Episode Transcript
[00:00:00] Speaker A: Okay. Welcome back to it's a kinetic thing with Karen K. And today we're going to talk about weight loss, which is a big topic these days.
[00:00:08] Speaker B: It is, it is pretty fascinating. Yeah.
[00:00:11] Speaker A: Let's talk about your weight loss first.
[00:00:12] Speaker B: Okay.
[00:00:13] Speaker A: And how you did it. And then we can kind of get into the weight loss shot.
[00:00:16] Speaker B: And so I would say Covid hit 20, 20, 2020. You know, I had lost a lot of weight years, probably 20 years ago. I had kept it off successfully for a long time and then I opened a business a year and a half later. It had. We had to move into a new location, build out a new location, was working a full time job while I was getting my businesses up and running and so was not going to the gym the way I was used to going to the gym. And then Covid hit suddenly and I was at home doing nothing after being used to working, you know, two full time jobs and 90 hours a week and just let myself go and put on about, I think £50 over a couple years and just finally looked in the mirror and went, what have I, you know, we've all done that, I'm sure a little too much wine, sitting at home, too much things like that. And anyway, so about that time, the new weight loss injections were just starting to be talked about. You know, the Wegovy and Ozempic originally. And I knew it was something at my new clinic that I wanted to bring on board, but I never bring anything on board without trying it. Personally. I want to tell people, you know, the true pros and the cons and things I felt and then slowly start to introduce it to some people and see what they have. So I started on the weight loss shot. I did Semaglutide, which is the brand name Ozempic or Wegovy. And it was very interesting because it really did control my sugar cravings. Suddenly that glass of wine wasn't as appealing as it used to be. But I really didn't lose any weight for about three to four months. I was losing some inches, but wasn't really losing weight. But I just kept sticking to it and slowly titrating my dose up like as recommended. And it was real interesting because it was about month four or five, suddenly like £10 was gone.
[00:02:10] Speaker A: So it just dropped.
[00:02:10] Speaker B: It just dropped. And I wasn't doing anything different than I had been doing the first four to five months, you know, so it was really interesting. And then after that, the weight kind of just kept falling off very easily. I got to my goal weight in about four, five months. And so that time I just started slowly dropping my dose down and then spreading the time between the dose. And so I've been at my goal weight now, I would say about three years. Occasionally I'll take another shot if I notice cravings are coming back or maybe the scales crept up about five pounds or something like that. Then I'll take a low dose injection maybe once a month or so. And I've been able to maintain my weight with that pretty easily. And since that time now I've probably prescribed one of the two GLP1 medications hundreds and hundreds of times and really started to know kind of how to titrate what things to coach my clients on and have seen just some amazing success with men and women, even post menopausal women. I've got a young man right now in his 30s that sadly was morbidly obese to the point he was starting to have some congestive heart failure, obstructive sleep apnea. I just saw that gentleman the other day. He's doing fantastic. He's on a moderate dose of Brazepatide or Mongero and he's down 160 pounds. He's off his water pills or diuretics.
He does not have any more swelling in his legs. Weeping his legs, they look healthy again. He looks like a different human being.
[00:03:47] Speaker A: I bet he does.
[00:03:48] Speaker B: I think we calculated of the 157 pounds that he's dropped, 152 of it was fat, only like 5 muscle, which that's something those shots get a lot of bad press about. People are like, oh, you're just losing muscle, you're not losing fat. And I've not found that to be true with my clients. I calculate their protein needs every day and I assign that to them. I give them, you know, their water intake needs for a day. I give them some diet tips and things to help with mitigate side effects that might come from it. And so I've had a few people be extremely successful, but this one gentleman, you know, he's kind of a shining star. He was actually signed up for bariatric surgery, gastric bypass. And even he was telling me yesterday, you know, I, I continue to go to the bariatric program because I like seeing the nutritionist and the food psychologist. And you know, for a long time they were really badgering me, you just need to have the surgery. You need to have the surgery. And now that they've watched, they're like, tell me more about what she's prescribing how are you doing this? Yeah. Maybe you don't need the surgery.
[00:04:54] Speaker A: Just so unhealthy, that surgery.
[00:04:56] Speaker B: I've seen people on it, the tricky surgery. It's. You know, a lot of people say you cheated, you took shortcuts, whether you take the injections or you do bariatric surgery, you know, and that's what we were talking about. I was talking about this young man the other day. It's. You still have to do the work. Yeah. Whether you're taking the shots, it's not a magic wand. You still have to get your protein. You have to cut your carbs. You have to have some activity.
[00:05:20] Speaker A: Yeah.
[00:05:20] Speaker B: You got to get your water in. You have to be in a calorie deficit. It's just a tool that makes it easier to do those things because you're not starving and you're not craving sugar and you're not so tired you can't move and things like that. And so it just is a tool that makes the journey a little easier.
[00:05:39] Speaker A: Well, I have questions about yours. So you. You're not on now. You only do it if you feel like you've put on. And Are you having any cravings? The cravings didn't come back.
[00:05:47] Speaker B: Sometimes I do get the sugar cravings again. I'd say that's my biggest, probably food weakness. And I didn't notice. I was, you know, eating a lot more little, picking up a bite of candy out of this bowl. That bowl. You know how that goes.
[00:06:00] Speaker A: Yeah.
[00:06:00] Speaker B: And so. Yeah. And I had. I try to really hard, keep myself within about four pounds. Okay. You know, because I'm almost 60, and we do. Women especially, I can change my weight 5, 6 pounds from morning to evening, just depending on, you know, where you're at and how much water you retained and what you've eaten. I do weigh myself first thing in the morning, every morning. And I really. I'm at 5 foot 9. I'd like to stay between 160, 165. I feel good there. I feel like I look good there. If I get under that, people start to tell me I don't look healthy. But if I get close to 165 or over, then I'll usually take an injection. And maybe once a month.
[00:06:41] Speaker A: Oh, wow, that's. That's amazing. And then back on those first three or four months when you weren't losing anything, did you. You still weren't craving.
[00:06:50] Speaker B: Still wasn't craving sugar? I wasn't hungry. I certainly know probably to cut my calorie count in half. And like I said, I was noticing inches.
[00:07:01] Speaker A: Okay.
[00:07:01] Speaker B: And the other thing I was noticing is we do have a body scanner in our clinic, and we really monitor fat versus lean muscle so that we do make sure our clients on those are losing fat and not los their lean muscle. So I was. Even though the weight wasn't changing, the inches were changing, I. The composition was changing where it was less and less fat, more and more lean mass or muscle.
[00:07:26] Speaker A: So you were seeing that. So that was what kept you encouraged to keep doing it, even though you didn't see the scale move.
[00:07:32] Speaker B: Yeah, absolutely. And you know, the other thing that these medications do, they really act in four ways. I say one is they slow your GI tract down so you get full faster and you stay full longer. So that's two ways. The third thing they do is they work on the pleasure center in our brain and those dopamine receptors and quiet those down. And those are the ones they call it our hedonic, hedonic, hedonistic center in our brain that we want things that are bad. You know, we want the chocolate, we want the chips. It quiets that message down. And then lastly, it lowers your insulin resistance. And so when your cells are resistant to the insulin, your pancreas is pumping out. It doesn't let the insulin get to those receptor sites and do its job. And so your body is much more prone store food as fat versus burning it as fuel. And so that's why your neighbor might have lost £12 on the lowest dose. And you may not lose any pounds for four months until you get to a bigger dose. They may have more insulin resistance than, you know, the person that lost £12 in a month. And it's going to take a bigger dose to overcome that insulin resistance to get your body metabolizing things like it should.
[00:08:44] Speaker A: So the GLP1 is a natural peptide?
[00:08:47] Speaker B: It is in our bodies. Yeah, our body makes it naturally in our intestines. And GLP stands for glucagon, like peptide 1. And so it's really kind of become the miracle drug of this decade. And I think we're going to see more and more of these type of medications be patented and produced and distributed, and we're going to see more and more success with it. And, you know, the first generation was Semaglutide, Ozempic, and Wegovy. And it worked on one of the receptor sites for the insulin. And now we have Zepbound or Mongero. Generic name is Tirzepatide. And it works on two receptor sites. So some People get a little better weight loss with the tirzepatide than they do the semaglutide. Some people have less nausea with the tirzepatide than they do the semaglutide. But it's also very person specific. I know my partner, a physician, took the very lowest dose of semaglutide. In fact, he took a half of the lowest dose and was horribly sick for a week and could not tolerate it. And now he's taking tirzepatide and he does great with it and no problems whatsoever. And personally, I got up at one point to the highest dose semaglutide recommended and never had any nausea, never had any problems. I thought after a while I would try to switch to tirzepatide and took a very small, you know, lowest recommended dose. And I had the most horrible cramps, stomach cramps. It just felt like somebody had vice grip around my intestines. And I have another client's the same way. So you know, it, it is patient dependent, somewhat related to your genetics. And so from one person to the next, they may act completely different on one versus the other. So if one's not working great for you and you've titrated dose up, then I switch and do the other one.
[00:10:41] Speaker A: And so the. So if your blood sugar is low or your glucagon is low, is that a good thing if you're on the dots?
[00:10:46] Speaker B: Well, you want it regulated. Yeah. You don't want your blood sugar running high. Obviously, that long term, if it stays up there, that's diabetes. And anytime you're run running, your insulin resistant, your glucose is running elevated. It's almost like sandpaper is running through your cardiovascular system. And it's very destructive to the veins and arteries. And so, you know, all of those systems are connected together. You're insulin resistant, your vessels are getting, you know, sandpapered inside. You start, you could start developing clot, developing high blood pressure that starts to affect your kidneys over time. Your kidneys are doing so bad, your liver's working over time. Scary. Yeah. It's a vicious cycle for sure. And that's why, you know, we're so starting to get cognizant of, you know, the American diet, how bad it is because. And why there's so much obesity in America and even in our children now, because the things we put in our food and all of those make us insulin resistance, which makes us more prone to chronic disease. It all comes down to being inflamed, having inflammation inside your body. And how harmful it is. And so that's, you know, they're finding more and more medical indications for the GLP1 medications. You know, at first it was just for diabetes, type 2 diabetes, and now they're saying, oh, sometimes for type 1 diabetes it still works even though these people aren't producing insulin and they may have to take insulin. Glucagon, like peptides are helpful as well. And now they're recommending and getting FDA indications for cardiovascular disease or kidney disease. So it's really interesting because it body all those, you know, you have one system not working well, pretty soon another one's going to start to fail and another one's going to start to fail.
[00:12:32] Speaker A: Yeah, I saw that with my mom. So you had mentioned that 10 years from now you feel like everybody's going to be on this medication for some reason or another.
[00:12:42] Speaker B: You know, right now, probably in the last 20 years, I think maybe one of the biggest advances in medication were the statins or the lipid lowering medicines, you know, the Torvastatin or Lipitor and those medicines. Medicines. And it was like if you're over 40, it just almost guaranteed your primary care doctor is going to want to put you on a statin or a lipid lowering medicine. I think 10 years from now you're over 40, you're probably going to get prescribed a GLP1 instead.
[00:13:10] Speaker A: Yeah, isn't that crazy? And you'd also talked about once that it not only is it helping people lose weight, but also for other addictive personality disorder.
[00:13:20] Speaker B: Yeah, I went to a really great conference on a lady that was working with, with addicts of all kinds. She, she was working with food addiction, but also alcoholism, drug addiction, gambling. And they're starting to find what the great effects it has again because it's affecting that pleasure center in the brain that's looking for that excitement, looking for that thrill, whether that food or a slot machine or alcohol. So they are starting to see positive benefits from that in addiction medicine as well.
[00:13:52] Speaker A: And it's so interesting how it removes the, the sense of or the craving for not only sweets, but even like weird stuff. Like I have a friend that just literally has zero desire to drink coffee.
[00:14:04] Speaker B: Yeah.
[00:14:04] Speaker A: Once she started taking it, just lost all interest. And she didn't drink it because she needed the caffeine. She truly just enjoyed the flavor.
[00:14:11] Speaker B: Yeah.
[00:14:11] Speaker A: Took it away completely.
[00:14:13] Speaker B: Yeah. I have friend that admitted to at least a bottle of wine, Prosecco, sparkling wine at night and now she's like, I can have half a glass and I feel fine. And I don't want any. And in fact, I feel bad if I drink more. So, you know, it is helping with alcohol and things like that as well.
[00:14:31] Speaker A: It's kind of crazy what all work does.
[00:14:33] Speaker B: It really is. And to think that honestly it is a naturally occurring substance in your body. You know, just, we talked a little bit about it being a peptide, but peptides are nothing but chains of amino acids, short chains of amino acids, 20 or less and so that occur naturally. So, you know, the peptide that's been around forever is insulin. Insulin is a peptide, but we think of it as a drug. Well, Mongero, semaglutide, wegovitricepatide, they are peptides. And for whatever reason, probably a lot have to do with again, the American diet. Our body's not producing adequate amounts. And so by getting our body to boost more of those, we're getting the healthy effects from that and usually very few side effects because it is something that your body produces.
[00:15:24] Speaker A: And the key is starting at a low dosage and working out.
[00:15:27] Speaker B: Yeah, you never, you know, I get asked all the time, people are in a hurry and they saw their friend lose this and I only lost £2 the first month. Put me on the big dose. No, we can't do that because you, you ask for all kinds of complications when you do that. Starting really low and titrating slowly and using the lowest effective dose is the correct way to prescribe. And you know, I had a heard a colleague that was in another state that really wanted to try it and had I think a chiropract or prescribe it for someone and started her immediately on the top dose. Well, first of all, she didn't have that much weight to lose, probably not even a candidate for it. But second of all, she became so nauseated and vomiting intractably that she ended up in ICU in renal failure and kidney failure because of the dehydration. And so it is so irresponsible to start on anything but the lowest dose and, and to just slowly titrate. And if you're going to do the program, you really need to commit to like six months and let provider take you along in the correct, safe manner.
[00:16:37] Speaker A: So talk about the difference between you prescribing it and an MD prescribing it for insurance versus what you work with.
[00:16:45] Speaker B: So there's really no difference in who prescribes it, whether it's a nurse practitioner or a physio or an md, as long as they are familiar with the drug and doing things right. The Brand name, the brand of drug generally comes in a preloaded pen that you self inject. Something like the EpiPens that have been around forever. But in order order to get your insurance to cover it for the majority of people, either A insurance doesn't cover it at all or B if they do cover it, they only cover it for type 2 diabetes at this point. Rarely some insurances will cover it for like morbid obesity if you have some comorbid conditions like high blood pressure, renal disease or things. But to get the branded name, if your insurance weren't to cover it, one, there's been a national shortage. So even diabetics that have a valid prescription and they valid insurance coverage, they just couldn't get it. Pharmacies, it's all sold out and the pharmacies can't get it in. So that's been a problem. And two, without insurance coverage, if you could get it, it's upwards of $1,200 a month. So we have been compounding the raw ingredient semaglutide or tirzepatide because of the shortage and because the compounders can make it much less, less expensively for our program it starts at 300amonth depending on which medication you take and goes up to a maximum of 500amonth. So that's a considerable savings over a thousand twelve hundred, fifteen hundred a month.
[00:18:17] Speaker A: And it's the same product?
[00:18:18] Speaker B: It's the same product, absolutely. You want to be sure that you get your product from a good FDA approved compounding pharmacy. There's some being sold out there on the Internet yet you probably found some ads on Facebook and what you'll notice with those, a lot of those are manufactured overseas. You don't know what other ingredients are in them. You're not sure if even they have the right brand name and they'll be labeled for research purposes only, not for human consumption.
[00:18:48] Speaker A: Well, that's scary right there.
[00:18:49] Speaker B: And it's, that's very scary. But I've seen people order it. You might get lucky and you might get a good compounder and you might, might get what you paying for. You may be getting nothing but water, you may be getting contaminants. We have client that came into our office recently was ordering a lot of peptides like that overseas and came in because he had a huge boil where he ejected it was, there's no telling what was in that.
[00:19:15] Speaker A: I'm just amazed that people do that online.
[00:19:17] Speaker B: Yeah. And if you're going to a provider and they're dispensing or Selling you something that says for research purposes only, it's not a good practice. Practice. And probably their malpractice would abandon them if there was an issue with that. Wow.
[00:19:34] Speaker A: And then you don't take insurance.
[00:19:36] Speaker B: We don't personally take insurance. Yeah. And like I said, there's very few. There's very few insurance that cover it. Unless. Unless you have a diabetes diagnosis. Now, the one, you know, the one gentleman that I was talking about that lost 157 pounds, he actually did not know of. But when we ran his initial blood work, we found he was a diabetic. And so I did appeal through his insurance and got his covered for him through his insurance. He still comes and sees me every month, gets his med through the pharmacy, but I fill out all the prias and send all his records proving he was a diabetic and things. And he sees me every month. So we can get him on the scanner. We make sure he's losing fat, not muscle, and we just talk about, you know, some coaching issues of struggles that he's had and things like that. But so occasionally I will work with someone as far as their pharmacy benefit, but. And I would like give them a bill if they want to fight their insurance and get their insurance to cover it. But for our clinic, we're a small clinic. I don't have the capital or the staff that it would take. Constantly fight insurance all day, every day and get denied over and over again. So for most, you know, it's just better for us and we're able to be much more cost effective by not doing insurance.
[00:20:51] Speaker A: So talk about your process in your weight loss system that you guys have.
[00:20:55] Speaker B: So first thing we do, obviously is an initial consult. So we'll bring you in, we get your medical history, we get a list of your medications, allergies, energies. We'll get you on that body scanner, get your height, your weight, your body fat percent how many pounds are muscle, how many pounds are fat. Our body scanner will also tell us how many calories you burn a day at rest, called your BMR or basal metabolic rate. So it can say for myself, I burn 1650 calories a day if I did nothing. And so then I know if I want to be in a calorie deficit, I've either got to really up my activity so I burn more calories or I've got to eat less than 1650 calories a day to lose weight. Okay, so, you know, we'll give you that information and then I take your weight, convert it into kilograms and come up with how many grams of protein you need a day so that I make sure the weight you're losing is fat and not muscle. And so we'll give you that. We'll give you a sheet that tells you, you know, just little tips of like, I want you to replace one meal a day with a salad, but I want that salad to have protein on it. And that way you're getting your roughage and your greens and your fiber so you don't have the constipation sometimes comes as a side effect of the meds. I'll let you know. I want you to drink 32 ounces or 64 ounces of water a day, depending on your size and your age, again, to help combat hunger, cravings, and constipation. So we go through all that, and then the other thing we do is draw a full lab panel. So we're going to look at one. We're going to make sure your heart or your kidney and liver are healthy. We're going to look at your thyroid panel because they're. There is a contraindication with certain thyroid disorders and taking the medicine. So we need to make sure your thyroid's one, okay. We don't have any sign of those contraindications. And then two, you know, your thyroid controls your metabolism a lot. So if your thyroid is underactive, it doesn't matter how many shots we give you, you're not going to lose weight. So we need to optimize your thyroid, and then we do the same thing with your hormones. If your hormones are horribly imbalanced, you're going to have a much harder time losing weight. So, for instance, the young man I talked about that was very testosterone deficient, even though he was young. So we also did testosterone therapy with him, and that's helped his weight loss journey come much easier and quicker.
[00:23:11] Speaker A: And then do you. What do you think about some of the, like, bad diets that are like.
[00:23:15] Speaker B: Carnivore, carnivore diet, things like that? Yeah, I think there's some good research behind that. I think the biggest thing is any diet you follow. You know, I tell people, I don't worry so much about that. If you stay in a calorie deficit, you stay under the calories that we determine you need a day. When you get your protein in a day, pretty much the calories are going to take care of their self, you know, and the carbs are going to take care of their self because you can't. You can't stand or 1600 calories and eat Thousand grams of carbs a day, you know.
[00:23:48] Speaker A: Right.
[00:23:48] Speaker B: And if you get your 90 or 150 grams of protein a day, then you're on the injection, you're probably going to be full.
[00:23:56] Speaker A: Yeah.
[00:23:57] Speaker B: You know, so the key is always.
[00:23:58] Speaker A: Going to be protein eating. Make sure you're getting protein.
[00:24:02] Speaker B: And they found that over and over again. And then, you know, we try to get you moving, whether that's just walking, you know, 30 minutes a day, or, you know, if you better shape and you want to do some drink training or bicycling or running, great. But if nothing else, we want to get you at least walking.
[00:24:19] Speaker A: And then they come in when they sign up with you on your program, they come in once a month away.
[00:24:24] Speaker B: And get to get additional medication. Talk to the provider, you know, talk over any issues you're having.
Do your body scan so we know you're losing muscle, or, excuse me, losing fat, not muscle. And then. Yeah, then you go home with another month's worth of medicine at whatever dose we decide is correct.
[00:24:43] Speaker A: And then if once they reach their goal weight, they can continue dosing and you micro dose it is that kind of the.
[00:24:50] Speaker B: Yeah. Usually what we'll do is once they get their goal weight, we'll start reducing their dose down to lower dose, lower dose, until we get them either at minimum dose, microdosing, and then depending on that person, maybe they're on a micro dose, like a half of what the guarding dose is once a week. Or maybe we go low dose and we go every two or three weeks. You know, it's each person's individual about how when their cravings come back, how they feel, how active they are, whether they keep the weight off with just totally coming off the meds, or maybe just much smaller, smaller doses less frequently.
[00:25:27] Speaker A: And do you have any signs that if someone's been on it, so say they were on it for a year to lose their weight and get to goal that once they come off of it, they don't have to do it as often just to keep it, because their body is just in that mode of just knowing. Yeah, they've gotten back on track.
[00:25:42] Speaker B: Yeah, we. There's some pretty good studies out there that your body kind of has a memory of what it wants its weight to be, and you have to get that weight off and keep it off for a while to reset your body's.
[00:25:54] Speaker A: Memory to go back to that original.
[00:25:57] Speaker B: And that's kind of our survival mode from back in the caveman days. You know, you got too skinny, you were weak, you couldn't hunt. And so we know that there's some of that set point. So we've got to get you at your goal and keep you there for a while. And then obviously your stomach doesn't have the capacity it did. You've gotten healthier eating habits. You've learned to focus on your protein, learn to control cravings, or they've kind of been gone as you've been eating healthier. So all those things together can help you keep that weight off once you get to goal.
[00:26:28] Speaker A: And so just tell them how to get in touch with you in case they wanted to start.
[00:26:32] Speaker B: Yeah, you can call us. Our phone number is 918-574-2376. Kinetic Clinic. You can email us. It's contactineticclinic.net and then we have a website and Facebook page. Kinetic Clinic as well.
[00:26:47] Speaker A: And you're accepting new patients?
[00:26:48] Speaker B: We're always accepting new patients.
[00:26:50] Speaker A: All right, that's our time for the day. Thank you.
