Hey Amanda, what are your thoughts on eczempic?
This is such a tough one for me.
On the one hand, my husband runs Lyft Clinic, it is something that we can prescribe.
But on the other hand, I just see so much misuse of the drug across clientele, across
even patients.
It's like using it for five or ten kgs of weight loss, or I should say five or ten pounds
of weight loss even, is irresponsible in my opinion.
You just lose muscles.
And that's the thing, I think if you screw up your muscle mass, you're really going to
impact your overall metabolic health.
Yeah, I mean I have a perfect example.
So client comes in, she's like, yeah I'm struggling with my weight, let me tell you about my journey.
So she tells me about losing a little bit of, so let's start back at the beginning.
So she comes in and she's 70 kgs, okay?
No worries.
I mean it's not too bad.
It's mildly overweight, okay?
Her trainer at that time tells her that she needs to lose weight.
Unfortunately she stops breastfeeding, she puts on weight.
So now she's 76 kgs.
Which sounds normal.
It's a normal process.
If you continue eating the way you did while you were breastfeeding, which is normal because
your appetite is going to grow, and you just get used to eating in a particular way.
As a breastfeeding mom, I definitely relate.
It is a transition when you come off it, right?
So now she's 76, right?
Now her trainer says, listen, you put on so much weight, the only solution for you is
Ozempic.
Okay, so does she try other stuff?
Like, prior, like, does she try sort of watching her macros and strength?
I don't believe so, let's be real.
I don't believe that she did.
So the trainer went straight to Ozempic?
That was it.
The trainer, by the way, I later found out, this is not my trainer, the trainer later
I found out was also on Ozempic.
So you can see how this went down, right?
So anyway, she's at 76 now.
So she's like, okay, I got to get this under control, goes on the Ozempic.
Alrighty, gets all the way down to 68.
So now we're below that 70 kg starting point, right?
And everything's hunky dory.
And she's happy with it.
Well, define happy.
Okay, so maybe she looked in the mirror and she or she looked at the scale and saw that
the weight had come down.
That made her happy.
But.
There's a but there.
Is eating a slice of toast today.
At the end.
So at the end, she was on it for about five and a half months.
So actually, for someone like me who absolutely loves food, that doesn't sound that happiness
to me.
Like just being able to eat a slice of toast.
Yes, that sounds like pure misery.
Misery.
And you're thinking, right?
So the reason you got on it is because you're coming off breastfeeding.
So AKA, you have a kid.
Yeah.
Alrighty.
So what you're sitting down with your kid and watching them eat at meals or you're
eating a piece of toast in front of your kid and saying, this is my daily intake of food.
I just like the messaging.
Yeah.
Like that's basically eating the wrong food altogether.
Like where are.
Where's the nourishment from that meal?
Well, that's so this brings me to my next point.
So now she's sitting down at 68.
Right.
She's feeling nice and skinny.
She confided me in and this is fair.
OK, so I relate to the statement that in a way it was a relief to not feel appetite.
OK.
And it eliminated kind of the issue of I'm hungry, I'm dieting and just kind of made
food a non-issue.
And I could see how, yeah, if you're a busy mom, taking something off your plate might
feel like a relief in the beginning.
Yeah.
OK.
But again, then you get down to the point where you're eating a piece of toast today.
And is it relief or is it just kind of like disinterest and disconnection from food, which
is never the goal.
Right.
So she realizes this is a problem.
She gets off it.
OK.
So her weight, well, let me she gets pregnant again.
No worries.
That's great.
Definitely can't be on ozempic and pregnant.
So that's good.
Actually, I have heard that there is an increase of pregnancies of women who do go on ozempic.
So in a way, like in the early, like, yeah.
So I think in a way it may help people who are, you know, struggling with fertility issues
due to obesity, due to obesity to, you know, get, I guess, get more fertile.
Yeah.
So definitely, like, you know, after I tell this story about this lovely lady, like, we
should definitely comment about what obesity and diabetes are, you know, indications for
ozempic versus just like feeling like you need a couple of LBs off.
Right.
So so she gets pregnant, has successful pregnancy, but she does gain.
OK.
So now she goes from being so 70 to begin 76 after breastfeeding, 68 after ozempic,
92 after pregnancy, too.
And we're talking cage.
And this is post baby being born.
OK.
So and obviously off the ozempic off the ozempic.
So now she comes to see me.
OK.
She's lost 12 of it on her own.
So she's now 80 kgs.
OK, that's great.
Which is super great.
OK.
It's still 10 kgs above that starting point.
Right.
So it is 10 kg away from her original starting point.
Correct.
But what she was doing was working.
So what's the issue?
Here's the issue.
OK.
We take an in body at the clinic.
OK.
So she lost.
So she was wonderful about tracking her in body.
And that's just a body composition machine.
Right.
So she was wonderful about tracking the in body stuff throughout the ozempic journey.
OK.
And the pregnancy journeys.
So what we see is that in that jump from 76 to 68, the ozempic five and a half months,
she lost 2.3 kgs of fat.
So that's great.
Yeah.
She also lost 2.9 kgs of muscle.
Fucking hell.
And this therein lies the beast.
So when she comes in now at 80 kgs and she's seeing me, she's telling me how the weight
is not coming off like it used to.
It's not going as fast as it used to.
It's not as easy as it used to be.
And this is why.
Because when you lose muscle, you lose metabolic power.
You are turning down the fire that burns the calories.
And that will stick with you for life.
So she can't eat as much as she used to.
Correct.
And she's going through the same kind of training like she used to.
She's qualitatively, quantitatively weaker.
Yes, less muscle.
Yeah.
And the reality is it is a harder journey because now she's got to put that muscle back
on just to get to that seven, you know, what her body was like before.
And then she still needs to build more muscle to continue kind of repairing the damage that
ozempic did.
So then she's in this kind of this struggle where in order to be anabolic and order to
gain muscle, she needs to gain weight.
Correct.
But lose fat.
Oh, which is the hardest journey.
Yeah.
Trust me, I know.
Yeah.
Sounds familiar.
So, yeah.
So now we're working together on a program to kind of get her out of this.
But the point is, if she had never gone on the ozempic journey, sure, she would still
have that weight gain in pregnancy.
Sure, she would still have fat to lose, but she wouldn't be starting from a point of lower
muscle, which is taking away that metabolic power.
So it's just it's a cautionary tale because to be clear, she was never obese.
She was overweight.
Okay.
And to be clear, she was never diabetic.
So the two indications for this medicine are people with obesity and people with diabetes.
And she was neither.
And she was on it.
That is the problem that I have with these drugs.
It's funny you say that because I think a couple of years ago, I had a client asked me
about ozempic and at the time I had never heard of it.
So I started doing some research.
And I was like, okay, this is interesting.
It's saying it's a diabetes drug.
It helps with satiety.
You know, it will.
These are true.
These are truths.
It will.
I think the gastric emptying is slower.
And I remember saying to her, why do you want to go on this when you can eat things like
protein and get the same effects without all the shitty side effects?
Yes.
And in my head, I just couldn't fathom why she would want to do that because she was
not obese, just a bit overweight.
There you go.
And I mean, the answer, if we're being real and listeners are being real with us, is desperation.
It's looking for the fastest, easiest, sure thing.
Because again, it is a drug with proven results.
Right.
So this is not something that's a shot in the dark.
It's a for sure.
But what we also know for sure is that the proportion of muscle loss to fat loss using
GLP-1 receptor agonists is greater.
So you will lose more muscle using a drug than you would use describing exactly what
you're saying, a high protein diet to increase satiety, a high fiber diet, right?
Using fasting to kind of, you know, control your gastric emptying, all these different
things.
It's like you can create those effects with food and your own body and not sacrifice the
muscle.
Because it's funny because GLP-1 is a peptide that is actually created within your body
anyway.
So it's not like you don't have this ability to be able to feel full.
It's just what you've been eating hasn't been aiding in your satiety signaling.
And girl, if only that like, again, the protein message has to keep getting out there that
you don't have to drug yourself.
You simply have to refine your diet.
And the reality is it takes discipline, intention and education.
Yeah.
Right.
So first, you have to know that's the case.
Secondly, you have to be disciplined enough to employ that.
And third, you know, you have to be intentional with your planning to achieve that.
And this is, you know, when I was telling this case study to my husband, he was like,
well, she wouldn't, you know, because he again, he does prescribe ozempic and GLP-1 receptor
agonist.
So he's like, it's not the drug that's a problem.
It's that they aren't eating enough protein and lifting enough weight while they're on
the drug.
And I agree.
Yeah.
Okay.
Because they are struggling to eat the protein.
Yes, because they have no appetite.
Okay.
And he's like, well, if I was on ozempic, I would just make sure I ate my protein.
I was like, that sounds hunky dory.
But try it.
When you have no appetite, nothing is appealing.
Food is a non-issue.
And you're putting 100 grams of protein minimum right down your gullet.
It's real hard.
You know what it reminds me of?
I remember sort of during my first trimester of being pregnant and you're just constantly
vomiting.
Yes.
You've got that nausea.
Yes.
And even the look of eating meat just is like, I just can't do it.
And I remember I would just eat toast with butter.
There you go.
Because that's the only thing that I could take down.
Correct.
And again, clinically, that is the most reported side effect of ozempic.
Oh, yeah.
Exactly.
Basically morning sickness of ozempic.
Right?
So we all know about-
And imagine that for like a year or the rest of your life.
Yes, or the rest of your life.
Exactly.
If you want to maintain those that way.
Because that's the other thing, right?
When you drug yourself, obviously you're introducing a stimulus that is not going to
last without the drug.
So if your appetite is only controlled by the drug, the drug goes bye-bye, you are no
longer controlling the appetite and you rebound.
And that's what we are seeing already with ozempic on the wide scale, right?
On the flip side, if you learn how to eat protein and you learn how to balance your
diet, those effects will also last forever.
And again, drug-free.
Exactly.
You simply have to do it, right?
And that's the hard part.
So obviously you guys do this at the Lyft Clinic.
So who would be the ideal candidate for something like ozempic?
Great question.
My ideal candidate, and again, I've yet to see this patient, so if this is you, come
see us, would be someone who is lifelong obese.
So living with obesity for a long time has developed, because most people that are living
with obesity for a long time, especially if they are doing even moderate weight training,
they tend to have a great deal of muscle underneath the body fat that's in excess.
So long story short, they have muscle to burn.
They can afford to lose some muscle on their weight loss journey because that will help
them achieve a healthy weight.
That will then help their lipid profile, their glucose profile.
It'll help them in the long run.
So I would love someone who is lifelong obese, who is doing some weight training and understands
that that's a part of their life, and is willing to eat a high protein diet while on ozempic.
That is my ideal candidate, because that person could achieve not only weight loss, but an
increase in their health span and longevity.
For sure.
Now, America, sorry.
No offense taken, girl.
I'll be the first one to point fingers.
Looking at this for kids, what's your viewpoint on that?
Well, again, this is a hugely contestable issue.
To be fair, we don't see juvenile patients in the clinic, so I can't comment on unique
cases in this regard.
But what I will say is, I do think that when there's an underage person who's an underage
child, a minor, that it's the parental responsibility to educate, discipline, and make intentional
that child's diet.
So I think the same three things apply, but it becomes the parent's job.
And they have to do the hard work.
Because putting a child on...
And just to be clear, I think everyone knows this about ozempic by now, but it's an injection.
You inject the drug in your abdomen.
It does not sound appealing to me at all.
And if you're going to tell me a kid gets out of childhood being injected in the abdomen
for being fat and doesn't have mental issues after that, can't fathom it.
That is, you're doing damage to that child, even if you think you're saving them or helping
them.
And the visual there and the process there is painful to think about.
And I think what I find quite sad is a lot of the kids that do get into this position,
they have, obviously, they've got this unhealthy relationship with food, but it's usually triggered
by the parents who are like, oh, they're hungry, or oh, I want to show them love, or oh, here's
a chocolate.
Yeah, I want to reward them.
And I tend to, like, I will obviously try to educate my kids and explain to them what's
healthy and what's not.
And they fucking hate it when they go to school and they have to eat fruit or whatever it
is that I pack for them.
And then other kids have got Oreo cookies and then they're asking, why don't we get
Oreos?
And, mom, you're the worst.
But I am trying to explain that it is what you put inside your body.
It's not that you can't have Oreos.
I'm not going to deny you of Oreos.
I would if I could.
And I know that's not going to be the case.
But it's not an everyday snack.
No.
And that is your authority as a parent to say, like, this isn't how we feel our bodies most
days.
Most days we have fruit.
And then at Cory's birthday party, we have an Oreo.
Right?
Like, this is life.
I don't know a Cory.
Like, this is how we do it.
I don't think there is, I think, an over sensitivity right now to being like, oh, you're going
to give your kid an eating disorder if you force them to eat healthy.
Oh, is it orthorexic?
That drives me nuts.
Yeah, obsession with eating healthy.
But you know what's really weird?
I feel like if you eat healthy, healthy, then you're orthorexic.
But actually, that is how you're supposed to eat.
And just because you don't want to eat shit shouldn't be called orthorexia.
Yeah, or just like don't eat majority shit.
Like there's there's your bumper sticker.
Make sure most of your diet isn't total crap.
And again, ensuring that most of your kids diet isn't total crap is a responsibility
as a parent.
You're not being orthorexia, not being an almond mom, because I know what that term
is.
It's just like, yo, we got to eat better because this is our life.
This is our one body that we take care of.
What about so I know some people who will be like, well, you know what?
He's just not going to eat if I don't give him dry cereal or chocolate or crisps or whatever
it is.
So they're constantly filling them up with like crappy processed snacks because they're
not going to eat.
Like my viewpoint on that is when they're hungry, they'll eat.
That's my view.
Do you?
I mean, that is always the viewpoint in my house.
Yeah.
Like, you know, kids aren't going to starve.
Like kids, you know, we've talked about this.
Kids are the original intuitive eaters.
Oh, yeah.
Right.
And that they want to eat to fill their bellies and stop when they're full.
And only the way that we present food and the way that we eat in our house is going
to change that culture for them.
So if you want your kids to eat as they intuitively would, just leave them alone on the on the
whole.
Right.
Obviously, there are definitely exceptions to this rule and children that are underweight,
undernourished that need different approaches.
And I feel like kids are also really bloody clever because if you say, OK, fine, you know,
I'll just give you that that Oreo cookie or whatever it is.
That's I'll just hold off a little bit because my mom's just going to give me the cookie.
Yeah.
You know, and then I don't need to eat more broccoli.
That's it.
Test.
It's another way to test boundaries.
Oh, yeah.
You know, in a large way.
Yeah.
And on the flip side of that, right, it's like, OK, you know, like back in the day,
I don't know if your parents ever did this or but it's like, you know, you've been bad,
you know, whatever.
Go to bed without dinner.
Like, you know, you would be kind of forced to intermittent fast because of misbehavior.
Now, again, I'm not condoning that.
But what I'm saying is like, I didn't die.
Yeah.
I went on living with one missed meal.
So I think, you know, particularly in Asia, there is this culture of like feed, feed,
feed, feed, feed.
And if they miss, you know, like one ounce of milk, you know, thinking about my little
newborn, it's like they're going to die.
It's like, no, they're going to be all right.
Yeah.
They just, you know, I don't want them to puke that ounce of milk out like let him be.
You know, like the overfeeding thing here is very, very real.
It is.
And like, I mean, I never really missed a meal.
You're like, I don't relate to that story, but I can imagine.
But yeah, but to be clear, all listeners, like this is not saying to withhold food from
your child as a penalty.
I definitely wouldn't do that actually.
But, and nor, you know, to underfeed a child that needs it.
But what I'm saying is if your child is healthy and growing and doing all the right things
and, you know, they want to go on a hunger strike because you didn't give them that Oreo
for one meal.
Oh, well, they'll be all right.
So be it.
They go eat when they're hungry again.
Exactly.
They can't.