The Uneducated PT Podcast - EP 83 GLP 1s With Karl. Solo Ep

Episode Date: May 17, 2025

In this episode I speak about GLP1s at a basic understanding how they work and why they're important. 

Hello and welcome back to the uneducated PT podcast. I am your host, Carlo Rourke. And right now we're going to do another solo episode where I am just going to talk waffle. No, I'm not going to talk waffle. I am going to talk today about OZempec and GLP ones and weight loss medication, which is obviously all the same thing. I'm going to explain to it. Now, I am by no means an expert on this.

topic. I've spoken to plenty of experts on this topic, but I'm just going to give it to you in, you know, a lame man's terms and explain to you basically what it is, why there's such controversy around the misconceptions from what I see. And hopefully by the end of the episode, it will just help you to be a little bit more compassionate or, less judgmental if you hear about people being on GLP ones. Because, you know, it's very easy to get caught up in the social media world of people, you know, making claims about it and fair mongering and saying why it's bad and then you kind of taking on them perceptions and then having judgment on other people without really

understanding about OZembek or about GLP ones. So I think we should just start off by talking. about obesity in general because that's that's pretty that's a pretty important topic when we're when we're discussed in this so like there is over one billion people worldwide living with obesity at the moment all right that's around 16% of global adults um who are suffering with obesity and like to try and understand the the ramifications the impact that has on society like things that we don't think about when we think about obesity we think about obesity and we think about oh people who are overweight people who are struggling with food um all that stuff we don't even think about

what the impact that this has actually on us as a society like the economic strain um that we put on society by uh this this epidemic that we have that it's and this is this is everyone's like this is everyone's issue it's not just the people who suffer with obesity Like the healthcare costs from obesity is immense. All right. Think about it. You know, we're excess body fat. We're carrying around a lot of weight.

You end up with all these kind of chronic conditions like type 2 diabetes, you know, heart disease, stroke, cancers, joint issues. And this leads to a lot of spending on kind of medicals, medications, surgeries, hospital beds. I know in Ireland, you know, we already suffer with not having enough. hospital beds. And I think what is it? The World Obesity Federation estimates that global obesity-related costs, costs $4.3 trillion annually. That's insane.

So the amount of money that we spend on obesity is insane. And it's not just the medical cost as well. You know, you lose a lot of productivity in terms of companies and stuff like that. You know, obesity leads to more sick days, reduced work performance. you know, early retirement because of health problems. So it impacts employers. And if you're someone who runs a business, obviously, you will know this.

You know, in terms of insurance and stuff like that, that goes up. You know, less energy, less focus. So it impacts society in loads of different ways that we don't even realize. You know, impact on public resources. So it's a real issue, not just in terms of the individual, but also in terms of the society. And also, you know, in terms of kind of lower income communities and stuff like that, you know, people, people always want to, you know, advocate for people who are struggling in society in terms of low income households and stuff like that. But something that low income households struggle with a lot is obesity.

And that comes from kind of food scarcity and stuff like that. going for foods that are cheaper that usually end up being like hyper-processed food and stuff like that. So that is obviously a big issue for people as well. And obviously then when we talk about the reduction in the quality of life of that actual person, just from a human standpoint,

thinking about people who suffer with obesity, joint pain, sleep issues, low energy, not mobile, not able to participate in social activities physical activities you know like people people always say things like oh well you know

if they're obese why don't they just go to the gym like if you have ever suffered with insecurities or anxiety or you know the thoughts have just gone into the gym for the first time now try to amplify that by PennX because

you've struggled with your weight your whole life and you know people have been making funny your whole life like you know how difficult it is to integrate yourself into kind of social society. It's very, very difficult. And this, you know, leads to kind of poor mental health, you know, depression, anxiety, eating disorders, body dissatisfaction. And like, everyone wants to,

you know, put up on social media how, you know, they're an advocate of mental health and, you know, just talk and all this stuff. But, you know, when someone who's suffering with obesity is suffering with mental health issues, well, they don't get the same sympathy because, you know, there is this perception that, you know, it's their fault. And, and, you know, and, you know, which I will go into a little bit. So then obviously comes out this kind of weight loss medication called GLP ones, which essentially helps to solve this issue that a lot of people are having and as a society we're having. Like remember, you know, we haven't been able to solve the obesity crisis.

Like telling people to work hard or hasn't worked. Telling people to eat less and move more hasn't worked. Telling people to have more discipline or have more willpower doesn't. work. And if we think about people in the 1960s, it's not that they had more willpower than people today. So then that kind of suggests that maybe it's not about willpower and maybe it's not about the individual's responsibility. Like obviously everyone should have individual responsibility, but maybe there's something greater to this that we're not really thinking about. So it's a very short-sided perspective that people have. So when we talk about GLPs that came out, so this is

basically a type of medication that helps to control blood sugar and control. hunger, you know, and, you know, your body naturally makes a hormone called GLP1. After you eat, basically, you feel full, you slow down, you know, you slow down how fast your stomach empties, and it tells your pancreas to release insulin, which, you know, lowers blood sugar. Now, some people don't make enough GLP1, all right, or their body doesn't respond to a property, and this is where the kind of genetics come into play as well. So, and you'll hear people say things like talk about food noise. It's where they feel, they always feel hungry.

So it's very difficult for us to think about that some people just have higher hunger cravings than other people. Because we think that we think that we have the exact same experiences as everyone else. So everyone kind of lives life through our own lenses, which it's a very difficult thing to understand that they don't. And this is where GLP1 medications came in. Like they mimic this natural hormone that helps to manage. your appetite and your blood sugar, which, like, is unbelievable for people who have constantly

felt like they're preoccupied by food all the time every single day of their lives. Like, to finally have that, that noise switch off. Like, I can't, obviously, I don't know what that feels like because I don't actually, you know, that's not an issue that I've ever had. But I can only imagine what that does to your quality of life, you know, so. What is OZembe? So OZembeck. So OZembeck is a brand name for a GLP1 medication. And it was originally made for people with type 2 diabetes. But doctors found that, you know, it also helped people to lose weight. A lot. It reduces hunger and helps people to feel fuller, faster and for longer. So now it's being prescribed for weight loss, basically. And it helps people who struggle with bingy and intense cravings. And, you know, people think there. There's this misconception that GLP one receptor agonist, that's what's basically called, that like, this GLP drug has only just come out. But this has been studied for nearly two decades since 2005 it was approved for type 2 diabetes. Okay.

Obviously since then, they've created newer versions and just made them more sophisticated and obviously with stronger effects and stuff like that. and then Wagovi, which is one of the weight loss drugs, that was approved by the FDA in 2021. And obviously now it's basically mainstream. So while it feels new in the public eye, GLP1 medications have been around and they've been studied for like 20 years. Now, there are side effects, all right?

And most of these side effects are like digestive issues. So like nausea and vomiting and constipation and diarrhea, diarrhea. And usually these are mild and usually they improve over time with taking the medication. But basically you can pretty much guarantee that, you know, they're safe because they've been so highly tested and so highly researched. But there is still nasty side effects. And I presume that's just that that's going to improve more and more throughout the years where they're eventually going to have, you know, medication where you might only have to take it once. and you know there will be probably minimum side effects and but obviously that that's that's not around the corner but um soon I'm sure um so like you have to think about this if you're someone

who has you know excess adipose tissue aka body fat you know and you've been struggling with your weight your whole life and you've run into all these problems of you know um constantly thinking about food, constantly overweight, constantly struggling to diet and lose weight and put it back on, lose weight and put it back on and fighting your biology. You know, I'm feeling like an outsider from society and society shaming you and judging you and, you know, not being able to engage in life the way that you want to engage in. And then this drug comes around and it's like, oh, well, you know, yes, there's side effects like nausea and, you know, di-degestive issues. But I mean, if that's the cost

but the benefit is everything that I've stated that I can finally go around without constantly thinking about food I can lose weight and finally feel confident to walk into a gym to go on a night out and not be worried if people are looking at me funny

or not be constantly in my head and finally have good quality to life you know not not having to go to the doctors every three months because I'm feeling sluggish and I'm having you know issues or, you know, having the energy to be able to keep up with my kids, to be around long enough to see my kids grow up, all these things.

Like, yeah, if it was me, I would take the medication. You know, so we have to think about it like, you're not just dropping numbers on a scale. It's not just about weight loss. It's about gaining something from your life. Like you're reducing the risk of multiple chronic diseases by, reducing the amount of body fat that you're holding onto. Like, you're going to solve things like type 2 diabetes, cardiovascular disease, high blood pressure, you know, certain cancers.

You know, obesity is linked to at least 13 types of cancer, like breast cancer, kidney cancer, pancreatic cancer, liver cancer. You're going to improve your sleep. A lot of people who are obese who have a lot of weight on them. You know, they struggle to sleep. sleep apnea, osteoarthritis because people have less pressure on their joints, especially around their knees and their hips, reduced pain, inflammation, mobility issues, improves, you know, fatty liver disease, like depression and anxiety that's like indirectly will improve them kind

of things because obviously improved body image, reducing inflammation, better sleep. All these things are going to improve your mental health. Again, you're going to feel more confident so you'll going to get involved in more things in the community. You're probably going to take on more challenges. Like the impact of this medication for some people is absolutely insane. Like there's so many positives to it for so many people. And yet there's such backlash around this medication. So what I'm going to do is I'm going to kind of go through some of the reasons as to why people

are against this medication that I have written down, that I have seen online, that you know, people get into arguments over. And, you know, obviously it's just people who are uneducated on the topic and people who are a little bit ignorant. And also people who are just faphobic, to be honest. But like one thing they have is this kind of short-cut mentality. So, like, they believe that using medication for weight loss is cheating or it's taking the easy way out. Like, instead of earning your results through willpower and diet and exercise, you know, like they did, and that's how they basically see.

reality is like this obviously ignores the biological, psychological and environmental complexities of obesity. And I just think it's like, again, you're just looking at life through your own lens. Like most of these people, most of them be these people who say this kind of stuff like, you know, oh, it's cheating or just maybe subconsciously think it. It's obviously because they have trained their whole life because they love training and it actually comes easy to them. Yes, they say that they work hard. And I'm sure they do work hard in terms of, you know, training and getting up every day to move in their body. But they've never probably really struggled with carrying excess body fat. And they've probably grown up, you know, you know,

feeling full, feeling satisfied when they have a meal, not constantly thinking about food, probably grew up with two parents who made them home-cooked meals, you know, probably had parents who brought them to sports club every week, you know, probably live in a decent environment where they have access to, you know, nutrient dense food. You know, they have all these things working for them that they don't realize actually makes it easier for them to maintain, you know, their body weight. So what we have to understand is obesity is a complex medical condition

involving like genetics, hormones, brain signaling, and your environment as well. And these GLP ones help level the playing field for those who, you know, are at a disadvantage biologically. So it doesn't replace the hard work. It supports it. I have clients who are on these medications and I promise you, they're not going through an easy time.

It's difficult for them. They're trying to learn new skills. They're trying to train. They're trying to navigate this thing called nutrition and get enough fiber and enough protein into their diet while also constantly feeling full. And then there's a psychological element of not using food as a coping mechanism. mechanism anymore for things that might have gone on in their life. You know, so, and like people still have to change their habits.

They still have to eat well. They still have to move their body. So it's not cheating. It's treating something that they find difficult. And like, it's like saying that, oh, you know, you know, having an inhaler is cheating. And no, I have fucking asthma. So I need to use a fucking inhaler. You know, breathe on your fucking own fucker.

That's basically what these people are saying. Like when you use different analogies, it doesn't make sense. Like, for me, maintaining my body weight is like walking on a treadmill, all right? Just walking on a flat treadmill. For someone else who constantly feels hungry, because they're genetically predisposed to, you know, have higher cravings. It's like walking up a, it's like a treadmill on incline. All right, it's more difficult for them. So it's just even in the evening, the, the, the, the playing field, basically.

Couldn't even get my words out there. But I hope that makes sense. And another objection people have is that like the side effects are awful. Oh, you should just do it naturally and stuff like that. Yes, there's nausea. Yes, there's vomiting. Yes, there's constipation. Yes, there's digestive issues.

But in reality, like, side effects are going to happen. But usually they're temporary and usually they're. dose dependent. And usually people are just after a few weeks. And like I said, compared to all the things that they get that improved the overall quality of their life, like the benefits outweigh the temporary discomfort for a lot of people. I'm not saying it for everyone. There's some people probably who get really, really bad side effects and probably can't continue to take the medication. And that's fine as well. But for a lot of people, it's life change in medication. And then another kind of objection people have

is they say things like, well, we don't know the long term risks. You know, we don't know if they're safe and all this shy. Well, actually we do. Like I said, 20 years of research. You know, a GLP ones have been used in type 2 diabetes since 2005.

You know, with decades of safety data behind it. And then obviously the newer kind of formulations as well are being monitored. But yeah, like, It's backed by science. So I don't know what people are fucking saying or talking about when they say, we don't know the long term effects of this medication.

Yeah, we do. And you know what else we know? The long term impact of obesity. Do you know what that is? It's fucking dying. So yeah, I think they'll take their chance with weight loss medication. And then another one they say is like, this is a kind of, this is an interesting one. So like people say that, you know, they'll.

just become dependent on them. Like, oh, once you, you know, once you take it, you have to take it forever. Um, yes, obviously. Like obesity, obesity is a chronic and relapsing thing. So just like high blood pressure or depression, like, would you stop taking blood pressure meds? Um, because you think you should manage it naturally. No, you wouldn't. You'd keep taking the medication so you keep on benefiting from the benefits of the medication. Now, some people could come off GLP ones after building strong habits and they might be able to maintain a lot of the progress that they've made. And other people are going to have to stay on it for long time,

for long term, for the rest of their life maybe. And that's okay. Like ongoing care is not a failure. It's just a part of the process. So we have to think about that. And then another objection people would have is like, oh, it's too expensive, only reach people can afford it and stuff like that. Yeah, access is an issue.

But the solution is advocating for broader healthcare coverage, not dismissing the medication. Like, that doesn't make sense at all. It means, all right, let's try and make this more affordable for more people who need it so they can get the benefits of it and society can actually get the benefits of it. Like diabetes patients often get coverage already and obesity treatment guidelines are shifting all the time. And so, you know, there's no point in criticizing the tool instead of just the system that, you know, we need to be able to make this more available to more people and make it safer and, you know, give people the support outside of the medication as well.

And then some of the kind of more just degenerate kind of criticisms from ignorant people are like, oh, people are just lazy. They just need more discipline. they don't need more drugs and, you know, stay away from the farthest pharmaceuticals, blah, blah, blah, all that stuff. And the reality is, like, this is just outdated and harmful thinking. Like, many people using GLP-1s have tried everything for years. They've tried the diets. They've tried the exercise. They've tried coaching.

They've tried therapy. They've tried a lot more things than the people who were actually criticizing them. They've actually worked harder than the people that are criticizing them. And again, they're fighting probably an uphill battle in terms of their biology and their environment. So, GLP ones reduce the biological drive to ovary, making room for people to finally act on the discipline and the knowledge that they already have. So it's not about willpower. It's about having support. And like, that's really, really important. Like, a lot of, like, a lot of people who are obese are very, very competent in a lot of areas of their life. like I find it easy to stay on top of my fitness

because it's part of me, it's part of my identity, you know, I grew up playing sport and stuff like that. So I find that easy. What I don't find easy is like managing my finances and stuff like that. I'm a terrible spender.

So like that is something that I struggle with, you know, where somebody who was obese might be really, really disciplined and really kind of on top and really sophisticated with that one area. This is just an area that they really struggle with because of certain things in their life. And, you know, I just think it's ironic that people think that, like,

they just, they hold this virtue of that, you know, I'm able to maintain a healthy body weight and therefore I'm superior than you. And now that people are being able to get help to maintain a healthy body weight, you know, I think that's challenging other people in terms of, you know, wearing fitness like a badge of honor. and Louise Perry who wrote this fantastic book called The Case Against

The Sexual Revolution She uses a great example about anesthesia And anesthesia And at the time Many religious and medical authorities believed that pain was natural It was necessary

Or it was even noble Like especially in childbirth So they were The public and the professional kind of people in this area, they were resistant to the idea of like removing pain or, you know, putting people unconscious so they didn't have to, you know, go through pain

when they were giving childbirth or when they were going through surgery or whatever it is. You know, and some even argued that pain was this moral important thing that you needed to do. But obviously, like we don't, we don't, We don't think about it like that anymore. Like we don't think like, yeah, give me something to relieve my pain. Give me something to put me asleep so I don't have to go through this agony, you know, and this torture.

And I think eventually society will come around to being like, you know, instead of having to endure weight loss, you know, let me use this weight loss medication to help support me and, you know, change my life. and not have this kind of moral or cultural pushback from it. So, yeah, I think that's, it's just something that we need to think about is that like, you know, it might seem unnatural at the moment for people. It's hard for people to get their head around that, oh, let's use weight loss injections to help improve, you know, our food and lifestyle decisions. Because this is the, this is the thing where people get caught in this binary thing where it's like, oh, I'm, you know, it's all about food and life.

It's all about nutrition and lifestyle. And if you're educated around food and lifestyle, you're going to lose weight. It's not this or that kind of thing. You know, using these medications help people to lose weight and help people to engage in a healthy lifestyle and engage in their nutrition easier now because they feel full, they feel satiated. They can take their time to actually make a healthy meal and to find out, oh, this has more protein in it. has more fiber in it. Oh, now I'm at a lighter body weight.

It means that, you know, my joints hurt less. You know, I might go out for a walk. I might go out for a run. You know, I might join the gym. So it's like it doesn't take away from a healthy lifestyle. It encourages a healthy lifestyle. It's easier for people to implement a healthy lifestyle now because they weigh less. So we need to kind of go away this, go away from this like holistic or natural approach.

like obesity is a natural either like it's a mismatch between like modern food systems and human biology like we're not we weren't designed to be surrounded by so much

hyper-pollitable food so GLP ones mimic a natural hormone your body already makes GLP ones and it helps you improve your nutrition decisions helps you to improve your movement helps you to improve your sleep

and again all these things complement our lifestyle They don't replace it. So that's all things that we need to think about. And another thing is people say, like, you know, they don't teach you how to keep the weight off. It will all come back, you know, once you stop taking the meds. Which, you know, again, in reality, if you go back to hold habits without support, yes,

you're probably going to put on weight. But that goes for, like, weight loss in general. Like, if you go on a weight loss journey, if you're going to diet and, you know, you add in all these healthy behaviours, like... getting your steps in and training and eat in a certain way and you know you stop doing them behaviours you're going to put that weight back on and so that it's no different between whether you take the medication and incorporate these habits or don't take the medication and incorporate these habits you know if you're if you stop doing the thing whether it's take the medication

and stop doing the habits you're not going to you're not going to maintain the results but GLP ones help build the foundation while people, like it gives people time to learn these new habits and for some staying on the medication, again, it's going to be long term for maintaining the results and that's okay. You know what I mean?

That is completely normal. So what? So like GLP ones aren't for everyone. I'm not saying, I know this sounds like I'm, you know, advocating GLP ones for everyone. They're not perfect, but they are very powerful. And they are safe.

And they are life changing for the right person. And when used responsibly, you know, like it is a great thing. And, you know, criticism can be valid at times. But, you know, it needs to be informed and not judgmental. And I think a lot of the criticism comes from judgment rather than being informed. So there are all things that we need to think about. And then the last one that I'll touch on is vanity weight. So, you know, some argue that, you know, people who aren't clinically obese are using these GLP1 medications just to lose a couple of pounds just to look better, all right?

Which we, again, we call this vanity weight. It's an aesthetic goal. And, you know, the weight has been designed. It's been developed to treat people with type 2 diabetes. You know, people with a BMI of 30 plus or at 27 plus with conditions like hypertension. And when someone who was a healthy, weight or a little bit overweight uses them just to get leaner, you know, people complain that this is a misuse of the medication. And I get that, but at the same time, I think it's just people, like, does that really impact you if someone's using this for their own vanity? Like, here were you to be the moral judge of what people can and can't do to look better. I'm sure you do it all the time in different ways, whether it's whatever it is. and so I don't

and you also have to remember that people who might not be overweight but taking these medications you don't know their full story these could be people who have you know body image struggles disorderly and behaviours

you know they might be under pressure and they're certain or under pressure in their certain profession you know maybe they're a dancer or a performer or a model you know and they're like they have all this pressure to be really really thin so they get caught in this kind of diaculture that, you know, my value is, my, my self-worth is tied up in, in how light I am on the scales.

So that person doesn't need judgment. They probably need empathy. And so that's me like saying, yeah, they probably don't need to be taking that medication. They probably just need education and guidance and support. and you know and you know someone to help them understand that you know they don't need to chase extreme tinnis in the first place but again like that like that has nothing to do with the positive benefits that this medication comes for a lot of people who are suffering from obesity so don't shame people who have obesity for for having support just because you don't like that people who are already quite lean are taking these medications to become leaner because they're obviously suffering with um you know things in their head body image issues and stuff like that um so the real issue isn't you know who uses g lp ones it's the real issue is like candy people who are using gLP ones also

get the support that they need in terms of a coach in terms of a therapist in terms of a qualified doctor and making sure that they understand the risks and the benefits and the alternatives before they kind of go in to take this medication. But like the whole reason for me just making this video or not this video, this podcast is just to give you an understanding that, you know, these medications are a net positive in people's lives and in society as well. Like why would you not want to help solve the obesity crisis that we have. Like that just baffles me. And am I saying these medications are perfect? No, they're not perfect. But, you know, it's better than the alternative, which is we can, you know, the numbers of obesity continue to rise. We continue to put strain on people's

lives. We continue to put strain on the healthcare system. So, you know, I think, in my own opinion, anyway from the research that I've seen from people who are more qualified than me, it's a net positive for the world. So my message to you today is just to stop being a judgmental bastard. So I hope that helps. So this has been a solo episode of the Uneducated PT podcast. Again, if you're enjoying these episodes, if you enjoy the solo episodes, share it, share it on your story, subscribe, leave a review.

let the world know that we're here waffling every day about different topics and, you know, bringing on, you know, interesting and knowledgeable guests to help inform me and the listeners as well. So have a wonderful Saturday and I will see you on the next one.