Latest / Pretty In Pink Again / Episode 71: GLP-1 One Year Later with PA Stephanie Gort: The Truth About the Shot, the Pill & What’s Next

Transcript

Episode 71: GLP-1 One Year Later with PA Stephanie Gort: The Truth About the Shot, the Pill & What’s Next · Pretty In Pink Again

• 0:00
  I'm Christina.
• 0:00
  And I'm Teef.
• 0:01
  And this is the Pretty in Pink Again podcast.
• 0:03
  Where motherhood meets rediscovery.
• 0:16
  When Steph joined us last year, GLP-1 medications were exploding in popularity.
• 0:21
  Fast-forward to today, and they're everywhere.
• 0:23
  But now the conversation has shifted.
• 0:25
  Women aren't just asking,"How do I get it?" They're asking,"Should I stay on it forever?
• 0:30
  What happens if I stop?
• 0:31
  What about the pill?
• 0:33
  Am I losing muscle?
• 0:34
  Is this changing my relationship with food?" Today, we're talking about what we know, what we don't know, and where this conversation is headed.
• 0:41
  Welcome, Steph Gore.
• 0:43
  Hey.
• 0:44
  Hello.
• 0:44
  Hi.
• 0:44
  She's back.
• 0:45
  I'm back.
• 0:45
  Your podcast, even the repeat one- Mm-hmm was one of the highest downloaded podcasts.
• 0:50
  Oh, thank you.
• 0:50
  Mm-hmm.
• 0:50
  Even the repeat one.
• 0:52
  I was like,"What?
• 0:53
  Why are so many people downloading this?
• 0:55
  It's, it's out there already." Yeah.
• 0:56
  But,, we've had new listeners, and it, it...
• 0:59
  So I'm so- thank you for coming back.
• 1:01
  Oh, that's exciting.
• 1:01
  I know.
• 1:01
  We're so excited to have you back- Thank you and chat because a lot has happened in a year.
• 1:05
  A lot has happened in a year.
• 1:05
  It's been a little under a year since we originally had you on, and there's been a lot that has changed in this world, and we're excited to have you back.
• 1:11
  Did you get any feedback about the first episode?
• 1:13
  I have some patients from the first episode.
• 1:15
  Do you really?
• 1:16
  That, like, joined after listening.
• 1:18
  A lot of feedback, people were surprised- that I wasn't as medical, and it wasn't so, like, nuanced, that I was more real about it because- Yeah I've been on these medications for so many years.
• 1:28
  I, so I have all the same fears as they have.
• 1:31
  I have all the same side effects that they have.
• 1:33
  So I think it's makes it easier for them to come to me.
• 1:36
  I think what we've learned in the past year, before it was all about, like, affordability'cause everything- Mm-hmm it was so expensive and you had to go, like, the back door to get it, and compounding and all of that stuff.
• 1:47
  I think what we've learned over the last year is that there are companies are making it more accessible to get it correctly.
• 1:52
  Mm-hmm.
• 1:52
  And I think it's so important to get it correctly and to take it correctly'cause if you're just given it and you're left to your own devices, like, that's when you're gonna seek problems.
• 2:02
  Right.
• 2:02
  Right.
• 2:03
  And you've seen it being in your profession, I'm sure you've seen, like, some problems then come to you- Oh, for sure because they end up finding you secondary.
• 2:11
  Well, so the...
• 2:11
  I work in GI primarily.
• 2:13
  Mm-hmm.
• 2:13
  And so I'll see a lot of patients for side effects of GLP-1s- Mm-hmm not knowing that I prescribed them.
• 2:19
  Got it.
• 2:20
  So we see a lot of, like, constipation and, you know, nausea, vomiting, stuff that they didn't even know was gonna happen because they weren't properly- Guided counseled on it.
• 2:28
  Right.
• 2:28
  Right.
• 2:28
  Yeah.
• 2:29
  So everyone sees weight loss, and they're like,"Sign me up," and not realizing there's so much else that comes with it.
• 2:34
  Right.
• 2:34
  Right.
• 2:35
  Right.
• 2:35
  I'm also interested now on, the pill form that there is.
• 2:39
  Mm.
• 2:39
  Mm-hmm.
• 2:39
  Like, I know a lot of people are afraid to inject themselves- Yeah or afraid of needles.
• 2:43
  Mm-hmm.
• 2:43
  And there's a pill form, and I'm curious, like, how that works.
• 2:45
  Is that, like, filtered through your liver?
• 2:47
  Does it stay in your stomach?
• 2:48
  Is that becoming more popular?
• 2:50
  Yeah.
• 2:50
  So I think interestingly enough, men were more apprehensive to use needles than women.
• 2:57
  So a lot more men are interested now because it's a pill.
• 3:00
  Hmm.
• 3:00
  And I, and I was thinking about that, and I was like, okay, women, Botox, IVF- Mm like, women know- Mm-hmm needles, and they're more comfortable with it.
• 3:07
  The men don't wanna say they're scared of it, so instead they were just like,"Oh," like- It's cheating, like all that stuff.
• 3:13
  But now guys are more likely to do it because it's a pill.
• 3:16
  Right.
• 3:16
  So the way the pill's working is you're taking it with a small cup of water.
• 3:20
  It's gonna attach to your stomach lining and hang out there for the whole day and, like, gradually release the hormone, and then it's clear in your system in the day.
• 3:29
  So it's a once a day pill instead of a once a week injection.
• 3:32
  Right.
• 3:33
  So people like that better because, two reasons.
• 3:36
  It reminds them to, like, stay on track every day'cause they're taking the pill every day, and it's not a needle, so it's helping them.
• 3:42
  And the side effects are thought to be less because it's shorter acting.
• 3:46
  How does it compare in terms of results?
• 3:49
  Yeah.
• 3:49
  So all the studies that are put out there by the drug companies, you have to remember, are on the highest dose of the pill.
• 3:55
  Mm-hmm.
• 3:55
  So it looks comparable.
• 3:57
  But we don't bring people to the highest dose unless we need to.
• 4:00
  Like even I said, you stay on the lowest dose as you can.
• 4:03
  So I think it's a little bit more modest.
• 4:05
  Okay.
• 4:05
  But I've had a girl who lost 20 pounds in two months on the second level up.
• 4:09
  You know, I think it's working for people.
• 4:11
  I think that, it's more affordable, so if insurance doesn't cover it, it's$150 a month for the starter doses.
• 4:19
  And I think it's just another avenue for people to take.
• 4:22
  Making it more accessible.
• 4:24
  And now the Medicare thing, so on July 1st, Medicare now covers weight loss medication.
• 4:28
  So if- And for our listeners who are not familiar with Medicare, Medicare is for patients that are older, correct?
• 4:34
  65 and older or have extenuating circumstances that otherwise were not covering weight loss medications unless you had, like, diabetes and stuff.
• 4:43
  So now it's just weight loss.
• 4:45
  Obesity is recognized as a disease,$50 a month with insurance.
• 4:49
  Wow.
• 4:49
  Right.
• 4:49
  And that's a huge thing.
• 4:51
  what's good is the drug companies themselves, brought the cost down a lot.
• 4:55
  So out of pocket now it's, the injection's like 199 to 499 a month based on which prescription and what dose you're on, where it used to be about 1,300,$1,400 a month.
• 5:05
  Mm-hmm.
• 5:05
  Wow.
• 5:06
  Wow.
• 5:06
  Well, and also, wasn't it, like, not available either?
• 5:09
  Yeah.
• 5:09
  Like, wasn't there, like, a huge scarcity of it as well?
• 5:11
  Yeah.
• 5:11
  There should be no shortage now'cause there's more and more coming, and there's more and more indications coming, meaning the medication can treat more things than we used to think.
• 5:19
  I wanted to talk to you about some of the indications'cause I feel like some of it...
• 5:23
  And maybe it just could be, like, me personally or what I'm seeing, but maybe I'm seeing a little bit less about just the weight loss indications and also, the whole, like, cognitive improvement and longevity indications for these medications.
• 5:35
  Yeah.
• 5:35
  Mm-hmm.
• 5:36
  Is that, a written indication yet?
• 5:38
  Or is that just- No something that you're seeing?
• 5:39
  So right now the GLP-1 medications are indicated for fatty liver disease, sleep apnea, chronic kidney disease, diabetes- Prevention of heart disease and obesity.
• 5:52
  But people are using it more and more off-label because we're seeing a lot of benefits like anti-inflammatory benefits- Right, right or GI, everything's slowing down, so in patients who have inflammatory bowel disease, Crohn's, ulcerative colitis, irritable bowel syndrome, their symptoms are getting better.
• 6:09
  So those are the people that you might think like are microdosing, but it's really the lowest level of the drug is just helping their symptoms.
• 6:17
  Mm-hmm.
• 6:17
  So people who don't even necessarily need to lose weight, they're seeing so many other benefits from the medication.
• 6:23
  So my sister has, endometriosis.
• 6:26
  Mm-hmm.
• 6:26
  Like really advanced endometriosis, and one of the doctors she saw recommended doing a very low dose of tirzepatide- Mm-hmm to help with endometriosis.
• 6:36
  Like how is that related?
• 6:38
  So the studies aren't out yet, but I think it's hormonally because they're also showing improvement in fertility.
• 6:44
  Yeah.
• 6:44
  You know, the improvement in PCOS and other- Yeah endocrine disorders.
• 6:48
  I just think a year later we were ready for them to be pulled off the market and be like,"All right, we were all wrong.
• 6:54
  Everyone's dying of them," and now we're actually seeing more and more benefits.
• 6:58
  Like Alzheimer's has a study coming out and, there's some like cancer.
• 7:03
  And again, none of this has been FDA approved yet, but a lot is coming out.
• 7:06
  Right.
• 7:07
  So they're, it's like all just starting to come out.
• 7:09
  Yes.
• 7:10
  Right.
• 7:10
  And imagine if it was around when we were growing up.
• 7:13
  You pose a good point because now we're raising kids that are gonna have the opportunity to do this.
• 7:17
  Mm-hmm.
• 7:17
  What do you think you'll do when your daughter's of the age to take this medicine if she has a re- like, a unhealthy relationship with her body?
• 7:25
  I shouldn't even say unhealthy because I wanna take them and I don't think I have an unhealthy relationship- No with my body.
• 7:30
  I just sometimes want to be smaller.
• 7:33
  Right.
• 7:34
  And I think at first I thought this was gonna drive eating disorder behavior up, and now I think it helps it.
• 7:40
  Mm-hmm.
• 7:41
  And I'll say that because personally growing up, I would never order pasta at a restaurant.
• 7:46
  Mm-hmm.
• 7:46
  I would never have, like, a potato with dinner or carbs for breakfast or whatever, and this medication is kind of like an insurance policy where I can have that and I don't need to restrict, and I can trust that I'm still gonna be okay.
• 8:01
  You're able to- Right listen to your body a little bit more.
• 8:03
  Right.
• 8:03
  So I can eat what I want- Right obviously in moderation.
• 8:06
  I think it's important when you're prescribed it that you have some degree of nutritional counseling because You're gonna be a lot less hungry, so what you eat actually matters.
• 8:16
  'Cause if you're only eating crap, you're gonna lose the muscle, you're gonna have the hair loss, you're gonna have all these issues.
• 8:23
  So I think it's important to know a little bit about nutrition when you're given this- Mm-hmm instead of just,"Take this, you'll eat less." So-'Cause yeah, you're eating less, but what should you eat?
• 8:32
  That's surprising to hear you say that because I think in less than a year when we had you on the last time, we were talking about the stigma, right, about the medications.
• 8:41
  I think that I've had patients who have had eating disorders growing up.
• 8:46
  Mm-hmm.
• 8:46
  And therefore I'm wary of prescribing something that's gonna give them weight loss and- Mm-hmm see results because I don't want the obsession to come back.
• 8:54
  I have been seeing, I'm not sure if anybody else has seen this, but I feel like We kind of moved away from like the skinny culture- Mm-hmm and we talked about that, like growing up in the'90s and the 2000s last podcast about that, the obsession with the skinny culture.
• 9:08
  Mm-hmm.
• 9:09
  Do we feel like this is gonna come back though?
• 9:11
  Because I feel like now this is so prevalent and I can't believe how rapidly this kind of onboarded itself over- Mm-hmm the last year that like now everyone's on this.
• 9:23
  Right.
• 9:23
  Now we're sitting here talking and saying like,"Oh, well, I kind of want it because I wanna be a little bit smaller and- Right now it helps with inflammation." And so that's the reason my ears are perking up about it because I feel inflamed all over.
• 9:35
  Yeah.
• 9:35
  So do we feel like this is going to create that obsession with skinny culture again?
• 9:41
  I think it can create a little bit if you're in the mindset of that person's heavy, why aren't they on it?
• 9:48
  Yeah.
• 9:49
  You know?
• 9:49
  Like there's something- Like the comparing they can do about it now.
• 9:51
  Yeah.
• 9:51
  Why aren't they on it?
• 9:52
  Yeah.
• 9:52
  And you also have to remember there are reasons not to take the medication.
• 9:55
  Mm-hmm.
• 9:56
  There's people- A lot you said.
• 9:56
  Yeah.
• 9:56
  Right.
• 9:56
  And there's people that can't handle the medication.
• 9:58
  And that still has, that's still the same.
• 9:59
  Yeah.
• 10:00
  And one thing that scares me a lot is we have patients who are on this medication lose hundreds of pounds- Mm-hmm and then bam, they get pancreatitis and they no longer can take the medication.
• 10:10
  They can't take anything in the class.
• 10:12
  They're gonna gain the weight back.
• 10:14
  And how like unfair and sad is it for that person to know that there is something that can help them, but now they can't take it anymore.
• 10:21
  And so that's what I'm petrified of.
• 10:22
  I've been on something like this for 10 years now.
• 10:25
  Every time I inject, like God forbid something happens and I can't take it anymore, might as well throw away all my clothes now and get ready to gain weight because once you stop the medication, all of the studies are showing that you're gaining it back.
• 10:38
  Wow.
• 10:39
  That's kinda crazy to think that.
• 10:41
  It's scary.
• 10:41
  Yes.
• 10:41
  That is scary.
• 10:42
  It is.
• 10:42
  What do you think you would do?
• 10:44
  Or what would you tell a patient to do?
• 10:45
  So I've had a couple patients on it, um, who have been wildly successful and then had a, complication that they couldn't take it anymore or insurance doesn't cover it anymore- Mm-hmm or for whatever reason.
• 10:57
  The first thing I would do is see if other medications would be safe for them.
• 11:01
  We've had a lot of conversations about bariatric surgery still.
• 11:05
  Are people still doing that procedure or is it not as common anymore?
• 11:07
  You know, some of them it's-- I feel like it's gonna be less common, especially as the newer one comes out.
• 11:13
  There's one called Retatrutide that's coming out that's- Oh yeah supposed to have- Reda.
• 11:16
  I heard about that equal percentage weight loss as some of the surgeries.
• 11:20
  Wow.
• 11:21
  I think some bariatric surgeons- Wow are using the medication also to help with post Bariatric weight gain.
• 11:27
  Hmm.
• 11:27
  I still think there's a place for surgery.
• 11:29
  I have patients who h- are on the medication, have lost 10% of their weight loss, meaning they're 400 pounds and they've lost 40 pounds.
• 11:37
  That's 10%.
• 11:38
  That's what, the drug company is promising, right?
• 11:40
  A 10% weight loss.
• 11:42
  10% weight loss looks different from, like, 150-pound girl- Yeah going down to 135- Yeah versus 400 down to 360.
• 11:48
  They still likely would need something to put them in a healthier body weight range.
• 11:53
  Right.
• 11:53
  And it's a hard conversation to have with the patients because they're so hopeful, and I've said,"Listen, you've done great.
• 11:59
  You've done everything the medication can do for you.
• 12:02
  It is not your fault that your body is not there yet, but there are other tools.
• 12:07
  You know, you may need more help." And I think once you accept that it's not a failure on your part, then patients are more likely to meet with a surgeon.
• 12:17
  That sounds rich.
• 12:19
  Like, c- but if that was me having to tell myself that, I would feel so defeated.
• 12:24
  Right.
• 12:24
  You know?
• 12:25
  Like, if- So you asked me what I would do you know?
• 12:27
  I would hate to say it, but I would have to go back to my restrictive behaviors.
• 12:31
  Mm-hmm.
• 12:31
  Overexercise.
• 12:31
  You know, if, if wanting- And those are...
• 12:33
  Yeah, those are rough terrible.
• 12:34
  Those are terrible.
• 12:35
  And you don't want your kids to see it.
• 12:36
  Right.
• 12:36
  And you don't want...
• 12:37
  And it wasn't fun.
• 12:38
  How much fun is it to go to out to dinner with your friends and, like, move food around?
• 12:41
  It's not fun to do that.
• 12:43
  So the fact that I can take a medication like this for now, eat what I want, stop when I'm full- Mm-hmm enjoy food still, and, you know, be at a healthy body weight, I think that's the most important thing.
• 12:55
  Yeah.
• 12:55
  But you have to know that- It may not be forever.
• 12:59
  Mm-hmm.
• 12:59
  And I even say this to, like, my sister, like...
• 13:01
  And we're petrified because I was never thin growing up, and this is a whole new life, and bam, I gain 40 pounds back.
• 13:10
  Like, what, how would my life look different?
• 13:12
  Right.
• 13:12
  And that's a scary thing to think about.
• 13:14
  Yeah, so I'm sure that is in the back of people's mind, is that they know first of all, we've, the studies have shown that- Yeah you will gain the weight back.
• 13:22
  You will gain the weight back.
• 13:23
  Yes.
• 13:24
  It's such, like, a daunting, you know, statement to make.
• 13:27
  You'll gain the weight back if you stop taking it, and that's why I think that this, like, obsession, right?
• 13:33
  Like, I could see- Yeah this being in the back of people's minds.
• 13:36
  I think just as a culture overall, like, we're gonna sit there and after we had this huge, body positivity movement- Yeah, that's over it's over.
• 13:45
  Yeah.
• 13:45
  It seems like it's over'cause it could be individual, where, like, you're just wanting to be at your thinnest but then it just seems like overall there's just an obsession- Right where you're kind of, like, looking around, who's taking this, who's not.
• 13:58
  I feel like there's been this movement where people are just so willingly sharing that they're on these things now.
• 14:04
  Good.
• 14:04
  Which is great.
• 14:05
  Yeah.
• 14:06
  Which is great.
• 14:07
  Last year when I was here, they weren't.
• 14:08
  But it becomes, then you're like, well, right.
• 14:09
  But then it becomes, well, then should I be on it?
• 14:11
  Right.
• 14:11
  Should she be on it?
• 14:12
  Well, and also social, social media is, is flagging influencers who are posting before and afters injecting.
• 14:20
  Okay.
• 14:20
  You're not allowed to show your injections, and you're not allowed to show before and afters on your social media because I really don't think that they know how to handle this realm of, like, medical advice through- Mm-hmm influencing.
• 14:34
  So it's not, you're not seeing-- You're seeing a snapshot.
• 14:36
  You're seeing this girl at the gym- Right sad, holding up a selfie at 400 pounds, and then you're seeing this, like, girl in an Alo matching set smiling at the gym, and it's supposed to be the same people.
• 14:46
  You don't see what's happening in between then.
• 14:47
  Right.
• 14:47
  You don't know how they're not just being- And you don't even know if it's a real person.
• 14:50
  Right.
• 14:50
  It could be AI.
• 14:50
  So I think that's why social media is like- And it's triggering for a ton of people.
• 14:54
  Right.
• 14:54
  Like cracking down on some of it.
• 14:55
  They are.
• 14:56
  Which is why- And there's a lot of eating disorder warnings on- Right, right like, a lot of these pages.
• 15:00
  Which is why I think your first podcast did so well, because it really opened up the whole conversation.
• 15:07
  You were kind enough to share your own personal struggles, and Christina and I are sharing now that we're turning 40 this year and that maybe we never struggled with our weight in the past, but as we get older, it's harder and harder to stay on top of it.
• 15:19
  Mm-hmm.
• 15:19
  And if there's a safe tool that I could use to add to my exercise regimen- Right and my healthy eating regimen, I am all for it.
• 15:27
  I know it's not, like, FDA approved for that- Right for, you know, weight control and- Yeah anti-inflammatory purposes, but I think a lot of people are fishing for that.
• 15:39
  Mm-hmm.
• 15:39
  Well, I think the word tool that you used is the most important thing, is it does not replace diet and exercise.
• 15:45
  Because for people who it, you're just taking the medication and living the way you've always lived, you're gonna be the one who is gaining the weight back immediately.
• 15:54
  You never learned how to eat right or to exercise.
• 15:56
  You're gonna be the one who loses the muscle mass and the hair, because when you are taking the medication, you're eating less.
• 16:03
  Mm-hmm.
• 16:04
  So what you should be told is when you're looking at your plate, the first thing you need to eat is the protein, because you're gonna get full quick, and if you're not getting full off the protein, then you're gonna be eating, nutrient poor foods.
• 16:18
  It's easy to miss all of the nutrients- Yes and f- get full faster.
• 16:21
  Get full faster by- Right.
• 16:22
  Y'all, that makes sense.
• 16:22
  Yeah.
• 16:22
  You can have a boatload of romaine lettuce- Right and feel so full from bulk, but if you started on your chicken breast and ate your chicken, you may never have even gotten to the lettuce, but you got all that protein.
• 16:35
  So that's why when you're losing weight rapidly and not prioritizing protein, that's when you're gonna see that Ozempic face and- Mm-hmm like, the skin hanging and all of that, because you need to prioritize what food goes in, has to, like, be the best bang for its buck'cause not that much is gonna go in.
• 16:51
  Right.
• 16:52
  So I'm also seeing a ton of, like, GLP-1 support supplements.
• 16:58
  Yeah, I- So what is that?
• 16:59
  What does that mean?
• 16:59
  I don't-- So I am jaded because I took a supplement class during my freshman nutrition year at Syracuse- Mm-hmm and the professor Put something in my head that if you eat a well-rounded diet, you do not need any supplements.
• 17:12
  Mm-hmm.
• 17:12
  You do not need anything.
• 17:13
  We've had people on here that have said the same thing.
• 17:15
  Yeah.
• 17:15
  And, and if you look at all of the, you know, FDA does not agree with any of these- Mm-hmm you know, whatever.
• 17:21
  So I've never taken supplements personally, but people like them, people swear by them.
• 17:26
  I think if you're eating a well-rounded diet with the colors of the rainbow you shouldn't need a multivitamin.
• 17:31
  So the well-balanced diet is supposed to offset some of the hair loss and some of the other- then the reason we see the hair loss and the muscle wasting is not because of the medication.
• 17:43
  Right.
• 17:44
  We see it because of rapid weight loss.
• 17:46
  Oh.
• 17:46
  So whether it's anorexia nervosa, Weight Watchers, Jenny Craig, or Wegovy, if you're rapidly losing weight, you're gonna see muscle wasting and hair loss.
• 17:54
  Okay.
• 17:55
  Even if you are- So that con- that's the connection nourishing your body.
• 17:58
  If you're nourishing your body, you should see about one to two pounds of weight loss a week.
• 18:02
  It should be gradual, and it should support your muscle and your fat and everything.
• 18:08
  So the- And that's why you're saying it make it so important- Oh, so if it's rapid to be using this with diet and exercise.
• 18:15
  Yeah.
• 18:15
  Like a good balanced diet and exercise because then you're not losing muscle mass.
• 18:20
  Yeah.
• 18:20
  You're prioritizing your protein still.
• 18:23
  Yeah.
• 18:23
  You're nourishing your body.
• 18:24
  The medication's getting a bad rep, but it's not the medication.
• 18:27
  It's the rapid weight loss.
• 18:28
  It's the rapid weight loss.
• 18:28
  Okay.
• 18:29
  So if you're not- Oh, I see doing it correctly and you're just taking the wrong dose or you're taking it and not eating well, you're gonna lose 20 pounds in a month, but you're gonna be all skin.
• 18:40
  That's why the most important thing for you to do is have the protein.
• 18:43
  Even if you use a protein powder in your coffee- Mm-hmm like as a creamer or something, you're physically full and can't eat a lot, use protein powder and put it in your coffee and get your grams.
• 18:52
  Most adults need like 80 to 120 grams of protein every day, and it can be individualized based on your weight.
• 18:59
  But that's the main thing you need to focus on.
• 19:03
  Now, I heard that one of these new medications that you talked about, the Retta- Retatride.
• 19:07
  Retatride- Mm-hmm is supposed to help promote- it works with your body that it does not promote muscle loss I think it's really how you use it.
• 19:21
  Cause patients will come in and be like, my chief complaint is muscle loss due to Wegovy." Mm-hmm.
• 19:26
  And it's not muscle loss due to Wegovy.
• 19:27
  Yeah.
• 19:27
  It's muscle loss due to rapid weight loss.
• 19:29
  That's a really important distinction.
• 19:30
  Yeah, because it's- Again, I don't think we got into the nitty-gritty of it- No last time, so I feel like this is just opening up and now really diving into using it and using it correctly since it is so prominent now.
• 19:43
  Well, same with the other complications, gallstones.
• 19:45
  Gallstones are from rapid weight loss or a bunch of other reasons, but not because the medication's giving you gallstones.
• 19:51
  Mm-hmm.
• 19:52
  Or vision changes are from your blood sugar lowering too quickly- Mm-hmm whatnot.
• 19:57
  It's not the medication's not hurting your vision.
• 20:00
  I think it's so important to be coached and prescribed correctly so you know what you're going into'cause it's not just like a miracle drug.
• 20:10
  Well, any wrong prescription, if taken too much of it and you are having- It'll land you in the hospital if you have like a rapid change in your weight, all of these other things can occur.
• 20:21
  Well, I have some patients who come to me and they were put on the h- highest dose as their starter dose.
• 20:26
  What's a high dose?
• 20:28
  So let's say we're talking just about Wegovy right now.
• 20:31
  It's.25 up to 7.2 milligrams.
• 20:36
  A patient was started on 7.2 milligrams.
• 20:39
  Their body never got used to it.
• 20:41
  They ended up in the emergency room with vomiting, dehydration.
• 20:44
  Oh my God.
• 20:44
  So that's why it's so important to like know where you're getting the stuff, educate yourself, but also trust your provider- Yeah and not just buy it online because you need to take it correctly or else it can hurt you.
• 20:54
  Right.
• 20:54
  Right.
• 20:55
  Same with any medication.
• 20:56
  But let's talk about still the safe providers- I'm getting confused now as a listener of like what's a safe- Right when you talk about getting it offline- Yes there's a lot of different websites now where- Right you can consult with a medical provider- Sure via telehealth.
• 21:13
  Yep.
• 21:14
  And if that medical c- provider can take like a full comprehensive- Mm-hmm history.
• 21:19
  Like telehealth.
• 21:20
  Do labs.
• 21:21
  Right.
• 21:21
  Find out, you know, like do you have a history of pancreatitis- Yep high blood pressure, hypertension, like what is your medical history?
• 21:28
  And if it is prescribed from their pharmacy, is that still considered, unsafe offline?
• 21:35
  No.
• 21:35
  No.
• 21:35
  Or is that considered a safe- I think when I say offline, I mean, like, a TikTok shop is selling it- Oh, okay like, in a bottle.
• 21:41
  Okay.
• 21:41
  Like, uh, like, as long as there is a medical provider with a license- Mm-hmm a background in this stuff, and has your personal history.
• 21:49
  The people who are selling it backdoor don't know if you've had family history of thyroid cancer- Mm pancreati- you know, whatnot.
• 21:56
  That's where I say it's unsafe.
• 21:57
  Okay.
• 21:57
  So as a patient, you should be filling out a medical questionnaire.
• 22:00
  They need to know about you before you start it.
• 22:02
  Right.
• 22:02
  Mm-hmm.
• 22:03
  Same with any medication.
• 22:04
  Do you have any allergies?
• 22:06
  Family history of certain cancers?
• 22:07
  What does your typical GI look like?
• 22:10
  And GI being gastro.
• 22:11
  Are you normally constipated?
• 22:12
  Do you normally have diarrhea?
• 22:13
  Like, it's not just like a mail-away order.
• 22:17
  You need to have a conversation with a medical provider.
• 22:19
  Okay.
• 22:19
  And it can be- So I think that that's, I think that that's a really good distinction- Yes because I think it does get confusing when you're saying you want it to go through a safe provider, and you're like, what does that mean?
• 22:28
  Because a lot of these sites are popping up where there is- Yeah a, quote-unquote,"safe provider." Yes.
• 22:33
  So you just wanna be able to have a conversation- Yep with somebody and have this be, like, a little bit still hand-holding through the process.
• 22:41
  Right.
• 22:41
  But I will say a lot of those online telemed popped up before the cash pay options became available at pharmacies.
• 22:50
  Mm-hmm.
• 22:50
  So now you can get that$149, payment at the pharmacy instead of having to do compounding.
• 22:56
  But someone still has to write it.
• 22:58
  Right.
• 22:58
  Right.
• 22:58
  But you can go to your primary care doctor.
• 23:01
  Right, and they can write it.
• 23:02
  And they can write it.
• 23:03
  Right.
• 23:03
  If they're comfortable with it, you know?
• 23:05
  Right.
• 23:05
  So you shouldn't have to, like, go sketch- You know, it doesn't, you don't have to jump through as many hoops now- No to get it, right.
• 23:13
  It should be more accessible.
• 23:13
  What about are there any other like updates in the GLP-1 world?
• 23:19
  Like if a patient now--'Cause now these have been around for a while.
• 23:22
  Yes.
• 23:22
  So what if you have a patient that's obese that has been on the highest dose possible- Yeah and there's nothing, and like there's nowhere else to go for them?
• 23:29
  Have they increased the dosage for these obese patients?
• 23:32
  Yeah.
• 23:32
  So short of switching to a different medication, there's a stigma that semaglutide is not as good as tirzepatide, which may not be as good as retatrutide when it comes out.
• 23:41
  Short of switching things, some of the medication companies are now adding a higher dose to help break that plateau.
• 23:49
  So for example, Wegovy used to be 2.4 milligrams as the highest, and people who have been on that for a year maintaining their weight but still need to lose more to be at a healthy weight, there's now something called Wegovy HD, and it's 7.2 milligrams.
• 24:03
  There are coupons available for a zero copay for a month trial of that high dose too.
• 24:08
  So ask your providers about that if that's also happening.
• 24:11
  This medication has helped tremendously with food noise.
• 24:17
  Mm-hmm.
• 24:17
  We talked about this a little bit last time.
• 24:19
  What is the difference, do you think, between food noise and emotional eating?
• 24:24
  So I think emotional eating or f- feel-good ea- eating even comes from a young age.
• 24:30
  So your daughter gets an A on her spelling test, what do you do?
• 24:33
  You take her out to ice cream.
• 24:34
  To celebrate.
• 24:35
  Yep.
• 24:35
  And then your kid says,"Oh, something good happened.
• 24:39
  We eat sweets." Or family tradition, you make, I don't know, rugelach or something with your family, and now you feel good when you see rugelach because it reminds you of your family.
• 24:50
  So those are still gonna be emotionally charged.
• 24:52
  Or like the holidays.
• 24:53
  Yeah.
• 24:54
  You cook all your favorite things.
• 24:55
  Yes.
• 24:55
  You eat.
• 24:56
  It's like, you know.
• 24:57
  Yeah.
• 24:57
  And this medication shouldn't make you a robot.
• 24:59
  You know, I have several people who are so scared that they're not gonna enjoy food.
• 25:04
  You know, I can still say that I look forward to looking at a menu and can't wait to try something new.
• 25:09
  You know, my sister makes dessert just for me to enjoy.
• 25:11
  Like, it's not gonna rob you of all your feelings, but I think it can help you stop when you're full, Food noise to me is more so we're sitting here talking, and in the back of my head, I'm like,"Ooh, in the car I have Goldfish," or, you know,"I wonder if I left those jelly beans, like, in my cup holder." You know?
• 25:31
  And it's just, like, something that shouldn't be part of our conversation right now is going on in my head.
• 25:35
  Mm-hmm.
• 25:35
  Or,"What's the next thing I'm gonna eat?" Or, you know, planning or thinking about food when it sh- is not an appropriate time to think about food.
• 25:43
  I truly think the medication pulls that away.
• 25:45
  But you don't think it pulls the food, like, the emotional eating away?
• 25:49
  Well, emotional eating sounds like-'Cause emotional eating sounds negative, but it doesn't necessarily have to be.
• 25:53
  It's not always negative.
• 25:53
  Right.
• 25:53
  Right.
• 25:53
  So two things.
• 25:54
  I had a shitty day at work.
• 25:55
  And I'm stopping and getting a slice of cake on my way home to make me feel better.
• 26:00
  I think as, at a young age, we need to start...
• 26:04
  Rewards are great.
• 26:05
  You know, I'm leaving here and I did a podcast.
• 26:07
  I have, social anxiety.
• 26:09
  I deserve something.
• 26:10
  Sure, ice cream cone would be great, but no, I'm gonna go buy myself a new workout set.
• 26:14
  You know, I think you should still have rewards for yourself and things to make you feel better, but I don't think it has to be food charged anymore.
• 26:21
  Right.
• 26:22
  So like today, Devin's going to the doctor to follow up on something.
• 26:25
  She w- had mono last week.
• 26:26
  Afterwards, we're going to get our nails done, whereas previously maybe we would've gone and gotten ice cream or something like that.
• 26:33
  Like, I think it's important to still have those feel-good rewards and things to make you feel better, maybe taking a bath at the end of a bad day I think it can have a place, but it doesn't need to be food.
• 26:43
  So when you talk about rewards now with your own kids, it's not just food-based rewards.
• 26:48
  Mm-hmm.
• 26:48
  It's a myriad of- Yeah a bunch of different things.
• 26:51
  Ice cream certainly could be one of those things.
• 26:52
  Yeah, and we certainly go to ice cream.
• 26:54
  I mean- Right, right Papa still picks the girls up and goes to ice cream, so they're gonna remember that and love that.
• 26:59
  But I think they, it shouldn't be used as a- They're not attaching food with everything right.
• 27:03
  It shouldn't be,"If you do this, I'll give you a lollipop." Trust me, I've done that, and like when we do family photos and they smile, they get a lollipop on the way home.
• 27:11
  Mm-hmm.
• 27:11
  Mm-hmm.
• 27:11
  But I think just like growing up, it should not always be the reward or the punishment.
• 27:17
  Right.
• 27:18
  Well, I feel like when you start to build in rewards into your routine, you like attach them.
• 27:22
  Like every time I go to barre class, I go to Dom's after for my coffee.
• 27:26
  Mm-hmm.
• 27:26
  Right.
• 27:26
  And I never realized, but like that became the routine.
• 27:28
  Right.
• 27:29
  And like the coffee became the reward for the workout.
• 27:31
  Right.
• 27:32
  And now I do it every single time.
• 27:34
  Yeah.
• 27:34
  You know, I can't like do one without the other.
• 27:36
  It feels like it's like not complete.
• 27:38
  Yeah.
• 27:38
  So I don't know, like is that emotional- So what we don't want is- like drinking?
• 27:42
  I just played tennis.
• 27:44
  I burned X amount of calories.
• 27:46
  I deserve to stop at Small Street Provisions and get a muffin.
• 27:49
  Now I can.
• 27:50
  You know, you like- Right you don't want to th- they shouldn't go together.
• 27:54
  I see.
• 27:54
  Like, I just played tennis.
• 27:56
  I had such a good time with my friends.
• 27:57
  Oh, you know what?
• 27:57
  I'm hungry and it's almost lunchtime.
• 27:59
  I'm gonna stop and get this because it's time to eat and I'm hungry.
• 28:03
  It's not because I did something else.
• 28:05
  Got it.
• 28:05
  So food should not be, uh, because- A reward you're good or bad.
• 28:11
  Yeah.
• 28:11
  Right.
• 28:12
  Yes, what is it?
• 28:13
  Come on in.
• 28:14
  Oh, hi.
• 28:15
  Hi.
• 28:15
  What's up?
• 28:17
  Thanks, sweetie.
• 28:18
  What's up?
• 28:19
  Oh, all right.
• 28:19
  You got a good tan going on.
• 28:20
  I know, you look good.
• 28:21
  All right.
• 28:21
  We're almost done.
• 28:23
  Love you.
• 28:25
  I love her.
• 28:25
  She's got a good tan though.
• 28:26
  She's so cute.
• 28:27
  I know, she looks great.
• 28:28
  Well, we went to Newport It was, it was so hot.
• 28:31
  Really?
• 28:31
  It was so hot.
• 28:32
  Even by the water?
• 28:33
  I had my chair, in the ocean.
• 28:36
  There's cute shopping there, right?
• 28:37
  Yeah, there's really cute shopping there.
• 28:39
  But we did-- Well, this is like, I digress, but w- I used to go to Newport as a kid with my family.
• 28:45
  Like, every summer, we would stay in, like, a hotel, like the Marriott in Middletown.
• 28:48
  We would go, and we would, like, pack up the car and go to the beach and spend the whole day at the beach and, like, eat at the beach and then go back and rinse off and go back to the hotel and then go out to dinner, and I do the same routine with my kids.
• 28:59
  Mm-hmm.
• 28:59
  And when I'm there, I feel this, like, sense of happiness.
• 29:03
  Mm.
• 29:03
  Like, making sandwiches on the beach, staying at the Marriott- Yeah or, like, the Holiday Inn Express- Yeah or whatever, like, random hotel we, like, picked to stay at.
• 29:11
  Yeah.
• 29:11
  Like, you know, packing up the car.
• 29:14
  So nice.
• 29:14
  Yeah.
• 29:14
  You know?
• 29:14
  Yeah.
• 29:14
  And then we went to dinner at Brick Alley Pub.
• 29:16
  Have you ever eaten there?
• 29:17
  Oh, yeah.
• 29:17
  Yeah.
• 29:18
  Well, Newport- It's been there forever is so good.
• 29:20
  So good.
• 29:20
  Newport to me reminds me of a size 14 Lilly Pulitzer dress that my mom bought me and said,"If you lose, you will lose weight to fit into it." And that day, I had my la- I had a french fry, dipped it in my milkshake'cause that was my favorite thing.
• 29:33
  Ugh.
• 29:33
  Ugh.
• 29:34
  I went home, I started South Beach Diet, and that's what started my entire weight loss journey.
• 29:38
  Was Newport in that Lilly Pulitzer dress?
• 29:40
  There you go.
• 29:40
  It was a Lilly Pulitzer bright green- Ugh tiger print dress.
• 29:42
  And I still have it at my dad's house.
• 29:45
  Oh my God, that dress represents so much.
• 29:47
  So much.
• 29:47
  So many memories.
• 29:49
  All right.
• 29:49
  So, I mean, you only have the best memories from your mom, with your mom.
• 29:53
  Everything, yeah.
• 29:53
  And she's taught you literally everything you know, but, like, what would you do now- Mm-hmm in that, in that case?
• 29:59
  Like, just because, like, you're in this space.
• 30:01
  I know.
• 30:01
  It was the same thing with,"I'll buy you this Burberry bikini, you know, when you get XXX." You know, that was the culture back then.
• 30:07
  Yeah.
• 30:08
  You know?
• 30:08
  And- It's so different luckily, my daughters right now have no, knock on wood, weight issues.
• 30:13
  But I wonder what I would be like.
• 30:15
  Would I police their food, you know, knowing what I know now?
• 30:18
  Would I...
• 30:20
  You know, I, I'm definitely the more lenient one than my husband is.
• 30:24
  Devin does good through the night.
• 30:25
  I give her Nutella toast for breakfast, you know, and that's exactly what I shouldn't do.
• 30:29
  Right.
• 30:30
  You know?
• 30:30
  Like a reward for- It's hard.
• 30:31
  It's easy for me to preach, but I do it all wrong too.
• 30:34
  But you try to find a reward that works.
• 30:36
  Right.
• 30:36
  Especially with- And with this, yeah.
• 30:37
  And with the Bible- Sometimes you just have food-motivated kids.
• 30:41
  Yes.
• 30:41
  Yeah.
• 30:41
  Def- Food mo- Yep.
• 30:41
  They have never- Food is sweet motivated kids had food restricted.
• 30:44
  Yep.
• 30:44
  These kids are obsessed with desserts.
• 30:46
  Mm-hmm.
• 30:46
  Yeah.
• 30:46
  And I told myself from the start, like, my kids will not be obsessed with desserts.
• 30:49
  Yeah.
• 30:49
  It's gonna be something you have on your plate, blah, blah, blah.
• 30:51
  They eat great.
• 30:52
  They eat salmon and steak and veggies, but they love dessert.
• 30:55
  Right.
• 30:55
  Same.
• 30:55
  And so it's- My kids love dessert.
• 30:56
  Yeah.
• 30:57
  I think it's less about that and more that Devin sees me enjoy the Nutella with her.
• 31:01
  Right.
• 31:02
  As opposed- It's like a ritual.
• 31:03
  Like, look- Right.
• 31:04
  Yeah we did, you did this last night.
• 31:05
  As a- We're celebrating together yeah, as opposed to growing up, and I would like- The, the women at my, like, holiday dinners would be picking and not, like, put it on their plate'cause, like, the calories don't count if you're just picking.
• 31:18
  You know, like, I think what d- my daughter sees me do is equally as important as what I'm preaching to her.
• 31:25
  Mm-hmm.
• 31:26
  Right.
• 31:26
  I did something that my mom never did this past weekend.
• 31:29
  I went on, in the ocean and got my hair wet.
• 31:31
  You said,"I went in the ocean this weekend"?
• 31:32
  I went in the ocean- Mm-hmm and I got my hair wet.
• 31:34
  And I know that sounds so stupid, but my mom never got her hair wet.
• 31:37
  She wouldn't go in the water'cause she wouldn't wanna get her hair wet because then she'd have to, like, blow it out- Mm-hmm or, like, she was like- It was such a big deal when my mom would go in the water it was such a big deal, right?
• 31:45
  Yeah.
• 31:45
  So I went all the way in, I got my hair wet.
• 31:48
  And your kids really had the best- I rode up the bay.
• 31:49
  I'm really, really proud of you.
• 31:51
  Yeah.
• 31:51
  We were so happy.
• 31:52
  Wait, not even that.
• 31:53
  We didn't even go back to the hotel.
• 31:55
  We- Wow I, like, showered in the outdoor shower and then- Yeah Mila, like, couldn't get all the sand off of her, so I was, like, dumping water on her with, like, a bar of soap in the parking lot.
• 32:04
  I was like,"We're gonna be flexible.
• 32:06
  We're gonna make it work." Yeah.
• 32:07
  "We're gonna tie her hair back-" And that's the memories they'll have and then we're gonna go to dinner." Yeah, that's so nice.
• 32:10
  Yeah.
• 32:11
  So I told my mom, and she was like,"I would've never done that." I'm like,"I know." But it's such a thing.
• 32:15
  Every time I bring my kids to the pool, I'm, like, sitting on the side.
• 32:19
  I have my hair- Yep pulled back, and I'm like- Yeah"I don't wanna have to redo it." And then, like, two days ago, I was like,"I'm just gonna go underwater.
• 32:24
  I want Devon to swim better.
• 32:25
  I'm just gonna go underwater." And she, night and day, like, like a fish, because I was swimming and having fun and whatever.
• 32:31
  I remember how excited I was when my mom would swim with me, and- They really model you.
• 32:37
  I know.
• 32:37
  They really, really do.
• 32:38
  Which is also a little scary.
• 32:39
  And, but going back to the food too- So scary I feel like even just, like, being adventurous with food and eating- Mm-hmm different things in front of my kids- Yeah then they are more motivated to try things.
• 32:50
  Mm-hmm.
• 32:50
  Yeah.
• 32:50
  So it's just a good reminder that your habits, it's so much pressure.
• 32:54
  Yeah.
• 32:54
  But- But it also shows that I'm not perfect at all.
• 32:57
  Right.
• 32:57
  Even though I know all these things, I'm not anywhere near perfect, and my kids will be okay.
• 33:04
  Like, you're doing the best you can.
• 33:05
  Mm-hmm.
• 33:06
  Yeah.
• 33:06
  And you're doing what works for your family that day.
• 33:08
  Right.
• 33:09
  So I have, like, the opposite with the boys.
• 33:13
  Like, my oldest, he won't eat'cause he just doesn't think about food.
• 33:16
  Right.
• 33:16
  His no- his food noise is, like, turned off.
• 33:19
  He, like-'Cause he has other things he cares about more he, like, forgets about to drink water, forgets to eat food.
• 33:23
  He just forgets to nourish himself, and he'll play squash for eight hours, and then I get him back and I'm like,"Are you okay?" And he's, like, lethargic, sickly.
• 33:32
  Yeah.
• 33:32
  I'm like, y- screaming at him like,"How did you not eat?
• 33:35
  How did you not drink?" I would've been taking, anxious breaks.
• 33:38
  Like,"Oh, I need to eat, otherwise-" Right"I won't be able to play hard" or whatever.
• 33:41
  And that's a lot of this, what we're talking about is some people, it just doesn't phase them.
• 33:45
  They're not thinking about what their next meal's gonna be.
• 33:47
  They're not thinking about,"Oh, I had four carbs before, so I can't have carbs now." They're just living.
• 33:51
  Yes.
• 33:51
  You know?
• 33:52
  And so he, knock on wood, will never have a bad relationship with food because it's not that important to him.
• 33:58
  Hopefully he knows food nourishes me, food keeps me alive, but it's, he doesn't seem to have an emotional connection to food.
• 34:05
  Yeah, I definitely do.
• 34:07
  Which is great, same.
• 34:08
  I think about food all the time.
• 34:08
  When you guys got here this morning, I was making, I was, like, packing lunches for me and Camilla.
• 34:12
  Yeah.
• 34:12
  'Cause I know we have, like, a big day ahead, and if her and I aren't fed, we're gonna be nasty.
• 34:17
  Mm-hmm.
• 34:17
  So I And I have some men who are emotionally, like, r- attached to food too.
• 34:22
  It's not just women.
• 34:23
  Um, but I think women have more...
• 34:26
  We're more verbal about it.
• 34:27
  Men are sometimes plagued with, like, these binge eating- Mm-hmm habits and overeating, and it's not spoken about too much.
• 34:36
  But I think with women it is a lot more.
• 34:38
  So I think, I guess my takeaway from the question was it, it really quiets the noise.
• 34:43
  Mm-hmm.
• 34:43
  But it does not really affect the emotional side of things.
• 34:46
  I don't think it takes away how you innately feel about food, but I think it will hopefully help you think about it less.
• 34:53
  Yeah.
• 34:54
  If food has always been a source of comfort for you, how do you feel about that then?
• 34:59
  I think you have to actively work It's not taking it away.
• 35:01
  I think a lot of it changed when I had my kids, and it's not active anymore.
• 35:04
  So, you know, I was driving here and I was like,"Oh my God, I'm so fucking nervous.
• 35:08
  I need to go get a latte." Like, no, I didn't need the latte, I just needed my emotional support latte.
• 35:13
  Right.
• 35:14
  You know?
• 35:15
  So does that, what happens when that comfort disappears then?
• 35:19
  You go get yourself a massage after.
• 35:21
  I mean, you still reward yourself.
• 35:22
  You replace it with some other type of- Yeah, just replace it reward.
• 35:24
  Yeah, and you can have vice.
• 35:25
  Like I have bad vi- I'm a serial shopper.
• 35:27
  I love going to the mall.
• 35:29
  Those are my now rewards and punishments.
• 35:32
  But food is too emotionally charged that I can't have it as part of my rewards and punishments.
• 35:38
  I'll go get ice cream tonight because it's a hot night and I like ice cream, not because I was a good person.
• 35:43
  Okay.
• 35:43
  Okay.
• 35:43
  Mm-hmm.
• 35:44
  I think you should still enjoy food.
• 35:46
  I love food more than anyone.
• 35:48
  And my mom used to, like when I would eat something that I really enjoyed, like I would close my eyes and I would enjoy it.
• 35:54
  Mm-hmm.
• 35:54
  And my mom loved watching me do that.
• 35:57
  Mm-hmm.
• 35:57
  And now I see it in Dana do it.
• 35:58
  Yeah, same.
• 35:58
  And like she would- Watching your kids eat- Yeah is such a joy When Dana like tries something new and she like- Yeah enjoys it, I'm like so happy.
• 36:05
  My kids do like a little dance sometimes- Yeah when they love something.
• 36:08
  And it's so nice.
• 36:08
  Your kids like make a noise.
• 36:09
  They make, they go,"Mm, mm." When they're, her kids, when they're eating- They do they're like- They're so into it I love that eating.
• 36:15
  I did that when I first started.
• 36:16
  Yeah.
• 36:16
  It's the cutest thing.
• 36:16
  Yeah.
• 36:16
  I love it.
• 36:16
  It's so cute.
• 36:16
  It's so sweet.
• 36:16
  Food should be exciting- Yeah and new and- Yeah you know, it shouldn't, it's not...
• 36:26
  I think the medication's allowing it to be less of a weapon- Mm-hmm and more of a cultural thing or a, you know, enjoyment thing, a night out thing.
• 36:37
  I just, it used to be so scary to a lot of people.
• 36:40
  Like a lot of girls with eating disorders or- Food used to be so scary food used to be so scary.
• 36:44
  Right.
• 36:45
  Right.
• 36:45
  Knowing you were going to a party and there was gonna be food out and you wouldn't be able to turn it away.
• 36:49
  Mm-hmm.
• 36:49
  Now you can.
• 36:50
  I think it's just- Probably the feeling that you're in control- Yes feels so good, right?
• 36:56
  And it's so new to people.
• 36:58
  Right.
• 36:59
  People who have never felt that in their life.
• 37:00
  Right.
• 37:01
  It's like control in a good way- Yes for once.
• 37:03
  Yes.
• 37:03
  Right?
• 37:04
  Yes.
• 37:04
  What is one of the earliest ages that you're seeing this medication prescribed to patients?
• 37:10
  12 is the earliest- Wow approved age for Wegovy.
• 37:14
  I don't see patients under 18.
• 37:15
  But I've talked to some pediatricians who have started these patients on it, and I think as long as they need the team approach, so like a nutritionalist or a diet- registered dietician- Therapist um, a therapist.
• 37:27
  Yeah.
• 37:27
  Like, I think, I think it's a good opportunity to teach the pediatric population, and I think it can change a lot of their lives.
• 37:36
  I think that, again, I n- I know that this isn't like...
• 37:40
  I can't speak from experience, but any time my kids have anything going on with them, I feel like I need a whole education on it as well.
• 37:48
  Mm-hmm.
• 37:49
  So I feel like if you're a parent that has a child that needs this because of obesity- Mm-hmm uh, the parent needs to see- Right the dietician and the therapist too, because you are the one providing your kids these meals.
• 38:00
  Yeah.
• 38:00
  You know?
• 38:00
  Like, I feel like it's- And unfortunately, a lot of childhood obesity can be from things like financial, like...
• 38:06
  limitations even.
• 38:07
  Yeah, not having enough money for good food, and it's not the kids' fault that they can't- Mm-hmm eat healthily.
• 38:13
  Right.
• 38:13
  Right.
• 38:13
  So I think it is a whole family approach.
• 38:14
  It's not an overabundance of food.
• 38:16
  You know- Right it's like a scarcity It's a type of food- Yeah.
• 38:18
  Yeah.
• 38:18
  Or some people that I see grew up, um, had to clean their plate because they didn't know when the next food was coming type of thing.
• 38:26
  Right.
• 38:26
  And so then they grow up into adulthood, and they feel like they have to finish their plate, and now everything's in abundance.
• 38:30
  You order something, and they give you enough for four people, but they grew up having to clean their plate, so now they clean their plate, and that's where their obesity comes from.
• 38:38
  I think a lot of it, the medication helps control things that have been wired in our brain for so long.
• 38:45
  So if you have a patient that is not medically obese- Yes but has struggled with their weight- Yeah and is, like, 18, which is still young- Mm-hmm how would you, what would you say to that patient?
• 38:57
  So with the younger patients, the biggest thing that I say to them is,"You will be on this medication the rest of your life." Mm-hmm.
• 39:04
  And I use it sort of as not a last resort, but I wanna make sure that we've exhausted all dietary...
• 39:10
  I don't think it replaces diet, exercise- Right healthful eating, and so I wanna make sure that we've exhausted everything we can do before starting this because you just don't wanna start someone on something that they're gonna be on for 60 years.
• 39:24
  Right.
• 39:24
  Yeah.
• 39:25
  That's a great point.
• 39:25
  Yeah.
• 39:26
  That's a great point.
• 39:26
  I'm, I'm asking that because, like, I'm just posing it as a parent now, if you have kids that are struggling with, like, food and- Mm food noise and their weight, and you know that it affects, like, their confidence, their friendships- Yeah.
• 39:37
  It's the hardest thing to watch their relationships as they're entering college, and, like, you feel like as a mom you've given them access to nutrition and to exercise and you just, you can't do anything else.
• 39:46
  Like, do you feel like you're cheating or taking a shortcut by having them do it, you know?
• 39:50
  But is it gonna become like braces, you know, where, like- Yeah every kid has them?
• 39:53
  You know, like, or Invisalign now.
• 39:55
  I mean- Right I'm hoping as the adults get healthier and have a better relationship with food, there'll be less childhood obesity.
• 39:59
  Mm-hmm.
• 40:00
  Well, just like, I know, I, I don't know if this is even related, but, the boys have ADHD.
• 40:04
  They have 504 plans.
• 40:05
  I feel like every one of their friends, I mean, I don't mean to overly generalize- Right but, like, a lot of their friends have 504 plans.
• 40:11
  It's like- Mm-hmm everybody comes with one now.
• 40:14
  Mm-hmm.
• 40:14
  You know?
• 40:15
  And I'm like,"Do you really n- need this?" Like, d- do...
• 40:17
  Why do we have this?
• 40:18
  It's, it's rampant.
• 40:19
  Like, you know?
• 40:19
  It's everywhere.
• 40:20
  Right.
• 40:20
  And the teachers are like- Right"We're make, we make these provisions for all the kids now." Right.
• 40:23
  Like, this is nothing- Yeah this is nothing new.
• 40:26
  It's just in writing now.
• 40:27
  I think as it's just more accessible and more available, people are gonna be using it.
• 40:31
  Right.
• 40:32
  I feel like this is almost becoming, like, the new Botox, right?
• 40:37
  Where it's like, it was kind of something that not everybody used- Right and you didn't admit to.
• 40:42
  I just can't believe how fast this kind of happened over the last year since you were sitting across from us.
• 40:48
  Yeah, and I mean, remember, this stuff has been going, I...
• 40:50
  Like, weight loss medications, like injectables, have been prescribed since at least 2017.
• 40:55
  Mm-hmm.
• 40:56
  No one talked about it until it was more streamlined.
• 40:58
  It was very hush-hush.
• 40:59
  Yeah.
• 40:59
  Right.
• 41:00
  Yeah.
• 41:00
  And I think honestly that's better- Mm-hmm that we're talking about it.
• 41:03
  Mm-hmm.
• 41:03
  But I don't think it means everyone needs to be on it.
• 41:05
  Right.
• 41:06
  But I think it means that people can know it's there as a tool.
• 41:09
  I know we talked about this before, but I feel like we were talking about diet culture and us growing up in that, but it's almost like- Could there be this, like, medication culture that we're gonna replace that with, where there is pressure to be on something because everybody else is doing it?
• 41:27
  That goes back to, like, well, why is anyone fat anymore?
• 41:30
  You know, if everyone could do something.
• 41:33
  But then you think about the limitations.
• 41:35
  They can't...
• 41:35
  Insurance, cost, safety, accessibility.
• 41:39
  You have to remember,, no, not everyone can be on it.
• 41:41
  Mm-hmm.
• 41:41
  Like, we're very lucky to be talking about this and to be able to be on it.
• 41:44
  Mm-hmm.
• 41:45
  But I think we still need to go down to the root of diet and exercise.
• 41:48
  Mm-hmm.
• 41:48
  Like, it'll always go back to that.
• 41:51
  And there are a lot of limitations for a majority of the population.
• 41:54
  Mm-hmm.
• 41:54
  So what we're talking about is a very small part- Yeah of the population.
• 41:59
  So we wanna do some rapid fire myth busting with you, if that's okay.
• 42:03
  All right, hit me.
• 42:04
  So does this ruin your metabolism?
• 42:07
  No.
• 42:08
  Does everybody gain the weight back?
• 42:10
  No.
• 42:11
  I think, and I say this to patients, I think if you're genetically obese and you've struggled with weight your whole life and you lose weight on this medication, you are more likely to definitely gain it back when you're off of it.
• 42:23
  Mm-hmm.
• 42:23
  I think if you are genetically slim and you are healthy and you had kids and you're having a hard time losing weight after the kids, and you use this medication as a tool and then slowly ta- To jumpstart you maybe and then slowly taper off correctly, I think you should be better.
• 42:40
  I don't think everyone's created equal.
• 42:42
  Does this affect fertility?
• 42:44
  So it's not FDA approved for pregnant women or people who are trying to get pregnant because you cannot do research studies on that population.
• 42:53
  But anecdotally, it has improved fertility in a couple ways.
• 42:59
  It can decrease absorption of this birth control pill, so people should know that they need to take a second form of birth control.
• 43:06
  That is very interesting.
• 43:07
  Yeah.
• 43:07
  I never heard that before.
• 43:08
  So if you're only on birth control pills- Wow and you're on this medication, you need to take a second form.
• 43:12
  Wow.
• 43:13
  Um, and I know some fertility centers are using it for patients who are in fertility treatment.
• 43:18
  So to piggyback on that question, what is it doing to any other medications that you could be taking?
• 43:22
  Like if you're taking anxiety medication or if you're taking other supplements, do- can it affect that too?
• 43:28
  It hasn't shown-- Like in all the studies they've done with blood pressure lowering medications, statins, and everything, it has not shown to.
• 43:34
  For some reason, oral contraception drugs have been affected.
• 43:37
  Interesting.
• 43:37
  Wow.
• 43:38
  But like antibiotics, nothing like that should be.
• 43:40
  Are there any correlation with perimenopause?
• 43:44
  I think just improvement in perimenopausal symptoms when on some of these.
• 43:47
  Wow.
• 43:48
  Why is that?
• 43:48
  Which are?
• 43:49
  I don't know the hormonal everything- Right but I do think something to do with insulin resistance, getting sugar into your cell for energy instead of fat storage, less of that central fat, you know, abdominal fat, in perimenopause is when we see a lot of that.
• 44:03
  Right.
• 44:04
  Oh, okay.
• 44:04
  When you start to see- Yeah the fat sort of- In the midsection help start in the midsection.
• 44:07
  Right.
• 44:08
  So it's getting food in the cells for energy instead of hanging out in the bloodstream being turned into fat cells.
• 44:13
  Got it.
• 44:14
  Because it keeps your blood sugar levels...
• 44:16
  so it keeps your blood sugar levels because if you think of like a lock and a key, the medication's opening your cell for, for sugar to get into your cell to use it for energy.
• 44:27
  As opposed to when you're insulin resistant, that cell is locked and you can't get the food in, so you're having blood sugar spikes, you're having crash outs, you know.
• 44:36
  So it's not- That like jittery feeling as you're getting- Yeah, your body's not using it correctly.
• 44:39
  Right.
• 44:39
  It's not using the food or the sugars the best way it can.
• 44:43
  However, it's not FDA approved- For any of it for any of this.
• 44:46
  Any of it.
• 44:47
  I just wanna, like, make that clear.
• 44:49
  Yes.
• 44:49
  Mm-hmm.
• 44:49
  Like, the-- in all of these studies, it's hard to study it, right?
• 44:52
  Yeah.
• 44:53
  We don't hear about studies until they're past, like, phase three.
• 44:56
  So first they're doing all their research, and then they might be, you know, looking at subpopulations.
• 45:01
  We don't hear about it until it's, in mass populations.
• 45:03
  So this won't be weighed- This is way- till way down the line.
• 45:06
  Yeah.
• 45:06
  Way down the line.
• 45:06
  Right now they're working on, like, liver stuff and kidney stuff and, you know, more mainstream medical indications for it, but I think there's gonna be a lot that we're seeing way down the line.
• 45:17
  Can you take this medicine when you're pregnant?
• 45:19
  You are not supposed to because you're technically not supposed to be losing weight.
• 45:22
  You should be gaining weight when you're pregnant.
• 45:25
  We talked about some of the contraindications earlier.
• 45:27
  Are there any other like red flags for patients Um, I'd say if you have, like, a really wonky gastrointestinal tract, if you're very constipated all the time or you feel bloated, nauseous, vom- Yeah you know, I think you should talk to your provider about that.
• 45:44
  I don't think it's a hard stop, but I think you might have to wean up slower or you need to have some s- more support.
• 45:49
  What is the, um, a- recommended age for your first colonoscopy?
• 45:53
  Is it 40 or 45?
• 45:55
  So it is 45 for the general population, but if you have a family history of, like, polyps or cancer, it's gonna be 40 now.
• 46:01
  Do you recommend if you're on these medications for the long run that you start...
• 46:06
  Like, is there any correlation that you need to have, like, a colonoscopy- No or anything sooner?
• 46:10
  No, you just may need to have a stronger clean-out prior to your co- colonoscopy.
• 46:15
  Okay.
• 46:16
  Because the food hangs out longer, so you might need t- you might be more constipated than you would've been otherwise, and so you sometimes- Okay need to do, like, a two-day prep.
• 46:24
  Or you have to go off of them?
• 46:26
  They used to tell you to go off of them.
• 46:28
  Now the general rule is a 24-hour clear liquid diet.
• 46:32
  Okay.
• 46:32
  But different anesthesia centers have different rules.
• 46:35
  Okay.
• 46:35
  So always important if you're going into surgery.
• 46:37
  Have you had a colonoscopy yet?
• 46:38
  I have.
• 46:38
  You have?
• 46:39
  I haven't.
• 46:39
  And now I want a colonic.
• 46:41
  You are?
• 46:41
  No, I'm not going to, and they're not, like, supposed to be good for you.
• 46:44
  There's, like, places that you can go for it.
• 46:46
  I know.
• 46:46
  It just seems so cool.
• 46:48
  Right?
• 46:48
  Like, to see all the yucky stuff come out and...
• 46:51
  Oh my God.
• 46:52
  I mean, when, when I worked in fluoroscopy and radiology- Yeah one of the procedures that we used to have to do was, like, it was called an enema.
• 46:58
  Mm-hmm.
• 46:59
  Yeah.
• 46:59
  And you had to, like, hang a bag- Yeah and put the dye in it, and you would have to, like, retrograde, like, have this, like radioactive dye go into the patient- Mm-hmm and then you would like take X-rays of the patient, and then when they were done, you had to like empty it out and everything- Yeah, it's so cool came out.
• 47:17
  And it was disgusting- but the patients used to like weirdly love it.
• 47:21
  I know.
• 47:21
  I mean, you feel, um, people after colonoscopies, I mean, you feel like depleted and- Yeah whatever, woozy, but you feel thin, and I feel like that's what people like.
• 47:29
  You feel so- You feel empty I'm having my first one in September.
• 47:31
  It's really fun.
• 47:32
  Are you coming to my practice?
• 47:33
  Are you in Bloomfield?
• 47:34
  Does your- Uh, Connecticut GI Connecticut GI?
• 47:36
  Yeah.
• 47:36
  I'm going, I'm going in September- Great when I turn 40,'cause I have a family history.
• 47:41
  But I keep like asking people about like the colonoscopy.
• 47:44
  I'm like,"So what's it like?" It's great.
• 47:45
  "Tell me everything." It's, it's great.
• 47:48
  I mean, it's a good nap.
• 47:49
  I love anesthesia.
• 47:52
  We're all about the nap.
• 47:53
  Yeah.
• 47:53
  We love a nap.
• 47:54
  No, I'm excited.
• 47:55
  It'll be good.
• 47:55
  Do, will I wake up woozy?
• 47:56
  No.
• 47:57
  It's sh- it's like the best nap you've ever had.
• 47:59
  It's only like 10 minutes.
• 48:00
  Did you take the pill or did you do the drink?
• 48:02
  I did the pill.
• 48:03
  So I've tried both, because I feel like if I'm prescribing it to people, I need to know what people- Yeah need to expect.
• 48:08
  The pill is good if you don't mind taking like a lot of pills at once.
• 48:12
  So you have to take 12.
• 48:13
  Oh.
• 48:14
  All of them?
• 48:14
  And then, yeah.
• 48:15
  Yeah, but the drink I've heard is awful.
• 48:17
  The drink used to be awful.
• 48:18
  Okay.
• 48:18
  It used to be a big jug.
• 48:19
  Yeah.
• 48:19
  Now they're smaller.
• 48:20
  Oh, okay.
• 48:20
  I mean, none of it's gonna be pleasant.
• 48:23
  Um, but we just do it.
• 48:24
  I think I'm gonna do the drink.
• 48:25
  I don't think I wanna do the pills.
• 48:27
  Yeah.
• 48:27
  You'll be fine.
• 48:28
  I'm gonna get a really good squeaky clean out.
• 48:30
  And a good nap and a good nap.
• 48:31
  What a day.
• 48:32
  I'm excited.
• 48:33
  It is fun.
• 48:33
  It's gonna be great.
• 48:35
  It's fun.
• 48:35
  Maybe I'll document it.
• 48:36
  Imagine- You should.
• 48:37
  You should do a vlog.
• 48:39
  So 20 years from now, what do you think we'll say about this moment in medicine?
• 48:47
  I think it's gonna be the start of wonderful things.
• 48:51
  I think people will be healthier.
• 48:52
  Hopefully the obesity epidemic will be less.
• 48:55
  And I think that it'll still be on the market.
• 48:58
  Do you think that it will be as common as cholesterol medication?
• 49:02
  Hopefully it won't have to be.
• 49:05
  So hopefully we'll have less obese people, and therefore need to use it less.
• 49:11
  Okay.
• 49:11
  Let's, let's do our pink spotlight.
• 49:13
  Okay.
• 49:13
  You shared one when you got here.
• 49:14
  Yes.
• 49:14
  Yeah.
• 49:15
  Okay, so our pink spotlight is our weekly person, place, thing, tip, mantra, anything making T and I's life a little bit easier this week.
• 49:23
  Steph already shared one when she walked in the door, and we're excited to chat- Okay a little bit more.
• 49:29
  All right.
• 49:29
  So you can go first- Yeah.
• 49:32
  This is a- Two?
• 49:32
  new development what?
• 49:33
  I thought you had two.
• 49:34
  Well, I was gonna do- Kind of had two the Lola blanket, which I'm obsessed with.
• 49:36
  Oh, I love the Lola blanket.
• 49:37
  I love it.
• 49:38
  Never buy it unless you have a discount code.
• 49:40
  Abs-- I do.
• 49:41
  It's ridiculous.
• 49:41
  I have a discount code.
• 49:42
  How much are they?
• 49:43
  They're like$249.
• 49:45
  They're absurd.
• 49:45
  But, like, I get online 50% off.
• 49:46
  But then there's, like, a 40%...
• 49:47
  Yeah, there's, like, 40 to 50% off discounts.
• 49:49
  They're amazing.
• 49:50
  Unreal.
• 49:50
  I have one downstairs and upstairs because, I needed it.
• 49:54
  It's amazing.
• 49:55
  You are a private influencer.
• 49:57
  I just love- You send me the best links- good things for everything.
• 50:00
  I always ask you everything.
• 50:00
  That's why I call you my private influencer- That's a good one'cause you don't share links online.
• 50:03
  It's a real...
• 50:04
  I love the Lola blanket.
• 50:05
  That's a really good one.
• 50:06
  For the kids, ugh.
• 50:06
  I know, but your other one- They did, like, a dog bed.
• 50:08
  Yes.
• 50:09
  Your other one was so good too.
• 50:09
  But my other one is new off the press'cause I learned about it last week- Mm-hmm and it's worked.
• 50:14
  Um, and so We're always woken up throughout the night, whether it's to pee, or our kids are waking us up, or our husbands are snoring, and it's so hard to fall back asleep.
• 50:22
  Mm-hmm.
• 50:22
  So my friend Molly, she taught me this trick where you close your eyes like you're going to sleep, and you're gonna start at A and work in the alphabet, and you're gonna think of three things non-related to each letter.
• 50:36
  So for A you would say, like, apple, archery, application, like three random words, and then B you'd be like bucket, bubbles, ball.
• 50:45
  Like, things that don't matter.
• 50:46
  I swear once you get to, like, H you're asleep.
• 50:48
  I cannot...
• 50:49
  I am gonna try that tonight.
• 50:51
  Even if you remember it, though, like even if you're doing it every night- Yeah, good question I've never got- You don't, like, remember like your three- No, I've done it every night for a week.
• 50:57
  But do you still, do you repeat?
• 50:59
  No,'cause I forget what...
• 51:00
  'Cause you're, like, kind of half asleep- Okay.
• 51:01
  Okay so you forget.
• 51:02
  Oh, so you forget?
• 51:02
  Yeah.
• 51:02
  'Cause I feel like it would work for me for like the first three nights- Yeah, until you have a pattern and then I would be like- No right?
• 51:07
  And then you're kind of, like, searching for words, and then you're, like, falling asleep.
• 51:10
  I didn't even get to B last night.
• 51:11
  What?
• 51:12
  It's real.
• 51:13
  Oh, it real, it's real.
• 51:14
  It works?
• 51:14
  For real.
• 51:14
  And I used to, like, toss and turn after my kids woke me up.
• 51:16
  I'm a bad sleeper.
• 51:17
  You really gotta try it.
• 51:17
  And I'm always, like, someone where if I wake up- Mm-hmm F my life.
• 51:22
  Yeah.
• 51:22
  Like, I have, that's it.
• 51:23
  Yeah.
• 51:23
  Like, so it's really hard for me to get back to sleep.
• 51:25
  There's nothing worse than not being able to fall back asleep.
• 51:26
  Yes.
• 51:26
  So try it.
• 51:27
  The worst.
• 51:27
  Okay.
• 51:27
  Right?
• 51:27
  I'm probably gonna have to try it tonight, unfortunately for me.
• 51:30
  It's really good.
• 51:30
  But- I wanna try.
• 51:31
  You go up, T I, this is like, I, I started using packing cubes- Oh, I love those for packing.
• 51:36
  Oh, the best.
• 51:37
  And I got the Calpak ones- Right from, um, Marshalls.
• 51:42
  Like, they're nothing fancy.
• 51:43
  Mm-hmm.
• 51:43
  I'm sure you could buy them on Amazon or anywhere, but I got all of my stuff into a carry-on for my trip- Perfect to Italy.
• 51:49
  Wow.
• 51:50
  And- Good for you with packing cubes.
• 51:52
  Packing cubes are life-changing.
• 51:53
  Well, they're a great gift.
• 51:54
  It changed my life.
• 51:54
  My sister used to Cricut, like, personalization you can do all different things with them, and it's a great gift for people.
• 52:00
  Mm-hmm.
• 52:00
  That's a really- Yeah that's a good idea.
• 52:02
  But when we had the organizer on- Oh, yeah I, like, went through, and her s- recommendation was go through all of your boxes and pull out all the shoe bags that you have.
• 52:11
  Mm-hmm.
• 52:11
  So I, like, went through all my old shoe boxes, and I pulled out all the bags, and I threw the bags, the shoe bags into the packing cubes.
• 52:18
  And then I put the packing cubes in the luggage.
• 52:20
  So when I went to go pack for this trip, it was, like, all right there for me.
• 52:23
  Everything was there.
• 52:23
  Everything was right there.
• 52:24
  Yep.
• 52:24
  Do you ever do the trick- And so- where the hanging door, thing on the door for kids?
• 52:28
  So, like, y- the shoe hanger off the door, it comes with, like- With all the little pockets those little pockets.
• 52:32
  Yep.
• 52:32
  Oh, yeah.
• 52:33
  I would do, like, each kid's, like, pajama, bathing suit, nighttime outfit, and then I would just hang it up when we got to the trip, and then I'm not worried about, like- All of the things, all over the place picking out the clothes.
• 52:43
  So, like, they're already, their outfits are there.
• 52:45
  The bows were attached to the outfits.
• 52:47
  Have you done that?
• 52:47
  Oh, that's genius.
• 52:47
  I've done that.
• 52:47
  I did that when we went away.
• 52:48
  So you put it all, you organize it, and then you roll it up.
• 52:51
  So I pack it in the thing.
• 52:52
  Yep, okay.
• 52:52
  Roll up the thing- Yep and put it in the suitcase.
• 52:54
  Wow, that's- Oh, that's- It's a good one.
• 52:56
  I've seen that too.
• 52:56
  I've just never- Yeah heard it working.
• 52:58
  Yeah, I liked it.
• 52:59
  That's great.
• 52:59
  We have these- And the kids can go and just grab it and- That's also so nice for storage and stuff.
• 53:05
  Yeah.
• 53:05
  That's smart.
• 53:05
  I like that.
• 53:06
  Once you're there.
• 53:06
  Maybe I'll try that.
• 53:07
  You know?
• 53:07
  That's like when dance, you have, like, the pop-up bag.
• 53:10
  Yes.
• 53:11
  And we have all of these different bags.
• 53:13
  So, like, you have a different clear- Mm-hmm garment bag- Mm-hmm for every dance, and it has all of the jewelry- Yeah the earrings, the makeup, the lip gloss- Yeah for each dance.
• 53:22
  So it's so, it's so great.
• 53:23
  I d- never understood why I didn't do that, like, prior to dance.
• 53:26
  For yourself, yeah.
• 53:27
  Yeah, for myself.
• 53:28
  No, Nick has this, um, Tumi luggage that it's like a garment bag on wheels.
• 53:34
  Yep.
• 53:34
  And we, he and I usually bring that and put all of, like, our hanging stuff in that, and then we'll do, like, another shared suitcase.
• 53:42
  Mm-hmm.
• 53:42
  But this time we didn't do that.
• 53:43
  I just did my- You did a carry-on for the whole trip?
• 53:45
  I d- I did a carry-on for my whole trip.
• 53:46
  That's good.
• 53:46
  Yeah.
• 53:46
  I did packing cubes.
• 53:47
  You for a week.
• 53:48
  Th- And I'm gonna wear- You have so much jeans jeans.
• 53:50
  And w- how many different shoes are you wearing?
• 53:51
  Uh, well, I was just gonna say, I have a pair of, like, kitten heels- Okay that are tan and a pair of kitten heels that are black.
• 53:57
  Like, you know- Okay the Fong ones- Yeah that are really popular right now.
• 54:00
  Yeah.
• 54:01
  And then I have a pair, like, these flats I'll bring and a pair of sneakers.
• 54:04
  You'll wear sneakers with you.
• 54:04
  And I'll wear the sneakers- Yeah on the plane.
• 54:06
  And then I just got the best set from Vuori, um- For traveling?
• 54:11
  For traveling.
• 54:11
  Mm-hmm.
• 54:12
  Was it the wide leg?
• 54:13
  It's c- it's the wide leg, the Halo- Halo wide leg.
• 54:15
  Yeah wide leg.
• 54:16
  I had it in black, and then I was w- I wanted to order, like, the tan color, and one of my girlfriends was wearing it over the weekend, and I was like,"That is, like, the tan color is so cute." Mm-hmm.
• 54:24
  So I'm gonna wear one on the way there and one- Very good.
• 54:27
  on the way home.
• 54:28
  Nice.
• 54:28
  So I'm all, I'm all packed up and ready- Yeah to go'cause I used- Good for you you know, the packing cubes.
• 54:32
  I know be there with Paige.
• 54:33
  Paige DeSorbo's there.
• 54:34
  Maybe you'll see her.
• 54:34
  Mm.
• 54:35
  Oh, I love her.
• 54:36
  Love her.
• 54:37
  Me too.
• 54:37
  Nick says he, I look like her.
• 54:39
  You do.
• 54:39
  You can.
• 54:40
  I love that.
• 54:40
  Yeah, I see it.
• 54:41
  I think it's, like, the voice too.
• 54:44
  I'm obsessed with her.
• 54:44
  She's very cute.
• 54:45
  Very cute.
• 54:47
  Anyway, all right, what do you have?
• 54:48
  Okay, so mine is a dupe for another pink spotlight I've shared before.
• 54:54
  So I love the Kosas Brow- I'm obsessed Nano Pencil.
• 54:58
  Obsessed.
• 54:58
  I don't think you use the nano though.
• 55:00
  No, I have the larger one.
• 55:01
  I use the n- yes, I have the...
• 55:02
  So I love the nano.
• 55:03
  It's like the finest pencil for m- for eyebrows, and I feel like it just makes it made them look so natural, but it was$28 and it was so small.
• 55:14
  I could barely even make it a month, and I was like,"This is so annoying." So I ended up finding one.
• 55:19
  It is by CoverGirl.
• 55:21
  It's called the Clean Fresh Brow Nano, and it is a dupe and it is 8.99 on Amazon, and it's larger so I feel like you get more, and I've already gone the full month having the same pencil and I still have more.
• 55:34
  So- Okay it's like a third of the price.
• 55:36
  It's crazy.
• 55:36
  I go through eyebrow pencils quickly- Yes'cause I use it every single day.
• 55:39
  But like$30 a month is insane.
• 55:40
  I use it every single day.
• 55:42
  Like, sometimes I use it even if I have like, not any other makeup on my face, I still have my brows done.
• 55:47
  Yeah.
• 55:47
  So this is so good.
• 55:48
  It is the exact same, same shade.
• 55:51
  I use like soft brown.
• 55:53
  I think I had used one of the s- one of the lighter browns- Mm-hmm from Kosas, but literally would never know.
• 56:00
  Okay.
• 56:01
  And I love when I find a dupe of something that I love.
• 56:03
  I do love a dupe.
• 56:03
  I love a dupe.
• 56:04
  I love a, I mean, who doesn't love a deal?
• 56:06
  I'm like, this is so great.
• 56:07
  Who doesn't love a deal?
• 56:08
  So great, and it's a bigger pencil.
• 56:10
  Okay.
• 56:10
  Like longer, like, so you get more product, so.
• 56:12
  Okay.
• 56:13
  If anybody got turned on to the Kosas Brow Nano Pencil, get this instead, I swear.
• 56:18
  Yeah.
• 56:19
  Save yourself some money.
• 56:19
  You always pick out the best beauty products.
• 56:21
  I do like a beauty product.
• 56:22
  You always pick out the...
• 56:23
  What's your favorite drugstore product right now?
• 56:26
  I think it's always gonna be the pink and green mascara.
• 56:28
  Oh, so good.
• 56:28
  Oh, the Maybelline pink and green mascara.
• 56:29
  I, I mean, why have we even- Although I really like a La Roche-Posay moisturizer.
• 56:34
  Ooh.
• 56:34
  Oh.
• 56:34
  I think that's a good one.
• 56:35
  Like if you need like a drugstore- I like their face wash.
• 56:37
  Yeah.
• 56:37
  Yeah, yeah, yeah.
• 56:38
  If you need a drugstore like sunscreen moisturizer- Mm that one's really good.
• 56:41
  Yeah.
• 56:42
  I love drugstore finds.
• 56:43
  I feel like we could do a whole episode on it because I just- Well, and also- I live for them there's a drugstore everywhere you go.
• 56:48
  Yeah.
• 56:49
  It's like- So, like, you can just- Well, that's- get it, you know?
• 56:51
  also a good point because I feel like when I would run out of my...
• 56:55
  I would always have to have a backup.
• 56:58
  Mm-hmm.
• 56:58
  And it was never on Am- like, it would- the color that I would use for Cosis was sometimes on Amazon, and sometimes it wasn't.
• 57:06
  So I was like,"What am I gonna do?" When things aren't on Amazon- When you run out- I'm like,"What?" When you run out- Yeah what do you do?
• 57:11
  Because you can't just run out.
• 57:13
  Like, I would have to, like, run out to Sephora.
• 57:15
  I don't wanna run out to Sephora.
• 57:16
  Right.
• 57:16
  I want it to be here.
• 57:18
  So, like, this is nice because it's at CVS, it's at Target.
• 57:21
  It's, like, somewhere where I- It's at the grocery store can quickly go get it.
• 57:23
  Mm.
• 57:23
  You know?
• 57:23
  And so good point.
• 57:25
  Yeah.
• 57:26
  Okay.
• 57:26
  What's your favorite CVS product?
• 57:28
  Currently, it's the Se- what, how do you pronounce it?
• 57:31
  CeraVe?
• 57:31
  Oh, yeah.
• 57:32
  CeraVe.
• 57:32
  CeraVe.
• 57:32
  Yeah.
• 57:33
  The face wash.
• 57:33
  Oh, you know what?
• 57:34
  The milky one.
• 57:34
  I love CeraVe.
• 57:34
  The K18 thing they told me about.
• 57:38
  Oh, the K18 hairspray.
• 57:38
  That actually made a difference.
• 57:38
  Wait, is that the dry shampoo or hairspray?
• 57:40
  So it's, it's dry shampoo.
• 57:41
  Um, both.
• 57:41
  No, I got the Root Lift and the dry shampoo.
• 57:43
  Did you get both?
• 57:43
  I got both.
• 57:44
  The, how, with the- Isn't it like a mist?
• 57:45
  The Root Lift smells- Yeah.
• 57:46
  It smells really good the Root Lift smells so good.
• 57:48
  I need, I need that- So-'cause I hate dry shampoo right now.
• 57:50
  I- I hate the chalkiness.
• 57:52
  Me too.
• 57:52
  This is like a m- this is like a spray.
• 57:54
  It's not like a shh spray.
• 57:56
  Yeah.
• 57:56
  Yeah.
• 57:57
  It's like ch, ch, ch spray.
• 57:58
  Yes.
• 57:58
  It's really nice.
• 57:59
  It smells good.
• 58:00
  My hair has been lasting a full week- Wow without having to wash it.
• 58:05
  Okay, I need some of that.
• 58:06
  Like a full week, maybe even longer.
• 58:07
  Influenced.
• 58:08
  It's really good.
• 58:08
  It's really good.
• 58:09
  I like it a lot.
• 58:10
  Okay.
• 58:10
  'Cause I don't even use dry shampoo anymore.
• 58:12
  Yeah.
• 58:12
  I feel like once I got it out of my hair,'cause I used to be, like, an addict.
• 58:16
  And now I'm like,"I cannot." It makes my hair feel disgusting.
• 58:17
  I just have to wash my hair constantly.
• 58:18
  My hair never stays the same.
• 58:19
  Like- No.
• 58:20
  So I need to try it.
• 58:20
  This is good.
• 58:20
  It is good.
• 58:21
  'Cause I cannot also wash my hair every three days.
• 58:24
  I'm going crazy.
• 58:25
  Right.
• 58:26
  No, like, it's- Every three days is, like, a blessing.
• 58:26
  I have to do it, like, ev- how do you work out and then not- It's gross but you train your hair.
• 58:30
  It eventually- I know.
• 58:31
  You've told me this it eventually, like- My hair is just gross does not get dirty anymore.
• 58:35
  Mine'll be greasy by the end of the day.
• 58:35
  Yeah.
• 58:35
  No.
• 58:35
  I have to wash it.
• 58:36
  Your hair looks really good right now.
• 58:37
  Thanks so much.
• 58:37
  Shout out to Blow in Canton.
• 58:39
  Oh.
• 58:39
  Oh.
• 58:39
  Love it.
• 58:40
  They do a nice job there.
• 58:40
  They do do a nice job there.
• 58:41
  We, I wash- I went in the ocean on Sat- Saturday or Sunday, I guess.
• 58:46
  You ruined that Thursday blow out.
• 58:47
  And you washed it.
• 58:47
  You washed it Sunday.
• 58:47
  And I ruined my Thursday blow out.
• 58:49
  Your Thursday blow out.
• 58:50
  So I just, like, slicked my hair back.
• 58:52
  The girls are really into those slick sticks.
• 58:54
  I love a slick back.
• 58:55
  Wait, have you ever heard of the Maen?
• 58:56
  M-A-E- Oh, yeah N.
• 58:57
  Obsessed.
• 58:58
  Is it the, the slick stick?
• 58:59
  So they make that one that's like a clear mascara wand.
• 59:02
  Okay.
• 59:03
  And there's also a spray that comes with a brush.
• 59:05
  Mm.
• 59:05
  Allie told me about it- Oh for, like, the dance kids.
• 59:07
  Yeah.
• 59:07
  But I do it, Devin has, like, that frizz, like, really curly hair.
• 59:10
  Mm-hmm.
• 59:11
  I'm obsessed with it.
• 59:12
  Okay.
• 59:12
  M-A-E-N.
• 59:13
  I need that.
• 59:14
  I need something to slick the- So Mila and Ava, theirs looks like deodorant.
• 59:18
  Oh, really?
• 59:18
  But it's like a stick.
• 59:19
  Oh, I have one from Kids that.
• 59:19
  Oh, Brandon has that.
• 59:20
  Like a Bed Head one too.
• 59:21
  Yes.
• 59:21
  I have one from Kids that.
• 59:22
  It's like that.
• 59:23
  This one's so good.
• 59:23
  And then they have a brush that they like to use.
• 59:25
  But that one makes your hair feel gross.
• 59:26
  No, but this is beautiful.
• 59:28
  Well- This is amazing.
• 59:29
  Okay.
• 59:29
  I want an Amazon box.
• 59:30
  I want a box.
• 59:31
  Oh.
• 59:31
  But it's amazing, especially for beauty It needs to be on Amazon.
• 59:34
  It needs to be on Amazon.
• 59:35
  I know.
• 59:35
  Or I'm not buying it.
• 59:37
  Rhode, uh, whatever that brand is, isn't on Amazon, and I'm freaking out.
• 59:40
  Well, I went- So when I got home from the beach on Sunday, I showered, and I didn't...
• 59:46
  I washed my hair and I let it air dry.
• 59:47
  This is air dry?
• 59:48
  And this is air dry, and then I took the c- the curler tool- Oh, I like it and I just like threw- It looks good waves in it.
• 59:54
  It looks good.
• 59:54
  But I got the Davi- Have you ever tried the Davi shampoo and conditioner?
• 59:58
  Mm-mm.
• 59:58
  It made my hair like clean and bouncy.
• 1:00:00
  Oh, it did?
• 1:00:01
  I don't know.
• 1:00:01
  I did like the scalp, the scalp one.
• 1:00:04
  I know- You didn't like it?
• 1:00:04
  Yeah, because I feel like sometimes it's just- Did you feel like it was heavy?
• 1:00:07
  I, yeah,'cause, and I feel like there was like a film left over.
• 1:00:09
  See, and I thought the opposite.
• 1:00:11
  I thought it like made my hair- It could be water.
• 1:00:12
  It could be water.
• 1:00:13
  Really clean.
• 1:00:14
  Yeah.
• 1:00:14
  I swear.
• 1:00:14
  Or you have thicker hair and you have thinner hair.
• 1:00:16
  Yeah.
• 1:00:16
  I thought it made my hair like super clean and almost like bouncy.
• 1:00:20
  Mm.
• 1:00:20
  Bouncy.
• 1:00:20
  Because like everybody likes the Oribe shampoo and conditioner, and I feel like that's too heavy for my hair.
• 1:00:26
  Yes, that i- that is very heavy.
• 1:00:28
  Yeah, but some people like love it.
• 1:00:29
  Do you know what?
• 1:00:30
  I'm gonna share another thing spotlight.
• 1:00:30
  I like Pantene Pro-V two-in-one.
• 1:00:32
  I was gonna say.
• 1:00:33
  Oh.
• 1:00:33
  My hairstylist hates that I use it- I- but I do Sam- Why?
• 1:00:36
  It's been around forever turn away.
• 1:00:37
  Don't listen.
• 1:00:38
  Two-in-one.
• 1:00:38
  I lis- So I follow this girl, Abby Young, she's on Instagram, and she's like reviews drugstore and like- Yeah you know, salon products.
• 1:00:48
  And she swears by Pantene Pro-V volume.
• 1:00:53
  It's a clear shampoo.
• 1:00:56
  And I bought it.
• 1:00:57
  It's like$5, and it is, if you need, like, a deep scrub, it is so much better than any of the clarifying shampoos I've ever used.
• 1:01:06
  Like, I have bought ones from Ouai, from, like, a mil- um, I've tried- Yeah a million.
• 1:01:10
  Oribe, like, where it's, like, d- just like a good scrub.
• 1:01:14
  Pantene Clear, it's a clear volumizing shampoo.
• 1:01:18
  Okay.
• 1:01:19
  But it, your hair will be squeaky clean.
• 1:01:22
  Ooh, I love a nice squeaky clean.
• 1:01:22
  And I'll use it every once in a while.
• 1:01:24
  I'll just, like, throw it in the mix, and especially, if you have, like, buildup, if you are someone that uses dry shampoo, it just gets rid of everything.
• 1:01:33
  Like, my hair is, like, so clean.
• 1:01:35
  Oh.
• 1:01:36
  But, like, stylists hate when you say that.
• 1:01:38
  Need it.
• 1:01:38
  But, like-'Cause there's, like, petroleum in there or something I get it, but, like, sometimes you just need a squeaky clean.
• 1:01:43
  Well, it has been a pleasure once again, Steph.
• 1:01:46
  Thanks for chatting with us.
• 1:01:46
  Of course.
• 1:01:46
  Thank you for coming and hanging with us again- Thanks for having me and giving us all the scoop, and we love you.
• 1:01:51
  Thank you so much.
• 1:01:52
  Thank you.
• 1:01:52
  Happy to be here.
• 1:01:52
  Where can our listeners find you if they need to see you in your practice?
• 1:01:57
  So my Instagram handle will be tagged, and then I am in practice at Connecticut GI.
• 1:02:02
  I work in the Glastonbury and Bloomfield location.
• 1:02:05
  But you can catch me virtually or on telemedicine anywhere.
• 1:02:08
  Amazing.
• 1:02:08
  Yes.
• 1:02:09
  In Connecticut.
• 1:02:10
  Thank you.
• 1:02:10
  Thank you- You're welcome so much.
• 1:02:11
  We will see you, and we will be back next week.
• 1:02:13
  Thank you, guys.
• 1:02:15
  All right.
• 1:02:15
  Bye.