The Difficult Questions On Ozempic & Weight Loss
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Dr. Rocio Salas-Whalen is a double board-certified physician with broad experience across all facets of endocrinology, with a particular emphasis on obesity, diabetes and thyroid disorders. She has been an outspoken proponent of Ozempic injections to help patients navigate diet and weight. I've been a bit skeptical about the emergence of Ozempic, so I wanted to dive in with an expert who can really discuss the nuts and bolts of the science to get to the bottom of who exactly should be taking these medications and what impacts they can actually have.
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00:00 Intro
01:00 Ozempic overview
03:44 BMI, Diabetes, Skinny Fat
06:44 Who Needs Ozempic?
09:13 Fat Bias
17:20 Every obese patient should be on Ozempic?
20:55 Big Food vs. Big Pharma
23:02 Celebrity Use
25:55 Side Effects
27:30 Professional Athletes
29:26 Quick Fix
32:28 Getting Off Ozempic
38:49 Ozempic Shortages
44:18 Snake Oil
47:17 Advice for patients
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Wow. As someone who lost 120 and has fought DAILY to maintain that over a decade later, hearing her describe it as a full-time job made me tear up. That is EXACTLY how it feels. There is literally not a moment of my day where I'm not thinking about food and my body. It is exhausting beyond anything I can describe.
I don’t want to undercut the seriousness of what you’re saying because I’ve lost over 10% of my entire body weight recently, it’s like DeAngelo from the US version of The Office, “Once you’ve conquered obesity, everything else is easy. Life literally moves in slow motion.” Losing a large amount of weight really changes your perspective of everything around you but you are just hyper vigilant of goof around you or how your body would welcome it but poorly react to it.
I like that Dr. Mike is trying to understand this area better. Weight management is just going to be harder for some people.
I have lost 50 pounds with fasting of different timing and have not struggled. Metabolic switching shuts off the struggle of hormone triggered hunger.
It's easy if you do fasting. No breakfast. Regular lunch and sometimes like as your 3rd meal/evening
@@allahbless2278 maybe for some people. personally, I can't fast. If I don't eat frequently, I get stomach aches. So it's not just my brain feeling hungry but also my body signaling that it is not for it.
There's also a discussion to be had about how reckless companies in the US are with developing such calorie dense foods
skyblock person :D
Not only calorie dense but full of sugar. I recently read about how in zoos, the zoologist can no longer feed most fruits and many vegetables to the animals because they are GMOd so much to increase the taste of the plants that it means that they have so much more sugar in them then they ever used to. The animals are becoming obese...on fruit and vegetable based diets. They now almost completely cut out fruits and they feed them with specific vegetables that typically have less sugar and supplements made for the animals.
@amandasnider2644 you're right, I worked at a parrot sanctuary and many of the birds had heart disease and diabetes despite a constant, generous stream of donated produce from Costco. But it's not GMOs (too recent), it's the result of selective breeding over thousands of years of human agriculture to reduce fiber and increase sugar content. It's one of the (many) reasons a "paleo" diet is a joke- contemporary farmed meat and produce is vastly different than the food which would've sustained us in Paleolithic times.
Yep!!
Or how corn sugars have flooded produce even in areas it's not needed
I'm just so impressed by Dr. Mike's interview style, he's patient, asks great questions, always acts as a surrogate to his audience, keeps things simple and understandable, and pushes back when necessary. All the things I want to hear from a good interview.
very true!
I love that he’s challenging her and himself also in this. It’s clear her perspective is a bit different from his initial takes and it’s wonderful that he’s balanced in this way (asking hard questions and willing to hear and offer uncomfortable answers). I saw another great podcast about processed foods being a big factor in mass obesity. I think he’s right to be concerned that this drug is probably a bandaid for a wider health issue. Really informative interview from two valid and different viewpoints
It's a nice change to see an interview about serious, complicated problem, but with an explanation easy to understand even without medical degree.
Very true. The lay people can easily understand what is being talked about. Which is effective
I dont like that people get angry at others for how they lose weight or say they are “cheating”. But then other people are angry that someone is overweight at the same time! 😰
Yeah honestly you can’t win.😂
Nobody gets angry when others lose weight. They get angry when someone claims they did it naturally when they obviously didn’t.
You see a ripped body builder saying “I got like this naturally” when it’s 100% obviously they’re on steroids giving false hope to people just so they can keep their sponsors and sell their bullshit to ignorant people and kids who don’t know any better. I’ve never seen anyone other than crazy fat loving left wing nut bags get mad at someone for losing weight.
@@dustinadair7893 thats not entirely true. Some people will say its “cheating” when people get Lipo suction or bariatric surgery and are completely honest about it.
Most people don't care, in the grand scheme of things, it's just better to be honest about things. If you have worked very hard for a goal and just see people floating through with medication then it can be disheartening. @@Cherry-wf8qv
This conversation was so intense in the calmest way lol
I agree i thought they were gonna kick each other at one point😂
What about discussing the possible long term side effects which there are and some quite serious? And also why is the trend moving towards finding a pill for everything instead of approaching the problem as lifestyle? And if it's not lifestyle, then what is it in our environment that is making us obese and addressing that as our number one health problem that needs fixing pronto.
@andreavanda5402 Did you not listen to the whole show? They addressed much of this. Our environment may be causing some of this, but that cannot be fixed on the individual level and will take generations. Patients need help in the present.
@@andreavanda5402 One of the key points of this conversation is that lifestyle is a necessary, but insufficient element of the equation for weight loss for many people. And while I would love a world where we all had low stress jobs and lives, and were growing our own food and making healthy meals, unfortunately that just isn't reality for most of us.
@andreavanda5402: Sometimes doctors can be a little too unjudgmental.
I am insulin resistant due to pcos. My doctor put me on wegovy which is ozempic. When I went on it it was AMAZING. I really didn’t lose a lot of weight on it but how great my body felt was worth it. I finally felt full, I naturally craved healthier foods. I wasn’t in pain from inflammation. My gut wasn’t gassy and bloated and it significantly reduced my ibs symptoms. I had energy again because my sugar levels were staying stable. it was like my finally worked correctly. Now that’s on back order I can’t get it and all my symptoms are back and I’m miserable
Damn I'm underweight and what that drug does sounds amazing Maybe I'd end up gaining weight from healthier food?
I'm in the same boat
@@Xnoob545don't think so. The active ingredient in Ozempic is semaglutide, which works by inducing satiety. Thereby reducing appetite or addictions. So you would be at higher risk with it. Please talk to a doctor before using any such medication. edit: apparently semaglutides can help with it. still best to consult a doctor
I've recently been diagnosed with PCOS and insulin resistance as well! I was a bit scared of Ozempic/Wegovy (bcs I have a history of depression) so my endo in collaboration with my psychiatrist put me on Contrave and I have also felt amazing results. What you said about finally feeling full when you eat - i also went through that - and I'm sure to people who don't have insulin resistance it sounds silly, but it's such an amazing feeling to be able to trust your body in terms of when you feel hungry/full. There is such a stigma with weight loss medications, but for many people they really are life-changing, and not just for superficial reasons. Im sorry you're dealing with back order issues, and I hope you can get your medication soon!
@@Xnoob545if you don't have insulin resistance or diabetes... chances are, ozempic will do nothing good for you, and you will suffer from adverse effects.
I am a member of Alcoholics Anonymous for many years. I have dear friends who have had to take medication to help them get odd heroin. That, incorporated with AA, has literally saved lives. I haven't had to use that, just like some people don't use these medications but are able to change and stick with a healthy lifestyle. I love that there is different options for different people because everyone is different.
As a family doctor this was a great conversation to hear bc I was prescribing this medication very grudgingly As I saw it as a crutch. I can see that it is more nuanced now so that allows me a better method of educating and prescribing.
My (awesome naturopath) doctor was more than happy to prescribe it for me. He said it’s truly life changing, and no longterm side effects or negatives. He did insist that I agree to see a nutritionist and get on a healthy eating plan, and gave me a recommendation for a great dietitian. I was so happy that he not only didn’t fight me on it, or shame me for asking about it, but was very excited for me that I had made this healthy choice to improve my life and make a positive l lifestyle change. I think there’s ways to approach it without shaming people, and my doctor did it in such a great way.
This is exactly what I was thinking about while listening to the interview. I'm sure plenty of healthcare providers have a narrow (not meant to offend) view of the medications and patient population requesting the medication, and both doctors here did a great job of broadening that view and giving a road map for bringing patients from point a (wanting to lose weight) to point b (understanding their health and habits) through education.
Good for you. Have you read some of the cmnts? Like the ones before your cmnt? Very interesting how it has helped people in different ways.
You sounds like a great dr informing yourself : )
The pharmaceutical company thanks you.
It seems like Dr. Mike had some disagreements with her and was challenging her answers. It's always good to have healthy discussions and debates to get different perspectives and opinions.
I noticed that too, Mike is always for achieving well being from better lifestyle and naturally adapting, while she thinks that well being comes at all costs, if the medicine exists, why not?
I don’t know if she changed her mind, versus redirecting her message promoting lifelong meds. For example, she was incredibly comfortable calling GLP-1s “lifelong medications”, later saying the goal is the lowest dose (still vague, still same message)
@@FelipeFreitasFSher practice financially depends on these meds.. of course this is her opinion
@@arminmadari4808Her viewpoint was that if you can get off of it, you should, but many people will never be able to manage their weight without and those people should be taking it as ling as they need to. It may be a very low dose, or less frequently than prior. Not really changing a view point
@@arminmadari4808I think what she meant is that for some people it will be necessary for the medications to be a lifelong thing. And that we shouldn't look down on it or feel to scared of it, because for those people not taking those medications for the rest of their lives would be even worse and far more unhealthy.
I would say Ozempic changed my brain chemistry. It took the cravings away, I was able to stop bingeing, my brain actually registered as being full when I ate a meal. I lost weight, but for me, weight loss was truly a side effect. For the first time in my life I was in control of my eating, not the other way around. I felt like I could take absolute control of my life - really make headway when I worked out; take control of my medical issues (from poor diet) - lower my A1C's; lower cholesterol, lower my BMI, etc.
Agree! That to me has been the most mind blowing thing. I never binge eat anymore, I also tear up thinking about the fact that this has happened. I don’t know about you but I do something think “is this how normal people eat food?”
nope it didnt change any brain chemistry. If you go off you will fall right back into it. This is why Pharma wants you on it. Becauase you will stay on it
@@alexsummers1897 I thought that all the time. I wake up thinking about food. I think about it before I go to sleep. I hate it. I would give it up if I could. Unfortunately, my insurance won’t cover it anymore. I feel like I just bounced right back.
I say it’s the Antibuse of obesity meds.
Same! I've only been on it for like a week. I already feel more comfortable in my relationship with food and I also don't feel that need for food to "hit that spot." It's awesome other people have a similar experience.
This is the best interview I have ever seen. “We don’t cure hypertension we manage it” is such a great discription on how this helps like other medications. Also “your patients have probably been trying everything for decades” so true oh my gosh, finally someone who actually understands obesity, I’ve never felt more understood.
I really love watching this channel very awesome and informative, we're you watching from?
Except you CAN cure hypertension, can't you?
@@shonaaitken7635if it’s hypertension caused by something like atherosclerosis then no. It’s more managing it because your arteries aren’t going to regain elasticity. This happens as you age but can be accelerated by many factors. This is managed through ACEi, ARBs, b-blockers, etc. as well as changing lifestyle factors. However “obesity” can be cured. The cause of it maybe not
@@shonaaitken7635how?
Yes. Lifestyle! But most people want a quick fix!
I am so surprised that when talking about weight they are not discussing psychology of a patient , it's crazy that this factor is being totally overlooked .
Some of us have missed that the goal of this conversation is to have many perspectives brought to light - On one end we have a specialist who regards these medications favorably and on the other end we have a general practice doctor who is readily questioning and learning about the practice of these prescriptions. It’s great to hear the full spectrum and understand that mass medication isn’t necessarily evil when done carefully, and in turn also recognize that people tend to misconstrue medications due to popularity and possibly misuse them. Two things can be true at once.
Facts. This is a great conversation from two physicians who are working in two different ways.
That's a very reasonable and MATURE point of view. Good on ya!
omg, do americanatzis think this is full spectrum?!?! omg, no wonder they're living through full blown societal collapse 🤦♂
The way you phrased that is so good. Thank you
I do feel like Pharma is very gung ho on meds and gets defensive when Doctor Mike asks the stats of pharmas practice, but he's very good at give her a soft out to soften the blow and answer. This is a beautiful chat but i'm leaning very much on Doctor Mike's side.
37:56 she mentioned losing enough weight to do basic tasks again, and feeling able to exercise.. I’ve been paying for a gym membership for 4+ years and haven’t gone since before Covid. But I’ve lost 25lbs on Wegovy and actually FEEL a desire to MOVE and it’s truly a beautiful thing.
Gym possibly not the right choice for you then. Find something you actually want to do that you like :)
As a medical professional, I find this conversation highly engaging. While I typically lean toward holistic and natural approaches, I do recognize the significance of medications and surgical interventions when they become necessary. With the prevalent issue of obesity in the United States, it's crucial that we explore every viable option to help patients achieve better health, both in terms of appearance and overall well-being. If medications can contribute to improving patients' quality of life, I wholeheartedly support their usage.
I have found this approach most helpful for me as well. The balance of natural/holistic and medicine. I've had numerous medical adventures through the years and this approach gave the best results. I just wished more collaboration were possible on a professional level for more patients to receive the results. May I go so far as to say this...insurance companies cover functional medicine practitioners.
@KreativeKerri There's just not enough quality evidence to support a lot of what "functional medicine" does. Far to often, if there was evidence to support "alternative medicine" then it would just be called, medicine.
@@cathiehealey4608 I understand your point. I'm all for research studies and evidence. With that being said, we are dealing with huge corporations, big pharm, and the like who would loose money if more natural approaches were also utilized. I'm not a huge conspiracy kind of person so hear me out. There is something to the mind-body-spirit(inner self) connection. I live how functional practitioners take a whole body approach. Specialists of different systems have limitations. They may say this could be effecting that but there is lack of collaboration. Also, when dealing with alot of diagnosises, m-b-s can all play a factor. Have a doctor specialized in one system, could they surrender to the idea that the root may be in a different rhelm? I know I'm talking in general hypothetical scenarios. I guess my main point is this. Just western medicine limits the scope of practice. Just functional medicine doesn't allow for enough patients to take part their practice for peer reviewed practice. In my experience, my chronic pain and RA symptoms have significantly decreased when I apply both ways. Its not a 1 or the other. Its an AND.
@@KreativeKerri If they want to be invited to the table, they need to provide the same standard of evidence. I'd hazard a guess that whenever 'holistic' approaches have worked for you - it has been alongside healthy lifestyle changes. The same ones your doctor told you to make but you didn't listen because he was wearing shoes, like a total square. It's the fable of the magic stone soup. It was not the magic stone that made the soup delicious, the magic stone was incidental. It wasn't even supplementary - it was completely unecessary.
@@frankcooke1692 are you asking me did I listen to my medical doctors or ate you assuming I didn't? Just want some clarity before responding. Also stone soup was one of my favorite stories when I was a little girl. You may want to go back and reread this story. You're missing the premise. Your misconception is just a little skewed.
Mike says, “If we could put people on 150 minutes of moderate exercise a week, put them on the appropriate caloric intake for their healthy body weight, they would all get there.” I am fortunate enough to work out with a personal trainer twice a week. I can afford to buy a lot of fresh produce and whole foods which I prepare mostly at home. I don’t drink my calories and try to prioritize protein and fiber in my diet. I also have a BMI of 35. When I try to reduce my caloric intake, all I can think about is food. It becomes an unending, obsessive misery. And I’m not eating more than I did when I was at a normal BMI, but after having a baby 3 years ago, entering my 40s, and grappling with chronic pain, it’s a lot more complicated than 150 weekly minutes of exercise and making better nutrition choices.
I am going to say something a bit mean, but true: He is right, and you are wrong. Energy is energy, and if you eat less than you spend, you are going to lose weight. Having a baby doesn't change this, in fact, nothing changes this. This is objective, UNDENIABLE fact. I am overweight myself, and I know what it feels like to just really want to eat. Ultimately however both you and me are in control of the hand that grabs that fork, and we CAN command it to put the fork down. Ultimately, it is a question of willpower. There is no two ways about it.
It's really not,you just happen to be an outlier
It’s not just willpower. That’s insulting. So many things come into play. Environment, hormones, and micro biome are the primary non-CICO factors. Saying that it’s just willpower is speaking from privilege. Willpower only takes you so far. Habit is essential.
@@katherinegallousis4395 None of those discount CICO whatsoever. Habit is formed through your actions, aka willpower. I don't see how that is insulting, it's not a personal insult toward you to if I tell you correctly that you have agency in this world and are able to influence your life. You only take that as an insult if you feel I am making a value judgement of you when I say it. I am not. I'm just speaking the truth. I am overweight myself, and it's not easy to lose weight. But it is possible, and it's MY FAULT if I don't. I can put the fork down and go for a jog. So can anyone else.
I will add to this: 95% of diets fail. That means one in twenty succeeds. That is not a horrible rate. Be that one in twenty instead of whinging.
I'm on Ozempic now. Yes, I've lost weight, but I'm more impressed with my blood sugar numbers. I'm almost completely off insulin and that's huge for me.
❤ Good for you! It is amazing... I'm completely off insulin, myself!
@@stephaniemerrill4515 insulin is a hormone and so is semaglutide so you pretty went much went from one hormone injection to another hormone injection? which is more affordable long term?
Limiting carb intake fixed my insulin levels and got my cravings under control in ten days after I decided to change my eating habits. Also my food receptors no longer numb and everything tastes so much better. No drugs needed, saved money. Doctors hate me for this weird trick.
@@guntisber5415 That is actually wonderful for you, congrats on that! But also, not everyone is you and will have the same experience and the way you framed this comes of very passive aggressive to people who will not have the same experience and result as you. I am glad this worked for you and I am also glad that medication exists that helps people. One method is not superior over the other tho and thinking it is helps literally no one.
Two things: Regarding psych meds, I am on them forever. In order to keep my sanity with Bipolar 1, I will be on them for life... have been on them since 1995 continuously. It will be the same for obesity meds. Diet changes (down 40lbs), Trulicity (down 86lbs), and now on Mounjaro (not weighing often)... I am down 150lbs and am still 100 lbs away from being "just" obese. I have no weight goal; I have met the goals of getting out of bed, not using a wheelchair and walker, and many more personal triumphs. I know there are still more to come as I can _finally_ be alive. I'm 62, did Phen-Fen, had an RNY Gastric Bypass, and regained it all back and more. That I can treat my obesity disease now _forever_ brings me immense joy.
I am so happy for you. I'm a mental health professional and I agree with you completely. Many people with chronic illness stay on medications for life. Many psychiatric illnesses are also chronic illnesses and thus need life long medications to manage it, to STAY ALIVE and hopefully to live a contented life. I don't think a lot of people understand that. I was shocked with @DoctorMike said he tells his patients that the SSRIs he is prescribing are not for long term. I have so many questions about that, and I find it distressing, having worked in the field for over 30 years. You have been through so much. You are still here and moving forward. I was very moved by your comment and I wish you all the best.
@@yukonswimmom thank you so much for this comment. Mike's SSRI take seemed very strange to me. I was put on SSRIs by my neurologist for three months and those were the best months of my life... until the course ended, the withdrawal almost killed me, and my depression came back with a new force. Luckily he then referred me to a psychiatrist who got me on a much better treatment plan. I've been going to therapy and taking my psych meds for two years now and while I still struggle with depression, I feel infinitely better now. My anxiety doesn't affect my day-to-day life nearly as much anymore, my OCD is almost completely cured and I finally feel like a person again... But it took two years of medication and hard work to get to this point, with many setbacks down the road. My doctor told me that only after 3+ months of stable and consistent improved well-being can she start lowering the doses, let alone taking me off the SSRIs completely. You don't just mess with meds like this for a short time and think that the patient will be fine.
Absolutely agree. I have been taking my SNRI for 15 years now and I have reduced the dose many times, and I have relapsed several times even while on medication when my dose was lowered, so it is likely I will need it for life at this point. For me it is a chronic recurrent illness. Having said that, a lot of people with mild or moderate depression who haven't had it before or if it's due to a stressful life event or loss will only need medication short-term, so I understand what he's saying. I'm sure he knows that some people need psychiatric medication long-term, but it's hard to explore the nuance when that's not the topic of the conversation.@@yukonswimmom
@@alinashirinian2485 Agree with you, I think the problem is that these drugs are often over-prescribed by people who don't necessarily have a mental illness but are experiencing low mood because of life circumstances. In which case, yeah, you won't need to take it for as long and can just come off of it when things are better. Whether it's right to prescribe them in those cases is not my place to say, but it's not the intended use.
How can you even be “manic” when your that fat? Just kidding. I’m petty sure psychiatrist just call increasing sedation “treating” mania. Because that is what all the research on animal studies really does is test different ways to sedate rats.
She’s the First doctor I’ve seen on social media that actually understands obesity.
Dr. Mike is a great example of why it's so hard to implement change in traditional medicine
@@eliassamona3585Right? Even after everything the specialist said, he was back to diet and exercise as the way to weight loss.
@@Sandikalthere are some of us dietitians who also do counseling but there are not enough of us or as many specialists at it to recommend for the general population. For long term behavior change, lifestyle psychotherapy is very effective but not all dietitians and not all mental health professionals are trained on the niche. Many people benefit from talking about their eating habits with a counselor or dietitian weekly or biweekly or monthly. It is very inexpensive for insurance too compared to complications.
@@Sandikal Is that a good thing or bad thing? Because they both agree diet and exercise is still the way to weight loss/healthy body. Difference? Dr. Mike leans less on medication, and Dr. Salas is more likely to lean on medication.
Came here to say exactly that. Through the entire conversation you could tell he wasn't convinced, even though he tried to hide it and was very polite about it. Disappointing when you have such a renowned specialist on the show.
I hear her saying that most patients will never get off of these drugs once they are on them. And then in the next sentence she says that she always talks to her patients about getting off of this drug at some point. HUH?? I think our society has gone off the rails when it comes to the conversations that we need to be having around healthy lifestyles. We are always looking for the quick fix. Thank you, Dr. Mike for the conversations you are having about this.
You probably missed Minute 34:20
Learned so much from this. The way the two conducted their conversation with a bit of pushback, answering things that maybe wouldn't normally get asked and the information behind obesity being more than just a failure to stick to a healthy lifestyle was absolutely brilliant. This whole thing was incredible, we need all medical professionals to be like these two.
From a Pharmacy Technician THANK YOU for this interview. Accurate medical information is important, and we just want our patients to be able to get this medication regularly who need it the most. Please don’t abuse these drugs, they help many of lives everyday!
Wonder how many concurrent prescriptions of olanzapine and semiglitude you will see?
The hard thing to understand is that the plan is not to cure...diabetes, high blood pressure or obesity. Mean while lowcarb/high fat way of eating har reversed all of them, Dr Mike knows, thats why hi was so direct on his observations and questions.
48:16 "I have yet to meet the single patient with obesity that is the couch potato that we have the picture of." So refreshing to find a doctor that sees this, and believes that sometimes, you can have the perfect lifestyle and STILL not see the results.
I have type 2 diabetes and that's why I was put on Ozempic. I'm very grateful for it, except for the side effect of nausea that I experience when my dosage is increased. I just wish that the medication supply would keep up with demand, because Ozempic is my sole diabetes medication and there is an access issue lately. I want everyone who needs the medication to have it, but I do hope it gets prescribed and used responsibly. I really appreciated this conversation.
One of his best videos. His body language exuded being critical of the information provided, but also respectful and polite. I thought they both brought up very good points. This was informative and enjoyable. I hope to see other almost-intensely critical / engaging videos like this from Dr. Mike.
She gets it! I lost over 100lbs, and am starting to back slide pretty badly with binge eating and I have lost the motivation to continue to exercise. It was SO mentally taxing and it took up my entire brain space. It was a full time job!
Maybe reduce the amount of time you spend exercising, but always remember how hard it is to lose weight as compared to trying to maintain it. And it’ll not be just about looking fit but also your mental health and how you view yourself. So if at all possible try not to lose the motivation, don’t go as hard but don’t fully stop because once you all that effort is gone. And starting that process for a second time is tough.
Exercising can be simple, walking down the block, it can be fun, jump roping, it can be calming a long yoga or Pilates KZhead video. I don’t think you need to start with really hard workouts or weights unless you feel ready! You can do it!
Also I’m not sure if this is healthy but if you did nothing all day, remind yourself your body doesn’t need extra energy in the form of food. Maybe snack on some healthy things like cheese or nuts or fruits and vegetables. If you had a long day where you did a lot mentally or physically then your body will need more energy in the form of food. Gotta be mindful and that’s the hard part and we’ll as self regulation
Get on the drug and stabilize yourself. No reason to go through that again then work to get off and only go back on to stabilize. Very simple actually but I am sure there are many who will say just use will power. That’s BS!! Good luck.
@@Shomo-lk8zh I wish it were that simple. My doctor tried to get me on Wegovy, but health insurance wouldn't approve it since I'm not diabetic.
as someone whose been trying to lose weight since middle school, and haven’t gone through one day of my life not concerned about my weight or body. listening to this video helped me feel better, after many doctors telling me to just “lose the weight”
I got a gastric sleeve 29 days ago. What made me decide to do it is learning about how it changes your biology in a way where you'll prefer healthy foods and that obesity is not my fault. I used to blame myself for being fat and that made me indulge even more just to get a "high" from food.
I lost 200lbs by making changes to my diet and lifestyle. I'm at a healthy weight now, and I've maintained that for a couple of years, but it is absolutely a daily if not hourly battle. I am always, always thinking about food, planning meals, working out what I can and cannot "allow myself" or just resisting the urge to overeat. Calling it a job doesn't do it justice, it is just a constant, all-consuming pressure. And the few times I've let my weight creep back up a little, the stress and anxiety it causes is unreal. I don't need to lose any more weight, but I still can't even begin to articulate the improvement it would make to my quality of life if I could just take an injection once a week and not have to deal with that any more.
I hope you can get that peace of mind you seek, but I want to congratulate you on how far you've come! People like you with that fortitude are examples for so many others without knowing it!
I don't know how long that process has been for you, but I reckon eventually your appetite will adjust. I've been trying to lose weight myself. I almost enjoy the project, personally. The meal planning is like a fun little puzzle. It doesn't have to be a chore, there's plenty of fun things you can still 'allow'. Butter Chicken (with greek yoghurt, not so much cream), pesto chicken, special fried rice with garlic soy chicken, chili con chicken, chicken wraps. Those are all low calorie options I'd happily live off. The only thing I've had to cut out are potato/corn chips, beans, nuts and sugary drinks. But then I guess there's still the issue of portion control. I do sympathise.
Totally agree. I would almost trade losing weight just not to have all this food noise in my head. It's that not the weight that impact my life and quality of life.
Do people read food labels in the US? EVerything has sugar in it yet food companies are not called out on this. I reckon most of this obsession with needing food all the time starts as toddlers and it becomes an addiction because of sugar. If one watches movies from the 70's and early 80's the cast and crew are all normal weight, even slim. Everyone. Now I watch tennis matches in America where even the ball kids are overweight. No wonder it's so difficult to stop. It's kind of like in people's DNA by now. I was very against people taking a diabetes drug to lose weight but if it helps people's health physically and mentally and also affects the bottom line of companies peddling sugar in food then I'm all for it.
For me, loosing weight was so absolutely impossible because my depression made it so difficult. I would eat just to cope as an alternative to self-die. And when its either suicide or obesity I suppose society moves you in the direction of fatness.
I'm sorry you've gone through that. ❤
More people need to realize that those aren't the only options, and we should be moving away from the quick fixes whether it be pharma, food, drugs etc. I know it is easy to opt for those but solving the root cause is much more beneficial even if it is harder in the beginning. If you know the reason for putting on weight, or difficulty losing it, then you are ahead of most.
I think mental health is a really important factor in this conversation. It sounds like you have been through a lot. I'm glad your here. I hope you are getting some support!
This is not just one person. I am in the same situation. I could maybe take drugs, or drink alcohol or cut myself instead of overeat...but that would made it all even worse. Why don't I go the a therapy? I wait for over a year now to see a therapist. The waiting time is long where I live. The obesity problem is a symptom of mental health crisis all over the world.
@@2leg1t2qwt5if you know how to solve depression, please share. There are millions waiting to hear, as well as their doctors.
Thank you for doing this interview. Dr Salas-Whalen is amazingly knowledgeable, and she hit some really important points that I think bridge the gap between patients and doctors, such as when she emphasized that people with genetic predispositions can't always lose weight with lifestyle changes, and it in fact those changes might make it worse for them. I think that fact alone is a core driver of conflict on this issue, along with the idea that people who need to lose weight to be healthy just "aren't trying." I've known several people who have excess weight run in their families who tried all kinds of things, and end up just wanting to love themselves for who they are because they believe that their body won't change. Because without medication, they're probably right about that. Because self hatred can lead to eating disorders which could have even worse health outcomes than just living with obesity. Because their EDs can impact their future children. Obesity doesn't run in my family, but my mother developed it after struggling with an eating disorder as a teen and young adult, and I've been overweight all my life no matter my lifestyle, thanks to epigenetics.
I think I find it hard to emphasize with the genetic predisposition argument rather than lifestyle. Anecdotally my mother and I are the only ones in my family who are not obese. Seeing what other family members eat, and how inactive they are I know for sure I would be in the same position with those habits. Further my siblings and I were always in shape as children. My sister stayed with our Father for a year and gained 10kg as a 12 Y/O, the only thing that changed was poor food choices. Then she came back and slowly lost the weight. Within a year of her and then later my brother leaving home they sharply shot to obese levels also where as I maintained my weight, the difference was 90% of my diet was healthy choices, where as their pantries were stocked with lollies, chips and constant take out meals, or simply really really big meals. This is the same situation with all my extended family members who are overweight. I did develop poor habits over COVID that honestly took months of self control of fighting junk food cravings from those habits until they finally died down to the point they weren't an issue. Not only that it took a few weeks for simply the base hunger to die down after moving my overall consumption back to what it had been for a decade prior to COVID. I guess this leaves me with quite a bias as I know that at least in my immediate family that everyone that is obese is obese purely due to life style choices.
100%. I've tried everything, eating healthy, working out for over an hour almost every day, and for most of my life I've been overweight. I finally got prescribed ozempic this week and looking forward to trying it.
@@PaulFilmer I agree with this. To me, taking meds/pills to lose weight is the last option. Accessibility and proper education on healthy foods and exercise should be the basic foundation. If it doesn't work on them then that's the time that other issues will be considered such as mental health checks, etc. The bottom line is.. proper food and exercise are the foundation of good health.
@@PaulFilmer The part you're missing is that when obesity runs in families, it gets passed on to children. I was raised in a family where exercise didn't occur. My parents didn't exercise and didn't encourage us to. When you're someone who spent their entire childhood not exercising, it is so so so difficult to motivate yourself and get into a good habit when you're an adult. I HATE exercise. If I had been encouraged to as a kid, I likely wouldn't hate it so much AND it would already have been part of my routine. On the same hand, parents who are obese don't tend to feed their children healthy foods or promote healthy eating habits. I grew up eating a lot of processed foods and was modelled eating when bored and not eating healthy snacks and not knowing when to stop eating, all habits I STILL have in my 20s because they were developed as a child. That said, I obviously know what foods are healthy and try to eat healthy as much as I can, but you can't ignore the fact that habits you developed and followed for 18 years aren't exactly easy to just break. So no, it's not all about choice. My entire family is fat, that's what was modelled to me. Have some compassion for those people who behind closed doors are probably struggling with the same things I am, you just have no idea. I also have PCOS which I choose not to disclose to the entire world. You have no idea what medical conditions your family members might have. Also, no one cares to hear comments about our bodies from people who have never struggled with weight. Congratulations. Be thankful.
I have to respectfully disagree with you. It runs in families because families live similar lifestyles. They eat the same foods, they work at about the same physical level, etc. If a family for recreation sit down and watch TV yeah they're not gonna have a healthy lifestyle. If they go out for hikes and family workout competitions for recreation they're gonna look different. We are what we repeatedly do. That's how it is. Now, if you wanna watch TV and eat pizza and be fat, then by all means, do it. Be happy with your decisions. Just don't blame other factors and look at things objectively.
I had a doctor (coworker) tell me that only BMI mattered. We were talking about body composition tests, and how I lately had been feeling ill, like my body was telling me I was fat even though I do not look fat at all. I was afraid I was developing insulin resistance. When I did the body composition test and felt so validated when it showed that my muscle was very low and my fat was very high and mainly visceral. A true example of skinny fat. I had been doing cardio and wasn't losing any weight. Now I understand what I needed was to gain muscle mass and that that would lower the visceral fat. So I have increased protein in my diet, lowered my carbs, and started weight lifting. I have lost 3 lbs in the last 2 weeks and am starting to feel better. Sometimes you have to listen to your gut and study. Maybe don't listen to the overweight doctor who tells you that you're OK if your BMI is fine, even if you feel sick.
Glad you are on the road to health. I'm a firm believer that a person is their own expert when it comes to their own body. Way to go for feeling better, I hope it continues in your favor.
@@pbandjedi5006 Thank you! Increasing protein and reducing carbs has definitely made a difference. But trying not to rely solely on that, building muscle is just as important.
I won't even entertain a fat doctor.
Is a body composition test easily available?
Most experts consider bmi to be kind of crude becuase on women you could have a healthy bmi but too low of a body fat to get a period if they are really athletic.
I'm a 70-year-old female who has been overweight since having my children. I also have other physical issues that qualify me for this medicine, including severe arthritis. After going to Kaiser's Healthy Living doctor, I was required to take their Healthy Eating Program, and after labs, I just started taking Ozempic two days ago. I have been watching several KZheads about this subject, and I'm so impressed with this interview. I just want to tell you it's been so informational and pleasant to listen to. Thank you so much.
This was very informative. I'm on ozempic due to needing help with weight loss and diabetes control. My doctor never mentioned the topic of muscle nor protein in take. I am going to mention this to her. Maybe she's unaware. Thank you for having this conversation.
Good job for taking this information to your doctor and advocating for yourself! 🫶🏻 wish you the best
Well done you, take polite charge and question as you learn. I do hope your treatment goes hand in hand with the lifestyle choices you are facing. Embrace them. It will be better than the meds. Good luck, you are the biggest part of the treatment and success.
@@imaner76 thank you so muvh
Honestly same here. They never said anything about muscle loss to me and boy did I notice after a few months. Also my doctor was disappointed in how much I have lost from my first appointment after taking ozempic to the next. I was like umm you do realize I have lost 30lbs in two months. I have another appointment next month with him and I will be bringing this up.
That makes me nervous about the muscle loss cuz I am big enough and not mobile enough and in pain to work out at this point. I will be able to hopefully after I've lost a bit more.
Im glad she touched on bmi, im tall and relatively muscular and my bmi is nearly overweight but my body fat perfentage is normal and my waist to height ratio is nearly underweight. Ive struggled with eating disorders in the past and a doctor telling me i need to lose weight despite being the healthiest ive ever been because of just one measurment when all the others are great would break my heart.
Yeah, BMI is broken. A good general analysis I suppose, but I’m 5’7” 195lbs at apx 10-12% body fat. That gives me a BMI of about 31 and obese 😂
The closer to the normal range of BMI you are the less useful it is. If you are someone well into the obese range it is very unlikely that you are not carrying around a lot of extra fat. However, Mike is right that it is typically people who are more muscular saying they don't like that BMI calls them overweight for example. At that point BMI isn't a useful tool. As she said focusing on muscle and fat percentages is far more useful at that point.
Same. I'm tall and a size zero but I've always been heavy. I can't possibly lose more weight without being a skeleton but my BMI is high. 🥴 I stopped allowing them to weigh me.
@@jenniferlawrence2988 I got lucky and have so far had nice doctors and PAs who have noticed my discomfort at my weight and taken the initiative to reassure me that I'm healthy despite being right on the line of overweight. I hope that luck remains. It helps that I look like I'm in good shape and I'm young so I worry that with age, I may have bad experiences.
She was literally arguing that the BMI ISN'T RESTRICTIVE ENOUGH, because it doesn't tell ENOUGH people they're overweight.
I appreciate that she speaks to the understanding that many people who are overweight are trying to lose weight and their whole world revolves around it. Her perspective felt like my experience was being spoken about. After being 125-130lb my entire adult life, covid added a large amount of pounds that I have been fighting to remove over the past 18 months. Even after diet and exercise adjustments, trainers, and doctors all helping me, it still feels impossible to shed the pounds. I appreciate her empathy and understanding towards her patients
This was a great discussion. "If it's not the easy way out, why are so many people asking for it?" is a great question. I can say for me, hearing that people on Ozempic were not obsessing over food and actually feeling full/satisfied was such a huge part of why I considered it. Obsessing over food/diet is a full time, soul crushing job. I do still think about food, but, often not in the same obsessive way. It's maybe a more thoughtful approach? It's hard to explain. But it's like depression meds- they didn't just make me happy. It was a subtle change that allowed me to actually function. Anyway, I don't see it as an easy way out, but it does help with some of the mental/emotional anguish of dieting and I don't think that's a bad thing.
She was wrong, it is the easy way out especially when comparing to only focusing on diet and exercise. But hey that's okay, easy is good for some as a start for short term. I agree it's definitely not a bad thing.
Yeah the "easy way" is not always bad. Life can be hard enough. I had to manage my mental/neurological issues with didciplined Lifestyle changes because I reacted so bad to most medication. I can do it but it us hard work and timeconsuming. I don't begrudge anyone for whom antidepressants and stabilizers work. Why shouldn't they take a shortcut? There are few enough in life. And if you Don't get your life together afterwards they will stop working anyway. We are all so averse to the idea of getting help.
Obviously it is the easy way out but you have to consider that some people have a harder time to begin with. There have been studies that say that addiction has a genetic component. Also people with ADHD tend to have a disregulated relationship with food. So just dismissing semaglutide as the easy way out without considering the increased difficulty for some people of actually following a diet and maintaining the lost weight isn't very fair.
@@pozz941 Good point. For some the comparativly "easy" way is still harder then the regular way for others.
As someone who has only successfully lost weight when I made it the focus of my life, it feels so validating to be seen! I don't qualify for Ozempic but I do believe for many people obesity is a disease. For people like Dr Mike who are super driven and have the time and the money I can understand why he'd think most people can lose weight through a healthier lifestyle.
SAME!
If i don't weigh and measure all my food, and count/track every calorie i fail to lose any weight or even maintain weight. That's with working out 2-3 times a week. The only time I've been successful at maintaining weight or losing it without it being a full time job was in high school, particularly with wrestling season where i was doing intense workouts at least twice a day. I felt that full time job comment in my soul.
Yes yes yes!! It does feel like a full time job losing weight! Which is the why the only time I was successful at it was during 2020 when I had so much down time to myself. I feel bad saying it but that was the only time in my life I've ever actually had enough available time to really focus on myself and take better care of me. Since going back to work we have not had the time to do it. I'm exhausted. The way our society is laid out with pushing everyone to work themselves to death just to be able to pay the bills nobody has extra time to take care of themselves.
Absolutely agree most can but it's the unrelenting food noise and craving that makes it so hard to lose and then to keep it off. Turning off the appetite is the magic.
I feel like this discussion really skirted around the issue of eating disorders. It talked about people on extremely restrictive diets, people who just wanted to lose a few pounds for aesthetic reasons, people who'd been trying diets since childhood, irresponsible providers...but never explicitly mentioned eating disorders. I appreciate that they discussed the importance of losing weight in a healthy way, but it was mostly framed as being because these unhealthy ways of losing weight will "fail" or are unsustainable, rather than having serious health consequences. I didn't know that losing weight too quickly could cause gallstones until after I found myself screaming in pain, barely able to crawl across my apartment to unlock the door for paramedics. Not to mention things like micronutrient deficiencies. I think it's important to screen patients looking to lose weight to see if they have a history of eating disorders (especially restrictive eating disorders) or are at a high risk of developing them.
THIS!!
Very good point.
I'm in the early stages of using Ozempic. The side effects have been mostly mild - some nasty acid reflux (solved by changing my sleep position), lots of gas. As a morbidly obese patient with diabetes, I see it as an aid. I still have to eat better and exercise. It ain't easy at all.
One of the best weight loss KZhead videos I've seen. (Internal Medicine Doc)
19:21 a full-time job (to lose weight) Y. E. S. I HAVE LIVED THIS 😮😮 Dr. Mike thank you so so much for having her on your show.
I really love watching this channel very awesome and informative, we're you watching from?
Ozempic changed me drastically. I grew up healthy and active, part of search and rescue, and eventually came to the point where if you couldn't find me then you need to look at the map in my bedroom because I will leave instructions there. But when I got pregnant I went from 170-180 and usually 100-120lbs of muscle to 155-160 then to over 300 and then with stress of life and other issues mixed in and loosing weight regardless of exercising, healthy eating, and dieting programs. I was in the process of figuring out how to have a gastric bypass (I can't meet the apnea machine requirements because of a child trauma) when my doctor mentioned Ozempic. I have been on it since the start and it changes my brain chemistry so I am not hungry all the time and because I am not constantly thinking about food I can meal prep better, I am eating smaller amounts and I've lost about 100lbs. I am super happy I did this route and it was open to me because I can get to the old me and not feel stuck.
I really love watching this channel very awesome and informative, we're you watching from?
I understand why so many doctors, like dr mike, think about prescribing different medications as a temporary solution but as someone with terrible genetics, chronic illness, and moderate-severe asthma, you get so tired of constantly telling doctors that reducing the dosage will result in my health going down. Every single doctor I’ve ever seen has tried to lower the asthma medication I take and every single time they’ve had to go back up bc I can’t breathe anymore, it doesn’t matter that I told them exactly what would happen they always have to try and lower it.
Another good question would have been "Do you receive any financial or other incentive from the pharmaceutical industry to recommend this medication?"
I lost 40lbs on wegovy and loved it! People who want to say people "dont need it" need to remember, they don't have access to other people's blood work. Their anger might be misplaced 😉. As always, consult your own doctor and refrain from diagnosing strangers 🤗
If it's necessary, like say your metabolism or any other sickness keep you from losing the weight with sport and a healthy diet - and I mean like balanced, without starving yourself, I think it's fair. However, there are probably many people thinking it's the easy way out, like Dr. Mike said. Those people are not only taking those drugs from the people who actual need it, they are kinda responsible for all the fake drugs going around. And those are literally deadly. They even end up in hospitals, even in Germany where I live. It's crazy.
Dr Mike, you responded to your guest saying she doesn't see lazy obese patients by saying you do. But in your explanation you point out that the ones you see that are the couch potato type aren't coming to you for weight loss. That's the difference. When people seek out a specialist for weight loss they are trying and have been trying to lose weight for a while.
My thoughts exactly. Like they clearly have exhausted every other solution once they find themselves in her office desperate
I'm disappointed in him, and have unsubscribed
@EK-xz8ig honestly, yeah, this conversation was a big letdown from him.
Yeah, the profiles are very different, she is the last resource for many.
Or they were just referred to a clinic like hers from their primary care doctor who wants their patients to work on their obesity. She has her own perspective, but his is not at all invalid.
I have a degree in journalism and I'm so happy with this interview. Great questions, great job holding each other accountable for providing the scientific knowledge to back up the answers. You both created a great road map for healthcare providers who want to use these drugs as a tool to help patients, with perspective on how they should address the concerns and patient goals.
What has worked wonders for me about these types of medications is the way my brain has changed and is not thinking about food and hunger so much! It is such a relief and a different experience to go through the day without my brain being hijacked by thoughts of food and sugar cravings. This has been the key for me.
That sounds amazing. I’ve struggled with binge eating for about 15 years now and nothing seems to help. I don’t live in America so I can’t get ozempic unless I have diabetes. I had a doctor tell me that I should be glad I can overeat this much without getting fat🙃
we're finally recognising that obesity is not a moral failing, but a complexe medical issue.
It can be both
@@Amber-sc9jpno
Probably both actually. Some people lack discipline unfortunately.
Lacking disciplin isn't a moral failing either.
It is neither. It just is. Both of these doctors are talking well outside their area of knowledge.
Here's what I can say anecdotally. I was on Semaglutide for a brief period, could not for the life of me tolerate the medication. "if it has no side effects it has no main effects". I was nauseous or vomiting after most meals, bloated, constipated, had an aversion to all foods and especially alcohol. The first week after the injection was the absolute worst. It's been more than 10 months since I had that experience and stopped the medication. And while it had no benefit for me in terms of weight loss, I've had ZERO CRAVINGS FOR ALCOHOL ever since. It's truly bizarre. So while I was never a heavy drinker, cutting alcohol out of my diet has helped my energy, sleep, and focus tremendously. There's so much about this medication we don't yet understand, but as someone who's been through the best and worst of it's effects, I can tell you the benefits aren't talked about enough.
You were taking too high a dose.
@@lbburgett too high or not used to it. I had a similar experience on mounjaro when walgreens gave me a 5mg instead of 2.5 mg the first month. It got better after a while
I’ve heard other people talk about how this medication has positively affected their fight with addiction. It’s really interesting much and how little we know about how our bodies and brains work. I really think there will be some fascinating discoveries due to research in the coming years. It’s unfortunate the medication is in such short supply right now and that some people have such devastating side effects (stomach parathesis I believe).
@lbburgett are you their doctor? Please be quiet on issues that have nothing to do with you.
There is a very well-studied phenomenon in psychology called conditioned taste aversion (CTA), where you experience a particular stimulus and then quickly afterwards you get really sick, so your brain associates the two and you learn that X thing is no good and you should stay away from it. It's often both a behavioural aversion to X and a physiological rejection of it, like feeling very nauseous if you smell it or taste it again. CTA is a common example of classical conditioning and is basically a survival mechanism to avoid things that may be poisonous. The issue comes when you eat or drink something that is perfectly fine but then you get sick for another unrelated reason soon afterwards and your body misinterprets the cause and then violently rejects that food/ drink that it associated with the sickness from then on. But yeah, it sounds like your experience with taking this drug and being very nauseous and ill when consuming most foods and especially alcohol has conditioned your brain into thinking that alcohol is very bad and should be avoided, so I guess that's a positive side effect in this case. CTA is more likely to occur when a first exposure to a new food/ drink is paired with some negative physiological event (like vomiting), or when the thing you consumed right before being sick has a very particular and strong taste. It's unlikely for someone to develop CTA with something mild and easy to digest like potatoes, but a strong-tasting alcohol or particular sauce? Oh yeah.
Interesting discussion. Thanks for this
@DrBeauHightower It's funny because I'm a fan of your channel and see your comments on so many videos. I think we have very similar interests. I've your comments are probably 50-plus videos. It's nice to see I'm not the only one scouring the deep reaches of KZhead.
Interesting was certainly one way to put it lol. I’m alarmed that the answer to our nations obesity problem is long term drug use. Our society as a whole is the issue.. the fast food around every corner, the preservatives in our foods, the portion controls, our overly stressful lives, mental health issues.. on and on . There are so many smaller things that have contributed to this problem and I’m so alarmed that her answer is to medicate almost every single person that struggles with weight. I just don’t know how I feel about this. I’m no expert and she’s much smarter than me haha but something about this doesn’t feel right.
@@jimkazetsky5897 🤘🤘🤘
@@jimkazetsky5897why is there very little discussion on this about neurology of obesity. The emotional system..we live in a culture of emotional sedation of trauma absorbed in innocence as children, sticky safeness. Motivation is talked about..there is an acceptance about not enough time. So either the model changes or start to regulate psychology opened out to therapists but tracking of outcomes by their regulatory body & patients details given to the regulatory body as results survey.. we have get away from feelings avoidance the toxicity of don't cry ideology prevalence in traditional masculinity leading to higher suicide rates etc..we can run away from the emotional system & deny it's importance. But it is the seat of decisions.. it's time ethical medicine graphs this can learns those modalities to employ with patients in the conversation with mp3s part of the audio prescription to enable emotional resolution.
I’m neither alarmed or surprised, the government has always rewarded poor behavior. Unfortunately, it’s become my expectation that these incompetent politicians do not have our best interest in mind.
That convesation bring light to a plethora of questions. As a person who is obese and uses saxenda, this discussion helps me a lot and gives me such motivation. Thank you. I hope to see more videos in this channel about this thematology. Have a great day! ❤
I LOVE the conversation about whether it is empowering or disempowering to believe you have control over your condition. I have stage 3 endometriosis which is obviously an incredibly complex disease but because it is an inflammatory condition, reducing stress, avoiding inflammatory foods etc. can seriously reduce symptoms. For some reason though, I've seen people with my disease get SO ANGRY when anyone suggests that making changes to their diet or lifestyle may help. To me, the thought that I was 100% at the mercy of the healthcare system when my disease is severely under-researched, under-diagnosed, and misunderstood was terrifying. The thought that I could make changes to my lifestyle and see symptom relief was so freeing to me but to others, suggesting that anything other than surgery and hardcore medication could help them was an insult. My theory is that by accepting that your choices can help your condition, you also have to accept that your choices may have been worsening your condition, which is a tough pill to swallow. We can't all know what's right for our bodies so there's no reason to feel guilt or reject medical help even if our choices do lead to disease. I hope we can get to a place where there's balance.
Well put!
Part of the problem is that the normal rhetoric around obesity isn't just "your choices have had an impact on your weight". It's usually "it's your fault you got this way so just stop and you'll get better. Why haven't you stopped yet? Just do it." But there is a very dangerous allure to the idea that if it's not your fault then you have no control and may as well just eat whatever you like. Like you said, reality is in the middle. But honestly I think our society as a whole doesn't do middle-ground anything any more. It's all extremes.
People get angry because that's a half step away from patient blaming. I have chronic migraine, for instance, and people are always like, reduce stress! Eat better! Drink more! Etc etc. That may help me avoid a migraine here and there, but the fact is that I have migraine. It's a neurological condition. It won't disappear because I drank enough water, and it's insulting to imply that it will. There's this idea that healthy people have, that they are healthy because of the choices they've made, and unhealthy people must have made poor choices. It doesn't take into account genetics and basic biology. I'm glad those things help you feel better- that's great, keep on doing it. But keep in mind that what works for you may not work in others, or it may not be feasible for them for whatever reason.
@@misschanandelerbong7946 oh I'm not at all saying that lifestyle changes will cure a disease. I still needed major surgery when my disease led to a burst cyst and sepsis, no amount of stress-reduction or changes to my diet would fix that. And I completely understand (and have experienced many times) that many medical professionals don't have the empathy or understanding to make lifestyle suggestions for symptom reduction without blaming a patient or minimizing their pain. All I'm saying is that I think it's an interesting conversation and that I do believe there's a way to give patients recommendations in a way that feels empowering and gives them some control so that they don't feel like their diagnosis means everything is hopeless. Migraines suck, I'm sorry you have to go through that!
@@OldSchoolLPsGames Absolutely agree! In my experience, a lot of medical professionals haven't found that balance. They either think it's a joke that lifestyle or anything outside of medicine could improve your quality of life, or they're at the other end of the spectrum and won't even investigate your symptoms because they assume the problem is your weight or the fact that you smoke etc. Any productive path forward needs to include taking patients seriously and actually investigating symptoms. Even if, in the end, a lifestyle change would help, that conversation needs to be approached with empathy
This was such an amazing interview, as someone who has lost 21 KG from April to this day (around 47 pounds), the take she has is the same my nutrionist had, and it's been an amazing journey, not killing myself with strict diets yet putting up in the gym with weight training, I do not take any medications yet I feel amazing!
Wow, 21 Kg is lot, keep up the good work
wait until you get bored from the gym
Damn I feel like I could have written this comment myself. Made some changes to my diet (cut Fats and Sugars, increased protein and fiber) reduced calories to 2200, 35-40% carbs and protein, and 25-30% fat, working out for an hour 6x a week and down 45lbs.
@@chuck180cross training
Extremely well explained. I’m sharing this video with my doctor. She has been amazing with explaining this medication to me and working with patients and obesity. She will love to hear this interview. I’m thankful I have an amazing doctor who takes the time to talk with me.
Dear Dr. Mike I know you will probably never see this or respond to this but I wanted to tell you thank you for helping me get through the rough times in my life! You truly have one of the kindest souls ! You are truly passionate about helping people and making sure your patients get the right medical treatment. You are so amazing, kindhearted, passionate ,honest and just want to help people “stay happy and healthy” you truly care about people knowing the actual accuracy of medical stuff because you know TikTok is not very accurate. I truly have so much more from you than my years is school. You actually helped me pass science so thank you! I actually can use the stuff you have taught me in your videos in my life instead of learning stuff I will never use in my life like math. Again thank you for everything you do you are truly an inspiration for many kids and adults! I actually either want to be a doctor or a veterinarian when I am older. I am currently a high schooler who has no idea what to do with her life 👍Keep up with what you’re doing “as always stay happy and healthy”
My daughter had struggled since childhood due to genetics from her dad's side, now in her 30s she follows diet excercise and ozempic and for the first time I see she finally no longer struggles but she does excercise daily. As a mother, her pain was mine. This is a great conversation. Stay positive. Blessings
I love the open conversation on a subject that is not, generally, included in conversation. This is quite informative. Thank, Dr. Mike.
I started taking Wegovy in March and have lost over 60lbs. The problem now is there is a shortage. You have to take action to help with the weight loss. You can't rely on the meds and think it'll fix you. I'm the only person in my family that hasn't had a stroke, so I am constantly worried about weight issues
How are your side effects? Any tips? I just started
We're not built to live in a constant feast/high calorie foods easily accessible, or sit at desks for 10 hours a day. This is an incredibly new development in human history, it makes perfect sense to me that most people would struggle to control their weight.
I'm on a GLP-1 medication and I think the biggest benefit that a lot of people don't talk enough about, and I wished she had of spoken to, was the feeling of regaining control of our lives. The brain trigger of satiety and being able to stop, or walking to the pantry, looking around and deciding, no I don't need anything is remarkable. We, as obese people, for various reasons, have lost a healthy relationship with food, in a multitude of ways; choices, quantity, time, shame, etc. That feeling of figuratively, and literally, of being able to push the plate away and saying, "I've had enough" is a massive step forward to regaining control. That feeling of control, leads into other things, deciding to go to the gym, deciding to go for a walk around the neighborhood, deciding that when I'm at Moe's, I'll get a bowl instead of a burrito, because I would rather have a few chips for carbs, than the wrap. It all adds up. That feeling of satiety is incredibly powerful, and one we lose because the food industry is poisoning us. It's so powerful, that there are now studies that are showing people are stopping drinking, smoking, or other harmful drugs. It's incredible.
I'm a Master Fitness trainer plus I'm certified as a health and fitness trainer....yet, even I have struggled with losing weight for my entire life. I would literally run 1/2 marathons monthly and 10k every weekend, and still I was considered obese.
I’m not overweight, but I’ve gained 10 pounds in ten years (now post menopausal) consuming the same diet and running about 12 miles/ week while increasing miles to train for half marathons in the summer. I’m am working hard to maintain 150 lbs. Luckily I was at the low end of my BMI to start with. Hormones play a huge role. Lack of estrogen is real.
I wonder if you might be seeing stress-induced difficulty in weight loss. Perhaps less exercise and instead a few high intensity workouts (not marathons) might improve your fitness level?
I really love watching this channel very awesome and informative, we're you watching from?
Exercise does not drive weight loss.
😂@@avapilsen
For me, Ozempic and Mounjaro have been life savers. I’ve tried EVERYTHING. Nothing works long term. Call it the easy way, call it cheating, I don’t care. I’ve lost 87 lbs in 2 years, (weight loss stopped for a year while I fought breast cancer and switched to Mounjaro when Ozempic stopped working) I feel better than ever!
I really love watching this channel very awesome and informative, we're you watching from?
‘Difficult Questions on Ozempic’ is a heckuva accurate title… there were times when this felt almost like a hostile interview. 😒 I respect Mike’s POV, but it seems like he’s very firmly in the old-school ‘just eat less and move more’ camp. Thing is, most obese ppl have already *tried* that…. again and again and again. And either couldn’t lose the weight, or did but couldn’t *keep* it off. 😢 So, given the long and sad record of *failure* with that approach, how about a NEW one? ‘Eat less, move more AND take these new meds. ‘Cuz, y’know, they actually WORK.’ 🤷♂️ They work BETTER in tandem with the lifestyle changes, but key thing is, they WORK. 🔑
This is a great conversation. I appreciate the nuance and the compassion of both doctors.
I use ozempic for weight loss. I am not diabetic it was recommended for me cause i wasnt losing weight and needed to for a possible heart transplant surgery. I am 24 and weighed 315 lbs and now weigh 265 lbs and must be 215 lbs to be at the 30.0 bmi or lower required to get on the wait-list for the heart transplant. Was diagnosed with CHF in 2021
Damn you caused your own heart to fail congestive heart failure at that age. It's probably for the better if someone else gets that heart at least it won't be wasted on you because you clearly don't deserve it
You don't need to justify why you're on ozempic. No one has a right to know your health issues and what you're prescribed for those health issues. I hope you hit your goal ❤
How quickly did you lose the weight?
@@cococmc Started May 29th of this year and still on the 0.5mg dose weighed in today at 262lbs.
@whonow5384 that's amazing. I'm going in to my doctor next month to try and get started. I currently weigh around 430. I want to eventually get down to at least 350. I suffered a spinal injury in 2021 so its difficult for me to exercise to help with my weight-loss. I need the help that hopefully ozempic can give me
I work at a big pharmacy in germany, we supply a lot of hospitals, nursing homes, even jails and so on. We've been struggling with a lot of shortages over the last 1-2 years already and the reasons for those shortages are all over the place but over the last months I had to talk to a lot of doctors and tell them they have to change the medication for their diabetic patients because of this. I have to say your interview did change my view of the whole situation, you did a really great job (as always)... but still, suddenly changing a patient's medication, even if they don't suffer any actual side effects still can create psychological issues, especially for older patients that are used to their old medication. I'd say the main issue here are the pharma companies, because they could handle a lot of this very differently to keep the supply chain in a better condition, but that's not just for ozempic/wegovy. Keep up the good work, doctor Mike, you're by far my favourite doctor and I'm not even your patient.
I love how you also talked about patients getting into SSRIs. It's reassuring that there's a possibility of weaning off of it and there are real patients going through it too. As much as I love taking them, the fluctuations in my weight is something I would really love to not have.
This is the way all conversations with opposing points of view should be done. Both sides have common agreement but being able to be mature and respectful about it the opposing points is what we are losing. This was intense to watch and educational. Learning is a journey.
I opt'd for a gastric bypass. It was the best thing I have ever done for my health! Diabties,acid reflux gone, sleep apnea better.This along with diet and exersice is a great option. I feel better than I have in years! I am happy to hear that there is a push to stop using BMI as an indicator for being over weight! Also the procedure is done using laparoscopy surgery, recover time is much less than in previous years. This was a really good interview thanks @Doctor Mike. Also whatever option you choose never let anyone convince you that you are taking the 'easy way out'! I should also note that here in Canada there is a year long process with a dietation, Dr, and psychiatrist before you are approved to have the procedure.
Diabetes gone? I doubt that.
There's nothing easy about gastric bypass. Like these drugs, it's a tool to help you get to a point where you CAN put in the work. Congrats on your success and getting to a healthier you!
I wish I could have gotten that done. I have rare genetic diseases that cause bleeding disorders, so he said I would probably die on the table. I spent hundreds of dollars to find out that I couldn’t get it. I had two family members that got it done. One of them did fine, and she kept most the weight off. The other one had a major issue right after surgery, they put him back under the knife, to correct it, but he came away with infections, and annul issues. It almost killed him. I hope you are able to find peace and happiness, and stay healthy for the rest of your life. You are worthy of good health!!!
Is about changing your habits and outing in the work.. Otherwise yiu just balloon back up.. Because main issue was not adressed but quick fixed. It happened to my aunt and many other people. There is no real shortcut here
I’d rather try a drugs first than cut up my body to make that work as that is permanent and still can have issues come back. My endocrinologist warned me that with my GERD gastric bypass was not a good idea as well.
Considering I need my ssri and other psychiatric drugs to keep myself able to do the work in therapy and other lifestyle things, I am tired of people acting like being prescribed medications is anything other than getting me to a place where I CAN physically do the work i need to do on myself to feel better. I assume it is similar for responsible use of ozempic.
The key is, is it being prescribed responsibly? We thought we were being "responsible" with opioids and look where that got us. We now realize we had overprescribed them massively and created an even bigger problem than we were first trying to solve. Now the people that do need them can't get them half the time, because doctors are too afraid to prescribe them. I bet we'll look back on this in 10 years and say the same thing about Ozempic and other drugs in its class.
@@OldSchoolLPsGamesexactly
This is a good example. My psych meds keep my head above water so I can do my therapy work!
I LOVE that you had Dr. Salas-Whalen on your show! She and I did the Tamron Hall show last year talking about these medications. I was a Surmount Phase I Clinical Trial participant in 2020 for Tirzepatide and I have lost a total of 208 pounds using this medication after a lifetime of suffering from obesity and after losing my oldest sister in 2018 to complications from obesity. Thank you for covering this hot topic!
I have been obese since childhood, and have extreme hormone issues. I am using no drugs to achieve similar outcomes of the drug. I went to a health retreat for a week where they eliminated sugar and gluten from the food, and showed me ways to eat that are vegetable heavy, and ways to move that help digestion (eg short bits of exercise, multiple times a day). The weight loss is slow but happening. And I’m changing my ways and feel that I can maintain it. I am listening to my body and I’m giving it foods that do not spike my sugar levels, so I don’t get as hungry. And I’m learning to enjoy cooking and eating vegetable and protein based meals. Many people who are bigger have lost weight like this. I’ve met them, and they gave me hope. It is possible, and you can do it. Some of these people who are bigger than me do intermittent fasting where they don’t eat breakfast, so they fast overnight into the morning. And another one is doing what I’m doing - cutting out breads, pastry and white carby, glutinous foods. I also exercise daily, doing activities I like to do. I’m doing it - you can do it!!
Thats awesome! Keep it up. The world is setting us up for taking a easy way out but it's costing our health. It ain't easy but you're doing the right thing.
Keep up the good work! Natural weight loss is far healthier than using drugs.
Dr Mike is growing. I see such maturing of style and delivery! THank you Dr. Mike
lol 🙄
As an student within healthcare, i had my first instance with Ozempic today. I had a patient who was on Ozempic and now had to get some medicin that doesnt work as well due to the fact Ozempic is on backorder. Her body doesnt recieve the new medicin as well so now her blood sugar has risen a lot. Personally people with diabetes should have priority over obese people, no question about it
For sure
considering this drug would sell like hotcakes why would big pharma not focus resources on making a ton of these?
🗣🗣🗣🗣
@@dominicblake5 They probably are. Might be a lack of supply due to increased demand and/or difficulty of production at scale. Some medications have very complex synthesis processes that may not be easily scaleable, even if you throw money at it.
@@dominicblake5they are. There will be more approved in the coming years. I have heard but can't confirm that the shortage is more trusted to the injector pens than it is to the actual drugs, which is frustrating.
I have several autoimmune diseases that lead me from being a size 10 to a size 20-22 in about 2yrs. My doctor and I had being doing everything over an 18month period before trying Ozempic. It wasn’t something I wanted because of the negative media surrounding it but my doctor was the best support system and I’m glad I listened to them. I’m still nowhere near where I used to be before my body decided to attack itself but I’m in a much better place now since being on Ozempic. The one thing I will say, I’m very lucky in the lack of negative symptoms I’ve had. People I know have had very horrible side effects. My main worry is that it’s become really difficult to get again and last time it was 6 months before I was able to access a dose
Losing 20% of your weight makes one feel so much better and makes exercise so much easier.
This was a great interview! Dr. Mike really helped challenge some of the questions that I have as a potential patient and it was great hearing those different perspectives from two medical professionals. I’ve heard a lot of good things about the drug, but I’m a skeptic so research is key. It was also really good hearing her talk about muscle building and protein being the biggest factor in coming off the medication because I don’t want to be stuck on a medication for life. Many of the patients I know on this drug aren’t incorporating muscle building into their lifestyle so it’s good to know now. It’s also great to see the conversations happening in the comments!
I've never been overweight or obese but I've always struggled with working out because I just felt horrible and that feeling never improved. It wasn't until I started working with a trainer that I finally starting figuring out why (undiagnosed silent GERD and exercise-induced asthma). So when she talked about patients adapting to the lifestyle once it started to actually feel good and then were able to see results, I felt that 1000%. The self-confidence from knowing what my body is truly capable of is the intrinsic motivation to overcome the barriers stopping me. Sometimes we just need help lowering the barriers, and that can be medication.
Exercise induced asthma sounds like a funny way of saying out of shape
@@swishersweet1322 google is free if you want to educate yourself. The Mayo Clinic, Cleveland Clinic, NIH, and Asthma and Allergy Foundation all have great explanations of it.
To be fair none of thoose things are a reason for not improving when working out O.o .... so .... to work out and being "fit" you dont need to run a maraton .... seems more like an excuse .
@@swishersweet1322 exercise induced asthma is not being out of shape, it can be worse if you're out of shape but it will always be present unless medication is taken. I had to take a steroid and rescue inhaler when I played sports - it didn't matter if it was beginning, middle, or end of season, it was always there.
I’m SO glad Dr. Mike had Dr. Rocio Salas-Whalen on to discuss this. She is a phenomenal resource.
She seems just like dr. Mike to trily care about her patients. I love these interviews and the passion i see for what they do. Grateful to have doctors like them in our world.
This was the most helpful guidance on both obesity and ozempic! Thank you so much for taking the time to inform and educate. ❤
She is incredibly knowledgeable and extremely compassionate. An effective doctor cannot be one without the other. ❤ I'd go to her for help with my obesity and binge eating.
I really love watching this channel very awesome and informative, we're you watching from?
This was such a good discussion. I am so appreciative of the information from both sides as an obese, papillary thyroid cancer survivor that struggles every day with my weight. This was so informative
My doctor put me on Ozempic, but I was never told about upping my protien. I will be doing that now. It has been amazing for me. My previous doctor had given up trying to help me.
Thank you for making videos on educational topics like this one, keep up the good work, I love this ❤
The amount of times I've been told I'm obese despite my body composition being like 75% muscle
Obese just refer to the ratio of weight to height. It does not say anything of composition but could be an indication to further check/tests. If it's a muscular person it isn't unhealthy (but some bodybuilders could still be so big they risk damage to joints). And as they talked in the beginning there are also TOFIs (thin outside fat inside) that can have health risk. Dr Sean O'Mara have some example of seasoned marathon runners doing several marathons per year who are very lean with very little subcutaneous fat but still having visceral fat.
My husband is the same way. He is looks obese but has so much muscle that he does not float when swimming.
I wish the pancreatitis side effect wasn't played down. My endocrinologist didn't put me on Ozempic, but one of the medications that has the same active ingredient, semaglutide, with Rybelsus, and I ended up developing gallbladder issues, pancreatitis, was hospitalized twice, and had surgery to remove my gallbladder that finally addressed excruciating upper abdominal pain that my endocrinologist downplayed and dismissed. Thankfully I moved to a different endocrinologist that doens't dismiss my feelings or symptoms now.
It’s refreshing to see two highly intelligent professionals discuss a topic involving controversy and using evidence based medicine to guide their decision making. I was initially skeptical about the direction of the conversation but I found it to be very informative without much of any biases.
I am on trulicity which is really the same class as ozempic and works the same way, just attacks a different hormone. I am on it for type 2 diabetes. Since taking it I have noticed I do crave more healthy foods and less garbage, less candy, less soda, etc. I eat less portion wise, and I feel fuller longer. One thing I've noticed is if my stomach is empty I get extremely nauseous and it goes away within seconds of me eating something. So I keep healthy snacks around at all times and I'm good! But the great thing is the 60 lbs I've lost in about a year has motivated me. I have never done well on diets or sustaining exercise regimens and such but I'm committed to losing more weight. People are noticing my weight loss now and it's great!
The psychology of weight loss plays an important role, which I believe you both alluded to and she addressed in a related way. It’s a challenging thing to address due to the number of factors. Having the medication as a tool to assist is no different than other treatment regimens. It’s the methodologies used by the providers that will determine the efficacy alongside patient participation. That too is no different than other treatment plans and outcomes.
Absolutely, in the same way you wouldn't give someone SSRIs and then tell them there is no need for therapy, just go have fun, you wouldn't prescribe these and then not worry about the lifestyle factors. I think she did a good job of driving that point home.
Thank you for this informative, insightful and compassionate look into this sensitive topic.
I really appreciate this interview struggling with keeping a healthy weight myself. Thank you for asking the hard questions Doctor Mike. You are a wonderful and beautiful human in every way. Truly.
I really enjoyed this conversation she was compassionate and caring and her end goal is just the health of her patients ❤️
Looking forward to listening to this. It’s frustrating to me to see all these people on social media (mainly women) who are getting rx for ozempic despite not being t2 or even needing to lose weight for medical reasons. All it’s going to do is make it harder for those who really need it to get it.
Exactly!
I have found that a LOT of people who have autoimmune diseases (and are not overweight at all) are being prescribed this...not for the weight loss...not for blood sugar issues...but apparently it is helpful for autoimmune treatment. So, it's not all just people trying to lose weight. Although I do see the anger...diabetes can be immediately life threatening and detrimental.
@sonjablue9850 very true, there are some studies that have shown it can be helpful for people with certain autoimmune diseases!
@@skyelynnaeceliacs is one of those diseases.
I think the issue with the shortage isn’t the patients or doctors faults who are utilizing this for reasons other than diabetes or obvious obesity. It seems like doctors are finding it can help more people and more people are seeking out help knowing there are medication options for them. I think they simply need to make more of the drug, which I’ve seen they are working on. This argument is similar to people with adhd being frustrated that people without adhd are getting prescribed stimulants and then blame these people for using a medication they “don’t need”. More people benefiting from a medication shouldn’t be seen as a bad thing or empower strangers on the internet to determine whether or not someone’s prescription is necessary for them or not. That can only be determined by the individual patient and their prescribing doctor. The production of these drugs need to work to provide for the increases in demand, which seems to be continuing to increase as doctors find that this medication can help with a variety of conditions.
Thanks for this episode. Listening to this interview was amazing. Thanks Dr. Rocio!
i'm so happy for this! i'm on a GLP-1 right now for my blood sugar. struggled with weight loss my whole life. And the combo of metformin and trulicity has completely changed my relationship with food. I had NO idea just how out of whack my eating was...immediately i started eating 1/5th what i ate before and I can recognize what feeling full feels like before it 'hurts'...which I absolutely could not recognize beforehand...now I feel like I could go off the meds and still eat better. and it's DESTROYING my Ac1 numbers in just these past 2 mons. Now i'm making decisions about what I'm eating knowing I wont be able to eat everything i "want" so I'm getting filled up on the good stuff, not having any room for the bad stuff. I am a little scared I will slingshot back Up in weight like I always have before after I get my A1c under control and stop taking the meds...
You guys touched on the economic factors preventing people from losing weight (having to work 10 hours a day, cost of healthy food, etc.), but what about the economics of the drugs themselves? These aren't cheap medications (list price of Ozempic is about $900 per month). If patients can't afford to lose weight via lifestyle changes, how can they afford the medications? If your answer is insurance (public or private), that just shifts the cost to the healthcare system as a whole. In that case, how can the healthcare system as a whole afford it? Can the system afford to have a large percentage of the population relying on these drugs? Once again, if many patients can't afford to miss work or buy healthy food, and ultimately the system relies on money from the participants in the system (via patient premiums, copays, etc.), then where is the system getting the money to pay for their medications? If patients couldn't afford a $900 lifestyle change, then they probably can't afford a $900 increase in premiums. So where does the money come from? (I'm aware this is a gross simplication, but I think it's necessary for the sake of asking this question in this forum).
The point is that the price o the medication can fall with higher demand. On top of insurances getting more reason to finance it, because it's literally cheaper than e.g. longer stay in hospitals and higher incidence during pandemic. Aka the the reason this is a good approach is, because it's actually cheaper. Now that your health system is a hot mess, will complicate absolutely anything. :'D The only remedy against that is to tackle change there. Same goes for the overall unsocial society structures in America. America will have to learn from more functional countries in those regards and people will have to become smarter with their votes. You cannot go an misplace that whole dynamic onto a single medication. That said, the costs of the effects of obesity in America are so pricy and affecting to many ppl, that the incentive for political intervention will rise and it's well possible to establish programs that help to fund the medication for ppl in low income situations. What you missed, is that people failing to make progress with lifetime changes alone is not just a monetary issue. Aka there's a time factor, there's a cost factor to lifestyle changes. Aka do you think all the diets and whatnot that ppl try are free and the medication costs money? And the food that is eaten too much and the whole stuff around preparing it costs nothing? And the medical costs of not getting your weight down costs nothing? :'3 Aka even at this price range, actually having a working effect instead of wasting more money and get demotivating shame and stress and criticism and worse psychological states and then needing expensive therapy and so on and so forth ..... it's likely more expensive while not having the wanted effects. THAT is when having conversation about these medications will make sense.
We know this is false given the insulin issue. @@KxNOxUTA
You have insurance that pays for medication... insurance unfortunately doesn't pay for healthy food. I think the 10 hour per day comment was less an economic comment, and more a comment on peoples available time, thats why single parenting was included. The US doesn't have UHC so its not a case, plus the price the patient sees is not the price an insurance company pays.... not to mention in countries with UHC/Social HC they pay significantly less than Americans pay as they have collective bargaining. Australia for instance pays roughly $500 for a months supply, and not $900.
Doctor Mike is a genius! He asked all the questions that I wanted to ask as a medical intern in nephrology. And this interview in general is extremely useful for every physician in order to make proper decisions in today's more and more personalized medicine.
I enjoyed this conversion, I am surprised however to not have heard any mention of access. The lack of insurance coverage and the high cost of these medications are barriers for most people who need this help.
Thank you for doing this interview. I’m on week 9 of Wegovy and steadily losing about 2 lbs per week after being obese for 3 decades. I’m down 21 lbs in 2 months, my side effects are minimal, I feel great and I’m so excited and motivated to keep going on my weight loss journey. In the past m, I’ve tried fad diets, diet pills including OTC and Rx like phentermine, weight watchers, and nothing worked long term or I couldn’t stay with it over the long term. I feel like this med is helping me change my life, exercise and eating habits. I feel like I can have success with this long term.
I really love watching this channel very awesome and informative, we're you watching from?