Dhru Purohit Show - The Right and Wrong Way to Use Ozempic and Other GLP-1 Agonists

Starting point is 00:00:00 What's the right and wrong way to use OZempic and other GLP1 agonist? If you're curious about this question, today's compilation episode is 100% for you. Welcome to the Drew Prod podcast. Each week we explore the inner workings of the brain and the body with one of the brightest minds in wellness, medicine, and mindset. Today, we have experts from our community giving their honest and nuanced thoughts about OZempec and these other GLP1 weight loss drugs. This has been a highly requested episode, and today we're specifically going to focus on how to use these drugs correctly and how they are largely being used incorrectly, according to these

Starting point is 00:00:45 experts. And I want to address one important thing. Today's episode is less focused on whether or not these drugs should or shouldn't be used at all when it comes to tackling our obesity epidemic. We actually have a few other powerful podcasts that we've linked to in the show notes that cover this discussion more in depth that I highly recommend listening to after this episode. Instead, today, knowing that millions of patients are already on these prescriptions, my goal is to share some powerful insights from our podcast community and the experts that have been on here on how to use them the right way if somebody was going to so choose to use them. Some of the incredible experts that we have featured today are Celebrity Nutritionist and Fitness

Starting point is 00:01:35 Expert JJ Virgin. We have entrepreneur and health advocate Callie Means who's here to remind us how the reliance on these drugs, especially for our children, could take our nation completely sideways. We have a sneak preview from our upcoming interview with Dr. Gabriel, And in this clip today, she talks about the best and worst practices around these GLP1 agonist in her clinic. Stay tuned, by the way, for the full podcast episode, which will be out soon. And lastly, we have a clip from the podcast, A Whole New Level, which is hosted by Dr. Casey Means and the team at Levels Health. And in this clip, Dr. Casey Means is interviewing Dr. Robert Lustig on how people on these weight loss drugs can use

Starting point is 00:02:21 them as a jumpstart and most importantly how to get off of them for the long term. And by the way, the full interview that Dr. Casey Means and Dr. Robert Lustig did, which we have linked to in the show notes, is an absolute must listen to. Let's jump right in with our first clip featuring celebrity nutritionist and fitness expert JJ Virgin, giving her nuanced thoughts on this complicated topic of weight loss drugs, including OZempic. OZempic, right? I want your thoughts on. on it because I'm seeing more and more telemedicine emerge, these sort of startups emerge. And a lot of people who feel like they've been struggling

Starting point is 00:03:00 with weight for so long that they are seeing their friends that are out there and they're losing, especially where I live over here, where you used to live. I'm in Los Angeles and Brentwood and the Palisades in Santa Monica. And there's a lot of individuals that are on this. I was at a fundraiser this weekend. And you could tell that there was probably a lot of people

Starting point is 00:03:20 that were on those MPC that were there. Talk up a little bit of about this. I'm sure you've been following it very closely. And, you know, what are your thoughts on the situation? My answer is probably not what you think it is. No, I actually have a feeling that you're going to give a more nuanced answer. Yeah. Which is why I asked you. So when I was on the Dr. Phil show, he had a chapter in his book called Weight Loss Resistance. And I thought, that is such an interesting thing. And this was what 20 plus years ago? No, it was 2007. And I thought, weight loss resistance, what could get in the way of you losing weight and cause you to gain weight?

Starting point is 00:03:54 And I started digging in, you know, past looking at diet and exercise, what else is there? Well, there's thyroid, there's insulin resistance, there's toxicity, there's, at the time we didn't know that there was all this gut microbiome stuff and food sensitivity stuff. That's how that whole book came out of that. And genetics, obviously. And so there were, I got all of these different factors. And I was teaching a course to doctors all around the country, really working on this. And, you know, working with people who are weight loss resistant for whatever reason.

Starting point is 00:04:28 And there's so many different things, sleep, stress, right? And so when this OZMPIC came out, people need a little win, right? And this drug, there's also, if you start to dig into this drug, I went to, I was at Integrative Healthcare Symposium, where I actually did this cool thing with Mark this year. And they had a guy talk about this. And he started talking about the other effects beyond weight loss and the neuroregeneration and heart and kidney. I put my son Grant on this.

Starting point is 00:05:02 So my son Grant now is cycling it for the neuro regeneration. So I've been looking at this and I'm actually working with one of my doctor friends in Tampa and we put together a program. My next book actually is the perfect program for Ozembic, for Manjaro, for any of these things. Here's the problem with the drugs as I started to do the research. They are getting the drug and they aren't getting what should, the only way you should be able to get this drug is if you absolutely must track your food, eat protein first, get in your protein amounts and do resistance training.

Starting point is 00:05:36 And if you will not do that, you cannot have the drug. And the other thing that has to happen is that you have to monitor your fat-free mass and make sure that you are maintaining your skeletal muscle mass. Now, like 10% would be the least amount, the most that you could possibly lose of skeletal muscle, that you are losing from fat. The scary thing with this is that if you look at the diets online for this, they are basically low calorie, low fat, low protein diets. They eat little amounts. It's almost like a bariatric surgery diet. They're giving them really nothing, and they're not recommending resistance training. And now we're seeing this devastating impact to the metabolism.

Starting point is 00:06:21 People are saying they can never go off it. Well, true. If you devastate your metabolism, because you have to heal your metabolism to be able to lose fat and have a great, you know, great metabolic rate, if you are devastating it by losing muscle, you have a major problem. This episode is brought to you by the Birch mattress by Helix. Our modern world is filled with newsflash toxins, and they can wreak havoc on our well-being. But what if I told you there's a way to return to our ancestral roots and transform your sleep quality or at least get close to it? I'm talking about the birch mattress by Helix. Made from organic cotton, cashmere, and wool, the birch mattress is nature's gift to your bedroom.

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Starting point is 00:07:45 That's D-H-R-U for 20% off today. Fasting is all the rage right now. And for good reason, for most people fasting has incredible benefits for our health. It can be a super effective way to manage body composition and promote longevity. But if you've done a fast before, you know firsthand how hard it is to stick with it if you don't have the right kind of support system in place. That's why I'm totally excited to tell you about P. They have a fasting bundle with four kinds of T's specifically designed to enhance your fasting

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Starting point is 00:08:43 For limited time, Peek is offering my community 12% off their fasting tea bundle plus an exclusive gift. So head over to Peeklife.com slash Drew. that's peak p-I-Q-u-U-E-L-I-F-E-P-L-I-E-P-L-E-P-L-E-P-L-E-E-P-L-E-L-E-P-L-E-L-E-E-L-E-E-L-E-R-E-R-U-RU. That's me, Drew, to redeem, to redeem this exclusive offer today. So while these drugs could be the best thing ever, because we have now 80% overweight and obese. Yeah, and we're not going to just fix it by teaching everybody how to cook, even though it's a beautiful dream. more information than ever out there and we haven't fixed it yet. Now, for a lot of reasons,

Starting point is 00:09:26 we've gone after the wrong targets. Like just the description of diets alone and the way we put people on a diet where it's this, you know, we're lowering calories and we're giving them this ultra-processed food that makes them hungry is just mean and it doesn't work. It's ineffective. So if you could give them something that's going to now all of a sudden improve insulin, improve their satiety and give them a little, take the edge off a little bit, while your, you're, make you're having them track, increase their protein, add resistance training could be amazing. But it's not being done that way. And that's the big challenge.

Starting point is 00:10:03 What about any kind of concerns that are bubbling up about any kind of long-term health damage? But again, the long-term health damage. I mean, these drugs have been around for a decade for diabetes. The long-term health damage, what's the big health damage for long-term obesity? Yeah, it's huge. You know? Most people are getting all these chronic diseases. because they're diabetic, they're obese.

Starting point is 00:10:24 So you're just saying we have to weigh the pros and cons. So you look, yeah, risk reward on everything in life. The risk here is really about your muscle mass. Yeah. It could easily not be an issue. I'm literally building the program. We're doing the trial group right now on this to prove that you can do this and not lose muscle. Right.

Starting point is 00:10:44 So we don't need to demonize it. We do need some tools to tackle this sort of obesity epidemic. but it can't be this idea that you just take a medication and it's a free lunch because you're going to end up sacrificing all these other things. And we have a whole sort of maybe decade of a lot of women and some men too. They're going to be extremely frail, not strong, not to mention potentially they'll be skinny, but they'll be diabetic. Right.

Starting point is 00:11:13 Right? Because they're eating a lot of foods that are not supporting their overall body. the extra carbs, extra other things, even if their calories are lower. So it's like any other type of weight loss diet. I mean, we could go back to the biggest loser and go look at the metabolic adaptation that happened there and they were exercising like fiends and still exercising. It's going to be the same devastating metabolic adaptation effect. That's why how would you use this correctly?

Starting point is 00:11:41 You're frustrated. You haven't been able to lose weight. Your thyroid's working well. I always say, is your thyroid really working well? and I'm sure you've had a lot of thyroid experts on here. Your thyroid really has to be working well. You're sleeping well. You've managed your stress.

Starting point is 00:11:57 You still are a little insulin resistant, so that's probably one of the big issues. You're doing your exercise, you're eating, but you just need something to help you get started. And you are committed to making sure you're going to eat your protein first and you're going to eat the amounts that are right for your target body weight. You are committed to doing resistance training three days a week, walking. after meals, we all need to move so much more than we're moving. Holy smokes. You know, doing a little hit training for that visceral out of post tissue, you're going to do all of that stuff, but you're going to use this as a little helper. I think that it makes, we have got a crisis. We've got to do something. Now, when I was on Dr. Phil, we did, we tried to take on the teens because it was like,

Starting point is 00:12:43 if you're an overweight teen, the chance you'll be an overweight adult is like 70%. but the challenge was the parents. So we were like, chicken egg, what do we do here? Like, we would help the teens, but the parents would sabotage the teens. We'd help the parents. And then, you know, it's like, so I think that this done correctly is a huge opportunity. The other opportunity that's great with all of this is that we can talk about weight loss again. Because we couldn't talk about it for a while.

Starting point is 00:13:12 And, you know, I know this is unpopular what I'm about to say. It may not be with our audience, but jump into it. but I'm going to go there. It is absolutely inappropriate to tell people they can be healthy at any size. You should love yourself at any size. And then you should love yourself enough to say, I want to be my healthiest best self, whatever that is for me. And, you know, we cannot tell someone if you're 100 pounds overweight that you can be healthy

Starting point is 00:13:39 because that's a lie. It's a flat out lie. And it's doing them a massive disservice. Yeah. Where do you think that all that came from? Just like big picture. You know, you've been in this industry for a long time. You've seen all the different trends and the ups and downs, right?

Starting point is 00:13:57 Was that a reaction to, you know, not to demonize anybody, but like Vogue and these different magazines, putting the super skinny models on there and sort of a lot of that was going on in the 90s and the early 2000s, that that's the vision of beauty? That started the 60s with Twiggy. Like, that's been going on forever. I was born 82, so you know, I only have my own reference range. That was in, I mean, you know, I wasn't around then either, but it was Twiggy in the 60s, I think really started a lot of that. And they've been using these crazy skinny models ever since.

Starting point is 00:14:28 In fact, I've had this bizarro career. Part of my career I was living in Fort Lauderdale and I would go to South Beach and I did nutrition for the models down there. And they did not want to put any muscle. They needed to be super skinny. And I look at them now and I go, these are women who devastated their metabolism. right? If you look at what happened, especially over the pandemic, I remember hearing a statistic that by the year 2030, that we were going to be 100% diabetic. And I go, that is ridiculous. And then you look at what happened over the pandemic and how we went into the pandemic, 12% of the population was metabolically healthy came out of it, 6.8%. And the obesity statistics that have been on the rise since the 80s that are now the overweight and obesity is what nearly 80%. And I think we had to make being over fat, not overweight, over fat okay, because it was just, it's more normal than being. It's more normal than ever.

Starting point is 00:15:30 It's more. Well, if you look out around, I mean, go anywhere, go to Disneyland, go to mall, go whatever, the thin people are the not normals. Right. Right. The normal weight person's the not normal. So we just made it okay. but that's not helping anyone. Sure.

Starting point is 00:15:47 Maybe also a little bit of like the politically correct language. Yeah. Great safe spaces for everybody. Well, let's do that. Like, let's not demonize someone because they're struggling with their weight. I can pretty much guarantee you since I've worked in this field for 40 years that no one is sitting there going, you know, I feel great about being over fat. What I really want to communicate is feel good about yourself. You're doing everything you can.

Starting point is 00:16:10 They're frustrated. What I learned over the years working with so many people. who are over fat is that they knew more about it. They were trying harder. It's on their mind all the time. All the time. If you have a friend or a family member or somebody that's close to you, or maybe that's even that person is you, I never dealt with that myself.

Starting point is 00:16:27 I was always a skinny Indian vegetarian kid. So I had my own challenge. Yeah. But it is literally on your mind all the time. Anytime you get dressed in the morning, anytime you go in the mirror, anytime you walk into a room, people constantly have that narrative of, are people looking at me, are they going to like me? me or are they going to like me? Do they think I'm too fat? You know, that's just a constant thing.

Starting point is 00:16:46 So they don't want to be that way, right? And they haven't been given the right tools and information, kind of been lied to a little bit by the narrative that's been out there. Kind of been lied to. Like, you look at what we've done over the last 30 years telling people to eat. No, you just need to, no, you need to cut the fat out. All you need to do is go fat free. No, you need to eat pretty much only fat. No, you know, like you look at it and go, should I be fat free? love that. If you look at all of the traditional diets out there, it's carbs are fat, carbs are fats, carbs are fat, and they miss the most important one and just go, well, what if you just focused on your protein? And then it was like extra to do loads and loads and loads and

Starting point is 00:17:26 loads of cardio. We've devastated people. That can make you lose your muscle and raise stress hormones and make you hungrier for carbs. We know that when you do chronic endurance training. Burns up muscle, raises stress hormones, makes you hungrier. And then you're not supposed to eat because you're on a diet. Like, it's just a horrible situation that we've done over the years. Next up, we have health advocate and entrepreneur Callie Means, who's bringing a well-needed critical lens to these weight loss drugs that should be kept in mind for anybody who thinks that these drugs alone

Starting point is 00:17:59 are the miracle cure to our obesity crisis. What is this, Zempic? Why is it, you know, being talked about so much? in why is like 60 minutes doing, you know, basically commercials for it. And how has it become a hot button topic that you want to jump in the mix on? Well, let me try to take this from kind of my perspective of seeing the rig system and kind of how I would think about it early in my career as a consultant. So this is reported. The parent company of the Zimpic over the past several years has paid $30 million a year in direct consulting fees to obesity doctors, this new field of obesity.

Starting point is 00:18:41 And just to add in, a Zempic is basically being touted as this miracle weight loss drug. Yeah. A lot of celebrities are on it. It was reported that maybe Elon Musk is on it. And it's been catching a lot of excitement in the public. It's a miracle obesity cure. It's a weekly injection that you have to take for life. according to the description, the recommendations that you take it forever.

Starting point is 00:19:07 Because if you stopped taking it, many of the patients that stopped actually ended up gaining more weight back because they went back to eating exactly how they eat. More weight back and there is unknown and not fully understood metabolic impacts because the injection is fundamentally impacting your metabolism. So it's recommended that you never stop taking the weekly injections. The weight comes back. There's potentially some other metabolic factors that are negative. So that's the drug.

Starting point is 00:19:38 But it's being built as a miracle obesity cure. So we've had this like plethora of press. It just feels inevitable, you know, culminating in this 60-minute segment, the most watch news program in the United States, where they had doctors that were paid on a Zipic payroll saying that obesity is caused by genetics, is not caused by choice. Okay. So let's just look back the past couple of years.

Starting point is 00:20:02 and how how the system is rigged and how we rigged institutions of trust for this. Okay. So first, you have this document. OZIPIC has paid obesity specialists, $30 million in direct payments, not research payments, consulting fees, direct payoffs. So that's on the CMS.org, that's on the website. There's been over 400,000 payments per year, individual payments to obesity.

Starting point is 00:20:25 So they have absolutely strangled the obesity treatment profession. Big conferences, direct payoffs. 30 million dollars a year in the lead up to this, right? Also, then the FDA approval. The FDA has fast-tracked disapproval. They fast-tracked the approval for teens in less than 30 days. 70% of FDA funding directly comes from pharmaceutical companies. There's been an absolute, this has the potential to be one of the most profitable

Starting point is 00:20:51 drugs in the history of the United States. And the boards, the obesity boards, and you see this time and time again that actually approve and decide whether to fast-track drugs, whether they even approve drugs. They're not FDA bureaucrats. They're blue ribbon panels. And they're blue ribbon panels of obesity specialists that are on OZBIC payroll. Okay. Then you have 60 minutes, the news media.

Starting point is 00:21:12 Okay. The majority of their funding, literally the OZMPIC segment before and after, pharma ads run. So you have the news media carrying the water. You just had yesterday a doctor go on CNN who was billed as a nonpartisan, non-biased advocate. I actually looked into it. She was actually on Ozympic payroll. Yeah, you went to, what was the website you went to and you looked into-

Starting point is 00:21:37 Yeah, the CMS website. She's on Oseptic payroll. She was billed as a non-part. So it's weaponizing institutions of trust. Now, where is this rubber hit the road? As I mentioned, during COVID, 40% of children between 5 and 12 obese. The American Academy in Pediatrics, which is not some fringe organization. It credentials pediatricians.

Starting point is 00:22:01 It's the gold standard. The majority of their funding comes from pharmaceutical makers. That's on the website. And they say that the data is great, and we recommend surgery and ozimic for obese teens. That's 40% of teens. Okay. And then there's lip service. This wasn't even really in the guidance.

Starting point is 00:22:23 There's one line on nutrition interventions. And then doctors on Twitter are saying, well, we're going to do a nutrition. They don't make money on nutrition. And as I said, 80% of those doctors didn't take one nutrition class. You know, I've spoken to diabetes specialists, obesity specialists from Harvard who have not taken one nutrition class in their lives. Right. So that's a fallacy that there's going to be some like, we've all been to the doctor. Oh, eat your fruits and vegetables, go on your way.

Starting point is 00:22:51 There's no real nutrition advice from the doctor's doctor's office. But that is Zimpic. And again, these are good people. I'm not, but let's just look at the raw economic incentives. dispassionally, that is weekly ejections. They're literally cells will go berserk if they stop taking it for life. That's that's regular doctor's appointments for their entire life. And I'm not reflexively anti-drug, but let's dig into that. Let's dig into that. So let's take a, let's take a teen. And they're obese. They're obese because of food, right? They're eating

Starting point is 00:23:27 primarily three things. Process grains, which turn into sugar, which which, which converted to fat when they overwhelm the cells with glucose, sugar, which is off the charts, as we know, and inflammatory seed oils. If they take Ozypic, which changes the metabolism, you know, it changes dynamics in your gut to make you less hungry, they might be eating less cannol oil, less sugar, less inflammatory oils, but they're still eating these inflammatory ingredients that are causing violence to the cells. This is why the stats I just mentioned on statins being correlated with increased heart disease, methamphetamine. form in diabetes, all these things. It's because there's underlying issues. We're still

Starting point is 00:24:05 ingesting inflammatory foods. The American Diabetes Association until 2018, by the way, the American Diabetes Association, which credentials diabetes doctors, was funded by Coke and said, literally, their guidance until 2018, as Dr. Robert Lustig has pointed out, said you can eat whatever you want if you're diabetic as long as you take your insulin. Right. That's just one biomarker. the stands or one, they impact one biomarker. We're eating inflammatory food. It's the fuel. I don't know.

Starting point is 00:24:33 It seems so simple to me. It's the fuel for our bodies. And if they kid, right, the obesity could be seen as a warning sign. I will guarantee you, and we can play this back, I will guarantee you. I hope was Zempic, this is overturned. But it is not going to result in long-term obesity reduction for children. And it is going to result in increased comorbidities. because the cells are still under threat.

Starting point is 00:24:59 And that's what so, it's not reflexively anti-drugs, but it's like opportunity costs. It's like the $4 trillion. Why now, of course, this whole PR campaign is leading to the American taxpayer paying for this injection, you know, for tens of millions of Americans. What if that money went to incentivizing healthy food? Next up, we have Dr. Gabriel Lyon, who's here to talk about the best and worst practices around these weight loss drugs when it comes. to using them in our own clinic, and the pros and cons that come with any medical intervention. We have a society today, though, unfortunately, that's all programmed around people being over fat.

Starting point is 00:25:38 And we have this abundance of new medications, things like OZemPEC, and I'd love to get your take on them. Are these things good, not good, or it depends? Well, everything depends because everything is in context as it relates to medicine. I personally feel that these medications are game-changing for people, people that have really struggled for a very long time to move the needle and just cannot. Whether it is a Zempic or Monjourno, I think that it's amazing. I think that with every medication, you have to weigh out the risks and benefits.

Starting point is 00:26:17 There's a lot of discussion about what is its impact on skeletal muscle health. I have never seen a mechanism of action that at least at this time, that negatively impacts skeletal muscle health. Right. And so some of what has been out there is that if people, if we're talking about some of the similar things that I've seen, if people are relying on OZempic to lose weight, and what are the other medications called Ozempic?

Starting point is 00:26:42 Mongerna, which is tri-epatide. There's another one called Wagovi. So Wagovi, they're all. Semaglut. They're all. So if people are relying on those, there's a decrease in lean muscle mass, but generally when people lose weight, there's going to be a decrease is what you're saying so in our practice we utilize ozempic and

Starting point is 00:27:02 mondurno and you know a handful of other things we are not seeing a loss of skeletal muscle mass because you're having people do everything else exactly yeah i appreciate you sharing about that because it's uh even the wellness spaces a lot of people that feel like they're very concerned about some of these things and some of the side effects that have been reported out there and obviously everything makes the news because these drugs are you know new you know some of the concerns that people have are like are the usage of these drugs linked to cancers i've seen or the usage of these drugs linked to um you know uh there was one recently that was all over CNN in the New York times there was one about like they people can't eat the same way like what was it again

Starting point is 00:27:44 right so gastroporesis and i want to mention this concept of um the cancer so it's basically thyroid cancer. So there's a black box warning on these incretins as it relates to potential risk for thyroid cancer. I think that if you look at the literature, perhaps that is incidental. That is an incidental finding. First thing. The second thing is what is more risky, being overweight for decades and decades or utilizing a medication to manage it at least initially because we get people off these medications. I know that in clinical practice and in the media, they say, okay, once you're on it, you're on and forever. We don't see that.

Starting point is 00:28:28 We see a kickstart in people's metabolism. We say once we get them really dialed in on nutrition and training, we use this as an augmented tool for those that need it. And we've seen tremendous change. The negative side effects, again, everything comes with side effects, a medication, there's no free lunch. When an individual gets gastroporesis, which is what you're hearing about, is slowing gastroempting, that's exactly what the medication is supposed to do.

Starting point is 00:28:54 It's not necessarily, I mean, is it a side effect? Yes, but it's also an intention of the medication. It slows gastric emptying, individuals are less hungry. And your argument would be, well, actually, I'll back up and say, some of the people on the other side would say, like, look, this cannot be the solution to fix America's obesity crisis. And I'm hearing you say that, yeah, if we're only going to use these drugs and we're not going to do everything else, we could end up having a bunch of people who are skinny and have

Starting point is 00:29:25 a ozempic face. But, but, you know, that's a little, little joke. People who are skinny, but actually their metabolic health is not that good. But that's because they weren't doing all these other things like prioritizing muscle. And their diet is not prioritizing protein. So they might be eating a lot of carbohydrates or, you know, fats in their diet or other things. And their metabolic health doesn't look great, but they are lean. And you're saying it doesn't have to be that way. And your clinic is one example of a clinic that is helping people use these drugs to get a kickstart.

Starting point is 00:29:59 You're not trying to keep them on there forever, but then they're working out and they're prioritizing protein and doing all this other stuff. And I want to mention something else to you that I've been sitting here debating for the last few minutes if I was going to mention. But I want to mention it because I want to highlight the disparity. Please. Physicians can prescribe something to make people less obese. Okay, no problem.

Starting point is 00:30:22 But people cannot prescribe, physicians cannot prescribe things for muscle health. So at this time, for example, testosterone is not FDA approved for women. But we can prescribe anti-obesity medications, but there are multiple medications potentially that would help with muscle health that, you know, we're just not legal to prescribe. Like peptides, potentially testosterone replacement therapy. Yeah, which by the way, you know, again, you're able to prescribe certain things off-label. But that is just an example of how backwards everything is. Think about that.

Starting point is 00:31:02 You can go to the physician to pursue. You can go to a provider and get anti-fat medication, but you cannot go to a provider to get pro-muscle medication. Our last clip today is an excerpt from the podcast, a whole new level, hosted by Dr. Casey Means. And in this clip, Dr. Means is interviewing Dr. Robert Lustig, who's been a regular on this podcast, and they're talking about how someone could use these drugs in the right way as a jumpstart, and more importantly, how an individual could think about, of course, discussing with their doctor, getting off of these drugs for long-term usage. So given the fact that there are going to be millions of Americans on this medication, and there are going to be probably a lot

Starting point is 00:31:46 people who have an awakening about the fact this is not a panacea, it's not a silver bullet, they might have horrible side effects, they want to get off it. I think there's probably going to be a huge opportunity for essentially plans for people to, while they're on the medication, also set themselves up for success for getting off it and maybe use the medication as a jump start to get the motivation and energy to then do the things that actually get to the root cause. So let's say someone's listening who's on OZempic, this episode's kind of freaking the out a little bit and they're thinking they might want to eventually get off it. What do you think are some of the steps that someone could take to really set themselves up for success when weaning?

Starting point is 00:32:25 Right. So I couldn't agree more. I think that ultimately these medications will be good jumpstarts. In other words, that means that they will be adjuncts to other therapies. Okay. Ways of getting people to have early success so that they can basically feel some self-efficacy, some agency that they can actually do something to help themselves and ultimately be able to carry that forward. I'm for that. I'm totally for that. And if that is ultimately how Ozempic and Wagovi are used,

Starting point is 00:33:00 I will likely be a proponent for them. That's not how they're being used now. All right. But if you can see that changing your diet will basically be something that you can actually do and follow through on. And, you know, Ozympic and Mugobi help you get there, all right, to that point where you can actually, like, change what's in your pantry. And, you know, you'll be able to sort of subdue the cravings, you know, so that you don't

Starting point is 00:33:35 fall backwards. I think that would be a fine way to do it. So it could be sort of a short-term, you know, jumpstart and then come off it and, you know, use it in that respect with that in mind. But that means that you need a nutritionist involved. That means that you're going to need your primary care physician to really sort of take command and help you navigate how to do this and how to navigate the grocery store going forward. So I could see, you know, these drugs being an adjunct to, you know, more codified lifestyle program. And, you know, then maybe they'll be a good value to them. Yeah.

Starting point is 00:34:21 I mean, I'm just thinking like, okay, let's say there's someone who, you know, is morbidly obese and they're really just don't have the energy or motivation to kind of get started. They get some early success with the medication like this, get more energy. They're able to move more. I can imagine a situation in which, like, that's, at that moment, if they're able to get a support team around them, exactly what you said, like learn how to cook, shop at the grocery store, prepare whole foods, start a resistance training programs. So they, you know, lose as little of the lean muscle mass as possible, maybe even build some, you know, really dial in on protein and amino acids and kind of, you know, prevent the sarcopenic effect, you know, work on the mental health piece. And then maybe, you know, it's like it's, it helps them kind of then eventually just move from one state to a much better future and get off the medication eventually. But I just don't see a situation in which if none of that happens, there's no resistance training, there's continuing to eat ultra-process foods, just less of them, that the body, do the body getting less of something crappy is not the equivalent of health, right?

Starting point is 00:35:31 If something is toxic, then less of something is less toxic, but that doesn't make it healthy. Well, okay. So I, so you have some of the most, I think, amazing perspective on, on actually, like, evidence-based, like, the actually evidence-based ways for sustained weight loss, especially in children. And I know you've done some research in your work on this. So the American Academy Piatrics recently in their obesity guidelines that were at least in January made a recommendation that. these medications and other pharmacologic agents for obesity could be used in children as young as 12. I wonder if you could just speak to some of your research about weight loss in children, about what are the factors that actually allow children to lose weight in a sustainable way? And maybe just your commentary generally on the AAP guidelines. Right.

Starting point is 00:36:22 So the AAP guidelines that came out earlier this year said two things. And one I agree with and the other one I disagree with. So what did it say? It said that obesity is a problem. I agree. Obesity is a problem. They said that pediatricians have far too long ignored obesity in the children that they see. And that by saying to parents, oh, it's just baby fat, it'll go away.

Starting point is 00:37:00 you're actually perpetuating the problem. So they called the pediatricians on the carpet, you know, for basically ignoring the problem as the problem festered under their feet. That part of the AAP guidelines I agreed with. Then was the second part, which I disagree with. What it said was, because obesity is such a problem and because it is, is a disease and because kids aren't getting better, you are entitled and rightfully, appropriately commissioned to use medication as young as 12 years old. Now, look, I used medication

Starting point is 00:37:49 when I was head of the OBC program at UCSF. F fully one quarter of the patients that I took care of were on metformin. And the reason that they were on metformin, was because metformin was targeted at the problem. These kids had insulin resistance. They needed their insulin to go down. I knew that as long as their insulin stayed up, they were going to continue to gain weight because insulin is the energy storage hormone.

Starting point is 00:38:19 Get the insulin down. And metformin was the drug that we had at our disposal at that time that kids could take that would get the insulin down. And the reason is because it worked at where the insulin problem was, the liver. It was targeted to the liver to improve insulin sensitivity at the level of the liver by increasing the enzyme AMP kinase. Now, AMP kinase is the fuel gauge on the liver cell. It is the thing that tells your liver to make more mitochondria. So if you increase AMP kinase activity, you're going to make more mitochondria, which means you're going to burn energy better and faster, and you're going to

Starting point is 00:39:04 improve insulin sensitivity, and you have a chance to get your insulin down and, you know, have weight loss. That's why we used it, because it was directed to the correct problem. I also knew from my own studies from back in the 90s when Metformin first came out that if the kids consume soft drinks, metformin was useless, did not work. And the reason was because they were poisoning that AMP kinase. So you can't raise your AMP kinase when it's being poisoned. It doesn't work. All right.

Starting point is 00:39:39 So soft drinks were the antithesis of metformin activity. And I had to get people off the soft drinks before the metformin would work. All right? I had to do both. I had to stop the soft drinks and do the metformin. But when I did that, then it would work. And I had plenty of good data to show that. And I published this out, you know, this was out in the world.

Starting point is 00:40:02 How many people did it? You know, how many pediatricians adopted that? You know, only the ones who listened to me, you know, which is not enough. All right. Now, can we ultimately, you know, get kids to change their diet so that they don't need medicine? And the answer is no. we can't because the food environment that they find themselves in is so unbelievably toxic. We have to fix the food environment in the schools.

Starting point is 00:40:41 We have to fix the food environment in the grocery store so that the food environment at home can ultimately be fixed. And the parents, you know, we expect them somehow to be the gate gate. keepers. And the problem is they can't be. It's too difficult that we've made it too difficult. And of course, that's the food industry's goal is to make it too difficult. In addition, most of those parents are sugar addicts themselves. So how are we going to fix the food for the kids if we haven't fixed the food for the parents? How do you expect the kids to get better when the parent is the sugar addict and it's still bringing the, you know, Oreos into the house. What, you know, what's that about? All right. So, so to me, that doesn't work. It requires a much bigger effort and

Starting point is 00:41:39 not expecting that the parent alone is going to be able to solve this problem. So giving drugs to kids is not the right answer, even though I did it, but I did it for the right patient, for the right reason at the right organ. All right. But just throwing Ozempic and Wagovi at kids is not the answer to this problem. I hope you enjoyed today's compilation episode. By no means is today's episode meant to be the final word on this complicated subject? But one promise I can make you is I will continue to ask experts that come on my podcast about their thoughts on OZempe and these other GLP-1. And these other GLP, weight loss drugs and will continue the conversation. And as always, I'll ask about all of the complicated topics that you want to know about so that you can be more empowered in your health

Starting point is 00:42:34 journey. Be sure to follow all the experts featured on today's clip in the show notes below and I'll see you next week. Hi everyone, Drew here. Two quick things. Number one, thank you so much for listening to this podcast. If you haven't already subscribe, just hit the subscribe button on your favorite podcast app. And by the way, If you love this episode, it would mean the world to me. And it's the number one thing that you can do to support this podcast is share it with a friend. Share with a friend who would benefit from listening. Number two, before I go, I just had to tell you about something that I've been working on that I'm super excited about.

Starting point is 00:43:11 It's my weekly newsletter. And it's called Try This. Every Friday, yes, every Friday, 52 weeks a year, I send out an easy-to-digest protocol of simple steps that you or anyone you love can follow to optimize. your own health. We cover everything from nutrition to mindset to metabolic health, sleep, community, longevity, and so much more. If you want to get on this email list, which is, by the way, free and get my weekly step-by-step protocols for whole body health and optimization, click the link in the show notes that's called Try This or just go to Drew Perot.com. That's D-H-R-U-P-U-R-H-I-T dot com and click on the tab that says, try this.

Dhru Purohit Show - The Right and Wrong Way to Use Ozempic and Other GLP-1 Agonists

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