Wow. As someone who lost 120 and has fought DAILY to maintain that over a decade later, hearing her describe it as a full-time job made me tear up. That is EXACTLY how it feels. There is literally not a moment of my day where I'm not thinking about food and my body. It is exhausting beyond anything I can describe.
I don’t want to undercut the seriousness of what you’re saying because I’ve lost over 10% of my entire body weight recently, it’s like DeAngelo from the US version of The Office, “Once you’ve conquered obesity, everything else is easy. Life literally moves in slow motion.” Losing a large amount of weight really changes your perspective of everything around you but you are just hyper vigilant of goof around you or how your body would welcome it but poorly react to it.
@@allahbless2278 maybe for some people. personally, I can't fast. If I don't eat frequently, I get stomach aches. So it's not just my brain feeling hungry but also my body signaling that it is not for it.
I'm just so impressed by Dr. Mike's interview style, he's patient, asks great questions, always acts as a surrogate to his audience, keeps things simple and understandable, and pushes back when necessary. All the things I want to hear from a good interview.
I love that he’s challenging her and himself also in this. It’s clear her perspective is a bit different from his initial takes and it’s wonderful that he’s balanced in this way (asking hard questions and willing to hear and offer uncomfortable answers). I saw another great podcast about processed foods being a big factor in mass obesity. I think he’s right to be concerned that this drug is probably a bandaid for a wider health issue. Really informative interview from two valid and different viewpoints
His bias is quite clear, and he walks a line where he’s sharing the bias with his audience to ask the questions people are curious about (good), and challenging her when she’s pretty clearly more educated than he is on the particular subject (questionable). The thing that bothers me is that he’s pretty clearly set in his bias and opinion even after talking to her. He asked the questions, got an answer he seems to disagree with - and he handles it well, yes; he’s patient - but he values his opinion over hers (that lifestyle alone is the answer), despite the information she’s sharing that contradicts it. I think this is because it’s difficult to measure (subjective) data in a lot of cases. It’s easy to discredit her observations of patient “feelings,” which are actually an important part of this discussion since statistics already don’t convince most people (it’s rare for diet & exercise alone to work for patients in the long term, but these drugs make it more possible in several ways).
This is the best interview I have ever seen. “We don’t cure hypertension we manage it” is such a great discription on how this helps like other medications. Also “your patients have probably been trying everything for decades” so true oh my gosh, finally someone who actually understands obesity, I’ve never felt more understood.
@@shonaaitken7635if it’s hypertension caused by something like atherosclerosis then no. It’s more managing it because your arteries aren’t going to regain elasticity. This happens as you age but can be accelerated by many factors. This is managed through ACEi, ARBs, b-blockers, etc. as well as changing lifestyle factors. However “obesity” can be cured. The cause of it maybe not
I am insulin resistant due to pcos. My doctor put me on wegovy which is ozempic. When I went on it it was AMAZING. I really didn’t lose a lot of weight on it but how great my body felt was worth it. I finally felt full, I naturally craved healthier foods. I wasn’t in pain from inflammation. My gut wasn’t gassy and bloated and it significantly reduced my ibs symptoms. I had energy again because my sugar levels were staying stable. it was like my finally worked correctly. Now that’s on back order I can’t get it and all my symptoms are back and I’m miserable
@@Xnoob545don't think so. The active ingredient in Ozempic is semaglutide, which works by inducing satiety. Thereby reducing appetite or addictions. So you would be at higher risk with it. Please talk to a doctor before using any such medication. edit: apparently semaglutides can help with it. still best to consult a doctor
I've recently been diagnosed with PCOS and insulin resistance as well! I was a bit scared of Ozempic/Wegovy (bcs I have a history of depression) so my endo in collaboration with my psychiatrist put me on Contrave and I have also felt amazing results. What you said about finally feeling full when you eat - i also went through that - and I'm sure to people who don't have insulin resistance it sounds silly, but it's such an amazing feeling to be able to trust your body in terms of when you feel hungry/full. There is such a stigma with weight loss medications, but for many people they really are life-changing, and not just for superficial reasons. Im sorry you're dealing with back order issues, and I hope you can get your medication soon!
@@Xnoob545if you don't have insulin resistance or diabetes... chances are, ozempic will do nothing good for you, and you will suffer from adverse effects.
Not only calorie dense but full of sugar. I recently read about how in zoos, the zoologist can no longer feed most fruits and many vegetables to the animals because they are GMOd so much to increase the taste of the plants that it means that they have so much more sugar in them then they ever used to. The animals are becoming obese...on fruit and vegetable based diets. They now almost completely cut out fruits and they feed them with specific vegetables that typically have less sugar and supplements made for the animals.
@amandasnider2644 you're right, I worked at a parrot sanctuary and many of the birds had heart disease and diabetes despite a constant, generous stream of donated produce from Costco. But it's not GMOs (too recent), it's the result of selective breeding over thousands of years of human agriculture to reduce fiber and increase sugar content. It's one of the (many) reasons a "paleo" diet is a joke- contemporary farmed meat and produce is vastly different than the food which would've sustained us in Paleolithic times.
I'm a 70-year-old female who has been overweight since having my children. I also have other physical issues that qualify me for this medicine, including severe arthritis. After going to Kaiser's Healthy Living doctor, I was required to take their Healthy Eating Program, and after labs, I just started taking Ozempic two days ago. I have been watching several TH-cams about this subject, and I'm so impressed with this interview. I just want to tell you it's been so informational and pleasant to listen to. Thank you so much.
Some of us have missed that the goal of this conversation is to have many perspectives brought to light - On one end we have a specialist who regards these medications favorably and on the other end we have a general practice doctor who is readily questioning and learning about the practice of these prescriptions. It’s great to hear the full spectrum and understand that mass medication isn’t necessarily evil when done carefully, and in turn also recognize that people tend to misconstrue medications due to popularity and possibly misuse them. Two things can be true at once.
I do feel like Pharma is very gung ho on meds and gets defensive when Doctor Mike asks the stats of pharmas practice, but he's very good at give her a soft out to soften the blow and answer. This is a beautiful chat but i'm leaning very much on Doctor Mike's side.
It seems like Dr. Mike had some disagreements with her and was challenging her answers. It's always good to have healthy discussions and debates to get different perspectives and opinions.
I noticed that too, Mike is always for achieving well being from better lifestyle and naturally adapting, while she thinks that well being comes at all costs, if the medicine exists, why not?
I don’t know if she changed her mind, versus redirecting her message promoting lifelong meds. For example, she was incredibly comfortable calling GLP-1s “lifelong medications”, later saying the goal is the lowest dose (still vague, still same message)
@@arminmadari4808Her viewpoint was that if you can get off of it, you should, but many people will never be able to manage their weight without and those people should be taking it as ling as they need to. It may be a very low dose, or less frequently than prior. Not really changing a view point
@@arminmadari4808I think what she meant is that for some people it will be necessary for the medications to be a lifelong thing. And that we shouldn't look down on it or feel to scared of it, because for those people not taking those medications for the rest of their lives would be even worse and far more unhealthy.
We're not built to live in a constant feast/high calorie foods easily accessible, or sit at desks for 10 hours a day. This is an incredibly new development in human history, it makes perfect sense to me that most people would struggle to control their weight.
I would say Ozempic changed my brain chemistry. It took the cravings away, I was able to stop bingeing, my brain actually registered as being full when I ate a meal. I lost weight, but for me, weight loss was truly a side effect. For the first time in my life I was in control of my eating, not the other way around. I felt like I could take absolute control of my life - really make headway when I worked out; take control of my medical issues (from poor diet) - lower my A1C's; lower cholesterol, lower my BMI, etc.
Agree! That to me has been the most mind blowing thing. I never binge eat anymore, I also tear up thinking about the fact that this has happened. I don’t know about you but I do something think “is this how normal people eat food?”
nope it didnt change any brain chemistry. If you go off you will fall right back into it. This is why Pharma wants you on it. Becauase you will stay on it
@@alexsummers1897 I thought that all the time. I wake up thinking about food. I think about it before I go to sleep. I hate it. I would give it up if I could. Unfortunately, my insurance won’t cover it anymore. I feel like I just bounced right back.
Same! I've only been on it for like a week. I already feel more comfortable in my relationship with food and I also don't feel that need for food to "hit that spot." It's awesome other people have a similar experience.
What about discussing the possible long term side effects which there are and some quite serious? And also why is the trend moving towards finding a pill for everything instead of approaching the problem as lifestyle? And if it's not lifestyle, then what is it in our environment that is making us obese and addressing that as our number one health problem that needs fixing pronto.
@andreavanda5402 Did you not listen to the whole show? They addressed much of this. Our environment may be causing some of this, but that cannot be fixed on the individual level and will take generations. Patients need help in the present.
@@andreavanda5402 One of the key points of this conversation is that lifestyle is a necessary, but insufficient element of the equation for weight loss for many people. And while I would love a world where we all had low stress jobs and lives, and were growing our own food and making healthy meals, unfortunately that just isn't reality for most of us.
I wish the pancreatitis side effect wasn't played down. My endocrinologist didn't put me on Ozempic, but one of the medications that has the same active ingredient, semaglutide, with Rybelsus, and I ended up developing gallbladder issues, pancreatitis, was hospitalized twice, and had surgery to remove my gallbladder that finally addressed excruciating upper abdominal pain that my endocrinologist downplayed and dismissed. Thankfully I moved to a different endocrinologist that doens't dismiss my feelings or symptoms now.
Learned so much from this. The way the two conducted their conversation with a bit of pushback, answering things that maybe wouldn't normally get asked and the information behind obesity being more than just a failure to stick to a healthy lifestyle was absolutely brilliant. This whole thing was incredible, we need all medical professionals to be like these two.
37:56 she mentioned losing enough weight to do basic tasks again, and feeling able to exercise.. I’ve been paying for a gym membership for 4+ years and haven’t gone since before Covid. But I’ve lost 25lbs on Wegovy and actually FEEL a desire to MOVE and it’s truly a beautiful thing.
@tahloz6688 Yeah, no. At a certain weight every workout even going up stairs is a struggle. That point was that Jumpstart of losing weight gives them the chance to actually try sports, workout, hobbies they can actually like.
I am a member of Alcoholics Anonymous for many years. I have dear friends who have had to take medication to help them get odd heroin. That, incorporated with AA, has literally saved lives. I haven't had to use that, just like some people don't use these medications but are able to change and stick with a healthy lifestyle. I love that there is different options for different people because everyone is different.
That’s a good comparison. I’ve heard people in AA say any treatment with medication is cheating or you’re not really sober. They don’t realize how detrimental it can be to someone’s recovery to convince them they shouldn’t get on or be on meds. Would you rather have someone on suboxone and “not really sober” or find them dead from an overdose? Would you rather have someone who “cheated” to lose weight, or someone dead at 40 due to obesity?
I'm on Ozempic now. Yes, I've lost weight, but I'm more impressed with my blood sugar numbers. I'm almost completely off insulin and that's huge for me.
@@stephaniemerrill4515 insulin is a hormone and so is semaglutide so you pretty went much went from one hormone injection to another hormone injection? which is more affordable long term?
Limiting carb intake fixed my insulin levels and got my cravings under control in ten days after I decided to change my eating habits. Also my food receptors no longer numb and everything tastes so much better. No drugs needed, saved money. Doctors hate me for this weird trick.
@@guntisber5415 That is actually wonderful for you, congrats on that! But also, not everyone is you and will have the same experience and the way you framed this comes of very passive aggressive to people who will not have the same experience and result as you. I am glad this worked for you and I am also glad that medication exists that helps people. One method is not superior over the other tho and thinking it is helps literally no one.
One of his best videos. His body language exuded being critical of the information provided, but also respectful and polite. I thought they both brought up very good points. This was informative and enjoyable. I hope to see other almost-intensely critical / engaging videos like this from Dr. Mike.
As a family doctor this was a great conversation to hear bc I was prescribing this medication very grudgingly As I saw it as a crutch. I can see that it is more nuanced now so that allows me a better method of educating and prescribing.
My (awesome naturopath) doctor was more than happy to prescribe it for me. He said it’s truly life changing, and no longterm side effects or negatives. He did insist that I agree to see a nutritionist and get on a healthy eating plan, and gave me a recommendation for a great dietitian. I was so happy that he not only didn’t fight me on it, or shame me for asking about it, but was very excited for me that I had made this healthy choice to improve my life and make a positive l lifestyle change. I think there’s ways to approach it without shaming people, and my doctor did it in such a great way.
This is exactly what I was thinking about while listening to the interview. I'm sure plenty of healthcare providers have a narrow (not meant to offend) view of the medications and patient population requesting the medication, and both doctors here did a great job of broadening that view and giving a road map for bringing patients from point a (wanting to lose weight) to point b (understanding their health and habits) through education.
From a Pharmacy Technician THANK YOU for this interview. Accurate medical information is important, and we just want our patients to be able to get this medication regularly who need it the most. Please don’t abuse these drugs, they help many of lives everyday!
The hard thing to understand is that the plan is not to cure...diabetes, high blood pressure or obesity. Mean while lowcarb/high fat way of eating har reversed all of them, Dr Mike knows, thats why hi was so direct on his observations and questions.
I dont like that people get angry at others for how they lose weight or say they are “cheating”. But then other people are angry that someone is overweight at the same time! 😰
You see a ripped body builder saying “I got like this naturally” when it’s 100% obviously they’re on steroids giving false hope to people just so they can keep their sponsors and sell their bullshit to ignorant people and kids who don’t know any better. I’ve never seen anyone other than crazy fat loving left wing nut bags get mad at someone for losing weight.
@@dustinadair7893 thats not entirely true. Some people will say its “cheating” when people get Lipo suction or bariatric surgery and are completely honest about it.
Most people don't care, in the grand scheme of things, it's just better to be honest about things. If you have worked very hard for a goal and just see people floating through with medication then it can be disheartening. @@Cherry-wf8qv
What has worked wonders for me about these types of medications is the way my brain has changed and is not thinking about food and hunger so much! It is such a relief and a different experience to go through the day without my brain being hijacked by thoughts of food and sugar cravings. This has been the key for me.
That sounds amazing. I’ve struggled with binge eating for about 15 years now and nothing seems to help. I don’t live in America so I can’t get ozempic unless I have diabetes. I had a doctor tell me that I should be glad I can overeat this much without getting fat🙃
Two things: Regarding psych meds, I am on them forever. In order to keep my sanity with Bipolar 1, I will be on them for life... have been on them since 1995 continuously. It will be the same for obesity meds. Diet changes (down 40lbs), Trulicity (down 86lbs), and now on Mounjaro (not weighing often)... I am down 150lbs and am still 100 lbs away from being "just" obese. I have no weight goal; I have met the goals of getting out of bed, not using a wheelchair and walker, and many more personal triumphs. I know there are still more to come as I can _finally_ be alive. I'm 62, did Phen-Fen, had an RNY Gastric Bypass, and regained it all back and more. That I can treat my obesity disease now _forever_ brings me immense joy.
I am so happy for you. I'm a mental health professional and I agree with you completely. Many people with chronic illness stay on medications for life. Many psychiatric illnesses are also chronic illnesses and thus need life long medications to manage it, to STAY ALIVE and hopefully to live a contented life. I don't think a lot of people understand that. I was shocked with @DoctorMike said he tells his patients that the SSRIs he is prescribing are not for long term. I have so many questions about that, and I find it distressing, having worked in the field for over 30 years. You have been through so much. You are still here and moving forward. I was very moved by your comment and I wish you all the best.
@@yukonswimmom thank you so much for this comment. Mike's SSRI take seemed very strange to me. I was put on SSRIs by my neurologist for three months and those were the best months of my life... until the course ended, the withdrawal almost killed me, and my depression came back with a new force. Luckily he then referred me to a psychiatrist who got me on a much better treatment plan. I've been going to therapy and taking my psych meds for two years now and while I still struggle with depression, I feel infinitely better now. My anxiety doesn't affect my day-to-day life nearly as much anymore, my OCD is almost completely cured and I finally feel like a person again... But it took two years of medication and hard work to get to this point, with many setbacks down the road. My doctor told me that only after 3+ months of stable and consistent improved well-being can she start lowering the doses, let alone taking me off the SSRIs completely. You don't just mess with meds like this for a short time and think that the patient will be fine.
Absolutely agree. I have been taking my SNRI for 15 years now and I have reduced the dose many times, and I have relapsed several times even while on medication when my dose was lowered, so it is likely I will need it for life at this point. For me it is a chronic recurrent illness. Having said that, a lot of people with mild or moderate depression who haven't had it before or if it's due to a stressful life event or loss will only need medication short-term, so I understand what he's saying. I'm sure he knows that some people need psychiatric medication long-term, but it's hard to explore the nuance when that's not the topic of the conversation.@@yukonswimmom
@@alinashirinian2485 Agree with you, I think the problem is that these drugs are often over-prescribed by people who don't necessarily have a mental illness but are experiencing low mood because of life circumstances. In which case, yeah, you won't need to take it for as long and can just come off of it when things are better. Whether it's right to prescribe them in those cases is not my place to say, but it's not the intended use.
How can you even be “manic” when your that fat? Just kidding. I’m petty sure psychiatrist just call increasing sedation “treating” mania. Because that is what all the research on animal studies really does is test different ways to sedate rats.
As a medical professional, I find this conversation highly engaging. While I typically lean toward holistic and natural approaches, I do recognize the significance of medications and surgical interventions when they become necessary. With the prevalent issue of obesity in the United States, it's crucial that we explore every viable option to help patients achieve better health, both in terms of appearance and overall well-being. If medications can contribute to improving patients' quality of life, I wholeheartedly support their usage.
I have found this approach most helpful for me as well. The balance of natural/holistic and medicine. I've had numerous medical adventures through the years and this approach gave the best results. I just wished more collaboration were possible on a professional level for more patients to receive the results. May I go so far as to say this...insurance companies cover functional medicine practitioners.
@KreativeKerri There's just not enough quality evidence to support a lot of what "functional medicine" does. Far to often, if there was evidence to support "alternative medicine" then it would just be called, medicine.
@@cathiehealey4608 I understand your point. I'm all for research studies and evidence. With that being said, we are dealing with huge corporations, big pharm, and the like who would loose money if more natural approaches were also utilized. I'm not a huge conspiracy kind of person so hear me out. There is something to the mind-body-spirit(inner self) connection. I live how functional practitioners take a whole body approach. Specialists of different systems have limitations. They may say this could be effecting that but there is lack of collaboration. Also, when dealing with alot of diagnosises, m-b-s can all play a factor. Have a doctor specialized in one system, could they surrender to the idea that the root may be in a different rhelm? I know I'm talking in general hypothetical scenarios. I guess my main point is this. Just western medicine limits the scope of practice. Just functional medicine doesn't allow for enough patients to take part their practice for peer reviewed practice. In my experience, my chronic pain and RA symptoms have significantly decreased when I apply both ways. Its not a 1 or the other. Its an AND.
@@KreativeKerri If they want to be invited to the table, they need to provide the same standard of evidence. I'd hazard a guess that whenever 'holistic' approaches have worked for you - it has been alongside healthy lifestyle changes. The same ones your doctor told you to make but you didn't listen because he was wearing shoes, like a total square. It's the fable of the magic stone soup. It was not the magic stone that made the soup delicious, the magic stone was incidental. It wasn't even supplementary - it was completely unecessary.
@@frankcooke1692 are you asking me did I listen to my medical doctors or ate you assuming I didn't? Just want some clarity before responding. Also stone soup was one of my favorite stories when I was a little girl. You may want to go back and reread this story. You're missing the premise. Your misconception is just a little skewed.
I lost 200lbs by making changes to my diet and lifestyle. I'm at a healthy weight now, and I've maintained that for a couple of years, but it is absolutely a daily if not hourly battle. I am always, always thinking about food, planning meals, working out what I can and cannot "allow myself" or just resisting the urge to overeat. Calling it a job doesn't do it justice, it is just a constant, all-consuming pressure. And the few times I've let my weight creep back up a little, the stress and anxiety it causes is unreal. I don't need to lose any more weight, but I still can't even begin to articulate the improvement it would make to my quality of life if I could just take an injection once a week and not have to deal with that any more.
I hope you can get that peace of mind you seek, but I want to congratulate you on how far you've come! People like you with that fortitude are examples for so many others without knowing it!
I don't know how long that process has been for you, but I reckon eventually your appetite will adjust. I've been trying to lose weight myself. I almost enjoy the project, personally. The meal planning is like a fun little puzzle. It doesn't have to be a chore, there's plenty of fun things you can still 'allow'. Butter Chicken (with greek yoghurt, not so much cream), pesto chicken, special fried rice with garlic soy chicken, chili con chicken, chicken wraps. Those are all low calorie options I'd happily live off. The only thing I've had to cut out are potato/corn chips, beans, nuts and sugary drinks. But then I guess there's still the issue of portion control. I do sympathise.
Totally agree. I would almost trade losing weight just not to have all this food noise in my head. It's that not the weight that impact my life and quality of life.
Do people read food labels in the US? EVerything has sugar in it yet food companies are not called out on this. I reckon most of this obsession with needing food all the time starts as toddlers and it becomes an addiction because of sugar. If one watches movies from the 70's and early 80's the cast and crew are all normal weight, even slim. Everyone. Now I watch tennis matches in America where even the ball kids are overweight. No wonder it's so difficult to stop. It's kind of like in people's DNA by now. I was very against people taking a diabetes drug to lose weight but if it helps people's health physically and mentally and also affects the bottom line of companies peddling sugar in food then I'm all for it.
I have a degree in journalism and I'm so happy with this interview. Great questions, great job holding each other accountable for providing the scientific knowledge to back up the answers. You both created a great road map for healthcare providers who want to use these drugs as a tool to help patients, with perspective on how they should address the concerns and patient goals.
I appreciate that she speaks to the understanding that many people who are overweight are trying to lose weight and their whole world revolves around it. Her perspective felt like my experience was being spoken about. After being 125-130lb my entire adult life, covid added a large amount of pounds that I have been fighting to remove over the past 18 months. Even after diet and exercise adjustments, trainers, and doctors all helping me, it still feels impossible to shed the pounds. I appreciate her empathy and understanding towards her patients
I'm just curious what you've tried to loose the weight? Essentially it does boil down to calories in vs calories out. How many are you eating on a daily basis vs burning?
I have type 2 diabetes and that's why I was put on Ozempic. I'm very grateful for it, except for the side effect of nausea that I experience when my dosage is increased. I just wish that the medication supply would keep up with demand, because Ozempic is my sole diabetes medication and there is an access issue lately. I want everyone who needs the medication to have it, but I do hope it gets prescribed and used responsibly. I really appreciated this conversation.
As someone who has only successfully lost weight when I made it the focus of my life, it feels so validating to be seen! I don't qualify for Ozempic but I do believe for many people obesity is a disease. For people like Dr Mike who are super driven and have the time and the money I can understand why he'd think most people can lose weight through a healthier lifestyle.
If i don't weigh and measure all my food, and count/track every calorie i fail to lose any weight or even maintain weight. That's with working out 2-3 times a week. The only time I've been successful at maintaining weight or losing it without it being a full time job was in high school, particularly with wrestling season where i was doing intense workouts at least twice a day. I felt that full time job comment in my soul.
Yes yes yes!! It does feel like a full time job losing weight! Which is the why the only time I was successful at it was during 2020 when I had so much down time to myself. I feel bad saying it but that was the only time in my life I've ever actually had enough available time to really focus on myself and take better care of me. Since going back to work we have not had the time to do it. I'm exhausted. The way our society is laid out with pushing everyone to work themselves to death just to be able to pay the bills nobody has extra time to take care of themselves.
Absolutely agree most can but it's the unrelenting food noise and craving that makes it so hard to lose and then to keep it off. Turning off the appetite is the magic.
I LOVE that you had Dr. Salas-Whalen on your show! She and I did the Tamron Hall show last year talking about these medications. I was a Surmount Phase I Clinical Trial participant in 2020 for Tirzepatide and I have lost a total of 208 pounds using this medication after a lifetime of suffering from obesity and after losing my oldest sister in 2018 to complications from obesity. Thank you for covering this hot topic!
as someone whose been trying to lose weight since middle school, and haven’t gone through one day of my life not concerned about my weight or body. listening to this video helped me feel better, after many doctors telling me to just “lose the weight”
I got a gastric sleeve 29 days ago. What made me decide to do it is learning about how it changes your biology in a way where you'll prefer healthy foods and that obesity is not my fault. I used to blame myself for being fat and that made me indulge even more just to get a "high" from food.
Im of average to skinny build and my sister was born overweight because of pregnancy diabetes. We have the same diet but she has a bigger appetite and eats faster and I’ll admit I eat very slow so I understand how restrictive it would be if she tried to have my habits. I comment because I feel for you and how much time you spent worrying. I just wanted to share that I could have been in your shoes but wasn’t because of chance. But I still worried in my life about other things in my appearance or just in general. So yeah my conclusion is we often find our self worrying no matter who we are.
I'm on Zepbound for PCOS. I used to get so hungry I would cry. I could never eat the right amount of food to keep me full no matter what I did. My relationship with food was so damaged. I was depressed, in recovery from an ED, and suffering every single day. Most of that went away with the first dose. I got useful hunger cues for the first time since hitting puberty. I'm not afraid of food. I'm not afraid of what my body will do if I eat. I have more energy, I have more brain space, my depression is gone, and my ED symptoms have lessened. The relief is immeasurable.
@@elle.grey2 Not with Zepbound. I lost a lot of hair with my eating disorder, but it fully recovered from that. Hair loss experienced on Zepbound is related to malnutrition, not the drug itself.
This was a great discussion. "If it's not the easy way out, why are so many people asking for it?" is a great question. I can say for me, hearing that people on Ozempic were not obsessing over food and actually feeling full/satisfied was such a huge part of why I considered it. Obsessing over food/diet is a full time, soul crushing job. I do still think about food, but, often not in the same obsessive way. It's maybe a more thoughtful approach? It's hard to explain. But it's like depression meds- they didn't just make me happy. It was a subtle change that allowed me to actually function. Anyway, I don't see it as an easy way out, but it does help with some of the mental/emotional anguish of dieting and I don't think that's a bad thing.
She was wrong, it is the easy way out especially when comparing to only focusing on diet and exercise. But hey that's okay, easy is good for some as a start for short term. I agree it's definitely not a bad thing.
Yeah the "easy way" is not always bad. Life can be hard enough. I had to manage my mental/neurological issues with didciplined Lifestyle changes because I reacted so bad to most medication. I can do it but it us hard work and timeconsuming. I don't begrudge anyone for whom antidepressants and stabilizers work. Why shouldn't they take a shortcut? There are few enough in life. And if you Don't get your life together afterwards they will stop working anyway. We are all so averse to the idea of getting help.
Obviously it is the easy way out but you have to consider that some people have a harder time to begin with. There have been studies that say that addiction has a genetic component. Also people with ADHD tend to have a disregulated relationship with food. So just dismissing semaglutide as the easy way out without considering the increased difficulty for some people of actually following a diet and maintaining the lost weight isn't very fair.
Ozempic and these other weight loss drugs are not going to solve your weight problems if you are morbidly obese like I was. It will help a lot in the short term, but your body will become used to it and your appetite will come back a bit. It still helps, and so I am not saying not to take it anymore. It will help with the diabetes for sure. However, you will need to eventually start eating healthier. I have been in Ozempic other weight loss medication for over a year now.
Dear Dr. Mike I know you will probably never see this or respond to this but I wanted to tell you thank you for helping me get through the rough times in my life! You truly have one of the kindest souls ! You are truly passionate about helping people and making sure your patients get the right medical treatment. You are so amazing, kindhearted, passionate ,honest and just want to help people “stay happy and healthy” you truly care about people knowing the actual accuracy of medical stuff because you know TikTok is not very accurate. I truly have so much more from you than my years is school. You actually helped me pass science so thank you! I actually can use the stuff you have taught me in your videos in my life instead of learning stuff I will never use in my life like math. Again thank you for everything you do you are truly an inspiration for many kids and adults! I actually either want to be a doctor or a veterinarian when I am older. I am currently a high schooler who has no idea what to do with her life 👍Keep up with what you’re doing “as always stay happy and healthy”
My daughter had struggled since childhood due to genetics from her dad's side, now in her 30s she follows diet excercise and ozempic and for the first time I see she finally no longer struggles but she does excercise daily. As a mother, her pain was mine. This is a great conversation. Stay positive. Blessings
She seems just like dr. Mike to trily care about her patients. I love these interviews and the passion i see for what they do. Grateful to have doctors like them in our world.
Wow! I was put on OZEMPIC for borderline diabetic. I was amazed when the weight started coming off. Insurance stopped paying when my levels were back to normal. I continued with the compound semaglutide. I personally don’t think it worked the same as OZEMPIC. Different insurance now and back on OZEMPIC. Goal was to loose up to 100 pounds. I’m down 80 pounds currently. She hit home with great information. I wish my doctor informed me about muscle loss and protein intake. The other thing she hit home about was, as you lose the weight you feel more comfortable. I’ve currently been going to the gym since November of last year. And I started taking protein shakes daily. Thank you so much for this vlog.
It’s refreshing to see two highly intelligent professionals discuss a topic involving controversy and using evidence based medicine to guide their decision making. I was initially skeptical about the direction of the conversation but I found it to be very informative without much of any biases.
Thank you for doing this interview. Dr Salas-Whalen is amazingly knowledgeable, and she hit some really important points that I think bridge the gap between patients and doctors, such as when she emphasized that people with genetic predispositions can't always lose weight with lifestyle changes, and it in fact those changes might make it worse for them. I think that fact alone is a core driver of conflict on this issue, along with the idea that people who need to lose weight to be healthy just "aren't trying." I've known several people who have excess weight run in their families who tried all kinds of things, and end up just wanting to love themselves for who they are because they believe that their body won't change. Because without medication, they're probably right about that. Because self hatred can lead to eating disorders which could have even worse health outcomes than just living with obesity. Because their EDs can impact their future children. Obesity doesn't run in my family, but my mother developed it after struggling with an eating disorder as a teen and young adult, and I've been overweight all my life no matter my lifestyle, thanks to epigenetics.
I think I find it hard to emphasize with the genetic predisposition argument rather than lifestyle. Anecdotally my mother and I are the only ones in my family who are not obese. Seeing what other family members eat, and how inactive they are I know for sure I would be in the same position with those habits. Further my siblings and I were always in shape as children. My sister stayed with our Father for a year and gained 10kg as a 12 Y/O, the only thing that changed was poor food choices. Then she came back and slowly lost the weight. Within a year of her and then later my brother leaving home they sharply shot to obese levels also where as I maintained my weight, the difference was 90% of my diet was healthy choices, where as their pantries were stocked with lollies, chips and constant take out meals, or simply really really big meals. This is the same situation with all my extended family members who are overweight. I did develop poor habits over COVID that honestly took months of self control of fighting junk food cravings from those habits until they finally died down to the point they weren't an issue. Not only that it took a few weeks for simply the base hunger to die down after moving my overall consumption back to what it had been for a decade prior to COVID. I guess this leaves me with quite a bias as I know that at least in my immediate family that everyone that is obese is obese purely due to life style choices.
100%. I've tried everything, eating healthy, working out for over an hour almost every day, and for most of my life I've been overweight. I finally got prescribed ozempic this week and looking forward to trying it.
@@PaulFilmer The part you're missing is that when obesity runs in families, it gets passed on to children. I was raised in a family where exercise didn't occur. My parents didn't exercise and didn't encourage us to. When you're someone who spent their entire childhood not exercising, it is so so so difficult to motivate yourself and get into a good habit when you're an adult. I HATE exercise. If I had been encouraged to as a kid, I likely wouldn't hate it so much AND it would already have been part of my routine. On the same hand, parents who are obese don't tend to feed their children healthy foods or promote healthy eating habits. I grew up eating a lot of processed foods and was modelled eating when bored and not eating healthy snacks and not knowing when to stop eating, all habits I STILL have in my 20s because they were developed as a child. That said, I obviously know what foods are healthy and try to eat healthy as much as I can, but you can't ignore the fact that habits you developed and followed for 18 years aren't exactly easy to just break. So no, it's not all about choice. My entire family is fat, that's what was modelled to me. Have some compassion for those people who behind closed doors are probably struggling with the same things I am, you just have no idea. I also have PCOS which I choose not to disclose to the entire world. You have no idea what medical conditions your family members might have. Also, no one cares to hear comments about our bodies from people who have never struggled with weight. Congratulations. Be thankful.
I have to respectfully disagree with you. It runs in families because families live similar lifestyles. They eat the same foods, they work at about the same physical level, etc. If a family for recreation sit down and watch TV yeah they're not gonna have a healthy lifestyle. If they go out for hikes and family workout competitions for recreation they're gonna look different. We are what we repeatedly do. That's how it is. Now, if you wanna watch TV and eat pizza and be fat, then by all means, do it. Be happy with your decisions. Just don't blame other factors and look at things objectively.
@@Sandikalthere are some of us dietitians who also do counseling but there are not enough of us or as many specialists at it to recommend for the general population. For long term behavior change, lifestyle psychotherapy is very effective but not all dietitians and not all mental health professionals are trained on the niche. Many people benefit from talking about their eating habits with a counselor or dietitian weekly or biweekly or monthly. It is very inexpensive for insurance too compared to complications.
@@Sandikal Is that a good thing or bad thing? Because they both agree diet and exercise is still the way to weight loss/healthy body. Difference? Dr. Mike leans less on medication, and Dr. Salas is more likely to lean on medication.
Came here to say exactly that. Through the entire conversation you could tell he wasn't convinced, even though he tried to hide it and was very polite about it. Disappointing when you have such a renowned specialist on the show.
I had a doctor (coworker) tell me that only BMI mattered. We were talking about body composition tests, and how I lately had been feeling ill, like my body was telling me I was fat even though I do not look fat at all. I was afraid I was developing insulin resistance. When I did the body composition test and felt so validated when it showed that my muscle was very low and my fat was very high and mainly visceral. A true example of skinny fat. I had been doing cardio and wasn't losing any weight. Now I understand what I needed was to gain muscle mass and that that would lower the visceral fat. So I have increased protein in my diet, lowered my carbs, and started weight lifting. I have lost 3 lbs in the last 2 weeks and am starting to feel better. Sometimes you have to listen to your gut and study. Maybe don't listen to the overweight doctor who tells you that you're OK if your BMI is fine, even if you feel sick.
Glad you are on the road to health. I'm a firm believer that a person is their own expert when it comes to their own body. Way to go for feeling better, I hope it continues in your favor.
@@pbandjedi5006 Thank you! Increasing protein and reducing carbs has definitely made a difference. But trying not to rely solely on that, building muscle is just as important.
Most experts consider bmi to be kind of crude becuase on women you could have a healthy bmi but too low of a body fat to get a period if they are really athletic.
She gets it! I lost over 100lbs, and am starting to back slide pretty badly with binge eating and I have lost the motivation to continue to exercise. It was SO mentally taxing and it took up my entire brain space. It was a full time job!
Maybe reduce the amount of time you spend exercising, but always remember how hard it is to lose weight as compared to trying to maintain it. And it’ll not be just about looking fit but also your mental health and how you view yourself. So if at all possible try not to lose the motivation, don’t go as hard but don’t fully stop because once you all that effort is gone. And starting that process for a second time is tough.
Exercising can be simple, walking down the block, it can be fun, jump roping, it can be calming a long yoga or Pilates TH-cam video. I don’t think you need to start with really hard workouts or weights unless you feel ready! You can do it!
Also I’m not sure if this is healthy but if you did nothing all day, remind yourself your body doesn’t need extra energy in the form of food. Maybe snack on some healthy things like cheese or nuts or fruits and vegetables. If you had a long day where you did a lot mentally or physically then your body will need more energy in the form of food. Gotta be mindful and that’s the hard part and we’ll as self regulation
Get on the drug and stabilize yourself. No reason to go through that again then work to get off and only go back on to stabilize. Very simple actually but I am sure there are many who will say just use will power. That’s BS!! Good luck.
Mike says, “If we could put people on 150 minutes of moderate exercise a week, put them on the appropriate caloric intake for their healthy body weight, they would all get there.” I am fortunate enough to work out with a personal trainer twice a week. I can afford to buy a lot of fresh produce and whole foods which I prepare mostly at home. I don’t drink my calories and try to prioritize protein and fiber in my diet. I also have a BMI of 35. When I try to reduce my caloric intake, all I can think about is food. It becomes an unending, obsessive misery. And I’m not eating more than I did when I was at a normal BMI, but after having a baby 3 years ago, entering my 40s, and grappling with chronic pain, it’s a lot more complicated than 150 weekly minutes of exercise and making better nutrition choices.
I am going to say something a bit mean, but true: He is right, and you are wrong. Energy is energy, and if you eat less than you spend, you are going to lose weight. Having a baby doesn't change this, in fact, nothing changes this. This is objective, UNDENIABLE fact. I am overweight myself, and I know what it feels like to just really want to eat. Ultimately however both you and me are in control of the hand that grabs that fork, and we CAN command it to put the fork down. Ultimately, it is a question of willpower. There is no two ways about it.
It’s not just willpower. That’s insulting. So many things come into play. Environment, hormones, and micro biome are the primary non-CICO factors. Saying that it’s just willpower is speaking from privilege. Willpower only takes you so far. Habit is essential.
@@katherinegallousis4395 None of those discount CICO whatsoever. Habit is formed through your actions, aka willpower. I don't see how that is insulting, it's not a personal insult toward you to if I tell you correctly that you have agency in this world and are able to influence your life. You only take that as an insult if you feel I am making a value judgement of you when I say it. I am not. I'm just speaking the truth. I am overweight myself, and it's not easy to lose weight. But it is possible, and it's MY FAULT if I don't. I can put the fork down and go for a jog. So can anyone else.
This is the way all conversations with opposing points of view should be done. Both sides have common agreement but being able to be mature and respectful about it the opposing points is what we are losing. This was intense to watch and educational. Learning is a journey.
She is incredibly knowledgeable and extremely compassionate. An effective doctor cannot be one without the other. ❤ I'd go to her for help with my obesity and binge eating.
Ozempic changed me drastically. I grew up healthy and active, part of search and rescue, and eventually came to the point where if you couldn't find me then you need to look at the map in my bedroom because I will leave instructions there. But when I got pregnant I went from 170-180 and usually 100-120lbs of muscle to 155-160 then to over 300 and then with stress of life and other issues mixed in and loosing weight regardless of exercising, healthy eating, and dieting programs. I was in the process of figuring out how to have a gastric bypass (I can't meet the apnea machine requirements because of a child trauma) when my doctor mentioned Ozempic. I have been on it since the start and it changes my brain chemistry so I am not hungry all the time and because I am not constantly thinking about food I can meal prep better, I am eating smaller amounts and I've lost about 100lbs. I am super happy I did this route and it was open to me because I can get to the old me and not feel stuck.
Extremely well explained. I’m sharing this video with my doctor. She has been amazing with explaining this medication to me and working with patients and obesity. She will love to hear this interview. I’m thankful I have an amazing doctor who takes the time to talk with me.
Im glad she touched on bmi, im tall and relatively muscular and my bmi is nearly overweight but my body fat perfentage is normal and my waist to height ratio is nearly underweight. Ive struggled with eating disorders in the past and a doctor telling me i need to lose weight despite being the healthiest ive ever been because of just one measurment when all the others are great would break my heart.
The closer to the normal range of BMI you are the less useful it is. If you are someone well into the obese range it is very unlikely that you are not carrying around a lot of extra fat. However, Mike is right that it is typically people who are more muscular saying they don't like that BMI calls them overweight for example. At that point BMI isn't a useful tool. As she said focusing on muscle and fat percentages is far more useful at that point.
Same. I'm tall and a size zero but I've always been heavy. I can't possibly lose more weight without being a skeleton but my BMI is high. 🥴 I stopped allowing them to weigh me.
@@jenniferlawrence2988 I got lucky and have so far had nice doctors and PAs who have noticed my discomfort at my weight and taken the initiative to reassure me that I'm healthy despite being right on the line of overweight. I hope that luck remains. It helps that I look like I'm in good shape and I'm young so I worry that with age, I may have bad experiences.
I'm on a GLP-1 medication and I think the biggest benefit that a lot of people don't talk enough about, and I wished she had of spoken to, was the feeling of regaining control of our lives. The brain trigger of satiety and being able to stop, or walking to the pantry, looking around and deciding, no I don't need anything is remarkable. We, as obese people, for various reasons, have lost a healthy relationship with food, in a multitude of ways; choices, quantity, time, shame, etc. That feeling of figuratively, and literally, of being able to push the plate away and saying, "I've had enough" is a massive step forward to regaining control. That feeling of control, leads into other things, deciding to go to the gym, deciding to go for a walk around the neighborhood, deciding that when I'm at Moe's, I'll get a bowl instead of a burrito, because I would rather have a few chips for carbs, than the wrap. It all adds up. That feeling of satiety is incredibly powerful, and one we lose because the food industry is poisoning us. It's so powerful, that there are now studies that are showing people are stopping drinking, smoking, or other harmful drugs. It's incredible.
I am 61 and have never had problems with my weight. Now that I have gone through menopause I have so much trouble losing weight. I go to the gym and watch my diet. I’m only 35 pounds overweight. I’m doing all I can. Dr. Mike, not everyone is sitting on the couch eating junk food. I continue doing my best and nothing is happening. Sorry I don’t live in your perfect world. Your gust is a very awesome doctor who really cares her patients!
Exactly. After losing 150lbs, I spent so much mental and physical energy on keeping the weight off. Fighting with cravings and food choices for 4, 5, 6 years is so draining. My brain fought me every single day. Those horrible intrusive thoughts of "oh just one bite" and you've eaten a whole cake...it was the worst mental fight of my life. After experiencing hypoglycemia, I tried semaglutides and suddenly that mental fight was silenced. It was so sudden and so relieving. I really want to emphasize how insanely difficult food addiction is to battle, and it was absolutely miraculous to me when semaglutide somehow turned my brain back to a normal, non obsessive muscle. Dr Mike may have opinions on obesity, but the mental fight is something difficult to understand if you haven't experienced it.
I enjoyed this conversion, I am surprised however to not have heard any mention of access. The lack of insurance coverage and the high cost of these medications are barriers for most people who need this help.
Love you turning this around on her to make sure people know they still hold responsibility over there choices❤the reason why people don’t get the satiation response is because most of what’s consumed in the place of food is not real food. It’s all condensed calorie bombs, low fiber, low water, so no real feeling of fullness until it’s far past the need. Our bodies want vitamins and minerals, not just macros. ✨
3x board certified Queen Dr. Rocio Salas-Whalen 👑 She speaks facts on so many different levels, to emphasize and understand now a days is such a hard quality to find in a provider! I have such a crazy weight loss history story that it’s too much to write, but everything she said YES! ❤
As a clinical pharmacist, I absolutely enjoyed listening to this episode. You gave viewers who are not in the medical field the many different point of views as to when weight loss medications should be incorporated. I would agree that I would not be offering them to everyone suffering with obesity to help “lift the responsibility off their shoulders.”
This was very informative. I'm on ozempic due to needing help with weight loss and diabetes control. My doctor never mentioned the topic of muscle nor protein in take. I am going to mention this to her. Maybe she's unaware. Thank you for having this conversation.
Well done you, take polite charge and question as you learn. I do hope your treatment goes hand in hand with the lifestyle choices you are facing. Embrace them. It will be better than the meds. Good luck, you are the biggest part of the treatment and success.
Honestly same here. They never said anything about muscle loss to me and boy did I notice after a few months. Also my doctor was disappointed in how much I have lost from my first appointment after taking ozempic to the next. I was like umm you do realize I have lost 30lbs in two months. I have another appointment next month with him and I will be bringing this up.
That makes me nervous about the muscle loss cuz I am big enough and not mobile enough and in pain to work out at this point. I will be able to hopefully after I've lost a bit more.
I feel like this discussion really skirted around the issue of eating disorders. It talked about people on extremely restrictive diets, people who just wanted to lose a few pounds for aesthetic reasons, people who'd been trying diets since childhood, irresponsible providers...but never explicitly mentioned eating disorders. I appreciate that they discussed the importance of losing weight in a healthy way, but it was mostly framed as being because these unhealthy ways of losing weight will "fail" or are unsustainable, rather than having serious health consequences. I didn't know that losing weight too quickly could cause gallstones until after I found myself screaming in pain, barely able to crawl across my apartment to unlock the door for paramedics. Not to mention things like micronutrient deficiencies. I think it's important to screen patients looking to lose weight to see if they have a history of eating disorders (especially restrictive eating disorders) or are at a high risk of developing them.
this medication has all but cured my ED. having the food noise go away had given me the control my ED was faking. the food noise doesn't control my life. i had soo much brain power i upped my therapy to twice a week to try to handle this in a healthy way. this is the most powerful ED tool i've ever experienced and i'm a black belt in that stuff now. ;) coupled with therapy, this will help soo many people struggling with food=soothed trauma.
I have to say props to this lady❤️ I have struggled with weight all my life and I am so happy that she is informing people that we do try! We Think about our weight every single day and we Dream of the day where we can take charge and truly have a healthy lifestyle… but losing like 50 kilos is A LOT! And it takes years and years to Reach that goal. This was a good discussion and I am now considering wegovy❤️ Thank you for Sharing!
I started taking Wegovy in March and have lost over 60lbs. The problem now is there is a shortage. You have to take action to help with the weight loss. You can't rely on the meds and think it'll fix you. I'm the only person in my family that hasn't had a stroke, so I am constantly worried about weight issues
As soon as I saw that all of these celebrities (Oprah, Rebel Wilson, Adele, Kelly Clarkson, etc) who have tried every other diet are now within normal weight ranges, I knew something new was going on. If those wealthy people with all of the connections in the world, and access to the best dieticians and trainers available, and the motivation of public shame couldn’t do it in their own, what chance did I have? After 20+ years of steadily gaining weight, and only keeping weight off for a few months on Weight Watchers and fasting and various other diets, I finally decided that I don’t care about the people who say disparaging things about it being a “crutch.” If it works, why am not allowed to stave off type two diabetes and get healthier and happier? Why should I have to wait until I’m actually diabetic? I’m not Kim Kardashian trying to get into a dress that’s way too small for me. I’m a person who has mobility issues due to weight, and is finally seeing a light at the end of the tunnel. My doctor did require that I see a dietician and get on a healthy eating plan as well.
❤Ah! Can't leave a comment except below someone else's. That's ok. Anyway, I love the guest doctor! She's covered everything and made sense---very holistic and compassionate toward the real life long suffering many of her patients have endured. Her overall genius is impressive to this humble licensed Health Science educator. Dr Mike's brainiac and seemingly cognitive empathy and overly emphasized need to get patients off of SSRIs is bothersome only in that doctors who seem anxious, a little touchy, and controlling are often condescending to the "poor medically uneducated" patient. They tend to hide their blame of the patient, but it seeps out in their attitude, just as in this conversation. Contrast the guest to him and it's day and night!❤
@@deanaburnham9571 Well at least someone replied to my comment :) But yeah, TH-cam is weird and just makes comments disappear, or won’t let you make a new comment. I kinda hate how they sort of shadow ban, or light shadow ban, all of us for weird reasons. Like oh no this person is commenting a lot. Better block them.
Oprah hosted a 1 hour special on ABC in March 2024 called "Shame, Blame and the Weightloss Revolution" after leaving Weight Watchers, talking about how happy she is taking glp-1 (she didn't name the medication). It was very unusual for me to hear that she always heard food noise before this, tried losing weight by exercising, diets all her life but nothing worked until now. Myself I am considered obese now, having gained weight slowly into my menopausal years at age 60. Would I take Ozempic? Not yet. This interview was the best, and thank you both for having this for us all to watch and learn. So many questions I had about Ozempic were answered. It will be interesting what the US will look like in 10 years with this being popular now.
I have been obese since childhood, and have extreme hormone issues. I am using no drugs to achieve similar outcomes of the drug. I went to a health retreat for a week where they eliminated sugar and gluten from the food, and showed me ways to eat that are vegetable heavy, and ways to move that help digestion (eg short bits of exercise, multiple times a day). The weight loss is slow but happening. And I’m changing my ways and feel that I can maintain it. I am listening to my body and I’m giving it foods that do not spike my sugar levels, so I don’t get as hungry. And I’m learning to enjoy cooking and eating vegetable and protein based meals. Many people who are bigger have lost weight like this. I’ve met them, and they gave me hope. It is possible, and you can do it. Some of these people who are bigger than me do intermittent fasting where they don’t eat breakfast, so they fast overnight into the morning. And another one is doing what I’m doing - cutting out breads, pastry and white carby, glutinous foods. I also exercise daily, doing activities I like to do. I’m doing it - you can do it!!
Thats awesome! Keep it up. The world is setting us up for taking a easy way out but it's costing our health. It ain't easy but you're doing the right thing.
I hear her saying that most patients will never get off of these drugs once they are on them. And then in the next sentence she says that she always talks to her patients about getting off of this drug at some point. HUH?? I think our society has gone off the rails when it comes to the conversations that we need to be having around healthy lifestyles. We are always looking for the quick fix. Thank you, Dr. Mike for the conversations you are having about this.
I really appreciate how she mentioned contributing factors to obesity and how putting all the reason and responsibility on the patient isn't helpful. She worded that beautifully, and her understanding and empathy show that she cares about her patients' wellbeing.
I opt'd for a gastric bypass. It was the best thing I have ever done for my health! Diabties,acid reflux gone, sleep apnea better.This along with diet and exersice is a great option. I feel better than I have in years! I am happy to hear that there is a push to stop using BMI as an indicator for being over weight! Also the procedure is done using laparoscopy surgery, recover time is much less than in previous years. This was a really good interview thanks @Doctor Mike. Also whatever option you choose never let anyone convince you that you are taking the 'easy way out'! I should also note that here in Canada there is a year long process with a dietation, Dr, and psychiatrist before you are approved to have the procedure.
There's nothing easy about gastric bypass. Like these drugs, it's a tool to help you get to a point where you CAN put in the work. Congrats on your success and getting to a healthier you!
I wish I could have gotten that done. I have rare genetic diseases that cause bleeding disorders, so he said I would probably die on the table. I spent hundreds of dollars to find out that I couldn’t get it. I had two family members that got it done. One of them did fine, and she kept most the weight off. The other one had a major issue right after surgery, they put him back under the knife, to correct it, but he came away with infections, and annul issues. It almost killed him. I hope you are able to find peace and happiness, and stay healthy for the rest of your life. You are worthy of good health!!!
Is about changing your habits and outing in the work.. Otherwise yiu just balloon back up.. Because main issue was not adressed but quick fixed. It happened to my aunt and many other people. There is no real shortcut here
I’d rather try a drugs first than cut up my body to make that work as that is permanent and still can have issues come back. My endocrinologist warned me that with my GERD gastric bypass was not a good idea as well.
Dr Mike, you responded to your guest saying she doesn't see lazy obese patients by saying you do. But in your explanation you point out that the ones you see that are the couch potato type aren't coming to you for weight loss. That's the difference. When people seek out a specialist for weight loss they are trying and have been trying to lose weight for a while.
Or they were just referred to a clinic like hers from their primary care doctor who wants their patients to work on their obesity. She has her own perspective, but his is not at all invalid.
Interesting discussion. I do think Dr Mike asking the questions about putting more responsibility on the patients versus giving them the point of blame being “genetics” etc is very valid… we do need to continue to emphasize that disease may not always be your fault, it is your responsibility to manage if you wish to give yourself the best chance at a good life.
Thank you for doing this interview. I’m on week 9 of Wegovy and steadily losing about 2 lbs per week after being obese for 3 decades. I’m down 21 lbs in 2 months, my side effects are minimal, I feel great and I’m so excited and motivated to keep going on my weight loss journey. In the past m, I’ve tried fad diets, diet pills including OTC and Rx like phentermine, weight watchers, and nothing worked long term or I couldn’t stay with it over the long term. I feel like this med is helping me change my life, exercise and eating habits. I feel like I can have success with this long term.
I love how you also talked about patients getting into SSRIs. It's reassuring that there's a possibility of weaning off of it and there are real patients going through it too. As much as I love taking them, the fluctuations in my weight is something I would really love to not have.
Really Appreciate her! I am Not perfect as an eater. But I do get my fruits & veggies in & I do moderate exercise in. As a single mom w/Professional job I am Often Exhausted mentally & emotionally & physically. Yet I am Overweight. When I was younger And had High cardio my weight was muuuuuuuuch better. But as a single mom I Truly do my Best. Society is also against us being healthy. Recognizing me personally doing My Best + a bit of help could be all I need.
I lost 40lbs on wegovy and loved it! People who want to say people "dont need it" need to remember, they don't have access to other people's blood work. Their anger might be misplaced 😉. As always, consult your own doctor and refrain from diagnosing strangers 🤗
If it's necessary, like say your metabolism or any other sickness keep you from losing the weight with sport and a healthy diet - and I mean like balanced, without starving yourself, I think it's fair. However, there are probably many people thinking it's the easy way out, like Dr. Mike said. Those people are not only taking those drugs from the people who actual need it, they are kinda responsible for all the fake drugs going around. And those are literally deadly. They even end up in hospitals, even in Germany where I live. It's crazy.
Preach! I’ve been ripped to shreds for using ozempic but I’m disabled and unable to work out. Being disabled so suddenly I gained so much weight. Not everyone has the capability of just “going to the gym”. I’m so glad you had success.
@DrBeauHightower It's funny because I'm a fan of your channel and see your comments on so many videos. I think we have very similar interests. I've your comments are probably 50-plus videos. It's nice to see I'm not the only one scouring the deep reaches of TH-cam.
Interesting was certainly one way to put it lol. I’m alarmed that the answer to our nations obesity problem is long term drug use. Our society as a whole is the issue.. the fast food around every corner, the preservatives in our foods, the portion controls, our overly stressful lives, mental health issues.. on and on . There are so many smaller things that have contributed to this problem and I’m so alarmed that her answer is to medicate almost every single person that struggles with weight. I just don’t know how I feel about this. I’m no expert and she’s much smarter than me haha but something about this doesn’t feel right.
@@jimkazetsky5897why is there very little discussion on this about neurology of obesity. The emotional system..we live in a culture of emotional sedation of trauma absorbed in innocence as children, sticky safeness. Motivation is talked about..there is an acceptance about not enough time. So either the model changes or start to regulate psychology opened out to therapists but tracking of outcomes by their regulatory body & patients details given to the regulatory body as results survey.. we have get away from feelings avoidance the toxicity of don't cry ideology prevalence in traditional masculinity leading to higher suicide rates etc..we can run away from the emotional system & deny it's importance. But it is the seat of decisions.. it's time ethical medicine graphs this can learns those modalities to employ with patients in the conversation with mp3s part of the audio prescription to enable emotional resolution.
I’m neither alarmed or surprised, the government has always rewarded poor behavior. Unfortunately, it’s become my expectation that these incompetent politicians do not have our best interest in mind.
Oh Dr. Silas, you sound just like my doctor and my doctor has been such an angel. Thanks to her. I have been able to successfully keep weight off although I’m still very much on my journey. I’ve had so many doctors believe that I just wasn’t trying hard enough so thank you for this. It’s people like you that are going to help people with obesity have a much better quality of life
This was such an amazing interview, as someone who has lost 21 KG from April to this day (around 47 pounds), the take she has is the same my nutrionist had, and it's been an amazing journey, not killing myself with strict diets yet putting up in the gym with weight training, I do not take any medications yet I feel amazing!
Damn I feel like I could have written this comment myself. Made some changes to my diet (cut Fats and Sugars, increased protein and fiber) reduced calories to 2200, 35-40% carbs and protein, and 25-30% fat, working out for an hour 6x a week and down 45lbs.
As a person who is a healthy weight I always looked negatively at ozempic. I do work hard to keep myself a healthy weight and have never been overweight. This conversation really changed my outlook. In the end it doesn't matter if it has some side effects, the side effects of being extremely overweight are much worse and this drug gives peole back their lives, which some have not ever even had before. Who cares if it's 'cheating' or 'an easy way out'. If it's for a fulfilling life, people should do it!
I’ve struggled with weight my entire adult life and the ONLY time I’ve been able to lose significant amount of weight was when I went on a very low calorie diet, like 500 calories a day. It was mentally and physically exhausting. Naturally I gained it back once I stopped torturing myself. I prefer a Whole Foods diet, with little to no processed food and I still gained it back. I started this medication just a few weeks ago and I can attest the reduced “food noise” is a game changer. I eat significantly less but I’m not always thinking about what I’m allowed and not allowed to eat. It is actually the opposite. I know I need to get maximum nutrition in my meals because I eat so much less so I my meal choices are based on that and not on calories.
I think about food 24/7. Even when I am focusing on other things, there is constant food noise. The way she describes this struggle is a huge eye opener for me, to know some doctors really understand the struggle. Great podcast.
48:16 "I have yet to meet the single patient with obesity that is the couch potato that we have the picture of." So refreshing to find a doctor that sees this, and believes that sometimes, you can have the perfect lifestyle and STILL not see the results.
I can promise you most obese people do not have a perfect lifestyle. All the obese people I know are inactive and eat junk. But yes, there are exceptions to the rules.
For me, loosing weight was so absolutely impossible because my depression made it so difficult. I would eat just to cope as an alternative to self-die. And when its either suicide or obesity I suppose society moves you in the direction of fatness.
More people need to realize that those aren't the only options, and we should be moving away from the quick fixes whether it be pharma, food, drugs etc. I know it is easy to opt for those but solving the root cause is much more beneficial even if it is harder in the beginning. If you know the reason for putting on weight, or difficulty losing it, then you are ahead of most.
I think mental health is a really important factor in this conversation. It sounds like you have been through a lot. I'm glad your here. I hope you are getting some support!
This is not just one person. I am in the same situation. I could maybe take drugs, or drink alcohol or cut myself instead of overeat...but that would made it all even worse. Why don't I go the a therapy? I wait for over a year now to see a therapist. The waiting time is long where I live. The obesity problem is a symptom of mental health crisis all over the world.
What she talks about at 6:55 was EXACTLY my experience. I was "skinny fat". Overweight but didn't really look it, struggled with binge eating my entire adult life, and initially sought Ozempic/Mounjaro because I hated looking at myself, and for health reasons. Eventually, my whole attitude about myself changed after losing just a few pounds and feeling more in control of my food choices. I've been going to the gym regularly, making healthier choices (not just eating smaller amounts of junk), and EVERYTHING about my life, both personal and professional, has improved.
I LOVE the conversation about whether it is empowering or disempowering to believe you have control over your condition. I have stage 3 endometriosis which is obviously an incredibly complex disease but because it is an inflammatory condition, reducing stress, avoiding inflammatory foods etc. can seriously reduce symptoms. For some reason though, I've seen people with my disease get SO ANGRY when anyone suggests that making changes to their diet or lifestyle may help. To me, the thought that I was 100% at the mercy of the healthcare system when my disease is severely under-researched, under-diagnosed, and misunderstood was terrifying. The thought that I could make changes to my lifestyle and see symptom relief was so freeing to me but to others, suggesting that anything other than surgery and hardcore medication could help them was an insult. My theory is that by accepting that your choices can help your condition, you also have to accept that your choices may have been worsening your condition, which is a tough pill to swallow. We can't all know what's right for our bodies so there's no reason to feel guilt or reject medical help even if our choices do lead to disease. I hope we can get to a place where there's balance.
Part of the problem is that the normal rhetoric around obesity isn't just "your choices have had an impact on your weight". It's usually "it's your fault you got this way so just stop and you'll get better. Why haven't you stopped yet? Just do it." But there is a very dangerous allure to the idea that if it's not your fault then you have no control and may as well just eat whatever you like. Like you said, reality is in the middle. But honestly I think our society as a whole doesn't do middle-ground anything any more. It's all extremes.
People get angry because that's a half step away from patient blaming. I have chronic migraine, for instance, and people are always like, reduce stress! Eat better! Drink more! Etc etc. That may help me avoid a migraine here and there, but the fact is that I have migraine. It's a neurological condition. It won't disappear because I drank enough water, and it's insulting to imply that it will. There's this idea that healthy people have, that they are healthy because of the choices they've made, and unhealthy people must have made poor choices. It doesn't take into account genetics and basic biology. I'm glad those things help you feel better- that's great, keep on doing it. But keep in mind that what works for you may not work in others, or it may not be feasible for them for whatever reason.
@@misschanandelerbong7946 oh I'm not at all saying that lifestyle changes will cure a disease. I still needed major surgery when my disease led to a burst cyst and sepsis, no amount of stress-reduction or changes to my diet would fix that. And I completely understand (and have experienced many times) that many medical professionals don't have the empathy or understanding to make lifestyle suggestions for symptom reduction without blaming a patient or minimizing their pain. All I'm saying is that I think it's an interesting conversation and that I do believe there's a way to give patients recommendations in a way that feels empowering and gives them some control so that they don't feel like their diagnosis means everything is hopeless. Migraines suck, I'm sorry you have to go through that!
@@OldSchoolLPsGames Absolutely agree! In my experience, a lot of medical professionals haven't found that balance. They either think it's a joke that lifestyle or anything outside of medicine could improve your quality of life, or they're at the other end of the spectrum and won't even investigate your symptoms because they assume the problem is your weight or the fact that you smoke etc. Any productive path forward needs to include taking patients seriously and actually investigating symptoms. Even if, in the end, a lifestyle change would help, that conversation needs to be approached with empathy
This definately helped me examine some of my biases about weight loss. My primary concern for most patients is poor nutrition with reduced food intake. Just because patients decrease food intake doesn't mean they are eating healthy and I am concerned about the nutrient density of their food. Not to mention the many benefits that come with lifestyle changes such as increased physical activity, which may be missed out on without that in conjunction. That being said I do feel that when patients are struggling to even be physically active due to weight, especially when they have an orthopedic condition in conjunction with that, can especially benefit from these medications. Or, and I'm still not sure if I actually believe this, for patients who refuse to change lifestyle, to at least give them some better quality of life and lower healthcare utilization.
I'm still new to Dr. Mike, so I don't know anything about a lot of past videos, or if his views have changed at all with new knowledge and education. But I certainly can't see why anyone would see this man as fat phobic. He seems logical, empathetic, understanding, and realistic about the topic. I think a lot of his questions might not have just been his curiosities, but a lot of what we hear from the general public. That non-natural approaches are "cheat methods" that "natural is better" etc. I think he cares very much about this matter and wants to see people feeling better! Great video!
For me, Ozempic and Mounjaro have been life savers. I’ve tried EVERYTHING. Nothing works long term. Call it the easy way, call it cheating, I don’t care. I’ve lost 87 lbs in 2 years, (weight loss stopped for a year while I fought breast cancer and switched to Mounjaro when Ozempic stopped working) I feel better than ever!
What an absolutely fabulous guest. She very clearly knows how to navigate the world of hype and misinformation in a way that is accessible to the listener. Thank you for this!
Doctor Mike is a genius! He asked all the questions that I wanted to ask as a medical intern in nephrology. And this interview in general is extremely useful for every physician in order to make proper decisions in today's more and more personalized medicine.
Looking forward to listening to this. It’s frustrating to me to see all these people on social media (mainly women) who are getting rx for ozempic despite not being t2 or even needing to lose weight for medical reasons. All it’s going to do is make it harder for those who really need it to get it.
I have found that a LOT of people who have autoimmune diseases (and are not overweight at all) are being prescribed this...not for the weight loss...not for blood sugar issues...but apparently it is helpful for autoimmune treatment. So, it's not all just people trying to lose weight. Although I do see the anger...diabetes can be immediately life threatening and detrimental.
I think the issue with the shortage isn’t the patients or doctors faults who are utilizing this for reasons other than diabetes or obvious obesity. It seems like doctors are finding it can help more people and more people are seeking out help knowing there are medication options for them. I think they simply need to make more of the drug, which I’ve seen they are working on. This argument is similar to people with adhd being frustrated that people without adhd are getting prescribed stimulants and then blame these people for using a medication they “don’t need”. More people benefiting from a medication shouldn’t be seen as a bad thing or empower strangers on the internet to determine whether or not someone’s prescription is necessary for them or not. That can only be determined by the individual patient and their prescribing doctor. The production of these drugs need to work to provide for the increases in demand, which seems to be continuing to increase as doctors find that this medication can help with a variety of conditions.
Great show. One thing: You have to separate the businesses online popping up shipping meds from who knows where vs. doctors working with licensed pharmacists who operate FDA-regulated 503B sterile compounding pharmacies. I've been prescribed compounded medicines before and have used both the branded and non-branded GLP-1 medication (tirzepatide). The meds worked the same. Without compounding, many people would be SOL in these shortages.
30:25 I really like that the host called her out on this narrative here. This is the same thing all the medspas are telling my friends when they sell them semaglutide - that nobody has time to work out and eat right, and it’s not fair to ask that of people, so they should just go on the drug. But then they tell them that maintaining the weight loss will be dependent on eating right and building muscle. This is a contradiction. Either lifestyle impacts weight loss or it doesn’t. You can’t tell people they don’t have time for lifestyle changes in order to sell them your drug, but then tell them they have to make those same lifestyle changes in order for that same drug to work. It’s honestly become a selling tactic, telling vulnerable people that the bar for change is sky high and unachievable without medication.
I got put on Mounjaro last year and at first it was great. I was losing weight and eating better so I thought all was good. I started getting these pains in my upper abdomen that were so severe I thought I was going to die. After going to my doctor I realized that my gallbladder was acting up. A few months later I had to get it removed. Please be aware of gallbladder and pancreas issues that may arise from taking these drugs!
This is the first of your videos I’ve watched, and I really appreciate the educated and honest conversation. I got a lot of insight from both of your perspectives and the important questions you posed. ⭐️⭐️⭐️⭐️
I'm in the early stages of using Ozempic. The side effects have been mostly mild - some nasty acid reflux (solved by changing my sleep position), lots of gas. As a morbidly obese patient with diabetes, I see it as an aid. I still have to eat better and exercise. It ain't easy at all.
A lot of people cast judgement but don’t actually understand what the drug is and requires. Best of luck on your weight loss journey. I’m rooting for you
OMG so many doctors need, i mean NEED to listen to her! She is so guiltfree! Obesity is not the fault of a person. Its a disease in itself! But please, make enough Ozempic for everyone! I have to switch to Rybelsus, tablets, and its so not the same with my sugar levels.
Yes. When I was young I ate healthy and played all kinds of sports and never got fat. Then when I become an adult and started to drink tons of soda and eat tons of fast food meals, and was no longer playing sports, I became fat. I knew what I was doing was unhealthy, but I continued to do it anyway. Definitely not my fault though. I guess I had no choice in the matter.
Wow. As someone who lost 120 and has fought DAILY to maintain that over a decade later, hearing her describe it as a full-time job made me tear up. That is EXACTLY how it feels. There is literally not a moment of my day where I'm not thinking about food and my body. It is exhausting beyond anything I can describe.
I don’t want to undercut the seriousness of what you’re saying because I’ve lost over 10% of my entire body weight recently, it’s like DeAngelo from the US version of The Office, “Once you’ve conquered obesity, everything else is easy. Life literally moves in slow motion.” Losing a large amount of weight really changes your perspective of everything around you but you are just hyper vigilant of goof around you or how your body would welcome it but poorly react to it.
I like that Dr. Mike is trying to understand this area better. Weight management is just going to be harder for some people.
I have lost 50 pounds with fasting of different timing and have not struggled. Metabolic switching shuts off the struggle of hormone triggered hunger.
It's easy if you do fasting. No breakfast. Regular lunch and sometimes like as your 3rd meal/evening
@@allahbless2278 maybe for some people. personally, I can't fast. If I don't eat frequently, I get stomach aches. So it's not just my brain feeling hungry but also my body signaling that it is not for it.
I'm just so impressed by Dr. Mike's interview style, he's patient, asks great questions, always acts as a surrogate to his audience, keeps things simple and understandable, and pushes back when necessary. All the things I want to hear from a good interview.
very true!
I love that he’s challenging her and himself also in this. It’s clear her perspective is a bit different from his initial takes and it’s wonderful that he’s balanced in this way (asking hard questions and willing to hear and offer uncomfortable answers).
I saw another great podcast about processed foods being a big factor in mass obesity. I think he’s right to be concerned that this drug is probably a bandaid for a wider health issue. Really informative interview from two valid and different viewpoints
It's a nice change to see an interview about serious, complicated problem, but with an explanation easy to understand even without medical degree.
Very true. The lay people can easily understand what is being talked about. Which is effective
His bias is quite clear, and he walks a line where he’s sharing the bias with his audience to ask the questions people are curious about (good), and challenging her when she’s pretty clearly more educated than he is on the particular subject (questionable).
The thing that bothers me is that he’s pretty clearly set in his bias and opinion even after talking to her. He asked the questions, got an answer he seems to disagree with - and he handles it well, yes; he’s patient - but he values his opinion over hers (that lifestyle alone is the answer), despite the information she’s sharing that contradicts it.
I think this is because it’s difficult to measure (subjective) data in a lot of cases. It’s easy to discredit her observations of patient “feelings,” which are actually an important part of this discussion since statistics already don’t convince most people (it’s rare for diet & exercise alone to work for patients in the long term, but these drugs make it more possible in several ways).
This is the best interview I have ever seen. “We don’t cure hypertension we manage it” is such a great discription on how this helps like other medications.
Also “your patients have probably been trying everything for decades” so true oh my gosh, finally someone who actually understands obesity, I’ve never felt more understood.
I really love watching this channel very awesome and informative, we're you watching from?
Except you CAN cure hypertension, can't you?
@@shonaaitken7635if it’s hypertension caused by something like atherosclerosis then no. It’s more managing it because your arteries aren’t going to regain elasticity. This happens as you age but can be accelerated by many factors. This is managed through ACEi, ARBs, b-blockers, etc. as well as changing lifestyle factors. However “obesity” can be cured. The cause of it maybe not
@@shonaaitken7635how?
Yes. Lifestyle! But most people want a quick fix!
I am insulin resistant due to pcos. My doctor put me on wegovy which is ozempic. When I went on it it was AMAZING. I really didn’t lose a lot of weight on it but how great my body felt was worth it. I finally felt full, I naturally craved healthier foods. I wasn’t in pain from inflammation. My gut wasn’t gassy and bloated and it significantly reduced my ibs symptoms. I had energy again because my sugar levels were staying stable. it was like my finally worked correctly. Now that’s on back order I can’t get it and all my symptoms are back and I’m miserable
Damn
I'm underweight and what that drug does sounds amazing
Maybe I'd end up gaining weight from healthier food?
I'm in the same boat
@@Xnoob545don't think so. The active ingredient in Ozempic is semaglutide, which works by inducing satiety. Thereby reducing appetite or addictions. So you would be at higher risk with it. Please talk to a doctor before using any such medication.
edit: apparently semaglutides can help with it. still best to consult a doctor
I've recently been diagnosed with PCOS and insulin resistance as well! I was a bit scared of Ozempic/Wegovy (bcs I have a history of depression) so my endo in collaboration with my psychiatrist put me on Contrave and I have also felt amazing results. What you said about finally feeling full when you eat - i also went through that - and I'm sure to people who don't have insulin resistance it sounds silly, but it's such an amazing feeling to be able to trust your body in terms of when you feel hungry/full. There is such a stigma with weight loss medications, but for many people they really are life-changing, and not just for superficial reasons. Im sorry you're dealing with back order issues, and I hope you can get your medication soon!
@@Xnoob545if you don't have insulin resistance or diabetes... chances are, ozempic will do nothing good for you, and you will suffer from adverse effects.
There's also a discussion to be had about how reckless companies in the US are with developing such calorie dense foods
skyblock person :D
Not only calorie dense but full of sugar. I recently read about how in zoos, the zoologist can no longer feed most fruits and many vegetables to the animals because they are GMOd so much to increase the taste of the plants that it means that they have so much more sugar in them then they ever used to. The animals are becoming obese...on fruit and vegetable based diets. They now almost completely cut out fruits and they feed them with specific vegetables that typically have less sugar and supplements made for the animals.
@amandasnider2644 you're right, I worked at a parrot sanctuary and many of the birds had heart disease and diabetes despite a constant, generous stream of donated produce from Costco. But it's not GMOs (too recent), it's the result of selective breeding over thousands of years of human agriculture to reduce fiber and increase sugar content. It's one of the (many) reasons a "paleo" diet is a joke- contemporary farmed meat and produce is vastly different than the food which would've sustained us in Paleolithic times.
Yep!!
Or how corn sugars have flooded produce even in areas it's not needed
I'm a 70-year-old female who has been overweight since having my children. I also have other physical issues that qualify me for this medicine, including severe arthritis. After going to Kaiser's Healthy Living doctor, I was required to take their Healthy Eating Program, and after labs, I just started taking Ozempic two days ago. I have been watching several TH-cams about this subject, and I'm so impressed with this interview. I just want to tell you it's been so informational and pleasant to listen to. Thank you so much.
Some of us have missed that the goal of this conversation is to have many perspectives brought to light -
On one end we have a specialist who regards these medications favorably and on the other end we have a general practice doctor who is readily questioning and learning about the practice of these prescriptions. It’s great to hear the full spectrum and understand that mass medication isn’t necessarily evil when done carefully, and in turn also recognize that people tend to misconstrue medications due to popularity and possibly misuse them. Two things can be true at once.
Facts. This is a great conversation from two physicians who are working in two different ways.
That's a very reasonable and MATURE point of view. Good on ya!
omg, do americanatzis think this is full spectrum?!?! omg, no wonder they're living through full blown societal collapse 🤦♂
The way you phrased that is so good. Thank you
I do feel like Pharma is very gung ho on meds and gets defensive when Doctor Mike asks the stats of pharmas practice, but he's very good at give her a soft out to soften the blow and answer. This is a beautiful chat but i'm leaning very much on Doctor Mike's side.
It seems like Dr. Mike had some disagreements with her and was challenging her answers. It's always good to have healthy discussions and debates to get different perspectives and opinions.
I noticed that too, Mike is always for achieving well being from better lifestyle and naturally adapting, while she thinks that well being comes at all costs, if the medicine exists, why not?
I don’t know if she changed her mind, versus redirecting her message promoting lifelong meds. For example, she was incredibly comfortable calling GLP-1s “lifelong medications”, later saying the goal is the lowest dose (still vague, still same message)
@@FelipeFreitasFSher practice financially depends on these meds.. of course this is her opinion
@@arminmadari4808Her viewpoint was that if you can get off of it, you should, but many people will never be able to manage their weight without and those people should be taking it as ling as they need to. It may be a very low dose, or less frequently than prior. Not really changing a view point
@@arminmadari4808I think what she meant is that for some people it will be necessary for the medications to be a lifelong thing. And that we shouldn't look down on it or feel to scared of it, because for those people not taking those medications for the rest of their lives would be even worse and far more unhealthy.
We're not built to live in a constant feast/high calorie foods easily accessible, or sit at desks for 10 hours a day. This is an incredibly new development in human history, it makes perfect sense to me that most people would struggle to control their weight.
I would say Ozempic changed my brain chemistry. It took the cravings away, I was able to stop bingeing, my brain actually registered as being full when I ate a meal. I lost weight, but for me, weight loss was truly a side effect. For the first time in my life I was in control of my eating, not the other way around. I felt like I could take absolute control of my life - really make headway when I worked out; take control of my medical issues (from poor diet) - lower my A1C's; lower cholesterol, lower my BMI, etc.
Agree! That to me has been the most mind blowing thing. I never binge eat anymore, I also tear up thinking about the fact that this has happened.
I don’t know about you but I do something think “is this how normal people eat food?”
nope it didnt change any brain chemistry. If you go off you will fall right back into it. This is why Pharma wants you on it. Becauase you will stay on it
@@alexsummers1897 I thought that all the time. I wake up thinking about food. I think about it before I go to sleep. I hate it. I would give it up if I could. Unfortunately, my insurance won’t cover it anymore. I feel like I just bounced right back.
I say it’s the Antibuse of obesity meds.
Same! I've only been on it for like a week. I already feel more comfortable in my relationship with food and I also don't feel that need for food to "hit that spot." It's awesome other people have a similar experience.
This conversation was so intense in the calmest way lol
I agree i thought they were gonna kick each other at one point😂
What about discussing the possible long term side effects which there are and some quite serious? And also why is the trend moving towards finding a pill for everything instead of approaching the problem as lifestyle? And if it's not lifestyle, then what is it in our environment that is making us obese and addressing that as our number one health problem that needs fixing pronto.
@andreavanda5402 Did you not listen to the whole show? They addressed much of this. Our environment may be causing some of this, but that cannot be fixed on the individual level and will take generations. Patients need help in the present.
@@andreavanda5402 One of the key points of this conversation is that lifestyle is a necessary, but insufficient element of the equation for weight loss for many people. And while I would love a world where we all had low stress jobs and lives, and were growing our own food and making healthy meals, unfortunately that just isn't reality for most of us.
@andreavanda5402:
Sometimes doctors can be a little too unjudgmental.
I wish the pancreatitis side effect wasn't played down. My endocrinologist didn't put me on Ozempic, but one of the medications that has the same active ingredient, semaglutide, with Rybelsus, and I ended up developing gallbladder issues, pancreatitis, was hospitalized twice, and had surgery to remove my gallbladder that finally addressed excruciating upper abdominal pain that my endocrinologist downplayed and dismissed. Thankfully I moved to a different endocrinologist that doens't dismiss my feelings or symptoms now.
Learned so much from this. The way the two conducted their conversation with a bit of pushback, answering things that maybe wouldn't normally get asked and the information behind obesity being more than just a failure to stick to a healthy lifestyle was absolutely brilliant. This whole thing was incredible, we need all medical professionals to be like these two.
37:56 she mentioned losing enough weight to do basic tasks again, and feeling able to exercise.. I’ve been paying for a gym membership for 4+ years and haven’t gone since before Covid. But I’ve lost 25lbs on Wegovy and actually FEEL a desire to MOVE and it’s truly a beautiful thing.
Gym possibly not the right choice for you then. Find something you actually want to do that you like :)
@tahloz6688 Yeah, no. At a certain weight every workout even going up stairs is a struggle. That point was that Jumpstart of losing weight gives them the chance to actually try sports, workout, hobbies they can actually like.
@@dodgek5270 Just walk. It's amazing the results you can get with just walking.
I am a member of Alcoholics Anonymous for many years. I have dear friends who have had to take medication to help them get odd heroin. That, incorporated with AA, has literally saved lives. I haven't had to use that, just like some people don't use these medications but are able to change and stick with a healthy lifestyle. I love that there is different options for different people because everyone is different.
Suboxone saves lives
That’s a good comparison. I’ve heard people in AA say any treatment with medication is cheating or you’re not really sober. They don’t realize how detrimental it can be to someone’s recovery to convince them they shouldn’t get on or be on meds.
Would you rather have someone on suboxone and “not really sober” or find them dead from an overdose?
Would you rather have someone who “cheated” to lose weight, or someone dead at 40 due to obesity?
I'm on Ozempic now. Yes, I've lost weight, but I'm more impressed with my blood sugar numbers. I'm almost completely off insulin and that's huge for me.
❤ Good for you! It is amazing... I'm completely off insulin, myself!
@@stephaniemerrill4515 insulin is a hormone and so is semaglutide so you pretty went much went from one hormone injection to another hormone injection? which is more affordable long term?
Limiting carb intake fixed my insulin levels and got my cravings under control in ten days after I decided to change my eating habits. Also my food receptors no longer numb and everything tastes so much better. No drugs needed, saved money. Doctors hate me for this weird trick.
@@guntisber5415 That is actually wonderful for you, congrats on that! But also, not everyone is you and will have the same experience and the way you framed this comes of very passive aggressive to people who will not have the same experience and result as you.
I am glad this worked for you and I am also glad that medication exists that helps people. One method is not superior over the other tho and thinking it is helps literally no one.
go figure. it was originally developed for Diabetes.
One of his best videos. His body language exuded being critical of the information provided, but also respectful and polite. I thought they both brought up very good points.
This was informative and enjoyable. I hope to see other almost-intensely critical / engaging videos like this from Dr. Mike.
As a family doctor this was a great conversation to hear bc I was prescribing this medication very grudgingly As I saw it as a crutch. I can see that it is more nuanced now so that allows me a better method of educating and prescribing.
My (awesome naturopath) doctor was more than happy to prescribe it for me. He said it’s truly life changing, and no longterm side effects or negatives. He did insist that I agree to see a nutritionist and get on a healthy eating plan, and gave me a recommendation for a great dietitian. I was so happy that he not only didn’t fight me on it, or shame me for asking about it, but was very excited for me that I had made this healthy choice to improve my life and make a positive l lifestyle change. I think there’s ways to approach it without shaming people, and my doctor did it in such a great way.
This is exactly what I was thinking about while listening to the interview. I'm sure plenty of healthcare providers have a narrow (not meant to offend) view of the medications and patient population requesting the medication, and both doctors here did a great job of broadening that view and giving a road map for bringing patients from point a (wanting to lose weight) to point b (understanding their health and habits) through education.
Good for you. Have you read some of the cmnts? Like the ones before your cmnt? Very interesting how it has helped people in different ways.
You sounds like a great dr informing yourself : )
The pharmaceutical company thanks you.
From a Pharmacy Technician THANK YOU for this interview. Accurate medical information is important, and we just want our patients to be able to get this medication regularly who need it the most. Please don’t abuse these drugs, they help many of lives everyday!
Wonder how many concurrent prescriptions of olanzapine and semiglitude you will see?
The hard thing to understand is that the plan is not to cure...diabetes, high blood pressure or obesity.
Mean while lowcarb/high fat way of eating har reversed all of them, Dr Mike knows, thats why hi was so direct on his observations and questions.
I dont like that people get angry at others for how they lose weight or say they are “cheating”. But then other people are angry that someone is overweight at the same time! 😰
Yeah honestly you can’t win.😂
Nobody gets angry when others lose weight. They get angry when someone claims they did it naturally when they obviously didn’t.
You see a ripped body builder saying “I got like this naturally” when it’s 100% obviously they’re on steroids giving false hope to people just so they can keep their sponsors and sell their bullshit to ignorant people and kids who don’t know any better. I’ve never seen anyone other than crazy fat loving left wing nut bags get mad at someone for losing weight.
@@dustinadair7893 thats not entirely true. Some people will say its “cheating” when people get Lipo suction or bariatric surgery and are completely honest about it.
Most people don't care, in the grand scheme of things, it's just better to be honest about things. If you have worked very hard for a goal and just see people floating through with medication then it can be disheartening. @@Cherry-wf8qv
What has worked wonders for me about these types of medications is the way my brain has changed and is not thinking about food and hunger so much! It is such a relief and a different experience to go through the day without my brain being hijacked by thoughts of food and sugar cravings. This has been the key for me.
That sounds amazing. I’ve struggled with binge eating for about 15 years now and nothing seems to help. I don’t live in America so I can’t get ozempic unless I have diabetes. I had a doctor tell me that I should be glad I can overeat this much without getting fat🙃
Two things: Regarding psych meds, I am on them forever. In order to keep my sanity with Bipolar 1, I will be on them for life... have been on them since 1995 continuously. It will be the same for obesity meds. Diet changes (down 40lbs), Trulicity (down 86lbs), and now on Mounjaro (not weighing often)... I am down 150lbs and am still 100 lbs away from being "just" obese. I have no weight goal; I have met the goals of getting out of bed, not using a wheelchair and walker, and many more personal triumphs. I know there are still more to come as I can _finally_ be alive. I'm 62, did Phen-Fen, had an RNY Gastric Bypass, and regained it all back and more. That I can treat my obesity disease now _forever_ brings me immense joy.
I am so happy for you. I'm a mental health professional and I agree with you completely. Many people with chronic illness stay on medications for life. Many psychiatric illnesses are also chronic illnesses and thus need life long medications to manage it, to STAY ALIVE and hopefully to live a contented life. I don't think a lot of people understand that. I was shocked with @DoctorMike said he tells his patients that the SSRIs he is prescribing are not for long term. I have so many questions about that, and I find it distressing, having worked in the field for over 30 years. You have been through so much. You are still here and moving forward. I was very moved by your comment and I wish you all the best.
@@yukonswimmom thank you so much for this comment. Mike's SSRI take seemed very strange to me. I was put on SSRIs by my neurologist for three months and those were the best months of my life... until the course ended, the withdrawal almost killed me, and my depression came back with a new force. Luckily he then referred me to a psychiatrist who got me on a much better treatment plan. I've been going to therapy and taking my psych meds for two years now and while I still struggle with depression, I feel infinitely better now. My anxiety doesn't affect my day-to-day life nearly as much anymore, my OCD is almost completely cured and I finally feel like a person again... But it took two years of medication and hard work to get to this point, with many setbacks down the road. My doctor told me that only after 3+ months of stable and consistent improved well-being can she start lowering the doses, let alone taking me off the SSRIs completely. You don't just mess with meds like this for a short time and think that the patient will be fine.
Absolutely agree. I have been taking my SNRI for 15 years now and I have reduced the dose many times, and I have relapsed several times even while on medication when my dose was lowered, so it is likely I will need it for life at this point. For me it is a chronic recurrent illness. Having said that, a lot of people with mild or moderate depression who haven't had it before or if it's due to a stressful life event or loss will only need medication short-term, so I understand what he's saying. I'm sure he knows that some people need psychiatric medication long-term, but it's hard to explore the nuance when that's not the topic of the conversation.@@yukonswimmom
@@alinashirinian2485 Agree with you, I think the problem is that these drugs are often over-prescribed by people who don't necessarily have a mental illness but are experiencing low mood because of life circumstances. In which case, yeah, you won't need to take it for as long and can just come off of it when things are better. Whether it's right to prescribe them in those cases is not my place to say, but it's not the intended use.
How can you even be “manic” when your that fat? Just kidding. I’m petty sure psychiatrist just call increasing sedation “treating” mania. Because that is what all the research on animal studies really does is test different ways to sedate rats.
As a medical professional, I find this conversation highly engaging. While I typically lean toward holistic and natural approaches, I do recognize the significance of medications and surgical interventions when they become necessary. With the prevalent issue of obesity in the United States, it's crucial that we explore every viable option to help patients achieve better health, both in terms of appearance and overall well-being. If medications can contribute to improving patients' quality of life, I wholeheartedly support their usage.
I have found this approach most helpful for me as well. The balance of natural/holistic and medicine. I've had numerous medical adventures through the years and this approach gave the best results. I just wished more collaboration were possible on a professional level for more patients to receive the results. May I go so far as to say this...insurance companies cover functional medicine practitioners.
@KreativeKerri There's just not enough quality evidence to support a lot of what "functional medicine" does.
Far to often, if there was evidence to support "alternative medicine" then it would just be called, medicine.
@@cathiehealey4608 I understand your point. I'm all for research studies and evidence. With that being said, we are dealing with huge corporations, big pharm, and the like who would loose money if more natural approaches were also utilized.
I'm not a huge conspiracy kind of person so hear me out. There is something to the mind-body-spirit(inner self) connection. I live how functional practitioners take a whole body approach. Specialists of different systems have limitations. They may say this could be effecting that but there is lack of collaboration. Also, when dealing with alot of diagnosises, m-b-s can all play a factor. Have a doctor specialized in one system, could they surrender to the idea that the root may be in a different rhelm? I know I'm talking in general hypothetical scenarios. I guess my main point is this. Just western medicine limits the scope of practice. Just functional medicine doesn't allow for enough patients to take part their practice for peer reviewed practice.
In my experience, my chronic pain and RA symptoms have significantly decreased when I apply both ways. Its not a 1 or the other. Its an AND.
@@KreativeKerri If they want to be invited to the table, they need to provide the same standard of evidence. I'd hazard a guess that whenever 'holistic' approaches have worked for you - it has been alongside healthy lifestyle changes. The same ones your doctor told you to make but you didn't listen because he was wearing shoes, like a total square.
It's the fable of the magic stone soup. It was not the magic stone that made the soup delicious, the magic stone was incidental. It wasn't even supplementary - it was completely unecessary.
@@frankcooke1692 are you asking me did I listen to my medical doctors or ate you assuming I didn't? Just want some clarity before responding.
Also stone soup was one of my favorite stories when I was a little girl. You may want to go back and reread this story. You're missing the premise. Your misconception is just a little skewed.
I lost 200lbs by making changes to my diet and lifestyle. I'm at a healthy weight now, and I've maintained that for a couple of years, but it is absolutely a daily if not hourly battle. I am always, always thinking about food, planning meals, working out what I can and cannot "allow myself" or just resisting the urge to overeat. Calling it a job doesn't do it justice, it is just a constant, all-consuming pressure. And the few times I've let my weight creep back up a little, the stress and anxiety it causes is unreal. I don't need to lose any more weight, but I still can't even begin to articulate the improvement it would make to my quality of life if I could just take an injection once a week and not have to deal with that any more.
I hope you can get that peace of mind you seek, but I want to congratulate you on how far you've come! People like you with that fortitude are examples for so many others without knowing it!
I don't know how long that process has been for you, but I reckon eventually your appetite will adjust. I've been trying to lose weight myself. I almost enjoy the project, personally. The meal planning is like a fun little puzzle. It doesn't have to be a chore, there's plenty of fun things you can still 'allow'. Butter Chicken (with greek yoghurt, not so much cream), pesto chicken, special fried rice with garlic soy chicken, chili con chicken, chicken wraps. Those are all low calorie options I'd happily live off. The only thing I've had to cut out are potato/corn chips, beans, nuts and sugary drinks. But then I guess there's still the issue of portion control. I do sympathise.
Totally agree. I would almost trade losing weight just not to have all this food noise in my head. It's that not the weight that impact my life and quality of life.
Do people read food labels in the US? EVerything has sugar in it yet food companies are not called out on this. I reckon most of this obsession with needing food all the time starts as toddlers and it becomes an addiction because of sugar. If one watches movies from the 70's and early 80's the cast and crew are all normal weight, even slim. Everyone. Now I watch tennis matches in America where even the ball kids are overweight. No wonder it's so difficult to stop. It's kind of like in people's DNA by now. I was very against people taking a diabetes drug to lose weight but if it helps people's health physically and mentally and also affects the bottom line of companies peddling sugar in food then I'm all for it.
It’s so expensive:( I hope you get it. You deserve it
I have a degree in journalism and I'm so happy with this interview. Great questions, great job holding each other accountable for providing the scientific knowledge to back up the answers. You both created a great road map for healthcare providers who want to use these drugs as a tool to help patients, with perspective on how they should address the concerns and patient goals.
I’m SO glad Dr. Mike had Dr. Rocio Salas-Whalen on to discuss this. She is a phenomenal resource.
I appreciate that she speaks to the understanding that many people who are overweight are trying to lose weight and their whole world revolves around it. Her perspective felt like my experience was being spoken about.
After being 125-130lb my entire adult life, covid added a large amount of pounds that I have been fighting to remove over the past 18 months. Even after diet and exercise adjustments, trainers, and doctors all helping me, it still feels impossible to shed the pounds. I appreciate her empathy and understanding towards her patients
I'm just curious what you've tried to loose the weight? Essentially it does boil down to calories in vs calories out. How many are you eating on a daily basis vs burning?
Be grateful you weren't a fat kid that's a psychological burden that scars your soul.
I have type 2 diabetes and that's why I was put on Ozempic. I'm very grateful for it, except for the side effect of nausea that I experience when my dosage is increased. I just wish that the medication supply would keep up with demand, because Ozempic is my sole diabetes medication and there is an access issue lately. I want everyone who needs the medication to have it, but I do hope it gets prescribed and used responsibly. I really appreciated this conversation.
Ohh pharmaceutical companies are keeping that supply low because they could charge more.
Well, it looks like there’s gonna be a lot of generic brands so that’s a good thing
As someone who has only successfully lost weight when I made it the focus of my life, it feels so validating to be seen! I don't qualify for Ozempic but I do believe for many people obesity is a disease. For people like Dr Mike who are super driven and have the time and the money I can understand why he'd think most people can lose weight through a healthier lifestyle.
SAME!
If i don't weigh and measure all my food, and count/track every calorie i fail to lose any weight or even maintain weight. That's with working out 2-3 times a week. The only time I've been successful at maintaining weight or losing it without it being a full time job was in high school, particularly with wrestling season where i was doing intense workouts at least twice a day. I felt that full time job comment in my soul.
Yes yes yes!! It does feel like a full time job losing weight! Which is the why the only time I was successful at it was during 2020 when I had so much down time to myself. I feel bad saying it but that was the only time in my life I've ever actually had enough available time to really focus on myself and take better care of me. Since going back to work we have not had the time to do it. I'm exhausted. The way our society is laid out with pushing everyone to work themselves to death just to be able to pay the bills nobody has extra time to take care of themselves.
Absolutely agree most can but it's the unrelenting food noise and craving that makes it so hard to lose and then to keep it off. Turning off the appetite is the magic.
I LOVE that you had Dr. Salas-Whalen on your show! She and I did the Tamron Hall show last year talking about these medications. I was a Surmount Phase I Clinical Trial participant in 2020 for Tirzepatide and I have lost a total of 208 pounds using this medication after a lifetime of suffering from obesity and after losing my oldest sister in 2018 to complications from obesity. Thank you for covering this hot topic!
as someone whose been trying to lose weight since middle school, and haven’t gone through one day of my life not concerned about my weight or body. listening to this video helped me feel better, after many doctors telling me to just “lose the weight”
I got a gastric sleeve 29 days ago. What made me decide to do it is learning about how it changes your biology in a way where you'll prefer healthy foods and that obesity is not my fault. I used to blame myself for being fat and that made me indulge even more just to get a "high" from food.
Im of average to skinny build and my sister was born overweight because of pregnancy diabetes. We have the same diet but she has a bigger appetite and eats faster and I’ll admit I eat very slow so I understand how restrictive it would be if she tried to have my habits.
I comment because I feel for you and how much time you spent worrying.
I just wanted to share that I could have been in your shoes but wasn’t because of chance. But I still worried in my life about other things in my appearance or just in general. So yeah my conclusion is we often find our self worrying no matter who we are.
I'm on Zepbound for PCOS. I used to get so hungry I would cry. I could never eat the right amount of food to keep me full no matter what I did. My relationship with food was so damaged. I was depressed, in recovery from an ED, and suffering every single day. Most of that went away with the first dose. I got useful hunger cues for the first time since hitting puberty. I'm not afraid of food. I'm not afraid of what my body will do if I eat. I have more energy, I have more brain space, my depression is gone, and my ED symptoms have lessened. The relief is immeasurable.
Have you experienced any hair loss with Zepbound?
@@elle.grey2 Not with Zepbound. I lost a lot of hair with my eating disorder, but it fully recovered from that.
Hair loss experienced on Zepbound is related to malnutrition, not the drug itself.
This was a great discussion. "If it's not the easy way out, why are so many people asking for it?" is a great question. I can say for me, hearing that people on Ozempic were not obsessing over food and actually feeling full/satisfied was such a huge part of why I considered it. Obsessing over food/diet is a full time, soul crushing job. I do still think about food, but, often not in the same obsessive way. It's maybe a more thoughtful approach? It's hard to explain. But it's like depression meds- they didn't just make me happy. It was a subtle change that allowed me to actually function. Anyway, I don't see it as an easy way out, but it does help with some of the mental/emotional anguish of dieting and I don't think that's a bad thing.
She was wrong, it is the easy way out especially when comparing to only focusing on diet and exercise. But hey that's okay, easy is good for some as a start for short term. I agree it's definitely not a bad thing.
Yeah the "easy way" is not always bad. Life can be hard enough. I had to manage my mental/neurological issues with didciplined Lifestyle changes because I reacted so bad to most medication. I can do it but it us hard work and timeconsuming. I don't begrudge anyone for whom antidepressants and stabilizers work. Why shouldn't they take a shortcut? There are few enough in life. And if you Don't get your life together afterwards they will stop working anyway. We are all so averse to the idea of getting help.
Obviously it is the easy way out but you have to consider that some people have a harder time to begin with. There have been studies that say that addiction has a genetic component. Also people with ADHD tend to have a disregulated relationship with food. So just dismissing semaglutide as the easy way out without considering the increased difficulty for some people of actually following a diet and maintaining the lost weight isn't very fair.
@@pozz941 Good point. For some the comparativly "easy" way is still harder then the regular way for others.
Ozempic and these other weight loss drugs are not going to solve your weight problems if you are morbidly obese like I was. It will help a lot in the short term, but your body will become used to it and your appetite will come back a bit. It still helps, and so I am not saying not to take it anymore. It will help with the diabetes for sure. However, you will need to eventually start eating healthier. I have been in Ozempic other weight loss medication for over a year now.
Dear Dr. Mike I know you will probably never see this or respond to this but I wanted to tell you thank you for helping me get through the rough times in my life! You truly have one of the kindest souls ! You are truly passionate about helping people and making sure your patients get the right medical treatment. You are so amazing, kindhearted, passionate ,honest and just want to help people “stay happy and healthy” you truly care about people knowing the actual accuracy of medical stuff because you know TikTok is not very accurate. I truly have so much more from you than my years is school. You actually helped me pass science so thank you! I actually can use the stuff you have taught me in your videos in my life instead of learning stuff I will never use in my life like math. Again thank you for everything you do you are truly an inspiration for many kids and adults! I actually either want to be a doctor or a veterinarian when I am older. I am currently a high schooler who has no idea what to do with her life 👍Keep up with what you’re doing “as always stay happy and healthy”
My daughter had struggled since childhood due to genetics from her dad's side, now in her 30s she follows diet excercise and ozempic and for the first time I see she finally no longer struggles but she does excercise daily. As a mother, her pain was mine. This is a great conversation. Stay positive. Blessings
She seems just like dr. Mike to trily care about her patients. I love these interviews and the passion i see for what they do. Grateful to have doctors like them in our world.
Wow! I was put on OZEMPIC for borderline diabetic. I was amazed when the weight started coming off. Insurance stopped paying when my levels were back to normal. I continued with the compound semaglutide. I personally don’t think it worked the same as OZEMPIC. Different insurance now and back on OZEMPIC. Goal was to loose up to 100 pounds. I’m down 80 pounds currently. She hit home with great information. I wish my doctor informed me about muscle loss and protein intake. The other thing she hit home about was, as you lose the weight you feel more comfortable. I’ve currently been going to the gym since November of last year. And I started taking protein shakes daily. Thank you so much for this vlog.
It’s refreshing to see two highly intelligent professionals discuss a topic involving controversy and using evidence based medicine to guide their decision making. I was initially skeptical about the direction of the conversation but I found it to be very informative without much of any biases.
Thank you for doing this interview. Dr Salas-Whalen is amazingly knowledgeable, and she hit some really important points that I think bridge the gap between patients and doctors, such as when she emphasized that people with genetic predispositions can't always lose weight with lifestyle changes, and it in fact those changes might make it worse for them. I think that fact alone is a core driver of conflict on this issue, along with the idea that people who need to lose weight to be healthy just "aren't trying." I've known several people who have excess weight run in their families who tried all kinds of things, and end up just wanting to love themselves for who they are because they believe that their body won't change. Because without medication, they're probably right about that. Because self hatred can lead to eating disorders which could have even worse health outcomes than just living with obesity. Because their EDs can impact their future children. Obesity doesn't run in my family, but my mother developed it after struggling with an eating disorder as a teen and young adult, and I've been overweight all my life no matter my lifestyle, thanks to epigenetics.
I think I find it hard to emphasize with the genetic predisposition argument rather than lifestyle.
Anecdotally my mother and I are the only ones in my family who are not obese. Seeing what other family members eat, and how inactive they are I know for sure I would be in the same position with those habits. Further my siblings and I were always in shape as children. My sister stayed with our Father for a year and gained 10kg as a 12 Y/O, the only thing that changed was poor food choices. Then she came back and slowly lost the weight.
Within a year of her and then later my brother leaving home they sharply shot to obese levels also where as I maintained my weight, the difference was 90% of my diet was healthy choices, where as their pantries were stocked with lollies, chips and constant take out meals, or simply really really big meals. This is the same situation with all my extended family members who are overweight.
I did develop poor habits over COVID that honestly took months of self control of fighting junk food cravings from those habits until they finally died down to the point they weren't an issue. Not only that it took a few weeks for simply the base hunger to die down after moving my overall consumption back to what it had been for a decade prior to COVID.
I guess this leaves me with quite a bias as I know that at least in my immediate family that everyone that is obese is obese purely due to life style choices.
100%. I've tried everything, eating healthy, working out for over an hour almost every day, and for most of my life I've been overweight. I finally got prescribed ozempic this week and looking forward to trying it.
@@PaulFilmer The part you're missing is that when obesity runs in families, it gets passed on to children. I was raised in a family where exercise didn't occur. My parents didn't exercise and didn't encourage us to. When you're someone who spent their entire childhood not exercising, it is so so so difficult to motivate yourself and get into a good habit when you're an adult. I HATE exercise. If I had been encouraged to as a kid, I likely wouldn't hate it so much AND it would already have been part of my routine. On the same hand, parents who are obese don't tend to feed their children healthy foods or promote healthy eating habits. I grew up eating a lot of processed foods and was modelled eating when bored and not eating healthy snacks and not knowing when to stop eating, all habits I STILL have in my 20s because they were developed as a child. That said, I obviously know what foods are healthy and try to eat healthy as much as I can, but you can't ignore the fact that habits you developed and followed for 18 years aren't exactly easy to just break. So no, it's not all about choice. My entire family is fat, that's what was modelled to me. Have some compassion for those people who behind closed doors are probably struggling with the same things I am, you just have no idea. I also have PCOS which I choose not to disclose to the entire world. You have no idea what medical conditions your family members might have. Also, no one cares to hear comments about our bodies from people who have never struggled with weight. Congratulations. Be thankful.
I have to respectfully disagree with you. It runs in families because families live similar lifestyles. They eat the same foods, they work at about the same physical level, etc. If a family for recreation sit down and watch TV yeah they're not gonna have a healthy lifestyle. If they go out for hikes and family workout competitions for recreation they're gonna look different. We are what we repeatedly do. That's how it is. Now, if you wanna watch TV and eat pizza and be fat, then by all means, do it. Be happy with your decisions. Just don't blame other factors and look at things objectively.
@@myoung6067that's exactly the point though.
She’s the First doctor I’ve seen on social media that actually understands obesity.
Dr. Mike is a great example of why it's so hard to implement change in traditional medicine
@@eliassamona3585Right? Even after everything the specialist said, he was back to diet and exercise as the way to weight loss.
@@Sandikalthere are some of us dietitians who also do counseling but there are not enough of us or as many specialists at it to recommend for the general population. For long term behavior change, lifestyle psychotherapy is very effective but not all dietitians and not all mental health professionals are trained on the niche. Many people benefit from talking about their eating habits with a counselor or dietitian weekly or biweekly or monthly. It is very inexpensive for insurance too compared to complications.
@@Sandikal Is that a good thing or bad thing? Because they both agree diet and exercise is still the way to weight loss/healthy body. Difference? Dr. Mike leans less on medication, and Dr. Salas is more likely to lean on medication.
Came here to say exactly that. Through the entire conversation you could tell he wasn't convinced, even though he tried to hide it and was very polite about it. Disappointing when you have such a renowned specialist on the show.
I had a doctor (coworker) tell me that only BMI mattered.
We were talking about body composition tests, and how I lately had been feeling ill, like my body was telling me I was fat even though I do not look fat at all. I was afraid I was developing insulin resistance. When I did the body composition test and felt so validated when it showed that my muscle was very low and my fat was very high and mainly visceral. A true example of skinny fat.
I had been doing cardio and wasn't losing any weight. Now I understand what I needed was to gain muscle mass and that that would lower the visceral fat.
So I have increased protein in my diet, lowered my carbs, and started weight lifting.
I have lost 3 lbs in the last 2 weeks and am starting to feel better.
Sometimes you have to listen to your gut and study. Maybe don't listen to the overweight doctor who tells you that you're OK if your BMI is fine, even if you feel sick.
Glad you are on the road to health. I'm a firm believer that a person is their own expert when it comes to their own body. Way to go for feeling better, I hope it continues in your favor.
@@pbandjedi5006 Thank you! Increasing protein and reducing carbs has definitely made a difference. But trying not to rely solely on that, building muscle is just as important.
I won't even entertain a fat doctor.
Is a body composition test easily available?
Most experts consider bmi to be kind of crude becuase on women you could have a healthy bmi but too low of a body fat to get a period if they are really athletic.
She gets it! I lost over 100lbs, and am starting to back slide pretty badly with binge eating and I have lost the motivation to continue to exercise. It was SO mentally taxing and it took up my entire brain space. It was a full time job!
Maybe reduce the amount of time you spend exercising, but always remember how hard it is to lose weight as compared to trying to maintain it. And it’ll not be just about looking fit but also your mental health and how you view yourself. So if at all possible try not to lose the motivation, don’t go as hard but don’t fully stop because once you all that effort is gone. And starting that process for a second time is tough.
Exercising can be simple, walking down the block, it can be fun, jump roping, it can be calming a long yoga or Pilates TH-cam video. I don’t think you need to start with really hard workouts or weights unless you feel ready! You can do it!
Also I’m not sure if this is healthy but if you did nothing all day, remind yourself your body doesn’t need extra energy in the form of food. Maybe snack on some healthy things like cheese or nuts or fruits and vegetables. If you had a long day where you did a lot mentally or physically then your body will need more energy in the form of food. Gotta be mindful and that’s the hard part and we’ll as self regulation
Get on the drug and stabilize yourself. No reason to go through that again then work to get off and only go back on to stabilize. Very simple actually but I am sure there are many who will say just use will power. That’s BS!! Good luck.
@@Shomo-lk8zh I wish it were that simple. My doctor tried to get me on Wegovy, but health insurance wouldn't approve it since I'm not diabetic.
The way she speaks is so validating bcs she acknowledges the obstacles that ppl w overweight & obesity face
Totally, I feel like I understand more now why so many people are using this drug
Mike says, “If we could put people on 150 minutes of moderate exercise a week, put them on the appropriate caloric intake for their healthy body weight, they would all get there.”
I am fortunate enough to work out with a personal trainer twice a week. I can afford to buy a lot of fresh produce and whole foods which I prepare mostly at home. I don’t drink my calories and try to prioritize protein and fiber in my diet. I also have a BMI of 35. When I try to reduce my caloric intake, all I can think about is food. It becomes an unending, obsessive misery. And I’m not eating more than I did when I was at a normal BMI, but after having a baby 3 years ago, entering my 40s, and grappling with chronic pain, it’s a lot more complicated than 150 weekly minutes of exercise and making better nutrition choices.
I am going to say something a bit mean, but true: He is right, and you are wrong. Energy is energy, and if you eat less than you spend, you are going to lose weight. Having a baby doesn't change this, in fact, nothing changes this. This is objective, UNDENIABLE fact. I am overweight myself, and I know what it feels like to just really want to eat. Ultimately however both you and me are in control of the hand that grabs that fork, and we CAN command it to put the fork down.
Ultimately, it is a question of willpower. There is no two ways about it.
It's really not,you just happen to be an outlier
It’s not just willpower. That’s insulting. So many things come into play. Environment, hormones, and micro biome are the primary non-CICO factors. Saying that it’s just willpower is speaking from privilege. Willpower only takes you so far. Habit is essential.
@@katherinegallousis4395 None of those discount CICO whatsoever. Habit is formed through your actions, aka willpower. I don't see how that is insulting, it's not a personal insult toward you to if I tell you correctly that you have agency in this world and are able to influence your life. You only take that as an insult if you feel I am making a value judgement of you when I say it. I am not. I'm just speaking the truth.
I am overweight myself, and it's not easy to lose weight. But it is possible, and it's MY FAULT if I don't. I can put the fork down and go for a jog. So can anyone else.
I will add to this: 95% of diets fail. That means one in twenty succeeds. That is not a horrible rate. Be that one in twenty instead of whinging.
This is the way all conversations with opposing points of view should be done. Both sides have common agreement but being able to be mature and respectful about it the opposing points is what we are losing. This was intense to watch and educational. Learning is a journey.
amazing interview, greetings from a doctor in germany. Really changed my mind on Ozempic, cheers
She is incredibly knowledgeable and extremely compassionate. An effective doctor cannot be one without the other. ❤ I'd go to her for help with my obesity and binge eating.
I really love watching this channel very awesome and informative, we're you watching from?
Ozempic changed me drastically. I grew up healthy and active, part of search and rescue, and eventually came to the point where if you couldn't find me then you need to look at the map in my bedroom because I will leave instructions there. But when I got pregnant I went from 170-180 and usually 100-120lbs of muscle to 155-160 then to over 300 and then with stress of life and other issues mixed in and loosing weight regardless of exercising, healthy eating, and dieting programs. I was in the process of figuring out how to have a gastric bypass (I can't meet the apnea machine requirements because of a child trauma) when my doctor mentioned Ozempic.
I have been on it since the start and it changes my brain chemistry so I am not hungry all the time and because I am not constantly thinking about food I can meal prep better, I am eating smaller amounts and I've lost about 100lbs. I am super happy I did this route and it was open to me because I can get to the old me and not feel stuck.
I really love watching this channel very awesome and informative, we're you watching from?
How long did you take it ?
Extremely well explained. I’m sharing this video with my doctor. She has been amazing with explaining this medication to me and working with patients and obesity. She will love to hear this interview. I’m thankful I have an amazing doctor who takes the time to talk with me.
Im glad she touched on bmi, im tall and relatively muscular and my bmi is nearly overweight but my body fat perfentage is normal and my waist to height ratio is nearly underweight. Ive struggled with eating disorders in the past and a doctor telling me i need to lose weight despite being the healthiest ive ever been because of just one measurment when all the others are great would break my heart.
Yeah, BMI is broken. A good general analysis I suppose, but I’m 5’7” 195lbs at apx 10-12% body fat. That gives me a BMI of about 31 and obese 😂
The closer to the normal range of BMI you are the less useful it is. If you are someone well into the obese range it is very unlikely that you are not carrying around a lot of extra fat. However, Mike is right that it is typically people who are more muscular saying they don't like that BMI calls them overweight for example. At that point BMI isn't a useful tool. As she said focusing on muscle and fat percentages is far more useful at that point.
Same. I'm tall and a size zero but I've always been heavy. I can't possibly lose more weight without being a skeleton but my BMI is high. 🥴 I stopped allowing them to weigh me.
@@jenniferlawrence2988 I got lucky and have so far had nice doctors and PAs who have noticed my discomfort at my weight and taken the initiative to reassure me that I'm healthy despite being right on the line of overweight. I hope that luck remains. It helps that I look like I'm in good shape and I'm young so I worry that with age, I may have bad experiences.
She was literally arguing that the BMI ISN'T RESTRICTIVE ENOUGH, because it doesn't tell ENOUGH people they're overweight.
I'm on a GLP-1 medication and I think the biggest benefit that a lot of people don't talk enough about, and I wished she had of spoken to, was the feeling of regaining control of our lives. The brain trigger of satiety and being able to stop, or walking to the pantry, looking around and deciding, no I don't need anything is remarkable. We, as obese people, for various reasons, have lost a healthy relationship with food, in a multitude of ways; choices, quantity, time, shame, etc. That feeling of figuratively, and literally, of being able to push the plate away and saying, "I've had enough" is a massive step forward to regaining control. That feeling of control, leads into other things, deciding to go to the gym, deciding to go for a walk around the neighborhood, deciding that when I'm at Moe's, I'll get a bowl instead of a burrito, because I would rather have a few chips for carbs, than the wrap. It all adds up. That feeling of satiety is incredibly powerful, and one we lose because the food industry is poisoning us. It's so powerful, that there are now studies that are showing people are stopping drinking, smoking, or other harmful drugs. It's incredible.
Very encouraging, thanks
My experience exactly. Thank you.
I am 61 and have never had problems with my weight. Now that I have gone through menopause I have so much trouble losing weight. I go to the gym and watch my diet. I’m only 35 pounds overweight. I’m doing all I can. Dr. Mike, not everyone is sitting on the couch eating junk food. I continue doing my best and nothing is happening. Sorry I don’t live in your perfect world. Your gust is a very awesome doctor who really cares her patients!
19:21 a full-time job (to lose weight)
Y. E. S. I HAVE LIVED THIS 😮😮 Dr. Mike thank you so so much for having her on your show.
I really love watching this channel very awesome and informative, we're you watching from?
Exactly. After losing 150lbs, I spent so much mental and physical energy on keeping the weight off. Fighting with cravings and food choices for 4, 5, 6 years is so draining. My brain fought me every single day. Those horrible intrusive thoughts of "oh just one bite" and you've eaten a whole cake...it was the worst mental fight of my life. After experiencing hypoglycemia, I tried semaglutides and suddenly that mental fight was silenced. It was so sudden and so relieving. I really want to emphasize how insanely difficult food addiction is to battle, and it was absolutely miraculous to me when semaglutide somehow turned my brain back to a normal, non obsessive muscle. Dr Mike may have opinions on obesity, but the mental fight is something difficult to understand if you haven't experienced it.
when she said that i felt it! oh my god. i felt seen
I enjoyed this conversion, I am surprised however to not have heard any mention of access. The lack of insurance coverage and the high cost of these medications are barriers for most people who need this help.
Love you turning this around on her to make sure people know they still hold responsibility over there choices❤the reason why people don’t get the satiation response is because most of what’s consumed in the place of food is not real food. It’s all condensed calorie bombs, low fiber, low water, so no real feeling of fullness until it’s far past the need. Our bodies want vitamins and minerals, not just macros. ✨
3x board certified Queen Dr. Rocio Salas-Whalen 👑 She speaks facts on so many different levels, to emphasize and understand now a days is such a hard quality to find in a provider! I have such a crazy weight loss history story that it’s too much to write, but everything she said YES! ❤
I love the open conversation on a subject that is not, generally, included in conversation. This is quite informative. Thank, Dr. Mike.
As a clinical pharmacist, I absolutely enjoyed listening to this episode. You gave viewers who are not in the medical field the many different point of views as to when weight loss medications should be incorporated. I would agree that I would not be offering them to everyone suffering with obesity to help “lift the responsibility off their shoulders.”
Dr Mike is growing. I see such maturing of style and delivery! THank you Dr. Mike
lol 🙄
This was very informative. I'm on ozempic due to needing help with weight loss and diabetes control. My doctor never mentioned the topic of muscle nor protein in take. I am going to mention this to her. Maybe she's unaware. Thank you for having this conversation.
Good job for taking this information to your doctor and advocating for yourself! 🫶🏻 wish you the best
Well done you, take polite charge and question as you learn. I do hope your treatment goes hand in hand with the lifestyle choices you are facing. Embrace them. It will be better than the meds. Good luck, you are the biggest part of the treatment and success.
@@imaner76 thank you so muvh
Honestly same here. They never said anything about muscle loss to me and boy did I notice after a few months. Also my doctor was disappointed in how much I have lost from my first appointment after taking ozempic to the next. I was like umm you do realize I have lost 30lbs in two months. I have another appointment next month with him and I will be bringing this up.
That makes me nervous about the muscle loss cuz I am big enough and not mobile enough and in pain to work out at this point. I will be able to hopefully after I've lost a bit more.
One of the best weight loss TH-cam videos I've seen. (Internal Medicine Doc)
I feel like this discussion really skirted around the issue of eating disorders. It talked about people on extremely restrictive diets, people who just wanted to lose a few pounds for aesthetic reasons, people who'd been trying diets since childhood, irresponsible providers...but never explicitly mentioned eating disorders. I appreciate that they discussed the importance of losing weight in a healthy way, but it was mostly framed as being because these unhealthy ways of losing weight will "fail" or are unsustainable, rather than having serious health consequences. I didn't know that losing weight too quickly could cause gallstones until after I found myself screaming in pain, barely able to crawl across my apartment to unlock the door for paramedics. Not to mention things like micronutrient deficiencies. I think it's important to screen patients looking to lose weight to see if they have a history of eating disorders (especially restrictive eating disorders) or are at a high risk of developing them.
THIS!!
Very good point.
this medication has all but cured my ED. having the food noise go away had given me the control my ED was faking. the food noise doesn't control my life. i had soo much brain power i upped my therapy to twice a week to try to handle this in a healthy way. this is the most powerful ED tool i've ever experienced and i'm a black belt in that stuff now. ;)
coupled with therapy, this will help soo many people struggling with food=soothed trauma.
I have to say props to this lady❤️ I have struggled with weight all my life and I am so happy that she is informing people that we do try! We Think about our weight every single day and we Dream of the day where we can take charge and truly have a healthy lifestyle… but losing like 50 kilos is A LOT! And it takes years and years to Reach that goal. This was a good discussion and I am now considering wegovy❤️ Thank you for Sharing!
I started taking Wegovy in March and have lost over 60lbs. The problem now is there is a shortage. You have to take action to help with the weight loss. You can't rely on the meds and think it'll fix you. I'm the only person in my family that hasn't had a stroke, so I am constantly worried about weight issues
How are your side effects? Any tips? I just started
As soon as I saw that all of these celebrities (Oprah, Rebel Wilson, Adele, Kelly Clarkson, etc) who have tried every other diet are now within normal weight ranges, I knew something new was going on. If those wealthy people with all of the connections in the world, and access to the best dieticians and trainers available, and the motivation of public shame couldn’t do it in their own, what chance did I have? After 20+ years of steadily gaining weight, and only keeping weight off for a few months on Weight Watchers and fasting and various other diets, I finally decided that I don’t care about the people who say disparaging things about it being a “crutch.” If it works, why am not allowed to stave off type two diabetes and get healthier and happier? Why should I have to wait until I’m actually diabetic? I’m not Kim Kardashian trying to get into a dress that’s way too small for me. I’m a person who has mobility issues due to weight, and is finally seeing a light at the end of the tunnel.
My doctor did require that I see a dietician and get on a healthy eating plan as well.
❤Ah! Can't leave a comment except below someone else's. That's ok. Anyway, I love the guest doctor! She's covered everything and made sense---very holistic and compassionate toward the real life long suffering many of her patients have endured. Her overall genius is impressive to this humble licensed Health Science educator. Dr Mike's brainiac and seemingly cognitive empathy and overly emphasized need to get patients off of SSRIs is bothersome only in that doctors who seem anxious, a little touchy, and controlling are often condescending to the "poor medically uneducated" patient. They tend to hide their blame of the patient, but it seeps out in their attitude, just as in this conversation. Contrast the guest to him and it's day and night!❤
@@deanaburnham9571 Well at least someone replied to my comment :)
But yeah, TH-cam is weird and just makes comments disappear, or won’t let you make a new comment. I kinda hate how they sort of shadow ban, or light shadow ban, all of us for weird reasons. Like oh no this person is commenting a lot. Better block them.
Oprah hosted a 1 hour special on ABC in March 2024 called "Shame, Blame and the Weightloss Revolution" after leaving Weight Watchers, talking about how happy she is taking glp-1 (she didn't name the medication). It was very unusual for me to hear that she always heard food noise before this, tried losing weight by exercising, diets all her life but nothing worked until now. Myself I am considered obese now, having gained weight slowly into my menopausal years at age 60. Would I take Ozempic? Not yet. This interview was the best, and thank you both for having this for us all to watch and learn. So many questions I had about Ozempic were answered. It will be interesting what the US will look like in 10 years with this being popular now.
I have been obese since childhood, and have extreme hormone issues. I am using no drugs to achieve similar outcomes of the drug. I went to a health retreat for a week where they eliminated sugar and gluten from the food, and showed me ways to eat that are vegetable heavy, and ways to move that help digestion (eg short bits of exercise, multiple times a day). The weight loss is slow but happening. And I’m changing my ways and feel that I can maintain it. I am listening to my body and I’m giving it foods that do not spike my sugar levels, so I don’t get as hungry. And I’m learning to enjoy cooking and eating vegetable and protein based meals. Many people who are bigger have lost weight like this. I’ve met them, and they gave me hope. It is possible, and you can do it. Some of these people who are bigger than me do intermittent fasting where they don’t eat breakfast, so they fast overnight into the morning. And another one is doing what I’m doing - cutting out breads, pastry and white carby, glutinous foods. I also exercise daily, doing activities I like to do. I’m doing it - you can do it!!
Thats awesome! Keep it up. The world is setting us up for taking a easy way out but it's costing our health. It ain't easy but you're doing the right thing.
Keep up the good work! Natural weight loss is far healthier than using drugs.
I hear her saying that most patients will never get off of these drugs once they are on them. And then in the next sentence she says that she always talks to her patients about getting off of this drug at some point. HUH?? I think our society has gone off the rails when it comes to the conversations that we need to be having around healthy lifestyles. We are always looking for the quick fix. Thank you, Dr. Mike for the conversations you are having about this.
You probably missed Minute 34:20
I really appreciate how she mentioned contributing factors to obesity and how putting all the reason and responsibility on the patient isn't helpful. She worded that beautifully, and her understanding and empathy show that she cares about her patients' wellbeing.
I opt'd for a gastric bypass. It was the best thing I have ever done for my health! Diabties,acid reflux gone, sleep apnea better.This along with diet and exersice is a great option. I feel better than I have in years! I am happy to hear that there is a push to stop using BMI as an indicator for being over weight! Also the procedure is done using laparoscopy surgery, recover time is much less than in previous years. This was a really good interview thanks @Doctor Mike. Also whatever option you choose never let anyone convince you that you are taking the 'easy way out'! I should also note that here in Canada there is a year long process with a dietation, Dr, and psychiatrist before you are approved to have the procedure.
Diabetes gone? I doubt that.
There's nothing easy about gastric bypass. Like these drugs, it's a tool to help you get to a point where you CAN put in the work. Congrats on your success and getting to a healthier you!
I wish I could have gotten that done. I have rare genetic diseases that cause bleeding disorders, so he said I would probably die on the table. I spent hundreds of dollars to find out that I couldn’t get it. I had two family members that got it done. One of them did fine, and she kept most the weight off. The other one had a major issue right after surgery, they put him back under the knife, to correct it, but he came away with infections, and annul issues. It almost killed him. I hope you are able to find peace and happiness, and stay healthy for the rest of your life. You are worthy of good health!!!
Is about changing your habits and outing in the work.. Otherwise yiu just balloon back up.. Because main issue was not adressed but quick fixed. It happened to my aunt and many other people. There is no real shortcut here
I’d rather try a drugs first than cut up my body to make that work as that is permanent and still can have issues come back. My endocrinologist warned me that with my GERD gastric bypass was not a good idea as well.
Dr Mike, you responded to your guest saying she doesn't see lazy obese patients by saying you do. But in your explanation you point out that the ones you see that are the couch potato type aren't coming to you for weight loss. That's the difference. When people seek out a specialist for weight loss they are trying and have been trying to lose weight for a while.
My thoughts exactly. Like they clearly have exhausted every other solution once they find themselves in her office desperate
I'm disappointed in him, and have unsubscribed
@EK-xz8ig honestly, yeah, this conversation was a big letdown from him.
Yeah, the profiles are very different, she is the last resource for many.
Or they were just referred to a clinic like hers from their primary care doctor who wants their patients to work on their obesity.
She has her own perspective, but his is not at all invalid.
Interesting discussion. I do think Dr Mike asking the questions about putting more responsibility on the patients versus giving them the point of blame being “genetics” etc is very valid… we do need to continue to emphasize that disease may not always be your fault, it is your responsibility to manage if you wish to give yourself the best chance at a good life.
Thank you for doing this interview. I’m on week 9 of Wegovy and steadily losing about 2 lbs per week after being obese for 3 decades. I’m down 21 lbs in 2 months, my side effects are minimal, I feel great and I’m so excited and motivated to keep going on my weight loss journey. In the past m, I’ve tried fad diets, diet pills including OTC and Rx like phentermine, weight watchers, and nothing worked long term or I couldn’t stay with it over the long term. I feel like this med is helping me change my life, exercise and eating habits. I feel like I can have success with this long term.
I really love watching this channel very awesome and informative, we're you watching from?
I love how you also talked about patients getting into SSRIs. It's reassuring that there's a possibility of weaning off of it and there are real patients going through it too. As much as I love taking them, the fluctuations in my weight is something I would really love to not have.
Really Appreciate her! I am Not perfect as an eater. But I do get my fruits & veggies in & I do moderate exercise in. As a single mom w/Professional job I am Often Exhausted mentally & emotionally & physically.
Yet I am Overweight. When I was younger And had High cardio my weight was muuuuuuuuch better. But as a single mom I Truly do my Best.
Society is also against us being healthy.
Recognizing me personally doing My Best + a bit of help could be all I need.
I lost 40lbs on wegovy and loved it! People who want to say people "dont need it" need to remember, they don't have access to other people's blood work. Their anger might be misplaced 😉. As always, consult your own doctor and refrain from diagnosing strangers 🤗
If it's necessary, like say your metabolism or any other sickness keep you from losing the weight with sport and a healthy diet - and I mean like balanced, without starving yourself, I think it's fair. However, there are probably many people thinking it's the easy way out, like Dr. Mike said. Those people are not only taking those drugs from the people who actual need it, they are kinda responsible for all the fake drugs going around. And those are literally deadly. They even end up in hospitals, even in Germany where I live. It's crazy.
Preach! I’ve been ripped to shreds for using ozempic but I’m disabled and unable to work out. Being disabled so suddenly I gained so much weight. Not everyone has the capability of just “going to the gym”. I’m so glad you had success.
Interesting discussion. Thanks for this
@DrBeauHightower It's funny because I'm a fan of your channel and see your comments on so many videos. I think we have very similar interests. I've your comments are probably 50-plus videos. It's nice to see I'm not the only one scouring the deep reaches of TH-cam.
Interesting was certainly one way to put it lol. I’m alarmed that the answer to our nations obesity problem is long term drug use. Our society as a whole is the issue.. the fast food around every corner, the preservatives in our foods, the portion controls, our overly stressful lives, mental health issues.. on and on . There are so many smaller things that have contributed to this problem and I’m so alarmed that her answer is to medicate almost every single person that struggles with weight. I just don’t know how I feel about this. I’m no expert and she’s much smarter than me haha but something about this doesn’t feel right.
@@jimkazetsky5897 🤘🤘🤘
@@jimkazetsky5897why is there very little discussion on this about neurology of obesity. The emotional system..we live in a culture of emotional sedation of trauma absorbed in innocence as children, sticky safeness. Motivation is talked about..there is an acceptance about not enough time. So either the model changes or start to regulate psychology opened out to therapists but tracking of outcomes by their regulatory body & patients details given to the regulatory body as results survey.. we have get away from feelings avoidance the toxicity of don't cry ideology prevalence in traditional masculinity leading to higher suicide rates etc..we can run away from the emotional system & deny it's importance. But it is the seat of decisions.. it's time ethical medicine graphs this can learns those modalities to employ with patients in the conversation with mp3s part of the audio prescription to enable emotional resolution.
I’m neither alarmed or surprised, the government has always rewarded poor behavior. Unfortunately, it’s become my expectation that these incompetent politicians do not have our best interest in mind.
Oh Dr. Silas, you sound just like my doctor and my doctor has been such an angel. Thanks to her. I have been able to successfully keep weight off although I’m still very much on my journey. I’ve had so many doctors believe that I just wasn’t trying hard enough so thank you for this. It’s people like you that are going to help people with obesity have a much better quality of life
This was such an amazing interview, as someone who has lost 21 KG from April to this day (around 47 pounds), the take she has is the same my nutrionist had, and it's been an amazing journey, not killing myself with strict diets yet putting up in the gym with weight training, I do not take any medications yet I feel amazing!
Wow, 21 Kg is lot, keep up the good work
wait until you get bored from the gym
Damn I feel like I could have written this comment myself. Made some changes to my diet (cut Fats and Sugars, increased protein and fiber) reduced calories to 2200, 35-40% carbs and protein, and 25-30% fat, working out for an hour 6x a week and down 45lbs.
@@chuck180cross training
Oh what a fresh breath of air. She is saying everything I have been feeling for years. Diets do not work because the brain still talks to you to eat
Yes the brain does so even more when you are restricting and not allowed to eat certain foods, etc
As a person who is a healthy weight I always looked negatively at ozempic. I do work hard to keep myself a healthy weight and have never been overweight. This conversation really changed my outlook. In the end it doesn't matter if it has some side effects, the side effects of being extremely overweight are much worse and this drug gives peole back their lives, which some have not ever even had before. Who cares if it's 'cheating' or 'an easy way out'. If it's for a fulfilling life, people should do it!
I’ve struggled with weight my entire adult life and the ONLY time I’ve been able to lose significant amount of weight was when I went on a very low calorie diet, like 500 calories a day. It was mentally and physically exhausting. Naturally I gained it back once I stopped torturing myself. I prefer a Whole Foods diet, with little to no processed food and I still gained it back. I started this medication just a few weeks ago and I can attest the reduced “food noise” is a game changer. I eat significantly less but I’m not always thinking about what I’m allowed and not allowed to eat. It is actually the opposite. I know I need to get maximum nutrition in my meals because I eat so much less so I my meal choices are based on that and not on calories.
Losing 20% of your weight makes one feel so much better and makes exercise so much easier.
I think about food 24/7. Even when I am focusing on other things, there is constant food noise. The way she describes this struggle is a huge eye opener for me, to know some doctors really understand the struggle. Great podcast.
48:16 "I have yet to meet the single patient with obesity that is the couch potato that we have the picture of."
So refreshing to find a doctor that sees this, and believes that sometimes, you can have the perfect lifestyle and STILL not see the results.
I can promise you most obese people do not have a perfect lifestyle. All the obese people I know are inactive and eat junk. But yes, there are exceptions to the rules.
For me, loosing weight was so absolutely impossible because my depression made it so difficult. I would eat just to cope as an alternative to self-die. And when its either suicide or obesity I suppose society moves you in the direction of fatness.
I'm sorry you've gone through that. ❤
More people need to realize that those aren't the only options, and we should be moving away from the quick fixes whether it be pharma, food, drugs etc. I know it is easy to opt for those but solving the root cause is much more beneficial even if it is harder in the beginning. If you know the reason for putting on weight, or difficulty losing it, then you are ahead of most.
I think mental health is a really important factor in this conversation. It sounds like you have been through a lot. I'm glad your here. I hope you are getting some support!
This is not just one person. I am in the same situation. I could maybe take drugs, or drink alcohol or cut myself instead of overeat...but that would made it all even worse. Why don't I go the a therapy? I wait for over a year now to see a therapist. The waiting time is long where I live. The obesity problem is a symptom of mental health crisis all over the world.
@@2leg1t2qwt5if you know how to solve depression, please share. There are millions waiting to hear, as well as their doctors.
What she talks about at 6:55 was EXACTLY my experience. I was "skinny fat". Overweight but didn't really look it, struggled with binge eating my entire adult life, and initially sought Ozempic/Mounjaro because I hated looking at myself, and for health reasons. Eventually, my whole attitude about myself changed after losing just a few pounds and feeling more in control of my food choices. I've been going to the gym regularly, making healthier choices (not just eating smaller amounts of junk), and EVERYTHING about my life, both personal and professional, has improved.
I LOVE the conversation about whether it is empowering or disempowering to believe you have control over your condition. I have stage 3 endometriosis which is obviously an incredibly complex disease but because it is an inflammatory condition, reducing stress, avoiding inflammatory foods etc. can seriously reduce symptoms. For some reason though, I've seen people with my disease get SO ANGRY when anyone suggests that making changes to their diet or lifestyle may help.
To me, the thought that I was 100% at the mercy of the healthcare system when my disease is severely under-researched, under-diagnosed, and misunderstood was terrifying. The thought that I could make changes to my lifestyle and see symptom relief was so freeing to me but to others, suggesting that anything other than surgery and hardcore medication could help them was an insult.
My theory is that by accepting that your choices can help your condition, you also have to accept that your choices may have been worsening your condition, which is a tough pill to swallow. We can't all know what's right for our bodies so there's no reason to feel guilt or reject medical help even if our choices do lead to disease. I hope we can get to a place where there's balance.
Well put!
Part of the problem is that the normal rhetoric around obesity isn't just "your choices have had an impact on your weight". It's usually "it's your fault you got this way so just stop and you'll get better. Why haven't you stopped yet? Just do it." But there is a very dangerous allure to the idea that if it's not your fault then you have no control and may as well just eat whatever you like. Like you said, reality is in the middle. But honestly I think our society as a whole doesn't do middle-ground anything any more. It's all extremes.
People get angry because that's a half step away from patient blaming. I have chronic migraine, for instance, and people are always like, reduce stress! Eat better! Drink more! Etc etc. That may help me avoid a migraine here and there, but the fact is that I have migraine. It's a neurological condition. It won't disappear because I drank enough water, and it's insulting to imply that it will. There's this idea that healthy people have, that they are healthy because of the choices they've made, and unhealthy people must have made poor choices. It doesn't take into account genetics and basic biology. I'm glad those things help you feel better- that's great, keep on doing it. But keep in mind that what works for you may not work in others, or it may not be feasible for them for whatever reason.
@@misschanandelerbong7946 oh I'm not at all saying that lifestyle changes will cure a disease. I still needed major surgery when my disease led to a burst cyst and sepsis, no amount of stress-reduction or changes to my diet would fix that. And I completely understand (and have experienced many times) that many medical professionals don't have the empathy or understanding to make lifestyle suggestions for symptom reduction without blaming a patient or minimizing their pain. All I'm saying is that I think it's an interesting conversation and that I do believe there's a way to give patients recommendations in a way that feels empowering and gives them some control so that they don't feel like their diagnosis means everything is hopeless. Migraines suck, I'm sorry you have to go through that!
@@OldSchoolLPsGames Absolutely agree! In my experience, a lot of medical professionals haven't found that balance. They either think it's a joke that lifestyle or anything outside of medicine could improve your quality of life, or they're at the other end of the spectrum and won't even investigate your symptoms because they assume the problem is your weight or the fact that you smoke etc. Any productive path forward needs to include taking patients seriously and actually investigating symptoms. Even if, in the end, a lifestyle change would help, that conversation needs to be approached with empathy
This definately helped me examine some of my biases about weight loss. My primary concern for most patients is poor nutrition with reduced food intake. Just because patients decrease food intake doesn't mean they are eating healthy and I am concerned about the nutrient density of their food. Not to mention the many benefits that come with lifestyle changes such as increased physical activity, which may be missed out on without that in conjunction. That being said I do feel that when patients are struggling to even be physically active due to weight, especially when they have an orthopedic condition in conjunction with that, can especially benefit from these medications. Or, and I'm still not sure if I actually believe this, for patients who refuse to change lifestyle, to at least give them some better quality of life and lower healthcare utilization.
Also I’m only on .25mg/3mL. I don’t plan to increase until I plateau if that is even necessary.
I'm still new to Dr. Mike, so I don't know anything about a lot of past videos, or if his views have changed at all with new knowledge and education. But I certainly can't see why anyone would see this man as fat phobic. He seems logical, empathetic, understanding, and realistic about the topic. I think a lot of his questions might not have just been his curiosities, but a lot of what we hear from the general public. That non-natural approaches are "cheat methods" that "natural is better" etc. I think he cares very much about this matter and wants to see people feeling better! Great video!
For me, Ozempic and Mounjaro have been life savers. I’ve tried EVERYTHING. Nothing works long term. Call it the easy way, call it cheating, I don’t care. I’ve lost 87 lbs in 2 years, (weight loss stopped for a year while I fought breast cancer and switched to Mounjaro when Ozempic stopped working) I feel better than ever!
I really love watching this channel very awesome and informative, we're you watching from?
I really enjoyed this conversation she was compassionate and caring and her end goal is just the health of her patients ❤️
What an absolutely fabulous guest. She very clearly knows how to navigate the world of hype and misinformation in a way that is accessible to the listener. Thank you for this!
Doctor Mike is a genius! He asked all the questions that I wanted to ask as a medical intern in nephrology. And this interview in general is extremely useful for every physician in order to make proper decisions in today's more and more personalized medicine.
Looking forward to listening to this. It’s frustrating to me to see all these people on social media (mainly women) who are getting rx for ozempic despite not being t2 or even needing to lose weight for medical reasons. All it’s going to do is make it harder for those who really need it to get it.
Exactly!
I have found that a LOT of people who have autoimmune diseases (and are not overweight at all) are being prescribed this...not for the weight loss...not for blood sugar issues...but apparently it is helpful for autoimmune treatment. So, it's not all just people trying to lose weight. Although I do see the anger...diabetes can be immediately life threatening and detrimental.
@sonjablue9850 very true, there are some studies that have shown it can be helpful for people with certain autoimmune diseases!
@@skyelynnaeceliacs is one of those diseases.
I think the issue with the shortage isn’t the patients or doctors faults who are utilizing this for reasons other than diabetes or obvious obesity. It seems like doctors are finding it can help more people and more people are seeking out help knowing there are medication options for them. I think they simply need to make more of the drug, which I’ve seen they are working on. This argument is similar to people with adhd being frustrated that people without adhd are getting prescribed stimulants and then blame these people for using a medication they “don’t need”. More people benefiting from a medication shouldn’t be seen as a bad thing or empower strangers on the internet to determine whether or not someone’s prescription is necessary for them or not. That can only be determined by the individual patient and their prescribing doctor. The production of these drugs need to work to provide for the increases in demand, which seems to be continuing to increase as doctors find that this medication can help with a variety of conditions.
Great show. One thing: You have to separate the businesses online popping up shipping meds from who knows where vs. doctors working with licensed pharmacists who operate FDA-regulated 503B sterile compounding pharmacies. I've been prescribed compounded medicines before and have used both the branded and non-branded GLP-1 medication (tirzepatide). The meds worked the same. Without compounding, many people would be SOL in these shortages.
30:25 I really like that the host called her out on this narrative here. This is the same thing all the medspas are telling my friends when they sell them semaglutide - that nobody has time to work out and eat right, and it’s not fair to ask that of people, so they should just go on the drug. But then they tell them that maintaining the weight loss will be dependent on eating right and building muscle. This is a contradiction. Either lifestyle impacts weight loss or it doesn’t. You can’t tell people they don’t have time for lifestyle changes in order to sell them your drug, but then tell them they have to make those same lifestyle changes in order for that same drug to work. It’s honestly become a selling tactic, telling vulnerable people that the bar for change is sky high and unachievable without medication.
I got put on Mounjaro last year and at first it was great. I was losing weight and eating better so I thought all was good. I started getting these pains in my upper abdomen that were so severe I thought I was going to die. After going to my doctor I realized that my gallbladder was acting up. A few months later I had to get it removed. Please be aware of gallbladder and pancreas issues that may arise from taking these drugs!
This is the first of your videos I’ve watched, and I really appreciate the educated and honest conversation. I got a lot of insight from both of your perspectives and the important questions you posed. ⭐️⭐️⭐️⭐️
I'm in the early stages of using Ozempic. The side effects have been mostly mild - some nasty acid reflux (solved by changing my sleep position), lots of gas. As a morbidly obese patient with diabetes, I see it as an aid. I still have to eat better and exercise. It ain't easy at all.
A lot of people cast judgement but don’t actually understand what the drug is and requires. Best of luck on your weight loss journey. I’m rooting for you
OMG so many doctors need, i mean NEED to listen to her! She is so guiltfree! Obesity is not the fault of a person. Its a disease in itself! But please, make enough Ozempic for everyone! I have to switch to Rybelsus, tablets, and its so not the same with my sugar levels.
Yes. When I was young I ate healthy and played all kinds of sports and never got fat. Then when I become an adult and started to drink tons of soda and eat tons of fast food meals, and was no longer playing sports, I became fat. I knew what I was doing was unhealthy, but I continued to do it anyway. Definitely not my fault though. I guess I had no choice in the matter.