Weight Is Biology, Not Willpower: The Truth About Ozempic, GLP-1s and Women's Health

[SPEAKER_00]: weight is not a matter of real power. [SPEAKER_00]: It is biology and you are not broken. [SPEAKER_00]: Obesity is a disease caused by neuroharmonal dysregulation. [SPEAKER_00]: I don't want people to think this is just a matter of eat last move more. [SPEAKER_00]: So pushing away isn't the right answer. [SPEAKER_00]: Absolutely not. [SPEAKER_00]: It comes back to biology and hormones. [SPEAKER_00]: GLP ones are everywhere, but most people don't know what they really do. [SPEAKER_00]: They mimic a hormone that we naturally produce in our own gut. [SPEAKER_00]: This drug is so powerful because it is thousands of times stronger than what we naturally make. [SPEAKER_00]: The Ozempic face. [SPEAKER_00]: Have you heard this term? [SPEAKER_00]: Nobody

who ever needed to really lose weight of our complaints about Ozempic face. [SPEAKER_00]: I have seen complaints about GLP one. [SPEAKER_00]: The unexpected one is the jealousy between two partners. [SPEAKER_00]: I see all forms of it. [SPEAKER_00]: What I tell my patients is to be honest about it. [SPEAKER_01]: So is there someone you would tell you are not a candidate for a GLP one thing? [SPEAKER_01]: Yeah, in my opinion, it's [SPEAKER_01]: Content of the disruptor pod cast is for informational purposes only and does not constitute medical advice, please consult your healthcare provider for personalized guidance regarding hormone therapy and all your medical decisions. [SPEAKER_01]: Miracle melts by playground, deeply hydrating hormone-free inserts powered by hyaluronic

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Welcome to the Disruptor, where we challenge the status quo in women's health, spotlight, bold voices, and spark real change. [SPEAKER_01]: I'm your host, Dr. Sommagevade. [SPEAKER_01]: Today, we're joined with Dr. Alexander Soah. [SPEAKER_01]: A trailblazer in metabolic health, the founder of Soah Well Health, and a fearless advocate for patient-centered care. [SPEAKER_01]: Get ready for an episode packed with myth-busting, real talk, and the latest on GLP ones, metabolism, and sexual health. [SPEAKER_01]: Dr. Soah, you are a board-certified internist founder and metabolic health expert, what inspired you to disrupt traditional health care and build so well health. [SPEAKER_00]: I have always known that weight was not about well-power and I saw it in my own family. [SPEAKER_00]:

I saw it in myself and I for sure saw it in my patients. [SPEAKER_00]: And while I don't think that GOP ones are an easy way out, I do not think it should have to be hard the journey. [SPEAKER_00]: So as a founder, I've created products of written a book creating a whole ecosystem to support people on this incredible journey. [SPEAKER_00]: And this revolutionary tool of GLP ones that's now making weight loss doable and achievable and saying, yeah, it's about biology, not well-power. [SPEAKER_01]: I love the way you're so transparent and sharing your own journey. [SPEAKER_01]: I've been seeing patients for two decades, and that's what they say when you share personal things like menopause,

perimenopause, sexual health care, it allows patients to be more open in their own journey. [SPEAKER_01]: And I've watched clips of you, of course, and I've seen you on stage before, and been so inspired because you are open about your own struggles and how your family members also struggled. [SPEAKER_01]: So I just have to say, I love that about you. [SPEAKER_00]: Thank you. [SPEAKER_01]: Um, so GLP ones are everywhere, you know, everywhere. [SPEAKER_01]: We're seeing it everywhere. [SPEAKER_01]: So, but most people don't know what they really are or what they really do. [SPEAKER_01]: So, can you break down what it is and how it works? [SPEAKER_00]: Absolutely. [SPEAKER_00]: So, to start obesity is a disease and

obesity is caused by neuro hormonal dysregulation. [SPEAKER_00]: It's my favorite big phrase to say. [SPEAKER_00]: I don't want people to think, this is just a matter of eat last move more. [SPEAKER_01]: So pushing away from the table isn't the right answer. [SPEAKER_01]: Absolutely not. [SPEAKER_01]: So I was operating. [SPEAKER_01]: I was pregnant and the gentleman across for me, who was my attending surgeon, did not realize that I was pregnant. [SPEAKER_01]: And as he was like draping the patient, he accidentally ran into my abdomen, which was grab it or pregnant. [SPEAKER_01]: And he looked me dead pen in the eye and said, maybe it's time for you to push away from the table. [SPEAKER_01]: Oh, my

God. [SPEAKER_00]: Okay, can I one up you there with the rest of us, right? [SPEAKER_01]: Please do because when we share that this has even happened to us as medical professionals, I think patients not that it justifies, but it helps them feel less alone. [SPEAKER_00]: Okay, so a pregnancy story. [SPEAKER_00]: Oh, so I've had four children, my first [SPEAKER_00]: I was a third year resident. [SPEAKER_00]: I worked the entire time. [SPEAKER_00]: I went 40 and three days and finally went into labor. [SPEAKER_00]: I pushed and I pushed and I pushed and this kid was not fitting out. [SPEAKER_00]: Turns out he actually has a really large head. [SPEAKER_02]: Yeah. [SPEAKER_00]: He's a really smart kid,

really smart kid. [SPEAKER_00]: just in fit. [SPEAKER_00]: And the doctor said to me at the time, as I'm on like our, I don't know, 18 of labor and four of pushing. [SPEAKER_00]: This is what happens when you eat too many cookies and ice cream. [SPEAKER_00]: Oh my God. [SPEAKER_00]: I would kill. [SPEAKER_00]: How are you not murder us? [SPEAKER_00]: I mean, [SPEAKER_00]: My mom was in the room at the time and I like her face and my hydrogen was about to punch her and I was like, I need to distract her to deliver the baby. [SPEAKER_00]: Baby, he ended up having to be sea-section because he just didn't fit. [SPEAKER_00]: But I have never felt

so small and weak and I had so much power inside of me until that moment. [SPEAKER_00]: And I just wanted to give up. [SPEAKER_00]: He can't give up mid-labor, right? [SPEAKER_00]: And I promptly found a different doctor for the rest of my children. [SPEAKER_00]: But yeah. [SPEAKER_01]: I think that's honestly one of the most horrific stories I've heard, because having you've had four, I have three, but going through labor and having babies, I think is one of the toughest workouts that you do, not only physically, but emotionally, and when you've pushed for a very long time or had that pro-tracted long stage of labor, it's exhausting. [SPEAKER_01]: My first one was born via four steps

after five and a half hours of pushing, and I think if someone did that to me, that's like punching them in the gut and simultaneously breaking [SPEAKER_00]: So I am so sorry that that happened to you, but I share it often, especially with my patients who are either thinking of pregnancy or coming to me postpartum. [SPEAKER_00]: I at that time had a lot of the tools that I've now gone on to practice for the last 12, 15 years. [SPEAKER_00]: I did all the right things, but I still gained 50 pounds plus maybe even with each of my pregnancies. [SPEAKER_01]: Um, I did that with the first, with the second and third, I didn't, but I

also had them much earlier than expected. [SPEAKER_01]: So, you know, had I gone the whole time, I probably would have, but no, I gained almost 60 with my first one. [SPEAKER_00]: Yeah, and, you know, sometimes it is just biology. [SPEAKER_00]: It turns out for me, no matter what I did or what I didn't do, it was about just what my body needed to bring all these humans into the world. [SPEAKER_00]: And so I share that openly because we have got to stop shaming because, yes, there might be an ideal. [SPEAKER_00]: And there might be a population average. [SPEAKER_00]: But then there are all these allies, right? [SPEAKER_00]: And it comes back to biology and hormones.

[SPEAKER_01]: All right, so just for a second, a fun question because I know I agree with you completely, but there were things that I ate with Sean with my first one. [SPEAKER_01]: I could not get enough of, and here I am telling him a foodie, but remember I was in my 20s, spicy chicken sandwiches, man. [SPEAKER_01]: And I didn't do anything. [SPEAKER_01]: That was like my go-to craving. [SPEAKER_01]: It was my strongest craving of any of my pregnancies. [SPEAKER_01]: So what was your craziest? [SPEAKER_00]: I mean, even with my second, I had, like, on the cusp of hyperamus, scrabbitum, and I really couldn't eat. [SPEAKER_00]: I think it was just, like, salts that I wanted.

[SPEAKER_00]: Oh, yeah. [SPEAKER_00]: Right? [SPEAKER_00]: And I still ended up getting worried. [SPEAKER_00]: I don't know. [SPEAKER_00]: I think I did it pretty right. [SPEAKER_00]: I can't even remember now. [SPEAKER_00]: I've, like, you know, you block a lot of it out. [SPEAKER_00]: I think it's what happens when you go on to have more. [SPEAKER_01]: That's how you do it four times. [SPEAKER_01]: And so seven times between the two of us. [SPEAKER_01]: All right, so back to the GLB one question since now there's, you know, they're everywhere. [SPEAKER_01]: So what are they? [SPEAKER_01]: How do they work? [SPEAKER_00]: Tell us all about it. [SPEAKER_00]: Okay, so they're a hormone. [SPEAKER_00]: They mimic a hormone that we

naturally produce in our own gut. [SPEAKER_00]: And why we see these huge systemic improvements on these drugs. [SPEAKER_00]: If they're not just weight last drugs, they're not just blood sugar drugs. [SPEAKER_00]: It's because we have receptors all over our body to this hormone. [SPEAKER_00]: Yes, everywhere, fascinating. [SPEAKER_00]: Our brain, our eyes, our skin, are the lining of our blood vessels, our kidney. [SPEAKER_00]: I mean, everywhere, and that's why you start to see all of these big health improvements, and we'll get to that in a second. [SPEAKER_00]: But that's the first thing that I think people misunderstand. [SPEAKER_00]: So, right, I started off by saying obesity is a disease, hormonal dysregulation, so this medicine is a

hormone that mimics what we already make in our body. [SPEAKER_00]: It's so neat, this hormone, talking going back to being pregnant. [SPEAKER_00]: We release this hormone naturally at the back end of breast milk. [SPEAKER_00]: Interesting. [SPEAKER_00]: So babies are exposed to it, both in utero and then as they learn how to eat and control their hunger. [SPEAKER_00]: It's fascinating. [SPEAKER_00]: That is, I did not know that. [SPEAKER_00]: Yes, okay. [SPEAKER_00]: So we have it everywhere. [SPEAKER_00]: And why this drug is so powerful is because it is, [SPEAKER_00]: on the order of thousands of times stronger than what we naturally make. [SPEAKER_00]: So, okay, I'm not going around saying we should give everyone the shot, but

once your body has kind of tipped over into a place where fat is the predominant endocrine organ that's dictating how we store fat, which means it wants to store more fat once we already have an abundance, we don't really listen to our naturally-created [SPEAKER_00]: And even if we not truly increase it, so we eat the right foods, and we do the right things, our brain is not really responding to that level anymore. [SPEAKER_00]: Got it? [SPEAKER_00]: And that's where this drug comes in. [SPEAKER_00]: So right now, it is primarily in an injectable format. [SPEAKER_00]: We are starting to see now just as of the week of this recording, we now have an oral, we go

V-Pill on market, and more oral GLP-1 pills are coming. [SPEAKER_00]: But what this drug does is that it really talks to the brain, it talks to the gut, and it talks to the pancreas. [SPEAKER_00]: And this is how it really affects change on a weight level. [SPEAKER_00]: So it tells our brain, you're full. [SPEAKER_00]: And all those hormones, the fullness, satiety hormones that you stop listening to, we're going to get back in there. [SPEAKER_00]: And you don't have to keep eating. [SPEAKER_00]: And you actually can push away from the table. [SPEAKER_00]: Right? [SPEAKER_00]: You can just stop. [SPEAKER_00]: That's dramatic for people. [SPEAKER_01]: I think it's a game changer because what people describe to me

is they don't, they're not obsessing about food noise anymore. [SPEAKER_00]: Yes. [SPEAKER_01]: Planning meals, thinking about it all the time, it doesn't obsess their day, so there's so much more productive with work and in their relationships in life because they just don't have that food noise anymore. [SPEAKER_01]: I'm really curious because I haven't looked at the data yet and I see the advertisements and the information coming about oral versus the injectable. [SPEAKER_01]: Is there any data yet that does a head to head to comparison? [SPEAKER_01]: Like if someone said to you, I don't mind needles like which one do you recommend? [SPEAKER_00]: That's a whole nuanced answer because we have to look at efficacy and

so how much we do you have to lose right always start there and then what is your history of side effects because there are probably going to be some more GI side effects with anything we take early because that brings us to the second way the drug works is it works on the digestive system right and it really does slow down our stomach emptying time [SPEAKER_00]: and then GI transit time. [SPEAKER_00]: So that's really see most of the side of pet effects that people talk about, which are nausea. [SPEAKER_00]: constipation, diarrhea, reflex, things like that because we're directly affecting the emptying time of the stomach, but it's pretty dramatic in how that naturally talks to

the other hormones that are then backed talking to the brain. [SPEAKER_00]: So it's that decreased food noise, but then also you really get this fullness signal. [SPEAKER_00]: And none of these side effects are worth stopping the drug for. [SPEAKER_00]: And [SPEAKER_00]: And when you hear these terrible headlines of people say, I've got paralyzed stomach and I couldn't stop vomiting and I ended up in ER, unfortunately, they didn't get a lot of instruction on how to eat and how to listen to their signals because most of these things can be overcome with just like little hacks. [SPEAKER_00]: And then the final way these drugs work is the way that we see the big health implications. [SPEAKER_00]:

It's directly at the level of the pancreas and it makes our blood sugar in our insulin numbers so, so, so stable. [SPEAKER_00]: So the majority of chronic disease in this country stems from chronic inflammation. [SPEAKER_00]: And a little so much of what we see, hyper-tension heart disease, type 2 diabetes, even cancers comes back to hyper-inflammatory glucose states. [SPEAKER_00]: And so this drug is so effective. [SPEAKER_00]: It just bringing blood sugar down, keeping it nice and stable, and in turn, guess what that also does? [SPEAKER_00]: Is it feeds back into that hormonal dysregulation and makes everything right again? [SPEAKER_01]: So as far as the hacks go, because I'll show the ones that I have used with

my patients. [SPEAKER_01]: So just telling them, okay, if you can't tolerate every seven, well, obviously dose changes, right? [SPEAKER_01]: Making sure you're not, you're tight trading up slowly or keeping them at a dose. [SPEAKER_01]: If they're like, okay, I'm barely tolerating it. [SPEAKER_01]: Or telling them to inject themselves every 10 days or every 12 days, along with all the nutritional and lifestyle changes that you talk about with patients and really listening to their body and not, [SPEAKER_01]: even if they're eating something that's their absolute favorite, not to overstuff themselves, because it's one thing when we're not on the drug, it's a whole another thing when you're on the drug. [SPEAKER_01]: I feel like you pay

the consequences. [SPEAKER_01]: Absolutely. [SPEAKER_01]: And then obviously some patients, especially if they're prone to nausea, I will go ahead and give them so far. [SPEAKER_01]: What are some of the other hacks that you recommend to your patients? [SPEAKER_00]: So one of my favorite hacks is comes from pregnancy data. [SPEAKER_00]: So B6 for nausea. [SPEAKER_00]: Oh yeah, love that. [SPEAKER_00]: Oh yeah, so it's made into the electrolytes I create because it works. [SPEAKER_00]: And you probably used it as someone who had had her hair. [SPEAKER_00]: Exactly. [SPEAKER_00]: It was like you're familiar with the data. [SPEAKER_00]: and it really does work. [SPEAKER_00]: It helps because a lot of the nausea is not just directly related to

what we've eaten. [SPEAKER_00]: It actually, we do believe it comes from a deeper place, kind of brain-related nausea. [SPEAKER_00]: We see post-opt, too, and it works. [SPEAKER_00]: Also, hydration is key and salt. [SPEAKER_00]: So a lot of the side effects that people [SPEAKER_00]: experience, headache, nausea, fatigue, they come from the fact that they're just eating less, but they're also drinking less. [SPEAKER_00]: Yes, for sure. [SPEAKER_00]: So that same signal to the brain that says donate, it kind of crosses over with drinking water and they just don't drink enough and they're not getting as much salt and so electrolytes are a mainstay of my practice. [SPEAKER_01]: So they're drinking less, but isn't it true that it

also decreases your craving for alcohol? [SPEAKER_00]: Oh, absolutely. [SPEAKER_00]: So we're setting this. [SPEAKER_00]: It doesn't yet have FDA approval, but it will. [SPEAKER_00]: And so talk to anyone on these drugs. [SPEAKER_00]: It is especially people who struggle with alcohol overuse before being on the drug that it changes their whole lives. [SPEAKER_01]: So, um, very interesting. [SPEAKER_01]: There's so many other questions I want to ask you. [SPEAKER_01]: So we talked about some of the scary side effects. [SPEAKER_01]: So I think the scariest headlines that I've seen as a gynecologist and as a doctor and the question patients asked me, um, of course. [SPEAKER_01]: I'm not gonna go blind, am I a doctor? [SPEAKER_01]: So what,

and I know there's a lawsuit now, what are you thinking about? [SPEAKER_01]: The blindness to me, it looks like a couple of case reports, is there any causality? [SPEAKER_01]: What are you seeing or how do you counsel patients on that when they ask you that? [SPEAKER_00]: So I have to look at their risk and if someone's coming to me with uncontrolled blood sugar or type 2 diabetes or any history of any involvement of the eye, we just have to work with them all just. [SPEAKER_00]: But when you really look at the data, you have a much higher risk of going blind from uncontrolled type 2 diabetes. [SPEAKER_00]: and all the information that comes with it.

[SPEAKER_01]: I guess that doesn't make a sexy headline. [SPEAKER_00]: Yeah, just like to, okay. [SPEAKER_00]: All right, very interesting. [SPEAKER_00]: And so there's a correlation and not yet an established causation and we're really seeing it in a very specific subset. [SPEAKER_00]: So it's not something that I worry about for the average patient. [SPEAKER_01]: So I have polycystica variants syndrome or over a syndrome. [SPEAKER_01]: I had infertility. [SPEAKER_01]: I did not struggle with my weight though. [SPEAKER_01]: I was one of the lean PCOS until I was 40. [SPEAKER_01]: Then I hit 40, opened her MD, three children, and started to gain weight. [SPEAKER_01]: And then, um, so I did gain weight very easily in pregnancy, but

did lose it not quickly. [SPEAKER_01]: That was my first indicator. [SPEAKER_01]: But I had PCOS and I was like, okay, turned 40, Perry menopause, started putting on weight. [SPEAKER_01]: And then during COVID, passed on wine never tasted so good and so put on another 20. [SPEAKER_01]: And so finally a couple of years ago, you know, started a GLP one. [SPEAKER_01]: I've been on and off on and off, um, for various reasons. [SPEAKER_01]: But [SPEAKER_01]: For me, the biggest change aside from the weight loss. [SPEAKER_01]: And no, I did not become the size zero. [SPEAKER_01]: Like it didn't. [SPEAKER_01]: And someone said to me, you don't look like somebody out of jail. [SPEAKER_01]: He wanted. [SPEAKER_01]:

I was like, out. [SPEAKER_01]: I was like, but it was effective. [SPEAKER_01]: But you know what the biggest change was? [SPEAKER_01]: I don't know if you know my founding story. [SPEAKER_01]: I went into medicine because my mom almost died, 45 of cardiovascular disease. [SPEAKER_01]: And I have a type two B receptor defect. [SPEAKER_01]: I was seeing it the Cleveland Clinic. [SPEAKER_01]: So I have hyper-cluster alemia, two of my three children. [SPEAKER_01]: It's autosomodominate. [SPEAKER_01]: They also have it. [SPEAKER_01]: And they're like teeny tiny. [SPEAKER_01]: And they were being seen at cholesterol clinic. [SPEAKER_01]: I have never seen my cholesterol numbers as low. [SPEAKER_01]: Even, and I've been leaner, like in my younger years, but my

cholesterol was almost 300 when I was 18 years old. [SPEAKER_01]: And my cholesterol for the first time is well controlled, and they checked all my inflammatory markers, my apobi, my, um, what is it called again? [SPEAKER_01]: I'm like, see, this is my payment of Puzzle Brain Fog, the CRP, but the HSCR, yes. [SPEAKER_01]: All of them are normal for the first time ever. [SPEAKER_01]: And my doctor is like, what are you doing differently? [SPEAKER_01]: And I was like, I'm on a GLP one and he's like, this is the best your cholesterol has ever been. [SPEAKER_00]: Yeah. [SPEAKER_00]: Well, we do have approval for these drugs for secondary prevention of cardiovascular disease. [SPEAKER_00]: And when as

we open up, usage and the cost comes down, we're going to be using this in a lot more cases, just like that, where I got some high numbers. [SPEAKER_00]: Might not even have plaque yet, but we're going to go on this. [SPEAKER_00]: And it's really remarkable in that way. [SPEAKER_00]: And we talk about all of these improved disease outcomes down the road. [SPEAKER_00]: And we don't talk about that. [SPEAKER_00]: And to go back to that comment about, like, you don't look like a person. [SPEAKER_00]: Like. [SPEAKER_00]: People are the worst. [SPEAKER_01]: Don't say thank you, I guess. [SPEAKER_00]: No, but that is such a misconception that you have going on right now about this. [SPEAKER_00]:

And it translates into the office because people will say, well, I must be, I'm a non-responder. [SPEAKER_00]: And then I look at their total number of loss. [SPEAKER_00]: They're 30% down on their total body weight, right? [SPEAKER_00]: 25% they've improved all their health markers. [SPEAKER_00]: And so it is really crucial for patients, [SPEAKER_00]: two things. [SPEAKER_00]: Why do you have to know why you're doing this? [SPEAKER_00]: And skinny cannot be the answer because it is like the least motivating thing of all time. [SPEAKER_01]: No, I want to be strong, but I will tell you and I will say this is a vulnerable moment. [SPEAKER_01]: I looked, my husband had taken a picture of me and

then I was looking in the mirror. [SPEAKER_01]: And I did not recognize the person looking back at me and I was like, [SPEAKER_01]: No, it wasn't about at this point I had gotten over the number because girl, I'm 50. [SPEAKER_01]: So I was raised in the Jane Fonda and you know, less is more and then punishing yourself and getting on the treadmill for eating a cookie and I told you I love food and love food. [SPEAKER_01]: One of my favorite things to do, we travel, we eat and I still drink, I'm sorry, I know the majority of America doesn't drink anymore, but I still love my wine and my good cocktail. [SPEAKER_01]: I was like,

yeah, so I was, so my goals were I wanted to lose, you know, the 40 plus pounds that I had put on, but I wanted not, I wanted to remain strong, though. [SPEAKER_01]: I knew that was important to me and I wanted to maintain muscle mass and I wanted to maintain my bone density because of what I know as a menopause and sexual health care expert. [SPEAKER_01]: But I was never trying to get down to a certain size again. [SPEAKER_01]: The unexpected thing, though, was the cholesterol. [SPEAKER_01]: I was crying. [SPEAKER_01]: I was so happy. [SPEAKER_00]: And that's the other part of your story. [SPEAKER_00]: It's so important is that you knew where you started.

[SPEAKER_00]: So my one [SPEAKER_00]: big problem about how a lot of these medications are given out right now is that people are just treating a number on a scale and they're not doing any of the foundational prep before, why are we doing this? [SPEAKER_00]: And they're even skipping over getting labs, they're skipping over getting body comp, ptexas scans, they're skipping over all that stuff. [SPEAKER_00]: And so you don't even know where you started. [SPEAKER_00]: So, [SPEAKER_00]: I mean, if one day you're like, well, I think I'd like to go off these drugs. [SPEAKER_00]: You have no idea what they've done for you in a positive way. [SPEAKER_00]: And you have no idea in terms of,

you know, muscle mass and body composition. [SPEAKER_00]: You have no idea what it's either taken away or what you need to give toward the journey. [SPEAKER_00]: And that is something we need to talk about. [SPEAKER_00]: Yes. [SPEAKER_00]: for so long treatment of obesity has been stigmatized less than 1% just like in the menopause that like less than 3% of people who qualified were ever offered a drug. [SPEAKER_00]: Now that number is expanding but I worry that we're doing it. [SPEAKER_00]: in like a 1990s, yo-yo diet and culture, just with better drugs, because we're like here, take it. [SPEAKER_00]: Oh, you don't want anymore, okay. [SPEAKER_00]: Oh, here, take it again. [SPEAKER_00]: And we just don't,

we're not looking at it from a health lens. [SPEAKER_00]: No, we're not. [SPEAKER_01]: And even when I was started, I wasn't controlled on all the other benefits. [SPEAKER_01]: It was truly to, okay, you've gained this way. [SPEAKER_01]: You want to lose this way. [SPEAKER_01]: I wasn't even warned about how to protect my own muscle, my bone density, any of that stuff, which is, [SPEAKER_01]: I mean, not fine, but I'm a doctor, so I figured it out and I get to hang out with really cool people like you. [SPEAKER_01]: But for someone like me, who will number one, we know the number one killer of women is cardiovascular disease. [SPEAKER_01]: And I've had three women in

my life who I lost at 50 are younger. [SPEAKER_01]: And so for me, and I almost lost my mom at 45, she had a 95% obstruction of her Widowmaker or LED. [SPEAKER_01]: And they told us if the heart attack would have come, she would have never survived. [SPEAKER_01]: And so for me, for my children in the future, like this is a game changer. [SPEAKER_01]: It's a complete game changer. [SPEAKER_01]: And we don't talk about that enough. [SPEAKER_01]: Um, but I do want to talk about, so what I think the person who was telling me was she did tell me that I she was surprised that I wasn't thinner and being on GLP. [SPEAKER_01]: And I

was like, um, uh, yes, I've got curves. [SPEAKER_01]: But I think the other thing is she did say she's like, but your face, like, it doesn't look like the ozempic face. [SPEAKER_01]: And so have you heard this term? [SPEAKER_01]: Do you see it in your patients? [SPEAKER_00]: Are they complaining to you? [SPEAKER_00]: Nobody who ever needed to really lose weight or wanted to lose weight ever complains about a zembeck face. [SPEAKER_00]: I swear this is like the worst made up clickbait headline. [SPEAKER_00]: I mean yes, so if we lose weight and if we lose it rapidly and depending on your genetics and your age, our college and can't always keep up. [SPEAKER_00]: Right, there is

a solve for that. [SPEAKER_00]: It is called a lower piece. [SPEAKER_00]: And honestly, when I look at my practice, I really have not had many patients actually, they might have considered cosmetic procedure, but then in the end they're like, that this really doesn't bother me. [SPEAKER_00]: Like, I am, I achieved all of my wise for doing this, and if I have a little bit of extra lac skin here or there, so be it. [SPEAKER_00]: Now, there is something a little bit different when you lose significant weight. [SPEAKER_00]: And we're talking really significant weight around your middle section. [SPEAKER_00]: Yes. [SPEAKER_00]: And so more of my patients have now gone to do skin removal, tummy tucks,

things like that, because it starts interfere with your level of fitness, and your comfortability, and you're like, you lost all this weight, but I've got this leftover. [SPEAKER_00]: So, Ozzampic face really doesn't [SPEAKER_00]: I just have found that it's just a thing that we all laugh at now. [SPEAKER_01]: But there are there's great skin products out there. [SPEAKER_01]: There's facial hormones. [SPEAKER_01]: There's radio frequency. [SPEAKER_01]: There's micro-needling. [SPEAKER_01]: There's CO2 laser. [SPEAKER_01]: So there are things that can help with tone, texture, and laxity. [SPEAKER_01]: And like you said, not in those extreme cases, where there is a lot of skin laxity, but there's also other things like not smoking. [SPEAKER_01]: Things that will keep you

overall healthy, but also keep your skin dry. [SPEAKER_00]: In getting guidance, I mean, it's why I wrote this book, it was on Bec Revolution. [SPEAKER_00]: I was like, no one's talking about these things. [SPEAKER_00]: You don't really have time that Archer's office when you're talking about getting a prescription, but like, how do I avoid not getting those on Bec face? [SPEAKER_00]: Just don't lose weight too fast, no more than one percent of your total body weight per week, and really focus on your protein. [SPEAKER_00]: And it's the same way that we're gonna keep up our muscle mass, is going to help us with our skin laxity, and also lifting weights actually helps us avoid all

of the facial dripping. [SPEAKER_01]: So, you've alluded to hormonal health and to, or not, hormonal health. [SPEAKER_01]: Have you seen, as I'll tell you, as a sexual health doctor, I have seen headlines and I have seen complaints about GLP1, but I've also seen good things. [SPEAKER_01]: So, improved the good things, improved confidence. [SPEAKER_01]: Yes. [SPEAKER_01]: So, they're like, now I feel sexier, because in their mind, or they feel like they're more attractive to their partner. [SPEAKER_01]: Problems that I've seen is I'm so tired from my decreased caloric intake that between the kids, the job, the working out so I don't lose muscle, sex is the last thing on my mind. [SPEAKER_01]: So kind of decreased

appetite for food but also decreased appetite for sex. [SPEAKER_01]: The unexpected one that I've heard is the jealousy between two partners. [SPEAKER_01]: Oh, yes. [SPEAKER_01]: So one is on. [SPEAKER_01]: The DLP one and one is not either by choice, financial, whatever is going on. [SPEAKER_01]: And then there's almost this jealousy. [SPEAKER_01]: or someone liked their partner at their current size, pre-GLP1, and they're not as attracted because they miss the body the way it used to be. [SPEAKER_00]: So let's share, and do share, we said this was about food and sex, so, well, I see all forms of it. [SPEAKER_00]: And I think, fundamentally, it comes down to a fact that a relationship is a contract.

[SPEAKER_00]: It's a shared contract with shared beliefs and systems, and you like to do the same things [SPEAKER_00]: splitting a bottle of wine and, you know, not getting up on a Saturday and working out, but just staying cozy at home. [SPEAKER_00]: And for my patients where I didn't yield P1, that contract can sometimes shift and they do notice changes at home. [SPEAKER_00]: And what I tell my patients is to be honest about it and I've had some some couples enter into therapy and some just up front [SPEAKER_00]: You know, might have unearthed other problems, right? [SPEAKER_00]: For sure. [SPEAKER_00]: And it's just kind of to be upfront and bring your partner along into it and

try to be open and upfront. [SPEAKER_00]: But I think that's really fascinating. [SPEAKER_00]: Because like, what happens? [SPEAKER_00]: And I write about this in the book too. [SPEAKER_00]: And I don't just see it in couples. [SPEAKER_00]: I see it in friend groups. [SPEAKER_00]: So, if you're all of your friends and this really affects my younger patients, if all of your friends, all they ever do to socialize is go hang out at a bar and eat unlimited wings and drink beer. [SPEAKER_00]: Well, you know what? [SPEAKER_00]: You might not want to do that on a GLP one. [SPEAKER_00]: Like it just doesn't appeal to you and you can't tolerate it. [SPEAKER_00]: So, start suggesting other things

to do that aren't centered around that. [SPEAKER_00]: And you might lose some friends along the way. [SPEAKER_00]: You know, where they really friends is the conversation we sometimes have, but I see that in relationships too. [SPEAKER_01]: Well, and I think, you know, we're seeing this with like death of happy hour at work because there's less and less people. [SPEAKER_01]: So I love the idea of suggesting something else, and it was like, [SPEAKER_01]: do a painting class together, go, you know, do a escape room, go, if you live somewhere where it's not cold during the holidays, go outside and take a hike or do a photography class together something different where they're still bonding or you're

building friendships or in sexual relationship, you're building intimacy, so find other ways to reconnect exactly. [SPEAKER_01]: And that investigation also keeps things fun and also keeps things curious and pleasurable. [SPEAKER_01]: I tell people find other ways to connect. [SPEAKER_01]: But I don't you think you see the same discord when one partner is trying to quit smoking or one person is trying to reduce their alcohol intake. [SPEAKER_01]: anything that can be habit or something that was done together. [SPEAKER_01]: And now all of a sudden, it's not at the same level. [SPEAKER_01]: It causes discord, totally. [SPEAKER_00]: And we see this out in the world, too, and just even with this idea of like, you know, backhanded

compliments that come to you, like people will get this all the time, you know? [SPEAKER_00]: Oh, I would never go on that jab. [SPEAKER_00]: People will call that shot. [SPEAKER_00]: I'd never go on it because I hear a conchilliure make you blind, right? [SPEAKER_00]: Like, or are you cheating? [SPEAKER_00]: Or it's cheating. [SPEAKER_00]: It's these ideas that people put out into the world. [SPEAKER_00]: It really has to do with how they're feeling, right? [SPEAKER_00]: And anytime anyone makes you feel less sad or you feel something inside, it's like it's a reflection of what is turmoil within them. [SPEAKER_00]: And we see this in the same way with in relationships. [SPEAKER_00]: It's like you want to

change something. [SPEAKER_00]: I don't. [SPEAKER_00]: Well, that must mean I'm not. [SPEAKER_00]: I must be, you know, so I'm going to make you feel badly for your changes and I'm not going to come along for it because I don't want to highlight my insecurities. [SPEAKER_00]: So I think just having an awareness and getting ahead of it, finding these other things and sometimes in a household, people can have different interests in different ways of doing it. [SPEAKER_00]: What I will say is that my practice, it's remarkable and how many [SPEAKER_00]: You know, it's one spouse who comes and then it's the other spouse and then it's the sister and then it's the mom and then it's

the best friend and I've noticed that these evolutions don't all happen at once within communities but they kind of filter down and for me that's the most exciting thing about these drugs actually I think that they could give us pause into this chronic disease explosion that we face and allow us to say hmm. [SPEAKER_00]: Let's have this trickle down effect not just go from our homes and our local communities, but on a national level. [SPEAKER_00]: How can we take pause? [SPEAKER_00]: How can we take some of that money that all of that energy and we invested into the chronic diseases? [SPEAKER_00]: And maybe now that we'll have less of them, let's go back and fix

the food source. [SPEAKER_00]: Let's go back and fix the ecosystem around us that let us all to be sitting at a desk for 12 hours a day and not walk and not move. [SPEAKER_00]: locally and then I hope macro. [SPEAKER_01]: Well that is my goal is that we remove to a prevention mindset rather than of course we have to treat disease it's going to happen there's genetics there's our environment there's our ecosystem but I think if we can move more to a prevention mindset how much better would it be for longevity and living those years quality rather than in protracted illness. [SPEAKER_01]: So going back to hormones, I want to ask you two more questions

about female health care because these are the ones that I get. [SPEAKER_01]: So I know I've seen the studies that women who are on hormone therapy and gel p1s tend to do better than the ones that aren't getting on hormones. [SPEAKER_01]: So do you typically, you know, obviously you're telling your patients, you can lose muscle and you can lose fat on a gel p1 and you want to preserve your muscle, do you recommend testosterone? [SPEAKER_00]: I recommend global hormone replacement therapy if needed. [SPEAKER_00]: And that is really, I would, I, in my practice, do not recommend a one-off. [SPEAKER_00]: If you need it, we're going on it. [SPEAKER_00]: I will also say, I think this

conversation has gotten really loud and noisy that [SPEAKER_00]: You will only do well on GLP ones if you are on hormones. [SPEAKER_00]: Yeah, and that's not true. [SPEAKER_00]: And that's just not true. [SPEAKER_00]: And we have very hard data to show you that you are going to achieve the weight loss that is predicted on average with these drugs. [SPEAKER_00]: There are some retrospective studies that show that the weight loss is much more significant. [SPEAKER_00]: But it's very small data and we actually dissect out the pre that Perry and the postman of causal women on average, most of these drugs lose the same amount of weight. [SPEAKER_00]: And then the addition of hormonal placement therapy will

just like tick it up a little bit more. [SPEAKER_00]: Why? [SPEAKER_00]: Because your quality of life is better, but for all of them and you can't or don't want to have adjunct therapy, hormonal therapy, you're going to do great. [SPEAKER_01]: And then what about menstrual cycle changes? [SPEAKER_01]: For our younger patients that are perimenopausal or just premenopausal, you know, in athletes, for me, I would see a lot of amenorrhea. [SPEAKER_01]: So during season, meaning no cycles at all, or oligomenorrhea, where they're, you know, skipping cycles, because they're not abulating, there's hormonal changes. [SPEAKER_01]: They're losing a lot of body fat, maybe during the season. [SPEAKER_01]: And I would see this with my athletes or women

who just were generally very low body weight. [SPEAKER_01]: What menstrual cycle changes are you seeing on the GLP ones, if any? [SPEAKER_00]: Yeah, well, you will see quite a few, and so you have to counsel because people think they're dying. [SPEAKER_01]: It's not really saying yes, but, you know, for a lot of women, that's one of their brometers, right? [SPEAKER_01]: It's their cycle. [SPEAKER_01]: So tell the do share. [SPEAKER_00]: So pre-parry menopause, so those women who lose weight on the struggle often have breakthrough bleeding, regardless of whether they're on any form of birth control or not. [SPEAKER_00]: The breakdown of fat releases estrogen, and so you might get some changes in your cycle. [SPEAKER_00]: That

generally normalizes pretty quickly. [SPEAKER_00]: For women who are taking birth control, we do have to be careful because the drug, the absorption might be changed depending on when you take the pill and the level of the medication in your system. [SPEAKER_00]: And so when we start this drug, we do recommend backup birth control because the absorption. [SPEAKER_00]: can be changed. [SPEAKER_00]: And so then the most amount of questions I actually get about this are women who are peri and beyond and are on MHT and they will get spotting or feel like their medicines aren't working as well. [SPEAKER_00]: And that, so like progesterone, for example, I get this a lot. [SPEAKER_00]: Like, well, the day

that I take my injection, my, I can't sleep. [SPEAKER_00]: And I have started to troubleshoot that I do believe it has to do with delayed absorption of progesterone. [SPEAKER_00]: And we'll get breakthrough bleeding because of that too. [SPEAKER_00]: So a lot of doctors will say, well, there's nothing we can do. [SPEAKER_00]: Well, chart, you can do enemy trial protection through an ID, you can increase your dose. [SPEAKER_00]: There are things we can do. [SPEAKER_00]: So you don't have to suffer if you're having some absorption changes that manifest in many ways. [SPEAKER_01]: And sometimes for women who like me with PCOS, if you happen to be not the lean, but you've gained weight because if you're

PCOS, all of a sudden with the weight loss, they see that their cycles become regular. [SPEAKER_00]: Yeah, we probably should have started there. [SPEAKER_00]: Yeah, that's the thing that everyone's celebrating. [SPEAKER_00]: The good stuff is that, I mean, the amount of those I'm big babies I have in my practice is so high. [SPEAKER_00]: And technically, you're not supposed to be on these drugs in preparation for pregnancy. [SPEAKER_00]: I hope we can kind of eliminate some of that. [SPEAKER_00]: morning, but women who never thought they could get pregnant naturally, once they go on the drug, they lose some weight, their insulin sensitivity becomes normalized and then they start abulating regularly and then boom their pregnant. [SPEAKER_01]:

Oh my god, I love this so much. [SPEAKER_01]: So you have those Olympic babies and I have Addy babies. [SPEAKER_01]: Oh, yes! [SPEAKER_01]: Oh my god. [SPEAKER_01]: So for the women who didn't believe me and their sex drive came back after I have a patient who has a nine-year age gap and lovingly think of. [SPEAKER_01]: I had warned her and she's like, Dr. Javay, you're not gonna fix it that much. [SPEAKER_01]: It'll be fine. [SPEAKER_01]: And then, low and behold, she had a baby. [SPEAKER_01]: And so there's a nine-year age gap between two of them. [SPEAKER_01]: And I was like, that's the Addy baby that you have. [SPEAKER_01]: So adding into some big babies, so

my hack, my trick for someone who maybe like you were talking about secondary birth control is I really like Faxi, the contraceptive gel because if you're using it as a secondary agent, it works nice. [SPEAKER_01]: It feels like a lubricant, so most women [SPEAKER_01]: They love it and they don't think about it and so now you'll never forget it because I always tell them they're like, what was that? [SPEAKER_01]: They're going to go fexy. [SPEAKER_01]: It's a play on sexy And so no, I do now work for them. [SPEAKER_01]: They are not paying for this, but if you want to feel free But that's my little hack that's easy I'm going to carry that forward

And you only need it with sexual activity, so it's not like something they have to add to their daily regimen Unless they're having sex daily, then good for you [SPEAKER_01]: I love that. [SPEAKER_01]: So we were talking about this earlier. [SPEAKER_01]: We're both founders, and you're a founder and femme tech. [SPEAKER_01]: And so tell me, what's the biggest barrier to making metabolic health care more accessible? [SPEAKER_00]: Oh, that is a big question. [SPEAKER_00]: I think the first thing in front of us is still stigma. [SPEAKER_00]: And even though we're sitting here, we're talking about it. [SPEAKER_00]: And it feels like your feed might be full of people talking about these drugs or on them out

in the world, in doctor's offices, in our communities, within ourselves, we still have such stigma against treating obesity like a disease. [SPEAKER_00]: We'll stop. [SPEAKER_01]: I'm so glad you've said that twice during our conversation because you know how many women just self-blame. [SPEAKER_00]: Yeah, self-hate. [SPEAKER_00]: It's not your fault. [SPEAKER_00]: It's not your fault, it's not your fault. [SPEAKER_00]: It's a game mate, it's not your fault. [SPEAKER_00]: That you go through meta-pause. [SPEAKER_00]: It's gonna have enough all of us. [SPEAKER_01]: It really is. [SPEAKER_01]: And I'm so glad you're saying that. [SPEAKER_01]: It's not your fault. [SPEAKER_01]: I spend half the visit telling patients to stop self-loathing. [SPEAKER_01]: You know, we extend, think about it.

[SPEAKER_01]: We're both moms, we're doctors, like you extend grace to so many people. [SPEAKER_01]: Why don't we extend it to ourselves? [SPEAKER_01]: It drives me crazy. [SPEAKER_01]: So how do you think technology is going to help bridge the scalp between this cutting edge science and this everyday patient that doesn't have the medication yet? [SPEAKER_00]: So the second big, [SPEAKER_00]: problem in this sphere right now is misinformation and lack of education. [SPEAKER_00]: So that's to me where technology comes in. [SPEAKER_00]: So we can only ask so much of an in-person doctor. [SPEAKER_00]: encounter. [SPEAKER_00]: There is not that much time. [SPEAKER_00]: We know it is broken, right? [SPEAKER_00]: And even on these tech platforms that are

making access to the drugs easier, we're still missing a gap in education. [SPEAKER_00]: Huge. [SPEAKER_00]: And you know, I went old school, I put everything I know into a book. [SPEAKER_00]: But the way that we consume information now is through tech and we really need to make sure that we support people on their GLP one journey in an entirely supported ecosystem. [SPEAKER_00]: I always call it that. [SPEAKER_00]: So you're going to get the medication, then how are we going to track our food? [SPEAKER_00]: How are we making sure getting enough protein? [SPEAKER_00]: How are we making sure that you learn how to run the train? [SPEAKER_00]: Because let's be honest, we hear that all the

time. [SPEAKER_00]: No, I'm always saying it like, eat protein, make protein, but the fact is the majority of people who come to me have [SPEAKER_00]: had the worst experiences with the gym. [SPEAKER_00]: And even if they went there, it never gave them what they wanted, which was weight loss, and now I'm finally helping them with the weight loss, so they're like, our vlog gym, and I don't want to be there. [SPEAKER_00]: You know? [SPEAKER_00]: There's so many other benefits to that. [SPEAKER_00]: Exactly, exactly. [SPEAKER_00]: So how do we support them there? [SPEAKER_00]: And then for me, as the founder of So Well, how do we create products that are made to just for the GLP

one user? [SPEAKER_00]: So for so long, people who struggle with their weight were relegated to the diet aisle, it needs to feel about one inch tall, made to feel there was something wrong with them. [SPEAKER_00]: And now they do need products that are for this journey. [SPEAKER_00]: They need fiber for their constipation. [SPEAKER_00]: They need hydration. [SPEAKER_00]: And you know what? [SPEAKER_00]: an electrolyte that's made for a pro athlete, that's not for them, right? [SPEAKER_00]: A fiber that was really geared toward your grandma, right? [SPEAKER_00]: It was like, what's in it and how it's made? [SPEAKER_00]: It's not for you. [SPEAKER_00]: And so my vision as a founder is to create products that are just

for this user. [SPEAKER_00]: I love them. [SPEAKER_00]: I know them and I know what they need and so I am doing my part there. [SPEAKER_01]: I love that so much. [SPEAKER_01]: And so what's one innovation you wish every patient knew about right now? [SPEAKER_00]: Ducks a scans. [SPEAKER_00]: They're not just for bone. [SPEAKER_00]: So this is tricky and not that easy to find. [SPEAKER_00]: And I wish or easier. [SPEAKER_00]: So we know of Ducks a scans. [SPEAKER_00]: We get the bone health. [SPEAKER_00]: Unfortunately, we get them way too late in this country, right? [SPEAKER_00]: I think we can agree on that. [SPEAKER_00]: But if you go to your traditional radiology facility, and I actually made

this error when I first are practicing, I was like, I could disorder you with Daxis scan and I'll get everything I need. [SPEAKER_00]: Well, the majority of radiology facilities do not have the technology built in to look at your muscle and your fat in addition to your bone. [SPEAKER_00]: So you really have to go sort out, find search out places that will look at body composition. [SPEAKER_00]: Correct. [SPEAKER_00]: And that, I think, is a technology that's evolving fast in the process. [SPEAKER_00]: It's great. [SPEAKER_00]: The other thing, when we talk about giving you a really good work up at the start of your GLP one journey, there are a few other tests that are becoming

a lot more accessible. [SPEAKER_00]: One of those are at home sleep apnea tests. [SPEAKER_00]: So sleep apnea is often the underlying reason of waking, and then the waking then makes a sleep apnea worse, and you just feel horrible. [SPEAKER_00]: And it goes under diagnosed all the time. [SPEAKER_00]: So now at home sleep studies are getting really good. [SPEAKER_00]: And so they're affordable and they're easy to access. [SPEAKER_00]: So talk to your doctor about them. [SPEAKER_00]: We don't have to go to lab anymore. [SPEAKER_00]: And then the final test is a calcium coronary artery score, which I love and recommend all the time. [SPEAKER_00]: Yeah. [SPEAKER_00]: Yeah. [SPEAKER_00]: And insurance still won't pay for it. [SPEAKER_00]:

Even if you have the best insurance, it is something out of pocket. [SPEAKER_00]: But the cost of this is coming down anywhere from like $99 to about $200. [SPEAKER_00]: And what is it? [SPEAKER_00]: It's a snapshot of the arteries of your heart, and we see if there's any plaque buildup. [SPEAKER_00]: Now, it doesn't guarantee that there's no plaque buildup anywhere or there, but it's looking at a very particular type of plaque. [SPEAKER_00]: And I love it because for a few reasons one, I picked up a lot of heart disease that way. [SPEAKER_00]: and then we get to have a great discussion about why GLP1 is even more for you and let's talk about a statin

and next steps. [SPEAKER_00]: The second thing is that if I find it I can often get GLP1 coverage where weight might have been an exclusion and that's a whole other conversation but it's a great test. [SPEAKER_01]: So is there someone that you would tell other than allergy that you are absolutely not a candidate for GLP1? [SPEAKER_00]: Oh, yeah, it's, in my opinion, it's allergy. [SPEAKER_00]: And then we do carry a black box warning for people with history of medulary thyroid cancer, MEN type two cancers. [SPEAKER_00]: Personal or family history. [SPEAKER_00]: In personal, and then we should extend it and have the discussion about family history. [SPEAKER_00]: It's very, very rare. [SPEAKER_00]: And the risk is,

in humans, is really theoretical, and so I will still have discussions with people about their own risk tolerance. [SPEAKER_00]: The other thing, and this is like, let's have this discussion here because no one else will have it with me, but I think we are not studying a drug right for women. [SPEAKER_00]: Perry Metapaz and Metapaz, we talked about that. [SPEAKER_00]: You know what, we don't have any data on pregnancy. [SPEAKER_00]: Yeah. [SPEAKER_00]: So what do we do with all the women who will benefit from being on the drug for their fertility, for their health? [SPEAKER_00]: Are we just going to say, Eee, and that's what's happening now because we don't study it. [SPEAKER_00]: And we

used to have to say that breastfeeding was an exclusion, but we now have some data. [SPEAKER_00]: just came out this year that said this does not get into the breast milk. [SPEAKER_00]: So with an informed discussion with your doctor at a certain point, not a day one, probably not a month three, but maybe by month six, when your baby is eating solid food, you can go on the drug because it doesn't get into the breast milk. [SPEAKER_00]: So as long as you're keeping up your energy and your stores and you're being nourished, we can consider it. [SPEAKER_01]: That's amazing. [SPEAKER_01]: So give me an inspiring or memorable patient story that you have that blew away

with the GLP-1. [SPEAKER_00]: Oh gosh, well back to our start of our conversation, we're talking about food noise. [SPEAKER_00]: I have a a C-suite executive who literally came back to me after the first month on the drug, not because of the weight loss I helped her with, but because she was crying. [SPEAKER_00]: that she had four more hours in her day because she just wasn't obsessing about what to eat next. [SPEAKER_00]: And it wasn't that she even had dysmorphic body image or any disorder eating. [SPEAKER_00]: She just always always like, well, what's going to be the healthiest? [SPEAKER_00]: What's going to be the thing that doesn't cause me to gain weight? [SPEAKER_00]: Okay, okay, I'll

prep now so that I have that then. [SPEAKER_00]: I'm going to get my protein in. [SPEAKER_00]: And she still met all of her macros, but she just wasn't obsessing over it. [SPEAKER_00]: But I was always stuck with me. [SPEAKER_01]: Oh my god can you imagine that that's what I'm a calendar management is like the biggest thing and to get that many hours back in your day that's amazing she wasn't joking and it was like here's a highly functional person right this is someone who has it together and what a burden she was taking on so [SPEAKER_01]: And tell me about I'm on this bookwriting journey. [SPEAKER_01]: We're both founders. [SPEAKER_01]: I raised 40 million and

I feel like fundraising for me was easier than the bookwriting. [SPEAKER_01]: So I'm in the process of written my proposal. [SPEAKER_01]: I have an agent, I'm about to push my contract across the finish line. [SPEAKER_01]: And but it's been a journey. [SPEAKER_01]: You know, you pour yourself out there with your kids and your patients. [SPEAKER_01]: And so tell me, [SPEAKER_01]: What led to this, what, what people can expect from this? [SPEAKER_00]: So the old couple cop girl. [SPEAKER_00]: Oh, yeah. [SPEAKER_00]: So the Ozzampic Revolution. [SPEAKER_00]: So let's say. [SPEAKER_00]: So when I wrote this proposal, it was in, I think, the end of 23. [SPEAKER_00]: And at the time, I really wanted to call this

the GLP-1 Revolution when I came to publication. [SPEAKER_00]: And my publisher said, no, it has to be Ozzampic. [SPEAKER_00]: Because that's the only thing people recognize right now. [SPEAKER_00]: And I'm like, oh, God, God. [SPEAKER_00]: It's kind of like, Kleenex. [SPEAKER_00]: and Botox, right? [SPEAKER_00]: Exactly. [SPEAKER_00]: Exactly. [SPEAKER_00]: Exactly. [SPEAKER_00]: And it was kind of, you know, the catch-all. [SPEAKER_00]: But what I was realizing, I've been doing this for a long time. [SPEAKER_00]: I've been exclusively practicing obesity medicine for over 10 years. [SPEAKER_00]: And I had wanted to write this book for a long time. [SPEAKER_00]: I was lucky enough in my practice to practice exactly how I wanted. [SPEAKER_00]: And I knew that getting

a prescription was [SPEAKER_00]: a third of the journey, you know, it wouldn't even get you halfway there. [SPEAKER_00]: You needed so much more support than just the medication. [SPEAKER_00]: And in my practice, we're very holistic. [SPEAKER_00]: So the first section of this book is I teach you about how we got here. [SPEAKER_00]: We talked about the hormones. [SPEAKER_00]: And then the habits that you need to establish. [SPEAKER_00]: And some of these things seem a little familiar. [SPEAKER_00]: But they're very different once you're back on the medications. [SPEAKER_00]: Let's track our food. [SPEAKER_00]: Let's track our side effects. [SPEAKER_00]: So we know what we're eating is giving us the side effects, right? [SPEAKER_00]: Let's learn how

to make neutral and nice with the scale, because talking about Jane found to work out. [SPEAKER_00]: We're traumatized by the scale, right? [SPEAKER_00]: Trauma ties by it. [SPEAKER_00]: How many times have I told a woman, I'm sure you've said the same thing. [SPEAKER_00]: You're more than a number. [SPEAKER_00]: I hear more than a number, and it's just the data point. [SPEAKER_00]: Or I have to teach people that again. [SPEAKER_00]: And then we get to the food part, which is so important to me. [SPEAKER_00]: And we're not talking about that enough, but we have to fuel our bodies. [SPEAKER_00]: And we have to not make it complicated. [SPEAKER_00]: I mean, the amount of people that are

so, again, traumatized by calorie tracking, app tracking, that they're like, I don't want to do it. [SPEAKER_00]: And I'm like, just do it in my way. [SPEAKER_00]: I promise we're going to make it neutral. [SPEAKER_00]: Like, just make sure you get what you need, right? [SPEAKER_00]: And then finally, the part that nobody is still talking about is the effect on your brain. [SPEAKER_00]: And how a lot of the [SPEAKER_00]: So, one of the things that I have found surprising when I first started was that a lot of times people need therapy to deal with unearths grief and trauma after they've lost weight. [SPEAKER_01]: Is that because they still identify as someone who's obese or their

self-worth is low? [SPEAKER_00]: No, it could be a lot of things. [SPEAKER_00]: It could be, yeah, wow, I was hiding there for a long time, and I didn't deal with a lot in front of me or [SPEAKER_00]: They've, for all of these years, they thought, well, if I could be thin, everything will be fixed, and then you get thin, and truthfully, it doesn't change anything on the inside or the outside. [SPEAKER_01]: Very interesting. [SPEAKER_01]: So you can have the weight loss, but still have the work to do. [SPEAKER_00]: Of course, yes, and so we really need to make sure that we're taking care of people holistically, and that we're doing this for health. [SPEAKER_00]: And

we're just, you know, it's not as easy as just, well, here's a magic wand. [SPEAKER_00]: I wish it was, but it's not. [SPEAKER_01]: Don't you wish we could have that in almost every vertical of medicine? [SPEAKER_01]: There's your sex life. [SPEAKER_01]: Thanks, your hormones are fixed, right? [SPEAKER_01]: You're bleeding is fixed. [SPEAKER_01]: So what's your go-to? [SPEAKER_01]: So we have to remember to take care of ourselves, right? [SPEAKER_01]: I always talk about healing our healers so that women and men stay practicing medicine. [SPEAKER_01]: What's your go-to self-care ritual? [SPEAKER_00]: Right now, I'm very proud of myself. [SPEAKER_00]: It is working out. [SPEAKER_00]: So I have a tonal in my house, and I get down there,

and I love that they tell me what to do and they advance. [SPEAKER_00]: I don't have to think about it, and it's great. [SPEAKER_00]: Because for a long time, I was pregnant or breastfeeding for almost 10 years. [SPEAKER_00]: And so the ability to really take care of myself physically, it was tough, it was tough. [SPEAKER_00]: And so now I'm carving out time there. [SPEAKER_01]: I love that. [SPEAKER_01]: And I also, we were talking about this. [SPEAKER_01]: I love my tonal too. [SPEAKER_01]: One of the best things I've done for myself. [SPEAKER_01]: That and sauna are the two changes that I made this year. [SPEAKER_01]: So I'm forcing myself to lift. [SPEAKER_00]: Can I also be

really honest? [SPEAKER_00]: I actually want to challenge my answer to that question. [SPEAKER_00]: No, do it. [SPEAKER_00]: It has like, how sink to moanies is that? [SPEAKER_00]: I'm like, myself, care is lifting. [SPEAKER_00]: But like, really, I'm really happy that I make making time for it. [SPEAKER_00]: You know what it really is? [SPEAKER_00]: Slow, though. [SPEAKER_00]: I love it. [SPEAKER_00]: It's bad TV and sleep. [SPEAKER_01]: I love it. [SPEAKER_01]: And it lets your mind kind of just, you know, do a more relaxing thing. [SPEAKER_01]: They can totally zone out. [SPEAKER_01]: It is my meditation. [SPEAKER_01]: I love it. [SPEAKER_01]: If you could have, see, this is a cheat question, but it doesn't have to be

me. [SPEAKER_01]: So, because we are going out to dinner. [SPEAKER_01]: If you could have dinner with any female trailblazer, who would it be? [SPEAKER_00]: Oh my gosh. [SPEAKER_00]: I mean, I think my third grade south would say Marie Curie. [SPEAKER_00]: Oh, I want to build one of the breeds, right? [SPEAKER_00]: Like, what was it to live then, and to invent something so significant? [SPEAKER_01]: And to do the work, and a completely male-dominated field. [SPEAKER_01]: I love it. [SPEAKER_01]: She was like one of the original disruptors. [SPEAKER_01]: Oh geez. [SPEAKER_01]: Oh geez. [SPEAKER_01]: So where can listeners find you and learn more about so well-health? [SPEAKER_00]: Yes, so you can find me across all platforms that

I like under. [SPEAKER_00]: So I am deep, including Substack, which I just launched. [SPEAKER_00]: Love that. [SPEAKER_00]: We're going to have some fun talking about how this drug is showing up in culture. [SPEAKER_00]: And our website is getsowell.com. [SPEAKER_00]: And that is where you find products that I've created just for GLP one users because they are that special. [SPEAKER_01]: Oh, and what's the one message that you want every person to take away from this episode? [SPEAKER_00]: Wait, is not a matter of willpower? [SPEAKER_00]: It is not you, it is biology, and you are not broken. [SPEAKER_01]: I love that so much. [SPEAKER_01]: Thank you so much for your wisdom for shaking up this world of

women's health. [SPEAKER_01]: If today's episode sparked something for you, share it with a friend, subscribe, and keep disrupting the narrative one conversation at a time. [SPEAKER_01]: Thank you. [SPEAKER_01]: Thank you. [SPEAKER_01]: If today's episode resonated with you. [SPEAKER_01]: If you heard your experience reflected, validated, or even better, relieved, remember this. [SPEAKER_01]: suffering and silence is not inevitable. [SPEAKER_01]: We all deserve solutions that work, that honor our bodies, that restore comfort without compromise. [SPEAKER_01]: That's why we highlighted miracle melts by playground. [SPEAKER_01]: Products designed not just to hydrate, but to truly relieve painful symptoms. [SPEAKER_01]: So you can move beyond just enduring. [SPEAKER_01]: Don't forget, disrupt your listeners get 20% off their first order with Dr.

Semi, and if you are looking for a little extra comfort, try one of playgrounds FDA approved lubricants for dual action relief. [SPEAKER_01]: You're not alone, and you deserve to feel good. [SPEAKER_01]: This is more than a conversation. [SPEAKER_01]: It's a call, a call to build something better. [SPEAKER_01]: Subscribe, share, and bring more disruptors into this room. [SPEAKER_01]: For unfiltered insights and bold ideas, go to DrSomeet.com to sign up for the monthly disruptor newsletter and follow us on social at DrSomeet. [SPEAKER_01]: We're not waiting for a seat at the table. [SPEAKER_01]: We're building our own table.