Latest / The Body Pod / RE-RUN - Ozempic Weight Loss Debate with Obesity Specialist Dr. Rocio Salas-Whalen – Side Effects, Risks & Benefits

Transcript

RE-RUN - Ozempic Weight Loss Debate with Obesity Specialist Dr. Rocio Salas-Whalen – Side Effects, Risks & Benefits · The Body Pod

• 0:00
  Speaker 1: Welcome to the Body Pod. Today we are rerunning one
• 0:03
  Speaker 1: of our favorite and most popular episodes from twenty twenty four,
• 0:08
  Speaker 1: which is with doctor Rossio Salas Whalen on all Things
• 0:12
  Speaker 1: GLP ones and obesity treatment. Now, while this episode is
• 0:17
  Speaker 1: more than a year old and lots of research has
• 0:20
  Speaker 1: come out since this airing, we will be having doctor
• 0:24
  Speaker 1: Whyalan on in a upcoming course of mine this fall.
• 0:28
  Speaker 1: Enjoy this rerun with doctor Whalin.
• 0:31
  Speaker 2: Hi everyone, my name is Haley and this is Lara,
• 0:34
  Speaker 2: and welcome.
• 0:35
  Speaker 3: To the Body Pod. Welcome everyone to the Body Pod.
• 0:44
  Speaker 3: I am so honored to have our special guest today,
• 0:48
  Speaker 3: doctor Rossio Salas Whalen, who is a triple board certified
• 0:54
  Speaker 3: end yourcinologist and obesity specialist practicing in New York City.
• 0:58
  Speaker 3: So welcome dot Org your Waylan.
• 1:01
  Speaker 4: Thank you so much. I'm so happy and excited to
• 1:03
  Speaker 4: be here with both of you.
• 1:06
  Speaker 3: We are so excited. And U you're on vacation. Are
• 1:08
  Speaker 3: you on vacation?
• 1:09
  Speaker 1: Are you?
• 1:10
  Speaker 5: I'm with my kids.
• 1:12
  Speaker 6: She's just showed us the view and Haley and I
• 1:15
  Speaker 6: are so envious that we're not there doing it.
• 1:19
  Speaker 2: I know, I'm so mad.
• 1:22
  Speaker 3: I'm going to come see you in New York though,
• 1:23
  Speaker 3: I'm going to take you to lunch when i'm there next.
• 1:25
  Speaker 7: I was just there.
• 1:26
  Speaker 5: Please please please let me know when you're in the city.
• 1:29
  Speaker 7: Yes, let's go. Yeah time Hill.
• 1:32
  Speaker 3: Oh I just was there a week ago. Yeah, a
• 1:35
  Speaker 3: week and a half ago. So anyways, next time I'm there,
• 1:38
  Speaker 3: I'm going to hit you up. But anyhow, welcome, welcome, welcome.
• 1:41
  Speaker 3: We have so many questions to cover, so today everyone,
• 1:47
  Speaker 3: we are talking about all things sema, glue, tide, and
• 1:52
  Speaker 3: the obesity epidemic that we are facing. So doctor Whylan
• 1:57
  Speaker 3: is one of the top, if not I would say
• 2:00
  Speaker 3: the top in her field, definitely for me, that owns
• 2:05
  Speaker 3: a practice in New York City. So I'm just curious.
• 2:09
  Speaker 3: Can you just give us a little background about you know,
• 2:14
  Speaker 3: how long you've been practicing, what made you get into
• 2:17
  Speaker 3: this specific area. I'm so curious about that.
• 2:20
  Speaker 5: Yeah.
• 2:21
  Speaker 4: So I've been practicing since twenty ten when I finished
• 2:25
  Speaker 4: my specialty. And you know, fourteen years ago, we didn't
• 2:32
  Speaker 4: treat obesity, or we didn't talk about obesity as we
• 2:35
  Speaker 4: talk about it now. In fact, we didn't have a
• 2:37
  Speaker 4: specialty back then in obesity, right, it was into chronology
• 2:41
  Speaker 4: and that's the reason that I went into chronology was
• 2:44
  Speaker 4: to work on metabolism. I was always interested in type
• 2:49
  Speaker 4: two diabetes and its relationship with weight, right, and how
• 2:53
  Speaker 4: if you control one, you would control the other one.
• 2:58
  Speaker 5: And then obesity.
• 3:00
  Speaker 4: Then we started having medications for weight loss, and I
• 3:04
  Speaker 4: think that opened a huge Pandora box, right that for
• 3:09
  Speaker 4: the first time we could offer patients something that actually worked.
• 3:16
  Speaker 4: And then it just my path became more obesity and
• 3:20
  Speaker 4: weight loss and not so much type two diabetes.
• 3:24
  Speaker 3: Oh well, I want to start with this staggering statistic
• 3:30
  Speaker 3: that I heard you say that by the year twenty thirty,
• 3:33
  Speaker 3: the World Health Organization estimates that fifty percent of the
• 3:37
  Speaker 3: world population will have obesity.
• 3:39
  Speaker 2: Yes, I mean that is like so scarce, so terrified.
• 3:45
  Speaker 5: It is it is that we have.
• 3:48
  Speaker 4: And including children, right, I mean I think that's that's
• 3:53
  Speaker 4: the biggest difference in future statistics, is that it includes children,
• 4:01
  Speaker 4: and those children will become adults with obesity.
• 4:03
  Speaker 5: Right.
• 4:04
  Speaker 4: So we're not talking in the next seven years, We're
• 4:06
  Speaker 4: talking in the next decades.
• 4:09
  Speaker 3: Right, But do you do you think that America is like,
• 4:15
  Speaker 3: is America the worst?
• 4:17
  Speaker 5: America is not the worst.
• 4:19
  Speaker 4: The worst is the middle East right now, in certain
• 4:24
  Speaker 4: countries in Latin America, Mexico unfortunately, it is also very top.
• 4:28
  Speaker 4: But definitely the United States is i believe is number
• 4:31
  Speaker 4: three or number fourth in regards of world obesity, which
• 4:34
  Speaker 4: is pretty hard.
• 4:37
  Speaker 6: And obesity is do you find it growing because of
• 4:44
  Speaker 6: food quality or habit And obesity is a disease, so
• 4:50
  Speaker 6: some people technically are born with it also, correct.
• 4:54
  Speaker 4: Yes, so what we There's a lot of recent published
• 4:58
  Speaker 4: papers showing that prenatal mother's weight impacts the weight of
• 5:06
  Speaker 4: the offspring in the future. Right, so even your weight
• 5:10
  Speaker 4: preconception is going to impact the future of your future children.
• 5:17
  Speaker 4: So we're going even back then, right. And then we
• 5:21
  Speaker 4: live in a very industrialized world. We live that we
• 5:24
  Speaker 4: call obesogenic environments. Right, Everything in our life, from food industry,
• 5:30
  Speaker 4: the chemicals working from home promote obesity, right or make
• 5:35
  Speaker 4: it difficult.
• 5:36
  Speaker 5: For people to lose weight.
• 5:39
  Speaker 4: So if you think about it, I feel like we're
• 5:41
  Speaker 4: set for failure.
• 5:42
  Speaker 6: Right.
• 5:43
  Speaker 5: It's a very difficult.
• 5:45
  Speaker 4: Fight to win against everything else that is promoting waking
• 5:50
  Speaker 4: and obesity becoming part of our genes.
• 5:54
  Speaker 3: Literally, Ah, this is okay, And I think that a
• 5:58
  Speaker 3: lot of it has to do with I mean, you're
• 6:00
  Speaker 3: in New York City. I lived in New York City
• 6:02
  Speaker 3: for a hot minute. But when people can feed their
• 6:06
  Speaker 3: family at Taco Bell for twenty five dollars, I mean,
• 6:10
  Speaker 3: I know, New York City has made like the fruit
• 6:12
  Speaker 3: stands outside of the actual you know, grocery stores, you
• 6:17
  Speaker 3: can get decent, you know, really good pricing on that.
• 6:20
  Speaker 3: But I mean some places in the southeast, I mean
• 6:24
  Speaker 3: there's there's just a lot like it's easier to feed
• 6:28
  Speaker 3: your family at McDonald's.
• 6:30
  Speaker 2: I mean that's a problem.
• 6:31
  Speaker 4: And you know, I mean New York City is changing.
• 6:33
  Speaker 4: I remember when I moved to New York City.
• 6:37
  Speaker 5: You could see you didn't see so much of the city.
• 6:40
  Speaker 5: It wasn't it wasn't there.
• 6:42
  Speaker 4: But now there are Taco Bells next to the subway station.
• 6:48
  Speaker 4: There's Dunkin Donuts, there's Chick Filey, there's McDonald's, there's Krispy Kreme,
• 6:54
  Speaker 4: and they become so popular that even there's lines outside
• 6:58
  Speaker 4: those restaurants. Right, So, and New York City is different
• 7:02
  Speaker 4: now you can see how much more in regards to
• 7:06
  Speaker 4: a bcity has changed New York City. And we're a
• 7:10
  Speaker 4: city that we walk and we take the stairs and
• 7:12
  Speaker 4: we take the subway.
• 7:13
  Speaker 5: But even with that, the.
• 7:15
  Speaker 4: Food industry it's really really making it very difficult.
• 7:20
  Speaker 6: Yes, yeah, we're having to overcome the food industry, but yeah,
• 7:24
  Speaker 6: convenience and.
• 7:25
  Speaker 7: The quality of food and rice just yeah, I'm price huge.
• 7:32
  Speaker 4: You can ask a family, a single mother that is
• 7:36
  Speaker 4: working two jobs and has two three kids to buy
• 7:40
  Speaker 4: organic and buy everything clean, and I mean it's expensive.
• 7:48
  Speaker 3: So this is really interesting because I run like fat
• 7:52
  Speaker 3: loss courses throughout the year and it really.
• 7:56
  Speaker 2: Is just an eduction. It's an education course.
• 7:59
  Speaker 3: I mean we walk every one through it, but it's
• 8:01
  Speaker 3: just like giving all like taking out all the bs
• 8:04
  Speaker 3: of you know, everyone that's like do this, do this,
• 8:07
  Speaker 3: eat this, don't eat this, and just really being like,
• 8:09
  Speaker 3: this is what the evidence says, you know, in this area.
• 8:13
  Speaker 2: And we cover that.
• 8:14
  Speaker 3: But I can't tell you how many women come in
• 8:17
  Speaker 3: and they're like, I'm really not eating that bad and
• 8:20
  Speaker 3: I just keep put like packing on the weight.
• 8:23
  Speaker 2: And it's so hard.
• 8:24
  Speaker 3: Because the food industry, as you said, I mean it's like.
• 8:30
  Speaker 2: It's made to taste good.
• 8:31
  Speaker 3: Yeah, and all of these processed foods like where we
• 8:34
  Speaker 3: actually don't get full on them, and the brain doesn't
• 8:37
  Speaker 3: get the message to stop eating and all of that.
• 8:40
  Speaker 3: I mean, it's just fascinating because women come to me
• 8:43
  Speaker 3: all the time. They're like, I'm just like I'm done,
• 8:46
  Speaker 3: I'm done, Like I really, I'm exercising, I'm doing this.
• 8:49
  Speaker 3: And that's what's hard, is you just a lot of
• 8:53
  Speaker 3: it is we don't know the calorie content in our
• 8:56
  Speaker 3: foods as well, and we go to I mean, if
• 8:59
  Speaker 3: you're eating these restaurants or fast food places that I
• 9:03
  Speaker 3: call America the Land of Convenience, that are just anywhere
• 9:07
  Speaker 3: you go, it's really hard to be like, well, you know,
• 9:11
  Speaker 3: I'm really not eating that much, but what consists in
• 9:14
  Speaker 3: those calories? And and you know and yes, well and
• 9:20
  Speaker 3: and the I think the stigma that obesity is strictly like, well,
• 9:25
  Speaker 3: you just need to have more will power. I mean, like, no,
• 9:30
  Speaker 3: that's not that's not it.
• 9:32
  Speaker 5: I see that.
• 9:33
  Speaker 4: I'm talking about the food industry. Like I have a
• 9:36
  Speaker 4: lot of patients that are from different countries that they
• 9:39
  Speaker 4: coming from here, They're coming from Asia, they come from
• 9:42
  Speaker 4: and they all have the same story. They all gained
• 9:45
  Speaker 4: twenty thirty pounds when they move to America, do they not?
• 9:49
  Speaker 2: Yes?
• 9:50
  Speaker 4: Not surprising every single patient that I see, like in
• 9:54
  Speaker 4: that came immigrated here is the same story they gained
• 9:57
  Speaker 4: twenty thirty forty pounds of way right, And and yes,
• 10:02
  Speaker 4: I mean we know now that obesity is a chronic,
• 10:05
  Speaker 4: multifactorial disease, right, So it's not a problem of willpower.
• 10:11
  Speaker 4: I do feel I do think that the food industry
• 10:14
  Speaker 4: one day will become accountable for producing the statistics that
• 10:19
  Speaker 4: we have in obesity worldwide, right like this, like the
• 10:23
  Speaker 4: tobacco industry at one point. I feel like it's going
• 10:25
  Speaker 4: to be it's going to be the same. Hopefully one
• 10:27
  Speaker 4: day it will be. Because we talk about many solutions,
• 10:31
  Speaker 4: right and including way thot medications, but really the main
• 10:34
  Speaker 4: solution is changing.
• 10:36
  Speaker 5: What we eat.
• 10:37
  Speaker 4: Right, That's a huge part, and we have we have
• 10:41
  Speaker 4: little control, but but we haven't lost of control. I
• 10:44
  Speaker 4: always tell education is going to be our biggest weapon
• 10:49
  Speaker 4: against the food industry, right because the less we know,
• 10:53
  Speaker 4: the more they can control what we eat. The more
• 10:57
  Speaker 4: we know, the more we can sum how control what
• 11:01
  Speaker 4: food choices we make. So we still have some control
• 11:04
  Speaker 4: on it.
• 11:06
  Speaker 6: So if I'm a client of yours, and for example,
• 11:10
  Speaker 6: what you just said, if I'm a patient, I come
• 11:14
  Speaker 6: to you I'm thirty sixty pounds overweight?
• 11:20
  Speaker 7: How do you address And I know everyone is different,
• 11:24
  Speaker 7: but what.
• 11:25
  Speaker 6: Are the things before you know ozembic and all of
• 11:30
  Speaker 6: the medications in that family you know, or before you
• 11:33
  Speaker 6: treat them with that? What do you do to address
• 11:37
  Speaker 6: the situation besides what you just said educating educating them?
• 11:42
  Speaker 4: So first I take a very thorough family history, right,
• 11:47
  Speaker 4: I ask all my patients, all of my patients the
• 11:50
  Speaker 4: same question, at what age did you were you conscious
• 11:56
  Speaker 4: about your weight? Or at what age you being careful
• 12:01
  Speaker 4: of what you ate?
• 12:02
  Speaker 5: Right?
• 12:03
  Speaker 4: At what age did you stop being unconscious about how
• 12:07
  Speaker 4: you look or your weight? And the majority have the
• 12:09
  Speaker 4: same nine years old? Eight years old?
• 12:12
  Speaker 7: So young, that's heartbreaking.
• 12:14
  Speaker 5: Tell me.
• 12:15
  Speaker 4: I was put on my first diet at nine, I
• 12:17
  Speaker 4: had my first personal trainer at twelve. I was sent
• 12:20
  Speaker 4: to fat camps since twelve. So I just want to
• 12:25
  Speaker 4: see how far back in the patient's history was this
• 12:30
  Speaker 4: something of an issue, right, because then that tells me
• 12:35
  Speaker 4: how complex the disease is, how complex the obesity is,
• 12:39
  Speaker 4: and how little or not is lifestyle involved in this
• 12:45
  Speaker 4: patient's life.
• 12:46
  Speaker 5: Right.
• 12:48
  Speaker 4: So it's doing that, doing a family tree, right, I
• 12:52
  Speaker 4: want to know what's the weight history of the mom,
• 12:54
  Speaker 4: the dad, the siblings, even the grandparents, the uncles, just
• 12:58
  Speaker 4: to see where is.
• 12:59
  Speaker 5: This coming from.
• 13:00
  Speaker 4: And I would say in seventy eighty percent of my patients,
• 13:04
  Speaker 4: there's always some family inheritance of obesity.
• 13:07
  Speaker 6: So it's like seventy to eighty percent is kind of
• 13:10
  Speaker 6: a genetic.
• 13:11
  Speaker 4: Kind there is either coming from the father or the
• 13:14
  Speaker 4: mother's side, and there's impacting their weight, or that there's
• 13:17
  Speaker 4: a history of struggling of weight in one side of
• 13:20
  Speaker 4: the family or sometimes in both families.
• 13:22
  Speaker 6: Right.
• 13:23
  Speaker 4: Then definitely a medication list. I mean there's some medications
• 13:26
  Speaker 4: that can promote waking until the presence blood pressure medications,
• 13:30
  Speaker 4: some anti diabetic medications like insulin can promote waking too.
• 13:36
  Speaker 4: And then going into their lifestyle, their work, their sleep patterns, right, exercise,
• 13:42
  Speaker 4: what are there exercising? What normally they eat? I tell them,
• 13:46
  Speaker 4: tell me what you ate for breakfast, yesterday, lunch and dinner.
• 13:49
  Speaker 4: I just want to get a sense of really deep,
• 13:52
  Speaker 4: deep dive, dive deep into the patient's life and where
• 13:58
  Speaker 4: can there be twigs if any? But for the majority
• 14:02
  Speaker 4: of patients, it's something very humbling that I learned through
• 14:06
  Speaker 4: practicing obesity medicine is that the majority of patients with
• 14:10
  Speaker 4: obesity or struggling with weight, they're doing everything they can right,
• 14:15
  Speaker 4: They're exercising, they're eating healthy, they've tried hundreds of diets.
• 14:21
  Speaker 7: I mean, it's they've been on a diet since they're nine.
• 14:24
  Speaker 4: It's really sad. And it's when you hear somebody's even
• 14:33
  Speaker 4: from childhood weight and they're eating and their food in
• 14:37
  Speaker 4: front of them. It's twenty for seven, a full time job, right,
• 14:42
  Speaker 4: it's everything that is in front of them. How is
• 14:44
  Speaker 4: this going to impact my weight? Am I going to
• 14:47
  Speaker 4: feel guilty after I eat it? Am I not going
• 14:49
  Speaker 4: to feel guilty? Or how can I compensate? And it
• 14:52
  Speaker 4: becomes a mental health draining right from their weight. So
• 14:58
  Speaker 4: it's really unfair, and I always try to speak this
• 15:02
  Speaker 4: very out loud, is that we.
• 15:04
  Speaker 2: Had it wrong.
• 15:05
  Speaker 4: Patients are not the couch potato that we're thinking, and
• 15:08
  Speaker 4: that we have the idea that they're just eating, they
• 15:10
  Speaker 4: don't care and they're just gaining weight.
• 15:12
  Speaker 5: It's quite the opposite.
• 15:14
  Speaker 4: Patients with ob city, No, they have obesity, they want
• 15:17
  Speaker 4: to lose weight, they're trying to lose weight, but it's
• 15:20
  Speaker 4: just not happening.
• 15:22
  Speaker 3: This is I remember I reposted something that you had,
• 15:26
  Speaker 3: like something on your Instagram months ago that said, imagine
• 15:30
  Speaker 3: the noise that's constantly going on in their head? What
• 15:34
  Speaker 3: am I going to eat? What is it going to
• 15:36
  Speaker 3: do to me? How is it going to impact my weight?
• 15:39
  Speaker 3: Constant noise, like it's exhausting to think about an.
• 15:44
  Speaker 5: A every day?
• 15:45
  Speaker 6: Yeah, consuming which then affects how you show up every day,
• 15:49
  Speaker 6: your mental.
• 15:50
  Speaker 4: Health, mental health, your mental space, the mental space that
• 15:54
  Speaker 4: this occupies in people with ob city, overweight or struggling
• 15:57
  Speaker 4: with weight, it's a huge part of their of their
• 16:01
  Speaker 4: mental space that you can that you can think, what
• 16:04
  Speaker 4: would happen.
• 16:05
  Speaker 5: If we take that out, right?
• 16:08
  Speaker 4: What what are the possibilities to occupy that other mental
• 16:12
  Speaker 4: space that is being occupied by the constant thinking.
• 16:15
  Speaker 5: Of their weight and food? Mm hmm.
• 16:19
  Speaker 7: Yeah.
• 16:19
  Speaker 4: And it's something that well, you don't realize because in medicine,
• 16:23
  Speaker 4: as doctors, we hear, we learn about the pathology, like
• 16:26
  Speaker 4: the doctor side or what we can do, but we
• 16:29
  Speaker 4: never learn about what the patient is going through. Right,
• 16:32
  Speaker 4: we don't hear those stories that I hear every day
• 16:36
  Speaker 4: in my clinic. Right, is that that it makes you think,
• 16:39
  Speaker 4: like Wow, we've been telling patients go eat less, exercise more,
• 16:44
  Speaker 4: and that's all they've been doing all the time.
• 16:48
  Speaker 2: Well there's another.
• 16:52
  Speaker 3: I messaged you a few months ago when I was
• 16:54
  Speaker 3: doing a podcast with I don't know if you're familiar
• 16:58
  Speaker 3: with doctor Bill Campbell, but he's an in the fitness
• 17:00
  Speaker 3: world and he was just doing like the research on
• 17:06
  Speaker 3: ozepic and semaglue, tide and all that, Like that was
• 17:09
  Speaker 3: just the purpose of like, here's all of the current
• 17:12
  Speaker 3: research that we have. And so I reached out to
• 17:16
  Speaker 3: you because I mean when I put it on, I
• 17:18
  Speaker 3: was like, holy cow, this is a polarizing topic because
• 17:23
  Speaker 3: people were like, you know how they're taking it away
• 17:27
  Speaker 3: from type two diabetes and just freaking out. I was
• 17:29
  Speaker 3: like I'm the journalist here, like I'm not the one
• 17:33
  Speaker 3: taking it away. But I remember I reached out and
• 17:36
  Speaker 3: I was like, what's your like, what's your view on this?
• 17:39
  Speaker 2: And you you said that.
• 17:42
  Speaker 3: There's seventy two million people that were obese I mean
• 17:46
  Speaker 3: a few months ago, versus forty one million people with
• 17:49
  Speaker 3: type two diabetes. So it comes down to can you
• 17:53
  Speaker 3: explain that? Because I was just like, this is it
• 17:56
  Speaker 3: right here?
• 17:57
  Speaker 4: So this Mady case, this class of drops our impretense
• 18:00
  Speaker 4: glp ones. They were designed for type two diabetes and
• 18:05
  Speaker 4: it's a really I like the.
• 18:07
  Speaker 5: Story of how it was discovered.
• 18:09
  Speaker 4: It was in nineteen ninety four by an endochronologist and
• 18:12
  Speaker 4: researcher at the VA Hospital in the Bronx in New York,
• 18:15
  Speaker 4: doctor John Ng And he was studying the Gila monsters,
• 18:20
  Speaker 4: which are lizards from the south from the southwest, and
• 18:24
  Speaker 4: the Gila monster in its prey, they killed its prey
• 18:28
  Speaker 4: causing puncretitis. So doctor Ang wanted to know what in
• 18:34
  Speaker 4: the venom of the Gila monster causes puncretitis, what effect
• 18:38
  Speaker 4: does it happen the pancreas, and that's how he isolated
• 18:42
  Speaker 4: the first YELP one called accentotide back in nineteen ninety four,
• 18:47
  Speaker 4: So thanks to him we have this evolution of the
• 18:51
  Speaker 4: DLP once.
• 18:52
  Speaker 5: And then in two thousand and five.
• 18:54
  Speaker 4: Was the first FDA approved GLP one made from eccentotide
• 19:00
  Speaker 4: what he had isolated from the gillamnster, and it was
• 19:03
  Speaker 4: named Bayeta, and that was a daily injection before.
• 19:07
  Speaker 5: Breakfast, thirty minutes before breakfast.
• 19:08
  Speaker 4: And thirty minutes before dinner, and then after that Bayeta,
• 19:12
  Speaker 4: came Victosa, which was once a day injection, and then
• 19:15
  Speaker 4: twenty seventeen ozampek or semaglutide, which is once a week injection.
• 19:21
  Speaker 4: But when in twenty ten when I started practicing Victosa,
• 19:26
  Speaker 4: which is leraglutide also for nov northisk was fdata profer
• 19:30
  Speaker 4: type two diabetes, and I remember started using it in
• 19:32
  Speaker 4: my patients and they were coming back with better glucose
• 19:35
  Speaker 4: control and weight loss, which was the first time that
• 19:39
  Speaker 4: we were seeing that in a medication, because most medications
• 19:42
  Speaker 4: for diabetes promote waking actually, but this drug only asking
• 19:48
  Speaker 4: your pancreas if your sugar is elevated, so you actually
• 19:52
  Speaker 4: have to have diabetes to work as an anti diabetic drug,
• 19:56
  Speaker 4: meaning they don't cause hypoglycemia on somebody who doesn't have
• 20:01
  Speaker 4: diabetes like insulin. Right, if you've given to somebody who
• 20:04
  Speaker 4: doesn't have diabetes, the sugar is gonna drop, but they.
• 20:07
  Speaker 5: Can they can past, they can die. But in cretains
• 20:10
  Speaker 5: LP one, your sugar is normal.
• 20:13
  Speaker 4: It's not going to touch the pancres it's just going
• 20:15
  Speaker 4: to pass it next to it. But then we get
• 20:18
  Speaker 4: the benefits of the whales and that's when we started
• 20:21
  Speaker 4: using it off label, including myself, back in twenty ten
• 20:24
  Speaker 4: for whals independent of type two diabetes, and then in
• 20:28
  Speaker 4: twenty twelve it was fdat approof for whals. So these
• 20:32
  Speaker 4: medications have the f data approval for whales since two
• 20:37
  Speaker 4: thousand twelve.
• 20:38
  Speaker 7: So it really isn't just for diabetes.
• 20:40
  Speaker 4: It's not only for type two diabetes. We have clear
• 20:44
  Speaker 4: FD eight guidelines for whals independent of diabetes. What they
• 20:48
  Speaker 4: did the pharmaceuticals they changed the name bictosa to saxenda,
• 20:51
  Speaker 4: ozampic to Wegobi and now Munjaro to set down same drug,
• 20:56
  Speaker 4: same molecules, same pharmaceuticals, same dosing, same pen just different
• 21:01
  Speaker 4: names for different indications.
• 21:04
  Speaker 2: Oh that's so interesting.
• 21:06
  Speaker 3: So okay with when people are looking at this, I think,
• 21:10
  Speaker 3: I mean, I'm in the you know, personal training fitness world,
• 21:14
  Speaker 3: but when I have clients come to me, they're like, well,
• 21:18
  Speaker 3: I kind of am interested in this, but you know,
• 21:20
  Speaker 3: I don't want to have another fan fan of the
• 21:22
  Speaker 3: nineties where people are really free that there's going to
• 21:26
  Speaker 3: be all of these you know, side effects that come
• 21:30
  Speaker 3: out in ten twenty thirty years. Do you think that
• 21:33
  Speaker 3: there are some or what? What do you think of
• 21:36
  Speaker 3: the side effects.
• 21:37
  Speaker 4: So I mean and long term, going back to what
• 21:40
  Speaker 4: I just mentioned, I mean, we have close to thirty
• 21:43
  Speaker 4: years of data on this class of drugs.
• 21:45
  Speaker 5: Right.
• 21:47
  Speaker 4: The newer versions are newer generations, but with the same
• 21:52
  Speaker 4: concept back in nineteen ninety four. Right, So we have
• 21:56
  Speaker 4: enough data on these drugs to know it's safety.
• 22:01
  Speaker 5: Now.
• 22:02
  Speaker 4: I say this, and I said it multiple times, and
• 22:06
  Speaker 4: I said to all my patients, the safety of these
• 22:10
  Speaker 4: drugs and even the effectiveness the benefits of it will
• 22:14
  Speaker 4: depend on how much expertise who's giving you this drug
• 22:19
  Speaker 4: on them half. Right, If I start prescribing medications that
• 22:25
  Speaker 4: I don't have much experience, just because I'm a doctor,
• 22:28
  Speaker 4: I can prescribe chemo drugs, I'm going to create more
• 22:30
  Speaker 4: harm than actual benefits. So those side effects that.
• 22:35
  Speaker 5: We're seeing now that that were not reported in all
• 22:37
  Speaker 5: the control studies are being caused by providers.
• 22:42
  Speaker 4: That don't have experience on this medication, right, that don't
• 22:46
  Speaker 4: know how to lead the patient's journey with this drug.
• 22:51
  Speaker 4: Because every patient is different, one may work for one
• 22:54
  Speaker 4: may not work for the other one. So every treatment
• 22:57
  Speaker 4: should be very individualized to their lifestyle, to their necessities,
• 23:02
  Speaker 4: to their way to their other medications that they're taking.
• 23:06
  Speaker 5: But when you don't do that, then you run.
• 23:08
  Speaker 4: The risk of creating side effects that were not expected,
• 23:12
  Speaker 4: that were not seen in the control studies, Patients that
• 23:15
  Speaker 4: are not being followed properly, right, patients that are not
• 23:19
  Speaker 4: guided the right way. And then sometimes we have patients
• 23:22
  Speaker 4: that want to get results too fast and they may
• 23:26
  Speaker 4: overrun our recommendations.
• 23:28
  Speaker 5: Then we're going to see other side effects.
• 23:30
  Speaker 4: Right, So I feel like all those side effects that
• 23:32
  Speaker 4: we're seeing are really caused by improper use of the medication.
• 23:37
  Speaker 4: That makes sense, even and this is talking long term
• 23:40
  Speaker 4: and short term side effects.
• 23:42
  Speaker 6: Right, And if people that are obese, there are so
• 23:48
  Speaker 6: many risks and problems that help issues that come from that.
• 23:55
  Speaker 6: And a lot of people I know that have gone
• 23:58
  Speaker 6: on the medication and have lost a lot of way,
• 24:02
  Speaker 6: they actually are so much healthier now and issues health
• 24:06
  Speaker 6: issues they were having are now they aren't concerned. They
• 24:11
  Speaker 6: aren't concerned anymore. So it seems that the benefits far
• 24:16
  Speaker 6: out weigh anything than not taking it right.
• 24:21
  Speaker 4: Definitely, So we know there's more than sixteen cancers related
• 24:25
  Speaker 4: to obesity. Even now we're seeing more breast cancer related
• 24:28
  Speaker 4: to obesity than genetics, right, colon cancer, stomach cancer, thyrol cancer,
• 24:33
  Speaker 4: pancreatic cancer. We see more of that with obesity than
• 24:36
  Speaker 4: from the medications that we're hearing that right, These medications
• 24:41
  Speaker 4: really are going to change the way that we practice
• 24:44
  Speaker 4: medicine because I feel like in the next two three generations,
• 24:48
  Speaker 4: we're going to have less chronic diseases, much less type
• 24:52
  Speaker 4: two diabetes, less different types of cancers related to obesity.
• 24:56
  Speaker 4: So really we are exchanging one drug for a long
• 25:01
  Speaker 4: list of other medications or other health problems.
• 25:05
  Speaker 6: Do you think okays drug class will help the obesity epidemic?
• 25:11
  Speaker 6: Do you think that it could actually really drop the
• 25:15
  Speaker 6: numbers and make a change in this world.
• 25:18
  Speaker 4: I think that prediction of the who that twenty thirty,
• 25:22
  Speaker 4: I feel like that is going to be less thanks
• 25:26
  Speaker 4: to our current treatment that we have for obesity.
• 25:32
  Speaker 2: It's so interesting.
• 25:33
  Speaker 3: I mean, coming from the fitness world, I know that
• 25:36
  Speaker 3: I've been on a lot of like in groups where
• 25:39
  Speaker 3: we're discussing this because it's changing the fitness world.
• 25:44
  Speaker 2: Absolutely.
• 25:45
  Speaker 3: People are getting more comfortable to come into the gym,
• 25:48
  Speaker 3: you know, making a lot of changes, and there's of
• 25:51
  Speaker 3: course pros and cons on both sides of the issue.
• 25:54
  Speaker 3: But the conside would be trainers that are like, well,
• 25:58
  Speaker 3: now everyone's just taking it. It's super easy and they're
• 26:01
  Speaker 3: not actually learning, you know, the proper education and the
• 26:05
  Speaker 3: psychological component. But I'm going to guess that this is
• 26:09
  Speaker 3: where you're going to say, well, it comes down to
• 26:10
  Speaker 3: the provider. If someone at the next to the Walmart is,
• 26:15
  Speaker 3: you know, prescribing this drug that has no experience, just
• 26:21
  Speaker 3: for the sake of financial gain, then that's not helping either.
• 26:25
  Speaker 3: What what's your opinion on that?
• 26:27
  Speaker 4: Definitely, I think in regards to the fitness world, I
• 26:33
  Speaker 4: see something happening in my practice and I foresee that
• 26:39
  Speaker 4: this is what's going to happen, is that people are
• 26:43
  Speaker 4: going to start exercising for.
• 26:46
  Speaker 5: Us and not for weight loss. I think that I
• 26:51
  Speaker 5: feel like that's huge.
• 26:53
  Speaker 4: And it makes me so happy when I see patients.
• 26:57
  Speaker 4: I started going to the gym because one thing, I mean,
• 27:01
  Speaker 4: you're more self confident. Number one, when patients start losing weight,
• 27:04
  Speaker 4: you're more flexible, you're more movable, you're not short of breath,
• 27:08
  Speaker 4: you physically can perform better, right, and then patients, it's
• 27:15
  Speaker 4: very amazing to see the journey of patients they come
• 27:19
  Speaker 4: with the concept of wanting something external right, to look
• 27:23
  Speaker 4: certain certain way, to feel a certain way.
• 27:27
  Speaker 5: And then halfway of the journey, when we.
• 27:31
  Speaker 4: Because I always talk about muscle protein, it flips. They
• 27:35
  Speaker 4: start to feel healthy, they start to feel strong, and
• 27:39
  Speaker 4: it becomes a fitness journey and not a weight loss
• 27:43
  Speaker 4: journey anymore So, more than ever, I feel people are
• 27:48
  Speaker 4: start going to embracing exercising for the right reason and
• 27:53
  Speaker 4: not for the weight loss right because for the weight
• 27:56
  Speaker 4: loss you always see it as something temporary, as a punishment,
• 28:00
  Speaker 4: and you're exercising because you feel better, you want to
• 28:03
  Speaker 4: extend your longevity, you want to feel healthy. Then you
• 28:08
  Speaker 4: adapt it. It becomes part of your life. So I
• 28:11
  Speaker 4: think it's a very positive shift that you trainers are
• 28:17
  Speaker 4: going to see people coming in for the right reasons.
• 28:20
  Speaker 4: And not that everybody doesn't, but the majority of mentality
• 28:24
  Speaker 4: is exercise to lose weight, because that's what we we're
• 28:26
  Speaker 4: teaching before. That's changing, and more than ever, I feel
• 28:30
  Speaker 4: like the medical community and the personal trainer business we
• 28:34
  Speaker 4: have to be more in a allions than more because
• 28:40
  Speaker 4: together we're going to make the patient healthy and fit right.
• 28:45
  Speaker 4: More than ever, I've never recommended to my patients to
• 28:48
  Speaker 4: go to the gym or personal trainers as much as
• 28:51
  Speaker 4: I'm doing every day.
• 28:52
  Speaker 3: Now, well, I do have to say it's you know,
• 28:57
  Speaker 3: I have women coming into my courses all the time,
• 28:59
  Speaker 3: either one on one or in these groups that I
• 29:02
  Speaker 3: run multiple times a year. And when I'm running the numbers,
• 29:07
  Speaker 3: like I always like, there's always a couple of obese
• 29:11
  Speaker 3: people that come into the group, and emotionally, I am like,
• 29:17
  Speaker 3: I don't want this to be another source of failure
• 29:22
  Speaker 3: for them, because so this is totally I mean from
• 29:26
  Speaker 3: my point of view when I've been on these you know, panels,
• 29:29
  Speaker 3: I'm like, this this only helps us because it's giving
• 29:33
  Speaker 3: someone that they're then they're like, okay, well i don't
• 29:36
  Speaker 3: have as much noise in my head. I'm seeing some change,
• 29:40
  Speaker 3: so now I can take on this education component or
• 29:44
  Speaker 3: you know, in the behavior change and habit change and
• 29:48
  Speaker 3: all of those things that are needed when someone starts
• 29:51
  Speaker 3: to wean off of the drug. Do you recommend I mean,
• 29:55
  Speaker 3: I know this is still fairly new and this may change.
• 29:58
  Speaker 3: Do you have like and somebody beyond this for the
• 30:01
  Speaker 3: rest of their life or is the goal to get
• 30:04
  Speaker 3: them to a place where you're like Okay, we're going
• 30:06
  Speaker 3: to wan you off, but the habits, the behaviors, the
• 30:10
  Speaker 3: education has to be there as well.
• 30:12
  Speaker 4: So if we go back to what obesity is that
• 30:15
  Speaker 4: it's a chronic disease, and chronic diseases we don't cure, right,
• 30:20
  Speaker 4: we control. So the idea with these medications is that
• 30:24
  Speaker 4: they're designed for long term use. And one I think
• 30:27
  Speaker 4: it's a I think we should shift it as a
• 30:29
  Speaker 4: positive thing and that as a negative thing because for
• 30:33
  Speaker 4: the first time we have something that's going to help
• 30:35
  Speaker 4: you maintain the weight loss right, because many things can
• 30:39
  Speaker 4: probably take you there, restrictive diets, but the moment that
• 30:42
  Speaker 4: you stop or that you're left on your own is
• 30:45
  Speaker 4: when the weight regained happens. So with these medications, we
• 30:48
  Speaker 4: can not only take you to your goal, but we
• 30:50
  Speaker 4: can help you keep you on your goal.
• 30:52
  Speaker 5: They're safe to be used long term. If we're talking
• 30:55
  Speaker 5: about safety.
• 30:56
  Speaker 4: Now, weight loss medicine is very new you and a
• 31:01
  Speaker 4: lot of things are changing and we're learning as we're doing.
• 31:05
  Speaker 4: And if I can talk about my personal experience with
• 31:08
  Speaker 4: my patients, those patients are able to maintain their muscle mass,
• 31:14
  Speaker 4: those patients that are able to gain muscle mass have
• 31:20
  Speaker 4: more probability to maintaining the weight loss at the lowest
• 31:24
  Speaker 4: dose possible or with maybe no medication. Right because whenever
• 31:31
  Speaker 4: you hear oh losing weight slows down your metabolism. The
• 31:34
  Speaker 4: reason for that is because you lose muscle with weight loss, right,
• 31:38
  Speaker 4: with any and this is not exclusive to samagutai, This
• 31:40
  Speaker 4: is not exclusive to any other drugs that we're talking.
• 31:43
  Speaker 5: This is just exclusive of dieting patients lose muscle.
• 31:47
  Speaker 4: Muscle is our most and you know this muscle is
• 31:49
  Speaker 4: our most metabolic organ, right, It's our burning machine. It's
• 31:53
  Speaker 4: our burning calorie machine. So if you lose it while
• 31:55
  Speaker 4: you're losing weight, that's what's slowing down your metabolism. But
• 31:59
  Speaker 4: when you're losing the body fat, you're maintaining your muscle
• 32:02
  Speaker 4: or even gaining muscle. That becomes part of the maintenance
• 32:08
  Speaker 4: for the weight loss.
• 32:10
  Speaker 3: Yes, and I think it's interesting too that a lot
• 32:15
  Speaker 3: of you know, young trainers or just people not even
• 32:19
  Speaker 3: in the profession, think that there it's shocking to think
• 32:23
  Speaker 3: that like someone who is obese they carry a lot
• 32:28
  Speaker 3: of muscle mass, they also carry a lot of fat mass,
• 32:31
  Speaker 3: but it's assumed that they just don't have a lot
• 32:33
  Speaker 3: of muscle mass and that's not the case.
• 32:36
  Speaker 4: Well, it's interesting because research has shown that yes, people
• 32:40
  Speaker 4: with obesity have more muscle masks, but it's not healthy,
• 32:44
  Speaker 4: all healthy muscle mass because there is fat in between
• 32:49
  Speaker 4: the muscle vibers. So it's not necessarily that their metabolism
• 32:54
  Speaker 4: is higher because they have so much muscle. Their muscle
• 32:57
  Speaker 4: is not the same when it's lean muscle.
• 33:01
  Speaker 2: Okay, that's the ticket, right exactly, So.
• 33:04
  Speaker 6: When you're on this medication, it really is way more
• 33:08
  Speaker 6: beneficial to strength train and work out while you take this.
• 33:13
  Speaker 5: Medication one hundred percent.
• 33:16
  Speaker 4: So and it's strength training what I recommend right at
• 33:20
  Speaker 4: Persistence strength training. It's important for many patients. It will
• 33:26
  Speaker 4: take time, It will take twenty thirty pounds of weight
• 33:28
  Speaker 4: loss before they feel motivated physically and mentally motivated to.
• 33:33
  Speaker 5: Go to exercise.
• 33:35
  Speaker 4: Right, But I always have that the initial consult is
• 33:39
  Speaker 4: always half of it is going to be exercise improtein
• 33:45
  Speaker 4: exercise and protein or exercise and diet doesn't replace the medications.
• 33:50
  Speaker 4: The medications don't replace exercise and dieting.
• 33:53
  Speaker 5: It's hand in handfete.
• 33:56
  Speaker 7: Yeah, need all of the components.
• 34:00
  Speaker 6: Okay, so what about people that are taking it that
• 34:05
  Speaker 6: aren't Obyes, but they just have that like ten to
• 34:08
  Speaker 6: fifteen pounds and they just want to do it short
• 34:12
  Speaker 6: term and take it like patients that come to you.
• 34:17
  Speaker 7: I mean, do you have any patients like that?
• 34:19
  Speaker 5: Yes?
• 34:20
  Speaker 4: And it's easy to say when somebody, oh, it's only
• 34:25
  Speaker 4: ten or only fifteen, only twenty pounds that I may
• 34:27
  Speaker 4: have to lose, and whenever I do a body composition,
• 34:29
  Speaker 4: it turns out that they have really highly seal fat
• 34:32
  Speaker 4: or they.
• 34:33
  Speaker 5: Have more than ten pounds to lose.
• 34:36
  Speaker 4: Right, So if we go by the number and the scale,
• 34:40
  Speaker 4: or we go by the BMI, I think we are
• 34:43
  Speaker 4: undertreating many patients that can be that should.
• 34:48
  Speaker 5: Be treated, right.
• 34:49
  Speaker 4: So I feel like it's not fair to say this
• 34:52
  Speaker 4: patient doesn't need it just by looking at them without
• 34:55
  Speaker 4: knowing their body composition.
• 34:56
  Speaker 5: Right.
• 34:57
  Speaker 4: And then for those patients that are doing what they
• 35:00
  Speaker 4: should and they still cannot lose those twenty pounds, then
• 35:04
  Speaker 4: I dig more deeper into how much is this consuming
• 35:09
  Speaker 4: your life?
• 35:10
  Speaker 5: Right?
• 35:11
  Speaker 4: How much is this take over your day? And for
• 35:14
  Speaker 4: some patients it becomes again a twenty four seven to
• 35:17
  Speaker 4: lose twenty thirty pounds or ten to fifteen pounds. Then
• 35:20
  Speaker 4: those patients, if they didn't do what they were doing,
• 35:23
  Speaker 4: probably they will need more pounds to lose. So those
• 35:26
  Speaker 4: patients would benefit from the medication, right because they're being
• 35:32
  Speaker 4: consumed by that. And if we put their perimenopause menopause,
• 35:37
  Speaker 4: then it's going to be classic that they're doing what
• 35:41
  Speaker 4: they were doing in their thirties early forties and it's
• 35:44
  Speaker 4: not happening and they keep gaining weight, and it's because
• 35:46
  Speaker 4: of those changing hormones.
• 35:47
  Speaker 2: Right, Yeah, which brings me to my next talk.
• 35:52
  Speaker 6: The next btalkic that Haley and I love to talk about.
• 35:56
  Speaker 2: The hormone replacement therapy.
• 35:57
  Speaker 3: That ozembic study that just came out, which I haven't
• 36:00
  Speaker 3: had time to read because I just launched a course
• 36:03
  Speaker 3: a few days ago and I'm like buried, But I've
• 36:07
  Speaker 3: seen you talk about it already and I've seen it
• 36:10
  Speaker 3: on social media. So can we talk about that weight
• 36:14
  Speaker 3: loss response in regards with into hormone replacement therapy.
• 36:20
  Speaker 4: So, in this study showed that women that were on
• 36:23
  Speaker 4: HRT on hormone replacement therapy and semalutype versus the ones
• 36:27
  Speaker 4: that were just on HRT, they lost more than thirty
• 36:30
  Speaker 4: percent more weight loss than the ones that were that
• 36:33
  Speaker 4: was not on SAMLU type. With HRT, it's a very
• 36:37
  Speaker 4: small study, right, I feel like before we jump the
• 36:41
  Speaker 4: gun into saying that HRT helps with weight loos what
• 36:45
  Speaker 4: it does. It changes your body composition when we lose estrogen.
• 36:48
  Speaker 4: When we lose estrogen, the body fat that was in
• 36:51
  Speaker 4: our fertile years and our hip and our legs goes intravisceral,
• 36:55
  Speaker 4: so in our midline. Right when we give back the estrogen,
• 37:00
  Speaker 4: there is again that change in body composition.
• 37:03
  Speaker 5: We lose visceral fat.
• 37:04
  Speaker 4: It goes more into our ferral years areas, but it
• 37:07
  Speaker 4: doesn't cause weight loss. It just changes the bio redistribution.
• 37:12
  Speaker 4: Now we know that with perimenopause and menopause, especially with
• 37:15
  Speaker 4: the heart flashes, the lack of sleep that demotivates a
• 37:19
  Speaker 4: woman to exercise, right because you're tired, you're not sleeping, well,
• 37:24
  Speaker 4: you have the heart flashes. So they didn't look that
• 37:28
  Speaker 4: in the study if their lifestyle changed, it that they
• 37:32
  Speaker 4: were more prone to follow a healthy lifestyle just from
• 37:36
  Speaker 4: the decrease of some of the perimenopaustal symptoms including depression,
• 37:40
  Speaker 4: mental health, changing mood. So it's not the actual hormone
• 37:44
  Speaker 4: replacement therapy causing the weight loss. We don't know if
• 37:49
  Speaker 4: there were other factors involved because they didn't check them.
• 37:53
  Speaker 3: Well, I just love that there's a study on this
• 37:56
  Speaker 3: early with menopausal women because as you know, and I know,
• 38:02
  Speaker 3: and like, it's it's just we always get the shaft
• 38:06
  Speaker 3: in this age group.
• 38:07
  Speaker 2: It's like, oh, well, you know.
• 38:10
  Speaker 4: But I always tell my friends and patients, I said,
• 38:13
  Speaker 4: this is we're living in the right time to be
• 38:16
  Speaker 4: this age.
• 38:17
  Speaker 6: Yeah.
• 38:18
  Speaker 7: I could not agree more. That was one of my
• 38:21
  Speaker 7: fears in.
• 38:24
  Speaker 5: Changing.
• 38:25
  Speaker 4: And I'm so happy, and I'm so excited for a
• 38:27
  Speaker 4: woman and for myself and for my daughters because yeah,
• 38:32
  Speaker 4: we have ones were accepting more hormone replacement therapy. We
• 38:36
  Speaker 4: know it's safe, we know the short term benefits and
• 38:40
  Speaker 4: the long term benefits right, and now we have medications
• 38:45
  Speaker 4: that can help us with weightloads that for whatever reason,
• 38:50
  Speaker 4: it cannot happen on its own. So we are building superwomen,
• 38:55
  Speaker 4: superhuman and.
• 38:56
  Speaker 5: I feel like it's well deserved.
• 38:59
  Speaker 4: We waited for a long time, you know, no more
• 39:02
  Speaker 4: mental health, no more putting on unto the presence, no
• 39:04
  Speaker 4: more getting the short stick of the end. It's just
• 39:08
  Speaker 4: no more gaslighting. All our symptoms.
• 39:10
  Speaker 5: Basically, Yeah, one amen, I know.
• 39:15
  Speaker 6: I've been terrified to go through menopause and because I
• 39:19
  Speaker 6: thought my biggest fear was I'm not going to have
• 39:23
  Speaker 6: control of my body, because that's kind of what the
• 39:27
  Speaker 6: conversation always leads to. All of a sudden, I've gained weight,
• 39:30
  Speaker 6: I'm exhausted, the hormones, all of the things, and like
• 39:33
  Speaker 6: now we have all these tools. We have hormone replacement,
• 39:37
  Speaker 6: this medication, everything else, and it doesn't scare me, which
• 39:40
  Speaker 6: feels empowering.
• 39:43
  Speaker 4: And the best anti aging is muscle, right, So we
• 39:49
  Speaker 4: also have this concept. Now we're accepting this concept that
• 39:52
  Speaker 4: none more exercising just to lose weight, but for longevity
• 39:56
  Speaker 4: and anti aging. So we have we have where where
• 40:00
  Speaker 4: packed with our hormones are some muglutide and our right
• 40:03
  Speaker 4: left and we have all the tools and our protect
• 40:06
  Speaker 4: for a long, healthy, high quality of life.
• 40:11
  Speaker 7: Yeah, a lot of I'm majo.
• 40:16
  Speaker 3: That was like perfection that needs to be like on
• 40:19
  Speaker 3: a billboard or something.
• 40:21
  Speaker 5: Let me get a T shirt.
• 40:22
  Speaker 4: No, it's just you know, it's like I feel like
• 40:25
  Speaker 4: we women, like we get asked for so much and
• 40:28
  Speaker 4: we have so much pressure that even like midlife is like, Okay, now,
• 40:31
  Speaker 4: how are you gonna uh.
• 40:33
  Speaker 5: What are you gonna do now? New?
• 40:35
  Speaker 7: Right?
• 40:35
  Speaker 4: Like you have to reinvent yourself and yeah, it's like, no,
• 40:39
  Speaker 4: we've done enough. I feel like, also, we should see
• 40:43
  Speaker 4: it as just a continuation of our life. It doesn't
• 40:46
  Speaker 4: have to be this big change that what are we
• 40:49
  Speaker 4: going to do now? Just continue being as fabulous as
• 40:52
  Speaker 4: you were before going through benopause. It's just a continuation
• 40:57
  Speaker 4: of our mental life, sex life, which I think is
• 41:03
  Speaker 4: very important. And I feel like many women let it
• 41:06
  Speaker 4: go and give up after children, or.
• 41:08
  Speaker 5: After forty or after fifty. It is like, we don't
• 41:11
  Speaker 5: deserve our sex life. We had enough. We are kids.
• 41:14
  Speaker 4: No, you need to serve a healthy, satisfying sexual life,
• 41:18
  Speaker 4: physical life, so we we have the tools.
• 41:24
  Speaker 7: I appreciate you saying all of that. That speaks volumes
• 41:29
  Speaker 7: to me.
• 41:29
  Speaker 3: I feel like, so, what what are the drugs that
• 41:35
  Speaker 3: are Are there any drugs coming up? I remember you
• 41:37
  Speaker 3: saying something like this, and it piqued my interest a
• 41:39
  Speaker 3: few months ago about a new drug coming out. Maybe
• 41:46
  Speaker 3: it's out already, I'm not sure the timeline. It was
• 41:48
  Speaker 3: probably six months ago that there's a new drug that
• 41:52
  Speaker 3: can help hold on to muscle masks, Like, how is that?
• 41:55
  Speaker 5: So?
• 41:56
  Speaker 2: What is that?
• 41:57
  Speaker 4: This what we're seeing right now in samagot at osmpic
• 42:00
  Speaker 4: is the tip, right, It's just it. It's the beginning
• 42:05
  Speaker 4: of very sophisticated drugs that are coming our way. One
• 42:10
  Speaker 4: of them is one that promotes the weight loss, that
• 42:13
  Speaker 4: has the DP part and it has medication that will
• 42:18
  Speaker 4: help prevent muscle loss and help muscle gain in the drug.
• 42:24
  Speaker 7: Right, why it's like sign me up for that? Is
• 42:27
  Speaker 7: there a trial?
• 42:29
  Speaker 4: So there's again that the drugs are going to become
• 42:32
  Speaker 4: very sophisticated in the future. This is just the beginning.
• 42:36
  Speaker 4: I mean this, what we're seeing now is probably the
• 42:39
  Speaker 4: biggest event in medicine that we're going to see in
• 42:42
  Speaker 4: our lifetime.
• 42:44
  Speaker 7: Happening so exciting.
• 42:47
  Speaker 3: Oh so what is your professional opinion then about if
• 42:53
  Speaker 3: there is a drug that can hang on the muscle
• 42:55
  Speaker 3: or even grow muscle, why would somebody need to eat
• 42:58
  Speaker 3: a lot of protein and weight train because.
• 43:02
  Speaker 4: You need protein, you need the amino acids to build muscle.
• 43:05
  Speaker 4: Right that that is not sustainable, I mean nutrition. I
• 43:10
  Speaker 4: don't think there will be a point that will be
• 43:13
  Speaker 4: replaceable by a drug. Right, we need food, and our
• 43:19
  Speaker 4: muscles need amino acids right to build muscles. So you
• 43:23
  Speaker 4: can have a pro you can have a protein or
• 43:26
  Speaker 4: or a medication that prevents muscle laws, but you still
• 43:31
  Speaker 4: need the basis to promote muscle gain and to maintain
• 43:36
  Speaker 4: the muscle.
• 43:37
  Speaker 5: Right.
• 43:38
  Speaker 3: I'm trying to foresee the questions that will come up.
• 43:43
  Speaker 4: And again, this is not out yet, and even when
• 43:48
  Speaker 4: a medication comes out, you have to realize those are
• 43:52
  Speaker 4: control studies of one thousand and two thousand and two thousand.
• 43:55
  Speaker 4: But once it's out in the public, then we learn
• 43:58
  Speaker 4: more about them and what is still needed or not needed.
• 44:02
  Speaker 4: Like Ocempic, these medications. In the studies, they never did
• 44:06
  Speaker 4: body compositions, so they didn't.
• 44:08
  Speaker 5: Know that there was muscle loss.
• 44:11
  Speaker 4: Okay, until now we're doing it and we're doing body
• 44:13
  Speaker 4: compositions and everybody and we're like, oh, they lost thirty pounds,
• 44:17
  Speaker 4: but ten were muscle, so we're fixing that. So the
• 44:20
  Speaker 4: same way it's going to be with the future drugs.
• 44:26
  Speaker 3: So if somebody comes into you, I think this is
• 44:29
  Speaker 3: the other issue. How because it can be like five hundred,
• 44:33
  Speaker 3: seven hundred dollars a month, does insurance cover it for everyone?
• 44:37
  Speaker 2: Or is it still.
• 44:38
  Speaker 4: Hitting insurances the rock of every doctor in the shoe.
• 44:43
  Speaker 2: Yes, but how is it that's crazy in America? Like
• 44:47
  Speaker 2: can we not fix it still?
• 44:50
  Speaker 4: When there was and there was when there was shortage
• 44:53
  Speaker 4: of the medication? Oh, I see all my like my
• 44:55
  Speaker 4: assistance in my office. I call it the hunger games.
• 44:57
  Speaker 4: It was like getting to see who had the pharma.
• 45:00
  Speaker 4: You have the pharmacy had it or not? It's in
• 45:02
  Speaker 4: the insurance who would approve it?
• 45:05
  Speaker 2: Right now?
• 45:05
  Speaker 4: There's guidelines that the insurances go by, and it's the
• 45:08
  Speaker 4: guidelines that were done by the Obesity Society and the
• 45:11
  Speaker 4: Obesity Medical Association where they state that BMI greater equal
• 45:17
  Speaker 4: or greater to twenty seven with one commorbidity and this
• 45:20
  Speaker 4: could be sleep, apnelstarthritis.
• 45:22
  Speaker 5: High cholesterol are approved are for.
• 45:26
  Speaker 4: Weight loss medication or a BMI equal or greater than
• 45:29
  Speaker 4: thirty without any commobidity. They meet the qualifications for a
• 45:33
  Speaker 4: weight loss medications.
• 45:34
  Speaker 5: Right.
• 45:34
  Speaker 4: So you have a patient that may meet the qualifications,
• 45:39
  Speaker 4: but then the insurance may not have it on their plan. Right,
• 45:44
  Speaker 4: So it's not just that you meet the qualifications that
• 45:46
  Speaker 4: the insurance requires, but also that they actually have it
• 45:49
  Speaker 4: in their plan and some insurances have what they call exclusions,
• 45:53
  Speaker 4: and those are never approved even that you meet the qualifications.
• 45:58
  Speaker 4: And because there's medications relatively expensive, so most insurances don't
• 46:03
  Speaker 4: have them in their formulary. Now, if you're going to
• 46:06
  Speaker 4: pay out of pocket with the medication, then then whereby
• 46:09
  Speaker 4: passing the insurance? Right, But there are expensive medications. But
• 46:14
  Speaker 4: my question is how much money do people spend on
• 46:18
  Speaker 4: all the other diets right that they go through thousands
• 46:24
  Speaker 4: through their lifetime.
• 46:25
  Speaker 7: And how much is your health worth to you?
• 46:28
  Speaker 6: In my opinion, I mean, if someone said, I mean,
• 46:31
  Speaker 6: I don't know the cost of all of them, but
• 46:33
  Speaker 6: I don't know, I would say that your health should
• 46:35
  Speaker 6: be the number one most important thing that you're spending
• 46:39
  Speaker 6: your money and time on.
• 46:41
  Speaker 4: Yeah, and for out of pocket. Both pharmaceuticals right now
• 46:45
  Speaker 4: that have coupons. If you have a commercial insurance and
• 46:49
  Speaker 4: you're out of pocket meaning that the insurance is not
• 46:51
  Speaker 4: covering it, they have a coupon and it comes out
• 46:55
  Speaker 4: to about five hundred dollars a month, either Ozempegagobi, Munjaro
• 46:59
  Speaker 4: or step bound more likely around the same price if
• 47:04
  Speaker 4: you don't have insurance, and then it's about eleven hundred
• 47:07
  Speaker 4: dollars a month.
• 47:09
  Speaker 2: Oh my gosh, it's a lot.
• 47:12
  Speaker 7: Yeah, that is a lot.
• 47:13
  Speaker 3: But how scary is it to take something like you know,
• 47:17
  Speaker 3: a lot of the Americans. I'm not going to say
• 47:20
  Speaker 3: that I've never done it, go to Mexico and get
• 47:23
  Speaker 3: like a sleep drug or something like how dangerous would
• 47:27
  Speaker 3: it be for I'm sure there's nine million places that
• 47:31
  Speaker 3: you can get it, but like you said, it's not
• 47:33
  Speaker 3: through a physician, it's not managed can.
• 47:37
  Speaker 2: I mean, I'm sure those can be dangerous, just.
• 47:39
  Speaker 4: For you to know it's Unfortunately in the US, how
• 47:41
  Speaker 4: the prices of the medications are ridiculously high. It drugs,
• 47:46
  Speaker 4: osmpic and a pharmacy here in the United States out
• 47:49
  Speaker 4: of pocket is going to be eleven hundred dollars for
• 47:51
  Speaker 4: a month's supply. If you go anywhere else outside not
• 47:55
  Speaker 4: just Mexico, if you go to the Middle East, in
• 47:58
  Speaker 4: Europe and in Latin America, it's about two hundred dollars
• 48:01
  Speaker 4: a month.
• 48:02
  Speaker 5: Oh my what?
• 48:04
  Speaker 2: Okay, So it is the same though, it is It's
• 48:06
  Speaker 2: not like sketchy.
• 48:07
  Speaker 5: Yeah, no, it's not the same. It's the same.
• 48:11
  Speaker 3: This makes me so mad, like about America, because I
• 48:15
  Speaker 3: had a son that needed acutane.
• 48:17
  Speaker 2: And we were on like.
• 48:21
  Speaker 3: Private insurance at the time, like our own insurance. My
• 48:25
  Speaker 3: husband owned his own business at the time, and it
• 48:27
  Speaker 3: was five hundred dollars a month, and that was a
• 48:33
  Speaker 3: hard pill to swallow. But I'm like, my team doesn't
• 48:35
  Speaker 3: want to go outside. But then when we swapped somewhere
• 48:38
  Speaker 3: in between the eighteen months or what, I don't know
• 48:41
  Speaker 3: how long he was on it, but another one was
• 48:44
  Speaker 3: five was five dollars a month, just like a main
• 48:47
  Speaker 3: provider insurance, and I was like, this is there should
• 48:50
  Speaker 3: not be that discrepancy of five hundred and for any medication, Like,
• 48:59
  Speaker 3: I don't know.
• 48:59
  Speaker 2: It really is frustrated.
• 49:01
  Speaker 5: It is very frustrating. It is very frustrating.
• 49:03
  Speaker 4: And so you have people and then we like, there's
• 49:06
  Speaker 4: a Canadian there's Canadian pharmacies that they can patients get
• 49:10
  Speaker 4: it for about three hundred dollars a month with ascription
• 49:13
  Speaker 4: from from a US prescription.
• 49:15
  Speaker 5: Well, yes it is.
• 49:18
  Speaker 6: Yeah, do you think there'll be a shortage again since
• 49:22
  Speaker 6: there's it's like such a big medication.
• 49:26
  Speaker 4: There are small shortages of certain doses from time to time.
• 49:32
  Speaker 5: But I feel like the production Eli Leley.
• 49:37
  Speaker 4: Is doing the best, they're building factors as we speak,
• 49:41
  Speaker 4: to be able to supply. But it's just that demand
• 49:44
  Speaker 4: is so great, right world.
• 49:46
  Speaker 3: Yeah, well, I know I was in Australia the first
• 49:52
  Speaker 3: of the year and they were all sold out well
• 49:58
  Speaker 3: as as the strength and conditioning coaches were saying, because
• 50:01
  Speaker 3: all the bodybuilders were like hugging it from everyone.
• 50:06
  Speaker 2: Which is terrible.
• 50:07
  Speaker 3: I mean it's you know, like I don't know if
• 50:10
  Speaker 3: there's a shortage now, but I know that they were
• 50:12
  Speaker 3: like again, there were two sides to the story. But
• 50:17
  Speaker 3: down there it's it's very different obviously than here as well.
• 50:22
  Speaker 3: Every country has their own kind of issues and things,
• 50:26
  Speaker 3: but we've got to get the insurance part figured out
• 50:29
  Speaker 3: here in America for.
• 50:31
  Speaker 5: Sure, even for so for patients and for doctors.
• 50:34
  Speaker 3: Honestly, Yeah, yeah, I mean I ended up going I
• 50:38
  Speaker 3: ended up having a knee surgery, a major knee surgery
• 50:42
  Speaker 3: at HSS in New York and one of the top
• 50:46
  Speaker 3: physicians that there were like two that did this specific
• 50:49
  Speaker 3: knee surgery on women over forty because it's a terrible
• 50:52
  Speaker 3: success rate, and the doctor's like, well here's my price.
• 50:56
  Speaker 2: I'm like I'm out of pocket, and I was like,
• 50:58
  Speaker 2: take my money.
• 51:00
  Speaker 3: It was I mean, I was so desperate because I'd
• 51:02
  Speaker 3: been a year with just like nothing. But I get
• 51:05
  Speaker 3: why why physicians are just like, I'm not working with
• 51:08
  Speaker 3: us anymore.
• 51:09
  Speaker 5: It's yeah, it's a circumsturance in my office. But this
• 51:15
  Speaker 5: is so frustrated.
• 51:16
  Speaker 4: And spend one hour with my patients, right yeah, And
• 51:19
  Speaker 4: when you're talking to someone with obesity that they've struggled
• 51:23
  Speaker 4: to childhood and they're in an adult life, you cannot
• 51:27
  Speaker 4: have this conversation in fifteen minutes. You cannot open to
• 51:30
  Speaker 4: anybody in fifteen minutes. You can earn a trust and
• 51:34
  Speaker 4: build a relationship with a fifteen minute appointment.
• 51:37
  Speaker 5: Right.
• 51:38
  Speaker 3: No, I'm in love with you, and I'm like you
• 51:41
  Speaker 3: need to be in Let's put a trip to New York, Ailee.
• 51:45
  Speaker 6: Yeah, I know.
• 51:46
  Speaker 2: We're going to New York.
• 51:48
  Speaker 3: And I mean, I just think of all of these
• 51:50
  Speaker 3: people that have reached out to me that like, I mean,
• 51:56
  Speaker 3: they need you on speed dial. I don't even know
• 51:58
  Speaker 3: if are you taking new patients?
• 52:00
  Speaker 5: Yes, I am.
• 52:01
  Speaker 7: You do zoom like so for people that don't live
• 52:04
  Speaker 7: in New York.
• 52:05
  Speaker 4: Yes, I do tell a medicine I have patience all
• 52:08
  Speaker 4: over the world and.
• 52:11
  Speaker 3: You're about to not be accepting new patients because everyone
• 52:14
  Speaker 3: is going to be obsessed and like coming to you exactly,
• 52:17
  Speaker 3: but get on the wait list for a year.
• 52:20
  Speaker 4: No, I'm working very hard so I can accept I
• 52:23
  Speaker 4: cannot see everybody. I accepted that and I can't, but
• 52:26
  Speaker 4: I'm trying to see as much as I can.
• 52:29
  Speaker 2: I love that too.
• 52:31
  Speaker 6: Well.
• 52:31
  Speaker 3: Okay, so before we close, and this is something that
• 52:35
  Speaker 3: we should have talked about at the very first, but
• 52:36
  Speaker 3: I've just been so it's been so fascinating this entire conversation.
• 52:41
  Speaker 2: Can you explain for people?
• 52:43
  Speaker 3: I feel like everyone knows about these drugs now, especially
• 52:47
  Speaker 3: from like Oprah, you know, has talked about it a lot,
• 52:50
  Speaker 3: and obviously a lot of big people on social media.
• 52:53
  Speaker 3: But for someone that's like, oh, okay, I know that
• 52:56
  Speaker 3: this is a weightless drug, but what is it actually
• 52:58
  Speaker 3: doing to help me lose weight?
• 53:00
  Speaker 2: For people that don't understand that part.
• 53:03
  Speaker 4: So the pharmacology of this drug is there are synthetic hormones.
• 53:10
  Speaker 4: We make this hormone GLP one in our small gout and.
• 53:15
  Speaker 5: What they do.
• 53:16
  Speaker 4: We have receptors for this hormone all over our body.
• 53:21
  Speaker 4: But in regards to weilos what they do is in
• 53:24
  Speaker 4: our gut, in our stomach, we have receptors that when
• 53:28
  Speaker 4: we have this medication, when we take this medication, when
• 53:31
  Speaker 4: this hormone is there, it increases our satiety hormones, so
• 53:34
  Speaker 4: it activates our satiety. So when you start eating, it
• 53:39
  Speaker 4: activates your satiety signals and you get fuller with smaller
• 53:43
  Speaker 4: portions of food. And then in between meals it suppresses
• 53:47
  Speaker 4: your hunger hormones. So when you feel hungry, you eat
• 53:51
  Speaker 4: small portion, you get physically full and satisfied, and then
• 53:54
  Speaker 4: you're not hungry for a few hours. Then you get
• 53:56
  Speaker 4: hungry again, but then you eat a small normal portion.
• 54:01
  Speaker 4: And then in our brain in the hedonistic eating and
• 54:04
  Speaker 4: drinking area where we eat for our reward, for pleasure,
• 54:09
  Speaker 4: anxiety border, it takes away any anticipation of our reward
• 54:15
  Speaker 4: from food or alcohol. So if you think about it,
• 54:18
  Speaker 4: let's say a glass of wine. Whenever we think, oh,
• 54:20
  Speaker 4: I'm going to have a glass of wine at night,
• 54:22
  Speaker 4: you're anticipating I'm gonna feel relaxed, I'm gonna feel this,
• 54:26
  Speaker 4: I'm going to be in a social setting. It takes
• 54:29
  Speaker 4: away that anticipation. You reach for it, and it doesn't
• 54:33
  Speaker 4: give you that back anymore, and the behavior changes.
• 54:37
  Speaker 5: Same with foods.
• 54:38
  Speaker 4: Of some patients that eat border or anxiety at night
• 54:41
  Speaker 4: or bench at night, it's because you're seeking some sort
• 54:44
  Speaker 4: of relief or some sort of reward.
• 54:46
  Speaker 5: It takes it away.
• 54:47
  Speaker 4: You still enjoy your food when you're eating and you're hungry,
• 54:50
  Speaker 4: but when you're physically content, you don't think of food
• 54:54
  Speaker 4: anymore besides us food when you're hungry. So that's what
• 54:59
  Speaker 4: that noise that people say that stops because you're not
• 55:02
  Speaker 4: you don't and then and then it's not like you
• 55:04
  Speaker 4: don't have anything else to look for, because many patients said, well,
• 55:07
  Speaker 4: food is my pleasure.
• 55:09
  Speaker 5: Is you replace it for something else?
• 55:12
  Speaker 4: Many patients replace it with exercise, anything else, Then it's
• 55:16
  Speaker 4: not going to be food. And for so many alcohol,
• 55:19
  Speaker 4: which is another great thing with these medications is that
• 55:22
  Speaker 4: it cut.
• 55:22
  Speaker 7: Yeah, there are so many benefits.
• 55:24
  Speaker 6: Okay, So if one of a patient is on this
• 55:27
  Speaker 6: long term, do they usually have to stay at the
• 55:31
  Speaker 6: same dose or do you have to increase it or
• 55:35
  Speaker 6: decrease it?
• 55:36
  Speaker 7: Because so.
• 55:38
  Speaker 4: Depending how much weight we're talking about, right, I mean,
• 55:41
  Speaker 4: I've have patients the one that lost the.
• 55:43
  Speaker 5: Most is one hundred and seventy pounds.
• 55:45
  Speaker 4: Wow, So they work. I mean, when they work, they
• 55:49
  Speaker 4: work great. But to get to let's say, to that
• 55:53
  Speaker 4: goal or to thirty forty pounds, we may use higher
• 55:57
  Speaker 4: doses to get there. But once we're there, when we're
• 56:00
  Speaker 4: in maintenance, that we're not looking for anymore weight loss.
• 56:03
  Speaker 4: I cut back on the doses and this slowly. As
• 56:07
  Speaker 4: slowly we went up, slowly, we will go down because
• 56:11
  Speaker 4: we're not looking for more weight loss. With the patient
• 56:14
  Speaker 4: can be eating a little bit more for maintenance.
• 56:19
  Speaker 7: That makes sense.
• 56:20
  Speaker 6: I cannot believe the behavior, psychological changes, all the benefits
• 56:26
  Speaker 6: that come from this drug.
• 56:29
  Speaker 4: I've had grown men cry in my office that the
• 56:33
  Speaker 4: time they feel relief.
• 56:36
  Speaker 2: Yeah, that's okay. So wrapping up, Laura, do you have
• 56:41
  Speaker 2: any other questions?
• 56:42
  Speaker 6: No, I feel like you explain this so well, and
• 56:49
  Speaker 6: I don't know.
• 56:49
  Speaker 7: This has been such an exciting conversation.
• 56:53
  Speaker 3: I much needed conversation too, so to kind of wrap up.
• 56:58
  Speaker 3: And you have mentioned this now multiple times in this interview.
• 57:03
  Speaker 3: The biggest thing about the weight loss. I mean, I'm
• 57:08
  Speaker 3: just zoning on on one portion, but the muscle mass
• 57:13
  Speaker 3: is so imperative to keep for a myriad of reasons.
• 57:17
  Speaker 3: But mainly if we're looking at like, we don't want
• 57:21
  Speaker 3: the resting metabolic rate to go down from the lack
• 57:25
  Speaker 3: from the loss of muscle, especially these perimenopause postmenopause puzzle women.
• 57:31
  Speaker 3: So that has to be the priority. The high protein,
• 57:36
  Speaker 3: the strength training, you know, along with something like this for.
• 57:41
  Speaker 2: Those who need it. That's like the magic.
• 57:44
  Speaker 7: That's the trifecta.
• 57:46
  Speaker 4: Yeah, and even that I didn't mention this, but what
• 57:49
  Speaker 4: I see in my body compositions in my patients is
• 57:53
  Speaker 4: that when they lose muscle mass, they could be in one,
• 57:57
  Speaker 4: they could be in two weightless medications. They might have
• 58:00
  Speaker 4: lost ten pounds. If they lose muscle mass, their percentage
• 58:06
  Speaker 4: body fat may go up even though they lost weight.
• 58:12
  Speaker 4: So muscle is so imperative for the proper benefit or
• 58:18
  Speaker 4: the maximum benefit of the medication. And when patients see this,
• 58:23
  Speaker 4: when they see that they lost muscle and they gain
• 58:26
  Speaker 4: percentage body fat, it switches completely right, They get why
• 58:30
  Speaker 4: it matters so much. So I really think we should
• 58:33
  Speaker 4: focus more on muscle gain or preserving muscle, then weight
• 58:39
  Speaker 4: loss or fat loss, because if we concentrate on the muscle,
• 58:42
  Speaker 4: preserving the muscle or muscle gain, the fat loss is happening. Yeah,
• 58:47
  Speaker 4: you maximize the benefits of these drugs. You need to
• 58:52
  Speaker 4: have the conversation about muscle.
• 58:57
  Speaker 2: There it is, Mike drop. Nothing else needs to be such.
• 59:04
  Speaker 3: Okay, doctor Whalan, thank you so much for joining us this.
• 59:08
  Speaker 3: I appreciate your time. I know you're on spring break
• 59:12
  Speaker 3: with your kids taking time away, so.
• 59:14
  Speaker 2: We are so grateful.
• 59:15
  Speaker 3: I cannot wait for this episode to air, so thank
• 59:19
  Speaker 3: you so much for joining us.
• 59:20
  Speaker 4: Thank you for inviting me. I really enjoy this. We
• 59:23
  Speaker 4: should do it.
• 59:24
  Speaker 5: Again talking about Yeah, explusive and menopause. Woman, I think
• 59:28
  Speaker 5: we should.
• 59:30
  Speaker 2: Yes, let's do it. That's around two.
• 59:32
  Speaker 5: This week to serve a full podcast just for them.
• 59:35
  Speaker 3: Okay, we're doing it. Thanks so much, Thanks for listening everyone.
• 59:41
  Speaker 6: If you enjoyed this episode, please consider giving us a
• 59:44
  Speaker 6: five star rating and sharing the body Pod with your
• 59:47
  Speaker 6: friends until next time.
• 1:00:00
  Speaker 4: The better, the better, the
• 1:00:00
  Speaker 7: Middle better better