Dr. Ren-Fielding is my surgeon. She performed my VSG surgery on 11.11.2021.... this incredible surgeon saved my life. Not only did I lose the weight needed to (100 lbs down from my highest of 265, currently maintaining the loss) all of my medical issues have been reversed or put into remission. High BP and cholesterol, gone. Sleep apnea, heel spurs, gone. Fatty liver, reversed. Chronic asthma, controlled. Leukocytosis and thrombocytosis gone. T2 diabetes in remission. And my PCOS is so well controlled that I am actually considering having a baby because I am having healthy, normal ovulations for the first time in my life. Her expertise and guidance is something I fall back to every single day. THANK YOU DR REN-FIELDING. I'm finally living because of you . People... listen to this surgeon! She knows what she is talking about!
Out of curiosity, was that something that insurance covered as "medically necessary" ? Or did your insurance company push the idea that it's "cosmetic" in nature?
Something I learned from you, Dr Mike, is to appreciate when a doctor can and is willing to say, "I don't know." And this episode re-emphasized the importance of that.
So nice to listen to an actual doctor interviewing other scientists/doctors and not just Joe Rogans of the world. Respect, Doctor Mike. I will show you to my little cousin instead Joe.
Rogan has some experts but a lot of charlatans too, and he doesn't have the expertise himself to push back on misinformation. Also, he's has a supplement company selling snake oil for 15+ years
@@jasongrundy1717 yeah, he does have great experts on... And sometimes even NOT so great "experts" on, and he just affirmatively says "mmm" to whatever is being shoved to his face, even if it contradicts the person that sat in front of him last week. Incapable of intelligent pushback most of the time. But my personal favorite occurrence on JRE is, when he invites a world class expert on, and then proceeds to cut him off 30 minutes into the conversation to go on an hour long tangent about "the trans", wokeness, women's sports and "the radical left", it doesn't really matter who the guest is, Joe manages to fit his favorite topic into any conversation 😇. Add on mandatory topics he has to touch regularly as well, such as chimps, bow hunting, DTM and aliens, and no egaggeration, I have seen him derail half or even more time that could've been an interesting discussion 😕. Crazy just how much that podcast fell off, used to be a regular listener 6-8 years ago, but it has been gradually declining, to the point where it is now, politically heavily biased embarrassment 🧐
AMEN! And according to that lipedema... Even my doctors say... well... your body just says ... no. I am able to lose some weight if I live on 1500kcal PLUS intermittent fasting... Who knew.. I am only able to keep that up a few months.. I will have surgery next year.. and I have major respect... it's a huge deal for me.. 🙈
I love that Dr. Christine Ren-Fielding isn't tainted by social media and only provide scientific facts. Also kinda cute she's not aware of what's going on on social media. Glad she's not about the trend and just about science and experience. Thanks for this episode. Well done.
it's always funny to me when Mike has to explain to these esteemed experts how your average joe consumes information. it's actually really depressing 😭but i really appreciate his effort to bridge this gap and teach people how to express themselves in a more precise way given the current climate
Three years Post-Op RNY Gastric Bypass. I have zero regrets, even with an option today of medication, I wouldn't change my decision at all. 400lbs to 220lbs. I've ran 4 marathons since then. This has saved my life. No more apnea, my cholesterol is under control, my diabetes is gone. literally Best decision ever.
Congratulations! It's a life changing surgery with long term benefits, and people shouldn't be shamed for getting it. Do people get shamed for thyroid removal for hyperthyroidism? or a coronary bypass to treat blocked arteries? Absolutely not. They won't tell you to just "diet and exercise like a true person with effort," so why bariatric surgery getting all the flack? The conditions all these surgeries are treating are CHRONIC
Same for me. Got bariatric surgery in july. Have lost almost 80 pounds since then. My hyper tension is under control, cholesterol levels are way better and I sleep way better since I don't snore anymore. Best money I have spent
I am 46 years old, and I've never heard a doctor any doctor talk about weight without the shame or judgment. Until today, Dr. Ren spoke about treating the patient as a whole. I didn't hear anything but genuine concern for her patients' lives and well-being. I enjoyed this very much and renewed my faith in doctors and humanity as a whole.
I had bariatric surgery 13 months ago - best decision I ever made! I have to work every day to make good choices to keep the weight off but so thankful science has allowed this for my health, family and future.
I love how soothing Dr. Mike's voice is! The way Dr. Christine educates us about weight regulation without being judgmental is quite refreshing as well.
Thank you Dr Mike, I'm going to have bariatrics surgery next Monday and I'm so happy that I listened to this. I have PCOS and and it's a really under-addressed issue for women.
Doctor Mike, you make a really great podcast host. You remain patient and respectful, and you pick really great guests who are informed and willing to discuss. Cheers
My sleeve saved my life. It was the hardest experience I have ever lived. Not only for the physical and mental endurance you will go through years after your surgery but also for the stigma you carry. My mother was called a monster for supporting my decision. She was and is my rock.
I completely agree. I laughed when they suggested this is the easy way out. I work hard every single day to improve my health and life. I'm a year out from my vsg and down 71lbs. I still have 60 more i want to go and i know its going to take time but having each other and advocacy like this podcast helps break the stigma we live every day! You're doing amazing making sure you keep yourself in check! Proud of you
I had bariatric surgery when i was 23 and 153kg, i am now 30 and 80kgs. Its safe to say that this surgery saved my life. It allowed me to feel healthier, achieve a better health, have a kid, and reach some of my goals and dreams!
Set point theory is fascinating. I was 300 pounds around the age of 13. From maybe 11-15 years old I was around that weight. I dropped to 190 in a single year during my Junior year of high school. To this DAY, 20 years later, I still feel like it's so easy for me to gain weight and it's WHY I train every single day and track what I eat.
I do weight lifting 4x per week and try to increase my lifts 5-10% when I'm able. I also do 1-2 days a week of "free training". Yoga, hiking, martial arts etc@@theluschmasterinc
@@theluschmasterincI don't know about him, but I eat 1400 calories a day, train 30-60 minutes a day and weigh 330. If I have a new health problem like sleep apnea I gain a lot of weight. If I add any sugar to my diet like apples or bananas, or eat high carb foods like broccoli, carrots, or squash I gain weight. My exercise these days is body weight squats, stairs, walking, and some stretching. I used to do 100 pushups and situps and do bench and curls, but I got a hernia lifting an old water heater by myself, and I can't get it fixed because of my weight.
But ease of gaining weight could also be why you got to 300lbs in the first place, not that you created a set point when you gained the weight. Not too familiar with the theory though. If I were to guess I’d say you maybe just have high amount of Grelin or something making you more hungry. Personally I do get pretty hungry even after eating a lot, but specifically it takes a lot to make feel full.
I’m a year and a half out from VSG (gastric sleeve) and I’ve lost 100 lbs. I didn’t want to get it done to start, needed it. I can now get a kidney transplant and I feel so much better. This weight loss surgery saved my life.
sending love and prayers your way. so happy you were able to lose the weight and i hope you get a kidney soon! my husband has AMKD and is awaiting a transplant too
I went from 350 to 170. I started my bariatric journey Nov 2018 and I only wish I did it sooner. I look at myself in the mirror or in pictures now and I still can’t believe what I see. I not only can do more physically and feel generally better but I am so much more confident in how I operate in the world.
I'm a Type 1 Diabetic, I have PCOS, I'm one of the most insulin resistant patients my doctors have ever seen. I'm five foot on a good day and as of September, I weighed 240lbs with very little success in losing weight by diet and exercise alone. My PCP was able to get my insurance to cover Ozempic in late September and since I've been on it, I've lost around 10lbs. This is the first time I've lost weight since I was a young adult. It has made me want to eat better, healthier, exercise more, and take better care of myself. I love how my body and my mind are changing for the better. All from a weekly shot.
"it has made me want to eat better, healthier, exercise more, and take better care of yourself" Very respectfully and correct me if im wrong. It sounds like you're saying you haven't been (consistently at least) doing those things. But the medicine made the first 10 lbs come off easy and that motivated you to change your lifestyle?
I have been on mounjaro because of pcos for over a year. I had tried every fad diet you can think of and just couldn't lose the weight. With these meds I have lost 105 lbs and counting. I have been in the gym for years as well. These meds are saving my life and keeping me from needing surgery.
@Jellyclaws221 after reading my comment again I do see where that assumption would be made. But no, I have always eaten healthy and exercised (sans 2020 at least lol). But it was all with little to no success in losing weight, and I still had a horrible time controlling my blood sugars. I should have said that the Ozempic has helped given me hope and motivation to continue eating healthy and exercising and putting in the work to become a healthier me.
I'm a nurse, out of curiosity what was your insulin routine? I currently have a patient taking hundreds of units a day (just over 200, long+short) and that's the highest I've seen in 10 years on the job
Hi Dr. Mike, I sincerely want to thank you for all the information that you have given me, a viewer over the years. Today I had my first midterm exam in medicine about a subject named PCM (professionalism, communication, and morality) and as the name suggests it teaches Ethics, the connection between a patient and his physician etc. , when I first started studying this subject, I was shocked to find that I already have a rudimentary understanding of the majority of its content, thanks to you. You are truly one of the most inspiring people on this planet and an amazing role model for myself, and for anyone with a dream to help people. I truly wish you happiness in life. Sincerely, a child you inspired.❤
I cried while watching this. I’ve struggled with weight gain for years. My body has plateaued around 250, and stayed there give or take 5 pounds over the last 15 years. Im 42. While not struggling to find a doctor that won’t tell me to simply loose 80 pounds, my weight has consistently been an issue. I can’t tell you how many times I’ve received the side comment of “loosing 10 pounds will make it easier.” While true, it doesn’t help battle the societal lessons I’ve learned over my life, coupled with ADHD and CPTSD. To hear two doctors not fat shame me or people like me, or resort to medicine first is quite refreshing and hopeful. Thank you.
Its not too late.. go talk to a specialist.. we are different and thats ok! We're around the same age and i did my surgery last year. If there's one group of doctors that understand us it's bariatric specialists!
Summer of 2023, I was 250 lbs and 49 years old, BMI of 40. I had gastric bypass surgery in February and am down 85 lbs. in 10 months. If I could have done it at 42, I would have! Don't be afraid to talk to your doctor for a referral to a bariatric surgeon.
what an amazing conversation! Thank you Dr. Mike. I had bariatric surgery in 2022 after being a food addict for YEARS. the surgery allowed me to be able to have control and ive lost 100 pounds. More importantly, i live a healthy lifestyle now. It seems so easy now... crazy this seemed impossible before. I fell in love with exercise, and i feel in control of my eating. no regrets, this surgery completely changed my life. I am forever grateful for this tool.
Doctor Mike brings joy to everyone’s day. He is not only a phenomenal person, but also an understanding and overall kind human. He is open and teaches so much. Continue the great work Mike. We all love you and your content! ❤❤😊
As someone who reached 1 year post op gastric bypass last week, I found this conversation amazing. She is right. My satisfaction is very high. My life is much bettter. lost over 120 pounds. Amazing video. Thanks.
Dr. Ren-Fielding, I have never felt angrier or more hopeless about my weight and health than after watching this. Here's how this hits me as a fat person: "Don't bother trying to lose weight with diet and exercise. It is basically impossible to get skinny that way and keep it off. You'll just be part of the 99% who fail. Oh, and I'll never relate to you since, as a skinny person, I will never have to deal with being fat." You have, without a doubt, changed lives and for some, completely eliminated major health problems. But I watch this interview and It's soul-crushing. It's beating someone when they are down. It's taking away hope and inspiration. You are telling someone motivation and will isn't enough for success. It reads as a sales pitch for surgery and not the desire to help someone create a healthy lifestyle and reduce health risks. It seems you are in the right business for selling surgery, but not providing empathy for someone who is truly struggling. "The barbaric nature of obesity" was probably your best line of the whole interview.
Thanks for bringing Dr. Ren on she was my surgeon for Lap band surgery in 2005 and saved my life, she's a phenomenal doctor who cares about her patients like her own children, she's the best of the best, i lost 130 pounds and feel great.
High protein and fiber keeps you full longer and prevents blood sugar spikes and then crashes that make you hungry again. Eating carbs with these things still does the same thing. I track calories and weight daily and have lost a lot this way.
Also remember that your body is DIFFERENT THAN OTHERS!! what works for most people doesn't work for bariatric patients. I've never been able to lose weight. Even with the best diet and exercise I will either loose 1lb or maintain. I got the sleeve a year ago and I'm only 71lbs down and we just started GLP1 meds to help me get to where my doctor and I want me to be. Nothing except both surgery and meds with diet and exercise helped me... And thats ok! Because I'm not like others... Its ok if you're not like others too!
@@dez6278I feel like you completely missed the part where she explains that diet and exercise alone does not work for everyone. Instead of sharing what works for you take in consideration the true struggles others face. My entire life people told me similar things to what you're suggesting.. exercise harder, eat less, don't eat this and eat this instead. It didn't work for me because my body's composition is not "normal" to someone like yours. Her entire point was surgery is for people who are different.
@@gingin324 I understand that. I'm sharing a tip to be less hungry for the majority -that it does work for. You're not supposed to be given these medications or the surgery if your bmi is not obese/30 and many who are obese don't have the money for lifelong medications or don't feel comfortable committing to it or a serious surgery. Btw, if sleeve worked for you, it was literally the difference in calorie intake that made you lose weight. That surgery doesn't reverse diabetes etc. Waiting for the irate reply.
This was a great interview! I don't think there's a great understanding of how much emotional and physical pain people are usually going through before they are turning to surgical or medical intervention. There's still a lot education to be put out there. It's great to see so many success stories in the comments section; that warms my heart. My mother was a prime example of a person who underwent gastric surgery, but because of a lack of food education, emotional eating/psychological factors and just plain old genetics, has returned back to her original weight within 10 years. As for Ozempic, my sister went on this for type 2 diabetes and was one of the unlucky people to have some truly terrible side effects in the few months she was on it. I think it's a great drug, for the right people, but there's always risks involved in every medication. The "celebrity" dieting fad to lose a few kilos seems truly baffling to me. It should be left for the people who actually need it for medical reasons, but maybe that's my general bias towards comedic extremes.
I’ve listen to this episode twice now and I keep coming back to it. It made me realize that all these years I did do things right (training 5-6 times a week, eat right). And yet, I didn’t lose weight as much as was expected by my trainers and nutritionists. It makes me sad that my body is setting me up for failure. I am planning to discuss what I’ve learned from this podcast with my psychologist and my family doctor this month. Thank you both of you for this amazing discussion.
GLP meds are perfect for someone like you. I was like that, Always ate right and exercised, but almost 50 pounds overweight for most of my life. This medicine takes being hungry all the time off the table. It’s not just a matter of its slowing down your digestion, mentally you can really start to notice what is going on with you and why you eat. It completely removes over eating and mindless snacking. It has changed my life and I’ve never gone over .5 mg. If you can find a provider who will keep you at a lower dose to use as a tool and lose weight slowly, it is absolutely life-changing.
I had a sleeve gastrectomy surgery about 7 years ago. At my heaviest I was 380, and I am currently 235. It was hands down the best decision I made for my health and wellness. Thanks for highlighting it.
I wish I could get CEUs from this video! 😂 As a dietitian in GI surgery I see a lot of post-bariatric pts. I would have loved to hear more about the need for lifelong vitamin supplementation because I see a lot of pts that get surgeries at other centers and come to us with complications and they seemed to not realize the severity/importance of vitamin supplementation. Deficiencies can be life threatening. For a bypass it can be like 6 vitamins a day to avoid said deficiencies and I wish more patients were aware of that prior. I would have also loved to hear about complications including long term PO intolerance and dependency on TPN. Bypass reversal is actually becoming more common in my experience. Great video, loved the dialogue and I definitely learned a lot about the surgical perspective!
If they went a surgery center in The US I can almost guarantee they were repeatedly told about the importance of lifelong supplementation. I had to sign a “contract” saying I understood the need for lifelong supplementation and had to initial a list of things that could go wrong if I didn’t keep up with them. Obviously that’s not every program, but it is many.
I had roux n y gastric bypass august 2023. My life is SO changed for the better! One of the most difficult processes to go through and definitely not the easy way out! Hard work is necessary still. I have NO regrets!
I gained 180lbs on prednisone over a year and a half period. I was 12 when it started and in total kidney failure. My skin stretched so much I have striae on 80% of my body because of it. I lost some weight after I got sick but continued to be overweight despite many years of trying to lose it. Medical trauma and chronic illness are never discussed in weight gain situations. I have high blood pressure from my kidneys being bad. I was forced to be overweight and then kind of left to figure it out on my own. My doctors always attribute to me being overweight to me eating and it was never that. I had a job last year where I walked 30,000 steps a day for 3-5 days per week (worked in trade shows.) I wasn’t eating anything and working 65-70 hours a week. I went from 221 to 170. Then when I had to quit because my kidneys were failing again and I started eating normal meals not even bad ones, I blew back up to 230 the heaviest I have ever been. I lost about 25lbs now and am in a research study which I work with a nutritionist and my nephrologist/rheumatologist and the materials they give me are actually dumb and unhelpful. I don’t understand where the disconnect is with doctors and my experiences medically. I am trying so hard every day and it’s like everything is against me. I really want to change this part of the medical industry and I’m hoping I can contribute to this study and help others with lupus and lupus nephritis who are struggling to lose weight.
I have been on prednisone for 6 years since my kidney transplant. I gained 100lbs in a year. I tried to lose weight for 5 years and only managed to lose 20lbs. I went on Ozempic in December 2023 and have lost over 100lbs. I eat around 1400 calories/day and lift weights 3 days/week. I’m not ever planning to go off this medication. Not ever.
I also had prednisone for around 1-3 years idk exactly and I went from 45 kilos at 8 to 105 kg at 15 and I ate around the same quality of food (balooed +132 lbs in 7 years)
As someone who is about 100lbs overweight at 5’2 I’ve been seriously considering bariatric surgery but so scared of the backlash from friends and family.ive failed multiple ways of losing weight and I just want control over my life again…this episode came at the perfect time and appreciate the insight ❤
unfortunately, the lack of understanding and the lack of will to understand the struggles obese people are facing is still so prevalent and while it's getting better, it's not going away any time soon. so i hope you can put what the people around you think to the side (easier said than done i know) and focus on yourself and what you want and need. there's nothing "easy" about choosing surgery nor is it your personal failure that it got to that point, even if the society has done a great job of making you feel that way. good luck with whatever you choose and all the best!
I had the same concerns I didn’t share i had surgery until people started to notice all the weight I had lost (55lbs) Mainly because my cousin had surgery before I did and she mentioned how people kept asking her every week how much weight she was losing and it put a lot of pressure on her. I went from 5’3” 256 lbs to 124 lbs in 14 months. It’s a journey but it was worth it.
Don't let anyone else decide your life for you! What's the worst they can say? You took the easy way out? So what?!? Bariatric surgery isn't easy, but if it were, why would anyone choose the hard way? Seriously, ask them that. Where else in their life do they choose the hardest way to do something instead of doing it easier? Do they think you get a trophy for suffering? The surgery is a tool, a very effective one. But it still requires work to make the right choices every day. A hand saw might be good enough for one piece of wood, but if you're building a house, you should probably get an electric one. If you have 100 pounds to lose, you're basically building a triple decker.
It’s not even just extending your life but improving the quality of your life- I am on the very last step before scheduling my surgical consult for gastric bypass- it has been over a year in preparation- I am excited and ready!
I am a Duodenal Switch WLS patient, I am 5'10"... I went from 350lbs down to 150lbs today. This was the single best thing that has ever happened in my entire life, i would make this choice a million times over
I appreciate this episode! The stigma around obesity is insane. I have always struggled with my weight. A couple of instances of this- I was in the gym 5 days a week for over a year, doing very intense workouts and eating well. Still stayed 40lbs overweight. After my miscarriage some years ago, my body just kept gaining. And it became discouraging to even try anymore. Then fast fwd to last year, i broke my ankle. I got up to 288lbs, which is almost 120lbs more than what is normal for me. Glp1 meds have literally saved me(July2024) Exercise at that weight with my ankle issues was near unbearable not to mention the strain on my other joints. I am now 40lbs down and I finally feel well enough most days to get my body moving and motivated to continue losing weight. The mental game involved with losing more than 100lbs weighs more heavily than any amount of weight im physically carrying. Add in normal life stresses, and it can seem unbearable. Treat overweight people with compassion. They're likely beating themselves up enough anyway.
As a 4 ft 10 woman who is 174 lb (started at 187) and trying to lose 45 more lbs, this came at a perfect time. I won't be using ozempic or surgery personally but this is a fantastic talk!
It’s risk versus benefit. Bariatric surgery has been around longer and we’re more familiar with its long term risks/benefits. Ozempic has his own blessings and curses, though we have had less time compared to surgical options, to see it through.
I attended a seminar about palliative care last week and one of the biggest misconceptions is that it's about end of life care only. Every condition that has to be managed and can't be cured, can be treated by a palliative care doctor. Also, every oncologist that spoke that day said they wish Palliative Care would talk to the patients in earlier stages of the disease, and not wait until nothing else can be tried.
@ yes exactly! I think palliative care is the best with diseases with symptoms . Like cancer but there are some palliatives in sickle cell treatment. Lots in chf and copd management. The diseases that don’t have a lot of treatable symptoms like the last two it is hard to pinpoint how palliative can help the most. I am working on readmissions rates. I would argue that palliative is one of the harder specialities in internal medicine. For example if you have blood infection, you get infectious disease and they put on antibiotics and just monitor everyday. If it is not working they just switch to the next level up. Treating someone pain is so much harder. You got to make sure you give them enough to help but not give them too much to harm them. You got to see why something g is not working and should you switch meds. Lot less algorithms and more nuance
Bariatric surgery saved my life! I've had some regain I've been working on however, still the most impactful decision I've ever made next to managing my mental health.
Dr. Mike, thank you for always being so curious and inclusive. I truly enjoy listening to your podcasts. As a dietetic student and a future dietitian, I was wondering if it would be possible to have a Registered Dietitian on the podcast? Many people do not know what RDNs do, who they are, how they can help patients, how they differ from nutritionists, etc. A lot of pressure has been put on medical doctors and other healthcare providers to know everything about food and nutrition and to advise people on how and what to eat when a) they barely have time for a regular appointment and b) there are others (khm khm RDNs) whose educational background and experience are exactly that - food and nutrition. Thank you!
That's a really good idea . I've seen some shows where they were discussing foods with children who didn't even know basic fruits and vegetables - food knowledge is shockingly missing from a lot of people (through no fault of their own).
By half way through listening to this, I realized that I have had many biases against this procedure. This was really informative. Thank you for posting this interview.
Dr. Christine's husband was my surgeon for gastric bypass over 10 years ago. I was just 19 years old and very scared to go under general anesthesia. He looked at me and said "I've put thousands of fat people to sleep and every single one has woken up" it made me laugh. For anyone scared, just do it. You deserve the life you want to live. My life's trajectory was completely altered for the better.
Thank you, this has really opened my eyes. I’m a nurse in the UK and I’ve noticed the rise of Ozempic being prescribed for some of our patients. Although our health system is different than in the US the A&P is still the same. Every 3 years we have to re validate as nurses and your content always features in my reflective accounts so thank you 😊
gastric bypass 6 yrs ago lost 150 lbs, doing well no need for meds. i am 150 pounds still, considered overwt. but dont care. i am 5'4". so happy that I did surgery. Have / had diabetes, hypertension, cholesterol issues gone or better. was overwt since i was 11 yrs old and now i am 59
This is such an informative bright spot! I work as a navigator for ERAS with Bariatric surgery patients and I take tirzepatide with great success. I have always thought both of these methods are incredible depending on the patient. It’s refreshing to see a convo between Dr. Mike and Dr. Christine, vs what’s on TLC, lol. Side note, insurance companies make these procedures extremely stressful. The over reach is horrible.
So refreshing to hear two intelligent adults, educated in the fields they are discussing. Not just internet bros who have no clue what they are talking about. We need to go back to listening to experts and not internet randos. That’s the only way we can come together, when we all receive accredited information and not isolationist fake news from our preferred media bubbles.
I’m taking a GLP-1 and it’s working amazing. 205lbs and now I’m at 195 only 3 months later. Feel full after 3-6 bites of food. No snacking or cravings either. Amazing medicine and have had light symptoms from it.
This is a very honest and innocent question. Please don’t take offense if it sounds otherwise. I am curious to know the motivation behind using GLP-1 for just 205 lbs?
I had SADI-S bariatric surgery three years ago and it was the best decision I've ever made! I'm glad my doctor at the time really encouraged me to do that and not all the weight loss meds. I loved this discussion!!
6 years postbariatric surgery and i have zero regrets. Going from 350 to 170 has changed my life. Unfortunately i gained 50 pounds back last year. However, the classes i took as a result of the surgery have helped me loose 30 of regain. I love that Dr. Chistine talked about treating obesity. I genuinely believe we should have a real convo about treating obesity. Getting the weight off and to Dr. Mikes point of eating exercising. There is a big missing point mental. Why are they obese. Why are we, i say we, overeating.
I'm in a program right now scheduled to get agastric sleeve surgery. When I think about surgery compared to GLP1 meds, I think about a life without dependence on a particular medication. For me, that trade off just can't really be beaten.
God is good! I am in the process of having surgery due to the fact that I have a hard time maintaining weight loss. I have PCOS and I’m actually having surgery at this very same hospital. I appreciate Dr. Mike and Dr. Christine for bringing his topic to the forefront. Thank you for the information and for your medical professional information.
My primary care, Dr. told me I'd fail. I'm 10 months out from sleeve surgery. Now, I feel that she was right and it's messing up my mind. I've lost 80 lbs. I gained 6 lbs due to eating too much surgar during the holidays. I have to change my mindset. Thank you for this.
Thank you both for your diverse and educated views on the subject. I would love for anyone, who just says to obese people "just eat less and exercise", to watch this video and maybe come to the conclusion, that its way more complicated than just that. That humans are complicated creatures and that it IS different for people, who are fit and/or slim.
I am 2 years out from gastric bypass. I have tried everything. These included working out, and ozempic on the highest dose. None of it unsustainably worked for me. I had type 2 diabetes, high cholesterol, hypertension, elevated protein in my kidneys, skin issues and was over 100 lb overweight. Was taking four meds for diabetes, one for hypertension, one for cholesterol and a multivitamin. I have lost over 100 pounds and should have done this sooner. I feel much better. I am no longer on any of the medications. The only thing I have to take for the rest of my life is vitamins which is much better than injections and pills. I feel much more inclined to be active as I have the energy for it even after a long day's work and walk five to seven miles Minimum every single day. I am 6 months into my weight training. Best thing I could ever do for myself. I will say it's not for everyone. It was the route I felt was best for me. Godspeed on those struggling with weight. I wish you all the best.
I wonder if you get liposuction after losing most of the weight, if that could stop your body from trying to fill the fat cells up again, since they are gone?
From my understanding, I think no. You get fat around the organs like what the doctor was talking about at 37:43. You get visceral fat and central obesity which is actually much more harmful to your health.
I just launched an online weight loss practice in Florida and I love that experts put out this content. I am a huge advocate of health and wellness and greatly appreciate that we have effective tools to help people lose weight. My approach is weight loss plus lifestyle changes. Thanks for the content Dr. Mike and Dr. Ren-Fielding
This was a GREAT episode. Completely changed my perspective and my idea of how weight loss works. My dad is at a point where he should probably be taking medication for weight loss and I see him struggle everyday to make healthy choices and it’s bother me that he will for a week and then bounce back but now I understand that he’s REALLY struggling like telling someone with anxiety to just not worry about it 😮
I really appreciate this episode and I wish I had seen it sooner. Since I am 5’5” and 280lbs I asked my doc about ozempic for myself because I really want to lose weight but have really struggled. She referred me to see a dietician at our local bariatric center first before going to meds and they have recommended me for surgery. I had so many misconceptions about weight loss surgery so I’m glad I saw them and have started my journey. I plan to get weight loss surgery in a few months, and information like this really helps reaffirm that this is the right decision for me and helps me feel confident in that. Thank you!
I am same height as you and weigh almost the same I am just now feeling like my weight is affecting my life I’m young only 21 but I’ve been significantly overweight my whole life and I feel like it’s catching up to me. I am so scared too at the thought of surgery and this video Definitely helped. I have an appointment with a bariatric doctor. I hope everything goes smoothly for you and I’d love it if you updated when you got your surgery and any advice you have.
@@siobn.obrien2623 I’m only 26 so I get it. The last year I gained like 30 lbs and hadn’t changed anything. It’s been making life hard which is why I wanted help losing weight. I’m down 10 lbs now, so a bit of progress! I’m still a ways out from surgery though. If I remember I’ll definitely update!
I had The " sleeve" in 2021, i was 160kgs 6'1 at the day of surgery. I am now 87kgs and honestly dont regret it at all!, i regularly exercise more than i did and im back playing rugby.
I had the bypass done in July 2024. Within the first 2 weeks I was no longer needing blood pressure or diabetic medicine. I sleep all night now. 5 months later and I’m down 100lbs. I feel amazing and this tool has been life changing.
When you are extracting clips for short reels, there are at least 2 or 3 just starting from 1:27:13. Great conversation. It looks like Doctor Mike didn’t use notes for this one; I was engaged the entire time because it seemed like a questions flowed directly from the topics covered.
I’m a 64 year old female who has been on Monjurno for over a year. I was having major back surgery and needed to lose weight. I was pre-diabetic and have lost 70 pounds. Went from size 12/14 to 4/6. My BMI is 20.0, all bloodwork normal and have had zero side effects. I truly believe I will be on this life saving drug for life.
As a recovering alcoholic with 12 years sober, I can tell you that after my first bit on food in the day my cravings go into over drive just like an addict craving for a fix. I can't avoid the first bit. Glp1 drugs helped for the first year, I loss 50lbs, I do intermitting fasting, near zero processed food, protein increase/ carb decrease but it's still a struggle.
I am so emotional listening to this. People do not understand how impacful getting bariatic surgery is. I literally feel like I got a second chance at life after getting gastric sleeve!
This was so interesting to watch! My BMI is about 48 and considering glp1 meds myself. Surgery scares me so much, but this helps ease my mind a bit! I'm in my mid 30's and so far do not have any other health issues, so I need to get this tackled now. I was able to lose 50lbs on WW before covid but it was so hard, took over my life. Anything to help!
I've been on low-dose Wegovy for a week now, and the food "noise" in my head has almost completely gone. I have almost no cravings for carbs/sugars now. It's kinda freeing.
Thank you for this interview. I had surgery 10 days ago and wish I heard this before I went in. Fat shaming, easy way out was in my head going in…you made me feel so much better!
As a T2D who got her blood sugar under control naturally. It does not silence the food noise. Someone without the experience and her doctor mentality is coming through in her talking.
As someone who had bariatric surgery This is a nice podcast to listen to I wasn't told how invasive it was with the mental health that went with it Alcohol became my crutch for mental health afterwards Not to mention several stricture surgeries Funny enough i gained all the weight back Then just lost it all back starving myself and hurting myself mentally
I’m 5’4 and I would like to lose 75 - 100 lbs but I’ve been so apathetic about taking action because I have PCOS. I’ve lost a little weight on my own and I hope I’ll continue to do so. This video is really helpful for me to know what options I have because losing weight can be really defeating when you’re actively dieting & working out but not seeing much progress.
I had my sleeve in 2013 to treat my gastroparisis. Best decision of my life. I had a lower body lift in 2015 to get rid of my excess skin. Again, best decision. I had been struggling for years and I am so happy with both decisions. They are tools not easy ways. I still have my mental struggles. I still have to watch what I eat and all that. It's a tool, and thats it.
Also, if you can, please tell your guest that I love her attitude -- especially the fact that she truly understands the impact of fat shaming, which I don't think the doctor in "My 600 pound life" does.
One thing that I think is considered too little is surgical reduction of fat, for medical rather than cosmetic reasons. My own BMI was around 55, according to an NIH calculator (I'm well under 5 feet tall), and I had both ovarian and endometrial cancer. As part of my surgical treatment I had a pannectomy -- removal of the hanging abdomen, both skin and fat -- which resulted in about 35 pounds of weight loss. Most of that weight loss stayed off. As an aside, I didn't change my diet, except that for some time I needed to go on a LOW fibre diet due to the radiation I also had (which is known to cause diarrhea). I resisted that for a time, because it had cost me some effort to raise my fibre, but when I told the nutritionist I was thinking of it as "eating unhealthily" (because I didn't want to get used to it and have trouble eating high fibre again), she pointed out that eating very little fibre was healthy eating for me at that time. When I asked why pannectomies were not regularly done -- mine was an enormous boon -- I was told, "Oh, they generally grow back." The thing is that "growing back" is not a binary matter. In the years since 2007, when I had surgery, I have reacquired a little pooch at the bottom of my abdomen. So did my pannus grow back or not? The little pooch is maybe 5% of the size of the original pannus, so you could say it grew back -- but the benefits of that surgery remain, not far short of two decades since the operation. It was a bonus to me -- quite aside from curing the cancer, of course -- but I couldn't say the hanging fat and skin is ALL gone. If you put me in a database saying "grew back" or "didn't grow back," it might be said that I was in the "grew back" category -- and that would badly misstate the effectiveness of pannectomy for me. Equally, I wonder whether surgical removal of other large fat accumulations -- direct removal of fat cells, whether by liposuction or direct surgery -- might not be medically effective for many very fat people. I would suspect that little research has been done on that topic, due to the stigma of "taking the easy way out" of fat loss, and stigma against fat people in general.
Thank you for discussing this issue. It was one of the things that I was wondering about during the interview and hoped that they would address, particularly as is relates to set theory. It seems to me that if the empty fat cells are one of the issues driving the regain of weight, then the removal of excess ones in the pannus would help counter that.
I have lost over 65 kg, over half my highest weight by diet alone, and am keeping them off, so I am obviously biased, but I think that this was the very best interview on this medication/surgery subject I have ever seen. I recommend it to anyone who is struggling with weight.
I had the band surgery about 10 years ago and it did nothing for me at all. During Covid, my weight ballooned and I lost my mobility. In 2022 I had the band removed and I was supposed to have the sleeve gastrectomy a few months later. But in the meantime I developed severe debilitating lymphedema and gained even more weight and had to stop working. I became diabetic. It was only then that I got approved for mounjaro and it helped me lose 60 pounds to finally have the sleeve surgery. I’m now a month post op and as of 2 weeks ago l’ve lost almost 100 pounds and am finally starting to get my life back. So many people are ignorant as to the struggles and treatment, even doctors and nutritionists. I’m hoping to go back to school and become a nutritionist to provide the empathy and support to others.
I've had the lap sleeve and then I needed to have a bypass because of the acid reflux. I've lost over 100 pounds and found a new life. I have zero regrets.
I was so glad to see this. I'm a 200 lb. 67 year old formerly bulimic woman with one lung awaiting knee replacement surgery. I was able to get my weight down to 164 last year through healthy eating and walking 5 miles a day. I began gaining the weight back in January when my knee became bone on bone and I could no longer walk. Now I spend most days lying on the couch eating. My knee replacement is scheduled for March 2025. I need to lose weight and cannot find the motivation to do so. I'm on mood stablizers and antidepressants which makes it more difficult. I can't take nsaids for my knee pain due to bad kidneys. My PCP has offered a version of Ozempic but it scares me. I'm already taking a lot of medications that have messed with my metabolism. I need help to decide what to do to lose the weight.
I think it's worth talking through your fears with your PCP. Your history of Ed makes things like sleeve surgery tricky because it could trigger some stuff. I struggled with bulimia too but luckly I've been OK for the past 10 years, so I'm a less risky patient for surgery now. Time restricted eating and a low carb diet might help move a small amount of the weight to help with the knee.
My new knees have made a world of difference! I've lost weight for the first time in my life just because I can be more active again. My personal, non-medically trained opinion is to get your knee taken care of first, then think about your weight. I'm 5'6" and my weight peaked at 256lbs right before surgery. Less than a year out, I'm at 238lbs and still trending down. I'm just now working on adjusting what I eat. I've stopped taking ibuprofen. I went from struggling to walk my dog a half mile once a week to hiking 8 miles. I did find acupuncture helpful for pain relief until I could have surgery. Also, topical lidocaine.
I'm diabetic and have been on a few GLP1s, ozempic currently. I'm pretty sure ozempic is generally reported to be helpful for kidney problems if you stay hydrated. It has definitely affected my desire to eat and made it possible for the first time since I was a child to set my food down and say (and truly mean) that I was done before my plate was empty. If you start, just go very slow on dosage and don't let them bully you into higher doses if you are feeling any side effects (which is mostly nausea).
i feel like there are definitely cases for staying on ssris long term, i have ocd and it’s the only thing that keeps me sane - regular talk therapy exacerbates my symptoms. to be fair dr mike was probably referring to less complex scenarios.
I've been on Zepbound for 10 months and I've lost 64 pounds and I feel absolutely terrific. The food chatter is gone, and I finally can stop eating mid dinner and feel full. it wasn't until I started taking the GLP1 was I ever able to feel satisfied or been able to quit eating. Will I bet on this for the rest of my life? Probably.
Absolutely loved this episode! Going into my clinical rotations in PA school, this inspired me to consider weight loss medicine or bariatric surgery. What you both do for a living changes lives, much respect! 🙏🏻
My late mother only ate food she cooked herself. No “convenience” crap, never too much fat (she didn’t like fatty food, it made her feel sick - just like me) and never snacked. She was much too busy. She didn’t like sweets. I never saw her eat candy/chocolate or crisps. She literally ate like a model preparing for a Viktoria’s secret show. No cereals, never alcohol, no soda/coke or any other sugary beverages. No artificial sweeteners either. She didn’t restrict her intake of calories - she just was not a great eater. She liked bread though and baked it herself. Delicious whole grain bread. The only food she craved were leafy greens. We still commemorate her by snacking on parsley 😌 She was always busy and always went for long walks. Almost every day. She was overweight (not severely, but still..) and it annoys me that the calorie-restriction-doctrine is still something society and even doctors consider an indisputable truth. “The body is not a machine” - so very true! If it were that easy, medical school would be easy and you’d get a degree in about a year. Of course calories matter. With her genetics… if she ate 2500-3000 calories daily and was sedentary, she would have been severely overweight and probably diabetic or would have had high blood pressure etc. She was overweight but not 200 or 300 (maybe 180 - she was not tall..) pounds. Very healthy, vibrant, fit woman.. until Glioblastoma took her at a young age. Guess what: when I eat more than 1200 calories I put on weight and I was never thin - although I was hungry and ate very little my entire youth. I was on a 500 calorie diet for 16 months once, worked out twice a week (not very much, I know..) as a young woman, lost maybe 20 pounds and still was slightly overweight. Nobody believed me how little I ate. Of course I couldn’t maintain that diet and I still struggle. I am not “fat” (slightly overweight) but still struggle with my weight and the “image” it represents. Very little visceral fat and quite healthy though. It took a very sensitive and competent endocrinologist (most are useless…) 2-3 years ago (“it is not your fault! It’s genetics”!) to stop hating and blaming myself. Thank you, Dr. Mike ❤
In high school, I had a friend in the same activities so we were about equally active. She easily ate more than I do. I was already obese. My friend was so underweight she had to take medicine to gain weight. That's enough to show me there are factors beyond what you eat and how much you exercise. And knowing that unexplained weight gain or loss is a sign of illness shows there are other factors at play.
@@BionicMilkaholic absolutely, there are so many things that influence what actually happens to those calories when they "go in" and how they are processed and used by the body, as well as what effect they have on the body (like glucose on insuline resistant people). it's such a simplistic view of such an important and complex system that i can't believe even people like dr mike still endorse it. all it does is lead to even more stigma towards overweight people and even more self doubt and guilt among the people who struggle.
Lol at the "thank you Dr Mike". He started the video saying that at the end of the day, it's a calories-in/thermodynamics issue. That's why obese people get bariatric surgery.
I’m a nurse at a family practice office in Michigan and a lot of patients don’t qualify for GLP1 meds despite qualifying medically. I also see many patients that have qualified in the past and who did well on it but then renewed or changed their insurance and no longer qualify for the meds. Blue cross blue shield of Michigan actually changed their requirements for GLP1 injections in August 2024: they now have to have physical evidence of being involved in weight loss activity such as gum sign ins, food tracker or weight watchers activity. If you don’t have that they deny the PA.
Dr. Ren-Fielding is my surgeon. She performed my VSG surgery on 11.11.2021.... this incredible surgeon saved my life. Not only did I lose the weight needed to (100 lbs down from my highest of 265, currently maintaining the loss) all of my medical issues have been reversed or put into remission. High BP and cholesterol, gone. Sleep apnea, heel spurs, gone. Fatty liver, reversed. Chronic asthma, controlled. Leukocytosis and thrombocytosis gone. T2 diabetes in remission. And my PCOS is so well controlled that I am actually considering having a baby because I am having healthy, normal ovulations for the first time in my life. Her expertise and guidance is something I fall back to every single day. THANK YOU DR REN-FIELDING. I'm finally living because of you .
People... listen to this surgeon! She knows what she is talking about!
She was my surgeon as well. Amazing doctor
Congratulations. You sound so happy and that's the most important thing😊
Thanks for sharing your story!
Out of curiosity, was that something that insurance covered as "medically necessary" ? Or did your insurance company push the idea that it's "cosmetic" in nature?
@@Mike__BDid you even read her comment? Clearly it was medically necessary
Something I learned from you, Dr Mike, is to appreciate when a doctor can and is willing to say, "I don't know." And this episode re-emphasized the importance of that.
This needs to be said again! Saying you know everything is a red flag!
I agree soooo much !!!
I. Appreciate a doctor says instead..don't know but I will look into that.
So nice to listen to an actual doctor interviewing other scientists/doctors and not just Joe Rogans of the world. Respect, Doctor Mike. I will show you to my little cousin instead Joe.
Unfortunately, those videos get more clicks
Joe Rogan has experts on. You have JRDS.
Rogan has some experts but a lot of charlatans too, and he doesn't have the expertise himself to push back on misinformation. Also, he's has a supplement company selling snake oil for 15+ years
@@Alton7771 challenge accepted!!
@@jasongrundy1717 yeah, he does have great experts on... And sometimes even NOT so great "experts" on, and he just affirmatively says "mmm" to whatever is being shoved to his face, even if it contradicts the person that sat in front of him last week. Incapable of intelligent pushback most of the time. But my personal favorite occurrence on JRE is, when he invites a world class expert on, and then proceeds to cut him off 30 minutes into the conversation to go on an hour long tangent about "the trans", wokeness, women's sports and "the radical left", it doesn't really matter who the guest is, Joe manages to fit his favorite topic into any conversation 😇. Add on mandatory topics he has to touch regularly as well, such as chimps, bow hunting, DTM and aliens, and no egaggeration, I have seen him derail half or even more time that could've been an interesting discussion 😕. Crazy just how much that podcast fell off, used to be a regular listener 6-8 years ago, but it has been gradually declining, to the point where it is now, politically heavily biased embarrassment 🧐
Im happy that Dr Christine is talking about PCOS and insulin resistance. Not many people understand and this needs to have more awareness
AMEN! And according to that lipedema... Even my doctors say... well... your body just says ... no. I am able to lose some weight if I live on 1500kcal PLUS intermittent fasting... Who knew.. I am only able to keep that up a few months.. I will have surgery next year.. and I have major respect... it's a huge deal for me.. 🙈
@nickib.8364 wishing you the best of luck and a speedy recovery. You got this!
@@nickib.8364 good luck with your surgery!
I love that Dr. Christine Ren-Fielding isn't tainted by social media and only provide scientific facts. Also kinda cute she's not aware of what's going on on social media. Glad she's not about the trend and just about science and experience. Thanks for this episode. Well done.
it's always funny to me when Mike has to explain to these esteemed experts how your average joe consumes information. it's actually really depressing 😭but i really appreciate his effort to bridge this gap and teach people how to express themselves in a more precise way given the current climate
Three years Post-Op RNY Gastric Bypass. I have zero regrets, even with an option today of medication, I wouldn't change my decision at all. 400lbs to 220lbs. I've ran 4 marathons since then. This has saved my life. No more apnea, my cholesterol is under control, my diabetes is gone. literally Best decision ever.
Congratulations! It's a life changing surgery with long term benefits, and people shouldn't be shamed for getting it. Do people get shamed for thyroid removal for hyperthyroidism? or a coronary bypass to treat blocked arteries? Absolutely not. They won't tell you to just "diet and exercise like a true person with effort," so why bariatric surgery getting all the flack? The conditions all these surgeries are treating are CHRONIC
That's amazing for you. Congratulations on getting your life back!
That's phenomenal. Congratulations on your success. I'm sure that wasn't easy to go through, recover from, and adapt to.
@@evilherbivore13 it was a couple months of adjustment but well worth it. I have anr entire new lease on life at 40 where I may not have made it to 50
Same for me. Got bariatric surgery in july. Have lost almost 80 pounds since then. My hyper tension is under control, cholesterol levels are way better and I sleep way better since I don't snore anymore. Best money I have spent
I am 46 years old, and I've never heard a doctor any doctor talk about weight without the shame or judgment. Until today, Dr. Ren spoke about treating the patient as a whole. I didn't hear anything but genuine concern for her patients' lives and well-being. I enjoyed this very much and renewed my faith in doctors and humanity as a whole.
I was always judgemental of fat people. This cleared my vision and I legit have more empathy thank you this video was amazing
Takes a lot to admit something like this about ourselves, that we were wrong. Good job!
We are judgemental of ourselves too. A lot of self-hate is included in the cycle of repeated dieting and failing.
Thank you for sharing this, from a “fat person” with an earring disorder I’m recovering from every day
I love this guy
This comment proves that scientific communication does work
I had bariatric surgery 13 months ago - best decision I ever made! I have to work every day to make good choices to keep the weight off but so thankful science has allowed this for my health, family and future.
❤ congrats! Same here!
I love how soothing Dr. Mike's voice is! The way Dr. Christine educates us about weight regulation without being judgmental is quite refreshing as well.
How many educators do you know that are judgemental
The concept of health in "The 23 Former Doctor Truths" book completely explains this. I wish I read it sooner.
Thank you Dr Mike, I'm going to have bariatrics surgery next Monday and I'm so happy that I listened to this. I have PCOS and and it's a really under-addressed issue for women.
Doctor Mike, you make a really great podcast host. You remain patient and respectful, and you pick really great guests who are informed and willing to discuss. Cheers
My sleeve saved my life. It was the hardest experience I have ever lived. Not only for the physical and mental endurance you will go through years after your surgery but also for the stigma you carry. My mother was called a monster for supporting my decision. She was and is my rock.
You did what you had to and it wasn't easy. People are so quick to condemn these days and they have no idea. Bless your mother for backing you up.
I completely agree. I laughed when they suggested this is the easy way out. I work hard every single day to improve my health and life.
I'm a year out from my vsg and down 71lbs. I still have 60 more i want to go and i know its going to take time but having each other and advocacy like this podcast helps break the stigma we live every day!
You're doing amazing making sure you keep yourself in check! Proud of you
I had bariatric surgery when i was 23 and 153kg, i am now 30 and 80kgs. Its safe to say that this surgery saved my life.
It allowed me to feel healthier, achieve a better health, have a kid, and reach some of my goals and dreams!
Set point theory is fascinating. I was 300 pounds around the age of 13. From maybe 11-15 years old I was around that weight.
I dropped to 190 in a single year during my Junior year of high school.
To this DAY, 20 years later, I still feel like it's so easy for me to gain weight and it's WHY I train every single day and track what I eat.
you do heavy training everyday or like 30 minutes each day? what kind of stuff do you eat?
I do weight lifting 4x per week and try to increase my lifts 5-10% when I'm able. I also do 1-2 days a week of "free training".
Yoga, hiking, martial arts etc@@theluschmasterinc
@@theluschmasterincI don't know about him, but I eat 1400 calories a day, train 30-60 minutes a day and weigh 330. If I have a new health problem like sleep apnea I gain a lot of weight. If I add any sugar to my diet like apples or bananas, or eat high carb foods like broccoli, carrots, or squash I gain weight. My exercise these days is body weight squats, stairs, walking, and some stretching. I used to do 100 pushups and situps and do bench and curls, but I got a hernia lifting an old water heater by myself, and I can't get it fixed because of my weight.
I weight train 4x per week about an hour a day, then 1-2 days of yoga/martial arts/walking @@theluschmasterinc
But ease of gaining weight could also be why you got to 300lbs in the first place, not that you created a set point when you gained the weight. Not too familiar with the theory though. If I were to guess I’d say you maybe just have high amount of Grelin or something making you more hungry. Personally I do get pretty hungry even after eating a lot, but specifically it takes a lot to make feel full.
I’m a year and a half out from VSG (gastric sleeve) and I’ve lost 100 lbs. I didn’t want to get it done to start, needed it. I can now get a kidney transplant and I feel so much better. This weight loss surgery saved my life.
That's amazing 😊
Wonderful. Good luck with your transplant and may your health continue to improve.
sending love and prayers your way. so happy you were able to lose the weight and i hope you get a kidney soon! my husband has AMKD and is awaiting a transplant too
Wonderful
I love it when Dr Mike has other doctors on and talks medicine ! 😃, hope we get more of these kind of podcasts
I went from 350 to 170. I started my bariatric journey Nov 2018 and I only wish I did it sooner. I look at myself in the mirror or in pictures now and I still can’t believe what I see. I not only can do more physically and feel generally better but I am so much more confident in how I operate in the world.
I'm a Type 1 Diabetic, I have PCOS, I'm one of the most insulin resistant patients my doctors have ever seen. I'm five foot on a good day and as of September, I weighed 240lbs with very little success in losing weight by diet and exercise alone. My PCP was able to get my insurance to cover Ozempic in late September and since I've been on it, I've lost around 10lbs. This is the first time I've lost weight since I was a young adult. It has made me want to eat better, healthier, exercise more, and take better care of myself. I love how my body and my mind are changing for the better. All from a weekly shot.
"it has made me want to eat better, healthier, exercise more, and take better care of yourself"
Very respectfully and correct me if im wrong. It sounds like you're saying you haven't been (consistently at least) doing those things. But the medicine made the first 10 lbs come off easy and that motivated you to change your lifestyle?
I have been on mounjaro because of pcos for over a year. I had tried every fad diet you can think of and just couldn't lose the weight. With these meds I have lost 105 lbs and counting. I have been in the gym for years as well. These meds are saving my life and keeping me from needing surgery.
@Jellyclaws221 after reading my comment again I do see where that assumption would be made. But no, I have always eaten healthy and exercised (sans 2020 at least lol). But it was all with little to no success in losing weight, and I still had a horrible time controlling my blood sugars. I should have said that the Ozempic has helped given me hope and motivation to continue eating healthy and exercising and putting in the work to become a healthier me.
@@type.one.tess23 understood, congrats on getting healthier
I'm a nurse, out of curiosity what was your insulin routine? I currently have a patient taking hundreds of units a day (just over 200, long+short) and that's the highest I've seen in 10 years on the job
Hi Dr. Mike, I sincerely want to thank you for all the information that you have given me, a viewer over the years. Today I had my first midterm exam in medicine about a subject named PCM (professionalism, communication, and morality) and as the name suggests it teaches Ethics, the connection between a patient and his physician etc. , when I first started studying this subject, I was shocked to find that I already have a rudimentary understanding of the majority of its content, thanks to you. You are truly one of the most inspiring people on this planet and an amazing role model for myself, and for anyone with a dream to help people. I truly wish you happiness in life.
Sincerely, a child you inspired.❤
I cried while watching this. I’ve struggled with weight gain for years. My body has plateaued around 250, and stayed there give or take 5 pounds over the last 15 years. Im 42. While not struggling to find a doctor that won’t tell me to simply loose 80 pounds, my weight has consistently been an issue. I can’t tell you how many times I’ve received the side comment of “loosing 10 pounds will make it easier.” While true, it doesn’t help battle the societal lessons I’ve learned over my life, coupled with ADHD and CPTSD. To hear two doctors not fat shame me or people like me, or resort to medicine first is quite refreshing and hopeful. Thank you.
Just lose 80 pounds. If you can't do something that simple, you're not a person, you're an animal.
Its not too late.. go talk to a specialist.. we are different and thats ok! We're around the same age and i did my surgery last year.
If there's one group of doctors that understand us it's bariatric specialists!
@@jasongrundy1717 L troll
Check into perimenopause too
Summer of 2023, I was 250 lbs and 49 years old, BMI of 40. I had gastric bypass surgery in February and am down 85 lbs. in 10 months. If I could have done it at 42, I would have! Don't be afraid to talk to your doctor for a referral to a bariatric surgeon.
what an amazing conversation! Thank you Dr. Mike. I had bariatric surgery in 2022 after being a food addict for YEARS. the surgery allowed me to be able to have control and ive lost 100 pounds. More importantly, i live a healthy lifestyle now. It seems so easy now... crazy this seemed impossible before. I fell in love with exercise, and i feel in control of my eating. no regrets, this surgery completely changed my life. I am forever grateful for this tool.
Doctor Mike brings joy to everyone’s day. He is not only a phenomenal person, but also an understanding and overall kind human. He is open and teaches so much. Continue the great work Mike. We all love you and your content! ❤❤😊
It was incredibly kind and thoughtful of you to take the time to write such a lovely message. I hope he sees it 🤠
As someone who reached 1 year post op gastric bypass last week, I found this conversation amazing.
She is right. My satisfaction is very high. My life is much bettter.
lost over 120 pounds.
Amazing video. Thanks.
Dr. Ren-Fielding, I have never felt angrier or more hopeless about my weight and health than after watching this. Here's how this hits me as a fat person: "Don't bother trying to lose weight with diet and exercise. It is basically impossible to get skinny that way and keep it off. You'll just be part of the 99% who fail. Oh, and I'll never relate to you since, as a skinny person, I will never have to deal with being fat."
You have, without a doubt, changed lives and for some, completely eliminated major health problems. But I watch this interview and It's soul-crushing. It's beating someone when they are down. It's taking away hope and inspiration. You are telling someone motivation and will isn't enough for success. It reads as a sales pitch for surgery and not the desire to help someone create a healthy lifestyle and reduce health risks. It seems you are in the right business for selling surgery, but not providing empathy for someone who is truly struggling.
"The barbaric nature of obesity" was probably your best line of the whole interview.
Thanks for bringing Dr. Ren on she was my surgeon for Lap band surgery in 2005 and saved my life, she's a phenomenal doctor who cares about her patients like her own children, she's the best of the best, i lost 130 pounds and feel great.
After losing motivation about losing weight, perfect timing, thanks for this.
You can do it! I believe in you (and also get the struggle✌️)
High protein and fiber keeps you full longer and prevents blood sugar spikes and then crashes that make you hungry again. Eating carbs with these things still does the same thing. I track calories and weight daily and have lost a lot this way.
Also remember that your body is DIFFERENT THAN OTHERS!! what works for most people doesn't work for bariatric patients. I've never been able to lose weight. Even with the best diet and exercise I will either loose 1lb or maintain.
I got the sleeve a year ago and I'm only 71lbs down and we just started GLP1 meds to help me get to where my doctor and I want me to be.
Nothing except both surgery and meds with diet and exercise helped me... And thats ok! Because I'm not like others... Its ok if you're not like others too!
@@dez6278I feel like you completely missed the part where she explains that diet and exercise alone does not work for everyone. Instead of sharing what works for you take in consideration the true struggles others face.
My entire life people told me similar things to what you're suggesting.. exercise harder, eat less, don't eat this and eat this instead. It didn't work for me because my body's composition is not "normal" to someone like yours.
Her entire point was surgery is for people who are different.
@@gingin324 I understand that. I'm sharing a tip to be less hungry for the majority -that it does work for. You're not supposed to be given these medications or the surgery if your bmi is not obese/30 and many who are obese don't have the money for lifelong medications or don't feel comfortable committing to it or a serious surgery. Btw, if sleeve worked for you, it was literally the difference in calorie intake that made you lose weight. That surgery doesn't reverse diabetes etc. Waiting for the irate reply.
This was a great interview! I don't think there's a great understanding of how much emotional and physical pain people are usually going through before they are turning to surgical or medical intervention. There's still a lot education to be put out there. It's great to see so many success stories in the comments section; that warms my heart.
My mother was a prime example of a person who underwent gastric surgery, but because of a lack of food education, emotional eating/psychological factors and just plain old genetics, has returned back to her original weight within 10 years.
As for Ozempic, my sister went on this for type 2 diabetes and was one of the unlucky people to have some truly terrible side effects in the few months she was on it. I think it's a great drug, for the right people, but there's always risks involved in every medication. The "celebrity" dieting fad to lose a few kilos seems truly baffling to me. It should be left for the people who actually need it for medical reasons, but maybe that's my general bias towards comedic extremes.
I’ve listen to this episode twice now and I keep coming back to it. It made me realize that all these years I did do things right (training 5-6 times a week, eat right). And yet, I didn’t lose weight as much as was expected by my trainers and nutritionists. It makes me sad that my body is setting me up for failure. I am planning to discuss what I’ve learned from this podcast with my psychologist and my family doctor this month. Thank you both of you for this amazing discussion.
GLP meds are perfect for someone like you. I was like that, Always ate right and exercised, but almost 50 pounds overweight for most of my life. This medicine takes being hungry all the time off the table. It’s not just a matter of its slowing down your digestion, mentally you can really start to notice what is going on with you and why you eat. It completely removes over eating and mindless snacking. It has changed my life and I’ve never gone over .5 mg. If you can find a provider who will keep you at a lower dose to use as a tool and lose weight slowly, it is absolutely life-changing.
I had a sleeve gastrectomy surgery about 7 years ago. At my heaviest I was 380, and I am currently 235. It was hands down the best decision I made for my health and wellness. Thanks for highlighting it.
I wish I could get CEUs from this video! 😂 As a dietitian in GI surgery I see a lot of post-bariatric pts. I would have loved to hear more about the need for lifelong vitamin supplementation because I see a lot of pts that get surgeries at other centers and come to us with complications and they seemed to not realize the severity/importance of vitamin supplementation. Deficiencies can be life threatening. For a bypass it can be like 6 vitamins a day to avoid said deficiencies and I wish more patients were aware of that prior. I would have also loved to hear about complications including long term PO intolerance and dependency on TPN. Bypass reversal is actually becoming more common in my experience. Great video, loved the dialogue and I definitely learned a lot about the surgical perspective!
If they went a surgery center in The US I can almost guarantee they were repeatedly told about the importance of lifelong supplementation. I had to sign a “contract” saying I understood the need for lifelong supplementation and had to initial a list of things that could go wrong if I didn’t keep up with them.
Obviously that’s not every program, but it is many.
I had roux n y gastric bypass august 2023. My life is SO changed for the better! One of the most difficult processes to go through and definitely not the easy way out! Hard work is necessary still. I have NO regrets!
I gained 180lbs on prednisone over a year and a half period. I was 12 when it started and in total kidney failure. My skin stretched so much I have striae on 80% of my body because of it. I lost some weight after I got sick but continued to be overweight despite many years of trying to lose it. Medical trauma and chronic illness are never discussed in weight gain situations. I have high blood pressure from my kidneys being bad. I was forced to be overweight and then kind of left to figure it out on my own. My doctors always attribute to me being overweight to me eating and it was never that. I had a job last year where I walked 30,000 steps a day for 3-5 days per week (worked in trade shows.) I wasn’t eating anything and working 65-70 hours a week. I went from 221 to 170. Then when I had to quit because my kidneys were failing again and I started eating normal meals not even bad ones, I blew back up to 230 the heaviest I have ever been. I lost about 25lbs now and am in a research study which I work with a nutritionist and my nephrologist/rheumatologist and the materials they give me are actually dumb and unhelpful. I don’t understand where the disconnect is with doctors and my experiences medically. I am trying so hard every day and it’s like everything is against me. I really want to change this part of the medical industry and I’m hoping I can contribute to this study and help others with lupus and lupus nephritis who are struggling to lose weight.
I have been on prednisone for 6 years since my kidney transplant. I gained 100lbs in a year. I tried to lose weight for 5 years and only managed to lose 20lbs. I went on Ozempic in December 2023 and have lost over 100lbs. I eat around 1400 calories/day and lift weights 3 days/week. I’m not ever planning to go off this medication. Not ever.
I also had prednisone for around 1-3 years idk exactly and I went from 45 kilos at 8 to 105 kg at 15 and I ate around the same quality of food (balooed +132 lbs in 7 years)
Hearing Dr. Ren Fielding helped me pull the trigger, I underwent a mini gastric bypass on 28.12.2024.
As someone who is about 100lbs overweight at 5’2 I’ve been seriously considering bariatric surgery but so scared of the backlash from friends and family.ive failed multiple ways of losing weight and I just want control over my life again…this episode came at the perfect time and appreciate the insight ❤
unfortunately, the lack of understanding and the lack of will to understand the struggles obese people are facing is still so prevalent and while it's getting better, it's not going away any time soon. so i hope you can put what the people around you think to the side (easier said than done i know) and focus on yourself and what you want and need. there's nothing "easy" about choosing surgery nor is it your personal failure that it got to that point, even if the society has done a great job of making you feel that way. good luck with whatever you choose and all the best!
I had the same concerns I didn’t share i had surgery until people started to notice all the weight I had lost (55lbs) Mainly because my cousin had surgery before I did and she mentioned how people kept asking her every week how much weight she was losing and it put a lot of pressure on her. I went from 5’3” 256 lbs to 124 lbs in 14 months. It’s a journey but it was worth it.
What a shame putting your life in danger to please others to that I say u need Therapy more that fat loss surgery
Don't let anyone else decide your life for you! What's the worst they can say? You took the easy way out? So what?!? Bariatric surgery isn't easy, but if it were, why would anyone choose the hard way? Seriously, ask them that. Where else in their life do they choose the hardest way to do something instead of doing it easier? Do they think you get a trophy for suffering? The surgery is a tool, a very effective one. But it still requires work to make the right choices every day. A hand saw might be good enough for one piece of wood, but if you're building a house, you should probably get an electric one. If you have 100 pounds to lose, you're basically building a triple decker.
Get it! Best decision
It’s not even just extending your life but improving the quality of your life- I am on the very last step before scheduling my surgical consult for gastric bypass- it has been over a year in preparation- I am excited and ready!
I am a Duodenal Switch WLS patient, I am 5'10"... I went from 350lbs down to 150lbs today. This was the single best thing that has ever happened in my entire life, i would make this choice a million times over
I appreciate this episode! The stigma around obesity is insane. I have always struggled with my weight. A couple of instances of this- I was in the gym 5 days a week for over a year, doing very intense workouts and eating well. Still stayed 40lbs overweight. After my miscarriage some years ago, my body just kept gaining. And it became discouraging to even try anymore.
Then fast fwd to last year, i broke my ankle. I got up to 288lbs, which is almost 120lbs more than what is normal for me. Glp1 meds have literally saved me(July2024) Exercise at that weight with my ankle issues was near unbearable not to mention the strain on my other joints. I am now 40lbs down and I finally feel well enough most days to get my body moving and motivated to continue losing weight.
The mental game involved with losing more than 100lbs weighs more heavily than any amount of weight im physically carrying. Add in normal life stresses, and it can seem unbearable. Treat overweight people with compassion. They're likely beating themselves up enough anyway.
Do whatever you need to get yourself mentally and physically healthy! I'm down over 300lbs since gastric sleeve! Life Changing!
As a 4 ft 10 woman who is 174 lb (started at 187) and trying to lose 45 more lbs, this came at a perfect time. I won't be using ozempic or surgery personally but this is a fantastic talk!
I wish you willpower.
Well done on the first 13 lbs. 🎉
Wish you luck and success for the rest.
Great Job!
good luck with your journey!
@@andreamerlin223it's not about willpower, it's about consistency and creating new habits.
This is one of THE best videos I have ever seen! I wish there was a Spanish version of this discussion available.
It’s risk versus benefit. Bariatric surgery has been around longer and we’re more familiar with its long term risks/benefits. Ozempic has his own blessings and curses, though we have had less time compared to surgical options, to see it through.
You should have a palliative doctor on your show. Our profession is misunderstood and you could help educate.
Yes! A palliative doctor interview would be marvelous.
@ I am one so if he wants I could come on 😂😂
I attended a seminar about palliative care last week and one of the biggest misconceptions is that it's about end of life care only. Every condition that has to be managed and can't be cured, can be treated by a palliative care doctor. Also, every oncologist that spoke that day said they wish Palliative Care would talk to the patients in earlier stages of the disease, and not wait until nothing else can be tried.
@ yes exactly! I think palliative care is the best with diseases with symptoms . Like cancer but there are some palliatives in sickle cell treatment. Lots in chf and copd management. The diseases that don’t have a lot of treatable symptoms like the last two it is hard to pinpoint how palliative can help the most. I am working on readmissions rates.
I would argue that palliative is one of the harder specialities in internal medicine. For example if you have blood infection, you get infectious disease and they put on antibiotics and just monitor everyday. If it is not working they just switch to the next level up. Treating someone pain is so much harder. You got to make sure you give them enough to help but not give them too much to harm them. You got to see why something g is not working and should you switch meds. Lot less algorithms and more nuance
Yes pls. Hubby and I are healthcare workers and work palliatively for years
Bariatric surgery saved my life! I've had some regain I've been working on however, still the most impactful decision I've ever made next to managing my mental health.
Dr. Mike, thank you for always being so curious and inclusive. I truly enjoy listening to your podcasts. As a dietetic student and a future dietitian, I was wondering if it would be possible to have a Registered Dietitian on the podcast? Many people do not know what RDNs do, who they are, how they can help patients, how they differ from nutritionists, etc. A lot of pressure has been put on medical doctors and other healthcare providers to know everything about food and nutrition and to advise people on how and what to eat when a) they barely have time for a regular appointment and b) there are others (khm khm RDNs) whose educational background and experience are exactly that - food and nutrition. Thank you!
That's a really good idea . I've seen some shows where they were discussing foods with children who didn't even know basic fruits and vegetables - food knowledge is shockingly missing from a lot of people (through no fault of their own).
I agree with Tracey66, it's a great idea.
Loved this episode. It was such a fruitful discussion that has a lot of science, honesty of not knowing what's unkown, and nuance of what IS known.
By half way through listening to this, I realized that I have had many biases against this procedure. This was really informative. Thank you for posting this interview.
Dr. Christine's husband was my surgeon for gastric bypass over 10 years ago. I was just 19 years old and very scared to go under general anesthesia. He looked at me and said "I've put thousands of fat people to sleep and every single one has woken up" it made me laugh.
For anyone scared, just do it. You deserve the life you want to live. My life's trajectory was completely altered for the better.
Thank you, this has really opened my eyes. I’m a nurse in the UK and I’ve noticed the rise of Ozempic being prescribed for some of our patients. Although our health system is different than in the US the A&P is still the same. Every 3 years we have to re validate as nurses and your content always features in my reflective accounts so thank you 😊
gastric bypass 6 yrs ago lost 150 lbs, doing well no need for meds. i am 150 pounds still, considered overwt. but dont care. i am 5'4". so happy that I did surgery. Have / had diabetes, hypertension, cholesterol issues gone or better. was overwt since i was 11 yrs old and now i am 59
i it done nov last year i was 301 now im 187 as of today
This is such an informative bright spot! I work as a navigator for ERAS with Bariatric surgery patients and I take tirzepatide with great success. I have always thought both of these methods are incredible depending on the patient. It’s refreshing to see a convo between Dr. Mike and Dr. Christine, vs what’s on TLC, lol. Side note, insurance companies make these procedures extremely stressful. The over reach is horrible.
I don’t understand why some people don’t like Dr. Mike so heavily, he’s just a cool doctor spreading good medical information
So refreshing to hear two intelligent adults, educated in the fields they are discussing.
Not just internet bros who have no clue what they are talking about.
We need to go back to listening to experts and not internet randos.
That’s the only way we can come together, when we all receive accredited information and not isolationist fake news from our preferred media bubbles.
I’m taking a GLP-1 and it’s working amazing. 205lbs and now I’m at 195 only 3 months later. Feel full after 3-6 bites of food. No snacking or cravings either. Amazing medicine and have had light symptoms from it.
You will regret it.
@@m783w BS
This is a very honest and innocent question. Please don’t take offense if it sounds otherwise. I am curious to know the motivation behind using GLP-1 for just 205 lbs?
@@Confessionofadiabetic it depends on how tall they are. If they are short, 205 is more dangerous than a taller person.
@@m783wpeople with this attitude are the same ones that burned Galileo, and were scared of fire
I had SADI-S bariatric surgery three years ago and it was the best decision I've ever made! I'm glad my doctor at the time really encouraged me to do that and not all the weight loss meds.
I loved this discussion!!
6 years postbariatric surgery and i have zero regrets. Going from 350 to 170 has changed my life. Unfortunately i gained 50 pounds back last year. However, the classes i took as a result of the surgery have helped me loose 30 of regain. I love that Dr. Chistine talked about treating obesity. I genuinely believe we should have a real convo about treating obesity. Getting the weight off and to Dr. Mikes point of eating exercising. There is a big missing point mental. Why are they obese. Why are we, i say we, overeating.
I'm in a program right now scheduled to get agastric sleeve surgery. When I think about surgery compared to GLP1 meds, I think about a life without dependence on a particular medication. For me, that trade off just can't really be beaten.
But you will need to take vitamins for the rest of your life and most likely B12 shots
God is good! I am in the process of having surgery due to the fact that I have a hard time maintaining weight loss. I have PCOS and I’m actually having surgery at this very same hospital. I appreciate Dr. Mike and Dr. Christine for bringing his topic to the forefront. Thank you for the information and for your medical professional information.
Best of luck to you!!
I also have PCOS and had the sleeve done in august. No regrets.
My primary care, Dr. told me I'd fail. I'm 10 months out from sleeve surgery. Now, I feel that she was right and it's messing up my mind. I've lost 80 lbs. I gained 6 lbs due to eating too much surgar during the holidays. I have to change my mindset.
Thank you for this.
Get a new PCP. now.
Thank you both for your diverse and educated views on the subject. I would love for anyone, who just says to obese people "just eat less and exercise", to watch this video and maybe come to the conclusion, that its way more complicated than just that. That humans are complicated creatures and that it IS different for people, who are fit and/or slim.
I am 2 years out from gastric bypass. I have tried everything. These included working out, and ozempic on the highest dose. None of it unsustainably worked for me. I had type 2 diabetes, high cholesterol, hypertension, elevated protein in my kidneys, skin issues and was over 100 lb overweight. Was taking four meds for diabetes, one for hypertension, one for cholesterol and a multivitamin. I have lost over 100 pounds and should have done this sooner. I feel much better. I am no longer on any of the medications. The only thing I have to take for the rest of my life is vitamins which is much better than injections and pills. I feel much more inclined to be active as I have the energy for it even after a long day's work and walk five to seven miles Minimum every single day. I am 6 months into my weight training. Best thing I could ever do for myself. I will say it's not for everyone. It was the route I felt was best for me. Godspeed on those struggling with weight. I wish you all the best.
I wonder if you get liposuction after losing most of the weight, if that could stop your body from trying to fill the fat cells up again, since they are gone?
i have asked myself the same question if that could help!
From my understanding, I think no. You get fat around the organs like what the doctor was talking about at 37:43. You get visceral fat and central obesity which is actually much more harmful to your health.
I just launched an online weight loss practice in Florida and I love that experts put out this content. I am a huge advocate of health and wellness and greatly appreciate that we have effective tools to help people lose weight. My approach is weight loss plus lifestyle changes. Thanks for the content Dr. Mike and Dr. Ren-Fielding
This was a GREAT episode. Completely changed my perspective and my idea of how weight loss works. My dad is at a point where he should probably be taking medication for weight loss and I see him struggle everyday to make healthy choices and it’s bother me that he will for a week and then bounce back but now I understand that he’s REALLY struggling like telling someone with anxiety to just not worry about it 😮
I really appreciate this episode and I wish I had seen it sooner. Since I am 5’5” and 280lbs I asked my doc about ozempic for myself because I really want to lose weight but have really struggled. She referred me to see a dietician at our local bariatric center first before going to meds and they have recommended me for surgery. I had so many misconceptions about weight loss surgery so I’m glad I saw them and have started my journey. I plan to get weight loss surgery in a few months, and information like this really helps reaffirm that this is the right decision for me and helps me feel confident in that. Thank you!
I am same height as you and weigh almost the same I am just now feeling like my weight is affecting my life I’m young only 21 but I’ve been significantly overweight my whole life and I feel like it’s catching up to me. I am so scared too at the thought of surgery and this video Definitely helped. I have an appointment with a bariatric doctor. I hope everything goes smoothly for you and I’d love it if you updated when you got your surgery and any advice you have.
@@siobn.obrien2623 I’m only 26 so I get it. The last year I gained like 30 lbs and hadn’t changed anything. It’s been making life hard which is why I wanted help losing weight. I’m down 10 lbs now, so a bit of progress! I’m still a ways out from surgery though. If I remember I’ll definitely update!
I had The " sleeve" in 2021, i was 160kgs 6'1 at the day of surgery. I am now 87kgs and honestly dont regret it at all!, i regularly exercise more than i did and im back playing rugby.
I had the bypass done in July 2024. Within the first 2 weeks I was no longer needing blood pressure or diabetic medicine. I sleep all night now. 5 months later and I’m down 100lbs. I feel amazing and this tool has been life changing.
When you are extracting clips for short reels, there are at least 2 or 3 just starting from 1:27:13.
Great conversation. It looks like Doctor Mike didn’t use notes for this one; I was engaged the entire time because it seemed like a questions flowed directly from the topics covered.
Thank you for the compliment! For that reason, I actually never use notes for a podcast.
As someone who is considering this form of surgery, this podcast was soo helpful and informative. Thank you.
I love hearing you both talk.
So professional, sympathetic and calm. ❤
I’m a 64 year old female who has been on Monjurno for over a year. I was having major back surgery and needed to lose weight. I was pre-diabetic and have lost 70 pounds. Went from size 12/14 to 4/6. My BMI is 20.0, all bloodwork normal and have had zero side effects. I truly believe I will be on this life saving drug for life.
As a recovering alcoholic with 12 years sober, I can tell you that after my first bit on food in the day my cravings go into over drive just like an addict craving for a fix. I can't avoid the first bit. Glp1 drugs helped for the first year, I loss 50lbs, I do intermitting fasting, near zero processed food, protein increase/ carb decrease but it's still a struggle.
I am so emotional listening to this. People do not understand how impacful getting bariatic surgery is. I literally feel like I got a second chance at life after getting gastric sleeve!
Wow, what a great episode. Very insightful!
This was so interesting to watch! My BMI is about 48 and considering glp1 meds myself. Surgery scares me so much, but this helps ease my mind a bit! I'm in my mid 30's and so far do not have any other health issues, so I need to get this tackled now. I was able to lose 50lbs on WW before covid but it was so hard, took over my life. Anything to help!
I've been on low-dose Wegovy for a week now, and the food "noise" in my head has almost completely gone. I have almost no cravings for carbs/sugars now. It's kinda freeing.
That is a big difference between surgey and the meds. My dr said Monjouro reduces the food noise. Really does
Thank you for this interview. I had surgery 10 days ago and wish I heard this before I went in. Fat shaming, easy way out was in my head going in…you made me feel so much better!
As a T2D who got her blood sugar under control naturally. It does not silence the food noise. Someone without the experience and her doctor mentality is coming through in her talking.
Exactly balancing blood sugars does not quiet the food noise. Also surgery does not. Medication does.
As someone who had bariatric surgery
This is a nice podcast to listen to
I wasn't told how invasive it was with the mental health that went with it
Alcohol became my crutch for mental health afterwards
Not to mention several stricture surgeries
Funny enough i gained all the weight back
Then just lost it all back starving
myself and hurting myself mentally
Yikes in sorry you went through all that
this was a fantastic episode. shout out to special guest mike's dancing bang.
I’m 5’4 and I would like to lose 75 - 100 lbs but I’ve been so apathetic about taking action because I have PCOS. I’ve lost a little weight on my own and I hope I’ll continue to do so. This video is really helpful for me to know what options I have because losing weight can be really defeating when you’re actively dieting & working out but not seeing much progress.
Thanks for posting Dr. Mike❤
I had my sleeve in 2013 to treat my gastroparisis. Best decision of my life. I had a lower body lift in 2015 to get rid of my excess skin. Again, best decision. I had been struggling for years and I am so happy with both decisions. They are tools not easy ways. I still have my mental struggles. I still have to watch what I eat and all that. It's a tool, and thats it.
Also, if you can, please tell your guest that I love her attitude -- especially the fact that she truly understands the impact of fat shaming, which I don't think the doctor in "My 600 pound life" does.
Dr. Mike, I enjoy your podcasts. I am applying for a healthcare course, and your podcasts help me keep up with the latest medical controversies.
One thing that I think is considered too little is surgical reduction of fat, for medical rather than cosmetic reasons. My own BMI was around 55, according to an NIH calculator (I'm well under 5 feet tall), and I had both ovarian and endometrial cancer. As part of my surgical treatment I had a pannectomy -- removal of the hanging abdomen, both skin and fat -- which resulted in about 35 pounds of weight loss. Most of that weight loss stayed off.
As an aside, I didn't change my diet, except that for some time I needed to go on a LOW fibre diet due to the radiation I also had (which is known to cause diarrhea). I resisted that for a time, because it had cost me some effort to raise my fibre, but when I told the nutritionist I was thinking of it as "eating unhealthily" (because I didn't want to get used to it and have trouble eating high fibre again), she pointed out that eating very little fibre was healthy eating for me at that time.
When I asked why pannectomies were not regularly done -- mine was an enormous boon -- I was told, "Oh, they generally grow back." The thing is that "growing back" is not a binary matter. In the years since 2007, when I had surgery, I have reacquired a little pooch at the bottom of my abdomen. So did my pannus grow back or not? The little pooch is maybe 5% of the size of the original pannus, so you could say it grew back -- but the benefits of that surgery remain, not far short of two decades since the operation.
It was a bonus to me -- quite aside from curing the cancer, of course -- but I couldn't say the hanging fat and skin is ALL gone. If you put me in a database saying "grew back" or "didn't grow back," it might be said that I was in the "grew back" category -- and that would badly misstate the effectiveness of pannectomy for me. Equally, I wonder whether surgical removal of other large fat accumulations -- direct removal of fat cells, whether by liposuction or direct surgery -- might not be medically effective for many very fat people. I would suspect that little research has been done on that topic, due to the stigma of "taking the easy way out" of fat loss, and stigma against fat people in general.
Thank you for discussing this issue. It was one of the things that I was wondering about during the interview and hoped that they would address, particularly as is relates to set theory. It seems to me that if the empty fat cells are one of the issues driving the regain of weight, then the removal of excess ones in the pannus would help counter that.
I have lost over 65 kg, over half my highest weight by diet alone, and am keeping them off, so I am obviously biased, but I think that this was the very best interview on this medication/surgery subject I have ever seen. I recommend it to anyone who is struggling with weight.
This is such a great episode. Thank you for all you do Dr Mike!
I had the band surgery about 10 years ago and it did nothing for me at all. During Covid, my weight ballooned and I lost my mobility. In 2022 I had the band removed and I was supposed to have the sleeve gastrectomy a few months later. But in the meantime I developed severe debilitating lymphedema and gained even more weight and had to stop working. I became diabetic. It was only then that I got approved for mounjaro and it helped me lose 60 pounds to finally have the sleeve surgery. I’m now a month post op and as of 2 weeks ago l’ve lost almost 100 pounds and am finally starting to get my life back. So many people are ignorant as to the struggles and treatment, even doctors and nutritionists. I’m hoping to go back to school and become a nutritionist to provide the empathy and support to others.
I've had the lap sleeve and then I needed to have a bypass because of the acid reflux. I've lost over 100 pounds and found a new life. I have zero regrets.
I was so glad to see this. I'm a 200 lb. 67 year old formerly bulimic woman with one lung awaiting knee replacement surgery. I was able to get my weight down to 164 last year through healthy eating and walking 5 miles a day. I began gaining the weight back in January when my knee became bone on bone and I could no longer walk. Now I spend most days lying on the couch eating. My knee replacement is scheduled for March 2025.
I need to lose weight and cannot find the motivation to do so. I'm on mood stablizers and antidepressants which makes it more difficult. I can't take nsaids for my knee pain due to bad kidneys. My PCP has offered a version of Ozempic but it scares me. I'm already taking a lot of medications that have messed with my metabolism.
I need help to decide what to do to lose the weight.
I think it's worth talking through your fears with your PCP. Your history of Ed makes things like sleeve surgery tricky because it could trigger some stuff.
I struggled with bulimia too but luckly I've been OK for the past 10 years, so I'm a less risky patient for surgery now.
Time restricted eating and a low carb diet might help move a small amount of the weight to help with the knee.
My new knees have made a world of difference! I've lost weight for the first time in my life just because I can be more active again. My personal, non-medically trained opinion is to get your knee taken care of first, then think about your weight. I'm 5'6" and my weight peaked at 256lbs right before surgery. Less than a year out, I'm at 238lbs and still trending down. I'm just now working on adjusting what I eat. I've stopped taking ibuprofen. I went from struggling to walk my dog a half mile once a week to hiking 8 miles.
I did find acupuncture helpful for pain relief until I could have surgery. Also, topical lidocaine.
I'm diabetic and have been on a few GLP1s, ozempic currently. I'm pretty sure ozempic is generally reported to be helpful for kidney problems if you stay hydrated. It has definitely affected my desire to eat and made it possible for the first time since I was a child to set my food down and say (and truly mean) that I was done before my plate was empty. If you start, just go very slow on dosage and don't let them bully you into higher doses if you are feeling any side effects (which is mostly nausea).
Have a look on TH-cam for chair exercises. They have some awesome aerobic routines to music.
Try low dose ozempic - even « micro dosing » and see how you feel and what happens. You can always stop it if you don’t like it/it doesn’t work
i feel like there are definitely cases for staying on ssris long term, i have ocd and it’s the only thing that keeps me sane - regular talk therapy exacerbates my symptoms. to be fair dr mike was probably referring to less complex scenarios.
LOVED THIS ONE!! felt very natural and has made me more curious on this topic!!
I've debated this surgery, I'm so excited to watch this. Thanks Doctor Mike!
Excellent interview, Dr. Mike.
I've been on Zepbound for 10 months and I've lost 64 pounds and I feel absolutely terrific. The food chatter is gone, and I finally can stop eating mid dinner and feel full. it wasn't until I started taking the GLP1 was I ever able to feel satisfied or been able to quit eating. Will I bet on this for the rest of my life? Probably.
Absolutely loved this episode! Going into my clinical rotations in PA school, this inspired me to consider weight loss medicine or bariatric surgery. What you both do for a living changes lives, much respect! 🙏🏻
My late mother only ate food she cooked herself. No “convenience” crap, never too much fat (she didn’t like fatty food, it made her feel sick - just like me) and never snacked. She was much too busy. She didn’t like sweets. I never saw her eat candy/chocolate or crisps. She literally ate like a model preparing for a Viktoria’s secret show. No cereals, never alcohol, no soda/coke or any other sugary beverages. No artificial sweeteners either. She didn’t restrict her intake of calories - she just was not a great eater. She liked bread though and baked it herself. Delicious whole grain bread. The only food she craved were leafy greens. We still commemorate her by snacking on parsley 😌 She was always busy and always went for long walks. Almost every day. She was overweight (not severely, but still..) and it annoys me that the calorie-restriction-doctrine is still something society and even doctors consider an indisputable truth. “The body is not a machine” - so very true! If it were that easy, medical school would be easy and you’d get a degree in about a year. Of course calories matter. With her genetics… if she ate 2500-3000 calories daily and was sedentary, she would have been severely overweight and probably diabetic or would have had high blood pressure etc. She was overweight but not 200 or 300 (maybe 180 - she was not tall..) pounds. Very healthy, vibrant, fit woman.. until Glioblastoma took her at a young age. Guess what: when I eat more than 1200 calories I put on weight and I was never thin - although I was hungry and ate very little my entire youth. I was on a 500 calorie diet for 16 months once, worked out twice a week (not very much, I know..) as a young woman, lost maybe 20 pounds and still was slightly overweight. Nobody believed me how little I ate. Of course I couldn’t maintain that diet and I still struggle. I am not “fat” (slightly overweight) but still struggle with my weight and the “image” it represents. Very little visceral fat and quite healthy though. It took a very sensitive and competent endocrinologist (most are useless…) 2-3 years ago (“it is not your fault! It’s genetics”!) to stop hating and blaming myself.
Thank you, Dr. Mike ❤
In high school, I had a friend in the same activities so we were about equally active. She easily ate more than I do. I was already obese. My friend was so underweight she had to take medicine to gain weight. That's enough to show me there are factors beyond what you eat and how much you exercise.
And knowing that unexplained weight gain or loss is a sign of illness shows there are other factors at play.
@@BionicMilkaholic absolutely, there are so many things that influence what actually happens to those calories when they "go in" and how they are processed and used by the body, as well as what effect they have on the body (like glucose on insuline resistant people).
it's such a simplistic view of such an important and complex system that i can't believe even people like dr mike still endorse it. all it does is lead to even more stigma towards overweight people and even more self doubt and guilt among the people who struggle.
Lol at the "thank you Dr Mike". He started the video saying that at the end of the day, it's a calories-in/thermodynamics issue. That's why obese people get bariatric surgery.
I’m a nurse at a family practice office in Michigan and a lot of patients don’t qualify for GLP1 meds despite qualifying medically. I also see many patients that have qualified in the past and who did well on it but then renewed or changed their insurance and no longer qualify for the meds. Blue cross blue shield of Michigan actually changed their requirements for GLP1 injections in August 2024: they now have to have physical evidence of being involved in weight loss activity such as gum sign ins, food tracker or weight watchers activity. If you don’t have that they deny the PA.