway, let's start with my
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journey. It was a nurse that I worked with.
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Nothing dramatic, nothing preachy. She just kept
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losing weight quietly. And she mentioned her
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experience on ozempic and would occasionally ask
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me as a weight loss surgeon about ozempic. No
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evangelism, um, no sales pitch. She felt better.
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She did easier. The food noise was gone. Now, as a
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surgeon, you learn to respect quiet results
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because they are typically real. The second was a
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person. Someone I work with in Alaska. In fact,
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she and I grew up in the same town, Ketchikan.
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Then she told me something that stopped me cold.
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Yep, she had lost weight, but that wasn't the
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headline. She said the food noise stopped. And
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then she said something else. Her interest in
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alcohol dropped. And she had stopped smoking. This
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is when it stopped being about weight. That's when
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about the biology of it became real. Then came the
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event. Eli Lilly lowered the self pay price to
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about $500 a month. Suddenly, this wasn't
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theoretical. This was something I could budget. So
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I called my friend, Dr. Michael Albert. Now,
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Michael is a board certified obesity medicine
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specialist. And that matters. If you're
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considering this journey, Find someone who's
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actually trained in obesity medicine, not someone
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who says they are. Michael assumed I was calling
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about a patient. I said, no, no Michael. I'm
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calling about me. No judgment. Just one question.
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What's your height and weight? That was 45 pounds
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ago.
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Let me tell you about the first injection. The
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package derived from Eli Lilly. Inside were vials
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of zepbound syringes, needles, alcohol, swabs. I
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have a confession to make. Even though I got the
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polio vaccine, even though I keep up with my
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boosters, I hate needles. I. I hate them. I don't
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like them. I don't like getting injections. I will
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put off for any reason getting a booster, even
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though I do it. So I did the appropriate thing. I
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hydrated with Pedialyte in case there was some
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nausea. And, um, finding subcutaneous fat for my
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first injection. It just wasn't a problem. I mean,
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a man with belly has options. So I put alcohol on
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the vial. I put the air from the syringe into the
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vial. I swiped my skin with alcohol, thinking, am
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I really doing this? And I did it. I put the
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needle in. I put the plunger down. In half A CC
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was 2.5 milligrams of Zepbound subcutaneous. That
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was it. I wondered if I needed a sucker. The next
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morning, my partner said, that is the first time
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you haven't snored in years. I checked my withing
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sleep score. It was the best it had ever been. I
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had hardly ever cracked 70 as a sleep score, and
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all of a sudden, I was hitting the 80s. Let me
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tell you about another change. Before I injected
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myself, I did something very telling. I bought a
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new blender. Because when you know you're going to
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change your life or make a new habit, you prepare.
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It's like when I decided to take up running again.
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Before the first run, I, of course, bought new
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shoes and a tracksuit. Matching, of course. Same
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instinct. So I knew this change might mean more
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smoothies. Not just as a diet trick, but as a
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practical way to get nutrition in, you know, the
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fruits, the ber, that good stuff. And my Vitamix
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had been with me for 15 years. But it's a beast,
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and I wanted something easier. After all, I was
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going to inject myself. I deserved a simple
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blender. And so I did the research. I saw
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Wirecutter from the New York Times. I read
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reviews. I looked at comparisons. I saw lots of
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videos on TikTok, my favorite medium. And I bought
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a Nutribullet. Amazon delivered it the day before
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I started Zepboun. So I unpacked it, didn't read
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the instructions, of course, and had all the parts
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washed and ready to go. The next morning, after my
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first injection, I wondered about my breakfast.
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And I was traveling that day. So I made my usual
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smoothie, which is kind of for me. Oat milk, a
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banana, frozen blueberries, some egg protein. I'm
9:33
lactose intolerant, some peanut butter. And by the
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way, if you want the recipe, it's on
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terrysimpson.com now. You need to understand
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something about me. If you've not known me. I am
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known for eating fast. People notice it. I'm
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usually the first one diet, always. And so that
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morning, when I was traveling along in my commute,
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which is about two hours at the time, that
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smoothie wasn't guzzled. I would sip a little bit
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and put it down normally with my smoothie. If I'm
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traveling, that smoothie is gone, like a man who
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found an oasis in the middle of desert. But this I
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sipped, not consciously. It just happened. And
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then that night, I made some salmon with broccoli
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and chickpeas, one of my favorite recipes, and I
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love salmon. And I ate it slowly and then I
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stopped. I ate half the plate. Not because I was
10:16
uncomfortable, that was just done. Something had
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stopped. Something went quiet and reminded me.
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That's food noise. Do you know what it reminded me
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of? Years ago, when I was at the University of
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Chicago, I slept with the city noise. I lived by
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Lakeshore Drive, There were trains in the
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background, there was lots of cars going by 24
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hours a day. And I would sleep to that. You never
10:37
noticed that background noise until I would go
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home to catch canalaska at my parents house. And I
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would take time to fall asleep because there
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wasn't that background city noise. It was gone.
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And that's what happened in my brain. Food noise
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was gone. I didn't even know it was there. That's
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what food noise was.
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So things that changed first, before the scale
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moved, that first night sleep, the second thing I
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noticed was stress. Now sleep resets hormones,
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lowers inflammation, recalibrates metabolism.
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We've known this for years. And less sleep
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actually increases appetite. Stress does. Does
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too. So before this, you know, I commute a lot. I
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live in the north LA central coast area and
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commuting is just sort of a fact of life here. But
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hours of commute meant a lot of physiologic
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stress. And so when I would look at my Withings or
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my whoop watch and you would see the amount of
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stress I would have, if I had commuted two hours a
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day, I'd have two hours of stress. Now I notice
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the first week I might have five minutes of
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stress. Calories didn't lower the stress, calories
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didn't improve the sleep, the biology did. And
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over time, friends started to notice. People
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noticed. Now I have a few friends that were a
11:45
little more corpulent and they would always ask
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when they would see me, hey, what diet are you on?
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What are you doing, Terry? So finally I told them
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different ones at different times. And one by one,
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all of them began their own journey on zeppbound.
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And without planning it, we formed our own little
12:02
support group. They would call me or text me when
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they had an issue like, is this normal? What would
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you do? Does this go away? And we would talk it
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through, not as coaching, not as a program, just
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people who understand. Let me tell you about one
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of my friends. She travels constantly. If you were
12:16
to see her Instagram, if you follow her, it's full
12:20
of wonderful foods from wonderful restaurants
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around the something like 50 plus countries she's
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visited. I have traveled with her around the world
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and we both love great food and oddly, we still
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do. She still Loves great food. I still love great
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food. When we go out to eat together, we get great
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food. Interestingly, our desire for wine has kind
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of completely gone, but we still enjoy great food.
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Just small plates. Enjoy the taste, not the
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volume. I have another buddy, he travels
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constantly for work. Great guy. He has this
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amazing workout regimen he does in every hotel
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room, involving 100 push ups and calisthenics and
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all of this stuff. And he was in shape, it was
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just a round shape. So he asked me, what are you
13:05
doing, Terry? And I said, I'm doing Zepbound. I
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gave him the number of my guy, Dr. Albert. He
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called him up, he started it. You know, New Year's
13:13
is coming. And he said, he started laughing. He
13:15
said I had to buy a new tuxedo. Look at this. He
13:19
looks great. Then there's another friend of mine.
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He's a fellow physician. I've known him for 25
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years. We have gone and lectured together in
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countries from New Zealand to Sweden and always go
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out together at great restaurants. I've seen him
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go up and down in weight over time. Oh, I'm on the
13:33
Paleo diet. I'm losing weight and then regaining
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the weight. Now he's on Zepbound. And like me,
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he'll say, what do you think? Should I increase in
13:41
dose? Anyway, I've always believed in support
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groups, but now I understand them from the inside.
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I'm not your coach, and I don't do this alone. I
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work with a company called Accomplished Health.
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No, they don't pay me, they don't sponsor the
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podcast, but they practice real obesity medicine.
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And maybe if they hear this, they'll send me a
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coffee cup, which I would love. Here's a warning.
14:00
If you eat less, you still need micronutrients.
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And that's not theoretical. Here's the thing, as a
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weight loss surgeon, I've always told my patients,
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you need to take a multivitamin. And I realized on
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a GLP1, I need to take a multivitamin also. And
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the first time I ever threw up, the only time I've
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thrown up on this, was when I took a vitamin on an
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empty stomach. Sip of coffee and boom, it wasn't
14:21
staying down. Now, I'd heard this for years from
14:23
weight loss surgery patients that some vitamins
14:24
just don't work. And I even tried some of these
14:27
fancy bariatric vitamins and they didn't work
14:29
either. And the one vitamin group that worked for
14:31
me was AG1. No, again, not a sponsorship. It's not
14:34
an ad. They don't pay me. This stuff is way too
14:36
expensive. Which made me think I should probably
14:39
develop a vitamin routine for people on empty
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stomachs, because vitamins are critical,
14:43
especially thiamine, and the deficiency in
14:46
thiamine can be devastating. That's another reason
14:48
you really need someone to help you with this
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journey.
14:51
Now let's talk bowel movements. Here's something
14:53
really simple. If you eat less, you're going to
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have fewer bowel movements and that does not mean
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constipation. Less in means less out. You don't
15:00
need to go to the bathroom every day. Fiber still
15:03
matters. Mediterranean diet helps naturally.
15:05
Vitamins, legumes, whole groups. This is about
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understanding physiology and not panicking so why
15:10
am I going to write a book? I remember I was
15:12
disturbed when I saw a physician who's never been
15:15
on GL Pillar 1, never been on a wait list, but is
15:17
an obesity physician and fairly good and wrote a
15:19
book about how to eat on one. And I realized with
15:21
my background weight loss, surgery, culinary
15:23
medicine and living is I have to write a book and
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I'm thinking of calling it Willpower Is bs. You
15:29
know me. Subtle. Now my book agent retired long
15:33
ago, so if any of you know or are a good literary
15:36
agent, hey, hit me up. I'm back in the market.
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Anyway, this is just part one of this journey and
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as I record this, I'm about to inject 7m.5mg dose
15:45
of Zeppelin and God I still hate needles. I'll
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have more to share about the journey as we go, but
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don't worry, this is not going to become a
15:52
zepbound podcast. I'm going to continue to bust
15:54
myths about food and medicine to make sense of the
15:57
madness. If you want to find out more, you can
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read about it on the blog associated with
16:04
YourDoctorsOrders.com or ForkU.com and I am the
16:09
guy who researched and wrote this. I'm Dr. Terry
16:11
Simpson. I'm a board certified doctor but I am not
16:13
your doctor and before you make any changes to
16:16
your diet or if you get on zepbound, find a real
16:19
obesity physician like Dr. Albert or whomever. Dr.
16:23
Dalcy is a great one also in Michigan. Find them
16:27
and talk with them. All things audio are done by
16:30
my friends at Simpler media and the pod God
16:32
himself, Mr. Evo Terra. And by the way, while
16:36
weight loss isn't the big thing here, the big
16:37
thing is the medical changes that it has made By
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Hemoglobin is A1C has gone down. It was normal but
16:42
it's better. My blood pressure is down. It was
16:44
normal. It was better. Lots of things are down.
16:46
They're normal but better. But the weight down is
16:49
good, because if I were to die tomorrow, then Mr.
16:51
Evo, Tara would probably be one of my pallbearers,
16:54
and at least he would have less to work with. All
16:57
right. Eat smarter, live better. Leave guilt out
17:00
of the kitchen. This is Dr. Simpson. Have a good
17:03
week. Hey, Evo. I know, uh, you may be a
17:15
pallbearer, but I'm gonna make an ash out of
17:17
myself and be cremated. I hope you're doing well,
17:19
buddy. How do you like this for true confessions?
17:24
Yeah, it's not every day you hear boomers being
17:26
all vulnerable and stuff, but I'm proud of you,
17:29
man. And also, while we're in the sharing mode, I,
17:32
too, have been on the shot for, gosh, about a year
17:35
now, doing much better. I love it this way.