Latest / Metabolic Mind / Are We Using GLP-1 Medications All Wrong? with Dr. Ben Bikman

Transcript

Are We Using GLP-1 Medications All Wrong? with Dr. Ben Bikman · Metabolic Mind

0:00
So
0:00
to
0:00
me,
0:00
the
0:01
best
0:01
use
0:02
of
0:02
this
0:02
self
0:03
discipline
0:03
in
0:03
a
0:04
syringe
0:04
is
0:04
to
0:05
look
0:05
at
0:05
it
0:05
as
0:05
a
0:05
temporary
0:06
enhancement
0:07
to
0:07
overcome
0:08
addictions
0:09
rather
0:09
than
0:09
this
0:09
is
0:10
your
0:10
new
0:10
normal
0:10
and
0:10
you're
0:11
going
0:11
to
0:11
be
0:11
drugged
0:11
for
0:11
life.
0:16
Welcome
0:17
to
0:17
the
0:17
Metabolic
0:18
Mind
0:18
Podcast.
0:18
I'm
0:19
your
0:19
host,
0:19
Dr.
0:19
Bret
0:20
Scher.
0:20
Metabolic
0:21
Mind
0:21
is
0:21
a
0:21
nonprofit
0:22
initiative
0:23
of
0:23
Bouzouki
0:23
Group
0:24
where
0:24
we're
0:24
providing
0:25
information
0:25
about
0:25
the
0:26
intersection
0:26
of
0:26
metabolic
0:27
health
0:27
and
0:27
mental
0:28
health
0:28
and
0:28
metabolic
0:29
therapies
0:29
such
0:30
as
0:30
nutritional
0:30
ketosis
0:31
as
0:32
therapies
0:32
for
0:32
mental
0:32
illness.
0:33
Thank
0:33
you
0:33
for
0:34
joining
0:34
us.
0:35
Although
0:35
our
0:35
podcast
0:36
is
0:36
for
0:36
informational
0:36
purposes
0:37
only
0:37
and
0:38
we
0:38
aren't
0:38
giving
0:38
medical
0:38
advice,
0:39
we
0:40
hope
0:40
you
0:40
will
0:40
learn
0:40
from
0:40
our
0:41
content
0:41
and
0:41
it
0:41
will
0:42
help
0:42
facilitate
0:42
discussions
0:43
with
0:43
your
0:43
healthcare
0:44
providers
0:44
to
0:45
see
0:45
if
0:45
you
0:45
could
0:45
benefit
0:46
from
0:46
exploring
0:46
the
0:46
connection
0:47
between
0:47
metabolic
0:48
and
0:48
mental
0:48
health.
0:53
What
0:54
if
0:54
we're
0:54
using
0:54
GLP1
0:55
medications
0:56
all
0:56
wrong?
0:57
Look,
0:57
the
0:58
GLP1
0:58
medications,
0:59
WeGovy,
0:59
Manjaro,
1:00
Ozempic,
1:01
they
1:01
are
1:01
revolutionizing
1:03
the
1:03
medical
1:04
profession
1:04
of
1:04
weight
1:04
loss.
1:05
Right?
1:05
Like
1:05
the
1:06
medical
1:06
weight
1:06
loss
1:06
is
1:07
beyond
1:07
anything
1:08
we've
1:08
ever
1:08
seen.
1:09
But
1:09
what
1:09
if
1:09
we're
1:09
using
1:10
them
1:10
incorrectly?
1:11
What
1:11
if
1:12
to
1:12
get
1:12
optimal
1:13
metabolic
1:14
health
1:14
and
1:14
long
1:14
term
1:15
safety
1:15
and
1:15
long
1:16
term
1:16
weight
1:16
loss,
1:17
there
1:17
was
1:17
a
1:17
better
1:17
way
1:18
to
1:18
use
1:18
them?
1:18
I'm
1:19
joined
1:19
today
1:19
by
1:19
Dr.
1:20
Ben
1:20
Bickman,
1:21
who's
1:21
a
1:21
professor
1:22
and
1:22
researcher
1:22
at
1:23
BYU
1:23
and
1:24
and
1:24
he
1:24
specializes
1:25
in
1:25
insulin
1:26
and
1:26
metabolic
1:26
health
1:27
and
1:27
he
1:27
has
1:27
a
1:28
really
1:28
interesting
1:28
theory
1:29
about
1:29
using
1:29
these
1:30
medications
1:30
as
1:31
microdoses
1:32
to
1:32
help
1:32
curb
1:33
cravings
1:33
for
1:34
carbohydrates,
1:35
which
1:35
will
1:35
then
1:36
allow
1:36
a
1:36
transition
1:37
to
1:37
a
1:38
healthy
1:38
low
1:38
carb
1:39
diet
1:39
to
1:40
allow
1:40
for
1:40
longer
1:41
term
1:41
success
1:42
with
1:42
weight
1:42
loss,
1:43
but
1:43
more
1:43
importantly,
1:44
improved
1:44
metabolic
1:45
health
1:45
with
1:46
very
1:46
low
1:46
risk
1:47
for
1:47
any
1:47
side
1:48
effects
1:48
and
1:48
lower
1:49
cost.
1:50
Sounds
1:50
intriguing.
1:50
Let's
1:51
get
1:51
into
1:51
the
1:51
details
1:51
with
1:52
Professor
1:52
Ben
1:52
Bickman.
1:53
Many
1:53
of
1:53
the
1:53
interventions
1:54
we
1:54
discuss
1:54
can
1:54
have
1:55
potentially
1:55
dangerous
1:55
effects
1:56
if
1:56
done
1:56
without
1:56
proper
1:56
supervision.
1:57
Consult
1:58
your
1:58
healthcare
1:58
provider
1:58
before
1:59
changing
1:59
your
1:59
lifestyle
2:00
or
2:00
medications.
2:01
In
2:01
addition,
2:01
it's
2:01
important
2:02
to
2:02
note
2:02
that.
2:02
People
2:02
may
2:03
respond
2:03
differently
2:03
to
2:03
ketosis
2:04
and.
2:04
There
2:04
isn't
2:05
one
2:05
recognized
2:05
universal
2:06
response.
2:13
Well
2:13
Ben,
2:13
welcome
2:14
back
2:14
to
2:14
Metabolic
2:14
Mind.
2:14
It's
2:15
great
2:15
to
2:15
see
2:15
you
2:15
again.
2:16
Yeah.
2:16
Hey
2:16
Brett,
2:17
glad
2:17
to
2:17
connect
2:17
with
2:17
you.
2:18
Yeah,
2:18
I
2:18
enjoy
2:19
every
2:19
opportunity
2:20
to
2:20
sit
2:20
down
2:20
and
2:20
chat
2:21
with
2:21
you.
2:21
We
2:21
had
2:21
a
2:21
great
2:22
interview
2:22
a
2:22
while
2:22
back
2:23
here
2:23
on
2:23
Metabolic
2:24
Mind,
2:24
which
2:24
I
2:24
highly
2:25
recommend
2:25
people
2:25
check
2:26
out.
2:27
But
2:27
I
2:27
reached
2:28
out
2:28
to
2:28
you
2:28
to
2:29
circle
2:29
back
2:29
and
2:30
talk
2:30
to
2:30
you
2:31
again
2:31
because
2:31
of
2:31
this
2:32
really
2:32
interesting
2:33
article
2:33
you
2:33
wrote,
2:34
this
2:34
op
2:34
ed
2:34
about
2:35
the
2:35
use
2:35
of
2:35
GLP1s,
2:37
sort
2:37
of
2:37
microdosing
2:38
to
2:38
address
2:39
cravings.
2:39
So
2:39
I
2:39
want
2:39
to
2:40
get
2:40
into
2:40
all
2:40
that.
2:40
But
2:41
before
2:41
we
2:41
get
2:41
into
2:41
the
2:42
details
2:43
tell
2:43
us
2:43
a
2:43
little
2:43
bit
2:43
about,
2:44
you
2:44
know,
2:44
what
2:44
got
2:44
you
2:45
interested
2:45
in
2:45
metabolic
2:46
health
2:46
to
2:46
begin
2:47
with
2:47
and
2:47
maybe
2:47
how
2:48
that
2:48
led
2:48
you
2:48
to
2:48
think
2:48
about
2:49
GLP1s
2:50
and
2:50
so
2:50
forth.
2:50
Yeah,
2:51
my
2:51
journey
2:52
in
2:52
towards
2:53
the.
2:54
Well
2:54
to
2:54
the
2:54
point
2:54
I'm
2:55
at
2:55
now.
2:55
All
2:56
of
2:56
which
2:56
of
2:56
course
2:57
always
2:57
a
2:57
means
2:57
to
2:57
an
2:58
end.
2:58
As
2:58
a
2:59
young
2:59
married
3:00
guy
3:00
thinking
3:00
about
3:01
how
3:01
to
3:01
provide
3:01
for
3:01
a
3:02
future
3:02
family,
3:04
I
3:04
during
3:05
my
3:05
master's
3:05
degree
3:06
in
3:06
exercise
3:07
science
3:07
or
3:07
exercise
3:08
physiology,
3:08
which
3:09
really
3:09
had
3:10
me
3:10
thinking
3:10
that
3:10
I
3:10
would
3:11
have
3:11
a
3:11
career
3:11
devoted
3:12
to
3:12
muscle
3:13
tissue
3:13
and
3:14
muscle
3:14
metabolism.
3:15
But
3:15
in
3:15
the
3:16
course
3:16
of
3:16
that
3:17
thesis
3:17
work
3:17
I
3:18
stumbled
3:18
on
3:18
a
3:18
paper
3:19
that
3:19
had
3:19
just
3:20
recently
3:20
been
3:21
published
3:21
and
3:22
this
3:22
is
3:22
25
3:23
years
3:23
ago
3:24
ish
3:24
at
3:24
this
3:24
point.
3:25
And
3:26
the
3:26
paper
3:26
documented
3:28
a
3:28
phenomenon
3:29
that
3:29
was
3:29
an
3:29
absolute
3:30
revelation
3:30
to
3:30
me,
3:31
which
3:31
is
3:31
that
3:31
the
3:31
fat
3:32
cells
3:33
can
3:33
aggressively
3:34
secrete
3:35
pro
3:35
inflammatory
3:36
hormones
3:37
which
3:38
in
3:38
and
3:39
of
3:39
itself
3:39
was
3:39
fascinating.
3:40
The
3:40
fact
3:40
that
3:41
the
3:41
fat
3:41
cell
3:42
was
3:42
an
3:42
active
3:42
endocrine
3:43
organ.
3:43
I
3:43
had
3:44
no
3:44
idea
3:44
of
3:44
that
3:44
at
3:45
the
3:45
time.
3:45
I'd
3:45
never
3:45
learned
3:46
that.
3:46
But
3:46
during
3:47
the
3:47
course
3:47
then
3:48
of
3:48
my
3:48
dissertation,
3:49
which
3:50
was
3:50
my
3:50
dissertation
3:51
work
3:51
with
3:52
a
3:52
man
3:52
named
3:52
Linus
3:53
Dome,
3:53
my
3:54
work
3:54
was
3:55
looking
3:55
at
3:55
the
3:55
degree
3:56
to
3:56
which
3:56
inflammation
3:57
contributes
3:57
to
3:58
insulin
3:58
resistance.
3:59
And
3:59
in
3:59
fact
3:59
Linus
4:00
at
4:00
the
4:00
time
4:01
my
4:01
mentor,
4:01
whom
4:02
I
4:02
love
4:02
and
4:03
revere
4:04
to
4:04
this
4:04
day,
4:05
he
4:06
had
4:06
one
4:06
of
4:06
the
4:06
first
4:07
grants
4:08
funded
4:08
by
4:08
Johnson
4:09
and
4:09
Johnson
4:09
to
4:10
look
4:10
at
4:10
the
4:10
effects
4:11
of
4:11
these
4:11
incretins.
4:12
And
4:12
all
4:12
of
4:13
the
4:13
conversation
4:14
around
4:14
these
4:14
gut
4:14
derived
4:15
hormones
4:15
with
4:15
GLP1
4:16
then
4:17
and
4:17
even
4:17
now
4:17
still
4:18
being
4:18
the
4:18
most
4:18
famous,
4:19
was
4:19
focused
4:20
on
4:21
its
4:21
role
4:21
as
4:21
an
4:21
anti
4:22
diabetic.
4:23
But
4:23
there
4:24
was
4:24
this
4:24
side
4:24
effect,
4:24
there
4:25
was
4:25
this
4:25
known
4:25
phenomenon
4:26
that
4:26
people
4:27
on
4:27
these
4:27
drugs
4:27
tended
4:28
to
4:28
just
4:28
eat
4:28
a
4:29
little
4:29
less
4:29
and
4:29
would
4:29
thus
4:30
lose
4:30
a
4:30
little
4:30
weight.
4:31
And
4:31
that
4:32
became
4:32
of
4:32
course
4:33
the
4:33
fervor
4:34
that
4:34
we
4:34
find
4:34
the
4:35
world
4:35
enraptured
4:36
with
4:36
now,
4:36
which
4:37
is
4:37
this
4:37
idea
4:38
that
4:38
the
4:38
drugs
4:38
are
4:38
weight
4:39
loss
4:39
drugs.
4:40
So
4:40
I've
4:40
had
4:41
my
4:41
finger
4:41
on
4:41
the
4:41
pulse
4:42
of
4:42
these
4:42
drugs
4:43
for
4:44
over
4:44
20
4:44
years
4:45
now.
4:46
But
4:46
I
4:46
never
4:47
could
4:47
have
4:47
predicted,
4:48
in
4:48
fact
4:49
indeed
4:49
Brett,
4:49
if
4:49
I
4:50
had,
4:50
I
4:50
would
4:50
have
4:50
made
4:50
some
4:51
more
4:51
prudent
4:51
investments
4:52
to
4:52
secure
4:52
my
4:53
family's
4:53
financial
4:53
future.
4:54
I
4:54
never
4:55
could
4:55
have
4:55
imagined
4:57
the,
4:57
the
4:57
obsession
4:58
that
4:59
has
4:59
come
4:59
to
4:59
surround
5:00
what
5:00
was
5:01
what
5:01
had
5:01
long
5:01
been
5:02
known
5:02
as
5:02
just
5:02
a
5:03
pretty
5:03
effective
5:04
anti
5:04
diabetic.
5:05
Yeah,
5:05
I
5:05
think
5:05
it's
5:06
so
5:06
interesting
5:06
to
5:06
go
5:07
back
5:07
in
5:07
your
5:07
history
5:08
and
5:09
the,
5:09
the
5:09
concept
5:10
of
5:10
fat
5:10
being
5:11
an
5:11
endocrine
5:12
organ
5:12
and
5:12
actually
5:12
being
5:13
able
5:13
to
5:14
secrete
5:14
pro
5:14
inflammatory
5:15
marker
5:16
or
5:16
pro
5:16
inflammatory
5:17
hormones
5:17
and
5:18
chemicals
5:18
and.
5:18
And
5:19
you're
5:19
right,
5:19
that's
5:19
not
5:20
how
5:20
we're
5:21
taught
5:21
in
5:21
medical
5:22
school
5:22
or,
5:22
or
5:23
undergrad
5:23
or
5:24
you
5:24
know,
5:24
fat
5:24
is
5:24
just
5:25
something
5:25
that
5:25
is
5:25
stored
5:26
calories.
5:27
Basically.
5:28
You
5:28
don't,
5:29
it's
5:29
not
5:29
thought
5:29
of
5:30
so
5:30
much
5:30
as
5:30
being
5:30
active.
5:32
And
5:32
really
5:32
interesting
5:33
concept
5:33
about,
5:33
you
5:34
know,
5:34
GLP1s
5:34
have
5:34
been
5:35
on
5:35
the
5:35
radar
5:35
screen
5:35
for
5:36
a
5:36
long
5:36
time,
5:37
haven't
5:37
they?
5:37
We
5:37
think
5:37
they're
5:38
like
5:38
a
5:38
brand
5:38
new
5:38
drug,
5:39
but
5:39
it's
5:39
a
5:40
brand
5:40
new
5:40
formulation
5:41
and
5:41
a
5:41
brand
5:42
new
5:42
use.
5:42
And
5:43
there
5:44
was
5:44
actually
5:44
a
5:44
podcast
5:45
I
5:45
heard
5:46
not
5:46
too
5:46
long
5:46
ago
5:47
about
5:47
the
5:47
GLP1s,
5:48
about
5:48
sort
5:48
of
5:48
the
5:48
history
5:49
of
5:49
their
5:50
development
5:51
and
5:51
how
5:51
it
5:51
was
5:51
almost
5:51
scrapped.
5:52
Like
5:52
they
5:52
couldn't
5:53
quite
5:53
get
5:53
it
5:53
for
5:54
a
5:54
long
5:54
enough
5:54
half
5:54
life
5:55
and
5:55
a
5:55
high
5:55
enough
5:55
dose
5:56
and
5:56
like
5:56
it
5:57
sounded
5:57
like
5:57
it
5:57
was
5:57
so
5:57
close
5:58
to
5:58
being
5:58
scrapped,
5:58
but
5:59
then
5:59
of
5:59
course
5:59
turns
6:00
into
6:00
the
6:00
blockbuster
6:01
medication
6:01
that
6:01
it
6:02
is.
6:02
And,
6:02
and
6:03
a
6:03
very
6:03
effective
6:04
one.
6:04
Like,
6:04
we
6:04
have
6:04
to
6:05
be
6:05
be
6:06
honest,
6:06
like
6:06
people
6:06
are
6:07
losing
6:07
more
6:07
weight
6:08
on
6:08
these
6:08
medications
6:09
than
6:09
they've
6:09
lost
6:10
on
6:10
any
6:10
medication
6:11
in
6:11
the
6:11
past.
6:12
Now
6:12
the
6:12
question,
6:13
I
6:13
would
6:13
even
6:14
argue
6:14
that's.
6:15
That's
6:15
all
6:15
absolutely
6:16
amen.
6:17
They're
6:17
very
6:17
effective.
6:18
In
6:18
fact,
6:19
that's
6:19
really
6:20
why
6:20
I
6:20
think
6:20
we
6:21
need
6:21
a
6:21
little
6:21
bit
6:21
of
6:22
a
6:22
nuanced
6:23
view.
6:23
They're
6:24
too
6:24
effective.
6:25
Right,
6:26
Right.
6:26
So
6:26
let's
6:26
talk
6:27
about
6:27
that.
6:27
So
6:27
I
6:28
was
6:28
just.
6:28
So
6:29
the
6:30
fact
6:30
that
6:30
you
6:30
can
6:30
say
6:30
people
6:31
are
6:31
losing
6:31
more
6:31
weight
6:32
on
6:32
these
6:32
drugs
6:32
than
6:33
any
6:33
other
6:33
drug
6:34
in
6:34
the
6:34
history,
6:34
most
6:35
people
6:35
would
6:35
take
6:35
that
6:35
as
6:36
a
6:36
positive
6:36
thing,
6:37
was
6:37
to
6:37
say
6:37
you
6:37
don't
6:37
necessarily
6:38
see
6:38
that
6:39
as
6:39
an
6:39
overwhelming
6:40
positive
6:41
statement.
6:41
So
6:42
help
6:42
us
6:42
clarify
6:42
that.
6:43
Yeah,
6:43
yeah.
6:44
So
6:44
a
6:45
lot
6:45
of
6:45
my
6:45
view
6:45
on
6:46
the
6:46
current
6:46
use
6:47
of
6:47
these
6:47
drugs
6:48
is,
6:49
is
6:49
that
6:49
they
6:50
are,
6:50
they
6:50
are
6:50
a
6:51
little
6:51
too
6:51
much
6:51
of
6:51
a
6:51
good
6:52
thing.
6:52
So
6:52
with,
6:53
with
6:53
the
6:54
use
6:54
of
6:55
the
6:55
drug,
6:55
we
6:55
need
6:55
to
6:56
appreciate
6:56
what
6:56
GLP1
6:57
does.
6:58
And
6:58
GLP1
6:59
has
6:59
myriad
7:00
effects
7:00
throughout
7:00
the
7:00
body.
7:01
Yes.
7:01
On
7:01
the
7:01
alpha
7:02
cells
7:02
of
7:02
the
7:02
pancreas
7:03
regulating
7:04
glucagon.
7:05
Yes.
7:06
Receptors
7:06
on
7:07
the
7:07
intestine
7:08
regulating
7:09
the
7:09
movement
7:09
of
7:10
the
7:10
smooth
7:10
muscle,
7:10
or
7:11
in
7:11
other
7:11
words,
7:11
the
7:11
rate
7:11
at
7:12
which
7:12
food
7:12
is
7:12
moving
7:13
through
7:13
the
7:13
gut.
7:14
But
7:14
also
7:14
too,
7:15
there
7:15
are
7:15
effects
7:17
at
7:17
the
7:17
hypothalamus
7:18
in
7:18
the
7:18
brain
7:18
which
7:19
influence
7:19
satiety
7:20
and
7:20
hunger,
7:21
in
7:21
fact,
7:22
reducing
7:22
hunger,
7:23
promoting
7:23
a
7:23
sense
7:23
of
7:24
satiety.
7:24
And
7:25
when
7:25
you
7:25
combine
7:25
that
7:26
central
7:26
brain
7:26
effect
7:27
of
7:27
promoting
7:28
a
7:28
sense
7:28
of
7:29
fullness
7:30
with
7:31
the
7:31
slower
7:32
movement
7:32
of
7:33
food
7:33
through
7:33
the
7:33
intestines,
7:34
that
7:34
is
7:34
a
7:35
dynamite
7:35
combination
7:36
of
7:36
helping
7:37
someone
7:37
just
7:37
want
7:37
to
7:38
eat
7:38
less
7:39
now,
7:41
it
7:41
is
7:41
a
7:41
little
7:42
too
7:42
much
7:42
of
7:42
a
7:42
good
7:42
thing
7:43
where
7:43
you
7:43
are
7:44
starting
7:44
to
7:45
get.
7:46
There
7:46
are
7:46
enough
7:47
consequences
7:47
that
7:48
have
7:48
been
7:48
revealed
7:48
in
7:49
the
7:49
published
7:49
literature
7:50
that
7:50
I've,
7:51
I've
7:51
tried
7:51
to
7:52
be
7:52
a
7:52
voice
7:52
of,
7:52
of
7:53
caution.
7:53
But
7:54
I,
7:54
I
7:55
somewhat
7:55
regret
7:55
that
7:55
some
7:56
people
7:57
have,
7:57
have
7:57
assumed
7:58
that
7:58
I
7:58
am
7:58
just
7:58
universally
7:59
opposed.
8:00
I'm
8:00
actually
8:01
not
8:01
universally
8:02
opposed.
8:02
I
8:03
just
8:03
think
8:03
that
8:04
I
8:04
am
8:04
opposed
8:04
to
8:04
how
8:05
they're
8:05
currently
8:05
used,
8:06
which
8:06
is
8:07
that
8:07
the
8:07
dose
8:07
is
8:07
too
8:08
high
8:08
and
8:09
that
8:09
they
8:10
are
8:10
used,
8:10
they
8:11
are
8:11
prescribed
8:12
with
8:12
the
8:12
language
8:13
being
8:14
this
8:14
is
8:15
a
8:15
weight
8:15
loss
8:15
drug.
8:16
When,
8:16
when
8:16
I
8:17
actually
8:17
think
8:18
we,
8:19
we
8:19
don't
8:19
do
8:19
the
8:20
patient
8:20
any
8:20
good
8:21
when
8:21
we
8:21
describe
8:22
it
8:22
as
8:22
a
8:22
weight
8:22
loss
8:23
drug
8:23
because
8:24
we
8:24
ought
8:25
to
8:25
be
8:26
helping
8:26
using
8:27
it
8:27
in
8:27
a,
8:27
in
8:27
a
8:28
way
8:28
to
8:28
improve
8:28
habits.
8:29
Now
8:29
before
8:29
I
8:30
even
8:30
mention
8:30
the
8:30
habit
8:31
part
8:31
of
8:31
it
8:32
and
8:32
my
8:32
ideal
8:33
use
8:33
of
8:34
the
8:34
drug,
8:34
if
8:35
used
8:35
at
8:35
all,
8:36
I
8:37
just
8:37
want
8:37
to
8:37
mention
8:37
that
8:37
there
8:38
are
8:38
consequences
8:39
to
8:39
the
8:39
currently
8:40
prescribed
8:41
use
8:41
of
8:41
these
8:42
drugs,
8:42
including
8:42
a
8:43
significantly
8:43
elevated
8:44
risk
8:44
of
8:44
blindness
8:45
that
8:45
just
8:45
came
8:45
out
8:46
within
8:46
the
8:46
last
8:46
month,
8:47
a
8:47
twofold
8:48
increased
8:48
risk
8:48
of
8:49
blindness
8:50
and
8:50
the
8:50
consequences
8:51
on
8:52
overall
8:52
body
8:52
mass
8:53
where
8:54
a
8:54
two
8:54
year
8:55
trial
8:55
found
8:56
that
8:57
of
8:57
the
8:58
total
8:58
weight
8:58
lost,
8:59
roughly
9:00
40%
9:00
was
9:01
coming
9:01
from
9:01
fat
9:02
free
9:02
mass.
9:03
Now
9:03
that
9:03
doesn't
9:03
mean
9:03
it's
9:04
all
9:04
muscle
9:05
and
9:05
bone,
9:05
but
9:06
it
9:06
certainly
9:06
means
9:06
some
9:07
of
9:07
it
9:07
is
9:07
muscle
9:07
and
9:08
bone.
9:08
That
9:09
is
9:09
sobering
9:10
in
9:10
light
9:10
of
9:10
the
9:11
fact
9:11
that
9:11
over
9:12
70%
9:12
of
9:13
patients
9:13
in
9:13
the
9:13
United
9:14
States
9:14
get
9:15
off
9:15
the
9:15
drug
9:15
at
9:16
two
9:16
years
9:17
for
9:17
whatever
9:17
reason,
9:18
cost
9:19
or
9:19
access
9:20
or
9:20
they
9:20
get
9:21
tired
9:21
of
9:21
feeling
9:21
a
9:22
little
9:22
nauseous,
9:23
which
9:23
is
9:23
how
9:23
a
9:24
person
9:24
feels
9:24
when
9:24
the
9:24
stomach
9:25
slows
9:25
down
9:25
as
9:26
much
9:26
as
9:26
it
9:26
does.
9:27
And
9:27
what
9:27
do
9:27
they
9:28
gain
9:28
back?
9:29
Well,
9:29
the
9:29
human
9:29
body
9:30
will
9:30
readily
9:30
gain
9:31
back
9:31
fat,
9:32
but
9:32
depending
9:32
on
9:33
the
9:33
age
9:33
and
9:33
even
9:33
the
9:34
sex
9:34
of
9:34
the
9:34
individual,
9:35
they
9:35
may
9:35
never
9:35
gain
9:36
back
9:36
that
9:36
muscle
9:37
and
9:37
bone
9:37
mass,
9:38
even
9:38
as
9:38
modest
9:39
as
9:39
it
9:39
was,
9:39
that's
9:40
gone
9:40
probably
9:41
for
9:41
good.
9:42
And
9:43
one
9:43
last
9:44
nail
9:45
in
9:45
the
9:45
coffin
9:46
I
9:46
would
9:46
say
9:46
is
9:47
with,
9:47
with
9:47
regards
9:48
to
9:48
why
9:48
I'm
9:49
opposed
9:49
to
9:50
these
9:50
drugs
9:51
as
9:51
they're
9:51
currently
9:51
used
9:52
is
9:52
it's
9:52
the,
9:53
the
9:53
effect
9:54
on
9:55
emotional
9:55
well
9:56
being
9:56
where
9:57
we
9:57
often
9:59
hype
10:00
up
10:00
the
10:00
effects
10:01
of
10:02
the
10:02
food
10:03
noise,
10:03
where
10:04
the
10:04
person's
10:04
cravings
10:05
are
10:05
gone
10:06
for,
10:07
for
10:07
junk
10:07
food,
10:08
for
10:08
various
10:08
foods.
10:09
And
10:09
we'll
10:09
revisit
10:10
that
10:10
in
10:10
a
10:10
moment.
10:10
But
10:11
what
10:11
if
10:11
the
10:12
reality
10:12
is
10:12
that
10:13
their
10:13
cravings
10:14
for
10:15
many
10:15
things
10:15
they
10:16
used
10:16
to
10:16
enjoy
10:16
are
10:17
gone?
10:17
And
10:18
what
10:18
I
10:18
mean
10:18
by
10:18
that
10:19
is
10:19
there
10:19
is
10:20
an
10:20
over
10:21
about
10:21
a
10:22
200%
10:23
increased
10:23
risk
10:23
of
10:24
major
10:24
depression
10:25
in
10:25
these
10:25
individuals
10:26
on
10:26
the
10:26
drug
10:27
versus
10:27
placebo
10:28
as
10:28
well
10:28
as
10:28
an
10:29
over
10:29
100%
10:30
increased
10:30
risk
10:31
of
10:31
anxiety
10:32
and
10:32
even
10:32
suicidal
10:33
behaviors.
10:34
So
10:35
one
10:35
way
10:35
of
10:36
perhaps
10:36
more
10:37
honestly
10:37
describing
10:38
the
10:38
reduced
10:39
cravings
10:39
for
10:40
food
10:40
they
10:40
shouldn't
10:40
be
10:41
eating
10:41
may
10:42
be
10:42
to
10:42
say
10:42
that
10:42
you
10:43
just
10:43
aren't
10:43
going
10:43
to
10:44
like
10:44
anything
10:45
as
10:45
much
10:45
as
10:45
you
10:45
used
10:46
to
10:46
like,
10:47
in
10:47
other
10:47
words,
10:48
you
10:48
have
10:49
a
10:49
dude
10:49
who
10:50
is
10:50
less
10:50
interested
10:51
in
10:51
getting
10:51
together
10:51
with
10:52
his
10:52
guys,
10:52
his,
10:53
his
10:53
friends
10:53
to
10:53
go
10:54
bowling
10:54
or
10:54
you
10:55
have
10:55
a
10:55
gal
10:55
who's
10:56
less
10:56
interested
10:56
in
10:57
going
10:57
for
10:57
a
10:57
walk
10:58
around
10:58
the
10:58
block
10:59
with
10:59
her,
10:59
with
11:00
her
11:00
girlfriends
11:00
from
11:00
her
11:00
neighborhood
11:01
or
11:01
something.
11:02
And
11:02
so
11:03
you
11:03
have
11:03
people
11:03
who
11:04
just
11:04
may
11:04
be
11:04
less
11:04
interested
11:05
in
11:05
all
11:05
of
11:05
the
11:05
things
11:06
that
11:06
used
11:06
to
11:06
find
11:06
them,
11:07
to
11:07
bring
11:07
them
11:07
joy.
11:08
And
11:09
this
11:09
may
11:09
be
11:10
the
11:10
reality
11:11
that
11:11
explains
11:12
the
11:12
significant
11:13
effect
11:13
of,
11:14
on
11:14
mood
11:15
disorders.
11:16
So
11:16
that's
11:17
why
11:17
those
11:17
are
11:17
some
11:18
of
11:18
my
11:18
main
11:18
concerns
11:19
that
11:20
really
11:20
I
11:21
think
11:21
justify
11:22
some
11:23
heavy
11:23
caution
11:23
with
11:24
the
11:24
current
11:24
use
11:24
of
11:24
the
11:24
drugs.
11:25
Yeah,
11:25
it's
11:25
a
11:25
very
11:26
interesting
11:26
point
11:26
about
11:27
just
11:27
less
11:28
interest
11:28
in
11:29
everything
11:29
and
11:29
not
11:30
just
11:30
food.
11:30
I
11:31
hadn't
11:31
seen
11:31
so
11:31
much
11:32
about
11:32
that.
11:32
So
11:32
that's
11:32
very
11:33
interesting
11:33
to
11:33
hear
11:33
about.
11:34
And
11:34
we've
11:34
done
11:35
content
11:35
here
11:35
about
11:36
the
11:36
psychiatric
11:37
potential
11:37
impacts
11:38
with
11:38
some
11:39
studies
11:39
showing
11:40
no
11:40
worsening.
11:42
But
11:42
all
11:43
those
11:43
studies
11:43
exclude
11:44
anybody
11:44
with
11:45
any
11:45
kind
11:45
of
11:45
a
11:45
psychiatric
11:46
history.
11:46
And
11:47
those
11:47
that
11:47
don't,
11:47
sort
11:48
of
11:48
the
11:48
real
11:48
world
11:48
evidence
11:49
suggests
11:49
something
11:50
completely
11:50
different,
11:51
that
11:51
there
11:51
could
11:51
be
11:51
an
11:51
increased
11:52
risk
11:52
for
11:52
those
11:52
who
11:53
are
11:53
predisposed
11:54
to
11:54
depression
11:55
or
11:55
suicidality
11:56
or
11:56
whatever
11:56
the
11:56
case
11:56
may
11:57
be.
11:57
So
11:57
that's
11:57
really
11:57
interesting.
11:58
But
11:58
just
11:58
to
11:59
go
11:59
back
11:59
to
12:00
the
12:00
muscle
12:00
loss
12:01
or
12:01
the
12:02
lean
12:02
body
12:03
mass
12:03
loss,
12:05
you
12:05
know,
12:05
it
12:06
sort
12:06
of
12:06
highlights
12:06
that
12:07
weight
12:07
loss
12:07
isn't
12:08
necessarily
12:08
the
12:09
goal,
12:09
but
12:09
improved
12:10
metabolic
12:11
health
12:11
is
12:11
the
12:11
goal.
12:12
And
12:12
losing
12:13
fat
12:13
and
12:13
gaining
12:14
muscle
12:14
is
12:14
a
12:14
perfect
12:15
combination
12:15
for
12:16
improving
12:16
metabolic
12:17
health.
12:17
But
12:17
losing
12:18
fat
12:18
and
12:18
muscle
12:19
can
12:19
still
12:20
improve
12:20
metabolic
12:21
health
12:21
as
12:21
these
12:22
studies
12:22
have
12:22
shown.
12:22
But
12:23
makes
12:23
me
12:23
wonder
12:24
about
12:24
the
12:24
long
12:24
term
12:25
consequences
12:25
of
12:26
that
12:26
with,
12:26
with
12:26
decreased
12:27
muscle
12:27
mass.
12:28
And
12:29
then
12:29
to
12:29
throw
12:29
on
12:30
top
12:30
of
12:30
that
12:30
though,
12:30
some
12:30
people
12:31
are
12:31
saying,
12:31
well
12:32
it's
12:33
the
12:33
same
12:33
thing
12:33
with
12:34
weight
12:34
loss
12:34
surgery.
12:34
It's
12:35
the
12:35
same
12:35
thing
12:35
with
12:36
severe
12:36
caloric
12:37
restriction.
12:37
You
12:38
see
12:38
the
12:38
same
12:38
percentage
12:39
of
12:39
lean
12:39
mass
12:40
loss.
12:40
So
12:40
that
12:41
makes
12:41
it
12:41
okay.
12:41
So
12:42
I
12:42
want
12:42
to
12:42
get
12:42
your
12:42
impression
12:43
on
12:43
those
12:43
two
12:43
things,
12:44
both,
12:44
you
12:44
know,
12:45
justifying
12:45
it
12:46
that
12:46
way
12:46
and
12:46
also
12:46
the
12:46
impact
12:47
on
12:47
long
12:47
term
12:47
metabolic
12:48
health.
12:48
Yeah,
12:49
so
12:49
I,
12:49
I
12:49
do
12:50
think
12:50
it
12:50
is
12:50
appropriate
12:51
to
12:51
compare
12:51
the
12:52
use
12:52
of
12:52
the
12:52
GLP1
12:53
drugs
12:53
to
12:54
other
12:55
very
12:56
often
12:56
relied
12:57
on
12:57
weight
12:57
loss
12:58
interventions
12:58
like
12:59
gastric
13:00
bypass.
13:00
And
13:01
the,
13:03
the
13:03
other
13:03
one
13:03
you
13:03
mentioned.
13:03
It
13:04
was
13:04
gastric
13:04
bypass,
13:04
severe
13:05
caloric
13:05
restriction.
13:06
Very,
13:06
very
13:06
low
13:06
calorie
13:07
diet.
13:07
Yeah,
13:07
yeah,
13:07
that
13:08
actually
13:08
the
13:08
reason
13:09
I
13:09
mentioned
13:09
that
13:09
is
13:09
just
13:10
from
13:10
the
13:10
scientific
13:10
perspective,
13:11
which
13:11
is
13:12
that
13:12
it
13:12
helps
13:12
us
13:12
understand
13:14
how
13:14
a
13:14
person
13:15
is
13:15
losing
13:15
this
13:16
weight,
13:16
even
13:16
this
13:17
good
13:17
weight,
13:17
if
13:17
you
13:18
will,
13:18
the
13:18
lean
13:18
mass
13:18
potentially
13:19
on
13:19
the
13:19
drug
13:20
because
13:20
it
13:20
does
13:21
suggest
13:21
that
13:21
it's
13:21
not
13:21
a
13:22
direct
13:22
effect
13:22
of
13:23
the
13:23
drug
13:23
itself.
13:24
But
13:24
rather
13:25
an
13:25
artifact
13:26
of
13:26
the
13:27
fact
13:27
that
13:27
they're
13:27
just
13:27
not
13:27
really
13:28
eating
13:29
as
13:29
much
13:29
as
13:29
they
13:29
were
13:29
before.
13:30
And
13:30
even
13:30
maybe
13:31
what
13:31
they
13:31
are
13:31
eating
13:32
is
13:32
being
13:32
very
13:32
poorly
13:33
absorbed.
13:35
That's
13:35
certainly
13:35
part
13:35
of
13:36
the
13:36
consequence
13:36
of
13:37
so
13:37
significantly
13:38
slowing
13:39
the
13:39
rate
13:40
at
13:40
which
13:40
food
13:40
is
13:40
moving
13:40
through
13:41
the
13:41
intestine.
13:42
And
13:42
so
13:43
that's
13:43
an
13:44
interesting
13:44
just
13:44
point
13:44
for
13:45
people
13:45
to
13:45
take
13:45
away
13:45
from
13:46
how
13:46
you
13:46
phrased
13:47
the
13:47
question,
13:48
which
13:48
is
13:48
that
13:48
it
13:49
does
13:49
at
13:49
least
13:49
bring
13:49
some
13:50
comfort
13:50
to
13:50
the
13:50
fact
13:50
that
13:51
it's
13:51
not
13:51
a
13:51
direct
13:51
effect
13:52
of
13:52
the
13:52
drug,
13:53
for
13:53
example,
13:53
or
13:54
in
13:54
other
13:54
words,
13:54
it
13:55
doesn't
13:55
mean
13:55
the
13:55
semaglutide
13:56
is
13:57
somehow
13:57
directly
13:57
damaging
13:58
muscle
13:58
tissue,
13:59
but
13:59
again,
13:59
it's
14:00
rather
14:00
just
14:00
a
14:00
feature
14:01
of
14:01
the
14:01
overall
14:01
metabolic
14:02
milieu
14:02
of
14:02
someone,
14:03
of
14:03
someone
14:04
who
14:04
is
14:05
perhaps
14:05
poorly
14:06
nourishing
14:06
their
14:06
body.
14:07
Yeah,
14:07
but
14:08
further,
14:08
it's
14:09
not
14:09
like,
14:10
it's
14:10
not
14:10
like
14:11
those
14:11
interventions
14:12
severely,
14:13
severely
14:14
restricting
14:14
calories
14:14
and
14:15
undergoing
14:15
gastric
14:16
bypass
14:17
don't
14:17
have
14:17
a
14:18
rebound
14:18
themselves,
14:19
that
14:19
we
14:19
know
14:20
that
14:20
the
14:20
people
14:20
who
14:21
attempt
14:21
to
14:21
lose
14:22
weight
14:22
just
14:22
through
14:23
calorie
14:23
restriction
14:24
alone,
14:24
with
14:24
that
14:24
being
14:25
the
14:25
intention,
14:27
that's
14:28
also
14:28
the
14:28
intention,
14:28
that
14:29
is
14:29
the
14:29
mechanism
14:29
whereby
14:30
people
14:30
lose
14:30
weight
14:30
on
14:31
the
14:31
Biggest
14:31
Loser
14:32
game
14:32
show.
14:33
And
14:33
there's
14:33
a
14:33
reason
14:33
you
14:34
never
14:34
see
14:34
these
14:34
people
14:35
again,
14:35
because
14:36
once
14:36
they're
14:36
off
14:36
the
14:36
air,
14:37
they
14:37
can't
14:38
continue
14:39
this
14:39
starvation
14:40
induced
14:40
model.
14:41
And
14:41
then
14:42
hunger
14:42
always
14:42
wins.
14:43
Moreover,
14:44
even
14:44
the
14:44
rate
14:44
at
14:45
which
14:45
people
14:45
regain
14:46
weight
14:46
with
14:46
gastric
14:46
bypass
14:47
is
14:47
quite
14:47
sobering.
14:49
Where
14:50
they
14:51
can
14:51
start
14:51
to
14:51
out
14:51
eat
14:52
the
14:52
physical
14:53
restrictions
14:53
of
14:53
the
14:53
gut,
14:54
what
14:54
was
14:54
once
14:55
a
14:55
very
14:57
small
14:57
little
14:58
stomach
14:58
because
14:59
of
14:59
the
14:59
surgical
15:00
restriction
15:00
of
15:00
it,
15:01
the
15:01
intestines
15:02
have
15:02
this
15:02
remarkable
15:03
ability
15:03
to
15:03
be
15:04
somewhat
15:04
dynamic
15:05
or
15:05
plastic,
15:06
if
15:06
you
15:06
will,
15:06
and
15:06
then
15:06
they
15:07
can
15:07
start
15:07
to
15:07
stretch
15:07
out
15:08
again
15:08
with
15:08
repeated
15:09
stretching
15:10
and
15:10
before
15:10
the
15:10
person
15:11
knows
15:11
they're
15:11
back
15:11
to
15:12
eating
15:12
how
15:12
they
15:12
were
15:13
before
15:13
with
15:14
the
15:14
use
15:14
of
15:14
the
15:14
drug.
15:15
It's
15:15
actually
15:16
even
15:16
simpler
15:16
than
15:17
that,
15:17
which
15:17
is
15:18
that
15:19
this
15:19
phenomenon
15:20
of
15:20
diminishing
15:21
returns
15:22
where
15:22
you
15:22
have
15:22
too
15:22
much
15:23
of
15:23
a
15:23
signal,
15:23
in
15:23
fact
15:24
there
15:24
is
15:24
evidence
15:24
to
15:25
suggest
15:25
this,
15:26
although
15:26
it's
15:26
in
15:26
animals
15:27
that
15:27
with
15:27
repeated
15:28
GLP1
15:29
activation,
15:29
the
15:30
signal
15:30
starts
15:31
to
15:31
decay.
15:32
In
15:32
other
15:32
words,
15:33
too
15:33
much
15:33
of
15:33
a
15:34
signal
15:34
will
15:34
result
15:34
in
15:35
a
15:35
resistance
15:35
to
15:35
the
15:36
signal,
15:36
which
15:36
is
15:36
a
15:37
fundamental
15:37
principle
15:38
of
15:38
biology,
15:39
whether
15:39
it's
15:40
cancer
15:40
biology
15:40
and
15:41
chemotherapeutics,
15:42
whether
15:42
it's
15:42
antibiotics
15:43
to
15:43
treat
15:43
infections
15:44
and
15:44
even
15:45
hormones,
15:46
too
15:46
much
15:47
of
15:47
a
15:47
signal
15:47
will
15:48
result
15:48
in
15:48
the
15:48
decay
15:49
or
15:49
the
15:50
loss
15:50
of
15:50
that
15:50
signal
15:51
over
15:51
time.
15:51
And
15:51
GLP1
15:52
would
15:52
be
15:52
no
15:52
exception
15:53
to
15:53
this.
15:53
So
15:54
we
15:54
see
15:54
the
15:54
diminishing
15:55
returns
15:55
of
15:56
the
15:56
drug,
15:56
which
15:57
is
15:57
one
15:57
of
15:57
the
15:57
reasons
15:58
why
15:59
I
15:59
would
15:59
imagine
15:59
people
16:00
are
16:00
getting
16:00
off
16:01
it
16:01
at
16:01
such
16:01
a
16:01
high
16:01
rate
16:02
because
16:02
it
16:02
just
16:03
has.
16:03
It
16:03
stops
16:04
working
16:04
like
16:04
it
16:04
used
16:04
to.
16:05
Right.
16:05
If
16:05
you're
16:05
still
16:05
getting
16:06
the
16:06
side
16:06
effects
16:06
and
16:07
the.
16:07
And
16:07
the
16:07
bill
16:08
to
16:08
have
16:08
to
16:08
pay
16:09
for
16:09
it,
16:09
but
16:09
not
16:09
seeing
16:10
the
16:10
benefits,
16:10
why
16:10
would
16:10
you
16:11
continue
16:11
it?
16:11
Yeah,
16:12
well,
16:12
so
16:13
obviously
16:13
here
16:13
at
16:14
Metabolic
16:14
Mind,
16:14
we
16:15
focus
16:15
on
16:15
metabolic
16:16
health
16:16
and
16:16
mental
16:17
health.
16:17
And
16:17
the
16:18
reason
16:18
why
16:18
I
16:18
like
16:19
to
16:19
talk
16:19
so
16:19
much
16:19
about
16:19
these
16:20
medications
16:20
is
16:21
because
16:21
they
16:21
do
16:21
have
16:21
an
16:21
impact
16:22
on
16:22
metabolic
16:22
health,
16:23
but
16:23
also
16:24
that,
16:25
as
16:25
you
16:25
mentioned,
16:25
they
16:26
have
16:26
direct
16:26
brain
16:27
effects.
16:28
And
16:28
part
16:28
of
16:28
that
16:28
could
16:28
be
16:29
for
16:29
cravings.
16:29
Like
16:30
we
16:30
know
16:31
a
16:31
big
16:31
part
16:31
of
16:32
overeating
16:33
leading
16:33
to
16:33
obesity
16:34
and
16:34
type
16:34
2
16:34
diabetes
16:35
and
16:35
poor
16:35
metabolic
16:36
health
16:36
is
16:36
cravings
16:37
is
16:38
just,
16:39
you
16:39
could
16:39
say
16:39
the
16:39
brain
16:40
going
16:40
haywire,
16:41
so
16:41
to
16:41
speak.
16:41
And
16:41
it's
16:42
not
16:42
necessarily
16:43
willpower,
16:43
it's
16:44
not
16:44
necessarily
16:44
just,
16:45
you
16:45
know,
16:45
white
16:45
knuckle
16:45
it,
16:46
but
16:46
your
16:46
brain
16:47
is
16:47
almost
16:47
being
16:47
hijacked.
16:48
So
16:48
a
16:49
lot
16:49
of
16:49
what
16:49
you
16:49
wrote
16:50
in
16:50
this
16:50
article
16:50
of
16:51
maybe
16:51
a
16:51
new
16:52
way
16:52
to
16:52
use
16:53
these
16:53
GLP1s
16:54
focused
16:54
on
16:54
cravings.
16:55
So
16:55
tell
16:55
us
16:55
about,
16:55
about
16:56
that.
16:56
How,
16:56
how
16:57
you
16:57
got
16:57
into
16:57
that.
16:57
Yeah,
16:58
yeah,
16:59
it
16:59
was
16:59
a
16:59
paper.
17:00
So
17:00
I
17:00
need
17:00
to
17:00
give
17:01
some
17:01
credit
17:01
to
17:01
Arnie
17:02
Ostrup,
17:03
who
17:03
is
17:03
in
17:04
Denmark,
17:05
and
17:05
he
17:06
has
17:06
been
17:07
really
17:08
at
17:08
the
17:08
forefront
17:09
of
17:09
GLP1
17:09
research
17:10
maybe
17:11
since
17:11
its
17:11
inception.
17:12
I
17:12
was
17:13
at
17:13
an
17:13
event
17:13
with
17:13
him
17:13
and
17:14
he
17:14
had
17:14
mentioned
17:16
a
17:16
compelling
17:18
perspective,
17:18
which
17:19
now
17:19
in
17:19
hindsight
17:20
seems
17:20
obvious,
17:20
but
17:21
it's
17:21
not
17:21
one
17:21
that
17:21
I'd
17:21
considered,
17:22
which
17:23
is
17:23
that
17:23
he
17:23
had
17:23
said,
17:24
what
17:25
if
17:25
some
17:25
people
17:25
just
17:26
don't
17:26
have
17:26
a
17:26
sufficient
17:27
GLP
17:27
one
17:28
response
17:28
to
17:28
Food
17:29
and
17:30
that's
17:30
what's
17:30
driving
17:31
the
17:31
obesity
17:32
and
17:32
that
17:32
it
17:33
was
17:33
an
17:33
offhand
17:34
comment
17:34
and
17:34
I'm
17:34
sure
17:35
for
17:35
him
17:35
it
17:35
wasn't.
17:35
And
17:35
he
17:36
was
17:36
thinking
17:36
of
17:36
a
17:36
dozen
17:37
studies
17:37
that
17:37
he
17:38
could
17:38
readily
17:38
cite,
17:39
although
17:39
none
17:39
of
17:39
which
17:40
would
17:40
have
17:40
been
17:40
familiar
17:41
to
17:41
me
17:41
because
17:41
it
17:41
was
17:41
such
17:41
a
17:42
novel
17:42
view
17:42
for
17:42
me.
17:43
But
17:43
to
17:43
say
17:44
all
17:44
this
17:44
another
17:44
way,
17:45
there
17:45
was
17:45
a
17:45
paper
17:46
published
17:46
in
17:46
the
17:46
journal
17:47
Gut
17:47
by
17:48
Ranganath
17:49
et
17:49
al.
17:49
And
17:49
anyone
17:50
could
17:50
look
17:50
this
17:50
up.
17:50
It
17:51
is
17:51
fascinating
17:52
what
17:52
they
17:52
did
17:52
in
17:53
1996,
17:54
which,
17:54
Brett,
17:54
was
17:55
a
17:55
wonderful
17:55
year
17:55
to
17:55
graduate
17:56
from
17:56
high
17:56
school,
17:57
class
17:57
of
17:57
96,
17:59
but
17:59
also
17:59
also
18:00
a
18:00
fascinating
18:01
year
18:01
to
18:01
make
18:02
us
18:02
a
18:02
seminal
18:03
discovery
18:04
in
18:04
the
18:04
relevance
18:05
potentially
18:05
of
18:06
GLP1
18:07
when
18:07
it
18:07
comes
18:07
to
18:08
obesity
18:08
and
18:08
its
18:09
origins.
18:10
Neither
18:10
you
18:11
nor
18:11
I
18:11
are
18:12
saying
18:12
that
18:12
calories
18:12
don't
18:13
matter,
18:13
but
18:13
you
18:14
and
18:14
I
18:14
both
18:14
have
18:15
a
18:15
more
18:15
nuanced
18:16
view,
18:16
not
18:17
to
18:17
put
18:17
words
18:17
in
18:17
your
18:17
mouth,
18:18
but
18:18
that
18:18
there
18:18
needs
18:19
to
18:19
be
18:20
an
18:20
endocrine
18:20
component
18:21
that
18:21
allows
18:22
the
18:22
fat
18:22
cell
18:22
or
18:23
that
18:23
enables
18:23
the
18:23
fat
18:24
cell
18:24
to
18:24
even
18:24
store
18:24
that
18:25
energy
18:25
in
18:25
the
18:25
first
18:25
place,
18:26
and
18:26
that
18:26
would
18:26
be
18:26
the
18:26
hormone
18:26
insulin.
18:27
And
18:28
so
18:28
when
18:28
you
18:28
appreciate
18:29
the
18:29
necessity
18:30
of
18:30
insulin
18:30
telling
18:31
the
18:31
fat
18:31
cell
18:31
to
18:32
store
18:32
that
18:32
energy
18:33
and
18:33
then
18:33
the
18:33
need
18:34
for
18:34
sufficient
18:34
calories
18:35
to
18:35
fuel
18:36
that
18:36
storage
18:37
into
18:37
the
18:37
fat
18:38
cell,
18:38
it
18:39
does
18:39
leave
18:39
you
18:39
with
18:40
a
18:40
unique
18:40
perspective
18:41
that
18:42
has
18:42
you
18:42
say,
18:42
okay,
18:43
well
18:43
then
18:43
what
18:43
will
18:43
spike
18:44
insulin
18:44
the
18:44
most?
18:44
And
18:45
of
18:45
course
18:45
that's
18:45
going
18:45
to
18:45
be
18:45
dietary
18:46
carbohydrates.
18:47
Now,
18:47
to
18:47
bring
18:47
all
18:48
of
18:48
this
18:48
back
18:48
to
18:48
GLP1,
18:49
in
18:49
this
18:50
Ranganath
18:50
study
18:51
in
18:51
the
18:51
journal
18:51
Gut
18:51
in
18:52
1996,
18:53
they
18:53
took
18:53
people
18:54
and
18:54
separated
18:54
them
18:54
into
18:55
two
18:55
groups.
18:55
So
18:56
imagine
18:56
two
18:56
people.
18:56
Now,
18:57
I'm
18:57
oversimplifying,
18:58
but
18:58
one
18:59
is
18:59
lean,
18:59
one
18:59
is
18:59
obese.
19:00
They
19:00
eat
19:01
a
19:01
carbohydrate,
19:02
heavy
19:02
meal.
19:03
The
19:03
lean
19:03
guy
19:04
eats
19:05
that
19:05
same
19:05
amount
19:06
of
19:06
carbohydrate
19:06
and
19:07
his
19:08
brain
19:08
has
19:08
told
19:08
him,
19:08
you're
19:09
done,
19:09
you
19:09
don't
19:09
need
19:09
more.
19:10
And
19:10
so
19:10
he
19:11
pushes
19:11
the
19:11
plate
19:11
away,
19:11
he's
19:12
done,
19:12
he
19:12
gets
19:12
up
19:12
and
19:12
he
19:12
leaves.
19:13
But
19:13
his
19:13
buddy,
19:14
his
19:14
roommate,
19:15
his
19:15
college
19:15
roommate
19:16
eats
19:16
that
19:16
same
19:17
amount
19:17
of
19:17
carbohydrates.
19:18
And
19:19
he
19:19
does
19:19
not
19:19
get
19:19
the
19:19
signal
19:20
telling
19:20
him
19:21
to
19:21
stop.
19:21
In
19:22
fact,
19:22
not
19:22
only
19:22
does
19:22
he
19:23
not
19:23
get
19:23
the
19:23
stop
19:23
signal
19:24
as
19:24
GLP1
19:25
goes
19:25
down,
19:26
which
19:26
it
19:27
did
19:27
at
19:27
around
19:27
two
19:28
to
19:28
three
19:28
hours,
19:29
not
19:29
only
19:29
did
19:29
he
19:30
not
19:30
stop,
19:30
he
19:30
may
19:31
want
19:31
more.
19:32
And
19:32
now
19:32
we
19:33
have
19:33
this,
19:34
this,
19:34
I
19:35
think
19:35
an
19:35
alternate,
19:36
a
19:36
different
19:37
paradigm
19:37
here
19:38
when
19:38
we
19:38
look
19:38
at
19:38
GLP1
19:39
and
19:39
its
19:39
potential
19:39
utility.
19:41
Because
19:41
what
19:41
if,
19:41
based
19:42
on
19:42
that
19:42
study
19:43
and
19:43
others
19:43
like
19:44
it,
19:44
rather
19:45
than
19:45
saying
19:45
we're
19:46
going
19:46
to
19:46
give
19:46
you
19:46
this
19:47
drug
19:47
for
19:47
weight
19:48
loss,
19:48
the
19:48
individual
19:49
thinking
19:49
it
19:50
is
19:50
just
19:50
a
19:50
magic
19:51
intervention,
19:52
that
19:52
they
19:52
can
19:53
still
19:53
eat
19:53
whatever
19:54
they
19:54
want,
19:54
but
19:54
the
19:55
drug
19:55
is
19:55
going
19:55
to
19:55
help
19:55
them
19:55
lose
19:56
weight,
19:56
which
19:56
is
19:56
not
19:57
true.
19:58
The
19:58
drug
19:58
helps
19:59
the
19:59
person
19:59
lose
20:00
weight
20:00
as
20:00
it
20:00
changes
20:01
habits.
20:01
And
20:01
what
20:01
is
20:01
the
20:02
habit
20:02
that
20:02
it
20:02
perhaps
20:02
changes
20:03
the
20:03
most
20:03
when
20:04
it
20:04
comes
20:04
to
20:04
diet,
20:05
it
20:05
is
20:06
controlling
20:06
carbohydrate
20:07
consumption
20:08
or
20:08
the
20:08
cravings.
20:09
Because
20:09
within
20:10
the
20:10
scope
20:10
of
20:10
all
20:11
of
20:11
the
20:11
neurobiology
20:12
research
20:12
of
20:12
cravings,
20:14
there
20:14
is
20:14
no
20:14
evidence
20:14
that
20:15
humans
20:15
crave
20:15
fat.
20:16
There
20:16
is
20:17
no
20:17
evidence
20:17
that
20:17
they
20:17
crave
20:18
protein.
20:18
There
20:19
is
20:19
significant
20:19
and
20:20
consistent
20:20
evidence
20:21
that
20:21
they
20:21
crave
20:21
carbohydrates.
20:22
Now
20:23
someone
20:23
say,
20:23
well,
20:23
with
20:24
fat
20:24
makes
20:24
it
20:24
even
20:24
better.
20:25
Yeah,
20:25
but
20:25
still
20:26
carbohydrates
20:27
are
20:27
the
20:28
thing
20:28
that
20:28
they
20:28
crave
20:28
the
20:29
most.
20:29
And
20:29
we
20:29
intuitively
20:30
know
20:30
this.
20:30
No
20:31
one
20:32
is
20:32
sitting
20:32
down
20:33
and
20:33
craving
20:34
a
20:34
hard
20:34
boiled
20:35
egg.
20:35
You
20:36
know,
20:36
a
20:36
perfect
20:36
balance
20:37
of
20:37
fat
20:38
and
20:38
protein.
20:38
We
20:39
crave
20:40
carbohydrates.
20:41
The
20:41
saltier
20:42
and
20:42
crunchier,
20:43
the
20:43
better
20:43
or
20:43
the
20:44
sweeter
20:44
and
20:44
the
20:44
gooier.
20:45
The
20:45
best
20:45
of
20:46
all
20:46
perhaps,
20:47
but
20:47
it's
20:47
going
20:47
to
20:47
be
20:47
a
20:48
carbohydrate.
20:49
And
20:49
so
20:49
what
20:49
if
20:50
our
20:50
use
20:50
of
20:50
the
20:50
drug
20:52
influences
20:53
the
20:53
conversation
20:54
that
20:54
the
20:54
clinician
20:54
has
20:55
with
20:55
the
20:55
patient?
20:56
And
20:56
that's
20:56
maybe
20:57
to
20:57
sum
20:57
it
20:57
all
20:57
up
20:58
in
20:58
a
20:58
crystallized
20:59
way
21:00
here.
21:00
It
21:00
would
21:00
be
21:01
that
21:01
I
21:01
would
21:02
imagine
21:02
the
21:02
best
21:02
use
21:03
of
21:03
the
21:03
drug
21:03
being
21:03
a
21:03
clinician
21:04
who
21:04
sits
21:04
down
21:04
with
21:05
the
21:05
patient
21:06
and
21:06
then
21:07
explain,
21:07
you
21:07
know,
21:07
the
21:08
patient
21:08
doesn't
21:08
need
21:08
to
21:09
be
21:09
told
21:09
they're
21:09
overweight
21:10
or
21:10
unhealthy
21:10
because
21:11
of
21:11
it.
21:11
They
21:11
would
21:11
know
21:11
intuitively.
21:12
And
21:13
it
21:13
is
21:13
important
21:13
that
21:13
the
21:13
clinician
21:14
acknowledge
21:14
it
21:15
and
21:15
not
21:15
pretend
21:16
that
21:16
having
21:16
too
21:17
much
21:17
body
21:17
fat
21:17
is
21:18
benign.
21:18
But
21:19
they
21:19
say
21:21
you
21:22
need
21:22
to
21:22
learn,
21:23
you
21:23
need
21:23
to
21:23
change
21:24
the
21:24
way
21:24
you're
21:24
eating.
21:25
And
21:25
this
21:25
even
21:25
comes
21:25
back
21:26
to
21:26
an
21:26
earlier
21:26
part
21:26
of
21:26
our
21:27
conversation,
21:27
Brett,
21:27
where
21:27
I
21:28
said,
21:28
as
21:28
much
21:29
as
21:29
you
21:29
and
21:29
I
21:29
can
21:29
both
21:29
acknowledge
21:30
that
21:30
calories
21:30
matter,
21:32
that
21:32
should
21:32
not
21:32
be
21:32
the
21:32
beginning
21:33
of
21:33
the
21:33
conversation,
21:34
I
21:34
believe,
21:35
because
21:35
that
21:35
leads
21:36
to
21:36
hunger
21:36
and
21:36
just
21:36
pure
21:37
restriction.
21:37
What
21:38
we
21:38
ought
21:38
to
21:38
say
21:39
is,
21:39
let's
21:40
put
21:40
you
21:40
on
21:40
a
21:40
program
21:41
that's
21:41
going
21:41
to
21:41
help
21:41
lower
21:42
your
21:42
insulin,
21:43
because
21:43
when
21:43
you
21:43
lower
21:44
insulin,
21:44
the
21:44
body
21:44
will
21:45
be
21:45
burning
21:45
more
21:45
fat
21:46
and
21:46
metabolic
21:47
rate
21:47
will
21:47
go
21:48
up.
21:48
Thus
21:48
we
21:49
say,
21:49
don't
21:50
worry
21:50
about
21:50
your
21:50
calories,
21:51
just
21:51
control
21:52
your
21:52
insulin.
21:53
And
21:53
to
21:53
do
21:53
that,
21:53
most
21:54
effectively,
21:55
control
21:55
your
21:55
carbohydrates,
21:56
which
21:57
is
21:57
stop
21:57
getting
21:58
your
21:58
carbs
21:58
from
21:59
bags
21:59
and
21:59
boxes
21:59
with
22:00
barcodes.
22:01
Whole
22:01
fruits
22:01
and
22:01
vegetables.
22:02
Enjoy
22:02
them
22:02
liberally,
22:03
eat
22:03
them,
22:03
don't
22:03
drink
22:04
them,
22:04
but
22:04
stop
22:05
getting
22:05
these
22:05
refined
22:06
ultra
22:06
processed
22:07
carbs.
22:08
And
22:08
then
22:08
the.
22:08
The
22:09
seed
22:09
oil
22:09
crew
22:09
would
22:10
also
22:10
shit.
22:10
Nod
22:11
their
22:11
heads
22:11
to
22:11
that
22:11
because
22:12
that's
22:12
how
22:12
we
22:12
mostly
22:12
get
22:13
our
22:13
seed
22:13
oils
22:13
at
22:13
the
22:14
same
22:14
time,
22:14
within
22:15
those
22:15
packages
22:16
of
22:16
refined
22:16
carbs.
22:17
Right.
22:17
So
22:18
that
22:18
puts
22:18
an
22:18
extra
22:19
layer
22:19
on
22:19
sort
22:19
of
22:19
what
22:20
you
22:20
were
22:20
saying
22:20
about
22:20
this
22:21
study,
22:21
though,
22:21
because,
22:22
you
22:22
know,
22:23
same
22:23
time
22:23
we're
22:24
saying
22:24
that
22:24
they
22:24
were
22:25
craving
22:25
the.
22:25
Or
22:25
that
22:26
the,
22:26
the
22:26
GLP
22:27
one
22:27
did
22:27
not
22:28
go
22:28
up
22:28
with
22:29
the
22:29
carbs
22:30
and
22:30
they
22:30
were
22:30
craving
22:31
carbs
22:31
at
22:32
the
22:32
same
22:32
time.
22:32
They're
22:32
not
22:33
craving
22:33
probably
22:34
broccoli
22:34
and
22:35
beans
22:35
or
22:35
lentils.
22:36
Right.
22:36
They're
22:36
craving
22:37
the
22:37
more
22:37
refined
22:38
carbs
22:38
and
22:39
the
22:39
processing,
22:40
which
22:40
is
22:40
actually
22:40
really
22:40
interesting
22:41
because
22:41
now,
22:42
you
22:42
know,
22:43
so
22:43
many
22:43
people
22:43
are
22:43
focusing
22:44
on
22:45
the
22:45
processing
22:46
itself
22:46
and
22:46
it's
22:47
the
22:47
processing
22:47
and
22:47
maybe
22:48
focusing
22:48
less
22:49
on
22:49
the
22:49
fact
22:49
that
22:50
it's
22:50
carbohydrate
22:51
and
22:51
its
22:51
effect
22:52
on
22:52
insulin.
22:53
So
22:53
there
22:53
does
22:53
seem
22:54
to
22:54
be
22:54
like
22:55
a
22:55
little
22:55
bit
22:55
of
22:55
a
22:55
balance,
22:56
but
22:56
it
22:56
seems
22:57
like
22:57
GLP1
22:57
might
22:57
be
22:58
the
22:58
equalizer
22:58
for
22:58
that.
22:59
Do
22:59
you
22:59
think
22:59
it.
23:00
Because
23:00
it
23:00
addresses
23:01
both.
23:01
Yeah,
23:01
yeah,
23:02
that's.
23:02
I
23:03
think
23:03
so.
23:03
I
23:03
think
23:04
so,
23:04
Brett.
23:04
I,
23:04
in
23:05
fact,
23:05
that.
23:05
That
23:05
Question
23:05
sort
23:06
of
23:06
allows
23:06
me
23:06
to
23:07
sort
23:07
of
23:08
complete
23:08
that,
23:08
that
23:08
this
23:09
whole
23:09
long
23:09
ranting
23:10
thought,
23:11
which
23:11
is
23:11
that
23:12
I
23:12
think
23:12
the
23:12
best
23:12
use
23:13
of
23:13
the
23:13
drug
23:13
is
23:13
when
23:14
the
23:14
clinician
23:14
tells
23:14
the
23:15
patient,
23:15
you
23:16
need
23:16
to
23:16
control
23:16
your
23:16
carbs.
23:17
But
23:17
there
23:18
will
23:18
be
23:18
some
23:18
people
23:19
who
23:19
will
23:19
say
23:19
back
23:19
to
23:20
the
23:20
clinician,
23:20
maybe
23:21
even
23:21
having,
23:21
after,
23:22
after
23:22
having
23:23
attempted,
23:25
they
23:25
will
23:25
say,
23:25
I
23:25
just
23:25
can't
23:26
do
23:26
it.
23:26
I
23:27
am
23:27
trying
23:27
to
23:27
control
23:28
my
23:28
carbs.
23:29
Then
23:29
the
23:29
clinician
23:30
can,
23:30
with
23:30
nothing
23:30
but
23:31
empathy,
23:31
say,
23:31
all
23:32
right,
23:32
to
23:33
some
23:33
degree
23:33
or
23:33
another,
23:33
you're
23:34
addicted
23:35
now
23:35
let's
23:35
help
23:36
you
23:36
with
23:36
your
23:36
addiction.
23:37
And
23:37
so
23:37
here's
23:38
a
23:38
drug
23:38
at
23:39
what
23:39
we
23:39
could
23:39
call
23:40
a
23:40
microdose,
23:41
you
23:41
know,
23:41
a
23:42
fraction
23:42
of
23:42
what
23:42
it's
23:43
commonly
23:43
used
23:43
at
23:44
now.
23:44
And
23:45
then
23:45
I'm
23:45
going
23:45
to
23:45
cycle
23:46
you
23:46
on
23:46
this
23:46
for,
23:46
I
23:47
don't
23:47
know,
23:47
90
23:48
days.
23:49
And
23:50
then
23:50
during
23:50
this
23:50
time
23:51
will
23:51
be
23:51
checking
23:52
in
23:52
with
23:52
you
23:53
to
23:53
determine
23:53
how
23:54
well
23:54
you're
23:54
doing
23:54
at
23:54
controlling
23:55
your
23:55
carbohydrate
23:56
cravings.
23:57
The
23:57
thing
23:57
that
23:57
humans
23:58
crave
23:58
the
23:58
most
23:58
when
23:58
it
23:58
comes
23:59
to
23:59
nutrition.
24:00
And
24:01
many
24:01
people
24:01
I
24:02
have
24:02
known,
24:02
this
24:03
is
24:03
anecdotal,
24:03
which
24:04
pains
24:04
a
24:04
scientist
24:05
to
24:05
invoke,
24:06
but
24:07
I've
24:07
known
24:07
individuals
24:08
who
24:08
do
24:08
a
24:08
90
24:08
day
24:09
protocol
24:10
and
24:10
when
24:10
they
24:11
wean
24:11
themselves
24:11
off,
24:12
they
24:12
cycle
24:12
off
24:12
the
24:13
drug.
24:13
The
24:13
habits
24:14
have
24:14
persisted.
24:15
And
24:15
there
24:15
is
24:16
something
24:17
powerful
24:17
about
24:17
that
24:17
90
24:18
days.
24:18
When
24:18
it
24:18
comes
24:18
to
24:18
changing
24:19
habits
24:19
and
24:19
breaking
24:20
addictions.
24:21
Some
24:21
people
24:21
will
24:21
find
24:22
that
24:22
they
24:22
can
24:23
get
24:23
off
24:23
and
24:23
they're,
24:24
and
24:24
they
24:24
have
24:24
a
24:24
new
24:24
normal.
24:25
They've,
24:25
they've
24:26
rewired
24:27
their
24:27
habits,
24:27
if
24:28
you
24:28
will.
24:28
Some
24:29
people
24:29
will
24:29
be
24:30
good,
24:30
but
24:30
then
24:30
they'll
24:31
find
24:31
the
24:31
craving
24:31
starting
24:32
to
24:32
come
24:32
back.
24:32
Okay,
24:33
no
24:33
problems,
24:33
cycle
24:34
them
24:34
back
24:34
on.
24:35
And
24:35
so
24:35
overall,
24:36
my
24:37
view
24:37
and
24:38
the
24:38
perspective
24:38
that
24:38
I
24:38
attempted
24:39
to
24:39
articulate
24:40
in
24:40
that
24:40
article,
24:41
which
24:41
was
24:42
a
24:42
good
24:42
experience
24:42
for
24:42
me,
24:42
a
24:43
good
24:43
exercise
24:43
to
24:44
actually
24:44
crystallize
24:45
these
24:45
thoughts,
24:46
it
24:46
is
24:46
that
24:47
the
24:47
drugs
24:48
are
24:48
very
24:48
powerful
24:49
and
24:49
thus
24:49
could
24:50
be
24:50
effective
24:50
at
24:51
a
24:51
lower
24:51
dose
24:51
if
24:52
framed
24:52
in
24:53
the
24:53
context
24:53
of
24:54
this
24:54
is
24:54
a
24:54
drug
24:54
that's
24:55
helping
24:55
you
24:55
control
24:55
your
24:56
cravings,
24:56
not
24:57
framed
24:58
as
24:58
a
24:58
weight
24:58
loss
24:58
drug.
24:59
And
24:59
then
24:59
second,
25:00
presenting
25:01
the
25:01
idea
25:02
that
25:02
this
25:02
is
25:02
a
25:03
temporary
25:03
intervention.
25:04
You're
25:04
not
25:05
on
25:05
this
25:05
forever,
25:06
so
25:06
you
25:06
need
25:06
to
25:06
be
25:07
deliberate
25:07
about
25:07
the
25:07
habits
25:08
that
25:08
you're
25:08
changing
25:09
and
25:09
the
25:09
decisions
25:09
you're
25:10
making.
25:10
Because
25:10
in
25:11
90
25:11
days
25:11
I'm
25:11
going
25:12
to
25:12
want
25:12
to
25:12
start
25:12
to
25:12
cycle
25:13
you
25:13
off
25:13
this
25:14
to
25:14
see
25:14
how
25:15
well
25:15
the
25:15
habits
25:16
have
25:16
become
25:16
a
25:16
new
25:16
normal
25:17
for
25:17
you.
25:17
So
25:18
to
25:18
me,
25:19
the
25:19
best
25:19
use
25:20
of
25:20
this
25:21
self
25:21
discipline
25:22
in
25:22
a
25:22
syringe
25:23
is
25:23
to
25:23
look
25:24
at
25:24
it
25:24
as
25:24
a
25:24
temporary
25:25
enhancement
25:26
to
25:27
overcome
25:27
addictions
25:28
rather
25:28
than
25:28
this
25:29
is
25:29
your
25:29
new
25:29
normal
25:29
and
25:30
you're
25:30
going
25:30
to
25:30
be
25:30
drugged
25:30
for
25:31
life.
25:31
Right.
25:32
And
25:32
not
25:32
just,
25:33
well
25:33
here,
25:34
now
25:34
you're
25:34
going
25:34
to
25:34
eat
25:35
less
25:35
of
25:36
the
25:36
standard
25:36
American
25:37
diet
25:37
or
25:37
now
25:37
you're
25:38
going
25:38
to
25:38
eat
25:38
less
25:39
of
25:39
the
25:40
very
25:40
high
25:40
carb
25:40
diet,
25:41
but
25:41
rather
25:41
this
25:42
is
25:42
the
25:42
way
25:42
to
25:42
curb
25:43
your
25:43
cravings
25:43
and
25:44
your
25:44
addiction
25:44
so
25:44
that
25:45
you
25:45
can
25:45
transition
25:45
to
25:46
a
25:46
lower
25:47
carb.
25:47
Lower
25:47
carb
25:48
diet,
25:48
which
25:48
will
25:48
then
25:49
impact
25:49
your
25:49
insulin
25:50
and
25:50
your
25:50
fat
25:50
burning
25:51
and
25:51
lead
25:52
you
25:52
to
25:52
better
25:52
metabolic
25:53
health.
25:53
And
25:54
as,
25:54
as
25:54
you
25:55
pointed
25:55
out,
25:55
and
25:55
and
25:56
so
25:56
have
25:56
I
25:56
in
25:56
numerous
25:57
studies,
25:57
the
25:58
weight
25:58
loss
25:58
from
25:58
a
25:59
ketogenic
25:59
diet
26:00
is
26:00
generally
26:01
preserving
26:02
of
26:02
the
26:02
lean
26:03
mass
26:03
or
26:03
certainly
26:04
losing
26:04
a
26:04
lot
26:05
less
26:05
of
26:05
the
26:05
lean
26:05
mass.
26:06
So
26:06
it
26:06
seems
26:06
like
26:07
this
26:07
is
26:07
a
26:07
way
26:07
to
26:08
really
26:08
move
26:08
towards
26:09
greater
26:10
metabolic
26:10
health.
26:11
Is
26:11
that
26:11
how
26:11
you
26:11
see
26:12
it
26:12
as
26:12
well?
26:12
Yeah,
26:13
yeah,
26:13
yeah,
26:13
right.
26:13
In
26:14
fact,
26:14
that's
26:14
a
26:14
great
26:14
ending
26:15
there,
26:15
as
26:15
you
26:15
said
26:16
it,
26:16
because
26:16
earlier
26:17
you'd
26:17
sort
26:17
of
26:17
phrase
26:18
this
26:18
question
26:19
of
26:20
are
26:20
all
26:20
weight
26:21
loss
26:21
interventions
26:21
going
26:22
to
26:22
result
26:22
in
26:22
the
26:22
same
26:22
degree
26:23
of
26:23
lean
26:23
mass
26:24
loss?
26:24
And
26:25
no,
26:25
if
26:25
you
26:26
can
26:26
be
26:27
adequately
26:27
nourishing
26:28
the
26:28
body
26:28
with
26:29
all
26:29
of
26:29
what
26:30
it
26:30
needs,
26:30
vitamins,
26:31
minerals,
26:31
et
26:31
cetera,
26:32
and
26:33
not
26:33
driving
26:34
it
26:34
into
26:35
an
26:35
an
26:36
overt
26:36
caloric
26:37
deficit,
26:38
but
26:38
yet
26:39
insulin
26:39
is
26:40
low,
26:40
you
26:41
are
26:41
creating
26:41
an
26:42
environment
26:42
that
26:42
does
26:43
facilitate
26:43
uniquely
26:44
fat
26:44
loss
26:45
versus
26:46
muscle
26:46
loss.
26:47
And,
26:47
and
26:47
so
26:48
the,
26:48
in
26:48
fact
26:48
my
26:49
lab
26:49
published
26:49
a
26:49
report
26:50
finding
26:50
that
26:50
ketones
26:51
are
26:51
actually
26:52
muscle
26:53
preserving
26:53
at
26:53
a,
26:54
as
26:54
a
26:54
direct
26:54
signaling
26:55
molecule
26:56
that
26:56
where
26:56
beta
26:57
hydroxybutyrate
26:58
actually
26:59
inhibited
27:01
the,
27:01
we
27:01
gave
27:01
it
27:02
the
27:02
muscles
27:02
a
27:02
chemical
27:03
insult
27:03
and
27:03
beta
27:04
hydroxybutyrate
27:05
actually
27:05
made
27:05
the
27:05
muscle
27:06
cells
27:06
more
27:06
robust
27:07
and
27:07
resistant
27:08
to
27:08
injury.
27:09
So
27:09
we
27:09
have
27:09
evidence
27:09
right
27:10
at
27:10
the
27:10
level
27:10
of
27:10
the
27:10
cell.
27:11
Not
27:11
to
27:11
mention
27:12
the
27:12
significant
27:13
commentary
27:14
of
27:14
decades
27:14
of
27:14
work
27:15
from
27:15
Dr.
27:15
George
27:15
Cahill,
27:16
who
27:16
would
27:17
often
27:17
refer
27:17
to
27:18
ketones
27:18
as
27:18
the
27:18
great
27:19
muscle
27:19
preserving
27:20
molecule,
27:21
that
27:21
they're
27:21
muscle
27:21
sparing.
27:22
But
27:22
yeah,
27:23
I
27:23
think
27:23
it's
27:23
not
27:24
a
27:24
stretch
27:24
to
27:24
then
27:24
say
27:25
well
27:25
with
27:25
the,
27:25
with
27:26
a
27:26
ketogenic
27:27
low
27:27
carb
27:27
diet,
27:28
with
27:28
the
27:29
intention
27:29
being
27:29
I'm
27:30
just
27:30
lowering
27:30
my
27:31
insulin,
27:31
I'm
27:32
not
27:32
lowering
27:32
my
27:32
calories
27:33
per
27:34
se.
27:35
You're
27:35
going
27:35
to
27:35
find
27:36
I
27:36
think
27:36
yourself
27:36
in
27:37
a
27:38
very
27:38
superior
27:39
metabolic
27:40
environment
27:40
to
27:40
promote
27:41
selectively
27:41
greater
27:42
fat
27:42
loss.
27:42
Yeah,
27:43
and
27:43
I
27:43
think
27:43
that's
27:44
so
27:44
important
27:44
to
27:44
emphasize
27:45
that
27:45
it's
27:45
not
27:46
weight
27:46
loss,
27:46
it's
27:46
fat
27:47
loss,
27:47
especially
27:47
visceral
27:48
fat,
27:48
maintaining
27:49
lean
27:49
muscle
27:50
mass.
27:50
And
27:50
you
27:50
just
27:50
set
27:50
it
27:50
up
27:51
perfectly
27:51
for,
27:51
for
27:52
a
27:52
way
27:52
to
27:52
do
27:52
that.
27:53
Fellow
27:53
mental
27:54
health
27:54
clinicians
27:54
and
27:55
healthcare
27:55
providers,
27:56
you
27:56
now
27:56
have
27:56
access
27:57
to
27:57
a
27:57
suite
27:58
of
27:58
free
27:58
CME
27:59
lectures
27:59
on
28:00
metabolic
28:00
psychiatry
28:01
and
28:01
metabolic
28:02
health.
28:02
Each
28:02
of
28:03
these
28:03
CME
28:03
sessions
28:04
provide
28:04
insight
28:05
on
28:05
incorporating
28:05
Metabolic
28:06
therapies
28:06
for
28:06
mental
28:07
illnesses
28:07
into
28:08
your
28:08
practice.
28:08
These
28:09
CME
28:09
sessions
28:10
are
28:10
approved
28:10
for
28:10
AMA
28:11
Category
28:11
1
28:12
credits,
28:12
CNE
28:13
nursing
28:14
credit
28:14
hours
28:14
and
28:15
continuing
28:15
education
28:15
credit
28:16
for
28:16
psychologists.
28:17
And
28:18
they're
28:18
completely
28:18
free
28:18
of
28:18
charge
28:19
on
28:19
mycme.com
28:20
now
28:21
back
28:21
to
28:21
the
28:21
video.
28:22
Now,
28:23
you
28:23
know,
28:24
a
28:24
lot
28:24
of
28:25
studies
28:25
that
28:26
involve
28:26
pharmaceuticals
28:27
and
28:27
medications
28:28
are
28:28
sponsored
28:29
and
28:29
paid
28:30
for
28:30
by
28:30
the
28:31
pharmaceutical
28:31
company.
28:32
And
28:32
that's
28:32
why
28:32
they
28:32
get
28:33
done
28:33
quickly
28:34
and
28:34
with,
28:34
you
28:35
know,
28:35
thousands
28:36
and
28:36
thousands
28:36
of
28:36
people.
28:37
But
28:37
for
28:38
a
28:38
study
28:38
for
28:39
what
28:39
you're
28:39
proposing,
28:40
it
28:40
probably
28:41
wouldn't
28:41
be
28:41
to
28:41
the
28:42
benefit
28:42
of
28:42
the
28:42
pharmaceutical
28:43
company
28:43
because
28:43
it's
28:44
a
28:44
much
28:44
lower
28:44
dose
28:45
and
28:45
for
28:45
a
28:45
short
28:46
time,
28:46
as
28:46
opposed
28:46
to
28:46
the
28:47
current
28:47
high
28:48
dose,
28:48
take
28:48
it
28:48
forever,
28:49
see
28:49
you
28:49
later,
28:49
which
28:50
obviously
28:50
benefits
28:51
the
28:51
pharmaceutical
28:51
company.
28:52
So
28:52
do
28:52
you
28:53
think
28:53
labs
28:53
will
28:53
start
28:54
doing
28:54
research
28:54
studies
28:55
on
28:55
this?
28:56
They'd
28:56
have
28:56
to
28:56
get
28:56
NIH
28:57
funding
28:57
or
28:58
philanthropy
28:58
funding
28:59
or
28:59
whatnot.
28:59
But
28:59
do
28:59
you
28:59
think
28:59
more
29:00
will
29:00
be
29:00
doing
29:00
it
29:00
and
29:00
will
29:01
your
29:01
lab
29:01
be
29:01
doing
29:01
it?
29:01
Yeah.
29:02
Yeah,
29:02
good
29:02
question.
29:03
So
29:03
we
29:03
are
29:04
currently
29:04
actually
29:04
analyzing
29:05
a
29:05
data
29:05
set
29:06
from
29:06
a
29:06
clinic.
29:07
So
29:07
I
29:07
had
29:07
a
29:07
clinician
29:08
reach
29:08
out
29:08
to
29:08
me
29:09
who
29:09
has
29:10
been
29:10
using
29:11
low
29:11
dose
29:12
semaglutide
29:13
with
29:14
a
29:14
combined
29:15
low
29:15
carb
29:15
diet
29:16
and
29:16
their
29:16
results
29:16
outperform
29:18
even
29:18
the
29:18
reported
29:19
results
29:19
of
29:19
just
29:19
semaglutide
29:20
alone.
29:20
And,
29:21
and
29:21
again,
29:22
what
29:22
the
29:23
patient
29:23
finds
29:24
so
29:24
enjoyable
29:25
is
29:25
the
29:25
fact
29:25
that
29:26
they're
29:26
not
29:26
expected
29:27
to
29:27
be
29:28
on
29:28
the
29:28
drug
29:28
indefinitely.
29:30
I
29:30
think
29:31
that
29:31
is,
29:31
I
29:31
think
29:31
that's
29:32
common
29:32
as
29:32
as
29:33
much
29:33
as
29:33
we
29:33
have
29:33
a
29:33
culture,
29:34
particularly
29:34
in
29:35
the
29:35
US
29:35
where
29:36
people
29:36
are
29:36
able
29:36
to
29:36
see
29:37
advertisements
29:38
for
29:38
drugs
29:38
so
29:39
much
29:39
more
29:39
readily
29:39
than
29:39
almost
29:40
any
29:40
other
29:40
in
29:40
any
29:41
other
29:41
country
29:41
on
29:41
the
29:41
planet,
29:42
we
29:43
certainly
29:43
have
29:43
a
29:43
more
29:43
drug
29:44
friendly
29:44
culture
29:46
in
29:47
clinical
29:47
care
29:48
where
29:48
the
29:48
patient
29:48
comes
29:49
in
29:49
asking
29:49
for
29:50
a
29:50
drug,
29:50
which
29:50
is
29:51
very
29:51
odd
29:51
in
29:52
the
29:52
rest
29:52
of
29:52
the
29:52
world
29:53
because
29:53
they've
29:53
seen
29:53
an
29:54
ad.
29:54
But
29:54
even
29:55
then
29:55
I
29:56
don't
29:56
think
29:56
a
29:56
person
29:57
would
29:57
want
29:57
to
29:57
be
29:58
on
29:58
the
29:58
drug
29:58
indefinitely.
29:59
So
30:00
this
30:00
all
30:00
comes
30:00
back
30:01
to
30:01
what
30:01
I
30:01
mentioned
30:01
earlier,
30:01
that
30:02
I
30:02
think
30:02
a
30:02
lot
30:02
of
30:02
the
30:03
value
30:03
in
30:03
this
30:03
alternative
30:04
paradigm
30:04
of
30:05
the
30:05
use
30:05
of
30:05
the
30:05
drug,
30:05
namely
30:06
microdosing
30:07
and
30:07
cycling,
30:08
is
30:08
that
30:08
it
30:09
changes
30:09
the
30:11
purpose
30:12
of
30:12
the
30:12
drug,
30:12
that
30:13
the
30:13
person
30:13
is
30:13
looking
30:13
at
30:14
it
30:14
as
30:14
you
30:15
are
30:15
a
30:15
temporary
30:16
tool,
30:17
you
30:17
little
30:17
syringe,
30:18
to
30:18
help
30:18
me
30:19
learn
30:19
to
30:19
change
30:19
my
30:19
habits.
30:20
But
30:20
that
30:20
still
30:21
requires
30:21
some
30:22
effort
30:22
on
30:22
their
30:22
part.
30:24
It's
30:24
not
30:24
depriving
30:25
them
30:25
of
30:25
the
30:25
benefit
30:26
of
30:26
learning
30:27
that
30:27
self
30:27
discipline,
30:28
which
30:28
I
30:28
think
30:28
is
30:28
one
30:28
of
30:29
the
30:29
points
30:29
of
30:29
life
30:30
in
30:30
a
30:30
kind
30:30
of
30:30
grander
30:31
sense,
30:32
which
30:32
is
30:32
to
30:33
just
30:33
there's,
30:34
you
30:34
know,
30:34
to
30:34
me
30:35
telling
30:35
my
30:35
body,
30:36
hey,
30:36
you
30:37
fleshy
30:37
tabernacle
30:38
of
30:39
clay,
30:39
you're
30:40
not
30:40
in
30:40
charge.
30:40
I
30:41
am
30:41
the
30:41
part
30:41
of
30:41
me
30:41
that
30:42
is
30:42
beyond
30:43
this,
30:43
this
30:43
fleshy
30:44
body.
30:45
And
30:45
I
30:45
don't
30:45
like,
30:46
and
30:46
I
30:46
think
30:46
it's
30:46
human
30:47
nature,
30:47
we
30:47
don't
30:47
like
30:48
feeling
30:48
addicted
30:48
to
30:48
things.
30:49
We
30:49
don't
30:50
like
30:50
feeling
30:50
dependent
30:51
on
30:51
things.
30:51
Even
30:51
if
30:51
it
30:52
is
30:52
the
30:52
intervention
30:53
that's
30:53
helping
30:53
us
30:53
curb
30:54
the
30:54
addiction,
30:55
we
30:55
would
30:55
like
30:56
to
30:56
get
30:56
over
30:56
both
30:56
of
30:57
them.
30:57
We
30:57
want
30:57
to
30:58
stop
30:58
using
30:58
the
30:59
intervention
30:59
because
31:00
we've
31:00
learned
31:00
to
31:00
control
31:01
our
31:01
addictions.
31:02
Yeah,
31:02
yeah,
31:03
I
31:03
think
31:03
that's
31:03
really
31:03
well
31:04
said.
31:04
And
31:04
I
31:04
think
31:04
the
31:05
way
31:05
you're
31:05
proposing
31:06
it
31:07
is,
31:07
is
31:07
almost
31:08
like
31:08
a,
31:08
I
31:08
don't
31:09
know,
31:09
like
31:09
a
31:09
no
31:09
brainer,
31:10
like
31:10
why
31:10
not?
31:10
Why
31:11
wouldn't
31:11
you
31:11
try
31:11
this
31:12
first?
31:12
Right.
31:13
Rather
31:13
than
31:13
giving
31:14
somebody
31:15
a
31:16
large
31:16
dose
31:16
of
31:17
a
31:17
medication
31:17
that
31:18
has
31:18
serious
31:18
potential
31:19
side
31:19
effects
31:20
and
31:20
can
31:20
likely
31:21
sort
31:21
of
31:21
commit
31:22
them
31:22
to
31:22
lifelong
31:23
use,
31:23
why
31:23
wouldn't
31:24
you
31:24
try
31:25
a
31:25
lower
31:25
dose,
31:26
safer,
31:27
shorter
31:27
term
31:27
to
31:28
see
31:28
if
31:28
it
31:28
helps
31:28
kickstart
31:29
their,
31:30
their
31:30
own
31:31
sort
31:31
of
31:31
lifestyle
31:31
changes?
31:32
And
31:32
I'm
31:33
going
31:33
to
31:33
answer
31:33
my
31:33
own
31:33
question
31:34
here
31:34
because
31:35
I
31:35
think
31:35
part
31:36
of
31:36
that
31:36
is
31:38
doctors
31:38
have
31:38
sort
31:39
of
31:39
become
31:39
jaded.
31:40
They're
31:40
like,
31:40
ah,
31:40
diet
31:41
doesn't
31:41
work.
31:41
You
31:41
know,
31:42
lifestyle
31:42
interventions
31:43
don't
31:43
work
31:43
because
31:44
what
31:44
they've
31:44
been
31:45
taught
31:45
and
31:45
tried
31:45
for
31:46
so
31:46
long,
31:46
they
31:46
eat
31:47
less,
31:47
move
31:47
more
31:47
low
31:48
fat.
31:48
Yeah,
31:49
it
31:49
hasn't
31:50
worked
31:50
for
31:50
50
31:50
years.
31:51
So
31:52
they
31:52
get
31:52
sort
31:52
of
31:52
jaded.
31:53
But,
31:54
so
31:54
that's
31:54
the
31:54
other
31:54
part
31:54
that's
31:55
really
31:55
important
31:55
to
31:55
emphasize
31:56
of
31:56
what
31:56
you're
31:57
saying
31:57
is
31:57
it's
31:57
as
31:58
a
31:58
transition
31:59
to
31:59
reducing
32:00
the
32:00
carbohydrates.
32:01
So,
32:01
so
32:02
yeah,
32:02
why
32:02
wouldn't
32:02
they
32:03
do
32:03
that?
32:03
I
32:03
think
32:03
people
32:03
should
32:04
do
32:04
it
32:04
more
32:05
well.
32:05
And
32:05
I
32:05
think
32:05
it's
32:06
a
32:06
combination.
32:06
You
32:07
would
32:07
know,
32:07
of
32:07
course,
32:07
having
32:08
gone
32:08
through
32:08
medical
32:09
training.
32:10
I
32:10
think
32:10
it's
32:10
a
32:11
combination
32:11
of
32:12
the
32:12
fatigue
32:13
that
32:13
a
32:13
physician
32:13
may
32:14
experience,
32:14
the
32:14
fact
32:14
that
32:15
they
32:15
can't
32:15
bill
32:15
that
32:16
time.
32:16
You
32:16
get
32:16
paid
32:17
for
32:17
what
32:17
you
32:17
can
32:17
bill.
32:18
And
32:18
talking
32:18
about
32:19
nutrition
32:19
might
32:19
not
32:19
be
32:20
something
32:20
a
32:20
clinician,
32:21
a
32:21
physician
32:21
is
32:21
able
32:22
to
32:22
get
32:23
compensated
32:23
for.
32:23
So
32:24
I
32:24
really,
32:24
I
32:24
appreciate
32:25
that.
32:26
But
32:26
at
32:26
the
32:26
same
32:26
time,
32:27
they
32:27
might
32:27
not
32:27
have
32:27
even
32:28
learned
32:29
anything
32:29
other
32:30
than
32:30
eat
32:31
less,
32:31
exercise
32:31
more.
32:33
If
32:33
that
32:34
simplistic
32:34
mantra
32:35
worked,
32:35
we
32:36
would
32:36
have
32:36
solved
32:36
the
32:37
obesity
32:37
problem
32:37
before
32:38
it
32:38
ever
32:38
started.
32:38
Because
32:39
we've
32:39
been
32:39
saying
32:39
that
32:39
for
32:40
60
32:40
years.
32:41
Obviously
32:42
a
32:42
weight
32:43
loss
32:43
strategy
32:43
that
32:43
is
32:44
based
32:44
on
32:44
just
32:44
straight
32:45
calorie
32:46
deprivation
32:46
and
32:47
restriction
32:47
and
32:48
this
32:48
sort
32:48
of
32:49
mistaken
32:49
view
32:49
of
32:50
the
32:50
laws
32:50
of
32:50
thermodynamics
32:51
in
32:52
a
32:52
biological
32:52
system,
32:53
it
32:53
does
32:53
not,
32:54
it
32:54
does
32:54
not
32:55
lead
32:55
to
32:56
an
32:56
actual
32:57
successful
32:58
intervention.
32:58
Well,
32:59
I
32:59
appreciate
33:00
you
33:00
coming
33:00
on
33:00
and
33:01
giving
33:01
us
33:01
this
33:01
insight
33:02
and
33:02
I
33:02
think
33:02
it's
33:03
a
33:03
very
33:03
interesting
33:04
thought
33:04
and
33:05
I
33:05
hope
33:05
some
33:05
clinicians
33:06
will
33:06
embrace
33:07
it
33:07
and
33:08
try
33:08
it
33:08
because
33:08
it
33:08
does
33:09
seem
33:09
like
33:09
a
33:10
much
33:10
safer
33:10
and
33:10
potentially
33:11
longer
33:11
term
33:12
effective
33:13
solution.
33:14
So
33:14
if
33:14
people
33:15
want
33:15
to
33:15
hear
33:15
more
33:16
about
33:16
you,
33:16
learn
33:16
about
33:16
all
33:17
the
33:17
work
33:17
you're
33:17
doing,
33:17
where
33:18
can
33:18
we
33:18
direct
33:18
them
33:18
to
33:18
go?
33:19
Yeah.
33:19
Yeah.
33:19
Thanks
33:20
again,
33:20
Brett.
33:20
This
33:20
was
33:20
great.
33:21
Yeah.
33:21
I
33:21
have
33:21
two
33:22
efforts
33:22
that
33:22
I
33:22
really
33:23
try
33:23
to
33:23
stay
33:23
a
33:23
high
33:24
degree
33:24
of
33:24
involvement
33:24
with.
33:25
One
33:25
is
33:25
my
33:25
education
33:26
arm,
33:27
which
33:27
is
33:27
a
33:27
professor.
33:28
Just
33:28
thrills
33:28
me.
33:28
I
33:29
like
33:29
teaching
33:29
as
33:29
many
33:29
people
33:30
as
33:30
I
33:30
can,
33:30
but
33:31
people,
33:31
people
33:31
can
33:31
find
33:31
me
33:32
there@Ben
33:33
Bickman.com
33:34
and
33:34
Bickman
33:34
is
33:34
just
33:34
B
33:34
I
33:35
k
33:35
M
33:35
A
33:35
n
33:35
Ben
33:36
Bickman.
33:36
Com
33:37
and
33:37
then
33:37
I've
33:37
also
33:37
helped
33:38
put
33:38
together
33:38
a
33:38
coaching
33:39
effort
33:40
to
33:40
help
33:40
people
33:40
get
33:41
through
33:41
these
33:41
very
33:42
kinds
33:42
of
33:42
things
33:42
that
33:42
we've
33:42
been
33:42
talking
33:43
about.
33:43
And
33:43
that's
33:44
people
33:44
can
33:44
find
33:44
that@insuliniq.com
33:46
Great.
33:46
All
33:47
right,
33:47
well,
33:47
thank
33:47
you
33:47
so
33:47
much
33:47
Ben.
33:48
I
33:48
really
33:48
appreciate
33:48
it.
33:48
Yeah,
33:49
my
33:49
pleasure.
33:49
Thanks
33:49
Brett.
33:51
Thanks
33:51
for
33:52
listening
33:52
to
33:52
the
33:52
Metabolic
33:53
Mind
33:53
Podcast.
33:54
If
33:54
you
33:54
found
33:54
this
33:54
episode
33:55
helpful,
33:55
please
33:55
leave
33:56
a
33:56
rating
33:56
and
33:56
comment
33:57
as
33:57
we'd
33:57
love
33:57
to
33:57
hear
33:58
from
33:58
you.
33:58
And
33:58
please
33:59
click
33:59
the
33:59
subscribe
33:59
button
34:00
so
34:00
you
34:00
won't
34:00
miss
34:01
any
34:01
of
34:01
our
34:01
future
34:01
episodes.
34:02
And
34:02
you
34:03
can
34:03
see
34:03
full
34:03
video
34:03
episodes
34:04
on
34:04
our
34:04
YouTube
34:05
page
34:05
at
34:05
Metabolic
34:06
Mind.
34:07
Lastly,
34:07
if
34:07
you
34:07
know
34:08
someone
34:08
who
34:08
may
34:08
benefit
34:09
from
34:09
this
34:09
information,
34:09
please
34:10
share
34:10
it
34:10
as
34:10
our
34:11
goal
34:11
is
34:11
to
34:12
spread
34:12
this
34:12
information
34:13
to
34:13
help
34:13
as
34:13
many
34:13
people
34:14
as
34:14
possible.
34:15
Thanks
34:15
again
34:15
for
34:15
listening
34:16
and
34:16
we'll
34:16
see.
34:16
You
34:17
here
34:17
next
34:17
time
34:17
at
34:17
the
34:18
Metabolic
34:18
Mind
34:18
Podcast.