Unlocking Weight Loss through GLP-1

May 22, 2024

Unlock weight loss secrets with Dr. Stephen Jones, board-certified general surgeon and weight loss expert. Explore the science behind GLP-1 medications and their impact on weight management. Gain valuable insights to achieve sustainable weight loss and improve overall health.

Natalie 0:00

Hi, and welcome to the Invigor Medical Podcast, where we’re going to walk with you on your journey toward optimal health, performance and well being. My name is Natalie.

Derek 0:09

And I’m Derek.

Natalie 0:09

And we’re going to be your hosts on this journey. In each episode we share insights from top professionals and physical, mental and emotional health. With that said, let’s dive into today’s podcast.

Natalie 0:24

All right, today, we are super excited to introduce Dr. Steven Jones, who is our new medical spokesperson here at Invigor Medical. Dr. Jones has expertise in weight loss and minimally invasive gastrointestinal surgery. He’s also a board certified general surgeon, and he’s joining us today to share valuable insights and tips for achieving Healthy Weight Management. Dr. Jones, welcome to the show.

Dr. Jone 0:49

Thank you. Thank you. Thank you for having me. I really, really appreciate you guys taking the time to speak with me today. And hopefully I can not disappoint and impart a little bit of wisdom and some knowledge about the topic of GLP1’s and semaglutide.

Derek 1:02

Yeah.

Natalie 1:02

We hope so too. It’d be really sad for this to be your first and only. We’re planning on having a long relationship here.

Dr. Jones 1:08

Yeah, one and done. No, no,

Natalie 1:11

No, I’m excited for our listeners to get this introduction to you. And because like this is going to be an ongoing thing. Derek, you want to share a little bit about…

Derek 1:18

Yeah.

Natalie 1:18

…what is the role that Dr. Jones is going to be playing with us here?

Derek 1:20

For sure. You know, for everyone that’s been listening to the podcast, you’re well aware that we have been spending a lot of time with experts in the field. And we kind of came to the realization that we would like our own in house expert that can, you know, address the specifics of the treatments that we carry and that can address your question specifically as well. So we’re really excited to have Dr. Jones. You know, we had a pretty rigorous interview process to find the right candidates and we were very impressed with Dr. Jones and his qualifications and his story. So if you have questions for him, regarding weight loss, regarding any of the treatments that you have, you can always put those down in the comments. And we will direct those to him and love to get those answers. So yeah, that’s Dr. Jones. And, but, I don’t want to steal his thunder too much. In fact, Dr. Jones, you want to talk a little bit about your background, and what really interested you in in being here on the podcast?

Dr. Jones 2:11

Yeah, so just so everyone knows, I’m a, I’m a general surgeon by trade. I spent a lot of time in general surgery and training, getting familiar with just the GI tract in general, that was always kind of my interest. I did do a fellowship and advanced GI surgery where we spent a lot of time doing a lot of weight loss surgery. So my day, pretty much entailed doing gastric bypass surgery, doing gastric sleeve surgery. And these are all pretty extreme, you know, operations in order to help individuals lose weight, and they go through a very, very intensive monitoring program, prior to surgery, where they have to go through psychiatric testing, a lot of metabolic testing, they need to be tested to make sure that they are just right kind of for the operation. And then of course they spend, you know time in the hospital going through the actual operation, and then the recovery process, and it can be very, very taxing, you know, on the on the human body, there are a lot of things that can come up-a lot of kind of negative things, complications that can come up in the future, which we can talk about, you know, a little more in detail later on. But some of those things kind of really interested in me in the in the world of medical weight loss, because, you know, here’s a way that we can really, really impact patients and their lives, and add to their weight loss journey without having to go through such such an extreme surgery. Now, don’t get me wrong, I’m a surgeon, so I love to operate. But you know, you really need to tailor you know, tailor these for what’s best for the patient and not just operate for the sake of, you know, sake of operating. So, you know, that really sparked my interest into the medical weight loss world and what a perfect time to be a part of this. Because, you know, over the last several years, the evolution of the medical weight loss world has been just truly, truly outstanding. And, you know, I’m really, really excited about the future and where things are going to head. And who knows, we may be saying goodbye to gastric bypass and gastric sleeve surgery in the future. So that’s really kind of what got me into this. And now, you know, seeing that there are so many more options available.

Derek 4:14

It’s awesome to see how much passion you have for this. And you know, obviously you also with the passion, you bring a lot of knowledge and a lot of very deep insights on this topic. So that’s something that I’m interested to dive into. I don’t know, Natalie, based off of his story, is there anything that you wanted to touch on?

Natalie 4:32

No, I think we’re, I think we’re gonna get into it as we start exploring the GLP1 therapies which is literally what we have typed up here on my iPad and you know, because I’ve thought I’ve had the question to what you know, what you just mentioned about, you know, the gastric bypass and gastric gastric sleeve surgery and like knowing, you know, some of these other weight loss opportunities that are available out there because I know people that have been through the surgeries and even years later to witness like, how much their life is still altered, you know, much of it positive, right?

Dr. Jones 5:01

Yeah, of course.

Natalie 5:01

…because of how much their life has changed without the weight, but also like how much food they can eat and like, you know, and having one drink, you know, one alcoholic beverage and how that, you know, there’s all these things that it’s like that I had no idea were like these continuing…So I’m excited to kind of explore those comparisons, which might come a little bit, a little bit later in the conversation as we dive into these GLP1 therapies. So I’m happy to take it where you want to go next.

Derek 5:26

You know, actually, as we talk about this, I think that one of the, one of the best places to start might actually just be talking about like, the general approach to weight loss, like who should be considering weight loss? Just kind of address it from the from the broad picture, and then we can hone in on more specific therapies, I think that might be a good place to start.

Dr. Jones 5:46

Yeah, yeah, so. You know, first of all, first off, you know, obesity in America is, you know, really is an epidemic at this point, you know, there’s estimated that over 40% of all Americans suffer from obesity. Obesity in itself really can be boiled down to a physiological condition, much of which that can add to many adverse effects from a cardiovascular standpoint, from your kidneys, to your liver. So all of these things really, really add to the detriment of just the overall you know, population in America. So when we, when you look at being overweight or obese, we really, in order to kind of classify and be able to talk amongst medical professionals, we look at BMI. BMI really, lets us know, based off of your height and weight, you know, kind of where you fit in that range. And so as, as we know, 25, BMI is considered overweight, 30 is considered obese. Whereas when you think about it, you know, 40% of the American population being obese, I mean, that is a really significant number. So really, we look at these numbers, and we decide, hey, based off of these numbers, you know, these are the people who really should be considered some sort of, you know, weight loss, you know, therapy or weight loss program, in order to become, you know, more healthy and get rid of a lot of those metabolic conditions that really plague our, our population.

Derek 7:10

Yeah, for sure. And, and obviously, like, the the go to methods are the things that people have heard, time and time again, right? Lifestyle factors, exercise, diet, those kinds of things, controlling those factors. And so, but for so many people, like, they try those things, and it’s either an adherence thing, you know, and there’s so many variables to take into consideration, like someone’s hunger signals, how much calories they burn, just like doing nothing during the day. So like, for each person, it can be so different. But I guess this kind of gets us to the point of like, you know, GLP1 therapies, which GLP one just stands for glucagon, like peptide, and maybe we can dive right about that specifically, like, what that actually means. But that includes, you know, Ozempic, Wegovy, Saxenda, Mounjaro you know, like, all these things, the generic names being which liraglutide, SEMaglutide or semAGlatide, depending on who you talk to. Right? Terzepatide.

Dr. Jones 8:03

Yeah.

Derek 8:04

You know? Let’s talk. Let’s go ahead and dive into those. Tell us a little bit about the history of these medications. And who are they good for?

Dr. Jones 8:11

Yeah, yeah. So the GLP, like you mentioned, stands for the glucagon like peptide. Now, this is actually a native peptide that naturally lives, you know, within our gut. It lives in the intestinal cells in our gut. And though the way that it kind of works is after you consume a meal, you know, the food travels down, your swallowing tube goes into your stomach mixes with the acid starts to break down and then these the signals are released into the into the gut, and it causes the actual L cells to release the the GIP hormone. These hormones are which you may hear they’re called Incretin hormones, because what they do is they specifically target the pancreas. And it allows the beta cells within the pancreas to release insulin. And as we all know, insulin is the major hormone and glucose regulation. So when you release insulin, it causes your blood glucose levels to go down. So that’s really how these medications kind of were founded and how they started. They were really to regulate, you know, and treat diabetes. But what they found and treating the these diabetic patients were that they were getting amazing results in terms of weight loss. So as a result of that, then multiple studies began to come out to really show the true benefit of you know, the GLP1’s, not only as glucose metabolism, but also treating obesity. So that’s really how this this came about, initially for diabetes, but they found that also you get really extraordinary benefits in terms of weight loss.

Derek 9:49

That’s incredible. That’s incredible. And so just to break that down and summarize it in simpler form GLP1 medications, glucagon like peptide removes blood or lowers blood sugar, which has a lot of really good, great implications for for diabetics, right? Because blood sugars is the name of the game with diabetes. But in terms of actual weight loss, is it? Is it the removal of the sugar from the bloodstream that actually does the mechanism for the weight loss or is it something else?

Dr. Jones 10:23

Yeah, so it was really multifactorial, you know, to be completely honest. The GLP1 receptors in our body are kind of all throughout our body and as we as we sit here today, I mean, there’s still more and more research being done to really, really understand the total effects of GLP1 in our body, but from what we know now is that, you know, the majority of the effect happens within the pancreas. That also happens within our central nervous system, which is truly important, because that is really where the appetite and satiety really comes into play. We do know that people who are on the medication Semaglutide, it does truly affect their central nervous system, which allows a decrease in the appetite and increases their satiety. So these people, after they eat a small portion, they get full much quicker, and their appetite is suppressed. So not only do you get the decreased blood sugar, you get the appetite suppression, you get the, the filling of fulll much quicker. And then it also has an effect on gastric outlet. So the way I’m so, I’m going to a bunch of different subjects at once.

Derek 11:30

No you’re just fine.

Dr. Jones 11:31

But, you know, our body basically has a function. So once you consume food, there’s a little muscle at the end of the stomach, that closes. It allows time for the food to break down. It has a certain amount of time that the food mixes in the stomach, and then it exits into the small intestines. Well, we know that with the GLP hormone, that it causes food to stick around in the stomach a little bit longer. So you decrease the amount of you know, food that enters into the intestines at a rapid rate. So those patients tend to be less hungry. So the GLP effect really affects a lot of different areas of the body. But those are the main ones that we are aware of now.

Derek 12:14

Awesome. So so the empty the slow gastric emptying, right? It creates like this sensation of fullness. Is that just because it’s sticking around longer, so it’s like literally like a pressure in your body that’s like, Yeah, I’m not full? Or is there more to it, like a neurological or chemical effect to it?

Dr. Jones 12:32

Yeah, I mean, it’s a little bit of both. I mean, from a restrictive standpoint, when you think about it, like after, after Thanksgiving dinner, after you have a huge plate of food, you know, you’re just stuff you can’t really move. And that’s really, you know, kind of the same principle behind the GLP1’s. I mean, you’re going to have food that’s going to sit there much longer. So your body is going to think, Hey, I’m full for a longer period of time. So you’re not going to have that the appetite for more food, which is a truly a benefit.

Derek 13:00

Yeah.

Natalie 13:00 Yeah. I think it’s, it’s really interesting to kind of hear it broke down, because I think anybody who’s been paying attention to all has seen such a rise in these peptides and understanding what the differences are between them and what they’re actually doing in the body. So I know that Derek kind of had it broken down here a little bit and diving in. I know we’ve kind of already gone into semaglutide a little bit. But did you want to start with? Is it liraglutide? Is that what we’re calling?

Derek 13:25

Yeah, I mean, maybe so. So I guess it really depends on who you talk to. I’ve heard it so many ways. And I feel like this is just something that in the scientific community is like, you have one word Potato, Potato. Right? You know, there’s so many different ways to say it. But like lirAGlutide or liraGLUtide, I think most people, and what I prefer is liraglutide or semaglutide, or tirzepatide. But you know, depending on where you’re at, you might say it differently.

Dr. Jones 13:46

Yeah.

Derek 13:47

But I don’t know, maybe we can touch a little bit about like, how were these? I mean, we already touched on that they were initially developed as a diabetes medication. But maybe we can talk about what the actual differences are between liraglutide, semaglutide and tirzepatide.

Natalie 14:01

Yes. I think that’s important because people hear so many different conversations around what these are. And then oftentimes they’ll hear the name brand, right, like Ozempic, or whatever. And so there’s like a lot of confusion. And I think it’s really important for people to understand the differences because, you know, I think that we’re living in an age where advocating for your own health is super important, right? We want to rely on doctors and their expertise. But also it’s important for patients to have a sense of ownership and their own care and like understanding, you know what the options are out there. So they can go and have informal conversations with their doctors because I can just imagine like, going and sitting with a doctor like you know, all of these possible things that can be but like, you don’t have three hours to like, here’s all of these and here’s how they work. So if a patient comes in with a little bit of knowledge to be like, Okay, I feel like these couple of things might be it. Let’s dive into just this. So I like the idea of going through these peptides and kind of explaining what the differences are and how they operate differently in the body and even maybe what the difference like could be in the effects that they have in the body.

Dr. Jones 15:01

Sure. Sure. Yeah. So these, the way, the way I like to think about it, is that these are all kind of different generations of the same drug and mechanism. Just like with anything, you know, liraglutide was the, was really the truly one of the first GLP1 peptides that came out. So as you can imagine, with anything that’s early in the developmental stage, you know, it’s not going to be quite as good so to speak from the newer the newer GLP1’s. So for example with liraglutide is one that you have to use more often. So as opposed to a lot of people know about the pen, the injections with the pens that you have to take once a week. Well, liraglutide was one of the ones that you had to do daily.

Natalie 15:49

Wow. That’s a big difference.

Dr. Jones 15:51

Yeah, and that’s mainly-a lot of it has to do with the biochemistry of the actual polypeptide itself, which we won’t need to get into.

Derek 15:57

And like that the half life.

Dr. Jones 15:59

Yeah, but the way that this kind of works is that the GLP1 just in general has a very, very short half life. So scientists really needed to figure out a way to make sure that when they administer the GLP1, that it would actually stick around and be able to be efficacious to patients for an extended period of time. So liraglutide was one of the first where they figured out a way to keep it around a little bit longer. And I believe the, you know, the half life for liraglutide, which is the amount of time that you know, half the concentration of the drug is within the systemic circulation is about 12 hours or so. Okay?

Natalie 17:13

Okay.

Dr. Jones 16:37

So with that, you can imagine that you would need to kind of redose yourself every day, in order to get the maximum effect. As you get further down the generations to semaglutide, tirzepatide, those medications don’t-their half life as much longer because scientists have kind of figured out a way to keep the drug in the systemic circulation a little bit longer. So that’s really where the differences in the medications come into play. But liraglutide was kind of the first on the block and really set the foundation for the other ones, if that makes sense..

Natalie 17:13

That does make sense. And do they, you know, if you’re taking one of these medications today, like hanging around in your body, even for a time afterwards? Is it take time for your body to move all the way through? Or is it like, if you miss your weekly injection, like you’re already like, done, like it’s not operating in the body any longer.

Dr. Jones 17:29

Yeah. So I mean, you’re, you know, the concentration of the drugs are going to be the highest, you know, after administration. They kind of work on almost like a bell curve and then once you reach the halfway, then it starts to slowly taper off. So you can imagine that, after so many half lives, you’re going to have no concentration of the drug in your system. So you’re essentially going to be starting from, you know, starting from scratch, if you miss a couple of days. So that’s really the true benefit of the next generation, you know, with semaglutide. And that you only need to dose the medication, you know, once a week, because the half life of the drug lasts for like 160 hours or something like that, which is, you know, basically a week.

Natalie 18:09

Hang on, I had a thought I was just gonna ask. Oh, it was about dosing. Sorry. I’m like trying to keep up with all the questions rolling, right, in my mind. Does it also matter? Like how much is being dosed? Because I know, oh, God, it’s been probably two years ago, I did a round of semaglutide, when I was having some health issues and like needed help, like getting like, put on a bunch of weight for no reason was trying to figure out some gut issues. And I was like, I just mentally need a little help to get past this point. Because it was like, honestly, just depressing how poorly all my clothes were fitting, but the way it was set up was like the dose was gradually increased over a period of time. And so I guess my, I’m not even quite sure how to frame my question. So my question is, how does dosing work in that regard? And is it is it normal to like, you know, maybe some people need a higher amount, or some people need a lower amount, or you just taper it up for a specific reason?

Dr. Jones 19:02

Yeah. I mean, this is-you really need to tailor specific to the patient or client. I mean, to be honest, some people have a great effect with with a minimal dose and some people require a higher dose, just kind of depending on your body’s metabolism, in general. And then you also have to look at the safety profile and the side effects because obviously, if you’re at a higher dose, you may have you know, more of the side effects that are associated with the medication with the higher dose. So it’s really a tailored approach. With the medication. If you find that after, you know, a couple of months, hey, I’m just not where I want to be from a weight loss standpoint, based off of the medication profile, then we may need to increase the dose to get you to where you need to be. So it’s really a tailored approach that each practitioner needs to take in an account.

Natalie 19:51

That makes sense.

Derek 19:53

And so that’s-trying to find the right dose because in medicine in general, we’re always trying to look for the minimal viable dose, right?

Dr. Jones 19:58

Correct.

Derek 19:59

Like this is the amount that’s going to get you the results that you’re looking for. Because that’s also what helps minimize the number of side effects that you get. Maybe we can talk about some of the common side effects of semaglutide. And what people can do to essentially try to counteract those, because I’ve heard a lot about the different side effects, which can be a little bit embarrassing sometimes for people.

Dr. Jones 20:19

Yeah. So I mean, kind of, like you said, I mean, if you if you look online, and you Google YouTube, whatever, you’ll see, the pros and cons of you know, these medications. In my opinion, the pros far outweigh the cons, for sure, but you can have some side effects. And the biggest side effects, as you can imagine, typically come in the form of GI upset, basically. You know, these drugs are specifically working on the in the GI tract so you are going to have some GI. As I mentioned before, one of the, you know, major keys of the drug is that it slows down the outlet of food from the stomach. So if you can imagine, if you’re having more food kind of sitting around in your stomach for a longer period of time, it may give you the sensation of nausea. You may get some vomiting. Some of these medications increase the motility so you may get increase in passage of stool through the GI tract which could lead to diarrhea. So the major impact that it has is going to be on the GI tract, nausea, vomiting, a little bit of an upset stomach, some diarrhea. There’s been some other rare cases of pancreatitis, which is like inflammation per se of the pancreas, which can cause some pretty severe pain, that’s very, very rare. And then there’s one warning that if there’s any history of thyroid cancer in the family, that you or you have a personal history of thyroid cancer, that you should not take the medication. And they’ve seen increase in thyroid cancers in some animal models. Not in actual humans, but because of that they’ve had to mention that. So you may hear if you, you know, if you watch any of the commercials, they’ll mention something about medullary thyroid cancer. So…

Natalie 22:01

Hey. I hope you’re enjoying today’s podcast, I just wanted to take a quick break because if you’re listening, you probably know what we do here at a bigger medical podcast, but maybe not what we do and Invigormedical.com. So let me introduce us. At Invigor, we provide prescription strength treatments and peptides for weight loss, sexual health and lifestyle optimization. Every treatment plan is carefully prescribed by licensed doctors and sourced from legitimate pharmacies. You don’t ever need to buy questionable research chemicals again. And bonus, as a podcast listener, you get a 10% discount on your first treatment plan with code PODCAST10 at Invigormedical.com. Now, let’s get back to today’s episode.

Natalie 22:40

Well, but all that being said, you know, I think obviously, it’s important to be aware of side effects and you know, everybody should be aware of things like that before they take any kind of medication, right? 

Derek 22:48

Of course.

Dr. Jone 22:48

Yeah.

Natalie 22:49

But you know, thinking about it in comparison to these much more extreme weight loss surgeries that we’ve done historically, in the past, you know, those also come with their own risks and side effects, right?

Dr. Jones 23:05

They do.

Natalie 23:05

And many of them, many of them long reaching, like what I mentioned about and you could speak to this at a higher level. So I think it’s just-when it comes to, you know, people trying to find a way to get out of that obesity category. Right? And I thought about before, like, I just wonder it’s so interesting, you thinking about how we’ve changed physiologically as a human race due to the industrialization of our food.

Dr. Jones 23:31

Yes.

Natalie 23:32

And, you know, thinking about, you know, we talk about it being genetics, oftentimes. And I know there’s different, there’s different schools of thought on that and whether or not obesity is genetic. And I don’t necessarily want to get into that per se. 

Derek 23:47

Maybe a future episode.

Natalie 23:48

Yeah, but I did want to, I did, I did have the thought of like, well, maybe that-not that it’s a genetic predisposition necessarily to obesity. But maybe that genetically, the predisposition is to be intolerant, to the way that our food products are now interacting with our bodies, right? Because food is just not the same. And especially if you don’t have the education or don’t have the access to healthy foods for the first part of your life. It’s like now there’s just like this chain effect of events that has been kicked off that now it almost seems like you just can’t get in front of and get on top of at, you know, your 30s 40s 50s whatever beyond now. And now it’s this massive thing. And so now it’s like no matter what you try the chemical makeup of your brain and your hunger cues and your satiety cues, and the foods that you crave and how quickly you’re able to lose weight so that you can actually feel encouraged to stay on the path that you’re on.

Derek 24:01

Well and like how hyper palatable food is nowadays as well. Just add that on top of it.

Natalie 24:47

Right. And you just want more and more. Right? So in that sense, I think that it’s, I think that it’s important to have some empathy, right? Because I think that people, especially if they’ve never really had an issue with weight to a large to degree, you know, pretty much anybody you talk to, would love to lose a few pounds, at least right? There’s very few people you meet that are like, oh, yeah, no, I wouldn’t love to lose a little bit of weight five to 10 pounds, whatever. But unless you’ve ever really struggled with having to lose 50, 75, 100+ pounds, there can oftentimes be an attitude of, well just get off your butt. Like, well just don’t just don’t drink that soda. Just don’t do this, just go for a walk. And the just is so minimizing.

Dr. Jones 25:27

It is, yeah.

Natalie 25:28

And there’s not an understanding of really what so many people are going through, and trying to find the best way forward to get out of that obesity category. Right?

Dr. Jones 25:36

Yeah.

Natalie 25:36

And so, I think that’s the really cool thing about these conversations. And obviously, there are people that, you know, utilize, me being one of them, these peptides, you know, for weight loss that are not in the obesity category. And I don’t want to say like, shame on you, you shouldn’t do that. Hell, I’m one of those people, right? But as far as this conversation is relating to, you know, you know, your background with these more extreme interventions for weight loss for people with obesity, and how that translates to these peptides. Thinking about there being an option that is so non invasive comparatively, and really is having incredible results, I think is just really amazing. You know?

Dr. Jones 26:15

It is.

Natalie 26:15

For these people, it feels like hope.

Dr. Jones 26:18

It is yeah, for sure. And just to piggyback off of something you mentioned earlier about the genetic predisposition, I do a lot of gallbladder surgery, and gall bladders in general, you know, removing gall bladders is not really a genetic, you know, there’s really not a true genetic disposition to gallbladder surgery. But you-I run into patients all the time, who, you know, come up to me say, Oh, well, you know, my grandmother had their gallbladder out, my mom, my aunt, so every, all the women in my family have their gallbladder out. And it really just speaks to the kind of the paradigm that we’re kind of locked in. So you know, family, they tend to eat the same. So it’s not, it’s not per se that, hey, the gallbladder is the bad, you know, is bad. Its to say that hey, you guys all kind of eat bad. So yeah, make sense. It’s gonna make sense that you all are gonna get to see gallbladder issues. So it kind of speaks to the same thing. I mean, a lot of this is, you know, not to make light of the situation, but it is in, in a sense, kind of a mental disorder, in a sense. And the fact that, you know, a lot of people have this just mental hurdle mental block, with eating, the way they eat, how they eat. And it typically is just transferred down from generation to generation to generation. So you know, trying to stop that is really, in my opinion is going to be is going to be the key. These, these little adjuncts that we have available, you know, with the medical weight, loss of surgical weight loss, those, those are helpful, but in the long run, it’s really going to be, you know, stopping the source, so to speak.

Derek 27:48

Yeah, maybe we can dive a little bit deeper into that, because like, just like you’re saying, you know, what semaglutide does is it offers an opportunity for people that struggle with losing weight, it kind of gives them hope in a situation to do that. It also allows people to, you know, like, eat less, and I think actually be a little bit more thoughtful about what they’re eating. Right? Yeah, because in the long term, like, what we want to avoid is like a yo yo diet, where someone is on the medication for six months, and then they get off of it, and then they just returned back to their old habits of eating, and then they just put it back on again, and then go back on the medication and go all over again, because, you know, like, at least here at a Invigor Medical, we don’t necessarily want people to just keep on coming back for the medication, we want people to get the medication and like, get off of it and be able to maintain a good healthy weight. And so I think that a big part of that, I guess, maybe we can talk a little bit more about these mechanisms is like, you know, you reduce the amount of food that you eat. But that comes with its pros and its cons. Of like, if you reduce the amount of food you eat, if you’re still eating junk food, you know, you’re not necessarily doing yourself any favors. Whereas if your appetite is reduced, and you’re able to then say, Okay, I’m going to use this app, reduce appetite to try and be very conscientious about the foods I’m putting into my body. Maybe we can talk a little bit more about that.

Dr. Jones 29:13

Yeah, also to just to piggyback off of that, I think a lot of people don’t realize that the a lot of the data that we have from, you know, the GLP1’s and semaglutide. In the studies that were done to really prove all of this, that these these individuals who were studied, they were put through an actual program. So it wasn’t like they were just getting semaglutide injections weekly. No, these these people they were actually dieting. They were forced to do, they were forced to exercise. So you know, it was an entire survey. It wasn’t just a quick, you know, a quick fix of an injection, you know, daily or weekly. So, keep that in mind for sure. Because, again, if you form a habit, you know, it doesn’t take you know what they say you know, two weeks or so to form a habit once you form the habit of exercising, dieting, trying to eat right, you know, becomes like muscle memory, so to speak. And then you can kind of continue that on for the long term and not have, you know, the yo yo effect that you’re mentioning.

Natalie 30:13

Well, and not to use a term that can oftentimes kind of be-have a negative connotation, but I honestly kind of think of it as like a crutch. Like, if you suffer an injury, you break your leg or your ankle or whatever, and you you need to heal, right, if you if you just try to start walking, running on that broken ankle or leg, you’re probably going to reinjure, you’re gonna have a really hard time feel defeated and just not want to get up and do it. However, if you have a crutch, to help you, you start building the muscle to be able to get through that healing, so that you can eventually drop the crutch and do it on your own, right? And that’s kind of how I think of these peptides in my mind for that kind of thing is like, if you’re using it intentionally, and hopefully having some coaching or you know, to help you get through it, then the thing is, is like when those cues that have been around for so long for what you’re going to eat and when you’re going to eat and how you’re going to eat it-when those are helped by having these peptides, if you intentionally say okay, now I’m going to start getting rid of this food. Clear out the food in my kitchen, in my in my pantry in my fridge, get it out of there, I’m going to introduce these things. I’m going to start learning these recipes, while you have the the wherewithal and the willpower to start investing in these ideas and these practices. So that eventually when that the crunch of the peptides that you can wean off of that, you’ve you’ve done that really, really hard work, because one of the hardest things is to get all the junk out of the house, start thinking about food differently, learn new recipes, try new foods, get your tastebuds kind of used to those things. That’s that’s really hard stuff to do. So if you can have the help of a peptide to get you, you know, running with that, then use the crutch. You know? I think it’s an incredible opportunity.

Dr. Jones 31:54

And the beautiful thing about it is that, you know, while you’re doing that the semaglutide really is giving you positive reinforcement because you are seeing a difference, you’re noticing that you’re losing weight. So all of the you know, all the things that can affect that you’re putting you’re putting into place are working. And you see that so you continue that motivation to keep keep moving forward to keep making the right choices in terms of food and such. So you know, that’s the beauty of the semaglutide

Natalie 32:21

Yeah, that’s a really good point. Because sometimes this issue is like when people get started and they don’t see movement.

Dr. Jones 32:27

Yeah.

Natalie 32:28

Or it’s so slow. And unfortunately, we live in a society of like immediate gratification, you know, something even I struggle with, even though I’ve lost, you know, over 50 pounds three times in my life between pregnancies and stuff, like, and so it’s still even though I know how it can, you know, it’s but it’s just, well, what the heck? I didn’t lose any weight this week. Or I didn’t this and then, you know, add in things like you see shows like The Biggest Loser, like, Joe dropped 20 pounds last week. It’s like, holy cow! And I dropped .5?! you know? Or if you’re a husband/wife going through it, and the wife is always like, how did he just lose 10 pounds, like, nothing’s moving for me? And it really is kind of debilitating, you know? It’s so hard to like, stick to these things. And to make these habit changes, I just, I don’t think I can overemphasize, like, it’s really hard to do.

Dr. Jones 33:11

It is.

Natalie 33:11

And so having an opportunity to get a leg up, like, Man, I use supplements all the time to help me, you know, ketones to help with my energy and to like, help, if I’m in fasting, you know, there, there, there are different things that you can utilize. We got a lot of great technology now to help us be on a path to healthy living. So I’m really excited for us to get this episode out there and talk about-for people that have more education around what it is.

Derek 33:35

For sure. I think that one of the things that I wanted to touch on as well, that while we’re kind of on this topic is, you know, as you’re replacing all of this kind of junk food while you’re on this medication, you know, I’ve heard a lot from our staff, we talk to our patients, you know, people, they talk about how bad their side effects are. And they’re like, Well, what are you eating, and they’re like, oh, just about the same stuff I’m eating before fast food, really oily foods. And it’s just like, if you’re continuing to eat the same foods, while you know, taking this medication, all of a sudden, all this greasy food is just gonna be sitting there in your stomach and it’s like, you’re you’re wondering why you’re having all these bad side effects. You’re having all these bad side effects because you’re putting junk into your into your body and is having to deal with that for even longer, you know? And so maybe, I guess, one of the things that I really wanted to address is we talked about what some of the side effects are and there’s actually there’s one in particular that I wanted to add as well, which is sulfur burps. I don’t know if you’ve seen anything about the sulfur burps, you burp and it straight up tastes like eggs.

Natalie 34:32

Nice. Cute. Love it.

Derek 34:33

Like, yeah, very interesting, but like, maybe we can talk about what are some things that people can do when they’re on the medication and they’re experiencing the side effects? What can they do to alleviate the the severity of the side effects?

Dr. Jones 34:47

Yeah, no, I think you you actually touched on, you know, some of them. One is making sure that we are actually you know, making the changes to our diet that are that are going to be helpful, like you mentioned. I mean, if you’re still eating you know, horrible food, fast food, greasy food, fried foods, those are all going to make all the side effects and everything much, much worse. So that’s number one, making sure you’re you know, changing the diet. Making sure you’re getting plenty of liquids. Most people don’t drink enough. I mean, that’s just the bottom line. Or if they do they don’t drink enough water. So making sure that your body is able to kind of flush itself is going to be very, very key. And then as we mentioned earlier, depending on kind of the dosage that you’re on, you may need to scale back the dosage some, or you know, if that doesn’t work, maybe switch to a different GLP1.

Derek 35:37

Yeah. So what are-there’s two particular nutrition variables that I really want to dive deep into one being fiber, and how much of an impact that has on side effects and just general diet and digestion and importance when you’re taking DLP ones, the other is protein. And that one has more to do with making sure that you’re losing the right kind of weight, rather than just losing weight for the sake of losing weight. Because you know, like, I know that a lot of people, the only metric they look at when they’re trying to lose weight is the scale. But like if you’re losing weight, and a good chunk of that is muscle. That’s hugely detrimental to your short term and long term health. So maybe we can talk a little bit more about fiber, protein, and then the long term implications of muscle loss.

Dr. Jones 36:26

Yeah, you know, so you know, fiber, obviously, is great in terms of gut health, and healthy bowel movement. You know, a lot of people don’t have healthy bowel movements. A lot of people suffer from, you know, constipation, irritable bowel syndrome, and all of that. And most people in general just don’t get enough…

Natalie 36:42

Oh man. We just did a whole episode on poop. Like last week, we talked about poop so much on our last episode, so we’re touching on it again, like people. Poop is important!

Dr. Jones 36:42

Yeah. I consider myself a poop doctor, because all of my patients, my first question to them is, have you had a bowel movement today? That’s my first question for every patient. And we celebrate bowel movements.

Natalie 37:00

Wooo! I love it. It’s like you got a toddler in the house. That’s good stuff.

Dr. Jones 37:03

Yeah. But honestly, I mean, you will be surprised at the amount of people who have really irregular bowel habits where they can go 4 or 5, 6, 7, 8 days, you know, without having a bowel movement, and kind of think that that’s normal.

Natalie 37:04

I’m just in pain, just thinking about that.

Dr. Jones 37:19

Yeah. And like I said, the majority of people just don’t get enough, you know, fiber in their diet. So it’s important to make sure that you are eating foods that are, you know, that do contain fiber. Those are going to be of course, like leafy green vegetables, things that have a skin, fruits and vegetables, all those things, because those are going to really help with your digestion. Now, if you’re not used to fiber, and you all of a sudden go from eating no fiber to a ton of fiber, your body’s gonna fill it for sure. Because you’re gonna be more gassy. You’re probably gonna annoy your partner, for sure. You’re gonna have some fun times in the bathroom. But it’s a process and then making sure that again, you’re you’re contributing the right you know, the right foods to your, you know, your gut health is truly important. So in terms of fiber, make sure you get your fiber, make sure you’re eating plenty of, you know, foods with fiber, if you’re not, you can’t deal with food there, you know, there’s some great supplements that you can use, as well. And those are going to be helpful, also, when you take these medications, for sure. And in terms of proteins, you know, like you mentioned before, you want to make sure that you know, when you’re losing weight, that we’re not just losing muscle, because muscle is the you know, the universal building block. You need, you need your muscle, you need your muscle mass, so it’s important to make sure we’re losing weight in the right way, which is why I personally, you know, hate all the, these crazy diets that are out there, which I’m sure we’ll talk about at some point down the road. But making sure that you’re eating a well balanced diet, you know? I, you’ll hear a lot of differing opinions on this. But fat intake is important, you need fat. So it’s important to know how much fat not over eating fat but getting exactly what you need.

Natalie 39:01

And what kinds of fat.

Dr. Jones 39:03

Your body is going to kind of take what you ingest, and it’s going to move it the right way to the right places. But you need to make sure you’re you know, you’re doing the best you can to facilitate that it’s doing it correctly. So eating a well balanced diet that’s not overly processed, you know, that’s really going to be, really going to be the key. And then in terms of all the side effects from the medications is, like we like we mentioned before, making sure that the foods that we ingest are going to coincide with the lifestyle that we want.

Natalie 39:34

I love it. And I think this is such a great conversation because I just think so many people have, you know, heard of this as the miracle drug like that we’ve all been waiting for it. You know, it’s been that thing for a long time, like that weight loss thing that works for everyone, you know? And so, I know that it’s kind of talked about like that, and I’m sure you see news headlines ozempic The Miracle weight loss drug and it’s like, you know, in a real sense, it’s like yeah, you could lose weight and change nothing if you take this drug, right? But I think the point of…

Dr. Jones 40:01

Yeah. If you get the endorsement from Oprah, then you know, then you know you’re on to something.

Natalie 40:05

Yeah. Right? But I think the-what I love about this conversation is because it’s really staying true to what we’re all about here at Invigor Medical, which is how to create a healthy longevity, like long life, happy, healthy, all of those good things, right? And at the end of the day, a miracle weight loss drug that doesn’t change anything about your lifestyle, your overall health, because I mean, yeah, not being obese, and losing weight is a good marker. But like, there are plenty of, you know, skinny people who are really not healthy, right? So it’s not, the only thing is what’s the number on the scale? Right? So, you know, we’re just emphasizing on this episode, like, these are a great tool to have in the toolbox, and they’re not the magic wand, you know, to just change out, you know, like, this is going to fix everything. And it’s like, no, this is this is we want this to be a tool for you to have a better lifestyle, and to have health and longevity. And so I think these are just such great topics that we’ve covered so far. And I know that there’s probably a lot more we could go over.

Derek 41:06

Well to kind of transition and utilize that as well like talking about the different metrics that people can use to actually track health and things along those lines, I think that one of the big things, and this is this is the key metric for even qualifying for semaglutide is BMI. Right? Yeah. And, you know, I feel like BMI gets somewhat of a bad rep for different reasons, right? It’s a useful free tool, where people can get a general idea of like, am I overweight? Am I obese? But you know, you have different demographics where it skews. For example, I’ll use myself as an example. I am technically obese, you know? You wouldn’t be able to like, I guess, I mean, I could definitely…

Natalie 41:52

I would not think that. The camera does add 10 pounds. [laughing]

Derek 41:55

It does. But, you know, I could probably use to lose a few pounds. But like, if you were to look at me, it’s it’s very skewed. And so like, I think that really, for me, the best metrics for my health is body fat, body fat percentage, really, truly body fat percentage, because that’s the thing that I’m trying to lose, not, you know, decrease my weight. Because I’m happy with my body image. I’m happy with the functionality, you know? My general health is pretty good. And I think there’s a, there’s quite a few people that are in the same boat, especially when you start getting into like bodybuilding communities, people that do a lot of resistance training, NFL a lot of muscle mass. And so, I don’t know, maybe we could talk a little bit about using body fat percentage rather than BMI as like a good indicator of health.

Natalie 42:43

And maybe it’s taking a moment to explain the difference, right? Because not everybody may have an understanding of like, what BMI is, and what is body fat percentage.

Dr. Jones 42:54

Yeah, yeah. So I think I mean, you really hit the nail there with when you describe the BMI, because like you said, I mean, a lot of people’s body composition is different, you know? Men carry weight differently than women. Men’s weight tends to be more kind of a central weight. So we carry a lot of weight in our torso, abdomen. Women more so in their extremity. So when you you may look at someone and say, hey, this person, you know, doesn’t really look obese, but in terms of their BMI. Their BMI may be close to 30. So, you know, BMI doesn’t really take in kind of the full picture, it doesn’t, you know, kind of talk about certain demographics. It doesn’t talk about certain, you know, genetic predispositions, it just kind of gives you a broad overview. So just so when you’re having a, you know, normal conversation with someone, they may be able to, okay, I understand this person is, you know, their BMI is 27. So they may be a little bit overweight. So that’s really the key in BMI. It’s just kind of an easy standard for us to use to kind of look at patients and kind of characterize patients. When you look at percentage of body fat, that gives you kind of a better indication of again, of the amount of body fat that you know a person has. And then based off of that, you can kind of tailor that to determine, hey, this is how much you should lose in terms of percentage of body fat. So just kind of gives you a better overall just composition of the, of a person’s overall physique.

Natalie 44:22

And then also thinking about visceral fat, right? Which is the fat that’s like, packed in around your organs, which it’s like, comparatively, how much visceral fat to body fat, also has an-is a big indicator of like, how healthy you are, right? If you have a lot more visceral fat, that’s not a good marker.

Dr. Jones 44:38

That’s not a good-I mean, if you think about it, I mean, you have all of this fat just kind of sitting on your heart, your heart is you know, you’re over if you’re overweight, you have this fat sitting on heart, your heart is having to overcompensate for that and pump out against a lot of resistance is going to be very difficult and that’s where, you know, the obesity and cardiac effects, you know, to obesity. So, you know, because it’s bad for certain to carry, you know a lot of your weight centrally, or the visceral fat.

Natalie 44:38

And well maybe this is like kind of a tangent. And I know we’re running out of time. But now I’m curious because I’ve always wondered like, what how? How does that work? Like? Where you getting just like fat around your body versus visceral fat? Is it something that like, you may be more genetically predisposed? Or is it like, you fat that’s been hanging around for a really long time, but we haven’t lost now it gets stored there instead? It gets moved there? So like, how does that work?

Dr. Jones 45:30

Yeah. So there’s, there’s a lot of different different theories on this in general, but um, in my opinion, this is really a genetic predisposition. I think a lot of people, when you, if you lose weight, gain weight, lose weight, you tend to lose and gain weight in the same areas, the stubborn areas that just won’t go away. I mean, unfortunately, that’s just, you know, that’s just where it is, that’s where your fat is stored. And that’s where it’s going to come off at the…

Natalie 45:30

You’re just meant to have a big booty.

Dr. Jones 45:50

… um just at the very, very end. After you lose, you know, all of your muscle mass, then that that will finally come off. Yeah, so, you know, unfortunately, you know, there’s really no way you can’t really tailor, you know, you can’t do a certain workout to lose fat in this area. And that’s not really a thing, you’re going to lose weight in the way that your body loses weight, and you’re gonna gain weight in that same way. So, unfortunatlye that’s just how it is.

Derek 46:17

Yeah. So another thing I wanted to touch on, and I want to be cognizant of time here, but I think we’d be remiss if we didn’t talk about, like, ozempic face. Ozempic butt. And actually, and this kind of ties into something we’ve already talked about to a certain degree. But losing muscle mass while on semaglutide versus losing body fat percentage, can result in these things that you look somewhat unnatural. And the way that I’ve talked to my staff about it is like becoming skinny-fat, you know? Like, you lose weight, but like, if you don’t actually lose the fat, then it’s like, you’re just like this really skinny guy who has more body fat than you have muscle and like, that’s not a result anybody wants either, you know? Everyone wants to get on this medication, they want to look good. And so at that point, what what what do people need to do in order to avoid, you know, the dreaded skinny-fat?

Dr. Jones 47:05

You know, that is a great point, because we see that all the time in our surgical weight loss patients, you know, these, these patients, they lose rate pretty rapidly. And, you know, then they have they carry around a lot of excess skin carry, you know, their bodies kind of just look unnatural, then they have to undergo a lot of kind of cosmetic surgery in order to you know, nip and tuck some things here and there. So it’s the same way. I mean, you know, this is more of a journey and process as opposed to a quick fix, you know, you have to do all of the things, that someone who’s not on Ozempic or you know, semaglutide is on in order to create the effect that you want. So that, again, goes back to what we’ve been talking about this whole time is making sure you’re eating healthy, making sure you’re eating the right foods, making sure you’re working out, keeping the areas toned, that you want toned, and focusing on those…

Derek 47:33

Would you say resistence training is really important for that?

Dr. Jones 48:02

It is. It is super important for that. Because these all go hand in hand. Like I said, there’s these all kind of work together to get you to the place that you that you really need to be. You know, it’s not a miracle drug. It’s not a  quick fix. It’s all about creating the right lifestyle, the right habits to direct your, you know, your weight loss journey. And in doing so, you’ll get the body that you want, and the habits that are going to, you know, serve you well, not only in weight loss, but just in life in general.

Derek 48:33

Awesome. There’s one last thing. I know that-but I think that this is almost the one of the most important questions that I want to ask because this is I think the thing that I’ve gotten asked the most from patients is, do I have to do this forever? If I start taking this medication? Do I have to do this forever? Or is there a way to taper off? Is there? Is there some sort of treatment plan? You know, to phase this out?

Dr. Jones 48:56

Yeah. That is, that is a great question. And we’re still finding and trying to figure out the answer to that question. Number one, you know, all of these are still relatively new medications. Number one. So we don’t have a lot of long term data that would let us know. The data that we do have is only from a few years out. And what we found for sure is that once you do stop these medications, if you’re not changing your habits, if you’re not changing the lifestyle and the diet, you will gain that that weight back 100%. Okay? So if you’re one of the people who just kind of take the shots, take the shots, take the shots, and then you stop, you’re going to gain the weight back and you would be one of the people who are going to need the lifelong, you know, medications. If you’re one who are, who was really, really focused on creating that healthy lifestyle, and you’re using this really just to kind of supplement your weight loss journey. Those we think are going to be the people who are going to be able to maintain the weight loss.

Derek 49:59

Yeah. That’s great. And so just to put this out there as well at Invigor medical, we offer you know, different In phases of treatment for this, one of the phases that we include is a stabilization dose, where when people have reached their goal weight, and they say, Okay, I’m really comfortable with where I’m at, I don’t want to completely just go cold turkey from the medication, they can step down to a lower dose, where then they can kind of just play with it, you know, it’s like, okay, I’m not getting as much of the effects from the medication. I can figure out kind of my own natural signals a little bit where they come through a little bit more, and I can manage it, but then, you know, not having the full effect of the medication, and then eventually be able to completely go off of it, and have the chance to, like, put themselves to the test of like, did it did my habits stick? Am I able to continue to maintain this healthy lifestyle that I’ve tried to gain through the use of medication.

Natalie 50:41

Super smart.

Dr. Jones 50:42

Yeah, yeah, I think that that is key there. Because like you said, quitting cold turkey, anything is gonna be very, very difficult. Yeah. So being able to have that kind of as just, you know, to kind of helped you and push you along and keep you on the right path, I think is going to be key in making sure that people are able to maintain the weight loss that they want.

Derek 50:59

That’s incredible. Awesome.

Natalie 51:00

This has been such a good episode.

Derek 51:02

It has.

Natalie 51:02

I’m really excited for people to hear all of this information. And I, because I think it’s hard to find-it’s hard to I mean, it’s not hard to find information. But it’s hard to sort through everything, right. And especially with something that’s been so sensationalized as these peptides have, you know? It’s just, it’s just crazy out there. So I’m super excited for our listeners to get some more detail and some more answers. And you know, like Derek mentioned at the beginning, if you’re listening to this episode, and you have additional questions, you know, we want to hear from you. The cool thing about Dr. Jones [said in a different voice]. I had to do it once! Like, I had to do it once like the character in Indiana Jones. But the cool thing about having Dr. Jones with us is that he’s going to be recurring. So you know, questions that we get from our listeners on what is it that actually that you’re wondering, you know, did we answer everything in this episode? Are there things that are still lingering in your mind. Being able to comment those, whether it’s on YouTube, or Apple podcast, or whatever, gives us the opportunity to come back with Dr. Jones and address and address it at a higher level or things that we missed, you know? And I’m really excited for our listeners to have that opportunity. Because even though we will have some guests return, you know, it’s not with the same immediate availability, as well as Dr. Jones.

Derek 52:07

And also to let the audience know, you know, some of the episodes that we have lined up currently, were some of the topics we’re gonna cover are just popular diets like, you know, deep dive on the Mediterranean diet. Deep dive on the paleo diet. Deep dive on the keto diet, deep dive on the carnivore diet.

Natalie 52:23

Mmmm! I’m excited about that one.

Derek 52:24

Things you know, and another one that I’m really excited for in the future is even having one about like body dysmorphia, and things along those, what can you do to you know, increase body image and make sure that you’re not thinking about this in a pathological way. So, I’m very excited. If you have any questions about any of those topics, feel free to shoot them our way and we’ll be happy to discuss them here with Dr. Jones.

Derek 52:54

Thanks for tuning in to the Invigor medical podcast.

Natalie 52:57

If you enjoyed today’s episode, you can support us by liking and subscribing.

Derek 53:01

Your feedback matters. So feel free to share questions for future episode ideas in the comment section.

Natalie 53:05

For more information about our prescription strength treatments for weight loss, ED, and overall wellness, all from qualified doctors and reputable pharmacies, visit us at Invigormedical.com. And don’t forget to use code PODCAST10 for a 10% discount on your first treatment plan. Until next time, stay well.

Podcast Guests

Dr. Stephen Jones
MD, F.A.C.S.

Podcast Guests

Derek Berkey
Host
Natalie Garland
Host
5226 Outlet Dr, Paso, WA 99301
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