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!
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 🧐
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
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
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.
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.
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 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’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.
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
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.
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.
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.
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.❤
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.
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.
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
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 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!
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.
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).
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.
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!
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 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.
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!
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'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.
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'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.
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 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 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!!
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).
"Hello Dr. Mike, My name is Mustafa, and I am from Pakistan. I am very passionate about pursuing my education in the United States, but I am feeling quite overwhelmed and unsure of the right steps to take. Could you kindly offer some guidance on how to navigate the process of studying medicine in the U.S. as an international student? I would greatly appreciate any advice or insights you can provide. Thank you so much for your time and help!"
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 😮
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.
Just remember that it's hard work but worth it! Take it day by day and if you feel like you're slipping or something doesn't make sense - go back to your team of doctors. Some days are going to be very easy.. some days will be the worst day ever. I plateaued 6mo after my surgery and just stayed in touch with my team and we just put me on GLP1 after a year. But it's sooo worth it!! You will do great if you believe in yourself!
@ aww thank you for taking the time to send an encouraging message :) im currently on the pre-op diet which is a month long. I hate it but doing my best :)
Calories in, calories out is physics, but how we store calories matters for driving the behavior that influences those inputs and outputs. When energy is locked into fat it isn't available to increase base metabolic rate or energy for non exercise activities. So the macronutrients and the speed of various metabolic pathways matters. Humans are not just buckets of calories, they are complex systems with multiple steps to store and retrieve calories in multiple ways.
So, are you suggesting bodies dont use fat for NEAT? That sounds absurb, i need to see a source on that. Maybe for people with metabolic disorders, but thats an exception not the rule. If you dont or limit carb intake, you will most certainly use fat stores.
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?
Love what your doing in the field Doctor Mike, but the ads were a little heavy. At times interrupting sentences and once they end I rewind to just watch another ad interrupting the same sentence.
You should make a TH-cam video about Roman Atwood's KENETIK Nootropic Ketone Drink. It claims to use ketones for energy and focus. I'd love to see you fact-check these claims in a video!
I love this podcast. Thank you for this wonderful conversation on health. It really helped me think about my own health struggle, in a good way. I've had this extreme battle with the heat for years. I finally got a doctor last year but, recently, I got a letter saying that she will be leaving. I was given a list of doctors to choose from and there is only one DO. I really hope this is the right one. Nutrition is a big part of my condition that I struggle with, so that's one thing I'm going to put on my list of questions. It's a huge, stressful struggle. It's been quite a journey. Whew...
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 had VSG in 9/2019. I lost 120, over the past 5 years I've maintained 100 lb loss. No more high blood pressure, cholesterol, never had sugar problems. But now ove the past 2 years I have battled HORRIBLE heartburn. I've been on prescription anti heartburn medicine 2x daily, this past January I was diagnosed with an ulcer and gastritis after a GI did and endoscopy. I now follow a GERD diet to manage comfort. A suggested option is to operate to bypass. I'm in my late 40s, this is a terrible position.
This is such a brilliant conversation! I found it so informative. There were great explanations and analogies. Personally, GLPs have helped facilitate my journey to a healthier lifestyle in terms of eating and exercise. GLPs have definitely empowered me and positively motivated me in this regard.
Imagine having zero $ in your bank account, and someone tells you you really need to start saving your money... It tough, but doable if you figure out how to budget correctly, now imagine you have zero $ in your account, but you have 100k in debt to pay off... waaay more difficult to mentally handle, knowing you will try your best every month, and still see zero in your account. That's what it's like losing weight.
@@aych5865the debt is a significant amount of excess body fat. OP is likening a person with zero debt to a relatively normal sized person losing 20-30 pounds, and the 100k indebted individual as someone with 100+ pounds to lose before they see changes to health and physique. Hope that makes sense/is accurate to OPs intended message :)
@aych5865 Starting from zero is like being skinny, and wanting to build muscle. Having debt is like having alot of weight in your fat cells, you have to put in way more work for a longer period of time before you can be fit.
I think a better analogy is to compare overeating to alcoholism - you have to stop drinking to stay alive/you have to eat less to stay alive. But you can't stop eating altogether; you have to have three drinks every day (three meals), but not go overboard into alcoholism again. Now add all the psychological and emotional baggage into food and eating and meals, and it's a wonder *anyone* can ever lose weight!
Doctor Mike, would LOVE to see a conversation between you and an optician, ocularist, optometrist or ophthalmologist!! Really, anyone in the optical field.
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 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.
I managed to quit drinking soda with artificial sweeteners thanks to a friend who initiated this project. Now I quite rarely allow myself to drink a soda, for special occasions. When I choose soda with artificial sweetener, I feel myself craving more soda for at least a week after. After one soda with regular sugar, I don’t experience this craving in the same way at all. I find it easier to go back to water, or sparkling water after a regular soda.
Hello Doctor Mike ☺️ Appreciate you, and the work you put into your videos🙏🏼 Would love to see a video on tips on good communication with patients. How to keep the time frame of a consultation, yet getting the most out of the little time you have as a doctor🙏🏼☺️
They forgot to mention about dropping the weight before the surgery because the possible difficulties is doing anaesthesia in a too heavy person and decreasing the possibility of cardiac events
iv had Gastric bypass surgery last November i was 301 pounds now im currently 186 as of this morning and i had it in Mexico best decision of my life all y food addiction gone and not drinking sodas or energy drinks
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.
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 episode. Very informative. I'm honestly a little shell-shocked. I'm a 5'1" with 60-70lbs to lose. I have tried so many things and as I've sat processing this information I'm realizing that my body has a new 'set' weight, which does help me to understand my body's resistance. But I also feel a little heartbroken that it sounds like my only way forward is surgery or medications I can't afford.
It's certainly not impossible without surgery or medication so don't think that you have no chance. Prioritising protein and cutting out most processed food can help you a lot.
I was on Mounjaro for a year and lost some weight and my A1C came down. However I was still overweight. I had gastric sleeve last December. After a few months my A1C started to uptick and food noise came back. So now I am on Ozempic and the food noise is gone and my A1C is now down to 5.6. Losing the weight is still slow but it's going down slowly. I do exercise, prioritize protein and track my food.
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 had rny gastric bypass 18 months ago and it’s the best decision I ever made. I went from 300 to 120 lbs, I’m 5’3”. I was pre diabetic with sleep apnea and now my a1c is 5.0 and my apnea is gone and I have so much more energy. It’s a lifesaving procedure.
Really helpful for us this podcast....keep going.... I as a Science student I can learn so important term from your video....which is really important for me..
Hi Doctor Mike, my asked my doctor's about appetite suppressants and was told they don't work. So I went through Bariatric surgery. Imagine my shock when Ozempic and Wegovy became popular! Turns out maybe I knew what I needed after all?
Did Fen Phen in the 90's. Lost over 100 lbs. Never had the heart valve issues thankfully. LOVED how it cut off the "food chatter." Found it impossible to lose or maintain for long once I came off it and I tried everything! I had gastric sleeve surgery because I didn't want my innards re-routed (but in hindsight, I wonder if it would have been better....) 7 years ago. Only lost around 70 or so pounds of the 125 goal. I have regained 55 pounds or so. Regardless of one's weight, my bariatric office has everyone on 1200 calories. Not so much low carb, but high protein. I'm now on Oz which also shuts off the chatter. That makes a huge difference and it's something someone who doesn't KNOW....just can't understand.
Thanks, Doctor Mike and Dr. Ren-Fielding. This was a very interesting and informative discussion. And I think Dr. Ren-Fielding is correct in that patients with extremely high BMIs will continue to need bariatric surgery.
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.
I'm not sure if others experienced this, but every primary care doctor I've had always pressured me to take a medication or get bariatric surgery...why go to the extreme without referring me to a nutritionist? Spending 2 minutes telling me to exercise and eat right doesn't teach me anything. Educating pateints seems to not be a priority.
I asked my PCP why he doesn't send his GLP med patients to a dietician. He said that when insurance pays for the meds, they usually refuse to pay for a dietician. Go figure
I haven't listened to the entire conversation yet (this may be covered at some future point), but as an obese person who has recently taken up weight lifting, I am very curious as to how the dramatic and permanent reduction in calorie intake from bariatric surgery would affect an individual's ability to build a significant amount of muscle. It may have no impact at all, but learning about bulking, cutting, and body recomposition, I am very curious about this.
I know some naturally leaner people who have tried to bulk up past their bodies natural size and even with an unmodified stomach have a hard time eating the large protein portions necessary for extended lengths of time. If that type of bodybuilding is part of your long term goals, I would definitely consult with the bariatric team nutritionist before committing to surgery about what will be possible after.
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😊
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!
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 🧐
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
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
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
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.
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.
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 love it when Dr Mike has other doctors on and talks medicine ! 😃, hope we get more of these kind of podcasts
The concept of health in "The 23 Former Doctor Truths" book completely explains this. I wish I read it sooner.
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’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
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
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.
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.
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.
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.❤
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.
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.
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
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.
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!
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.
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.
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.
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!
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 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.
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!
is the backlash more important that your health? do u need their support and validation to put yourself first?
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'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.
Thia ís a wonderful discussion to truly understand the world of weight loss realities.
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'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.
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
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.
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 love hearing you both talk.
So professional, sympathetic and calm. ❤
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!!
As someone who is considering this form of surgery, this podcast was soo helpful and informative. Thank you.
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.
I was always judgemental of fat people. This cleared my vision and I legit have more empathy thank you this video was amazing
"Hello Dr. Mike,
My name is Mustafa, and I am from Pakistan. I am very passionate about pursuing my education in the United States, but I am feeling quite overwhelmed and unsure of the right steps to take. Could you kindly offer some guidance on how to navigate the process of studying medicine in the U.S. as an international student?
I would greatly appreciate any advice or insights you can provide.
Thank you so much for your time and help!"
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 😮
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.
Perfect timing! My surgery is scheduled for Dec 12! My bmi is waaay higher than 40.
Just remember that it's hard work but worth it! Take it day by day and if you feel like you're slipping or something doesn't make sense - go back to your team of doctors.
Some days are going to be very easy.. some days will be the worst day ever. I plateaued 6mo after my surgery and just stayed in touch with my team and we just put me on GLP1 after a year.
But it's sooo worth it!! You will do great if you believe in yourself!
@ aww thank you for taking the time to send an encouraging message :) im currently on the pre-op diet which is a month long. I hate it but doing my best :)
This video has taught me more than school 😂❤😊 respect to dr.Mike :)
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.
Calories in, calories out is physics, but how we store calories matters for driving the behavior that influences those inputs and outputs. When energy is locked into fat it isn't available to increase base metabolic rate or energy for non exercise activities. So the macronutrients and the speed of various metabolic pathways matters. Humans are not just buckets of calories, they are complex systems with multiple steps to store and retrieve calories in multiple ways.
So, are you suggesting bodies dont use fat for NEAT? That sounds absurb, i need to see a source on that. Maybe for people with metabolic disorders, but thats an exception not the rule. If you dont or limit carb intake, you will most certainly use fat stores.
@@dang1099 first search yourself, then if you cannot find, ask for sources.
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 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?
Such a great guest. She was so clear and rational in all her answers. Great stuff.
Wow, what a great episode. Very insightful!
Love what your doing in the field Doctor Mike, but the ads were a little heavy. At times interrupting sentences and once they end I rewind to just watch another ad interrupting the same sentence.
You should make a TH-cam video about Roman Atwood's KENETIK Nootropic Ketone Drink. It claims to use ketones for energy and focus. I'd love to see you fact-check these claims in a video!
I love these episodes. More so than the fun ones. Thank you Dr Mike
I love this podcast. Thank you for this wonderful conversation on health. It really helped me think about my own health struggle, in a good way. I've had this extreme battle with the heat for years. I finally got a doctor last year but, recently, I got a letter saying that she will be leaving. I was given a list of doctors to choose from and there is only one DO. I really hope this is the right one. Nutrition is a big part of my condition that I struggle with, so that's one thing I'm going to put on my list of questions. It's a huge, stressful struggle. It's been quite a journey. Whew...
I've debated this surgery, I'm so excited to watch this. Thanks Doctor Mike!
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
Dr. Christine looks so so charming and sounds so wise!
I had VSG in 9/2019. I lost 120, over the past 5 years I've maintained 100 lb loss. No more high blood pressure, cholesterol, never had sugar problems.
But now ove the past 2 years I have battled HORRIBLE heartburn. I've been on prescription anti heartburn medicine 2x daily, this past January I was diagnosed with an ulcer and gastritis after a GI did and endoscopy. I now follow a GERD diet to manage comfort. A suggested option is to operate to bypass.
I'm in my late 40s, this is a terrible position.
This is such a brilliant conversation! I found it so informative. There were great explanations and analogies. Personally, GLPs have helped facilitate my journey to a healthier lifestyle in terms of eating and exercise. GLPs have definitely empowered me and positively motivated me in this regard.
Imagine having zero $ in your bank account, and someone tells you you really need to start saving your money... It tough, but doable if you figure out how to budget correctly, now imagine you have zero $ in your account, but you have 100k in debt to pay off... waaay more difficult to mentally handle, knowing you will try your best every month, and still see zero in your account. That's what it's like losing weight.
What is the debt a metaphor of in this analogy?
Bad comparison.
@@aych5865the debt is a significant amount of excess body fat. OP is likening a person with zero debt to a relatively normal sized person losing 20-30 pounds, and the 100k indebted individual as someone with 100+ pounds to lose before they see changes to health and physique. Hope that makes sense/is accurate to OPs intended message :)
@aych5865
Starting from zero is like being skinny, and wanting to build muscle. Having debt is like having alot of weight in your fat cells, you have to put in way more work for a longer period of time before you can be fit.
I think a better analogy is to compare overeating to alcoholism - you have to stop drinking to stay alive/you have to eat less to stay alive. But you can't stop eating altogether; you have to have three drinks every day (three meals), but not go overboard into alcoholism again. Now add all the psychological and emotional baggage into food and eating and meals, and it's a wonder *anyone* can ever lose weight!
Doctor Mike, would LOVE to see a conversation between you and an optician, ocularist, optometrist or ophthalmologist!! Really, anyone in the optical field.
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 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.
Well...Dr.Mike im here to stop kids from saying first
🙇🙇🙇
😂😂😂
That’s just saying first with extra steps
First
I managed to quit drinking soda with artificial sweeteners thanks to a friend who initiated this project. Now I quite rarely allow myself to drink a soda, for special occasions. When I choose soda with artificial sweetener, I feel myself craving more soda for at least a week after. After one soda with regular sugar, I don’t experience this craving in the same way at all. I find it easier to go back to water, or sparkling water after a regular soda.
Hello Doctor Mike ☺️ Appreciate you, and the work you put into your videos🙏🏼 Would love to see a video on tips on good communication with patients. How to keep the time frame of a consultation, yet getting the most out of the little time you have as a doctor🙏🏼☺️
That is a great topic you suggested for a video 👍
They forgot to mention about dropping the weight before the surgery because the possible difficulties is doing anaesthesia in a too heavy person and decreasing the possibility of cardiac events
This was so interesting and eye opening! Thank you both.
Gut biome: would love to have heard about the impact of both surgery and the drugs on the gut biome.
iv had Gastric bypass surgery last November i was 301 pounds now im currently 186 as of this morning and i had it in Mexico best decision of my life all y food addiction gone and not drinking sodas or energy drinks
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.
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.
Unrelated, but Dr Mike please give us your take on DR OZ being appointed as administrator for Centers for Medicare and Medicaid Services!
More qualified than many previous appointees. The fact that Trump did it doesn't automatically make him bad.
@@jasongrundy1717Most health authorities consider him unqualified. The reverse is true also.
I've been walking and running in the treadmill for a while now but started dieting only monday now and I've been seeing results already
Mostly water loss in the start lol 😂
That is great 😊
I don’t understand why some people don’t like Dr. Mike so heavily, he’s just a cool doctor spreading good medical information
Howdy, thoughts on weight loss surgery for individuals with IBD issues like Crohn's disease? Worth it, too much risk, etc.?
Thank you for this episode. Very informative. I'm honestly a little shell-shocked. I'm a 5'1" with 60-70lbs to lose. I have tried so many things and as I've sat processing this information I'm realizing that my body has a new 'set' weight, which does help me to understand my body's resistance. But I also feel a little heartbroken that it sounds like my only way forward is surgery or medications I can't afford.
It's certainly not impossible without surgery or medication so don't think that you have no chance. Prioritising protein and cutting out most processed food can help you a lot.
Thanks for posting Dr. Mike❤
This is such a great episode. Thank you for all you do Dr Mike!
I was on Mounjaro for a year and lost some weight and my A1C came down. However I was still overweight. I had gastric sleeve last December. After a few months my A1C started to uptick and food noise came back. So now I am on Ozempic and the food noise is gone and my A1C is now down to 5.6. Losing the weight is still slow but it's going down slowly. I do exercise, prioritize protein and track my food.
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 had rny gastric bypass 18 months ago and it’s the best decision I ever made. I went from 300 to 120 lbs, I’m 5’3”. I was pre diabetic with sleep apnea and now my a1c is 5.0 and my apnea is gone and I have so much more energy. It’s a lifesaving procedure.
Really helpful for us this podcast....keep going.... I as a Science student I can learn so important term from your video....which is really important for me..
Hi Doctor Mike, my asked my doctor's about appetite suppressants and was told they don't work. So I went through Bariatric surgery. Imagine my shock when Ozempic and Wegovy became popular! Turns out maybe I knew what I needed after all?
I love these conversations, I take away a lot.
Did Fen Phen in the 90's. Lost over 100 lbs. Never had the heart valve issues thankfully. LOVED how it cut off the "food chatter." Found it impossible to lose or maintain for long once I came off it and I tried everything! I had gastric sleeve surgery because I didn't want my innards re-routed (but in hindsight, I wonder if it would have been better....) 7 years ago. Only lost around 70 or so pounds of the 125 goal. I have regained 55 pounds or so. Regardless of one's weight, my bariatric office has everyone on 1200 calories. Not so much low carb, but high protein. I'm now on Oz which also shuts off the chatter. That makes a huge difference and it's something someone who doesn't KNOW....just can't understand.
Ditto, I wish everyone could experience “food chatter” short term to understand how torturous it is. Walk a mile in my shoes kind of thing
this was a fantastic episode. shout out to special guest mike's dancing bang.
Thanks, Doctor Mike and Dr. Ren-Fielding. This was a very interesting and informative discussion. And I think Dr. Ren-Fielding is correct in that patients with extremely high BMIs will continue to need bariatric surgery.
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.
I would love to sed Dr. Mike discussing this issue with Dr. Casey Means to explore what is the root cause of metabolic dysfunction.
I would love to hear @AbbeysKitchen give commentary.
I'm not sure if others experienced this, but every primary care doctor I've had always pressured me to take a medication or get bariatric surgery...why go to the extreme without referring me to a nutritionist? Spending 2 minutes telling me to exercise and eat right doesn't teach me anything. Educating pateints seems to not be a priority.
I asked my PCP why he doesn't send his GLP med patients to a dietician. He said that when insurance pays for the meds, they usually refuse to pay for a dietician. Go figure
I haven't listened to the entire conversation yet (this may be covered at some future point), but as an obese person who has recently taken up weight lifting, I am very curious as to how the dramatic and permanent reduction in calorie intake from bariatric surgery would affect an individual's ability to build a significant amount of muscle. It may have no impact at all, but learning about bulking, cutting, and body recomposition, I am very curious about this.
I know some naturally leaner people who have tried to bulk up past their bodies natural size and even with an unmodified stomach have a hard time eating the large protein portions necessary for extended lengths of time. If that type of bodybuilding is part of your long term goals, I would definitely consult with the bariatric team nutritionist before committing to surgery about what will be possible after.