Latest / Wits & Weights | Strength & Fat Loss Over 40 / 28% Weight Loss on Retatrutide AND Protect Muscle? | Ep 477

Transcript

28% Weight Loss on Retatrutide AND Protect Muscle? | Ep 477 · Wits & Weights | Strength & Fat Loss Over 40

• 0:00
  Philip Pape: There is a new weight loss drug in the headlines right now.
• 0:03
  Philip Pape: It is a triple agonist called retatrit.
• 0:06
  Philip Pape: Some people call it retatutride.
• 0:08
  Philip Pape: And the numbers are the biggest that we've seen so far, up to 28% of body weight in the latest trial.
• 0:14
  Philip Pape: So if you're on a GLP1 or you're thinking about one, you're probably wondering, does this change anything for me?
• 0:19
  Philip Pape: Today I'm going to show you what the data shows, what it doesn't show, and one thing that this huge amount of weight loss is not actually going to fix, no matter how good the drug gets.
• 0:29
  Philip Pape: And I'm not talking about muscle.
• 0:35
  Philip Pape: Welcome to Wits and Weights, the show that puts a popular piece of fitness advice under the microscope, finds the hidden reason it doesn't work, and gives you the deceptively simple fix that does.
• 0:45
  Philip Pape: I'm your host, certified nutrition coach Philip Pape.
• 0:48
  Philip Pape: And a few weeks ago, we did a full episode on GLP1 medications as a category.
• 0:53
  Philip Pape: The whole picture, miracle drug versus is it cheating, what the body composition data says, all that stuff, the science behind it.
• 1:01
  Philip Pape: Today we're gonna get a little bit more narrow and very timely, very trendworthy because there's a specific drug, retatratide.
• 1:09
  Philip Pape: And by the way, pronunciation can go both ways.
• 1:11
  Philip Pape: Eli Lilly and their CEO call it retatrotide.
• 1:14
  Philip Pape: A lot of people will say retatrutide, like semaglutide, because of some linguistic, you know, rules, let's say.
• 1:22
  Philip Pape: I don't care.
• 1:22
  Philip Pape: I'm gonna say retatrotide because a lot of the guys I follow call it that.
• 1:26
  Philip Pape: It's been all over the news.
• 1:27
  Philip Pape: The phase three trials came out, and the weight loss numbers are the largest ever recorded.
• 1:31
  Philip Pape: I have some former clients and even current clients who have experimented with it on their own, not under my supervision, and report, you know, incredible results.
• 1:39
  Philip Pape: There are things about it that seem to go above and beyond weight loss as well, potentially for liver fat and stuff like that.
• 1:45
  Philip Pape: Uh, but I'm getting a lot of questions about it.
• 1:47
  Philip Pape: People want to know, you know, is this something I should do?
• 1:50
  Philip Pape: There's a lot of or consider, there's a lot of discussion in Reddit and in the body composition forums about like rapid fat loss.
• 1:57
  Philip Pape: It's kind of an interesting, you know, designer approach to rapid fat loss among bodybuilders.
• 2:03
  Philip Pape: Very interesting, uh, the way, the way it's being talked about compared to the other ones.
• 2:07
  Philip Pape: And then, of course, there's the whole muscle loss issue, right?
• 2:10
  Philip Pape: Which we'll address briefly, but you know, it's not gonna be the main thing here.
• 2:14
  Philip Pape: I really want to do two things today.
• 2:16
  Philip Pape: First, I want to separate what the data shows from what I think it means very deliberately with nuance.
• 2:21
  Philip Pape: They're different things.
• 2:22
  Philip Pape: A lot of the coverage in the news just smears all this stuff together.
• 2:25
  Philip Pape: It's very surface level.
• 2:27
  Philip Pape: And then I want to give you a framework, right?
• 2:29
  Philip Pape: Not a hot take, just a framework.
• 2:31
  Philip Pape: How do we think about this drug or any other drug that's coming down the pipeline?
• 2:36
  Philip Pape: Because more are coming.
• 2:37
  Philip Pape: I think retatrotide is not the last one.
• 2:39
  Philip Pape: There's other drugs on the other side of the spectrum for what do you call it, you know, preventing muscle loss as well, that we're looking at, like myostatin blockers, et cetera.
• 2:48
  Philip Pape: Then I want you to stick around to the end of today's episode.
• 2:50
  Philip Pape: I'm gonna give you a 30-second self-test to tell you whether you've done what you need to do to keep the weight off after you stop a medication like this.
• 2:58
  Philip Pape: And honestly, a lot of these things are things you should be doing regardless of that.
• 3:02
  Philip Pape: But I think it's important to ask yourself these questions so that you could actually maintain your results.
• 3:08
  Philip Pape: All right, let's talk about what this drug is retatrotide and the weight loss and all of that, because the mechanism is important.
• 3:15
  Philip Pape: You've heard of semaglutide, that's osempic, that's wagovi, that's a single agonist.
• 3:21
  Philip Pape: It hits one receptor, GLP1, that is a hormone that your gut releases that tells your brain that you're full.
• 3:28
  Philip Pape: And then it slows down how fast your stomach empties.
• 3:31
  Philip Pape: And by the way, side tangent, if you take, if you eat a lot of fiber, you're gonna get a lot of that naturally, just FYI.
• 3:37
  Philip Pape: Okay.
• 3:38
  Philip Pape: Then there's terzepatide, which is Manjaro and Zep bound.
• 3:41
  Philip Pape: That's the dual agonist.
• 3:43
  Philip Pape: It hits GLP1 and a second receptor called GIP.
• 3:48
  Philip Pape: So that is two targets.
• 3:49
  Philip Pape: And in the trials, it outperforms semaglutide on weight loss.
• 3:52
  Philip Pape: And again, semaglutide, semaglutide, doesn't matter.
• 3:56
  Philip Pape: Retatrotide is then the next step, which is a triple agonist.
• 4:00
  Philip Pape: It hits GLP1, GIP, and then a third one, glucagon.
• 4:04
  Philip Pape: And that's the interesting part.
• 4:06
  Philip Pape: And I want to explain why.
• 4:07
  Philip Pape: The glucagon is really interesting.
• 4:09
  Philip Pape: The first two receptors, GLP1 and GIP, they work mostly on the energy inside, right?
• 4:14
  Philip Pape: They turn down your appetite.
• 4:17
  Philip Pape: But the glucagon piece, the third piece for retatrotide, is theorized to work on the energy out side.
• 4:24
  Philip Pape: It acts on your liver and it's thought to increase energy expenditure and burn liver fat directly.
• 4:30
  Philip Pape: So, in theory, you've got here appetite suppression on one hand and a bump in how much energy you're burning on the other.
• 4:38
  Philip Pape: And we love talking about metabolism and how important that is.
• 4:41
  Philip Pape: And that's why this could be so powerful.
• 4:44
  Philip Pape: And so when you look at the numbers, it backs it up.
• 4:46
  Philip Pape: In the phase two obesity trial published in the New England Journal of Medicine, people on the highest dose of retatrotide lost 24% of their body weight over 48 weeks.
• 4:56
  Philip Pape: So that's just less than a year.
• 4:57
  Philip Pape: And it wasn't, it didn't plateau by that point.
• 5:00
  Philip Pape: It was still going when the trial ended.
• 5:02
  Philip Pape: And then the phase three trials came out, they call it Triumph 1.
• 5:06
  Philip Pape: And the highest dose, they got 28%, but that was over 80 weeks.
• 5:10
  Philip Pape: And then there was an extension group that had even more severe obesity and they got past 30% weight loss.
• 5:16
  Philip Pape: So if we put it in context, semaglutide in in the big trial that we know about there got to people, got people to about 15%.
• 5:23
  Philip Pape: Terzepatide got to 21, maybe 22%.
• 5:26
  Philip Pape: And now we've got a drug flirting with almost 30%.
• 5:29
  Philip Pape: So that is a huge amount of weight loss just from the drug.
• 5:32
  Philip Pape: Now, a real important caveat that's going to apply to the rest of the episode.
• 5:38
  Philip Pape: The comparisons I gave you were like the 15 versus 21 versus 28%.
• 5:42
  Philip Pape: These are across different trials, right?
• 5:44
  Philip Pape: They're different people, different starting weights, different lengths, different decades of life, et cetera, which it means they're not head-to-head, which for practical reasons you could understand why.
• 5:52
  Philip Pape: There are different drugs being tested under different, maybe different protocols and different groups and so on.
• 5:57
  Philip Pape: So there's never been like a head-to-head trial for tatrotide against trusepatite, semaglutide.
• 6:02
  Philip Pape: So when you see the comparisons, just you know, put a little skepticism on any of these claims because these are cross-trial comparisons.
• 6:12
  Philip Pape: I don't know.
• 6:12
  Philip Pape: That's just a caveat I thought I'd mention again, because we like nuance here.
• 6:16
  Philip Pape: So that's the drug, that's how much weight loss.
• 6:19
  Philip Pape: And now what we want to do is dig down a little bit deeper.
• 6:23
  Philip Pape: So when you lose 28% of your body weight, the obvious question, I think this is potentially the most important question, right?
• 6:31
  Philip Pape: Is what was the weight that you lost?
• 6:33
  Philip Pape: Was it fat, was it muscle, and how much of each?
• 6:35
  Philip Pape: That is what we care about on this show when we talk about body composition, health, physique, you know, muscle mass, is that when you lose weight, you want to lose body fat.
• 6:45
  Philip Pape: You don't want to just lose weight.
• 6:47
  Philip Pape: And when you look at the biggest trial, the one I mentioned in the New England Journal of Medicine, they didn't measure body composition.
• 6:53
  Philip Pape: They did there's no DEXA scan, no lean mass data, no fat mass data.
• 6:57
  Philip Pape: And it kind of floors me a little bit that they wouldn't measure those things because they're so focused on just weight loss, which I'm not saying weight loss isn't massively important for moving the needle for so many people when it comes to their health, because it is.
• 7:10
  Philip Pape: I'm also not saying that it isn't helpful for the reasons why people struggle to lose weight, right?
• 7:16
  Philip Pape: With like the food noise.
• 7:17
  Philip Pape: Super important things.
• 7:18
  Philip Pape: I get it.
• 7:19
  Philip Pape: But when you hear retatrotide being talked about on body composition and bodybuilding forums and Facebook groups and whatever, and saying, hey, this is more muscle sparing, there's no evidence for that.
• 7:32
  Philip Pape: There is zero evidence for that.
• 7:34
  Philip Pape: It's the same as any other form of weight loss.
• 7:36
  Philip Pape: You're gonna have to do the right thing to preserve your muscle, which is lift weights.
• 7:40
  Philip Pape: Uh, you know, eat protein, yes, but mostly the training stimulus is what holds on to the muscle.
• 7:46
  Philip Pape: And the the only retatrotide body composition data actually comes from a smaller group in a separate trial.
• 7:54
  Philip Pape: It was a diabetes trial, and they did get DEXA scans.
• 7:57
  Philip Pape: And guess what they found?
• 7:58
  Philip Pape: The proportion of weight losses lean mass was similar to other obesity treatments.
• 8:04
  Philip Pape: Not any better than it wasn't, it didn't protect their muscle mass or whatever.
• 8:07
  Philip Pape: So just I want to get that out of the way right now because you may have seen that kind of misinformation online already.
• 8:11
  Philip Pape: And if we look across the GLP1 drugs, when you don't strength train and you don't pay attention to protein, you can lose somewhere around a quarter to up to, in some cases, 40% of the weight is lean mass.
• 8:22
  Philip Pape: Now, not all of that is muscle, that's lean mass.
• 8:24
  Philip Pape: Some of it's water, some glycogen, some of it's your liver getting smaller, which is actually a good thing in this case, but a huge chunk of it is muscle mass, right?
• 8:32
  Philip Pape: The contractile, metabolically active tissue that we really, really love and care about.
• 8:36
  Philip Pape: So if we think about the math, if retatrotide loses, you know, causes a loss of lean mass at the same proportion as the rest, but it takes you to a bigger total weight loss, then of course, the raw, absolute pounds of muscle you're gonna lose is even more in the same amount of time, right?
• 8:52
  Philip Pape: Now, I again I mentioned like a former client who experimented with this, and we're at a place where you can only experiment with it until it's approved and available.
• 9:02
  Philip Pape: And you know, he was lifting weights.
• 9:04
  Philip Pape: So, of course, he got the benefit of the fat loss piece of it.
• 9:07
  Philip Pape: The appetite side is obviously super important for a lot of people.
• 9:11
  Philip Pape: And so just changing the energy in, and then now the potential energy out can be, of course, very powerful.
• 9:17
  Philip Pape: And I just wanted to sit with this for a bit because it's super important, you guys listening.
• 9:20
  Philip Pape: Most of you are in your 30s, 40s, 50s beyond listening to this show.
• 9:24
  Philip Pape: We have a lot of women who listen to the show, probably two-thirds of the audience.
• 9:27
  Philip Pape: If you're in your 40s or 50s, if you're going through perimenopause or past that, if you're already fighting the accelerated muscle loss that occurs with age, and that's why you're listening to the show because you want to lift weights, you want to have a better uh lifestyle, and you want to, you know, feel better in your body, you want to have better energy and function, then listen up, right?
• 9:44
  Philip Pape: Because, you know, if your estrogen is dropping or testosterone's dropping, it's harder to build and keep muscle.
• 9:48
  Philip Pape: Well, it's not harder to build muscle, it's harder to keep it if you're not building the muscle.
• 9:52
  Philip Pape: Let's just put it that way, and you're at most risk of that accelerated muscle mass.
• 9:56
  Philip Pape: Now you then go on to this drug and you're not already doing something to preserve that muscle.
• 10:01
  Philip Pape: Now I think you can see the problem, right?
• 10:03
  Philip Pape: So that's that's kind of the gist on retatrotide.
• 10:07
  Philip Pape: And, you know, one thing I like to tell people is look, that doesn't preclude you from working on your lifestyle while taking these drugs.
• 10:14
  Philip Pape: In fact, you need to, you have to work on the lifestyle.
• 10:17
  Philip Pape: We help people with this all the time in what's called eat more lift heavy.
• 10:20
  Philip Pape: And I know I talk about my program a lot, as you would expect, because it's our program and we bring you this content for free.
• 10:25
  Philip Pape: And this is the way that we support the podcast and our business.
• 10:29
  Philip Pape: But when you're on tursepatite, or in the future, I'm gonna see more people on retatrotide, there's an interesting phenomenon that happens.
• 10:37
  Philip Pape: Your appetite is highly suppressed, right?
• 10:39
  Philip Pape: And now you're starting to lose straight weight, and you maybe you're a little bit excited.
• 10:42
  Philip Pape: Maybe you are lifting weights, but then you start to have issues because you sometimes you can't eat enough or you can't eat enough of protein, and you're not in touch with their hunger signals as much.
• 10:53
  Philip Pape: And so now it's this weird limbo kind of you know, middle ground of, okay, do I titrate down a little bit as I'm building in the lifestyle?
• 11:01
  Philip Pape: You know, some people have such severe appetite issues that they don't, it doesn't actually cause a concern.
• 11:06
  Philip Pape: They could just stay on the drug and they can eat enough and they can, you know, lose fat and weight at the right glide path, let's say, while they're lifting and getting their protein locked in and all of that.
• 11:16
  Philip Pape: But what we like to help people with is figure out from your own data, from your own hunger signals, from your food, how you're logging it, where the issue is.
• 11:24
  Philip Pape: And just this, just the last couple of weeks, we have someone in the group who talked to their doctor and they say, you know what, we're gonna slowly get you off this drug because you may not need it anymore.
• 11:33
  Philip Pape: You you're on Phillips program and something magical is happening to you.
• 11:36
  Philip Pape: What's going on?
• 11:37
  Philip Pape: He's like, Well, I'm lifting consistently.
• 11:39
  Philip Pape: I'm tracking my food, I'm trying to get enough protein, I'm eating more fiber, and I'm losing weight, but I'm almost losing it too quickly.
• 11:45
  Philip Pape: And I don't have enough appetite to eat the minimum that I need to eat to stay at the right level of fat loss.
• 11:51
  Philip Pape: Isn't that crazy?
• 11:52
  Philip Pape: So if you go to eatmoriftheavy.com, you'll learn all about what we do.
• 11:56
  Philip Pape: Um, it's a very guided, structured approach over a six-month period where each week we drop a little nugget of knowledge to help you move forward.
• 12:05
  Philip Pape: And it's not information, it's actually do this this week.
• 12:08
  Philip Pape: Do this this week.
• 12:09
  Philip Pape: And it helps you set the skills up for the tracking and the lifting and the eating and all the other things.
• 12:15
  Philip Pape: And so if you're on GLP1 or, you know, a trazepotide or maybe or tatritide, you've got to have a structured approach to put in the lifestyle in parallel.
• 12:23
  Philip Pape: And that's really my key message with any of this stuff when I talk about GLP1s.
• 12:27
  Philip Pape: It's not that they're a shortcut or, you know, you didn't have the will to do it yourself or you didn't know how to modify your behavior.
• 12:34
  Philip Pape: It's like, no, okay, you chose to use this tool for one reason or another because you needed it, wanted it, your doctor suggested it, you struggled with something, whatever.
• 12:41
  Philip Pape: Doesn't matter.
• 12:42
  Philip Pape: I don't care.
• 12:42
  Philip Pape: That's great.
• 12:43
  Philip Pape: You're a human being with your own struggles, like we all have.
• 12:45
  Philip Pape: Now let's work to incorporate the lifestyle you need.
• 12:48
  Philip Pape: It doesn't guarantee for you as an individual you're gonna completely come off the drug.
• 12:52
  Philip Pape: You might have such massive food noise and emotional eating issues that it's necessary and helpful for that from a medical perspective.
• 12:59
  Philip Pape: But for many, it helps you titrate down and sometimes get off of it completely or use it as a tool when you need to.
• 13:06
  Philip Pape: And then from a budget perspective, it can be helpful because these things are darn expensive.
• 13:10
  Philip Pape: So let's that that's kind of the climax of the episode.
• 13:14
  Philip Pape: But, you know, the fix for retatrotide is the same fix for every other drug.
• 13:20
  Philip Pape: There's no special GLP1 protocol.
• 13:23
  Philip Pape: Don't get scammed into like a special GLP1 diet or GLP1 book.
• 13:27
  Philip Pape: I do know a couple of folks in the industry who I respect who have come out with GLP1 protocols and I'm a little bit kind of cringe or I feel a little icky about it, right?
• 13:37
  Philip Pape: Because it it's kind of like the preying on women who are in peri and postmenopause where your body's broken and it doesn't work anymore.
• 13:44
  Philip Pape: And so I'm gonna fix everything for you.
• 13:46
  Philip Pape: We need to balance your hormones.
• 13:47
  Philip Pape: It's that kind of language, which I don't like.
• 13:49
  Philip Pape: I'm perfectly fine saying, hey, if you're in perimenopause and your hormones are declining, now's the time to step it up and lift and learn to eat better for your body.
• 13:58
  Philip Pape: But we would do that anyway, whether you're in perimenopause or not.
• 14:01
  Philip Pape: But like now's the time to do it, but without preying on the fears.
• 14:04
  Philip Pape: And I think the same thing goes here with like the GLP ones.
• 14:07
  Philip Pape: You don't need a special protocol.
• 14:09
  Philip Pape: What do you need to do though?
• 14:10
  Philip Pape: Okay, four pieces.
• 14:12
  Philip Pape: Number one is absolutely resistance training.
• 14:14
  Philip Pape: This is the biggest lever in your life for the rest of your life that has to be part of a routine.
• 14:19
  Philip Pape: That has to be part of your routine.
• 14:21
  Philip Pape: It's more important than cardio, probably more important than steps and movement.
• 14:25
  Philip Pape: In fact, I would say it is because you have to do it.
• 14:28
  Philip Pape: In other words, if you had to pick lifting or steps, I would pick lifting.
• 14:32
  Philip Pape: Of course, it's not a mutually exclusive thing.
• 14:34
  Philip Pape: I don't want you lifting and sitting around all day.
• 14:36
  Philip Pape: We just did an episode about the sedentary lifter one or two episodes ago.
• 14:40
  Philip Pape: So go check that out.
• 14:41
  Philip Pape: But lifting is the number one lever because the stimulus for your muscles is the only thing that prevents muscle loss when you're losing weight, but also helps you preserve and build muscle even when you're not losing weight as we get old.
• 14:57
  Philip Pape: So that's number one.
• 14:58
  Philip Pape: Number two is having a certain minimum amount of protein.
• 15:00
  Philip Pape: Now, the more and more I talk about this and the more evidence we find, we see that number one, the amount you need isn't a crazy amount.
• 15:08
  Philip Pape: Okay.
• 15:08
  Philip Pape: Yes, we talk about up to one gram per pound of protein, but the minimum is more like 0.6, 0.7.
• 15:14
  Philip Pape: And if you're there, you are in great shape.
• 15:16
  Philip Pape: You've got like 90, 95% of the benefits.
• 15:18
  Philip Pape: Total protein for the day, 0.7 grams per pound of goal body weight is really the idea here.
• 15:24
  Philip Pape: So if you're quite overweight and you're trying to lose weight, you don't have to quite get 0.7 grams per pound of your current body weight.
• 15:30
  Philip Pape: It could be toward your target body weight.
• 15:32
  Philip Pape: But don't pick a ridiculously, you know, 100 pounds less body weight, just something reasonable for the next, say, six months where you're gonna get to.
• 15:40
  Philip Pape: So that's kind of the floor.
• 15:41
  Philip Pape: And the problem when you're on a GLP one drug is your appetite is lower and protein is very, very filling.
• 15:48
  Philip Pape: So if you are now bringing it up and you're on these drugs, that's where you might run into the wall of, oh my God, this is too much to eat.
• 15:54
  Philip Pape: I mean, we see it all the time in eat more lift heavy.
• 15:57
  Philip Pape: You come in and they're like, okay, I know I need to get this much protein.
• 15:59
  Philip Pape: I even know what foods make it up, but I can't physically do it, Philip.
• 16:02
  Philip Pape: I'm too full.
• 16:03
  Philip Pape: How do I do it?
• 16:03
  Philip Pape: Yeah, I've tried the shakes.
• 16:05
  Philip Pape: Yeah, I've tried more frequency.
• 16:06
  Philip Pape: Well, sometimes you just actually have to lower the drug dose.
• 16:09
  Philip Pape: And that's a great problem to have if many of you see that as a place you want to get to.
• 16:14
  Philip Pape: But protein's very, very important.
• 16:16
  Philip Pape: Uh, number three is how quickly you are losing weight.
• 16:20
  Philip Pape: So with one of these drugs, especially retatrotide, which is so powerful, you can lose weight faster than your body can handle without it losing muscle.
• 16:31
  Philip Pape: And again, number one and two, training in protein are gonna massively mitigate that.
• 16:36
  Philip Pape: But there is a cliff that you can go off of here where you're just losing way too fast.
• 16:42
  Philip Pape: Now it depends on the duration.
• 16:44
  Philip Pape: Depends on the duration.
• 16:45
  Philip Pape: So this is why I think retatrotide comes up in the rapid fat loss discussions, which we're gonna do an episode on that topic pretty soon.
• 16:53
  Philip Pape: Is that bodybuilders are like, okay, I'm gonna go on retatritide for like four weeks and I'm gonna lose a massive amount of weight, but I'm gonna keep my, I'm gonna do like a protein-sparing modified fast, and then I'm not gonna have the hunger.
• 17:04
  Philip Pape: And you know what?
• 17:05
  Philip Pape: I can't, I can't argue with the logic.
• 17:08
  Philip Pape: I really can't argue with the logic.
• 17:10
  Philip Pape: So the problem is right now is you can't get these drugs legitimately.
• 17:14
  Philip Pape: And somehow people are talking about retatrotide as if it's special versus the other two.
• 17:20
  Philip Pape: It's special in the sense that it has a third agonist that affects glucagon in your liver.
• 17:24
  Philip Pape: That that's actually pretty cool.
• 17:25
  Philip Pape: And that could move the needle in its own way.
• 17:27
  Philip Pape: I totally acknowledge that.
• 17:28
  Philip Pape: But it's not special in terms of the weight, in terms of like the muscle mass preservation part.
• 17:33
  Philip Pape: So just take that with a grain of salt.
• 17:35
  Philip Pape: Okay, so that's a third is the rate of loss.
• 17:37
  Philip Pape: And then the fourth piece is the off-ramp.
• 17:40
  Philip Pape: What happens when you stop, not just on the drug, but even when you're not on the drug?
• 17:43
  Philip Pape: What happens when you stop a fat loss or weight loss phase?
• 17:47
  Philip Pape: Well, why don't we dig into that?
• 17:48
  Philip Pape: Okay, so let's dig into that one for you guys, because I think that is important to sustaining your results.
• 17:55
  Philip Pape: And I, you know, I keep mentioning our program, Eat More Lift Heavy, but my goal with that was to take what I've learned with me and my clients who get to sustain, who get to fire me and never have to come back again or hire another coach, is how the heck do I sustain my fat loss and stay lean for a life?
• 18:11
  Philip Pape: If that is your goal.
• 18:12
  Philip Pape: Now, many people they get lean and now they're like, okay, great, now I'm gonna go in a muscle building phase, pack on some more weight, but do it for the right reasons.
• 18:20
  Philip Pape: But how do you maintain whatever you want to maintain?
• 18:22
  Philip Pape: All right.
• 18:23
  Philip Pape: So if we look at the drugs like semaglutide in the big trial for that, there was an extension part of the trial where they tracked people when they came off the drugs.
• 18:33
  Philip Pape: And within a year, people regained two-thirds of the weight they'd lost.
• 18:37
  Philip Pape: And then the metabolic improvements that came with the weight loss, blood pressure, blood sugar, those went back to where they started as well.
• 18:44
  Philip Pape: And now, if you think about retatrotide, you're just ramping that hole up.
• 18:48
  Philip Pape: You're you're just amplifying the that amount.
• 18:50
  Philip Pape: You're losing up to 30% of your body weight, and say two-thirds of that comes back.
• 18:55
  Philip Pape: You know, the bigger loss, the more there is to regain.
• 18:57
  Philip Pape: And again, if you're not protecting your muscle and lifting weights, you're gonna regain mostly fat.
• 19:01
  Philip Pape: That's called body fat overshooting.
• 19:02
  Philip Pape: You're gonna be worse off than when you started.
• 19:05
  Philip Pape: You're gonna have a higher body fat percentage than when you started, even if you're at the same weight, right?
• 19:12
  Philip Pape: And the problem is these drugs, they do something powerful.
• 19:15
  Philip Pape: They suppress appetite while you're on them, but they don't give you any specific skills, behaviors, or habit changes.
• 19:24
  Philip Pape: They don't teach you how to eat, they don't teach you how to build lift weights or even to lift weights, they don't give you the skill of navigating weekends or vacations or stressful weeks, you know, without the the wheels coming off.
• 19:35
  Philip Pape: Let's say, you know, the training wheels.
• 19:38
  Philip Pape: It it completely takes over the appetite piece, which is great until it's not, and you realize you didn't do the things you wanted to do.
• 19:46
  Philip Pape: And not only that, you you know, you may have lost muscle, et cetera, like we've already talked about a million times.
• 19:51
  Philip Pape: So the deceptively simple fix, the premise of this show is this that the time that you're taking these meds, that is not, I'll say, the end goal.
• 20:02
  Philip Pape: That is the window of opportunity where your appetite is quiet enough now, your food noise is quiet enough that you can build the skills while it's easy for you.
• 20:12
  Philip Pape: And you're gonna need those skills later when it gets a little bit harder.
• 20:15
  Philip Pape: And the funny thing is, when I say hard, when you build the skills while taking the drug, you actually make the hard moderate or you make the moderate easy.
• 20:26
  Philip Pape: Does that make sense?
• 20:27
  Philip Pape: Like now that you're having more protein, you're eating nutritionally or nutritiously, you have more fiber, you know how to track and how much you eat, you know how to lift, you're getting more steps and movement, hopefully.
• 20:39
  Philip Pape: You have structure and planning around your food and your routine.
• 20:43
  Philip Pape: All of that, you build those skills while taking the drug.
• 20:47
  Philip Pape: Then when you come up, now you have the behavior.
• 20:50
  Philip Pape: The drug gave you, you know, a lower appetite, but now when you get off it, you get to see what your true regulated appetite and hunger signals are.
• 20:58
  Philip Pape: And you could do that in a titration way.
• 21:00
  Philip Pape: You can slowly come off or you can go off big time.
• 21:03
  Philip Pape: I I one of my earliest clients, she was like in her mid-60s, she hadn't lifted weights before.
• 21:08
  Philip Pape: She took Ozempic for diabetes.
• 21:10
  Philip Pape: And I saw this when we went into a fat loss phase.
• 21:12
  Philip Pape: Her hunger was non-existent.
• 21:14
  Philip Pape: I thought it was incredible.
• 21:15
  Philip Pape: I'm like, okay, let's take advantage of this and keep the gas pedal down as aggressively as possible so you don't lose muscle.
• 21:21
  Philip Pape: She was lifting three days a week.
• 21:22
  Philip Pape: She was doing deadlifts, squats, all that fun stuff.
• 21:24
  Philip Pape: First time in her life, doing amazingly.
• 21:27
  Philip Pape: And then she went off the drug kind of cold turkey overnight while in a fat loss phase without me knowing.
• 21:32
  Philip Pape: And then her next check-in, she's like, oh, I have a lot of hunger all of a sudden.
• 21:36
  Philip Pape: Like, yeah, that makes sense because we hadn't gotten to the point of build finish building the skills, plus you came off a cold turkey, plus you did it while in a fat loss phase.
• 21:44
  Philip Pape: So there's like three things stacking on top of each other.
• 21:46
  Philip Pape: So my suggestion is to do one thing at a time, right?
• 21:50
  Philip Pape: Build the skill, start to titrate, not be in a fat loss phase, and then come off.
• 21:54
  Philip Pape: Something like that, right?
• 21:55
  Philip Pape: And I'm not a medical doctor, it's not medical advice.
• 21:58
  Philip Pape: This is just a suggested Approach that could be uh sustainable.
• 22:02
  Philip Pape: Okay.
• 22:03
  Philip Pape: All right.
• 22:04
  Philip Pape: So a quick word of caution before we wrap up on the science.
• 22:08
  Philip Pape: Again, retatrotide right now, as I record this, is not approved anywhere, not by the FDA or anywhere, as much as you might trust the FDA or not.
• 22:16
  Philip Pape: You can't get it at a pharmacy.
• 22:17
  Philip Pape: The only legitimate way to take it now is in a clinical trial.
• 22:22
  Philip Pape: So for the rest of you, taking it, buying it online from a peptide site, from a compounding source, just like with peptides, it's a Wild West.
• 22:31
  Philip Pape: You are taking a risk.
• 22:33
  Philip Pape: There's no guarantee of the dose, the purity, the safety.
• 22:36
  Philip Pape: So please, I'm not your doctor, but the term gray market or black market applies here.
• 22:43
  Philip Pape: And whatever risk tolerance that means to you, please take that to heart.
• 22:48
  Philip Pape: Just take it to heart.
• 22:49
  Philip Pape: That's all I can say.
• 22:50
  Philip Pape: All right.
• 22:51
  Philip Pape: Before we wrap up, remember, I'm going to give you three questions for 30 seconds.
• 22:55
  Philip Pape: It tells you whether you've built what actually keeps the weight off.
• 22:58
  Philip Pape: I'm going to give you that in just a second.
• 23:00
  Philip Pape: But first, if you're one of my listeners who are taking these medications or you're considering taking them and you're worried about the off ramp and the lifestyle, man, that is what we help with in Eat More Lift Heavy.
• 23:13
  Philip Pape: Go to eatmoreliftheavy.com.
• 23:15
  Philip Pape: That is the whole design of it.
• 23:16
  Philip Pape: The reason that it is 26 weeks long and not a quick fix or just a course.
• 23:21
  Philip Pape: And it builds the behavior while you've got the appetite working in your favor.
• 23:25
  Philip Pape: You've got two human coaches in there.
• 23:27
  Philip Pape: Carol and I will take you through getting your nutrition dialed, getting strong.
• 23:32
  Philip Pape: And then by the back half of the program, we start to hand the controls to you.
• 23:36
  Philip Pape: In other words, you build independence.
• 23:38
  Philip Pape: That is the off-ramp.
• 23:40
  Philip Pape: We built it that way on purpose.
• 23:41
  Philip Pape: That is the difference between losing weight and getting it back on and losing fat, getting lean, strong, healthy, feeling great, and staying that way.
• 23:50
  Philip Pape: So if you want to be the person who still has their results a year, five years, 10 years after they stop, and you don't need to hire another coach again, go to eatmoreliftheavy.com and take a look.
• 24:01
  Philip Pape: That's eatmoreliftheavy.com.
• 24:03
  Philip Pape: And look, if you have questions, just reach out to me.
• 24:05
  Philip Pape: It's Philip at witsandweights.com.
• 24:07
  Philip Pape: Philip with one word at witsandweights.com, but go to eatmoreliftheavy.com.
• 24:11
  Philip Pape: All right, here's a 30-second test you can run on yourself right now.
• 24:13
  Philip Pape: It's three questions.
• 24:14
  Philip Pape: I love these little quizzes at the end of these episodes.
• 24:16
  Philip Pape: Question one, if the drug disappeared tomorrow, like if you didn't have access to these at all, do you have a nutrition plan that you're confident with right now, especially hitting protein?
• 24:26
  Philip Pape: Do you even know how much of protein to hit and how to hit it and do it consistently?
• 24:30
  Philip Pape: So that's question one.
• 24:32
  Philip Pape: Question two, have you trained by lifting weights using resistance training at least twice in the last week, challenging your muscle, not just moving, but challenging and pushing each time in the gym?
• 24:44
  Philip Pape: Question three, do you have a plan for when things get hard, like a vacation, a stressful week, the holidays, where your structure is there even when your motivation is not and everything is changing?
• 24:58
  Philip Pape: If you answered no to any of these, that is a good sign that you might have trouble keeping your results.
• 25:08
  Philip Pape: Those are skills.
• 25:10
  Philip Pape: And again, this is whether you're on the medication or not.
• 25:12
  Philip Pape: It's just very important because if you are on them now, you want to have these skills in place before you come off.
• 25:17
  Philip Pape: That's just my opinion on that.
• 25:19
  Philip Pape: The drug handles the appetite, but all of these other things handle your life and how you deal with this going forward.
• 25:25
  Philip Pape: All right, until next time, keep using your wits, lifting those weights.
• 25:29
  Philip Pape: And remember that a bigger weight loss on the scale is not the hard part.
• 25:34
  Philip Pape: The skills that you build, that is the real story of success here.
• 25:38
  Philip Pape: I'm Philip Pape, and I'll talk to you next time here on the Wits and Weights podcast.