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GLP-1s Explained: Why They Reduce "Food Noise" · Doctor Turned Health Coach

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  Welcome to the Doctor Turned Health Coach Podcast. My name is Dr.
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  Ashori, a board-certified family medicine physician, helping you guys with the
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  support of a health coach and the expertise of a physician achieving your ideal health goals.
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  So I get this question a lot from my health coaching clients.
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  Now, with my health coaching clients, I don't prescribe any medications.
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  I work closely with their own doctors, but I don't give any individualized assessments, diagnoses.
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  I don't order labs, prescribe meds. That's the job of the patients,
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  of the person's own doctor, right? Leave that to them.
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  But something we discuss quite often is medical science, technology.
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  You know, what is hype? What is real? And one topic that comes up quite a bit are GLP-1s.
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  These are the incretin hormone medications, hormone-mimicking medications that
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  are quite popular. We've had incredible success with these medications,
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  and my health coaching clients naturally ask me a lot about them.
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  Hey, doc, do you think this is maybe something I should take?
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  Is this something that could work for me? How do they work? What are their side effects? Is it real?
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  So let's dive into that. this is going to, I'm not going to do a very deep dive,
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  but medications like GLP-1s or GIPs and glucagon receptor agonists,
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  they're all kind of in this category of medications.
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  They've been around for some time for the management of diabetes.
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  And one of their important side
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  effects is that it causes a lot of weight loss due to two main factors.
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  One is the appetite suppression, and two, it's the slowing of the intestine
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  that also causes appetite.
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  So imagine if you're very, very constipated, severely constipated,
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  the last thing you'd want is to eat something.
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  You would have no appetite because your gut is not moving.
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  And so just the idea of putting something in your mouth would probably make you want to throw up.
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  And that's what happens because your gut's not moving. If you put something
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  in it, it'll actually want to move the other way.
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  And that's one way that GLP-1s work because of the receptors on the intestines.
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  And when we add this GLP-1 receptor, it slows down the intestine.
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  Then the other way that it works, it's believed that maybe centrally in the
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  brain, it has some effects and it kind of decreases your appetite.
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  You're craving more so than the appetite because most appetite comes from the
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  craving for something delicious, something rich, something savory.
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  And one thing we've always known in medicine is that one person's food drive
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  is so different from another's.
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  Take me and my wife. I have very little food drives.
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  I could go a whole day without eating because I'll just forget or I'll get busy. I don't get hangry.
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  I don't really crave anything. I occasionally may want to have a pizza,
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  but really don't even crave that. It's just like, oh, I haven't had that in a while.
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  But my wife is very different. She has a strong food craving.
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  It's very important to her, the taste, the texture, the temperature of the food.
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  She will crave something and she'll have to have it. And she'll definitely experience
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  moments of severe hunger.
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  That's just the way two different human beings are. Different physiology,
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  different food circuitry.
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  So why is it important to understand how GLP-1s work?
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  Once a patient takes GLP-1s, number one, the first thing they'll say,
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  right, is, oh my god, I had no idea I had this much food noise.
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  I had no idea that I was thinking and craving food so much.
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  Because once it gets turned down by these medications, all of a sudden you're not craving food.
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  And then when I have a conversation with one of my patients or health coaching
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  clients who has taken these meds, and I'm like, yeah, that's kind of how I feel
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  most of the days. They're like, oh, it's so unfair.
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  All of my life, since I was a teenager, I've been having this,
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  constantly thinking about food, constantly craving food.
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  Yes, that's how we are so different as from one human being to another.
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  Now, the question then is, okay, so does it speed up your metabolism? No.
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  Does it change the way you absorb nutrients? Not really.
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  So then what is it doing? It is decreasing the amount of calories that you're taking in, right?
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  So then, of course, unfortunately, some health experts and social media gurus
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  have come and say, this medicine is bad because it's eroding the free will of people.
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  People should themselves be able to just say no to food. Well,
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  that's not the way it works.
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  That's not the way it works. We've known that for decades.
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  When somebody's food drive is so strong, it's very difficult for them to say no to food.
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  But if somebody finds out that the main reason this medication works is because
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  it lowers their food drive. So if they actually took in fewer calories, they would lose weight.
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  It could be something empowering. And they may not want to even take the medicine.
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  But it doesn't mean that it would be any easier for them to stop those dietary
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  habits, nutrition habits, and cut their calories because it would still be incredibly difficult.
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  But 95% of the way this medication seems to work right now is to decrease intake
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  of calories, which eventually results in weight loss.
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  So this is a value.
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  But remember, just because it's making somebody have fewer calories,
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  it's not the same as saying that everybody could just have fewer calories and
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  they would lose weight because it simply is not that simple.
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  It would be disregarding somebody's food drive, which can be quite different from another person.
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  Thank you for listening once again. And leave comments. Send me an email.
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  Hello at drashori.com. Take care.