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Should Endurance Athletes Use GLP-1s? The Risks of Chasing Race Weight · The Endurance Athlete Journey

• 0:08
  SPEAKER_00: Welcome everyone to the Endurance Athlete Journey Podcast.
• 0:11
  SPEAKER_00: I'm your host, Coach Justin.
• 0:12
  SPEAKER_00: I'm here with Coach Katie.
• 0:13
  SPEAKER_00: And this is uh episode 109.
• 0:16
  SPEAKER_00: And we are going to be discussing GLP1 drugs and their relationship to endurance sports and endurance athletes.
• 0:25
  SPEAKER_00: Uh these types of medications have become one of the biggest topics in health and fitness.
• 0:32
  SPEAKER_00: And I think the conversation stems from the argument on, you know, if I can weigh less, can I become faster?
• 0:42
  SPEAKER_00: And we did an episode uh previously in our library.
• 0:45
  SPEAKER_00: So if you go back and you find episode 73, we talked about weight and performance for endurance athletes.
• 0:53
  SPEAKER_00: So this is a an extension of that conversation where we want to see if there is a strategic use for these drugs and if there is any kind of validity to the statement of, you know, hey, if I if I'm if I'm lighter, am I faster?
• 1:09
  SPEAKER_00: But then the argument becomes, well, if I'm faster, does that mean that I'm more durable?
• 1:13
  SPEAKER_00: What are the consequences of using these types of strategies to make this quote unquote race weight?
• 1:20
  SPEAKER_00: Uh I know that this particular topic has been uh a hot button topic in endurance sports for years.
• 1:27
  SPEAKER_00: Uh the whole concept of trying to make race weight, that performance is some kind of function of your current weight, and is there an optimal weight that you want that you should be in order to optimize your performance?
• 1:43
  SPEAKER_00: And as we've now started to see the utilization of these types of drugs, uh how should we be implementing these types of strategies uh in our training?
• 1:57
  SPEAKER_00: And I want to uh uh d talk to you a little bit about you know how this topic came about.
• 2:03
  SPEAKER_00: And it this isn't just because it's a hot button topic.
• 2:06
  SPEAKER_00: I uh this was an actual conversation that I sat down with with an athlete uh where he was talking about how he was using a GLP one drug because he had gained some weight, he had a 70.3 uh triathlon that was coming up uh like in October, and this is July.
• 2:26
  SPEAKER_00: So we're talking still months away.
• 2:29
  SPEAKER_00: Um but he wanted to uh use these types of drugs in order to shed the weight that he had been having a difficult time getting rid of.
• 2:40
  SPEAKER_00: And he had a weight that was in mind, and his strategy was to use the drug until he made this particular weight, in which case he was suspend use of the drug and then hopefully try and maintain that weight.
• 2:54
  SPEAKER_00: I guess that's a that's a whole nother argument in itself.
• 2:58
  SPEAKER_00: And I was sitting down with this guy and I I was talking with him, and you know, I had all these things that were floating through my head.
• 3:06
  SPEAKER_00: What are the consequences of doing this types of thing?
• 3:08
  SPEAKER_00: How much performance is he sacrificing in order to make to make this magic number that he was trying to achieve?
• 3:18
  SPEAKER_00: And what was he losing in the process just to gain a uh performance potential uh down the road?
• 3:28
  SPEAKER_00: And you know, what are some of the the health uh ramifications associated with this when it comes to endurance athletes?
• 3:36
  SPEAKER_00: Uh are we able to per uh train with performance in mind, or do we have to shift our training paradigm to no longer train for performance or should we start to shift more towards a an exercise mentality where we're just looking for general overall health because there's there are absolute consequences to to the use of this of these types of medications.
• 4:01
  SPEAKER_00: So that's how this topic came about.
• 4:02
  SPEAKER_00: And so I I I approached it with Katie and I was like, let's let's talk about this, because I I think that there's some there's some interesting uh ideas that are here, uh, some things that people need to be aware of.
• 4:15
  SPEAKER_00: And I I think I've seen them in my own research and and other people that are coming out, you know, talking about the consequences of these types of medications and what are the the pros and cons of using them.
• 4:27
  SPEAKER_00: So I don't think that there's a whole lot of like groundbreaking uh you know information that's going to come of this, but I think that it's still nice to bring this conversation out to the forefront and just have one more episode come out and talk about, you know, what are the consequences of these.
• 4:43
  SPEAKER_00: Uh I do want to be completely transparent with the listeners that are out there.
• 4:48
  SPEAKER_00: Um probably about now, what is it like a 12 to 14, 15 years ago now, I had gastric bypass surgery.
• 4:56
  SPEAKER_00: And this was before I I ever got into endurance sports.
• 5:00
  SPEAKER_00: So I do want to be transparent, even though it's not the same thing as a GLP one.
• 5:05
  SPEAKER_00: Uh I have had, you know, a weight loss surgery.
• 5:09
  SPEAKER_00: And over the years, I've had to manage uh the uniqueness of my body as a result of this approach.
• 5:18
  SPEAKER_00: So I don't want people to think, well, this guy's just a hypocrite because he's talking about you know some kind of weight loss strategy where you know he has in fact had one.
• 5:25
  SPEAKER_00: But you know, so I do want to be honest about it and and throw this out from the very start.
• 5:30
  SPEAKER_00: Yes, I've had weight loss surgery.
• 5:32
  SPEAKER_00: Uh I've had regain, so I've I also struggle with you know the weight issue just like anybody else does.
• 5:39
  SPEAKER_00: And I don't consider myself uh isolated, you know, from this.
• 5:43
  SPEAKER_00: I I still struggle with everyone else.
• 5:45
  SPEAKER_00: So uh Katie, let's let's dig into this.
• 5:48
  SPEAKER_00: This is really more up your area of of expertise.
• 5:53
  SPEAKER_00: Um I I can talk about it you know from the performance side as a coach on you know how I would approach an athlete who would come to me with this type of strategy and and how we would would I recommend it?
• 6:07
  SPEAKER_00: Would I actually take them on as an athlete onto my roster if this is the way that they wanted to approach it?
• 6:13
  SPEAKER_00: I I think that that's a question that remains to be answered, you know, from from my perspective.
• 6:17
  SPEAKER_00: But let's at least start talking about the the physiological impact of of these types of medications.
• 6:23
  SPEAKER_00: What are they designed for?
• 6:25
  SPEAKER_00: How are they being used?
• 6:26
  SPEAKER_00: Why should they be used?
• 6:28
  SPEAKER_02: Yeah, a little bit of an overview.
• 6:29
  SPEAKER_02: Yeah.
• 6:30
  SPEAKER_00: Let's talk about this.
• 6:31
  SPEAKER_00: So let's let's kick this off.
• 6:32
  SPEAKER_00: Let's go.
• 6:32
  SPEAKER_02: Yeah, many people probably kind of have heard of them, GLP1 medications.
• 6:36
  SPEAKER_02: I mean, it's kind of all over the internet, I think.
• 6:40
  SPEAKER_02: You know, I think most people listening to probably heard of it at least, if not maybe thought about using them.
• 6:47
  SPEAKER_02: Um and I think it is there's a lot of conversation, but I don't know if I'm aware of a ton of conversation about the use in endurance athletes specifically, because you know, I just don't, I just haven't heard much on that end.
• 7:02
  SPEAKER_02: Um, so I think this topic will be interesting because we are talking, you know, generally about GLP1 medications and then really specifically about endurance athletes and whether or not it's a good idea to use or an endurance athlete to use the medication.
• 7:17
  SPEAKER_02: And I think I also want to preface this.
• 7:19
  SPEAKER_02: It's like I've never, I've never really struggled um with my weight like many people have.
• 7:24
  SPEAKER_02: So I try to come at this as unbiased as I can.
• 7:28
  SPEAKER_02: And actually, to be honest, I think these medications can have a lot of positive benefits for people.
• 7:34
  SPEAKER_02: I want to try to come at this in more of like a here's some of the pros and cons, and here's what endurance athletes specifically want to be thinking about, and more of like, here's the information, and then you can kind of decide what will work best for you.
• 7:46
  SPEAKER_02: But I don't, you know, I don't want to put a ton of judgment other than I do think that for endurance athletes specifically, there are probably more risks involved than for somebody who isn't maybe as active.
• 8:00
  SPEAKER_02: Um, and it maybe has actually a like it's probably a lot of benefit for someone who has quite a bit of weight to lose, but then, you know, it gets a little bit more in the gray area of whether or not somebody who only has 10 pounds or 20 pounds should be using these medications.
• 8:16
  SPEAKER_02: And I don't necessarily want to pass judgment, but I do know that for certain individuals, these medications can be life-changing, just similar in a sense to something like bariatric surgery.
• 8:27
  SPEAKER_02: You know, there's there can be, it's a tool, like any tool.
• 8:30
  SPEAKER_02: You either use it wisely or you don't, you know, so it's not magic.
• 8:35
  SPEAKER_02: Um, but I kind of want to come at it like that from that perspective, because some people might really benefit from these medications.
• 8:42
  SPEAKER_02: And so I don't want to um come at it with that sort of like, oh, it's all bad, because there are maybe some benefits.
• 8:47
  SPEAKER_02: So let's just go quickly.
• 8:49
  SPEAKER_02: Like, I think many people have heard of the medications.
• 8:52
  SPEAKER_02: So I don't want to spend a lot of time on like what they are, but I think it does help to kind of talk about that in the mechanism a little bit because when we talk about risk pros and cons and some of the risks and some of the benefits, uh, we that would maybe be helpful to know.
• 9:06
  SPEAKER_02: So I think the medications themselves, there's tons of different names.
• 9:10
  SPEAKER_02: You can even get like compounding pharmacies to make who that make GLP ones.
• 9:15
  SPEAKER_02: I mean, I'm not gonna go into what type of medication and exactly if it's even safe to use compounding pharmacies and all of that information.
• 9:24
  SPEAKER_02: There's a lot of information online on the actual each, you know, each individual medication type.
• 9:30
  SPEAKER_02: But there's like Ozempic, Wagovi, Manjaro, Zeppbound, Sexenda.
• 9:35
  SPEAKER_02: There's even like some more new age um GLP.
• 9:39
  SPEAKER_02: They're they're like, it's not just GLP one anymore.
• 9:42
  SPEAKER_02: It's like several peptides that they're using that have different mechanisms.
• 9:46
  SPEAKER_02: And so we can talk a little bit about that.
• 9:48
  SPEAKER_02: But something like retitrutide, which is a newer new age, kind of newer GLP one type medication that's coming out, or it may still be in the research phase, but might be coming out soon.
• 10:01
  SPEAKER_02: So there's medications that are even in development for that are kind of even more powerful, maybe.
• 10:06
  SPEAKER_02: Um, so we can talk a little bit about that.
• 10:08
  SPEAKER_02: But just as a reminder here, I mean, a lot of people think that these medications are like brand new.
• 10:13
  SPEAKER_02: Like we just came out with them, and they think that many people think that they're specifically for weight loss, but that's not the case at all.
• 10:19
  SPEAKER_02: In fact, medications like Ozempic have been around for years.
• 10:23
  SPEAKER_02: And when I was working in the diabetes, a little doing some work with diabetes back, you know, maybe now seven years ago, eight years ago, um, I was working with people who were on Ozempic who had type 2 diabetes.
• 10:36
  SPEAKER_02: And so it's actually that's the original intention is to help people control their blood sugar.
• 10:42
  SPEAKER_02: And one of the side effects just so happened to be like that they were losing weight.
• 10:46
  SPEAKER_02: And so I think then, you know, it's really more recently, it's like, oh, well, what if we use these medications to help with weight loss?
• 10:53
  SPEAKER_02: And so this whole weight loss trend for the medications is actually very new, probably over the past, you know, more recently, like five years, is when I've really seen it kind of become a big thing.
• 11:03
  SPEAKER_02: Um, maybe, maybe longer than that.
• 11:05
  SPEAKER_02: But really, I didn't even think about it for weight loss when I was working with my type 2 diabetes patients back then.
• 11:12
  SPEAKER_02: So just something to keep in mind because I hear a lot of people saying, like, oh, they're worried about using it because it's a brand new medication.
• 11:18
  SPEAKER_02: They're not brand, especially some of those older medications like Ozempic and maybe Wigovi or Manjaro are actually pretty old old.
• 11:25
  SPEAKER_02: They're not, they've been around a while.
• 11:27
  SPEAKER_02: I can't, I don't know how long.
• 11:28
  SPEAKER_02: I I probably should have looked that up, like how when they were developed, but it's been it's been here for a while.
• 11:33
  SPEAKER_02: So don't, you know, don't think, oh, it's only been within the five past five years that we've been developed these developing these medications.
• 11:40
  SPEAKER_02: We have had them around.
• 11:41
  SPEAKER_02: We do know we're starting to learn more and more about some of the side effects.
• 11:45
  SPEAKER_02: Um, we do at least have some information about their safety.
• 11:49
  SPEAKER_02: So there it there may be some risk, but honestly, in general, they're they can be safe in the sense that there may not be like extremely unsafe consequences.
• 11:59
  SPEAKER_02: Like occasionally people develop panreititis.
• 12:01
  SPEAKER_02: There are some risks for certain things that can be serious, just like any kind of medication you take.
• 12:07
  SPEAKER_02: But in general, there's quite a bit of safety around them in terms of like medical issues.
• 12:12
  SPEAKER_02: Now we'll talk about some of the risks, pros and cons when it comes to the way the medication works and how that might influence uh not only our weight and appetite, but what types of foods we eat and how we fuel our bodies and how that might be an issue for endurance athletes.
• 12:28
  SPEAKER_02: But in terms of like serious consequences, um, serious medical outcomes from using the medication, generally they're they're quite safe.
• 12:37
  SPEAKER_02: Although there is like any medication, some potential um um serious medical side effects.
• 12:44
  SPEAKER_02: That's probably a good place to start.
• 12:46
  SPEAKER_02: Let's just talk a little bit about how they work.
• 12:48
  SPEAKER_02: Have you ever heard?
• 12:49
  SPEAKER_02: I mean, I don't know, Justin, have you like have you had you when you had heard the medication?
• 12:54
  SPEAKER_02: Did you did did you get any information about like how they worked?
• 12:57
  SPEAKER_02: Or is it seemed like it's just more like, oh, they're like what what have you heard about the GLP medications?
• 13:02
  SPEAKER_00: I'm not um I mean to be honest, I didn't really know much about them at all.
• 13:08
  SPEAKER_00: I mean, before before I started working with you as as as my as my nutrition coach, um, I I went to my doctor and I was like, you know, I can't get rid of this, I can't get this weight off.
• 13:21
  SPEAKER_00: And I can't figure out it's like the amount that I'm training just doesn't make sense on why it's just not going anywhere.
• 13:27
  SPEAKER_00: Um and so, you know, there were there was a panel of of you know tests that we ran and we did find some some issues that I was dealing with at the time, but I don't think that those issues were enough to really kind of uh be the driving factor on on why I seen couldn't seem to to shed this shed the weight despite the the heavy training load.
• 13:50
  SPEAKER_00: And so my doctor actually had suggested uh that he's like, hey, would you would you consider going on Wagovi?
• 13:57
  SPEAKER_00: And he knew that I was already you know a gastric bypass patient.
• 14:02
  SPEAKER_00: He knew that I had the bariatric surgery.
• 14:04
  SPEAKER_00: And you know, when I started to dig into it a little bit, I just I got to the point where I found out what the price point was, and I immediately shut it down because I was like, no, I'm good.
• 14:15
  SPEAKER_00: I'll just I'll just suffer through it and figure it out.
• 14:18
  SPEAKER_00: Uh because you're not gonna be able to do that.
• 14:19
  SPEAKER_02: That's another con that I didn't even put on here.
• 14:21
  SPEAKER_00: There's there's no way that I'm willing to uh shell out that kind of expense just to to lose some pounds.
• 14:27
  SPEAKER_00: Um I didn't really understand the mechanisms until I started later to to start to see things, you know, in in reels from from experts that that were talking about how they were being used now.
• 14:44
  SPEAKER_00: Um while I think there is uh a safety history, you know, I've I've been involved with clinical trials before, as you know, as part of one of my jobs that I've had before.
• 14:54
  SPEAKER_00: And so I think the argument becomes is despite the fact that it had a it they have a pretty uh clean history, the question is is does the history remain clean with the new utilization and the extent in which they are being used?
• 15:11
  SPEAKER_00: I I I don't know.
• 15:12
  SPEAKER_02: I mean it it very well it very well could persist, but yeah, because you have people now who don't have type two who are using the medications and is there um risk.
• 15:24
  SPEAKER_02: And I think too, it's hard because we may it may be a while because you have to kind of see.
• 15:30
  SPEAKER_02: Clinical trials take a really long time to develop trials take a while, and then even when you open it to the general population, if there are the adverse side effects.
• 15:39
  SPEAKER_02: And I have worked with people who have had some serious side effects.
• 15:44
  SPEAKER_02: And I remember one woman had developed severe pancreatitis from that was linked to the medication, and she ended up losing part of her pancreas, no longer.
• 15:56
  SPEAKER_02: So she essentially almost developed, like, I can't remember the name for it when you develop diabetes, but it's because the pink, it was like the insulin wasn't being released like it should.
• 16:07
  SPEAKER_02: So it was only almost like a type 1 diabetes without it being autoimmune.
• 16:11
  SPEAKER_02: Um, there's a name for it, I can't remember, but it was like serious, it's a serious consequence of using the medication.
• 16:17
  SPEAKER_02: And I think there are certain medical conditions that put you at risk.
• 16:20
  SPEAKER_02: So it isn't as though there are no like high risks, you know, sometimes.
• 16:26
  SPEAKER_02: And I I mean, I this is someone I've worked with, like, you know, just a nutrition, generally um working with her for just generally health and and um I think also because she had that sort of diabetes that was caused by this.
• 16:39
  SPEAKER_02: There are risks, and so and I I you know I've seen it firsthand.
• 16:42
  SPEAKER_02: So I don't want people to think, oh, this is there's no potential like very serious risks.
• 16:47
  SPEAKER_02: It's just it's just maybe fairly rare.
• 16:49
  SPEAKER_02: I mean, they wouldn't put it out in the market if a lot of people were getting hurt, but it, you know, it can, it can have some serious side effects.
• 16:55
  SPEAKER_02: So I don't want to have it seem like I'm saying, oh, it's super safe, just because and we just don't know, like, yeah, with every with all of these people losing it, somebody who's an endurance athlete too.
• 17:06
  SPEAKER_02: I mean, because of our, and I'll talk a little bit about that because of our physiology, it might be something that might, you know, put us at greater risk for certain things.
• 17:14
  SPEAKER_02: Um, because we don't have diabetes.
• 17:16
  SPEAKER_02: So we don't need to have increased insulin sensitivity, maybe.
• 17:20
  SPEAKER_02: And you know, there might be some risks there.
• 17:21
  SPEAKER_02: So we'll chat about it, but let's go over through the uh how they work.
• 17:26
  SPEAKER_02: So yeah, the GLP1 refers to glucagon-like receptor or glucagon-like peptide one.
• 17:34
  SPEAKER_02: So it's just a type of peptides, basically like a hormone that our body naturally releases, our gut when we eat.
• 17:41
  SPEAKER_02: It's a hormone that it naturally releases and kind of sends that signal to our brain, like, hey, I'm full.
• 17:46
  SPEAKER_02: It's time to stop eating.
• 17:47
  SPEAKER_02: Except for with these medications, it's like a thousandfold.
• 17:51
  SPEAKER_02: You know, it's like this, this like signal is really amplified.
• 17:54
  SPEAKER_02: I don't know, it's I don't know how many fold, but it's like amplified with the medication.
• 17:58
  SPEAKER_02: So you're kind of getting extra signal to your brain to say, hey, it's I'm full, right?
• 18:03
  SPEAKER_02: So that's one of the benefits of the medication is that for people who are maybe feeling like they're hungry all the time, they that fullness signal is more amplified.
• 18:11
  SPEAKER_02: Um so that's really essentially part of it.
• 18:14
  SPEAKER_02: The other part of it is that there's like a slowing uh gastric um motility, like so we don't have so our contents of what we eat is more slowly released into the intestines.
• 18:25
  SPEAKER_02: So we don't, so it takes a little bit longer to for the food to be digested.
• 18:30
  SPEAKER_02: And that also kind of makes us feel a little bit more full and maybe we don't eat as much.
• 18:35
  SPEAKER_02: So there's like a couple of benefits with that.
• 18:37
  SPEAKER_02: Um, some of the newer medications are kind of dual acting, so they're acting on different peptides.
• 18:43
  SPEAKER_02: So there's like the GIP GLP agonist medications that are not only the glue the GLP1, but they have the glucose-dependent insulinotropic polypeptide, is the other one.
• 18:55
  SPEAKER_02: So sorry that's a long word, but and I had to look at it because I'm like, what was it?
• 19:00
  SPEAKER_02: But that's that's just basically another peptide or hormone that's another type of signal.
• 19:06
  SPEAKER_02: So they're basically now looking at different types of hormones that we have naturally that they can produce into like a medication to like amplify the whatever that hormone does and just kind of amplify it.
• 19:19
  SPEAKER_02: So in that case, um, it can lead to even greater weight loss potentially.
• 19:24
  SPEAKER_02: And then even some of these, um, like retitrutide, I I think is that the name of it, but that one itself can also, it also has, I think it adds maybe glucagon, which is a hormone um that kind of causes the body, the I believe it causes the liver to stop to really um to not release.
• 19:47
  SPEAKER_02: Or what is it?
• 19:48
  SPEAKER_02: Yeah.
• 19:48
  SPEAKER_02: I'm trying to remember.
• 19:50
  SPEAKER_02: Um from it it's it stops, it it creates, it causes the um liver to um basically, I believe it it causes, now I'm like trying to think of what it does because I'm like, what does the glucose on do?
• 20:06
  SPEAKER_02: Um basically helps us from having the glucose drop too low.
• 20:11
  SPEAKER_02: So like it kind of helps with glucose regulation.
• 20:14
  SPEAKER_02: So sometimes when someone has type 1 diabetes, they'll have that particular medication.
• 20:19
  SPEAKER_02: And I believe it works kind of on the liver to kind of just help keep our blood sugar a little bit more stable.
• 20:25
  SPEAKER_02: So it it helps maybe kind of counteract potentially some of the other things that the medications are doing.
• 20:32
  SPEAKER_02: Because what I didn't mention is another thing that the medication that these GLP medications can do is the reason it's so helpful for people who have diabetes is it can kind of help increase our insulin sensitivity and how we utilize glucose.
• 20:47
  SPEAKER_02: So if you have insulin resistance, it can kind of help with that piece as well.
• 20:51
  SPEAKER_02: So the glucagon is kind of like sometimes added, I think maybe as a mechanism to kind of help stabilize glucose a little bit.
• 20:58
  SPEAKER_02: Um, but see, but you can see how they're adding all these different medications in to sort of help uh enhance, you know, the the benefits and work on different mechanisms to help with weight loss.
• 21:12
  SPEAKER_02: So uh we'll talk a little bit about my thoughts on these sort of just dual or triple or even quadruple or whatever five acting, you know, they're using five different peptides or five different types of um things to kind of work in uh in different aspects.
• 21:30
  SPEAKER_02: Like I I'm not sure how I feel about that because I feel like it's, you know, are we are we just caught trying to cause people to never be hungry?
• 21:38
  SPEAKER_02: Like, I don't know.
• 21:38
  SPEAKER_02: I don't know if that's a good thing either.
• 21:40
  SPEAKER_02: Like if you're just taking something and you just never feel like eating, like we do, we do need to eat to fuel.
• 21:47
  SPEAKER_02: So, you know, there's there may be something there that I'm kind of like, okay, what at what point are we gonna like just sort of stop?
• 21:54
  SPEAKER_02: We don't have to like, you know, maybe use go crazy with these medications, but there are there are some coming.
• 22:00
  SPEAKER_02: Out that are kind of more acting on different horm, like basically hormone receptors, different, um, creating mimicking sort of different peptides that we have naturally in our body that help us basically feel full sooner, stay full longer, snack less, and think about food less.
• 22:17
  SPEAKER_02: So one of the benefits that people generally describe to me are that they tend to say, I don't think about food as much.
• 22:24
  SPEAKER_02: I feel full sooner, but I don't, but that food noise is gone, right?
• 22:30
  SPEAKER_02: So and a lot of people I think have that.
• 22:32
  SPEAKER_02: You know, I mean, I when I'm hungry, I think about food sometimes, you know, but I think there are, you know, there are individuals who think about food a lot and it's taking up a lot of space in their brain and the food noise is gone, which I think is a good benefit to it.
• 22:45
  SPEAKER_02: So it's not to say that's um that can be really like life-changing for some individuals who who have a lot of that food noise.
• 22:52
  SPEAKER_02: So there's a benefit.
• 22:54
  SPEAKER_02: Um and then, you know, we'll talk about some of the issues with athletes, but you could see how, I mean, if you're if it's taking your gut a little bit longer to digest the food, you could see how that might be problematic in certain situations for athletes.
• 23:08
  SPEAKER_02: I think the big thing, the big overarching thing why people actually lose weight is that all of these things contribute to lower calorie intake.
• 23:15
  SPEAKER_02: So people just eat less and they lose weight because it still and and it still comes down to what we eat, like how much we eat, right?
• 23:24
  SPEAKER_02: It's that equation of energy in versus energy out.
• 23:27
  SPEAKER_02: There's no other magic way to lose weight generally, like the keto diet versus, you know, there's no magic way to eat everything you ever wanted and still lose weight.
• 23:36
  SPEAKER_02: It still comes down to that equation.
• 23:38
  SPEAKER_02: And what this medication does is just have a, we just eat less.
• 23:41
  SPEAKER_02: And that's how we lose weight.
• 23:43
  SPEAKER_02: And so that's essentially what the medication's doing.
• 23:46
  SPEAKER_02: There isn't really any other magic potentially the insulin sensitivity benefits if somebody does have type 2 diabetes, maybe.
• 23:53
  SPEAKER_02: Um, but because we do know that insulin resistance is associated with weight gain and stubborn weight loss.
• 23:59
  SPEAKER_02: So there could be some potential benefit there for weight loss, but um essentially it's not nothing really any more magic than that.
• 24:07
  SPEAKER_02: We just it just has us or just causes us to eat less and therefore we lose weight.
• 24:11
  SPEAKER_02: That's the I guess the takeaway from that whole conversation on how the medications work.
• 24:16
  SPEAKER_00: Yeah, so I want to like I want to compare it a little bit to the to the bariatric surgery itself because when I was talking with this guy, he he was talking about some of this some of the so-called side effects or you know, quote unquote benefits of being on the medication was similar to the benefits that I had when I had my surgery.
• 24:37
  SPEAKER_00: So it was the absolute removal of hunger pains.
• 24:41
  SPEAKER_00: You know, you you could go all day and just not get hungry.
• 24:45
  SPEAKER_00: And that's that's the way that I was when you know I had my surgery.
• 24:49
  SPEAKER_00: I I just no longer would would become hungry.
• 24:53
  SPEAKER_00: And I mean, even to this day, I still don't get hunger pains like I I think a quote unquote normal person would, somebody with a normal digestive system.
• 25:02
  SPEAKER_00: And so I'm kind of curious on if when we compare the medications to the surgeries, is it is it just that the surgery just would would completely manipulate the digestive system and the storage capacity in order to take in food?
• 25:19
  SPEAKER_00: I would imagine there would have to be some kind of disruption of of hormone production as a result of that manipulation, but the drugs are basically doing the same thing.
• 25:29
  SPEAKER_00: They're just manipulating the hormone side of it without altering the digestive without altering the digestive system and the storage capacity of of food intake.
• 25:42
  SPEAKER_02: Yeah, it's basically uh, I mean the the gastric bypass, you're yeah, you're absolutely right.
• 25:47
  SPEAKER_02: It just causes the stomach to be very, very small.
• 25:51
  SPEAKER_02: So that limits how much we can eat on its own.
• 25:54
  SPEAKER_02: So then you feel full much quicker, and that so those signals go to your brain and um and it slows down a little bit, or it can slow down sometimes gastric emptying a little bit too with those surgeries, but um maybe not maybe it depends on the individual a little bit.
• 26:11
  SPEAKER_02: But I know that you know, because you have such a small, you know, stomach now, it's basically just more that you those signals are happening sooner and they're a little more amplified in that sense.
• 26:23
  SPEAKER_02: But it's um it's just it's just similar because but one is like a medication and one is a surgery, you know, that you do that you're actually having to, you know, go and alter your, you know, go through a a potentially like serious surgery and alter your entire gut.
• 26:40
  SPEAKER_02: So um, you know, I can't say like whether I would recommend one over the other, because if you want, like there's a lot of um discussion about these medications as being for especially for someone who's trying to lose weight and keep it off, that they may be more lifelong medications.
• 26:59
  SPEAKER_00: That's what I was about to just say.
• 27:00
  SPEAKER_00: Yeah.
• 27:01
  SPEAKER_02: Yeah.
• 27:01
  SPEAKER_02: So there's a cost to it potentially, and you then have to be on a medication potentially for the rest of your life.
• 27:07
  SPEAKER_02: Now, is it possible for you to stop taking them and maybe keep the weight off potentially?
• 27:12
  SPEAKER_02: But it could be very hard to do that, you know, like it is hard to, you know, lose weight and keep it off.
• 27:18
  SPEAKER_02: So I think there's a benefit to the surgery is that, you know, if you're doing it right, you're like you, it's but you know, supposedly like you do the surgery and you don't have to worry about it so much the rest of your life.
• 27:28
  SPEAKER_02: Although there are unfortunately people that like regain the weight and struggle.
• 27:32
  SPEAKER_02: So I don't know if that's a foolproof thing.
• 27:35
  SPEAKER_02: But um, but the medications are meant to be more lifelong.
• 27:39
  SPEAKER_02: You know, they're meant to help people who have a lot of weight to lose or type 2 diabetes with weight to lose, to lose the weight and then maybe stay on maybe not a high dose, but some dose of the medication potentially for the rest of their lives.
• 27:52
  SPEAKER_02: So it's not really meant.
• 27:54
  SPEAKER_02: These medications, I don't think, were meant to be for just short-term weight.
• 27:59
  SPEAKER_02: I mean, essentially, um, it's it's like I I understand that, you know, people want to lose the weight and it's hard to lose weight.
• 28:10
  SPEAKER_02: Like it's not easy.
• 28:11
  SPEAKER_02: I've worked with so many people who have just struggled to lose weight.
• 28:17
  SPEAKER_02: Even a little bit, you know, working with you, Justin, just like some some of the things of like, why is it like what the heck is going on?
• 28:24
  SPEAKER_02: It's so frustrating, right?
• 28:25
  SPEAKER_02: Because we're trying all these things and we're reducing calories and I get it's it's hard.
• 28:30
  SPEAKER_02: And so I think the pull to like use a medication to get there is um is is, you know, I understand that.
• 28:38
  SPEAKER_02: Um, but it's if you don't have some sort of uh some sort of plan while you're on the medication to make sure you're doing it correctly and eating correctly so you don't lose muscle mass and things like that.
• 28:48
  SPEAKER_02: And then if you don't have some sort of plan for when you come off the medication of how you're gonna keep the weight off, the medication is no different in some ways, other than it's maybe much easier, then it's really no different, in my opinion, than maybe a fad diet because essentially you're just using more of a medication rather than, you know, food restriction to get there.
• 29:06
  SPEAKER_02: But I mean you're still restricting food, but the medication is helping with that, right?
• 29:11
  SPEAKER_02: Um, and then if you don't have a plan, unfortunately, there are so many, I don't know, stories, I guess, or even people I've worked with who have then who are coming to me after they've used GLP one, gain all the weight back.
• 29:24
  SPEAKER_02: And then they're like, well, now I you know, like now I want to either go back and do it correctly or not use the medication and try to do it on my own.
• 29:31
  SPEAKER_02: But it then it's becomes a yo-yo diet thing where people are then losing the weight to get to a weight using the medication.
• 29:38
  SPEAKER_02: And then if they don't have a plan for how that's going to be maintained, they gain it all back.
• 29:43
  SPEAKER_02: And to the research on yo-yo diet, the yo-yo weight of going up and down and up and down in weight, the outcomes are far worse than if you were to just stay at whatever weight you're at and just maintain it, you know, even if you're technically overweight or obese according to the BMI.
• 29:58
  SPEAKER_02: You'll be healthy, but if you're healthy, it's better to maintain it than to try to yo-yo back and forth.
• 30:03
  SPEAKER_02: So the caution I would give people is if this is something you're actually thinking about using, whether you're an athlete or not, to think about how you're going to do it safely so that you don't compromise your metabolism or your muscle mass and your health.
• 30:18
  SPEAKER_02: And then how are you going to transition once you decide you've met your weight goal to coming off of the medication and maintaining that weight?
• 30:27
  SPEAKER_02: Because you don't want to be going even 20 pounds up and down isn't good for you.
• 30:31
  SPEAKER_02: So we want to be really trying to think about that.
• 30:34
  SPEAKER_02: Um, I'm not saying that the medication isn't a tool.
• 30:37
  SPEAKER_02: I I think it could be a tool.
• 30:39
  SPEAKER_02: You just need to use it wisely, right?
• 30:41
  SPEAKER_02: Like don't um, you know, don't risk your health just to get to a weight that you want to be at.
• 30:48
  SPEAKER_02: And um, I say that, but I do know that people struggle and there's a lot of stigma and there's a lot surrounding weight that, you know, in our society, I mean, I'm not gonna go into all of that.
• 30:59
  SPEAKER_02: I know that, you know.
• 31:00
  SPEAKER_02: So there's there's a lot there.
• 31:01
  SPEAKER_02: It's like a loaded thing, but I think, you know, I I I understand and I think it's a great tool, but we need to use it wisely.
• 31:07
  SPEAKER_02: So yeah, so let's dive into like the athlete piece.
• 31:10
  SPEAKER_02: Is that yeah?
• 31:11
  SPEAKER_02: Did I answer your question?
• 31:12
  SPEAKER_02: I mean, for the most part.
• 31:14
  SPEAKER_01: Yeah.
• 31:15
  SPEAKER_02: Um yeah, whether you choose to do anything, whether it's GLP one or a weight or a bariatric surgery, it's a big it's I think bariatric surgery obviously takes a little bit more of a thought because it's a surgery, but either way, I think you need to go into it kind of being prepared and just realizing it's a tool and not a magic.
• 31:35
  SPEAKER_02: Not any it there's no like nothing magical really about it.
• 31:38
  SPEAKER_02: You just have to use it as a tool, not as a this is gonna solve all my problems kind of thing.
• 31:44
  SPEAKER_02: Um so why uh why athletes like I don't know.
• 31:47
  SPEAKER_02: So you're in your did you mention this when you kind of did your intro?
• 31:50
  SPEAKER_02: Because you had talked to me about it, but when you were talking to that athlete, weren't they telling you a little bit about what their experience with it and how much they were eating?
• 31:59
  SPEAKER_02: Like where they did you mention that one?
• 32:01
  SPEAKER_00: Uh this guy was effectively eating like one meal a day.
• 32:04
  SPEAKER_00: Um and he did tell me a stor uh an episode where he did a bit of a refeed.
• 32:10
  SPEAKER_00: So there was one day where he had like three meals, but um by and large he's been eating like one meal a day.
• 32:18
  SPEAKER_00: It was a heavy protein meal.
• 32:20
  SPEAKER_00: And so, you know, as we were talking, it I made it perfectly clear.
• 32:24
  SPEAKER_00: I was like, we you are going into every single workout uh depleted.
• 32:27
  SPEAKER_00: So glycogen stores are gonna be way down.
• 32:31
  SPEAKER_00: Um there I I questioned in him on whether he had any kind of intensity in his training plan uh because my concern for it was that he just wasn't fueling enough in order to do higher intensity efforts.
• 32:44
  SPEAKER_00: Like if he was just gonna be doing all kind of like zone one, zone two kind of stuff, uh, and you know, this whole like maybe become more fat adaptive rather than relying on uh carb stores and like glycogen stores in order to fuel fuel his workouts.
• 33:01
  SPEAKER_00: And uh he said no, he he still had some intensity in his training plan.
• 33:05
  SPEAKER_00: Um and this we were actually on a group ride, and it was it can be a little challenging of a course, so there's some rolling hills, and it was hot, and uh he's he's definitely a much stronger athlete than I am, uh, and he had a lot nicer gear, faster, faster gear than I did, but I stayed in his back pocket the whole time, which surprised me because I was like, How am I keeping up with this guy?
• 33:34
  SPEAKER_00: Because this guy is a machine.
• 33:37
  SPEAKER_00: And uh we were on the last loop of of the route because it's just just a one big circular loop, and we just do as many as we can within the span of like 60 minutes.
• 33:49
  SPEAKER_00: And he dropped off on the last loop, and he just said he just hit a wall and he just bombed.
• 33:53
  SPEAKER_00: But I kept going.
• 33:54
  SPEAKER_00: I mean, I was perfectly fine.
• 33:55
  SPEAKER_00: I could have kept riding for hours, and it caught me off guard because I was looking behind him and I was like, How am I like just overtaking this guy?
• 34:03
  SPEAKER_00: I was like, this doesn't make much sense either.
• 34:05
  SPEAKER_00: I'm a lot stronger than what I'm giving myself credit for, or something's going on.
• 34:11
  SPEAKER_00: And so I was like, no, Justin, don't get a big head here.
• 34:14
  SPEAKER_00: You're you're not all this great.
• 34:15
  SPEAKER_00: So I I said I was trying to figure it out, and I kept looking behind me to to see where he was at.
• 34:20
  SPEAKER_00: He just disappeared, and so apparently he just dropped off, and he was just like, I'm I was done.
• 34:24
  SPEAKER_00: I just he just hit a wall.
• 34:27
  SPEAKER_00: And uh he said that that that has been happening with him, and so uh I questioned, I was like, Well, how are you just like maintaining any kind of like performance, trying to train for performance versus just training for fitness?
• 34:40
  SPEAKER_00: And I was like, How are you getting through workouts?
• 34:42
  SPEAKER_00: Because I mean, even at the 70.3 level, some of some of the workouts are are kind of long and they can have some some good intensity in them, so it's not like it's you know full Iron Man distance where we're going a little bit lower intensity and we're just going for hours and hours.
• 34:58
  SPEAKER_00: Uh trying to pace a 70.3 can be a little bit challenging because there is some intensity involved.
• 35:04
  SPEAKER_00: And I was like, how how are you doing this?
• 35:06
  SPEAKER_00: And the argument that he was making was that he had so much time before he really had to be concerned about trying to gain performance that he figured he was going to make his quote unquote race week or race weight within uh like the next I don't know, couple months.
• 35:25
  SPEAKER_00: And so for for typically for for half Iron Man, I would recommend a 16-week plan if you go in with to it with good solid fitness already.
• 35:34
  SPEAKER_00: And so, you know, that's where I was telling him, I was like, okay, well, you've got what, like a 16-week plan.
• 35:38
  SPEAKER_00: And I was like, probably as long as you start to as long as you're able to ramp things up around the eight-week mark, you have eight weeks to kind of stack on some some nice solid performance, some to reach your peak, so that you know you can go into the race uh at at your highest.
• 35:55
  SPEAKER_00: And he said, Yeah, that was that was his hopes.
• 35:58
  SPEAKER_00: And that, you know, he would be able to time this perfectly to where he would have, you know, eight or nine weeks left before race, before the race would hit to where he could then ramp things up.
• 36:09
  SPEAKER_00: M my gut was telling me that even if he did time it perfectly, he was gonna be in no no condition to really ramp things up.
• 36:16
  SPEAKER_00: I I think that it was going to delay things and he would need more than 16 weeks in order to execute a fairly decent 70.3 plan because he was spending, I think, so much time, what would be equivalent to low-end aerobic training and the fact that he may not be able to finish a lot of his workouts, you know, would would lead me questions like, okay, well, what kind of shape are you going to be in with eight weeks left to where you could then stack on that intensity without getting hurt?
• 36:46
  SPEAKER_00: Um, that was my concern because we know with the the rapid weight loss comes the cannibalized cannibalization of of lean muscle mass.
• 36:57
  SPEAKER_00: That happens with with weight loss surgery just like it happens with with GLP1 medications as well.
• 37:03
  SPEAKER_00: So it it's not something that is unique to that particular strategy.
• 37:08
  SPEAKER_00: I just think I just think it involves with just rapid weight loss like that.
• 37:12
  SPEAKER_00: The the body is just that's where it's going to pull from.
• 37:15
  SPEAKER_00: Uh I think it's just the the area of least resistance because when it starts to try and pull from fat, I mean, maybe, maybe I'm wrong, but you can correct me if I'm wrong.
• 37:24
  SPEAKER_02: Yeah, but did he was he telling you how much he was losing in like a week or any sort of idea of like how much he had to lose, or was there any I can't recall off the top of my head, but the amount that he had lost like in the span of like three weeks was was highly significant.
• 37:38
  SPEAKER_00: We were talking like 20 pounds, like in the span of just like just several weeks.
• 37:44
  SPEAKER_00: And I was like, dude, that is just that is insane.
• 37:46
  SPEAKER_00: And so I said, Do you do you have one of these scales that kind of you know reads like lean muscle mass, water weight, and all this kind of stuff?
• 37:52
  SPEAKER_00: I was like, Do you have a high tech scale to where you can track the the loss of lean muscle?
• 37:57
  SPEAKER_00: And he said, Yeah, he did.
• 37:58
  SPEAKER_00: And he said, I know I'm gonna lose some lean muscle, but I'm in the weight room and I'm focusing on the one meal that he did eat was gonna be a high protein meal.
• 38:10
  SPEAKER_00: And it just something just didn't sit right.
• 38:14
  SPEAKER_00: It just didn't.
• 38:15
  SPEAKER_02: I agree with you.
• 38:16
  SPEAKER_02: I think it's a lot of people.
• 38:18
  SPEAKER_00: So I was like, I was like, I to be and I didn't I don't really know the guy very well, and he already he uh he has a coach, and so I was just flat honest with him.
• 38:27
  SPEAKER_00: I was like, I bet your coach is pretty pissed at you right now.
• 38:29
  SPEAKER_00: He's like, Yeah.
• 38:30
  SPEAKER_00: So I was like, he's like, I was uh because I was like, there's no way that I would be thrilled with my athlete if they came to me and said, This is what I'm doing.
• 38:40
  SPEAKER_00: Um and you know, I'm not seeking your permission, I'm just letting you know that this is what's going on rather than trying to strategize about it.
• 38:49
  SPEAKER_00: So I was like, I imagine, I imagine your coach is pretty irate right now, but maybe just I don't know the relationship with them, but I know that I would be.
• 38:58
  SPEAKER_00: Um so yeah, I I would it just didn't sit right.
• 39:02
  SPEAKER_00: I was like, I don't I don't care how much you're in the weight room, and you're an endurance athlete already, so I know that you're not in the weight room very much because you're trying to still juggle, swim, bike, and run.
• 39:11
  SPEAKER_00: And I was like, at most, you're probably lifting like twice a week.
• 39:15
  SPEAKER_00: And so I was like, okay, well, that's that's maintenance lifting, really.
• 39:19
  SPEAKER_00: And I said, with one protein meal a day, I I can almost guarantee that you're you're not taking in enough of the amino acids to to repair the the muscles that you are damaging through strength conditioning anaerobic training, as well as trying to stave off muscle loss.
• 39:35
  SPEAKER_00: I was like, you you would have to eat a lot of protein in order for that to happen.
• 39:39
  SPEAKER_00: But maybe I'm wrong.
• 39:40
  SPEAKER_02: Probably a lot more than you can get in one meal.
• 39:42
  SPEAKER_00: I would imagine it would be a lot more than like one one meal a day.
• 39:45
  SPEAKER_00: Um that's like eating like one chicken breast a day and just be like, okay, that's that's all the protein I'm gonna do.
• 39:50
  SPEAKER_02: Even if it's like a large amount, like a big eight ounces or ten ounces, it's still not gonna be enough because it'd be only like 70 grams.
• 39:59
  SPEAKER_02: And even then, there's a little bit of interesting like in you know, data or research on like how much we can actually synthesize and utilize at once.
• 40:07
  SPEAKER_02: I mean, you know, it's actually better to have some doses throughout the day potentially for muscle maintenance.
• 40:15
  SPEAKER_02: But yeah, that is interesting.
• 40:16
  SPEAKER_02: I I have some thoughts.
• 40:17
  SPEAKER_02: I feel like, I mean, I I guess my first thought would be like, wow, there's like this obsession or something about being at some sort of race weight that he's deemed that he's needs to be at.
• 40:28
  SPEAKER_02: And I have fearful that he's gonna end up like maybe achieving that, but at the sacrifice of his race going well.
• 40:37
  SPEAKER_02: Um, because fundamentally, if you're not fueling properly, you're just not gonna be able to get a lot out of your training.
• 40:44
  SPEAKER_02: You're gonna leave, you know, with all those things you're mentioning.
• 40:46
  SPEAKER_02: So I I I don't know.
• 40:48
  SPEAKER_02: And then part of me thinks, Well, we're hitting like a boundary there of some sort of disordered um eating.
• 40:55
  SPEAKER_02: Um, like it's kind of blurring some lines there, like for me, of just like, wow, this is like what's really going on here fundamentally.
• 41:04
  SPEAKER_02: Is it really like a desire to perform well, or is there something else kind of happening here?
• 41:10
  SPEAKER_02: Because are is he or is there some sort of extreme misinformation about that sort of you have to be at race weight to like perform well?
• 41:17
  SPEAKER_02: You know, is there some sort of some he's consuming information he's consuming that's kind of like telling him that?
• 41:23
  SPEAKER_02: And he's not getting the facts correct about what it takes to actually perform well.
• 41:28
  SPEAKER_02: So I don't know, like there's something deeper there that I, you know, and I don't know this guy, but it it's screen, it's sort of like wow, that there's a lot of red flags that I'm like, this is concerning.
• 41:38
  SPEAKER_02: As is coach, if I were coaching someone like that, I would definitely be like, this is really worrying me.
• 41:44
  SPEAKER_02: That amount of weight.
• 41:45
  SPEAKER_02: Um it's obvious even if you're eating one, even if you were eating a lot of protein, like you're still gonna lose muscle mass.
• 41:52
  SPEAKER_02: And he did say he was gonna accept that.
• 41:54
  SPEAKER_02: But um, yeah, I just don't know, like at what risk, because you know, if it's several weeks or months that he's taking to do that, and he's uh I mean, the amount of calorie deficit he must be in is pretty substantial.
• 42:09
  SPEAKER_02: And, you know, we know that there can be disruptions in hormones and things like testosterone for men, and that can have very severe consequences long term.
• 42:20
  SPEAKER_02: Um, it can take months sometimes to restore testosterone and and feel good.
• 42:25
  SPEAKER_02: Again, I've worked with men, I've worked with women, but I've worked with men also who've actually had like maybe through an eating disorder or something else happening, like relative energy deficiency in sport, where they had underfueled and and got and it's detrimental to their performance.
• 42:39
  SPEAKER_02: But then it takes, you know, months and months for them to actually like recuperate and be able to per, you know, gain back any performance.
• 42:47
  SPEAKER_02: Because even after the body's even after you're eating an adequate amount of calories, it takes a lot sometimes to kind of restore all the balance, you know, especially some of our hormones.
• 42:58
  SPEAKER_02: So that kind of worries me that, you know, what is he considered like the longer term consequences of this?
• 43:04
  SPEAKER_02: It's not just about making weight rate race weight and then like having eight weeks to train, and you're just gonna, like you're saying, bounce back into it, feel great.
• 43:13
  SPEAKER_02: There could be some really long-term consequences that could not only affect his performance in his race, but longer than that, further out.
• 43:21
  SPEAKER_02: And that could take a while to come back from.
• 43:23
  SPEAKER_02: And so as a coach, I would be definitely explaining this.
• 43:27
  SPEAKER_02: Hopefully, I don't know, you know, maybe not all coaches feel comfortable doing that.
• 43:30
  SPEAKER_02: But as it, I think because I have a unique background, maybe, you know, I don't know.
• 43:34
  SPEAKER_02: Maybe then I would feel more comfortable explaining those sorts of things to somebody and and really trying to help them understand that.
• 43:41
  SPEAKER_02: Who's prescribing them these medications?
• 43:43
  SPEAKER_02: Like as a doctor, I would, you know, you're supposed to be the way to do it safely is you really need to be working with like a practitioner, like a physician.
• 43:51
  SPEAKER_02: And you should be ideally working with like a dietitian.
• 43:54
  SPEAKER_02: So, like that's the ideal scenario.
• 43:56
  SPEAKER_02: So is somebody just prescribing this like willy nilly?
• 43:59
  SPEAKER_02: Like, where is he?
• 44:00
  SPEAKER_02: Getting it online?
• 44:01
  SPEAKER_02: Is it a compounding farm pharmacy that he's just getting it through some sort of program and nobody's over there's no oversight?
• 44:07
  SPEAKER_02: Like that worries me a little bit.
• 44:08
  SPEAKER_02: And uh, you know, those are I think some of the things that we'll dive into.
• 44:11
  SPEAKER_02: But um, yeah, I mean, I think this kind of really hits on like I mean, I think it's like that race weight piece is really why I think athletes might be doing.
• 44:20
  SPEAKER_02: I mean, I don't think he's alone.
• 44:21
  SPEAKER_00: I feel like there's probably he's definitely not alone.
• 44:24
  SPEAKER_00: And I mean, I to be honest, I don't I don't really know the guy very well.
• 44:28
  SPEAKER_00: I've I've had just a couple interactions with him.
• 44:32
  SPEAKER_00: In this one conversation that that I had that I was having with him, I did uh pick up some uh behavioral uh things that were going on.
• 44:41
  SPEAKER_00: So I think it's interesting that that you touched on this because the guy is a high performing athlete, and he made a statement during the conversation where he said, if I don't make the podium, I'm pissed at myself.
• 44:55
  SPEAKER_00: And I think that that that was just as a coach, I'm sitting back saying, huge red flag.
• 45:00
  SPEAKER_00: I've I've see I see a lot of lights flashing right now, and so I can understand why his mind is going this way and why he perceives that this is the key to his performance, it's not training, it's making this particular weight because he has seen performance materialize and he was at that weight.
• 45:22
  SPEAKER_00: I I understand, I understand the logic.
• 45:24
  SPEAKER_02: He's making that connection there.
• 45:26
  SPEAKER_02: Yeah, of course.
• 45:27
  SPEAKER_02: I have to be at this weight, otherwise I will not.
• 45:29
  SPEAKER_00: Because it's the connection that I've made in my in my own mind as well, where you know I was smaller, I had better performance, I would be able to run faster, I was faster on the bike because it, you know, it was just easier to ride at a lower weight, so I had a better uh power to power to weight ratio, and so I was a better performing athlete.
• 45:48
  SPEAKER_00: But I I've gotten to the point now where I'm I I've just kind of given up on it, where it's just like, look, this is just what it is.
• 45:56
  SPEAKER_00: My performance can either be hindered or helped, and I don't know if it's going to be helped if I lose the weight.
• 46:03
  SPEAKER_00: Maybe if I can just become a strong and durable athlete, I can still perform.
• 46:10
  SPEAKER_00: Granted, I'm you know, I'm m several years older than I was before, so this is just a natural progression, but I I can't expect to perform the way that I did when I was 35 because I'm not 35, I'm 49.
• 46:25
  SPEAKER_00: So if I were to get back to the same weight that I was at when I was 35, would I see the same kind of performance?
• 46:32
  SPEAKER_00: I I don't know.
• 46:32
  SPEAKER_00: I I can't say that for certain.
• 46:35
  SPEAKER_00: So to make the assumption that, oh, I need to be at this particular weight in order to see the same performance that I had when I was at that weight doesn't necessarily jive.
• 46:45
  SPEAKER_00: With me, it doesn't.
• 46:47
  SPEAKER_00: Um be strong enough to to stand the test of time is my argument.
• 46:51
  SPEAKER_02: Yeah, and I I want people to kind of really think if you're if someone's listening is kind of resonating with them and they're like, wow, I really I'm like fixated on this weight from yeah, that I per performed my best race at at 35 or so, whatever it is, and I was at this particular weight, and they're like fixated on that number, um, to think about this because there's a lot of things that influence our weight and body composition does, and things can our weight can go up a little bit as we age, and um it can be really much harder when we're older to like be back at the weight we were at in our 20s.
• 47:25
  SPEAKER_02: That may just not be feasible.
• 47:26
  SPEAKER_02: And to get there, what you might have to do to get there could be very risky in terms of not only your health, but maybe your your performance, if that's really what you want.
• 47:34
  SPEAKER_02: So, like there may be a way to to do it, but I don't think um the way that this gentleman's going about it is a very good way to to to do it.
• 47:42
  SPEAKER_02: So we'll kind of talk about that.
• 47:43
  SPEAKER_02: But I think giving thinking about that, like how this the why someone is so tied to a certain a specific weight, is it are you hard on yourself or is there some something you're like, your weight is like somehow equivalent to your worth as a person or something?
• 47:59
  SPEAKER_02: Like that's not like just thinking about it, like is there something more to it?
• 48:04
  SPEAKER_02: Um, you know, like deeper like that, because um I would like really like to encourage people to try to get away from that concept of race weight or like there's a specific weight that they need to be at to perform.
• 48:16
  SPEAKER_02: And instead, you know, maybe they maybe there is a benefit to some weight loss, but I don't, you know, maybe, but we don't know that for sure.
• 48:25
  SPEAKER_02: So trying not to like put so much pressure on that and and um instead thinking about how maybe better you could perform better by just fueling better and having a great trading plan, you know, and like maybe some weight will happen, loss will happen just in that.
• 48:41
  SPEAKER_02: But you know, and and sometimes it's surprising what happens when you're actually fueling your body adequately.
• 48:46
  SPEAKER_02: Um, like what happens with your body composition and what happens with, you know, your weight naturally getting to a place where it naturally ought to be, you know.
• 48:55
  SPEAKER_02: So I would just encourage people to think about that.
• 48:57
  SPEAKER_02: I think the the not only the race weight, but I think people athletes tend to kind of want to use maybe think about these medications for like the power to weight ratio.
• 49:07
  SPEAKER_02: That's when, you know, maybe they're m calculating that somehow, you know.
• 49:11
  SPEAKER_02: They're like, oh, if I were lighter weight, I'll be at, you know, better at this or a faster uphill runny or faster going biking uphill or running uphill, or um, maybe somebody's really focused on looking extra lean and they want to be like 5% body fat or something, you know, like there's I don't know, like sometimes some people have sort of skewed versions of what they, you know, or they they think that's gonna help them perform better.
• 49:38
  SPEAKER_02: I don't know.
• 49:38
  SPEAKER_02: Um so there's and there's probably pressure too coming from social media a little bit here, maybe.
• 49:43
  SPEAKER_02: Like I don't see a lot of like I haven't seen other athletes out there like saying, hey, you know, you should really consider this, but maybe I'm just not seeing it.
• 49:52
  SPEAKER_02: But I do see a lot of like influencer type people out there, like, you know, touting these medications as like, though this is the best thing ever.
• 50:01
  SPEAKER_02: And I do see some of that.
• 50:03
  SPEAKER_02: And you know, I caution, I caution you to not trust certain people, you know, everybody, anybody on social media who I just hasn't a general opinion about them.
• 50:13
  SPEAKER_02: Um, and there's some negative opinions too.
• 50:15
  SPEAKER_02: And so I think sometimes people feel like it seems like a lot of people might be using the medications, but no one really wants to say they are because not well, maybe you're gent the gentleman you talked to talked to said he was.
• 50:26
  SPEAKER_02: But some people I think there's like some stigma with it too.
• 50:29
  SPEAKER_02: So there's a lot, a lot going on here.
• 50:31
  SPEAKER_02: But so we talked a little bit about the race weight and we talked a little bit about the performance piece, but let's just talk about like maybe some benefit, like let's go into some benefits that an athlete or just anybody might experience using the medication.
• 50:45
  SPEAKER_02: So we've already talked about this, but let's say like a scenario where we do have an athlete or somebody who's very active and they have like the definition of obesity is a BMI over 30, right?
• 50:56
  SPEAKER_02: So not to say that that really means, you know, I did that's a population-based measurement.
• 51:00
  SPEAKER_02: I'm not going to go into what BMI is and whether it's a good measurement or not.
• 51:04
  SPEAKER_02: But let's say we do have an athlete who, you know, does would benefit or or feels that they would benefit from losing some weight, you know, there and maybe they do have type 2 diabetes or some other condition that they would really benefit from it to use the medication.
• 51:19
  SPEAKER_02: I mean, there are benefits.
• 51:20
  SPEAKER_02: I think that's probably the category of people I would say would benefit the most from this medication would be individuals who have a lot of weight to lose potentially and or have like a metabolic condition like type 2 diabetes.
• 51:32
  SPEAKER_02: That's really where this medication is going to be the best.
• 51:35
  SPEAKER_02: And so improving metabolic health, lowering blood sugar potentially, um, it can, it does have some benefits of lowering cardiovascular risk.
• 51:44
  SPEAKER_02: So there's benefits there.
• 51:46
  SPEAKER_02: Maybe then like if you're losing weight, less joint stress, you know, maybe returning to exercise a little bit easier.
• 51:52
  SPEAKER_02: Um if if you're maybe at I think this could be a beneficial for someone who was an athlete who has weight to lose, you know, who maybe or wants to be active and they're realizing that the weight that they have is kind of hindering them, and that and maybe they have other conditions and they're like, I want to be healthier and start exercising more and being more athletic.
• 52:14
  SPEAKER_02: Sure, like because you're probably gonna do the medication before you, you know, jump into something like an at like a serious training program or something.
• 52:22
  SPEAKER_02: Yeah.
• 52:23
  SPEAKER_02: So that type of individual will probably benefit a lot.
• 52:26
  SPEAKER_02: Um, but really like blood pressure, blood, blood glucose, maybe even help for something like sleep apnea.
• 52:32
  SPEAKER_02: There's a lot of benefits these medications can have mostly with some of the glucose regulation and then the weight loss itself.
• 52:39
  SPEAKER_02: Um there might be some like psychological benefits we mentioned of just like reducing the food noise.
• 52:46
  SPEAKER_02: Maybe as somebody's not having so much food noise, they can continue to work on their relationship with food so they can start to um maybe work with counselors or things like that to improve their relationship with food and hunger.
• 53:00
  SPEAKER_02: And um, so maybe if they do come off the medication, it could allow them that sort of opportunity.
• 53:06
  SPEAKER_02: Um but it's very different than somebody, you know, who has only a few pounds to lose or 20 or less pounds to lose.
• 53:14
  SPEAKER_02: That's sort of a different scenario than, you know, the benefits for somebody who just has a little bit of weight to lose.
• 53:22
  SPEAKER_02: I don't know.
• 53:24
  SPEAKER_02: I mean, if you're someone struggling, like you really, really feel like you would benefit from that loss of weight and you feel like this is the only option you have, like, okay, I I don't want to pass judgment on that.
• 53:40
  SPEAKER_02: That's that is what it is, but just make sure like I'm gonna talk about do it in a way that is safe and you have a plan and you, you know, you're working with someone that can help you.
• 53:50
  SPEAKER_02: So once you're w reach your weight you want to be at, you you have a plan of how you're gonna maintain.
• 53:56
  SPEAKER_02: But I think that becomes this like medically, like somebody's using this medication to improve their health versus just like aesthetically.
• 54:05
  SPEAKER_01: Yeah.
• 54:05
  SPEAKER_02: You know, like I think we're getting into this point where people are using this to be able to look better.
• 54:13
  SPEAKER_02: And I don't know, it gets a little bit grave.
• 54:15
  SPEAKER_02: I don't want to say one person has the right to use it and someone else doesn't, but I think if someone's trying to lose 10 pounds and they think they need to use a medication, I would really encourage them to kind of maybe dig deeper into like their relationship with their body and you know, just general body image things because it's like there's something there deeper, maybe.
• 54:34
  SPEAKER_02: Just maybe really like dig into like your body image and why it is that you need to like just lose a few pounds.
• 54:40
  SPEAKER_02: And um, if you still feel like you need to use the medication, then I'll you know, so be it.
• 54:45
  SPEAKER_02: But that might be more of that sort of issue versus like an actual medical need or um benefit on a medical side from losing the weight.
• 54:54
  SPEAKER_02: Does that make sense?
• 54:55
  SPEAKER_00: Yeah, so if if you you mentioned that this would be uh it would be an option worth considering, I'll put it that way.
• 55:03
  SPEAKER_00: Um if you had quote unquote a lot of weight to lose.
• 55:07
  SPEAKER_00: So my question to you is are are you are you comfortable quantifying that?
• 55:13
  SPEAKER_00: Like what what does it mean by a lot of weight?
• 55:15
  SPEAKER_00: Because if you have somebody who if you have somebody who's let's say 200 pounds, uh to them, you know, getting down to you know 170, that's 30 pounds is that's a that's a lot of that's a lot of weight to lose relative to where they are, versus somebody who may be like 260 and wants to get down to 200, that's 60 pounds to lose.
• 55:40
  SPEAKER_00: But the the proportion of that weight loss relative to where they're starting from, is that considered to be a lot of weight to lose or is it not?
• 55:49
  SPEAKER_00: So that that's my question to you.
• 55:51
  SPEAKER_02: That's where it gets a little bit murky, right?
• 55:54
  SPEAKER_02: Because it's like where do we like if you wanted to set boundaries for who could and who could not use the medication, where do we set those boundaries?
• 56:01
  SPEAKER_02: And I have people I work with who have or I have one woman who has I work with currently who has type 2 diabetes and she is put on ozempic because she needs to control her diabetes, but she doesn't need to lose weight, you know, so there's still that piece of it too.
• 56:17
  SPEAKER_02: I think that's hard to say you're needing to lose the weight because it might benefit you medically, maybe that would be more of the reason, but it's hard because yeah, at what point do we say, well, if you only have 20 pounds to lose then or less, then that you don't need to use the medication.
• 56:31
  SPEAKER_02: But if it's above 30 20 pounds, you know, like I'm not gonna be the one to dictate that necessarily.
• 56:36
  SPEAKER_00: Um yeah, because I just I just did the math and the scenario that I came up with.
• 56:40
  SPEAKER_00: So if if you're 200 and you want to get down to to 170, that's 15% of your body weight that you want to lose.
• 56:48
  SPEAKER_00: Versus if you're 260 and you want to get down to 200, that's about 23%.
• 56:52
  SPEAKER_02: So yeah, so you have more.
• 56:53
  SPEAKER_00: So it makes more sense to think about it in terms of percentages, like how much body weight.
• 57:01
  SPEAKER_00: If you need to lose like anywhere of like 10, 10 to 20 percent, you know, more, yeah.
• 57:06
  SPEAKER_00: Is it is it worth doing?
• 57:08
  SPEAKER_00: Or if you're it might be then that's the question.
• 57:11
  SPEAKER_00: So that's what I'm thinking.
• 57:13
  SPEAKER_00: That's what I'm thinking.
• 57:18
  SPEAKER_02: Like they, you know, they're they're 20 pounds or less that they have to lose, and they just like I I don't know.
• 57:23
  SPEAKER_02: I just think that I'd be it's hard because at what point do you sort of just um accept, especially if you're health healthy overall, like what what risks are you willing to take to lose the weight?
• 57:34
  SPEAKER_02: And there are risks with the medication, and so at what point um, you know, is it become a little bit of um a gray area of like yeah, is it vanity or is it health, you know?
• 57:47
  SPEAKER_02: And who gets to decide who you know what scenario someone uses in?
• 57:50
  SPEAKER_02: And I don't know.
• 57:51
  SPEAKER_02: Like it's it's hard because I've never been in a situation where I've had 20 pounds and they just won't I won't budge.
• 57:57
  SPEAKER_02: And I've tried every single diet out there and I've tried everything and I've worked with a nutritionist and I've done all the, you know, like I know there are people out there like that.
• 58:06
  SPEAKER_02: And so what what point do you I say, no, well, you don't really need it, you know, because you only have 20 pounds, you know, like figure out your body image issues, you know.
• 58:15
  SPEAKER_02: But maybe somebody really feels like they would feel better about themselves.
• 58:19
  SPEAKER_02: Maybe they would.
• 58:20
  SPEAKER_02: I don't know.
• 58:20
  SPEAKER_02: So it's it's really hard to decipher that.
• 58:23
  SPEAKER_02: But let's just talk.
• 58:24
  SPEAKER_02: I mean, I think that gets into like the murky waters of like, I don't know, like you know, ethical things or something.
• 58:29
  SPEAKER_02: Like who's yeah, the ethics?
• 58:31
  SPEAKER_00: You definitely have to have to weigh the cost versus the benefits of doing it.
• 58:34
  SPEAKER_00: Yeah, I mean and anybody does, like if I were coach if I were coaching this guy, I mean, and he said that this is the strategy that he was going to implement, then I would I would honestly have to tell him that I have to change your training plan because of the the path that you have chosen.
• 58:51
  SPEAKER_00: I can't train you like I would if you were off the medication.
• 58:56
  SPEAKER_00: So that's a that's a consequence that you'd have that you'd have to take that.
• 59:00
  SPEAKER_02: Because we're talking about just general, but let's talk about the athlete population because this is where I think it gets regardless.
• 59:06
  SPEAKER_02: If you have 20 pounds to lose or you know, 60 or 70, what you know, is it as an athlete, should you be using the medication?
• 59:16
  SPEAKER_02: I think there's um some things that you really want to consider because the cons maybe in this scenario of being an endurance athlete may outweigh the benefits, um, especially if you're doing what this gentleman was doing, which is trying to do this while he's in the middle of a 16-week sort of training plan to get to this race.
• 59:35
  SPEAKER_02: Like that, that, you know, let's sort of talk about when it might be appropriate and the risks that can come with that.
• 59:42
  SPEAKER_02: So, like the first one, you know, let's just talk about why, why it would be risky.
• 59:46
  SPEAKER_02: And then we can go into the potential benefits and when it might be okay or possibly get a good time to use a medication like this to help with weight loss.
• 59:55
  SPEAKER_02: So the one I think of with him specifically already mentioned is red S or red relative energy deficiency in sport.
• 1:00:02
  SPEAKER_02: It's just that you're eating way less or you're, you know, than you're you're expending in your body, you're putting a lot of stress on your body.
• 1:00:10
  SPEAKER_02: People don't realize when they're underfueling significantly how much stress they're putting on their body.
• 1:00:16
  SPEAKER_02: It's significant.
• 1:00:17
  SPEAKER_02: And then, you know, on top of it, you're you have this extreme stress of under eating because your body is like, I'm not getting the fuel I need.
• 1:00:25
  SPEAKER_02: And that's a very stressful situation.
• 1:00:27
  SPEAKER_02: And then on top of it, I mean you're doing high intensity exercise, maybe you're trying to, it's just a recipe for disaster in my mind, because I do think not only are you going to kind of feel crappy during the workouts, but you know, you're you're setting yourself up, especially if this is ongoing over weeks or a couple even a couple months.
• 1:00:44
  SPEAKER_02: You know, it could happen.
• 1:00:45
  SPEAKER_02: This isn't have to be something that's like years long.
• 1:00:47
  SPEAKER_02: It could happen if someone's doing something extreme over the course of two or three months.
• 1:00:52
  SPEAKER_02: So that hormone dysfunction like decrease, you're just not recovering.
• 1:00:57
  SPEAKER_02: Like that guy's probably just not recovering very well.
• 1:00:59
  SPEAKER_02: I mean, how could you when you don't have the building blocks to repair a tissue and to recover?
• 1:01:04
  SPEAKER_02: You have fatigue, you know, you're he's setting himself up for potentially getting like a pretty significant illness, you know, like flu or something like that, and being taken out by it, you know, and that can happen to anybody training high volume, but when you're not recovering with fuel, that happens.
• 1:01:19
  SPEAKER_02: You know, injury poor performance, like we've already talked about that.
• 1:01:22
  SPEAKER_02: So that's my one concern in that scenario.
• 1:01:25
  SPEAKER_02: So I would not advise someone to decide, hey, I've just signed up for this race in 16 or weeks or so.
• 1:01:31
  SPEAKER_02: I'm gonna now I need to get to my race weight.
• 1:01:34
  SPEAKER_02: I'm gonna use a medication and try to use it, lose a significant amount of weight.
• 1:01:37
  SPEAKER_02: That's that is not where I would advise these medications be taken.
• 1:01:41
  SPEAKER_02: I would highly rec I would recommend that you just, if you'd want to race, if you absolutely need to, maybe just accept where you're at and try to fuel your body correctly.
• 1:01:50
  SPEAKER_02: And then maybe, you know, we'll talk about the timing of it, but just not a my opinion, it's risky.
• 1:01:56
  SPEAKER_02: Um, I mean, he could end up being okay.
• 1:01:58
  SPEAKER_02: You never know.
• 1:01:59
  SPEAKER_02: Some people are resilient, but I think a lot of people kind of in that scenario would would have some issues.
• 1:02:04
  SPEAKER_02: Um, not to mention like the muscle loss, which we already talked about.
• 1:02:07
  SPEAKER_02: Like at some point, I mean, even if you're eating, even if he were eating like at his what he's doing, he needs to be eating at least two grams of protein per kilogram, or maybe one gram per pound or a little more of protein, but it's just really hard to get that in one meal.
• 1:02:24
  SPEAKER_02: I mean, you'd have to eat a lot of protein.
• 1:02:26
  SPEAKER_02: So I'm guessing he's not even getting that amount.
• 1:02:29
  SPEAKER_02: So he, you know, in the amount of c catabolism or breakdown that's happening with the extreme calorie loss, he's losing muscle, no doubt.
• 1:02:37
  SPEAKER_02: And he might be losing a lot more muscle than he thinks.
• 1:02:40
  SPEAKER_02: Even if you're strength training, it's not enough really to like kind of maintain muscle in that scenario.
• 1:02:45
  SPEAKER_02: So yeah, that that would be my concern with athletes is like we don't generally want to lose our muscle, right?
• 1:02:51
  SPEAKER_02: That's really what's carrying us over.
• 1:02:53
  SPEAKER_02: I mean, unless you have like a bodybuilt or you're like a power lifter and you're going into a running, you know, wanting to run a marathon, maybe you have some muscle you could lose, but most of us need want to maintain our muscle, right?
• 1:03:04
  SPEAKER_02: And we don't want to lose body fat.
• 1:03:06
  SPEAKER_02: So I don't think that's a real recipe for losing.
• 1:03:09
  SPEAKER_02: It's a recipe, what he's doing probably is losing both fat and a lot of muscle, which is hard.
• 1:03:14
  SPEAKER_02: I mean, that's one of the major concerns of the medications themselves for anybody using them is that loss of muscle mass.
• 1:03:22
  SPEAKER_02: And most of the time, people, if they're not paying attention to how much protein they're eating, they'll and there's truly just, you know, eating less, they don't eat enough protein.
• 1:03:32
  SPEAKER_02: Most people who do the medication and don't have any sort of oversight of a dietitian or they're not paying attention to protein will just because they're eating less, eat less protein.
• 1:03:41
  SPEAKER_02: And then that's the reason usually why they're losing muscle.
• 1:03:45
  SPEAKER_02: Well, that's a really big deal because muscle is one of the most metabolic tissues.
• 1:03:50
  SPEAKER_02: So if you're losing muscle, then your metabolic rate goes down.
• 1:03:53
  SPEAKER_02: And so if you do come off the medication, you're then going to have a lower metabolic rate, and then it's gonna make it much harder for you to maintain that weight loss, and so you have that potential to gain.
• 1:04:05
  SPEAKER_02: Not to mention, like when we get old, like sarcopenia or loss of muscle is, you know, so if someone's doing this in their 20s and 30s and they're compromising their muscle, what's gonna happen to those individuals when they're 40, 50, 60?
• 1:04:19
  SPEAKER_02: Like, you know, it's harder to gain muscle and you're sort of fighting to maintain it at that point, right?
• 1:04:24
  SPEAKER_02: So they're gonna be at much higher risk for something like sarcopenia or loss of muscle, and that is a serious problem for elderly and or and you know, most people kind of maybe over their 60, over the age of 60.
• 1:04:36
  SPEAKER_02: But what is the ha consequence long term potentially if somebody's not thinking about that?
• 1:04:41
  SPEAKER_02: So there's a lot of risks to to not getting enough protein when you're on the medication and not maintaining muscle.
• 1:04:47
  SPEAKER_02: And so working with someone that's maybe doing some testing, you know, maybe in comp body composition to make sure you're maintaining muscle is important.
• 1:04:55
  SPEAKER_00: When you when you start to lose when you start to lose that lean muscle, it's really hard to get it back.
• 1:05:00
  SPEAKER_00: I mean, it it's not it's not easy.
• 1:05:03
  SPEAKER_00: And you have to be the method in which you have to employ in order to gain that muscle back is is gonna be counterproductive to the weight.
• 1:05:14
  SPEAKER_00: Coming from the perspective of an endurance athlete.
• 1:05:17
  SPEAKER_00: So I mean it's you're gonna have to focus on the weight room way more.
• 1:05:22
  SPEAKER_00: Yes, absolutely.
• 1:05:23
  SPEAKER_02: You're gonna have to eat potentially in a little bit of a surplus, like a little bit.
• 1:05:28
  SPEAKER_00: You're gonna have you're gonna have to eat in the surplus in order to to get the to bulk up a little bit in order to build that muscle back, which is gonna be counterproductive to to what it is that he's trying to achieve right now.
• 1:05:40
  SPEAKER_01: Right.
• 1:05:41
  SPEAKER_00: The the point that I was the point that I was trying to make with him, that I was really trying to drive home to him was not just the loss of lean muscle mass, but the the risk that he was opening up for bone remodeling.
• 1:05:53
  SPEAKER_00: Because I mean, as as runners, uh as a cyclist, it may not be that big of a deal because it's a non impact.
• 1:06:00
  SPEAKER_00: It's a non-impact activity, but we do run.
• 1:06:03
  SPEAKER_00: And so my concern with him was that okay, if if you're if you're in such a caloric deficit, I imagine your recovery is already inhibited.
• 1:06:13
  SPEAKER_00: I I I don't know what the quality of your sleep is like, so because that's where the restorative process takes place.
• 1:06:19
  SPEAKER_00: But I was like, you're really upping the the chances of you developing things like stress fractures and everything.
• 1:06:26
  SPEAKER_00: If you continue to train for performance, I I I believe that his risk profile changes, which is why we would have to change the training method.
• 1:06:36
  SPEAKER_00: If you're going to be in this much of a caloric deficit, we can't train for performance.
• 1:06:40
  SPEAKER_00: We're gonna have to train for a different methodology because I'm not I'm not willing to take on that risk as a coach to have you come down with a stress fracture because you're in such a caloric deficit and you know your body can't restore the damage that you've done to it.
• 1:06:56
  SPEAKER_00: So it's not just muscle loss, but it's the structural integrity that you've now put in jeopardy as a result.
• 1:07:04
  SPEAKER_02: Yeah, I agree.
• 1:07:05
  SPEAKER_02: I think, yeah, the the the injury risk is quite high.
• 1:07:11
  SPEAKER_02: Like he may not even make it to the race because he could end up injured.
• 1:07:15
  SPEAKER_02: I mean, just even muscularly not recovering.
• 1:07:17
  SPEAKER_02: I mean, there's probably risk there from more of a muscular standpoint as well.
• 1:07:22
  SPEAKER_02: I mean, if you think about it, we need it for cycling power running economy, injury prevention.
• 1:07:27
  SPEAKER_00: You just become you become unstable.
• 1:07:29
  SPEAKER_00: So it you know, you just you just don't have full control over uh your body movement, just controlling your body becomes more and more difficult the the more strength you lose.
• 1:07:42
  SPEAKER_00: And as you lose, as you lose lean muscle, you're going to be losing strength.
• 1:07:47
  SPEAKER_00: So the the concern that I would have would be okay, how are we are you still able to control the body movement that you need?
• 1:07:54
  SPEAKER_00: Because I mean that that's important when it comes to swimming, it's important when it comes to cycling and running.
• 1:07:59
  SPEAKER_00: So just being able to manage the way that the body moves and what muscles are engaged.
• 1:08:06
  SPEAKER_00: This whole thing was just really kind of stressing me, stressing me out as I was talking to this guy.
• 1:08:11
  SPEAKER_00: Yeah, but he took me out.
• 1:08:12
  SPEAKER_00: God, I'm not your coach, man, because this is this would be a really hard conversation that I would have to have with him.
• 1:08:18
  SPEAKER_02: So yeah, I was like, that would be a that was just stressing me out thinking about it.
• 1:08:22
  SPEAKER_02: More just I'm like worried for him a little bit, like, okay, like I hope he's gonna be okay.
• 1:08:27
  SPEAKER_02: Yeah.
• 1:08:27
  SPEAKER_02: You're doing this, but hopefully you'll come out of it okay.
• 1:08:30
  SPEAKER_02: Like, um, but the risks are there.
• 1:08:33
  SPEAKER_02: So yeah, if I, you know, thinking of it from that perspective of like coaching, I just hope somebody's kind of being a reason, like kind of giving some reason or some some helpful checks and balances of some sort, but it doesn't sound like it, but maybe I just hope somebody's uh helping him figure this out and he's not like just doing this sort of totally on his own, or there's somebody of reason like kind of like helping to give him some thoughts about it that maybe, I mean, I don't know.
• 1:08:59
  SPEAKER_02: It sounds like he's kind of just doing it, but hard to say.
• 1:09:02
  SPEAKER_02: But yeah, let's go on.
• 1:09:03
  SPEAKER_02: I think like some of the other risks of fueling specifically when we talk about like the gut motility piece is another one.
• 1:09:11
  SPEAKER_02: So um, I think I think of myself, like training.
• 1:09:15
  SPEAKER_02: I mean, not everybody's like this.
• 1:09:16
  SPEAKER_02: Every athlete's a little different, but I run into a lot of athletes that are like this where they really struggle to get enough to eat when they're training a lot, especially in the heat already.
• 1:09:25
  SPEAKER_02: Struggling to eat enough.
• 1:09:26
  SPEAKER_02: Imagine if you felt extra like full and never hungry all the time, and you're you you're it took longer for the contents to get through your gut.
• 1:09:34
  SPEAKER_02: Like that could be uh hard to manage, I think.
• 1:09:37
  SPEAKER_02: So it would be harder to like fuel, you know, even to have like the three meals and like pre and post snack.
• 1:09:45
  SPEAKER_02: For athletes, it's like you need to eat your meals, but you kind of sometimes when you're in a hard training phase, you also have to be eating other times.
• 1:09:51
  SPEAKER_02: And to eat that frequently might be very hard.
• 1:09:54
  SPEAKER_02: It might be hard to consume gels.
• 1:09:56
  SPEAKER_02: It might it might impact how well you can fuel during your training.
• 1:10:01
  SPEAKER_02: And um, you know, if you're not really able to eat a lot after to be able to recover might be compromised.
• 1:10:08
  SPEAKER_02: So those are things I would consider.
• 1:10:10
  SPEAKER_02: Um, and yeah, if you're like, do are you fueling for your 20-mile run?
• 1:10:15
  SPEAKER_02: Like, like for me, I'm never that hungry anyways, after that.
• 1:10:19
  SPEAKER_02: So I'm I'm trying to imagine like not being needed to not be hungry and never have that hunger come.
• 1:10:25
  SPEAKER_02: Like I'd be forcing myself to eat.
• 1:10:27
  SPEAKER_01: Yeah.
• 1:10:27
  SPEAKER_02: To eat enough, you know, potentially if I was on the medication.
• 1:10:31
  SPEAKER_02: So it might be something to think about.
• 1:10:33
  SPEAKER_02: Um so yeah, let's like look at some of the GI other GI side effects that kind of come with it, because I don't think we mentioned that maybe.
• 1:10:42
  SPEAKER_02: I don't know if we talked about the GI side effects, but there are some.
• 1:10:45
  SPEAKER_02: So like nausea, vomiting, constipation, diarrhea, bloating, like early fullness, those are all some of our side effects um that can't happen with the medication.
• 1:10:58
  SPEAKER_02: So not everyone experiences this, but it can, it's pretty common to have some of these GI side effects, or at least one or two of them.
• 1:11:05
  SPEAKER_02: So imagine trying to like train every day and you're like, I feel nauseated, or I want to vomit, or I'm bloated, or I'm full.
• 1:11:12
  SPEAKER_02: You know what I mean?
• 1:11:14
  SPEAKER_02: So that's those are all things we want to kind of consider.
• 1:11:18
  SPEAKER_00: Yeah, so I got I guess when it comes to you know trying to come up with a nutrition strategy uh for for training and for racing, I I imagine that this is have this has to be something that you have to take into account on your body's ability to not just get it in but absorb what it is that it's trying to take in, which is why I think that we tend to see more of of this bonking is not just from you know a glycogen depletion, but because you are going into the training sessions already depleted, but you have an inability to fuel during sessions.
• 1:11:50
  SPEAKER_00: So, you know, I I can imagine, especially when it comes to longer endurance events like you know, 70.3s and and full Iron Man and Marathons, I mean, there's there's no way that you can execute those types of races without some kind of nutrition strategy uh to implement.
• 1:12:08
  SPEAKER_00: So I guess the question that I would have would be if if you time it such that you know you you are off the meds uh when it comes to you know let's just use that scenario.
• 1:12:19
  SPEAKER_00: The guy had eight weeks left for his training plan where you know, let's say that he made his race weight, he went ahead and trained for the eight weeks.
• 1:12:27
  SPEAKER_00: Is there any risk to the GI track for the ability to implement a nutrition strategy eight weeks post coming off of the meds?
• 1:12:37
  SPEAKER_00: Is there a latency where, you know, it just takes a while for those for the drugs and the symptoms to try and work their way out?
• 1:12:46
  SPEAKER_02: Yeah, that's a good question.
• 1:12:47
  SPEAKER_02: I don't know when you stop it, like how long it kind of because some of them are taken, you know, on um like ozembic, for instance, is a injectable medication, so it lasts like a week, right?
• 1:12:59
  SPEAKER_02: So there may be some, you know, I'm sure it wears off at some point, because I do know that for diabetes, people with diabetes, like you can kind of see it in their blood sugar, like the last few days before they take their injectable again, you kind of see the glucose start to rise.
• 1:13:13
  SPEAKER_02: So you know it's kind of wearing off a little bit, but there is there can be some, you know, that it where it kind of stays around a little bit depending on the medication.
• 1:13:21
  SPEAKER_02: So would it be eight weeks?
• 1:13:22
  SPEAKER_02: Probably not.
• 1:13:23
  SPEAKER_02: I think it would probably wear off.
• 1:13:24
  SPEAKER_02: But you know, if you're not able to practice your fueling strategy, yeah.
• 1:13:28
  SPEAKER_02: I mean, eight weeks is doesn't leave you a lot of time to really practice that.
• 1:13:31
  SPEAKER_02: So that would be more of my concern, would be like, okay, if you're not really fueling that well during because you're not able to get get much down, you know, while you're using the medication, then if you only have a a small amount window of time to kind of practice fueling, it doesn't leave you a lot of opportunity to do that.
• 1:13:48
  SPEAKER_02: And if you do have some lingering side effects, then that even leaves you less time.
• 1:13:52
  SPEAKER_02: So that could be definitely um a concern, is just the yeah, like the fueling aspect of it.
• 1:14:01
  SPEAKER_00: Is there an impact on the body if you if you if you pers if you're in a persistent caloric deficit and glycogen stores stay depleted for a significant amount of time, does it affect the body's efficiency in absorbing carbs when you reintroduce it?
• 1:14:21
  SPEAKER_00: So let's say that this guy this guy was able to fuel efficiently for for a race, but has he now done anything to the way that his body behaves and takes in fuel when he comes off of the meds?
• 1:14:34
  SPEAKER_02: Yeah, because we do have like enzymes and different like transporters that we have for like absorbing and digesting carbs, and that could be impacted.
• 1:14:42
  SPEAKER_02: So maybe just don't have as many of the enzymes and transporters, so that could make it harder, you know.
• 1:14:49
  SPEAKER_02: Essentially, like even to try to train your gut back in that short amount of time would be really hard, you know, to kind of get your gut used to all of it again.
• 1:14:57
  SPEAKER_02: In eight weeks, it gives you little, like not very much time.
• 1:15:00
  SPEAKER_02: So yeah, those are all good questions because those are things I guess I wasn't exactly thinking about, but I think that's worth thinking about if it's impacting the ability for you to fuel, then you know, if you're only have a certain number of weeks to kind of be off the medication or to be maintaining and then trying to fuel, and you have all these change changes in the way your gut is utilizing carbs that could really make it hard for you to fuel for the race as well.
• 1:15:26
  SPEAKER_02: So yeah, and I think also like other things too, I'm thinking about just kind of looking through some of the other risks that were um I think dehydration is one we mentioned just because it might be harder to drink a lot if you're filling up your gut fluids, then you're maybe not fluid drinking.
• 1:15:42
  SPEAKER_02: But also like that hypoglycemia risk, kind of looking back at that, like if it's improv athletes have generally an increased sensitivity to insulin already because of all the activity that we're doing.
• 1:15:52
  SPEAKER_02: And so you're adding on something that maybe is influencing glucose, like, is there more of a risk of like ex some sort of hypoglycemia where you're gonna hit these bottom out where your blood glucose really goes low?
• 1:16:06
  SPEAKER_02: And that could be risky, right?
• 1:16:08
  SPEAKER_02: So if we don't, if we're not monitoring blood sugars, maybe that could be an issue, or if someone's taking the medication and constantly feeling like shaky or kind of fatigued or like um confused or like, you know, kind of having some of those symptoms of hypoglycemia, that could be a risk.
• 1:16:24
  SPEAKER_02: And you don't really want to be like on a ride or something and have like a hypoglycemic eps episode because that could actually be dangerous.
• 1:16:32
  SPEAKER_01: Yeah.
• 1:16:33
  SPEAKER_02: Because you might fall or get hit or something, you might not you might get in a you know, an accident or something.
• 1:16:39
  SPEAKER_02: So those are all I think things like I really want people to kind of think about.
• 1:16:42
  SPEAKER_02: I I mean the potentially if you're using them for a long period of time, there could be some micronutrient deficiencies that may occur.
• 1:16:49
  SPEAKER_02: So always something to kind of think about.
• 1:16:52
  SPEAKER_02: Um you know, if we're not eating enough in general, you're not maybe getting enough nutrients.
• 1:16:57
  SPEAKER_02: So that's always something like just like with you know, with any bariatric surgery, they always recommend taking a multivitamin and some, you know, certain nutrients to like make sure you're just getting enough, and that would be something I would generally maybe recommend in this scenario too.
• 1:17:13
  SPEAKER_02: Um but yeah, I mean I think the big question is like, could could this actually hurt performance?
• 1:17:21
  SPEAKER_02: And I think we I think I think we've concluded that in this scenario, you're talking about with this gentleman where somebody's taking the medications in the middle of their training plan, trying to lose maybe somewhat significant amount of weight.
• 1:17:34
  SPEAKER_02: It absolutely could, right?
• 1:17:36
  SPEAKER_02: Because I mean, fueling and recovery and all of those things that it takes to like the day-to-day consistency of training and having um your training, you know, consistently getting more and more fit and like improving, you know, day to day, not every day.
• 1:17:52
  SPEAKER_02: Are you improving in your fitness?
• 1:17:53
  SPEAKER_02: But it's that, you know, that cycle of fueling your workouts, recovering, doing it over again and over again that gets you better.
• 1:18:00
  SPEAKER_02: It's not you know, the weight is arbitrary kind of in that scenario if you're not doing that.
• 1:18:06
  SPEAKER_02: And I think that I think we've kind of made that point.
• 1:18:09
  SPEAKER_02: Um Yeah, if and we've already talked about kind of who might benefit.
• 1:18:13
  SPEAKER_00: So yeah, so like an illustration.
• 1:18:16
  SPEAKER_00: If if I had an athlete who wanted to to pursue this strategy, the way that I would the way that I would talk to them about this is like, okay, let's think of let's think of this, we have a a bucket, right?
• 1:18:26
  SPEAKER_00: And we've used the kind of like a bucket methodology before when we've talked about stress and things like that.
• 1:18:31
  SPEAKER_00: But I want to talk about this bucket where we're gonna fill it and filling it is gaining fitness.
• 1:18:38
  SPEAKER_00: So for me as a coach, if that's the strategy, I can't fill the bucket as full if this is the strategy that you want, because you're not going to be able to recover, adapt, absorb.
• 1:18:53
  SPEAKER_00: And so if this is a successful experiment in his mind, where it's just like, okay, I I reached race weight.
• 1:19:00
  SPEAKER_00: But if I said, But if your bucket is only half full, have you really gained have you have you really gained anything?
• 1:19:07
  SPEAKER_00: You're you're now going into your race, yes, at this magic number, but your fitness bucket isn't as full as it would have been if you had just accepted the higher number uh of your weight.
• 1:19:20
  SPEAKER_00: And it it's like building a house.
• 1:19:23
  SPEAKER_00: Uh, you know, we we lay in a brick, and that brick is oh, he makes his race weight.
• 1:19:30
  SPEAKER_00: But if it means that I have to take like three and four bricks out of the foundation, do you have a stronger foundation?
• 1:19:37
  SPEAKER_00: No.
• 1:19:38
  SPEAKER_00: I mean, because the costs were so much higher than the benefit of this one thing.
• 1:19:44
  SPEAKER_00: Yeah, you had one aspect of this perceived performance possibility, like your performance potential would have been some function or correlation with what your weight is.
• 1:19:54
  SPEAKER_00: But if it then jeopardized three or four things that we know contribute to fitness and performance, then have you gained?
• 1:20:02
  SPEAKER_00: And I would I would say that no, you haven't.
• 1:20:05
  SPEAKER_00: You're you're now going into the race, a weaker athlete, more depleted and and and worse in worse situation and worse fitness than if you had just said my my weight is what it is, I'm just going to now focus on being as strong as I possibly can and as durable as I can and stack on as much fitness as I can and make it deep and not just worry about what this number is.
• 1:20:28
  SPEAKER_02: Right.
• 1:20:29
  SPEAKER_00: Because I can guarantee if if you go into the race and the race is hot, your your performance is already now in jeopardy because you can't you can't perform like you would, you know, in in cooler temperatures.
• 1:20:40
  SPEAKER_00: So this potent this quote unquote potential performance is is not guaranteed just because-to have that be your goal, anyways, to have your goal be like the podium.
• 1:20:51
  SPEAKER_02: Like you never know who's gonna show up.
• 1:20:53
  SPEAKER_02: I mean, there's so many things writing on that to have that be like absolutely you're gonna be angry.
• 1:20:57
  SPEAKER_02: I I don't know.
• 1:20:58
  SPEAKER_02: There's definitely something a little bit more going on there that maybe I would question also as a coach, like, okay, what we need to think about that we need to talk about this a little more, kind of dig in.
• 1:21:08
  SPEAKER_02: But I don't know who is maybe the coach is trying to do that and I, you know, it's like I don't know, they just not getting through.
• 1:21:13
  SPEAKER_02: So it's hard to say.
• 1:21:14
  SPEAKER_02: Um, but let's say, like, so let's say in a scenario, a different scenario, like maybe what what type of scenario might this be?
• 1:21:21
  SPEAKER_02: Something somebody could use.
• 1:21:22
  SPEAKER_02: I think it's just it's just very similar to when we talked about like losing weight, like weight loss for endurance athletes.
• 1:21:28
  SPEAKER_02: It's a very similar to you know, we did a Zoom, I think it's on our YouTube.
• 1:21:32
  SPEAKER_02: It's like one of our very first things.
• 1:21:34
  SPEAKER_02: We did like a Zoom call thing that we talked about and I think we uploaded as a video.
• 1:21:38
  SPEAKER_02: And we maybe talked a little bit about it in that um episode 73 too.
• 1:21:43
  SPEAKER_02: But it's it's just really not trying to do any of this weight loss scenario in your like um lead up to a race.
• 1:21:51
  SPEAKER_02: So whenever you start that training plan, that 16, you know, usually anywhere between 12 and 18 weeks before the race, that should not be when you're like, oh, I'm gonna use a GLP medication to lose 20 or more pounds or something.
• 1:22:06
  SPEAKER_02: You know, like that's not the best that that's not a good time.
• 1:22:09
  SPEAKER_02: I would really advise you not to do that.
• 1:22:11
  SPEAKER_02: If you haven't lost the weight you want to lose by that point, you just have to let it go.
• 1:22:17
  SPEAKER_02: And you might lose a little bit in the training because I know I lose a like a pound or two usually.
• 1:22:22
  SPEAKER_02: Sometimes people lose a little more, but that shouldn't be the goal once you've started that training plan for a race.
• 1:22:29
  SPEAKER_02: Yeah.
• 1:22:29
  SPEAKER_02: Like you need to let the goal of weight or weight, um, race weight, you need to let it go.
• 1:22:34
  SPEAKER_02: Because, you know, unless you have five or ten pounds only to lose, uh, that might be a reasonable amount to try to lose in that time frame, very small half of a pound, maybe less a week, and you could eventually get there, you you're you you just it's not a good time to do it.
• 1:22:50
  SPEAKER_02: So don't do that.
• 1:22:52
  SPEAKER_02: Instead, either give yourself time, like in between races when you have when you haven't signed up or anything, or over the winter, or sometime when you're not training, and you can do some exercise and maybe maintain fitness, maintain strength, and enough time to lose, you know, safe weight loss is only one to two pounds a week, is what's really considered safe, unless you have a significant amount to lose.
• 1:23:15
  SPEAKER_02: And you can lose maybe four or five if you have a lot.
• 1:23:18
  SPEAKER_02: But at most people it's one or two pounds a week.
• 1:23:20
  SPEAKER_02: Calculate how much you need to lose.
• 1:23:22
  SPEAKER_02: Think, well, okay, well, maybe at most two pounds a week.
• 1:23:24
  SPEAKER_02: What is that, what's that range that it gives me?
• 1:23:27
  SPEAKER_02: And then try to lose it that way.
• 1:23:30
  SPEAKER_02: And if you have to use the GLP medication, that's fine, it's a tool, but make sure you're you're watching, you know, not losing too much weight.
• 1:23:39
  SPEAKER_02: You know, I know people want to lose weight, but when we lose too much, it's a significant impact on our body composition and it can actually have negative consequences for our metabolism and long term.
• 1:23:51
  SPEAKER_02: So we want to make sure it's a safe weight loss.
• 1:23:54
  SPEAKER_02: We want to make sure if we're adding the medication, we're working with a physician and maybe a dietitian or sports dietitian to like make sure you're getting enough protein, you're timing the meals correctly, and um do it other time, but don't do it, you know, maybe you have to take a whole fall off.
• 1:24:12
  SPEAKER_02: Like you have to take the entire fall or the entire spring off to work on this, and that's fine.
• 1:24:17
  SPEAKER_02: Because if that's really what you think is gonna help you, then and you really feel like the medication is gonna help you, that's fine.
• 1:24:23
  SPEAKER_02: But do it safely and do it in a way that's not gonna compromise your performance and do it in a way that's not gonna compromise your health long-term health or your current health and get there and then have a plan for how you're gonna maintain it, or you know, maybe then once you're at where you wanna be, then you start your training program and working with someone to help you maintain and fuel adequately while maintaining the weight loss.
• 1:24:45
  SPEAKER_02: That's fine, but that's that's how I would advise it.
• 1:24:48
  SPEAKER_02: And so I don't think it's necessarily don't do it, like it's bad.
• 1:24:51
  SPEAKER_02: You know, I'm not saying that at all, but just do it smartly.
• 1:24:55
  SPEAKER_00: You gotta have a you gotta have a strategy.
• 1:24:57
  SPEAKER_02: A strategy.
• 1:24:58
  SPEAKER_02: It's part of then we talked about plans last week.
• 1:25:00
  SPEAKER_02: This whole plan, your plan will be this, you know.
• 1:25:04
  SPEAKER_02: Well, maybe if I'm working with an athlete that wants to do that, I'm like, okay, now our plan changes.
• 1:25:08
  SPEAKER_02: We're trying to maintain some fitness, maintain your muscle mass, and work on weight loss.
• 1:25:13
  SPEAKER_02: And maybe you're adding the medication as a tool to do that, and that's fine.
• 1:25:17
  SPEAKER_02: Um, but these are the things we're working on, and this is now your plan.
• 1:25:20
  SPEAKER_02: And it's not a training plan.
• 1:25:22
  SPEAKER_02: It's not like you're training for a race, it's now a weight loss, fitness maintenance plan, right?
• 1:25:27
  SPEAKER_02: So yeah.
• 1:25:29
  SPEAKER_02: So that's that's how I would recommend doing it.
• 1:25:32
  SPEAKER_02: Whatever weight you need to lose, and if you feel like you need to lose it, just do it in a way that is smart, you know, and you're not compromising health and performance.
• 1:25:41
  SPEAKER_02: So um, yeah, I don't know.
• 1:25:44
  SPEAKER_00: Yeah, it's a I mean I ha I have to be honest that when I was talking with this guy, I started thinking strategically in my own from from my own perspective, okay, I'm gonna take my coach's hat off now and I'm gonna put my athlete hat on.
• 1:25:59
  SPEAKER_00: Is there a viable strategy where I could implement this and have it be effective and getting me where I want to be?
• 1:26:08
  SPEAKER_00: I mean, because I mean I have to be honest about that.
• 1:26:10
  SPEAKER_00: I mean it's just you know, do I still have weight that I want to lose?
• 1:26:14
  SPEAKER_00: Yes, I do.
• 1:26:15
  SPEAKER_00: You know, it it's definitely I have about 20% of my body weight that I feel like I could comfortably lose and and not feel weak.
• 1:26:24
  SPEAKER_00: I I think that it would put me in a a pretty good spot.
• 1:26:27
  SPEAKER_00: Now, okay, with that with that 20%, what am I willing to give up?
• 1:26:31
  SPEAKER_00: Am I willing to give up racing, you know, in order to switch my training from training for performance to just going into a fitness maintenance mode and really like the weight loss is the primary goal and not you know gaining fitness is the primary goal.
• 1:26:47
  SPEAKER_00: You know, I mean I have to be completely honest that I thought about this as well, you know.
• 1:26:52
  SPEAKER_02: So it's is this a viable strategy?
• 1:26:56
  SPEAKER_02: Yeah, when can I use it?
• 1:26:57
  SPEAKER_00: When should I not use it?
• 1:26:58
  SPEAKER_00: It or is it something that I should just say, look, this is this doesn't fit what it is that I that I want to accomplish.
• 1:27:05
  SPEAKER_02: You have to really think about what you want to accomplish though, because just looking at your training plan now, I wouldn't I don't I think you would have to really cut back a bit on what you're doing currently because yeah, yeah, because then you're almost putting your s you have to be careful because if your focus is weight loss and you're still training a lot, it's just hard to kind of really grasp, like because you're with the medication, you're also not that hungry, it's just really easy to under eat.
• 1:27:33
  SPEAKER_02: And then you put yourself in a hole.
• 1:27:35
  SPEAKER_02: Even if you're not training for something, you could still put yourself at risk, just like this gentleman did.
• 1:27:40
  SPEAKER_02: So you have to be careful, you know, because now you're adding in a different component, and that's the reduction of hunger and and some of that.
• 1:27:48
  SPEAKER_02: Um, those elements that make it harder to eat.
• 1:27:50
  SPEAKER_02: So you know, I think it just I think it's a lot more controllable if you can kind of have less training volume and maybe focus on like one strength training, like one more.
• 1:28:00
  SPEAKER_02: out a day instead of doing more than that, and you know, volume-wise would have to go down quite a bit just to be able to really focus on the weight loss piece.
• 1:28:08
  SPEAKER_02: And I don't know how hard that would be for you.
• 1:28:10
  SPEAKER_02: You know, that would be what I would be worried about for you.
• 1:28:13
  SPEAKER_02: I mean that's the other piece here is just because you're not in a training plan, if you're still doing a lot of training, you could still put yourself at risk for some of this stuff, but you just don't have a race at the end of it to kind of see how that goes negatively or whatever.
• 1:28:25
  SPEAKER_02: You know what I mean?
• 1:28:26
  SPEAKER_02: Like so you still could put yourself at risk for injury or relative energy deficiency.
• 1:28:32
  SPEAKER_02: You don't have to be thin to have that happen to you essentially.
• 1:28:37
  SPEAKER_02: Yeah if that makes sense.
• 1:28:38
  SPEAKER_00: I I think I I think the one thing that is keep it that would that's keeping me from thinking that this is a viable strategy for myself is because I've spent so much time and effort trying to get stronger in the weight room and the amount of time that I've spent in there.
• 1:28:51
  SPEAKER_00: Just the the possibility of losing whatever muscle that I've actually gained over the over the years that I've been trying to to gain it back.
• 1:29:00
  SPEAKER_00: Just it's a major red flag for me.
• 1:29:02
  SPEAKER_00: It's one thing that's really holding me back from from attempting it knowing that that is a possibility and all the hard work that I've put in just to to try and get stronger.
• 1:29:12
  SPEAKER_02: Yeah you would probably want to have it you know definitely work on getting a protein and then have the strength be a big emphasis in your program and then just have the cardio enough cardio to maintain fitness is that makes sense so that you would keep that muscle essentially so um and that's the other thing I would advise.
• 1:29:30
  SPEAKER_02: I guess they didn't mention that but if someone were to do this that um when they were in that phase in that plan of weight loss they would definitely need to be doing strength training.
• 1:29:41
  SPEAKER_02: There's no compromise there.
• 1:29:42
  SPEAKER_02: If you're going to be on these medications you're doing yourself a disservice I suppose if you're not doing strength training in in addition to taking the medication.
• 1:29:51
  SPEAKER_00: Should it be the primary focus?
• 1:29:53
  SPEAKER_00: We're not talking just like oh two two sessions two sessions a week and that's that's strength training.
• 1:29:57
  SPEAKER_00: That's not what we're talking about.
• 1:29:59
  SPEAKER_02: I would say the more you can do the better the more you can focus on strength the better.
• 1:30:02
  SPEAKER_02: So it would be like truly and it may not be necessarily even to like main like gain muscle it would be like really with the I mean you might if you were doing it really well timed and planned but you probably would just maintain muscle as the goal to not lose muscle.
• 1:30:21
  SPEAKER_02: So yeah I would anyone who comes to me and taking the medication I'm always like yeah you need to be strength training.
• 1:30:28
  SPEAKER_02: Yeah you know that's a big piece of it.
• 1:30:30
  SPEAKER_02: You gotta you the muscle piece should be a big big factor for most people.
• 1:30:34
  SPEAKER_02: I hope people you know are thinking about that.
• 1:30:38
  SPEAKER_02: So for you it'd be just like yeah really focusing on strength you know in a sense like you're not having to do it every day but at least three times a week and then that's what I was about to say three three to four sessions a week would probably be like my my recommendation.
• 1:30:51
  SPEAKER_00: Yeah you don't have to go like squeezing like a body what I would implement.
• 1:30:53
  SPEAKER_02: Yeah we're not trying to bulk and you know no no no just to maintain so three times a week maybe four and then cardio on the other days or if you do do two sessions you're just really not wanting to to be a lot of volume.
• 1:31:07
  SPEAKER_02: So it'd just be you know maintaining as best you can muscle and maintaining as best you can like the the fitness somewhat I mean you might lose a little bit but you'll gain it back.
• 1:31:18
  SPEAKER_00: You know but you still you still can't go into these sessions with with full power.
• 1:31:22
  SPEAKER_00: So it's not like you can just go into the weight rooms like okay we're gonna we're gonna do three to four strength sessions a week but even then the quality of those sessions are going to be suspect because of such the caloric deficit that you may not be able to even lift heavy in order to maintain in order to maintain muscle.
• 1:31:41
  SPEAKER_00: Right yeah so these these are the definitely the consequences and things that you have to consider if you're going to to use this approach and as an athlete as an athlete.
• 1:31:52
  SPEAKER_00: So you just have to figure out are are the are the benefits do they outweigh the costs?
• 1:31:57
  SPEAKER_00: Um and even if it and what's the longevity of the results that you're hoping to achieve you know are you able to to maintain that weight loss that that you achieved knowing full well that you're not going to be able to stay on those drugs the whole time or indefinitely unless you know you're I I don't even know.
• 1:32:16
  SPEAKER_00: I don't even know how I would approach an athlete who is going to to main to stay on those drugs for indefinitely.
• 1:32:23
  SPEAKER_00: Like how how would how would I train them?
• 1:32:25
  SPEAKER_02: The dose goes up a little bit like usually they'll start at a low dose and bring it up to kind of where the you know there's a happy place where you're losing weight but not too much weight.
• 1:32:35
  SPEAKER_02: So when you're if you're wanting to keep stay on the medication to maintain, I'm assuming you would kind of go on maybe one of the lowest doses.
• 1:32:42
  SPEAKER_02: So it may not be as much of a GI side effect.
• 1:32:44
  SPEAKER_02: You still might have some but then you would be managing it probably similar to someone who would have like gastric bypass that you'd just have to try different types of gels and kind of work with the way their gut was working but maybe not even to that same extent because there wouldn't be such a small stomach.
• 1:32:59
  SPEAKER_02: So you might be I think you would be I think someone in that scenario would maybe be okay.
• 1:33:05
  SPEAKER_02: Um but they're always kind of battling against potentially that you know reduction of hunger too.
• 1:33:11
  SPEAKER_02: So um but with the lower dose maybe not to the same degree just enough to maybe you know maintain the weight I don't know like I've never really I feel like there's not a ton of any researcher really and and I haven't worked with enough endurance athletes yet who have had this scenario to be honest.
• 1:33:27
  SPEAKER_02: So I don't even know you know all of the extent to which it would cause GI issues after you're done or like if you were on a low dose would it still be a big problem like I don't know at this point.
• 1:33:41
  SPEAKER_02: I don't even know if anyone knows maybe there's somebody out there working a lot with endurance athletes taking these medications that kind of seen that, but I would say it's not something I've seen a whole lot yet.
• 1:33:51
  SPEAKER_02: So maybe I mean I wish I I don't even know what the consequences there, you know, yet so it's hard to say.
• 1:33:58
  SPEAKER_02: So I guess there's a risk there because we don't know.
• 1:34:01
  SPEAKER_02: I think it's just important yeah to kind of weigh the pros and cons for yourself.
• 1:34:05
  SPEAKER_02: Someone's thinking about doing it and just realize like what it might take if they want to use the medication, you know, what they have to really keep in mind and really really think about what race weight really means.
• 1:34:17
  SPEAKER_02: If you have this very specific weight in mind that you think you need to be at it's one thing if you just want to lose a little bit of weight because you think you'd be faster and you're not really having like a specific outcome and it could be 10 pounds or 30 and you're just trying to see you know get to a point where maybe you feel better or something.
• 1:34:34
  SPEAKER_02: But it's another thing if you have a very specific like very low body weight that you want to achieve or even if you know even if it's unrealist is it really realistic like to really ask yourself these questions before you dive into something um because I think there's maybe more there to explore like you know what I mean?
• 1:34:53
  SPEAKER_00: Yeah to me it it just feels like it just feels like you need you need somebody needs a better why than just say you know I I want to make I want to make race weight there there has to be more to it you know if it's yeah if you were to come to me and it's like look I I've got you know 20% of my body weight that I want to lose I have constant joint pain um you know is stuff like that then I think it okay now we're going down the path of let's see if this is a justifiable approach.
• 1:35:23
  SPEAKER_00: But if you just came to me and just said look I I've got 15 pounds to lose like less than like 10% of my body weight and I want to do it because I think that you know my performance is going to be a function of my weight then I have to have a serious conversation with it.
• 1:35:38
  SPEAKER_02: And then your expectation was like I'm gonna have this weight and therefore I'm gonna get on the podium.
• 1:35:44
  SPEAKER_02: Like that's the expectation and the thought around it.
• 1:35:47
  SPEAKER_02: I think yeah there needs to be a little bit of a deeper discussion there of what's driving that and like kind of where that's coming from.
• 1:35:54
  SPEAKER_02: It's hard because I do know weight is is sometimes a hard topic for people because there is a lot of stigma and I know people struggle a bit and um so hopefully we were to kind of come we were able to kind of come at this from that, you know thinking about it from different scenarios and not so much like oh you know you shouldn't do this if you if you're in this one scenario but more so you know really like the question of why you want to lose weight and the why behind it I think is worth like digging into a little bit more regardless of where you're at.
• 1:36:25
  SPEAKER_02: But um hopefully we came at it in a way that wasn't like judgmental or you know it's hard sometimes.
• 1:36:31
  SPEAKER_02: I think people sometimes feel that way but um I really think you know I really do think these medications can have a lot of benefits.
• 1:36:40
  SPEAKER_02: So I don't want to come across as these are bad or there's danger to them, but we always have to weigh the pros and cons and the risks and the benefits and so they have a lot of benefits but there's also risks and as for endurance athletes some of those benefits and risks might be mm more so there might be different ones and maybe more serious risks because of what an endurance athlete is doing with their training and day to day um kind of the the amount that they're their stress they're putting on their body you know already.
• 1:37:14
  SPEAKER_02: So I do think it needs to be considered and these things need to be considered.
• 1:37:19
  SPEAKER_02: So yeah that's how I want to leave it.
• 1:37:20
  SPEAKER_00: I don't know if you have any last minute I I think this this wraps it up.
• 1:37:24
  SPEAKER_00: I I don't think that there's in much else that we could that we could say.
• 1:37:35
  SPEAKER_00: I think that we've been we've had a frank and honest conversation about you know when it would be a viable strategy and things to consider so that you can make an informed decision uh and at least start to trigger some additional questions that you should be asking yourself or you know if you're working with a coach maybe talking to them about that.
• 1:37:56
  SPEAKER_00: So I think this wraps it up.
• 1:37:59
  SPEAKER_00: So this has been episode 109 of the Endurance Athlete Journey podcast where we've talked about the the use and the relationship of GLP1 drugs with endurance athletes and sports.
• 1:38:11
  SPEAKER_00: If this conversation if this episode has resonated with you uh we hope that you will uh leave a comment or a review and subscribe whether you're watching this on YouTube or you're uh listening to it on whatever podcast platform uh you consume your content from hope that you will subscribe so that you don't miss any other future episodes we have a nice library that you can go back to previous conversations that we've had um in fact there's 108 of them so you can go back and and check out any of those.
• 1:38:44
  SPEAKER_00: If this episode you feel may help somebody that you know that either they're on GLP ones or they're they're talking about it or you know that they may have some concerns over weight um which is reasonable given the the stigma of of weight in endurance sports where we people think that we should look a certain way in order to perform.
• 1:39:08
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• 1:39:23
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• 1:39:33
  SPEAKER_00: So leaving comments and reviews is the one thing that does help the exposure of the podcast and helps other people find us as well.
• 1:39:41
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• 1:39:49
  SPEAKER_00: Those are greatly appreciated and really really help.
• 1:39:52
  SPEAKER_00: We also have the endurance athlete journey podcast group it's a closed group on Facebook you can go and answer one simple question agree to the group rules that is an area that we that we created from day one that allows you to connect with other listeners connect with us the hosts and there is a if you're listening to this and you haven't been out there yet go out there and check out the pool the poll that we posted uh because both Katie and I have done training specific like training build specific episodes where she's done her her road to grandma's marathon I did a uh a build for Ironman Florida 70.3 last year if those types of episodes were were helpful to you you enjoyed them you like listening to uh how we train and how we approach you know the races that we do uh as athletes not just as coaches go and check out that poll and vote and let us know that those episodes were helpful I know that we we still have plans for racing in the future but whether we share that that build with you and and create content out of it we only want to do that if you find them helpful and and useful and and relate to them.
• 1:40:56
  SPEAKER_00: So let us know what you think you can send us emails you can send us messages you can go and vote in the poll uh however you want to reach out to us uh that would be greatly appreciated so thank you for that um both of us are active coaches so we're bringing on athletes onto our rosters and so if you're interested in hiring a coach or you want somebody to help you move forward with with training plans or you're just tired of trying to figure out what workouts you should be doing and how much you should be doing or how little you should be doing what should you focus on what not to focus um we hope that you will consider either one of us or both of us as your coach for that matter.
• 1:41:33
  SPEAKER_00: If you want to reach out to coach Katie you can go to fuel the number two run dot com.
• 1:41:37
  SPEAKER_00: She does dietetics for all sports as well as run coaching and run plans.
• 1:41:43
  SPEAKER_00: I do single sport and multi sport training plans as well as one-on-one coaching you can go to tabularasseracing.com and reach out to me and I'm coach Justin we hope that we'd love to talk to you no matter what so uh I think this this wraps it all up so I want to thank you guys for the time that you continue to spend with us.
• 1:42:00
  SPEAKER_00: This has been a little bit of a lengthy episode so we thank you for hanging in there but we think that it's it's it's been a reasonable conversation and I I think it's an important one to have so thank you guys for hanging in there.
• 1:42:11
  SPEAKER_00: We greatly appreciate it.
• 1:42:13
  SPEAKER_00: And until next time I've been your host Coach Justin along with Coach Katie.
• 1:42:16
  SPEAKER_00: This has been episode 109 of the Endurance Athlete Journey Podcast and we look forward to coming to you next time.
• 1:42:21
  SPEAKER_00: Thanks a lot for listening guys and we'll talk to you later.
• 1:42:24
  SPEAKER_00: Bye-bye that wraps up today's episode of the Endurance Athlete Journey Podcast.
• 1:42:38
  SPEAKER_00: Endurance sports have a way of teaching us patience humility and resilience lessons that carry far beyond the workout progress in endurance sports doesn't come from shortcuts it comes from consistency discipline and doing the work when it's not glamorous.
• 1:42:55
  SPEAKER_00: Wherever you are on your endurance journey keep trusting the process and honoring the work you put in each day.
• 1:43:02
  SPEAKER_00: If today's episode resonated please subscribe leave a review and share it with someone to help on their endurance journey.
• 1:43:09
  SPEAKER_00: And don't forget to join the conversation on our social sites to help build and foster a community where we all learn and support one another.
• 1:43:17
  SPEAKER_00: We'll be back with more stories and insights from Coach Justin and Katie until then visit the podcast website at the endurance athlete journey dot buzzsprout dot com for more episodes from the endurance athlete journey podcast.
• 1:43:32
  SPEAKER_00: Have questions or comments about the podcast feel free to send us an email at the endurance athlete journey at gmail dot com.
• 1:43:41
  SPEAKER_00: For all things coaching visit coachkatie at fuel the number two run dot com and coachjustin at taboolarasta com.
• 1:43:51
  SPEAKER_00: Again thank you for listening to the endurance athlete journey podcast and remember to find joy in the journey