1 00:00:04,320 --> 00:00:07,800 Welcome to Peptides for Women. I'm Jennifer Woodward and this 2 00:00:07,800 --> 00:00:11,560 is your podcast for smart, honest conversations about 3 00:00:11,560 --> 00:00:14,000 peptide therapy and midlife Wellness. 4 00:00:14,240 --> 00:00:18,440 We cover everything from GLP ones to BPC 157, plus the 5 00:00:18,440 --> 00:00:22,560 foundations that still matter, sunlight, steps, strength 6 00:00:22,560 --> 00:00:25,560 training, protein and minerals. So if you're ready to feel 7 00:00:25,560 --> 00:00:29,480 better with science, back tools, and natural habits that actually 8 00:00:29,480 --> 00:00:32,240 work, you're in the right place. Let's dive in. 9 00:00:33,360 --> 00:00:36,960 I have to address the question I get more than almost any other 10 00:00:36,960 --> 00:00:41,160 question, More than what do I do about my belly fat, more than is 11 00:00:41,160 --> 00:00:43,960 this perimenopause, and honestly, probably more than 12 00:00:43,960 --> 00:00:47,480 questions from my own family. Where do I get my peptides? 13 00:00:47,960 --> 00:00:50,920 So here's the answer. I've been working with LEMD now 14 00:00:50,920 --> 00:00:53,760 for about a year and I genuinely love them. 15 00:00:54,040 --> 00:00:57,280 The physician oversight, the quality of the peptides, and the 16 00:00:57,280 --> 00:01:00,240 business opportunity they've built for practitioners like me 17 00:01:00,240 --> 00:01:03,360 is the real deal. If you want to order your own 18 00:01:03,360 --> 00:01:05,319 peptides, the link is in the show notes. 19 00:01:05,319 --> 00:01:07,880 It's super easy. And if you're a practitioner and 20 00:01:07,880 --> 00:01:11,480 you want to talk about how LEMD can work in your own practice, 21 00:01:11,560 --> 00:01:14,400 reach out to me directly. The conversation is free and 22 00:01:14,400 --> 00:01:17,080 it's a good one. But a couple of quick disclosure 23 00:01:17,080 --> 00:01:20,240 is because I'm a legally responsible adults, if you 24 00:01:20,240 --> 00:01:23,280 purchase through my show notes link, I do earn an affiliate 25 00:01:23,280 --> 00:01:24,400 income. Thank you. 26 00:01:25,040 --> 00:01:27,520 I also want to be clear that I'm not a doctor and I don't 27 00:01:27,520 --> 00:01:29,880 diagnose, treat, or prescribe anything. 28 00:01:30,200 --> 00:01:33,160 I'm just a woman who did a lot of research, has a lot of 29 00:01:33,160 --> 00:01:35,760 feelings about her hormones, and now has a podcast about it. 30 00:01:36,040 --> 00:01:41,360 OK, now let's get into it. Welcome back to the Peptides for 31 00:01:41,360 --> 00:01:43,720 Women podcast. I'm Jennifer Woodward, and I'm 32 00:01:43,720 --> 00:01:49,040 here today with Dr. Ian Ellis. Doctor Ellis is a physician and 33 00:01:49,040 --> 00:01:52,840 the founder of Voafit, a platform that revolutionizes 34 00:01:52,840 --> 00:01:56,400 obesity treatment by personalizing GLP one dosing 35 00:01:56,400 --> 00:01:59,560 based on individual drug levels. I've seen it. 36 00:01:59,560 --> 00:02:02,520 It's super rad. After struggling with his own 37 00:02:02,520 --> 00:02:06,360 weight and experiencing the limitations of standard GLP 1 38 00:02:06,360 --> 00:02:10,000 therapies, Doctor Ellis developed a method that reduces 39 00:02:10,000 --> 00:02:15,720 side effects, improves outcomes, and results in a 0% patient 40 00:02:15,720 --> 00:02:19,520 dropout rate in his clinic. With a passion for patient 41 00:02:19,520 --> 00:02:23,160 centered care, he's dedicated to helping individuals achieve 42 00:02:23,160 --> 00:02:25,840 lasting, sustainable weight loss and better health. 43 00:02:26,400 --> 00:02:28,400 Doctor Ellis, welcome to the show. 44 00:02:28,560 --> 00:02:30,320 Hey, yeah, thank you so much for having me. 45 00:02:30,320 --> 00:02:31,880 It's a true pleasure. So glad. 46 00:02:31,880 --> 00:02:35,480 To be here, it's a wonderful I've loved our chat so far, but 47 00:02:35,480 --> 00:02:37,200 there's some kind of fun things about you too. 48 00:02:37,200 --> 00:02:40,000 You're sitting inside your podcast studio, which also 49 00:02:40,000 --> 00:02:42,640 moonlights as your home gym. Tell me, what are some of the 50 00:02:42,640 --> 00:02:45,080 things you've got there behind the background in your home gym? 51 00:02:45,280 --> 00:02:49,920 Well, I started setting up this gym 10 years ago. 52 00:02:50,360 --> 00:02:54,520 I just had one set of adjustable dumbbells and a flat bench I 53 00:02:54,520 --> 00:02:57,000 worked out in my driveway with a trainer. 54 00:02:57,000 --> 00:02:59,920 This was me actually starting to get back in shape after 55 00:02:59,920 --> 00:03:01,880 residency. And I'm sure we'll actually talk 56 00:03:01,880 --> 00:03:05,920 about that experience. But you know, I had a garage, 57 00:03:06,160 --> 00:03:09,400 you know, was working really hard just in like early career 58 00:03:09,400 --> 00:03:12,160 emergency medicine, didn't have time to go to commercial gyms. 59 00:03:12,200 --> 00:03:15,000 And so gradually started accumulating pieces of equipment 60 00:03:15,520 --> 00:03:19,600 and then filled up the garage, moved into a place with kind of 61 00:03:19,600 --> 00:03:24,720 like a 32 by 22 foot addition. And that happened right around 62 00:03:24,720 --> 00:03:27,760 the time COVID hit. So when all the gym shut down 63 00:03:27,760 --> 00:03:30,840 and I was like, you know what, this is like my excuse to kind 64 00:03:30,840 --> 00:03:34,200 of go all out and and buy all the things that I want to, you 65 00:03:34,200 --> 00:03:37,520 know, have so that I never have the need to go to commercial gym 66 00:03:37,520 --> 00:03:40,120 ever again. And so most of my equipment is 67 00:03:40,120 --> 00:03:42,280 from Rogue. I have, you know, rogue power 68 00:03:42,280 --> 00:03:43,800 racks. I have two of those. 69 00:03:43,800 --> 00:03:47,600 I have a belt squat machine. I have a Woodway treadmill. 70 00:03:47,840 --> 00:03:52,320 I have, let's see, you know, cable crossover, full set of 71 00:03:52,880 --> 00:03:55,640 dumbbells, you know, all the attachments for high, low and 72 00:03:55,960 --> 00:03:58,600 high row and low row and just, you know, kind of everything 73 00:03:58,600 --> 00:04:01,200 you'd ever, ever need. So it's a fun place. 74 00:04:01,200 --> 00:04:03,080 It's a dull, this is my office as well. 75 00:04:03,400 --> 00:04:06,360 And so I get to spend most of my time in here. 76 00:04:06,360 --> 00:04:09,760 Actually, I wake up, I work out, I work in the gym, I do my 77 00:04:09,760 --> 00:04:12,920 podcast in the gym and then I, you know, leave at the end of 78 00:04:12,920 --> 00:04:14,240 the day. So it's it's good. 79 00:04:14,600 --> 00:04:16,920 Fantastic, I love it. OK, my all time favorite 80 00:04:16,920 --> 00:04:19,800 exercise must be the Romanian deadlift. 81 00:04:19,800 --> 00:04:24,840 What's yours? Let's see, it's so sad to answer 82 00:04:24,840 --> 00:04:27,640 the question because it just makes me such a cliche, but but 83 00:04:27,640 --> 00:04:30,240 it's it's bench press all day, all day long. 84 00:04:30,480 --> 00:04:33,960 OK, You know, I've done a fair amount of like focused strength 85 00:04:33,960 --> 00:04:36,520 training in my life. So kind of like big three lifts, 86 00:04:36,640 --> 00:04:39,680 you know, with your bench and squat and and deadlift with my 87 00:04:39,680 --> 00:04:45,280 bio mechanics, I bench really well and I squat very poorly and 88 00:04:45,280 --> 00:04:47,640 deadlift is kind of like always a challenge. 89 00:04:47,920 --> 00:04:51,000 And so, you know, bench day is the best day for sure. 90 00:04:51,560 --> 00:04:53,880 Today is the best day. I think I saw that on a T-shirt 91 00:04:53,880 --> 00:04:56,560 once. And you told me your kids also 92 00:04:56,560 --> 00:04:57,920 come in. You are training the next 93 00:04:57,920 --> 00:04:59,920 generation to lift. I love it. 94 00:04:59,920 --> 00:05:02,760 So you said your kids are 12, nine and seven. 95 00:05:02,760 --> 00:05:03,760 Is that right? Yes. 96 00:05:03,800 --> 00:05:09,160 So about to turn 12-9 and seven and I had two girls and a boy. 97 00:05:09,440 --> 00:05:11,840 The boy is the 9 year olds he is. 98 00:05:12,080 --> 00:05:14,920 I don't know where the genetics came from. 99 00:05:14,920 --> 00:05:17,360 I don't think they came directly for me because I feel like I've 100 00:05:17,360 --> 00:05:20,200 had to work really, really hard to have an athletic physique. 101 00:05:20,640 --> 00:05:25,280 He just came out like the star on every team he's ever been on. 102 00:05:25,280 --> 00:05:29,480 He's unbelievably athletic, crazy strong, can do head stands 103 00:05:29,480 --> 00:05:33,360 and hand stands and he can throw a baseball faster than I can 104 00:05:33,520 --> 00:05:37,360 literally at nine years old and loves telling everyone about 105 00:05:37,360 --> 00:05:40,280 that, by the way, Throws me under the bus every chance he 106 00:05:40,280 --> 00:05:42,640 can get. But yeah, he loves to come in 107 00:05:42,640 --> 00:05:46,840 and and do deadlifts with me. And, you know, obviously trying 108 00:05:46,840 --> 00:05:49,520 to find that balance between not like pushing him too hard at his 109 00:05:49,520 --> 00:05:52,120 age, but still allowing him to enjoy working out because he 110 00:05:52,120 --> 00:05:54,680 really does like it, wants to be as strong as Daddy someday. 111 00:05:55,000 --> 00:05:57,800 Oh, that is so, so great. There is nothing like it. 112 00:05:58,240 --> 00:06:00,080 But that makes you think of one other thing. 113 00:06:00,080 --> 00:06:02,520 While you were kind of talking about, you know, your genesis 114 00:06:02,520 --> 00:06:03,680 story of the gym. Yeah. 115 00:06:03,760 --> 00:06:06,440 You said that you started accruing all of your equipment 116 00:06:06,440 --> 00:06:09,760 when you were in emergency medicine and made me think why? 117 00:06:09,760 --> 00:06:13,120 I mean, you're a real affable, personable guy, right? 118 00:06:13,120 --> 00:06:15,280 You got to. There's a lot of charisma about 119 00:06:15,280 --> 00:06:18,040 you, and I feel like I've seen that the few times we've been to 120 00:06:18,040 --> 00:06:20,240 the ER. Like ER doctors are just 121 00:06:20,240 --> 00:06:23,040 generally pretty nice guys. Like they, they have a good 122 00:06:23,040 --> 00:06:25,160 bedside manner. Why do you think that is? 123 00:06:25,320 --> 00:06:28,640 So I think it's actually a few things, because that is true in 124 00:06:28,640 --> 00:06:30,840 general. ER docs are cool cats. 125 00:06:31,080 --> 00:06:34,160 It's a few things. You can't survive for very long 126 00:06:34,160 --> 00:06:38,280 in the ER unless you're pretty chill with a lot of crazy things 127 00:06:38,520 --> 00:06:42,200 like people that are very high in, let's say neuroticism or 128 00:06:42,200 --> 00:06:44,720 have high anxiety or stress just can't really function in that 129 00:06:44,720 --> 00:06:48,840 environment. You have to be able to juggle 6 130 00:06:49,040 --> 00:06:52,560 critical patients at the same time and be able to function. 131 00:06:52,720 --> 00:06:54,840 And so I think that attracts a certain type of personality 132 00:06:54,840 --> 00:06:57,040 where you're just like, you know, it's cool, like whatever 133 00:06:57,040 --> 00:06:59,080 happens, happens and I'll just do my best. 134 00:06:59,800 --> 00:07:03,760 I think also to the lifestyle, it's not a lifestyle specialty 135 00:07:03,760 --> 00:07:07,200 in terms of like it's, it's a hard life, but it is a life that 136 00:07:07,200 --> 00:07:11,800 is very structured in terms of you go to work, you clock in, 137 00:07:12,120 --> 00:07:14,800 you clock out. And when you're not at work as 138 00:07:14,800 --> 00:07:18,040 an ER doctor, you have no additional medicine 139 00:07:18,040 --> 00:07:19,720 responsibilities. You don't have follow up with 140 00:07:19,720 --> 00:07:23,960 your patients, you don't have clinic responsibilities or like 141 00:07:23,960 --> 00:07:27,640 you, you go to work, you punch in, you do your shift, you punch 142 00:07:27,640 --> 00:07:30,720 out. And so it allows for a lot of 143 00:07:30,720 --> 00:07:33,000 free time when you're not at work. 144 00:07:33,600 --> 00:07:37,880 So, you know, a full full time ER gig is like 36 hours per 145 00:07:37,880 --> 00:07:41,320 week, which is more than enough because those started 36 hours 146 00:07:41,320 --> 00:07:44,800 are extremely intense. But that does mean you have a 147 00:07:44,800 --> 00:07:47,000 lot of time off. And so ER tends to attract 148 00:07:47,000 --> 00:07:49,480 people that have like hobbies and other things they enjoy 149 00:07:49,480 --> 00:07:52,640 doing their off time. And so, you know, guys that'll, 150 00:07:52,840 --> 00:07:55,240 you know, ride their speed bike to the ER. 151 00:07:55,360 --> 00:07:57,000 That's like the classic stereotype. 152 00:07:57,000 --> 00:08:00,120 You like, you ride up to the ER on your, in your, your road 153 00:08:00,120 --> 00:08:03,400 bike, take off your helmet, put on your scrubs, and then, you 154 00:08:03,400 --> 00:08:04,920 know, ride back home at the end of your shift. 155 00:08:04,920 --> 00:08:07,360 You know, that's like a very common thing and it it certainly 156 00:08:07,360 --> 00:08:09,520 has proven to be true. Fantastic. 157 00:08:09,560 --> 00:08:12,440 OK, thanks for that. I I'm also curious now what, 158 00:08:12,440 --> 00:08:14,440 what's the genesis, what got you there? 159 00:08:14,440 --> 00:08:17,360 Tell me a little bit about your you know, your life, your 160 00:08:17,360 --> 00:08:20,800 health, what things were like for you as a younger man, just 161 00:08:20,800 --> 00:08:23,240 with regards to, you know, your weight and what kind of got you 162 00:08:23,280 --> 00:08:27,200 into the path you're on it now. Yeah, So, you know, I did not 163 00:08:27,520 --> 00:08:32,200 ever conceive of where I would be today when I was a younger 164 00:08:32,200 --> 00:08:36,240 adult or even into my mid 20s. I'm the first doctor in my 165 00:08:36,240 --> 00:08:38,880 family. I'm one of five kids. 166 00:08:39,039 --> 00:08:41,760 We do have a variety of different interests, but there 167 00:08:41,760 --> 00:08:45,960 was no medical exposure in my life growing up. 168 00:08:46,160 --> 00:08:50,760 And so my dad was a pastor of a little church in Wylie, TX. 169 00:08:50,840 --> 00:08:53,880 My mom was a stay at home mom, you know, raising the five kids. 170 00:08:54,360 --> 00:08:58,320 And so I had a very, I guess maybe typical early 80s, early 171 00:08:58,320 --> 00:09:03,040 90s childhood in, you know, small town Texas, USA with that 172 00:09:03,320 --> 00:09:06,680 being in the 80s and 90s, that was kind of maybe the peak of 173 00:09:07,040 --> 00:09:10,120 like thin as in like low fat craze. 174 00:09:10,360 --> 00:09:13,120 Everyone was trying to lose weight and they still are now 175 00:09:13,120 --> 00:09:15,080 today. But I think it was really a 176 00:09:15,080 --> 00:09:18,040 cultural moment where it was like just everyone was always 177 00:09:18,040 --> 00:09:19,160 trying to lose weight all the time. 178 00:09:19,520 --> 00:09:23,640 And the way to do it at that point in time was low fat diet, 179 00:09:23,760 --> 00:09:28,480 which is horrible mistake and just trying to not eat. 180 00:09:28,920 --> 00:09:31,560 You know, that was where anorexia was like a cultural 181 00:09:31,800 --> 00:09:35,240 thing that was really happening. And I think that the way that 182 00:09:35,240 --> 00:09:38,840 people tried to figure out how to be healthy was, you know, eat 183 00:09:38,840 --> 00:09:41,520 as little as possible for as long as possible until you reach 184 00:09:41,520 --> 00:09:44,280 your goal weight. And so I grew up around a lot of 185 00:09:44,280 --> 00:09:45,640 that. My parents were always trying to 186 00:09:45,640 --> 00:09:48,320 lose weight. They were never getting where 187 00:09:48,320 --> 00:09:51,400 they wanted to go. It was like, I mean, almost an 188 00:09:51,440 --> 00:09:54,040 everyday thing where I'd just hear my dad say, man, like, I'm 189 00:09:54,040 --> 00:09:57,440 so frustrated, you know, I'm so unhappy with how I look. 190 00:09:57,440 --> 00:10:00,600 And you know, he had big giant, you know, she, this is like pre 191 00:10:00,600 --> 00:10:04,960 Internet almost, you know, big sheets of graph paper taped up 192 00:10:04,960 --> 00:10:07,920 to the wall where he would track his weight over time with like 193 00:10:07,920 --> 00:10:10,160 a, you know, a ruler and a protractor. 194 00:10:10,160 --> 00:10:14,080 And always like striving and trying and restricting and never 195 00:10:14,080 --> 00:10:17,240 making any progress, like always ending up looking and feeling 196 00:10:17,320 --> 00:10:20,720 the same. And I noticed that like as a 197 00:10:20,720 --> 00:10:25,000 teenager, like 12/13/14, like everyone around me is trying so 198 00:10:25,000 --> 00:10:28,960 hard to be in shape. No one seems to succeed. 199 00:10:29,680 --> 00:10:33,480 I don't understand that or know why it's so hard, but hell if 200 00:10:33,480 --> 00:10:36,600 that's going to happen to me. And I remember I had a real 201 00:10:36,600 --> 00:10:37,760 moment. I was 14 years old. 202 00:10:37,760 --> 00:10:39,000 I was standing in front of the mirror. 203 00:10:39,200 --> 00:10:41,800 I was looking at my own, you know, teenage body, which in 204 00:10:41,800 --> 00:10:43,800 hindsight was a perfectly normal teenage body. 205 00:10:43,800 --> 00:10:46,960 But I had, like, a little bit of a role, you know? 206 00:10:47,480 --> 00:10:50,240 And I was like, I am going to win this battle. 207 00:10:50,240 --> 00:10:53,640 I'm going to do whatever it takes to fight this battle and 208 00:10:53,640 --> 00:10:55,560 win. I'm not going to be, you know, 209 00:10:55,560 --> 00:10:58,840 my mom, my dad, people around me spending every minute of their 210 00:10:58,840 --> 00:11:03,080 day trying and failing. OK, So again, pre Internet, like 211 00:11:03,160 --> 00:11:05,000 not pre Internet, there was Internet, but it was like, you 212 00:11:05,200 --> 00:11:08,920 know, very early forums and, you know, there wasn't a lot of good 213 00:11:08,920 --> 00:11:10,840 resources. I certainly had no specific 214 00:11:10,840 --> 00:11:13,280 training or knowledge and nutrition or exercise. 215 00:11:13,760 --> 00:11:17,960 And So what I came up with was not particularly elegant. 216 00:11:18,480 --> 00:11:23,200 It was, well, they're trying not to eat and they're failing. 217 00:11:23,640 --> 00:11:26,480 I'm going to try not to eat and I'm going to succeed. 218 00:11:26,840 --> 00:11:29,920 And they're exercising a whole lot and not making progress. 219 00:11:30,200 --> 00:11:34,440 So I'm going to exercise a lot more and I'm just going to will 220 00:11:34,440 --> 00:11:38,040 my way to victory. And kind of in that very old 221 00:11:38,040 --> 00:11:41,120 school, like it's simple. It's calories in, calories out, 222 00:11:41,560 --> 00:11:45,000 you know, don't eat too much and exercise a lot and everything 223 00:11:45,000 --> 00:11:48,160 else will sort itself out. OK, so I, you know, was an 224 00:11:48,160 --> 00:11:49,840 athlete. I've played on sports teams and 225 00:11:49,840 --> 00:11:52,000 everything. End up going to college pretty 226 00:11:52,000 --> 00:11:53,320 young because I was home schooled. 227 00:11:53,520 --> 00:11:55,280 My mom skipped me up a few grades. 228 00:11:55,280 --> 00:11:58,800 That's only relevant because I went to college and just turned 229 00:11:58,800 --> 00:12:02,480 16. Had no idea who I was, what I 230 00:12:02,480 --> 00:12:07,280 was, what I wanted to be like 0, you know, thought in my brain 231 00:12:07,280 --> 00:12:10,000 outside of, OK, I'm in college, like what's next? 232 00:12:10,320 --> 00:12:12,760 And what was next was to go to the gym and to kind of fall in 233 00:12:12,760 --> 00:12:15,840 with a bodybuilding kind of very aesthetically minded crowd of 234 00:12:15,840 --> 00:12:18,920 young men that were older than me that were had kind of 235 00:12:18,920 --> 00:12:22,760 aspirational physiques. And so developing A physique 236 00:12:22,760 --> 00:12:27,480 that was extremely aesthetic became the like focus of every 237 00:12:27,480 --> 00:12:31,720 moment of my days. I always share a few anecdotes. 238 00:12:32,120 --> 00:12:34,200 You know, I had like Michelangelo's David, the 239 00:12:34,200 --> 00:12:37,720 statue. I had his measurements. 240 00:12:37,720 --> 00:12:41,160 Don't ask me how it got him, but his measurements of like chest 241 00:12:41,160 --> 00:12:45,440 to waist to calf to forearm, you know, to whatever ratio taped up 242 00:12:45,440 --> 00:12:47,360 on my wall. And like that was what I would 243 00:12:47,360 --> 00:12:49,800 compare myself to. Like, have I arrived? 244 00:12:50,080 --> 00:12:52,720 Am I in good enough shape? Well, let's just find, you know, 245 00:12:52,920 --> 00:12:55,960 the pinnacle sculpture of Western civilization. 246 00:12:56,360 --> 00:12:58,200 Like, you know, compare myself to that. 247 00:12:58,200 --> 00:13:00,920 And if I'm not in that good of shape, then I'm not there yet. 248 00:13:01,280 --> 00:13:06,240 Really developed some extremely toxic and I'm sure we'll be 249 00:13:06,240 --> 00:13:09,200 familiar to you. Cycles of excessive restriction 250 00:13:09,680 --> 00:13:13,800 going as long as I could without eating inter dispersed with kind 251 00:13:13,800 --> 00:13:16,840 of like bulking phases in the bodybuilding community where you 252 00:13:16,840 --> 00:13:18,720 just eat everything Insight because you're trying to gain as 253 00:13:18,720 --> 00:13:21,800 much muscle as possible, you know, in your whipsawing 254 00:13:21,960 --> 00:13:28,840 intentionally, you know, up £40, down 40 lbs just in a bid to get 255 00:13:28,840 --> 00:13:33,120 to that idealized physique. Now externally because I was 256 00:13:33,120 --> 00:13:38,200 spending almost every waking moment thinking about that and 257 00:13:38,200 --> 00:13:41,160 trying to make that real. Externally I had a lot of 258 00:13:41,160 --> 00:13:43,440 success. You know, when I cut down, I did 259 00:13:43,440 --> 00:13:46,040 look great. You know, I did walk around an 260 00:13:46,040 --> 00:13:51,080 8% body fat and look and feel and was to other people kind of 261 00:13:51,080 --> 00:13:54,720 an aspirational physique. Well, underneath the surface, 262 00:13:54,840 --> 00:14:00,200 just a hot mess of totally obsessive tendencies doing 263 00:14:00,200 --> 00:14:04,720 things that were, you know, not being able to kind of hold on to 264 00:14:04,720 --> 00:14:08,560 the wheel when I was overly restricting, losing control, 265 00:14:08,840 --> 00:14:12,160 going to the fridge, eating 10,000 calories in a sitting, 266 00:14:12,400 --> 00:14:15,360 not eating for the next two days to make up for it or over 267 00:14:15,360 --> 00:14:17,960 exercising to kind of make up that deficit. 268 00:14:18,360 --> 00:14:23,200 One of the worst examples of that was we had Thanksgiving 269 00:14:23,200 --> 00:14:28,000 dinner one year and I had of course not eaten the day before 270 00:14:28,200 --> 00:14:31,400 to make room. We've all, perhaps sadly gone 271 00:14:31,400 --> 00:14:33,880 through that experience. You get to Thanksgiving with 272 00:14:33,880 --> 00:14:35,960 like, I'm just going to, you know, Peck at things that I'm 273 00:14:35,960 --> 00:14:38,560 not going to overeat. Well, you eat a little something 274 00:14:38,560 --> 00:14:41,640 and you're really hungry and you eat a little something more, and 275 00:14:41,640 --> 00:14:43,920 then you get a piece of pie and then you get seconds on 276 00:14:43,920 --> 00:14:45,520 stuffing. And then you start to get 277 00:14:45,520 --> 00:14:49,840 frustrated and sad and upset and mad and you just eat everything 278 00:14:49,840 --> 00:14:52,440 insight until you just can't eat anymore. 279 00:14:52,640 --> 00:14:55,960 And so that's what I did. But being a good little boy, I 280 00:14:56,120 --> 00:15:01,000 kept track and weighed and measured every calorie of extra 281 00:15:01,000 --> 00:15:06,400 stuffing and extra pumpkin pie and an extra Turkey and dressing 282 00:15:07,080 --> 00:15:10,080 and I kept a perfect count of how much I actually over ate. 283 00:15:10,480 --> 00:15:14,760 And it turns out that was 26126 hundred over maintenance. 284 00:15:15,120 --> 00:15:18,600 So I ate my whole day's worth. And then I kept eating until I 285 00:15:18,600 --> 00:15:23,000 had eaten 2600 more. So all I could come up with was 286 00:15:23,320 --> 00:15:27,160 I guess I need to burn off 2600 calories to get this back to 287 00:15:27,400 --> 00:15:29,800 baseline. And so I woke up the next day 288 00:15:30,040 --> 00:15:33,640 and I went to the gym and I ran a marathon on the treadmill by 289 00:15:33,640 --> 00:15:35,080 myself. Untrained. 290 00:15:35,160 --> 00:15:39,120 No, like life goals of running a marathon didn't like it wasn't a 291 00:15:39,120 --> 00:15:40,680 bucket list item. It was like, that's just how 292 00:15:40,680 --> 00:15:44,200 many miles I had to run to burn off that many calories. 293 00:15:44,360 --> 00:15:47,320 And when I say run, that's very charitable. 294 00:15:47,520 --> 00:15:53,040 I ran for like 6 miles and then I walked for, you know, 15 miles 295 00:15:53,280 --> 00:15:57,920 and then I, you know, hobbled along, you know, until I got to 296 00:15:57,920 --> 00:16:00,880 the finish line. But that's just a good example 297 00:16:01,240 --> 00:16:06,000 of where where my head was like just so relentlessly focused on 298 00:16:06,000 --> 00:16:08,520 I have to eat the right things and overly restricting and 299 00:16:08,520 --> 00:16:11,680 losing the handle, being a slave to my appetite and it just 300 00:16:11,680 --> 00:16:13,240 really taking over every minute of my life. 301 00:16:13,560 --> 00:16:17,080 OK Externally looked great. People were, you know, I became 302 00:16:17,080 --> 00:16:19,240 a personal trainer. I was helping other people do 303 00:16:19,240 --> 00:16:21,600 the same thing, OK. And, you know, preaching that 304 00:16:21,800 --> 00:16:23,360 same ridiculous gospel. Yeah. 305 00:16:23,360 --> 00:16:25,320 It's just so easy. Look, you just eat right and you 306 00:16:25,320 --> 00:16:28,160 just exercise. No big deal as I would then go 307 00:16:28,160 --> 00:16:31,280 home and clean out the fridge right and over exercise the next 308 00:16:31,280 --> 00:16:33,480 day. So this is going to be a long 309 00:16:33,480 --> 00:16:34,560 story. I always do this. 310 00:16:34,560 --> 00:16:38,040 I always talk too long. I then I went to Med school and 311 00:16:38,040 --> 00:16:40,920 I got married and I had a kid. And all of a sudden I went from 312 00:16:40,920 --> 00:16:44,480 being a single person who had all day long to obsess and focus 313 00:16:44,480 --> 00:16:48,600 on my physique and my diet and my exercise and all those things 314 00:16:48,960 --> 00:16:51,680 and was basically living in the gym, you know, training other 315 00:16:51,680 --> 00:16:55,240 people, exercising, you know, 6 to 8 hours a day, two working 316 00:16:55,240 --> 00:16:59,080 100 hour weeks, having the stresses and rigors of medical 317 00:16:59,080 --> 00:17:01,560 school and eventually residency, which was much worse. 318 00:17:01,920 --> 00:17:04,319 And I lost the ability to overcompensate. 319 00:17:04,560 --> 00:17:07,240 I couldn't run a marathon anymore because I was on 320 00:17:07,240 --> 00:17:09,680 overnight call. And I couldn't rigorously 321 00:17:09,680 --> 00:17:12,599 control every calorie that entered my body because I was at 322 00:17:12,599 --> 00:17:16,560 the hospital and I was hungry. And there's, you know, Ho Hos at 323 00:17:16,560 --> 00:17:17,920 the nurse's station. OK. 324 00:17:18,400 --> 00:17:22,000 And when I went home, I had responsibilities to my wife, to 325 00:17:22,000 --> 00:17:26,599 my kid, you know, other things that were too important for me 326 00:17:26,599 --> 00:17:29,520 to kind of do the same things to overcompensate. 327 00:17:29,600 --> 00:17:31,480 So the wheels completely fell off. 328 00:17:31,480 --> 00:17:35,160 This is where the shoe drops. I gained 60 lbs over that period 329 00:17:35,160 --> 00:17:37,560 of time. I stopped exercising. 330 00:17:38,080 --> 00:17:41,480 I, you know, ate whatever I could whenever I could, and, you 331 00:17:41,480 --> 00:17:45,520 know, still attempting to restrict as best I could, but 332 00:17:45,520 --> 00:17:49,840 failing miserably, OK, becoming that slave to my appetite and 333 00:17:49,840 --> 00:17:51,280 just not being able to control that. 334 00:17:51,760 --> 00:17:56,080 And so I graduated residency, 60 lbs overweight, 40% body fat, 335 00:17:56,200 --> 00:17:59,320 snoring like a freight train, you know, winded running back 336 00:17:59,320 --> 00:18:01,000 and forth to codes. Really. 337 00:18:01,000 --> 00:18:03,280 You know, you talk about a mirror moment, look in the 338 00:18:03,280 --> 00:18:05,360 mirror and going, you know, forget my French. 339 00:18:05,360 --> 00:18:08,600 God damn it. I'd become exactly what I 340 00:18:08,600 --> 00:18:11,200 feared. I'm looking at the same person 341 00:18:11,240 --> 00:18:13,240 in the mirror that I swore I would never become. 342 00:18:13,960 --> 00:18:17,000 Like with all my training, with all of my knowledge, with 343 00:18:17,000 --> 00:18:20,200 becoming a certified personal trainer, physician nutritionist, 344 00:18:20,400 --> 00:18:22,280 spending every minute of every day here. 345 00:18:22,280 --> 00:18:26,720 I was the same as everybody else, which was devastating. 346 00:18:26,880 --> 00:18:30,280 You know, you, you graduate residency and you go, I can't 347 00:18:30,280 --> 00:18:35,440 believe this happened to me, but with a new appreciation for I 348 00:18:35,440 --> 00:18:37,880 was lying to people. This isn't easy. 349 00:18:38,280 --> 00:18:42,840 It's extraordinarily difficult to have real a real life and 350 00:18:42,840 --> 00:18:46,560 real responsibilities and go through your day keeping those 351 00:18:46,560 --> 00:18:48,880 balls in the air and have a healthy physique. 352 00:18:49,240 --> 00:18:53,160 In our Western world, with our terrible food supply and all the 353 00:18:53,160 --> 00:18:56,320 stressors we have and our lack of time and all the things that 354 00:18:56,320 --> 00:19:00,880 contribute to the obesity crisis, it is extraordinarily 355 00:19:01,160 --> 00:19:04,400 difficult for most people to be successful. 356 00:19:04,520 --> 00:19:05,880 You know, and the numbers are clear, right? 357 00:19:05,880 --> 00:19:08,360 75% of the country is overweight or obese. 358 00:19:08,680 --> 00:19:10,920 Not for lack of trying, OK? Everyone's trying. 359 00:19:11,040 --> 00:19:14,840 Most people are failing, and in my experience, a majority of the 360 00:19:14,840 --> 00:19:19,320 people that succeed have to give up way too much to get there. 361 00:19:19,640 --> 00:19:22,040 They make fitness the focus of their entire life. 362 00:19:22,240 --> 00:19:23,720 All their friends are at the gym. 363 00:19:24,040 --> 00:19:27,320 All their recreational activities are related to, you 364 00:19:27,320 --> 00:19:30,200 know, winning that battle. OK, well, that's not good 365 00:19:30,200 --> 00:19:32,840 enough. Like there's a dream which will 366 00:19:32,840 --> 00:19:36,200 get to how I think that can be a reality now of having your cake 367 00:19:36,200 --> 00:19:39,560 and eating it too. Being fit and healthy, not being 368 00:19:39,560 --> 00:19:42,280 a slave to your appetite, but also being balanced, spending 369 00:19:42,280 --> 00:19:46,120 time with your family, not over exercising, over obsessing, 370 00:19:46,280 --> 00:19:49,320 spending every square, you know, every spare minute of the day 371 00:19:49,600 --> 00:19:52,560 trying to win that battle. And so I just talked for a very 372 00:19:52,560 --> 00:19:53,680 long time. I'm so sorry. 373 00:19:54,320 --> 00:19:56,000 OK, Does that a. Great story. 374 00:19:56,000 --> 00:19:59,920 No, I think it gives us a very interesting background and 375 00:19:59,920 --> 00:20:01,760 here's why I find it most fascinating. 376 00:20:01,920 --> 00:20:05,080 I also am a child of the 80s. Most of our listeners grew up in 377 00:20:05,080 --> 00:20:08,480 the Seventies, 80s and 90s. And so we are extraordinarily 378 00:20:08,480 --> 00:20:12,320 familiar with diet culture and Paris Hilton and all that, like, 379 00:20:12,560 --> 00:20:16,040 you know, anorexic culture. Yes, I did not realize that it 380 00:20:16,040 --> 00:20:18,200 also. Affected the other half of the 381 00:20:18,200 --> 00:20:21,800 population that that men also fell, you know, prey to some of 382 00:20:21,800 --> 00:20:23,920 those lies. You know, I think it is 383 00:20:24,160 --> 00:20:31,880 extremely underappreciated how much young men do know and care 384 00:20:32,000 --> 00:20:34,480 and obsess. And it, it, it expresses itself 385 00:20:34,480 --> 00:20:37,040 in a different way. You know, the, the goal as a 386 00:20:37,040 --> 00:20:39,840 male is not typically to be as thin as possible. 387 00:20:40,160 --> 00:20:43,360 It's to be as, you know, yoked as possible. 388 00:20:44,120 --> 00:20:47,360 And so it, it expresses itself in a different way, but it 389 00:20:47,360 --> 00:20:51,440 results in a similar toxicity of behaviors. 390 00:20:51,840 --> 00:20:54,440 And not to mention the abuse of substances, you know, taking 391 00:20:54,440 --> 00:20:56,880 anabolic steroids, you know, doing anything. 392 00:20:57,000 --> 00:21:00,560 I mean, nowadays, Oh my gosh, the percentage of young men who 393 00:21:00,560 --> 00:21:04,000 that are on some sort of performance enhancing substance, 394 00:21:04,240 --> 00:21:08,320 not that they're all wrong to take or necessarily bad, but 395 00:21:08,320 --> 00:21:11,560 they do indicate that everyone is doing something because they 396 00:21:11,560 --> 00:21:15,200 don't feel like they can do it on their own is extraordinarily 397 00:21:15,200 --> 00:21:18,520 high. Like the prototypical Instagram 398 00:21:18,520 --> 00:21:23,000 male physique is not achievable naturally. 399 00:21:23,120 --> 00:21:25,920 It is not for any amount of time. 400 00:21:26,600 --> 00:21:30,720 And so young men that are, you know, on Instagram or Facebook 401 00:21:30,840 --> 00:21:34,040 seeing these influencers and seeing how they look, they go, 402 00:21:34,040 --> 00:21:38,800 oh, I guess that's the goal. Well, that goal is not 403 00:21:39,120 --> 00:21:44,400 achievable by a human being who is not chemically enhanced so. 404 00:21:44,400 --> 00:21:45,680 You're saying nothing has changed? 405 00:21:46,040 --> 00:21:47,680 Nothing has changed since the 80s and 90s. 406 00:21:47,680 --> 00:21:48,440 No, no, no. It's. 407 00:21:48,440 --> 00:21:49,880 It's just expressed stuff in a different way. 408 00:21:50,560 --> 00:21:52,880 Now I'll just throw a little caveat in here. 409 00:21:53,360 --> 00:21:58,680 I'm not opposed to performance enhancing therapies because GLP 410 00:21:58,680 --> 00:22:03,920 ones by any definition, are they make the impossible possible. 411 00:22:04,080 --> 00:22:08,240 OK, And peptide therapies as a class, the sky seems to be the 412 00:22:08,240 --> 00:22:11,640 limit in terms of optimizing our physique and allowing us to 413 00:22:11,640 --> 00:22:17,800 function within a toxic Stew of cultural, you know, nutritional 414 00:22:18,320 --> 00:22:23,080 and societal pressures that, you know, push all of us downstream 415 00:22:23,200 --> 00:22:25,480 where we don't want to be. It's like peptides, GLP ones. 416 00:22:25,480 --> 00:22:29,440 Those kind of things are a lifeboat with a motor in it that 417 00:22:29,440 --> 00:22:32,960 allows you to, you know, get back upstream to where you would 418 00:22:32,960 --> 00:22:35,600 we where we probably all would be if we were in a pre 419 00:22:35,600 --> 00:22:39,000 industrial society and we were expending tons of energy in our 420 00:22:39,000 --> 00:22:42,400 day-to-day activities and all we had was natural unprocessed 421 00:22:42,400 --> 00:22:44,560 foods that we grew in the ground that we caught and prepared 422 00:22:44,560 --> 00:22:47,120 ourselves. You know we would all be healthy 423 00:22:47,840 --> 00:22:51,160 if we all lived 100 years ago because that is how it was. 424 00:22:51,480 --> 00:22:55,760 The average male in you know, 19/20 was 165 lbs. 425 00:22:56,440 --> 00:23:00,880 Well the average is up to 200. OK, not, and not 35 lbs of extra 426 00:23:00,880 --> 00:23:04,920 muscle either. You know, we have lost the plot 427 00:23:04,920 --> 00:23:07,160 in terms of, you know, and I was describing it this way. 428 00:23:07,400 --> 00:23:10,520 You go 100 years ago, people spent most of their day working 429 00:23:10,520 --> 00:23:13,440 really, really hard with their bodies, expending enormous 430 00:23:13,440 --> 00:23:16,760 amounts of energy, ending their day in a huge calorie deficit. 431 00:23:17,080 --> 00:23:20,200 And then they had a lot of food that was natural, that was 432 00:23:20,200 --> 00:23:23,160 prepared fresh, that had a lot of volume, that was not 433 00:23:23,160 --> 00:23:26,800 particularly energy dense. And so you had to eat a lot of 434 00:23:26,800 --> 00:23:29,000 that type of food to maintain your weight. 435 00:23:29,440 --> 00:23:32,480 So you work really hard and you get really hungry and you eat a 436 00:23:32,480 --> 00:23:35,600 whole lot of food and you get full and you go to bed and you 437 00:23:35,600 --> 00:23:37,400 do that again. And so, you know, type 2 438 00:23:37,400 --> 00:23:39,760 diabetes was not a thing 100 years ago. 439 00:23:40,000 --> 00:23:42,640 It literally did not exist as an entity. 440 00:23:43,320 --> 00:23:45,920 The world has changed. We now have unlimited access to 441 00:23:45,920 --> 00:23:47,720 food that we don't have to lift a finger to get. 442 00:23:47,960 --> 00:23:50,240 You could DoorDash every single calorie you ever ate. 443 00:23:50,360 --> 00:23:52,480 And you can actually instruct them in the app to put it inside 444 00:23:52,480 --> 00:23:55,000 your front door. So you don't even have to like, 445 00:23:55,120 --> 00:23:56,960 open your door and go outside to get it. 446 00:23:57,040 --> 00:23:58,720 OK. We don't have to work for food 447 00:23:58,720 --> 00:24:00,800 anymore. And we have unlimited amounts of 448 00:24:00,800 --> 00:24:05,320 incredibly calorie dense food that is hyper palatable that our 449 00:24:05,320 --> 00:24:07,240 brains are not designed to manage yet. 450 00:24:07,280 --> 00:24:10,560 Our bodies haven't changed in 100 years in terms of, you know, 451 00:24:10,560 --> 00:24:14,400 we still have the drive to eat because your body thinks I've 452 00:24:14,400 --> 00:24:17,680 worked really hard for this. I need these calories to sustain 453 00:24:17,680 --> 00:24:21,000 myself through the next day of hard work or God forbid of 454 00:24:21,000 --> 00:24:24,280 famine where I go, you know, a season where I don't have access 455 00:24:24,280 --> 00:24:26,280 to food. Well, you take that same human 456 00:24:26,280 --> 00:24:28,120 body. You put it in the post 457 00:24:28,120 --> 00:24:30,720 industrial age, you still have the drive to eat. 458 00:24:30,880 --> 00:24:33,800 When you try to manufacture a famine, that's called a diet. 459 00:24:34,360 --> 00:24:36,560 Your body goes, the food's right over there, bro. 460 00:24:36,680 --> 00:24:38,760 Like eat it. And you're like, no, I'm not 461 00:24:38,760 --> 00:24:40,280 going to. I'm in a famine. 462 00:24:40,280 --> 00:24:44,400 And it says, well, it is right over there and I'm going to make 463 00:24:44,400 --> 00:24:47,040 you eat it and I'm going to increase your appetite to 464 00:24:47,080 --> 00:24:50,160 intolerable levels. And that's where the concept of 465 00:24:50,160 --> 00:24:53,480 food noise comes in, right? The food noise becomes 466 00:24:53,480 --> 00:24:57,480 absolutely overwhelming to where it's all you think, feel, hear, 467 00:24:57,600 --> 00:25:00,800 smell. It's all that there is until you 468 00:25:00,800 --> 00:25:03,840 eat. OK, well, that's what we're up 469 00:25:03,840 --> 00:25:05,960 against. We're up against a body that has 470 00:25:05,960 --> 00:25:09,720 an unbelievably powerful tool to get you to do whatever it wants 471 00:25:10,000 --> 00:25:13,400 to maintain your weight. And I always, I usually share 472 00:25:13,400 --> 00:25:16,920 this stat because it blew my mind when I did this math. 473 00:25:17,760 --> 00:25:20,680 Let's say you maintain your weight, OK, or maybe you end the 474 00:25:20,680 --> 00:25:24,240 year within 2 lbs of where you started, which is most people's 475 00:25:24,240 --> 00:25:26,600 experience. No matter what people try to do, 476 00:25:26,880 --> 00:25:29,320 they usually end up where they started at the end of the year, 477 00:25:29,800 --> 00:25:34,080 if not a couple pounds heavier. Well, if you end the year within 478 00:25:34,080 --> 00:25:37,560 2 lbs of where you started, your body nailed it. 479 00:25:37,960 --> 00:25:47,560 Your insurance versus your outs to a 99.9998 percent degree of 480 00:25:47,560 --> 00:25:50,160 accuracy. You take however many, how many 481 00:25:50,160 --> 00:25:52,040 calories you burn in a year. It's about 1,000,000 calories 482 00:25:52,040 --> 00:25:55,600 for the average male and you ended up within 7000 out of 483 00:25:55,600 --> 00:25:58,720 1,000,000. Okay, think about that. 484 00:25:59,200 --> 00:26:02,440 And your body kept a perfect score. 485 00:26:03,080 --> 00:26:07,880 It knew exactly how much you needed to hit that number, and 486 00:26:07,880 --> 00:26:10,640 you did not have to try. It drove you. 487 00:26:10,920 --> 00:26:12,840 And this is where we have the illusion of control. 488 00:26:13,120 --> 00:26:17,800 An extra bite here, an extra sip there, an extra, you know, pita 489 00:26:17,800 --> 00:26:20,680 and hummus over there. An extra 2 bites of this or 490 00:26:20,680 --> 00:26:22,720 that. You think that you're in 491 00:26:22,720 --> 00:26:28,280 control, but you're not. Most people are, despite the 492 00:26:28,440 --> 00:26:32,280 attempts, kind of at the beck and call of our physiologic 493 00:26:32,280 --> 00:26:35,320 drives. And what I have come to terms 494 00:26:35,320 --> 00:26:38,960 with is that that is OK. Telling someone, hey, I want you 495 00:26:38,960 --> 00:26:43,440 to be off by 50,000 calories in a year when your body wants to 496 00:26:43,440 --> 00:26:48,000 be in a deficit of 0 is equivalent to saying, hey, you 497 00:26:48,000 --> 00:26:50,240 know what, just don't sleep anymore. 498 00:26:50,720 --> 00:26:53,800 Like being awake is better. You can get a lot more done, so 499 00:26:53,800 --> 00:26:56,440 just don't sleep, okay? Well, you might stay up for a 500 00:26:56,440 --> 00:26:58,840 day and you're really tired. You might actually be able to 501 00:26:58,840 --> 00:27:02,040 stay up for two days. You'd be really tired and day 502 00:27:02,040 --> 00:27:05,680 three you're hallucinating and day four you're asleep standing 503 00:27:05,680 --> 00:27:06,480 up. Okay. 504 00:27:06,600 --> 00:27:08,520 Physiology always wins in the end. 505 00:27:09,040 --> 00:27:13,520 The only way it doesn't win is through extreme application of 506 00:27:13,520 --> 00:27:16,840 intense effort forever, right? You can bend it out of 507 00:27:16,840 --> 00:27:19,840 tolerance, but you have to keep it bent because the minute you 508 00:27:19,840 --> 00:27:22,240 let go, it springs right back to where it was. 509 00:27:22,400 --> 00:27:24,800 OK. So I try to circle this back. 510 00:27:25,240 --> 00:27:29,000 So I graduate residency, I get right back on the horse. 511 00:27:29,160 --> 00:27:31,360 I hired a personal trainer. I started building my own gym. 512 00:27:31,640 --> 00:27:34,040 I paid someone a whole lot of money to work me out six days a 513 00:27:34,040 --> 00:27:35,960 week. And you know, my goal is to get 514 00:27:35,960 --> 00:27:37,680 back on a bodybuilding stage. OK. 515 00:27:38,000 --> 00:27:40,360 The only way I knew to do it was to do the same thing I'd always 516 00:27:40,360 --> 00:27:42,760 done. But knowing now that it was 517 00:27:42,760 --> 00:27:45,920 unacceptable, like now I was really hurting people around me 518 00:27:46,160 --> 00:27:49,400 and I knew that it was not good. Like I, I recognize now this was 519 00:27:49,400 --> 00:27:53,320 not the way, but I wasn't willing to just be fat and just 520 00:27:53,320 --> 00:27:57,040 be unhealthy. So I, you know, got back on the 521 00:27:57,040 --> 00:27:58,960 horse and kept trying to figure it out on my own. 522 00:27:59,600 --> 00:28:02,840 Well, in walked a dear colleague of mine in the emergency 523 00:28:02,840 --> 00:28:06,360 department who knew of my struggles, had had a similar 524 00:28:06,360 --> 00:28:09,080 weight loss journey. And she said, hey, I heard of 525 00:28:09,080 --> 00:28:12,200 this, this thing called semaglutide, it's a new drug. 526 00:28:12,560 --> 00:28:15,880 It's for diabetes. And supposedly it kind of like 527 00:28:15,880 --> 00:28:19,240 fixes the appetite problem and you just take it and your 528 00:28:19,240 --> 00:28:21,880 appetite goes away, your food nose goes down and you just lose 529 00:28:21,880 --> 00:28:23,520 weight. And I said, well, what do I need 530 00:28:23,520 --> 00:28:25,240 to know about this? That sounds great. 531 00:28:25,600 --> 00:28:28,320 And she said I don't think anything like apparently you 532 00:28:28,320 --> 00:28:33,000 just take it and it works. To which I said like my doctor 533 00:28:33,000 --> 00:28:37,160 brain fell out, my patient brain revved up into life and said 534 00:28:37,320 --> 00:28:41,440 sign me the Frick up for this right now because I am so tired 535 00:28:41,440 --> 00:28:45,320 of fighting this battle I don't want to do it anymore I cannot 536 00:28:45,440 --> 00:28:47,920 do this anymore. So write me a script. 537 00:28:48,360 --> 00:28:51,680 She wrote me the script. Semi glutide standard dosing OK 538 00:28:52,080 --> 00:28:57,120 .25 starting dose for four weeks escalate to .5 and off we go. 539 00:28:57,480 --> 00:29:00,760 All right, so I got the meds in the mail, read the instructions, 540 00:29:00,960 --> 00:29:06,760 took my first dose, and about 24 hours later, if you've been on a 541 00:29:06,760 --> 00:29:09,600 GOP 1, you know exactly what I'm talking about. 542 00:29:09,880 --> 00:29:14,440 Like when that stuff hits, like, you know, it, OK, your life 543 00:29:14,560 --> 00:29:18,440 changes, your body changes, your physical experience changes. 544 00:29:18,680 --> 00:29:21,920 And when I say change that first day after my first toast of some 545 00:29:21,920 --> 00:29:24,480 glutide, it's hard to overexpress. 546 00:29:24,640 --> 00:29:28,720 It's like the doors of heaven opened up and like a spotlight 547 00:29:28,840 --> 00:29:32,920 and of angels singing, you know, shone down on me because I was 548 00:29:32,920 --> 00:29:37,040 eating lunch and I was eating a really, really delicious meal 549 00:29:37,320 --> 00:29:40,720 that I would have wide knuckle my way through to not eat two or 550 00:29:40,720 --> 00:29:44,120 three of, probably eaten two or three of and then run on the 551 00:29:44,120 --> 00:29:45,480 treadmill that night to burn it off. 552 00:29:46,120 --> 00:29:50,080 And I got halfway through that rib eye sandwich and I all of a 553 00:29:50,080 --> 00:29:53,360 sudden had the most foreign sensation, which was just that I 554 00:29:53,360 --> 00:29:56,920 didn't want to eat it anymore. And I walked to the fridge and I 555 00:29:56,920 --> 00:29:59,960 wrapped it up and I put it in the fridge and I walked away 556 00:29:59,960 --> 00:30:02,480 from the fridge having like an out of body experience. 557 00:30:02,480 --> 00:30:07,360 Like what is this? Is this what it's like to feel 558 00:30:07,360 --> 00:30:12,080 full, to not fight this battle, to just be able to walk away and 559 00:30:12,080 --> 00:30:14,800 just not have interest in overeating? 560 00:30:15,920 --> 00:30:19,040 And I went about my day and I ate a little bit more that 561 00:30:19,040 --> 00:30:24,000 evening and I went to bed and I did it again the next day. 562 00:30:24,280 --> 00:30:26,920 And that first week was just absolutely amazing. 563 00:30:27,440 --> 00:30:29,160 I was like, this is what life should be like. 564 00:30:29,160 --> 00:30:30,480 I wasn't thinking about food all the time. 565 00:30:30,720 --> 00:30:34,000 I still had good energy, I felt good, still performing well in 566 00:30:34,000 --> 00:30:35,760 the gym. I just wasn't obsessing about 567 00:30:35,760 --> 00:30:40,640 food and it was fantastic. Well, next week I take the same 568 00:30:40,640 --> 00:30:46,680 dose .25 and 24 hours after that I didn't feel quite as good. 569 00:30:47,200 --> 00:30:50,400 Let's just say the doors of heaven had closed slightly 570 00:30:51,040 --> 00:30:53,760 because I just really didn't want to eat at all. 571 00:30:54,000 --> 00:30:57,440 And you know, I started to have a little bit of reflux and just 572 00:30:57,440 --> 00:31:01,240 kind of like, you know, this isn't like a great day, but you 573 00:31:01,240 --> 00:31:03,480 know, at least I'm not like fighting my appetite. 574 00:31:03,480 --> 00:31:05,760 So it's cool. Went through that week, you 575 00:31:05,760 --> 00:31:07,120 know, start to get hungry by the end of the week. 576 00:31:07,440 --> 00:31:10,120 Took dose 3. Dose 3, I didn't feel good at 577 00:31:10,120 --> 00:31:12,040 all. So I was starting to develop 578 00:31:12,040 --> 00:31:14,520 some real food aversion. I like thinking about eating was 579 00:31:14,520 --> 00:31:16,800 kind of making me feel sick. And when I did eat because I 580 00:31:16,800 --> 00:31:19,280 knew I had to like, I really didn't feel good. 581 00:31:19,520 --> 00:31:21,840 Like kind of that overly full feeling where you're like, man, 582 00:31:21,840 --> 00:31:24,360 like that just like I'm not enjoying this. 583 00:31:24,680 --> 00:31:27,680 I don't feel so good and not eating very much and starting to 584 00:31:27,680 --> 00:31:29,600 feel kind of fatigued and dehydrated and that kind of 585 00:31:29,600 --> 00:31:32,480 thing. Week 4, even worse, more and 586 00:31:32,480 --> 00:31:34,440 more sick, really not able to eat at all. 587 00:31:34,480 --> 00:31:36,320 And when I did, I I really didn't feel well at all. 588 00:31:36,320 --> 00:31:37,400 I had some nausea, had some bombing. 589 00:31:37,400 --> 00:31:40,960 I had a little bit of diarrhea. But again, like I told you, my 590 00:31:40,960 --> 00:31:44,000 doctor brain had fallen out. My patient brain was like, but 591 00:31:44,000 --> 00:31:48,640 the prescription says go up. So I doubled my dose and I went 592 00:31:48,640 --> 00:31:50,760 out to .5 and we all know what happened. 593 00:31:50,760 --> 00:31:53,440 I didn't leave the bathroom for a week. 594 00:31:53,680 --> 00:31:56,120 OK. I've like, I got really, really, 595 00:31:56,120 --> 00:31:59,120 really sick. And I continued to do my best to 596 00:31:59,120 --> 00:32:02,200 follow the standard dosing ladder because that was the 597 00:32:02,200 --> 00:32:05,560 ticket in the study to get maximum benefit and maximum 598 00:32:05,560 --> 00:32:07,480 weight loss. And I never felt good again 599 00:32:07,680 --> 00:32:10,280 after that. And three months later, I was 600 00:32:10,280 --> 00:32:15,600 down 30 lbs, Double thumbs up. And I got on in body scanner and 601 00:32:15,600 --> 00:32:18,120 I did body composition testing and I compared to where I had 602 00:32:18,120 --> 00:32:21,720 started and wouldn't you know, my body fat percentage had not 603 00:32:21,720 --> 00:32:24,760 changed. I had lost almost 2 lbs of lean 604 00:32:24,760 --> 00:32:27,640 mass for every pound of fat mass that I had lost. 605 00:32:28,080 --> 00:32:32,120 I ended 30 lbs down at almost exactly the same body fat 606 00:32:32,120 --> 00:32:34,760 percentage that I started at. I wasn't really healthier. 607 00:32:35,040 --> 00:32:38,480 I was lighter. I was smaller, but I was weaker. 608 00:32:39,240 --> 00:32:42,920 And on a body composition standpoint, I hadn't made any 609 00:32:42,920 --> 00:32:45,200 progress. And that was equally 610 00:32:45,200 --> 00:32:46,800 devastating. You know, I talked about 611 00:32:46,800 --> 00:32:48,640 devastating, you know, staying in front of the mirror, being 60 612 00:32:48,640 --> 00:32:52,840 lbs overweight, having, you know, defeat from the jaws of 613 00:32:52,840 --> 00:32:54,840 victory, right? I'm like, well, you know, I had, 614 00:32:55,040 --> 00:32:57,160 I had a lot of side effects, but at least I could lose the weight 615 00:32:57,160 --> 00:32:59,160 and at least I wasn't white knuckling my way through every 616 00:32:59,160 --> 00:33:01,400 day. That still felt like a win. 617 00:33:02,120 --> 00:33:04,600 And then you get to the end and you go, oh, I didn't really make 618 00:33:04,600 --> 00:33:08,080 much progress. I really harmed myself in the 619 00:33:08,080 --> 00:33:11,640 process of basically not eating for three months, right? 620 00:33:11,920 --> 00:33:14,480 And of course it makes sense in hindsight when you're basically 621 00:33:14,480 --> 00:33:16,880 not eating. I was, I was eating like 6 to 622 00:33:17,080 --> 00:33:20,120 900 calories a day of saltine crackers, right? 623 00:33:20,640 --> 00:33:22,360 Well, of course you're going to lose muscle. 624 00:33:22,520 --> 00:33:24,400 Of course you're not going to be able to perform in the gym. 625 00:33:24,400 --> 00:33:27,160 Of course you're going to be underfed and under nutrient head 626 00:33:27,360 --> 00:33:32,040 in that situation, but it felt like what other option is there? 627 00:33:32,120 --> 00:33:35,240 I either stop the medicine and I go back to fighting that same 628 00:33:35,240 --> 00:33:38,760 battle, which I wasn't willing to do, or I tough it out and I 629 00:33:38,920 --> 00:33:42,080 stay on the medicine and I tolerate the side effects to be 630 00:33:42,080 --> 00:33:44,840 able to get the outcome. Well, when the shoe dropped and 631 00:33:44,840 --> 00:33:49,120 my body composition came back as it was, I realized this didn't 632 00:33:49,120 --> 00:33:51,520 work. This isn't acceptable, but I'm 633 00:33:51,520 --> 00:33:55,800 not willing to go back to the life I had before of fighting my 634 00:33:55,800 --> 00:33:59,720 appetite every day. And so I became, this is the 635 00:33:59,720 --> 00:34:01,640 right term. And I'm a kind of obsessive 636 00:34:01,640 --> 00:34:05,680 personality, generally obsessed with how can I make this drug 637 00:34:05,680 --> 00:34:09,280 work for me because I had an an intuition. 638 00:34:09,560 --> 00:34:12,679 My first week was amazing. It's like my appetite was 639 00:34:12,679 --> 00:34:16,000 depressed, but I still got hungry when I ate, I got full 640 00:34:16,000 --> 00:34:19,360 fast, I still had good energy, I wasn't overly depleted. 641 00:34:19,800 --> 00:34:22,400 And that was to me what life was supposed to be. 642 00:34:22,600 --> 00:34:24,199 And then I never felt good again after that. 643 00:34:24,840 --> 00:34:26,639 And I just had the question, why? 644 00:34:26,880 --> 00:34:30,199 Like what happened in week two and three and four and five? 645 00:34:30,360 --> 00:34:34,639 Why did I have such a variable, unpredictable experience? 646 00:34:35,199 --> 00:34:40,000 And I put my doctor brain back in and I actually, you know, 647 00:34:40,480 --> 00:34:44,480 started to study the drug and you'd be like, OK, what is this 648 00:34:44,480 --> 00:34:46,400 drug anyway? How does it work? 649 00:34:46,639 --> 00:34:49,360 What are the pharmacokinetics? How do these those interact? 650 00:34:49,679 --> 00:34:52,480 And I, you know, came across kind of the standard like the 651 00:34:52,480 --> 00:34:55,199 pharmacokinetic equations for semaglutide. 652 00:34:55,199 --> 00:34:58,080 And I realized, OK, you, so the half life is 7 days. 653 00:34:58,200 --> 00:35:01,880 That means when you take your first dose on day zero at a 654 00:35:01,880 --> 00:35:06,240 week, there's still half of it left and you take the same dose 655 00:35:06,280 --> 00:35:08,800 again. So let's use round numbers. 656 00:35:08,960 --> 00:35:12,120 Unless you take 1 milligram. Well, you Fast forward a week 657 00:35:12,280 --> 00:35:14,760 from the patient experience side, you go, I'm, I'm taking 658 00:35:14,760 --> 00:35:17,440 the same dose. Great, no big deal, I'm not 659 00:35:17,440 --> 00:35:19,920 going up. But actually at the end of the 660 00:35:19,920 --> 00:35:22,360 week, there's still half a milligram left in your body. 661 00:35:22,640 --> 00:35:25,320 So you take 1 milligram and now how much is in you? 662 00:35:25,480 --> 00:35:29,200 I'll make you answer. 1.5 milligram. 1.5 So you, you 663 00:35:29,200 --> 00:35:33,240 increase your levels of the medication by 50% at the same 664 00:35:33,400 --> 00:35:36,080 dose. Well, OK, what did that do for 665 00:35:36,080 --> 00:35:37,680 me? I didn't feel quite so good, 666 00:35:37,840 --> 00:35:39,440 right? That was more medicine than I 667 00:35:39,440 --> 00:35:41,400 needed. You know, week 3 I'm like, well, 668 00:35:41,400 --> 00:35:43,680 thank God I'm not going up on my dose. 669 00:35:44,400 --> 00:35:48,040 Well, joke is on me because that same thing repeats the next 670 00:35:48,040 --> 00:35:50,280 week. Now half of that 1.5 is there. 671 00:35:50,280 --> 00:35:54,200 Now there's .75. Now you add on another one, now 672 00:35:54,200 --> 00:35:57,000 you're 1.75 and that cycle repeats. 673 00:35:57,000 --> 00:36:00,760 It takes 4 to 5 weeks, 4 to 5 half lives to reach any, you 674 00:36:00,760 --> 00:36:02,840 know, steady state for the medicine. 675 00:36:03,080 --> 00:36:08,920 So four different doses, or more precisely 4 of the same dose, 4 676 00:36:09,000 --> 00:36:14,760 distinct medication levels and therefore 4 distinct physiologic 677 00:36:14,760 --> 00:36:19,200 experiences as a patient. OK, well, what happens in week 5 678 00:36:19,360 --> 00:36:21,960 in the standard ladder? Do they let you stop? 679 00:36:22,160 --> 00:36:24,080 Do they let you hold? There they go. 680 00:36:24,080 --> 00:36:27,520 No, why don't you just go ahead and double your dose and then 681 00:36:27,640 --> 00:36:31,360 this is the the sick joke. It doesn't stop there because 682 00:36:31,400 --> 00:36:35,720 that cycle of accumulation happens again and you build up 683 00:36:35,880 --> 00:36:38,320 that higher dose over the next 4 weeks. 684 00:36:38,800 --> 00:36:42,360 If you follow the standard ladder for semaglutide, which is 685 00:36:42,360 --> 00:36:47,640 20 weeks of escalating doses, you will have 20 weeks of dosing 686 00:36:48,440 --> 00:36:53,320 and 20 distinct individual drug levels after each dose. 687 00:36:53,440 --> 00:36:57,800 You will not be afforded the opportunity to have the same 688 00:36:57,800 --> 00:37:02,520 experience in any week during the entire period of escalation. 689 00:37:02,880 --> 00:37:06,600 OK, now here's where I'm going to really put a focus on this. 690 00:37:07,200 --> 00:37:13,160 There surely there's one level of medication where you feel 691 00:37:13,160 --> 00:37:15,800 your best. I don't know if that is the 692 00:37:15,800 --> 00:37:20,120 level you would reach at week 1 or week 3 or week 8 or week 10, 693 00:37:20,680 --> 00:37:24,760 but there is one level where you as an individual, like this is 694 00:37:24,760 --> 00:37:28,960 my sweet spot, my personal doors of heaven opened up and I feel 695 00:37:28,960 --> 00:37:31,840 my best. Okay, that level does exist. 696 00:37:32,200 --> 00:37:34,480 Like it's obvious when you say it out loud. 697 00:37:34,720 --> 00:37:39,640 Of course you're an individual. There's a huge, wide range of, 698 00:37:40,320 --> 00:37:42,360 you know, potential drug levels of this medicine. 699 00:37:42,680 --> 00:37:45,960 And there's one spot in there where you would feel like your 700 00:37:45,960 --> 00:37:46,720 best. OK. 701 00:37:47,440 --> 00:37:50,640 The problem with standard dosing is it never asks the question. 702 00:37:50,920 --> 00:37:54,080 The standard dosing ladder was based on population studies to 703 00:37:54,080 --> 00:37:57,600 prove population efficacy. They had absolutely nothing to 704 00:37:57,600 --> 00:38:02,760 do with an individual person finding what is the right drug 705 00:38:02,760 --> 00:38:04,160 level for you. OK. 706 00:38:04,800 --> 00:38:07,440 And because it never asked the question, we never got an 707 00:38:07,440 --> 00:38:09,680 answer. Well, the FDA approved protocol 708 00:38:09,760 --> 00:38:13,800 is based on population studies, but we apply that population 709 00:38:13,800 --> 00:38:17,080 study to individuals. And so it results in a 710 00:38:17,240 --> 00:38:20,120 progressive escalation, which works great in the study 711 00:38:20,120 --> 00:38:22,800 environment that doesn't afford the individual patient the 712 00:38:22,800 --> 00:38:25,960 opportunity to stop. And to say, this is where I feel 713 00:38:25,960 --> 00:38:30,400 good because even if they keep their dose the same, they still 714 00:38:30,520 --> 00:38:32,680 increase. Do you understand that? 715 00:38:32,760 --> 00:38:35,720 Absolutely. That is so important, even if 716 00:38:35,720 --> 00:38:38,560 you stay the same. How did how did Lilly not figure 717 00:38:38,560 --> 00:38:40,160 this out? How did Lilly and Novo not 718 00:38:40,160 --> 00:38:42,320 figure this out? Well, there's two reasons why 719 00:38:42,720 --> 00:38:44,120 they did. They do know. 720 00:38:44,760 --> 00:38:47,640 For a population study, it's brilliant. 721 00:38:47,800 --> 00:38:52,160 It progressively increases medication levels consistently 722 00:38:52,200 --> 00:38:54,080 throughout the entire period of the study. 723 00:38:54,280 --> 00:38:58,560 So they get all of these snapshots on a population level. 724 00:38:59,120 --> 00:39:03,560 What does that look like? So it worked brilliantly to 725 00:39:03,560 --> 00:39:05,800 prove efficacy and to progressively move people 726 00:39:05,800 --> 00:39:08,320 through those medication levels to see what happened on a 727 00:39:08,320 --> 00:39:12,960 population basis. But their goal, and this is not 728 00:39:13,160 --> 00:39:15,640 anything we don't know, is to sell as much medicine as 729 00:39:15,640 --> 00:39:18,560 possible. So the incentive is not let's 730 00:39:18,560 --> 00:39:21,680 find the lowest effective dose. It's like, let's find the very 731 00:39:21,680 --> 00:39:24,520 highest dose that people can tolerate that produces the 732 00:39:24,520 --> 00:39:27,520 highest population weight loss. OK? 733 00:39:27,720 --> 00:39:31,480 So their goal is to get as many people as possible to 2.4 of 734 00:39:31,480 --> 00:39:34,280 semaglutide, to get as many people as possible to 15 735 00:39:34,280 --> 00:39:38,840 milligrams to Zapatite because they make the most money and on 736 00:39:38,840 --> 00:39:41,000 a population level, you get the most weight loss. 737 00:39:41,120 --> 00:39:44,400 Well, that seems like a win. And on a population basis, it 738 00:39:44,520 --> 00:39:47,640 kind of is. But on a personal, individual 739 00:39:47,640 --> 00:39:51,600 basis, when you overshoot your level, it's catastrophic, right. 740 00:39:51,800 --> 00:39:55,360 And the standard protocol doesn't give us the ability to 741 00:39:55,400 --> 00:40:00,200 identify where is the level for me and if I can find it, how do 742 00:40:00,200 --> 00:40:03,040 I stay there, OK, because fixed dosing isn't the answer. 743 00:40:03,160 --> 00:40:07,560 If I say I'm going to, you know, stay at 1 milligram, yet it 744 00:40:07,560 --> 00:40:11,040 continues to accumulate and your levels progressive increase even 745 00:40:11,040 --> 00:40:13,240 at a fixed dose, then fixed dosing can't work. 746 00:40:13,480 --> 00:40:14,680 OK. So we need something better. 747 00:40:15,320 --> 00:40:21,560 Well, my solution to that was delightfully labor intensive and 748 00:40:21,720 --> 00:40:24,520 utterly unscalable because I was like, you know what? 749 00:40:24,520 --> 00:40:28,080 I wonder if I can calculate my levels based on my previous 750 00:40:28,080 --> 00:40:29,640 doses. Can I? 751 00:40:29,640 --> 00:40:33,200 If as long as I know all of my previous doses, can I figure out 752 00:40:33,200 --> 00:40:36,440 where my level is today? And if I can figure that out, 753 00:40:36,440 --> 00:40:42,040 can I then identify where's my best level and how much do I 754 00:40:42,040 --> 00:40:45,680 need to take to get there every time I take a dose? 755 00:40:45,960 --> 00:40:49,120 Because I went back and I traced out my curve of these 756 00:40:49,120 --> 00:40:53,880 pharmacokinetic curves and I saw my first month and I could 757 00:40:53,880 --> 00:40:58,320 actually see it on day three after my first dose. 758 00:40:58,720 --> 00:41:02,040 I could identify this was my drug level on that day. 759 00:41:02,280 --> 00:41:04,680 And that is the drug level where I felt my best. 760 00:41:05,120 --> 00:41:07,000 But did I stay there? Nope. 761 00:41:07,200 --> 00:41:09,160 Nope. I just went walking right up the 762 00:41:09,160 --> 00:41:13,280 ladder, ran right past my therapeutic window, and I never 763 00:41:13,360 --> 00:41:15,600 felt good again. Well, imagine you could go back 764 00:41:15,600 --> 00:41:19,680 in time if you had a tool that could calculate your blood 765 00:41:19,680 --> 00:41:23,320 levels for you. And when you had that first good 766 00:41:23,320 --> 00:41:27,400 day where you're like, this is it, this is how I want to feel. 767 00:41:28,160 --> 00:41:32,800 And you can identify like with a real number, this is my ideal 768 00:41:32,800 --> 00:41:35,360 medication level. And then instead of just staying 769 00:41:35,360 --> 00:41:39,160 on the same dose and letting it escalate and overshoot, you can 770 00:41:39,160 --> 00:41:41,440 actually calculate. So how much do I need to take to 771 00:41:41,440 --> 00:41:42,840 hit that again? Simple as that. 772 00:41:43,040 --> 00:41:44,440 Well, it turns out that is possible. 773 00:41:44,520 --> 00:41:48,320 You can calculate your levels. You can identify the level that 774 00:41:48,320 --> 00:41:51,880 works best for you and you can calculate the precise dose to 775 00:41:51,880 --> 00:41:54,240 get there every time you take a dose. 776 00:41:54,640 --> 00:41:59,120 And you can also increase that level in a way that is visible. 777 00:41:59,280 --> 00:42:01,640 Instead of saying, I'm going to increase my, I'm going to double 778 00:42:01,640 --> 00:42:05,320 my dose and, you know, hope nothing bad happens, you go, 779 00:42:05,320 --> 00:42:09,240 what if I could just increase my level by like 2%, three percent, 780 00:42:09,680 --> 00:42:12,960 a little bit at a time? Just nudge it up to see if 781 00:42:12,960 --> 00:42:14,240 that's enough to break a plateau. 782 00:42:14,480 --> 00:42:17,720 Looking for what I call the minimum effective level. 783 00:42:18,280 --> 00:42:21,960 What's the least medicine as opposed to the pharmaceutical 784 00:42:21,960 --> 00:42:24,360 industry's goal? What's the least medicine I can 785 00:42:24,360 --> 00:42:29,240 take to have adequate appetite suppression to achieve my goals? 786 00:42:29,960 --> 00:42:32,880 And you know, if when you think about it that way, it's 787 00:42:32,880 --> 00:42:36,280 diametrically opposed to what the standard letter does because 788 00:42:36,280 --> 00:42:38,440 the standard letter says what's the highest level you can 789 00:42:38,440 --> 00:42:41,240 tolerate? And I'm asking what's the lowest 790 00:42:41,240 --> 00:42:44,480 level that I can take to still have a positive effect? 791 00:42:44,880 --> 00:42:47,880 All right. So the way I did that was with 792 00:42:47,880 --> 00:42:51,720 Google Sheets, a lot of pharmacokinetic equations and a 793 00:42:51,720 --> 00:42:55,040 whole lot of manual labor calculating at every dose. 794 00:42:55,080 --> 00:42:56,960 Where am I right now? Where do I want to be? 795 00:42:57,400 --> 00:42:59,720 What is the exact dose that I need to take to get there? 796 00:43:00,400 --> 00:43:02,480 Here's what happened. I had regained the weight 797 00:43:02,640 --> 00:43:05,520 because I wasn't satisfied with the amount of muscle loss. 798 00:43:05,520 --> 00:43:07,480 So I kind of regained all the muscle, got back to basically 799 00:43:07,480 --> 00:43:11,440 the same place and tried again, but this time dosing with 800 00:43:11,440 --> 00:43:14,280 precision, dosing with visibility and finding that 801 00:43:14,280 --> 00:43:16,760 minimum effective level, which turns out was very low. 802 00:43:17,520 --> 00:43:20,480 I didn't need that much medicine and I would not increase that 803 00:43:20,480 --> 00:43:23,600 level until I plateaued. That was kind of the goal and 804 00:43:23,680 --> 00:43:28,160 the baseline I said is I have to be able to eat enough protein, I 805 00:43:28,160 --> 00:43:32,080 have to be able to eat enough plants, and I have to be able to 806 00:43:32,080 --> 00:43:34,200 exercise. And if I wasn't able to do those 807 00:43:34,200 --> 00:43:35,720 things, then I would turn it down. 808 00:43:35,840 --> 00:43:38,600 OK, And just looking for that sweet spot all the time. 809 00:43:38,600 --> 00:43:41,560 Well, what was the outcome? You know, I lost the same 30 lbs 810 00:43:41,720 --> 00:43:45,080 and I barely lost any muscle and I was never sick and I had 811 00:43:45,080 --> 00:43:48,320 essentially 0 bad days in terms of side effects. 812 00:43:48,440 --> 00:43:52,000 And if I did have a bad day of side effects, guess what? 813 00:43:52,280 --> 00:43:54,240 I just turned it down a bit, right? 814 00:43:55,000 --> 00:43:58,240 Well, it worked and in fact, it worked extraordinarily well and 815 00:43:58,240 --> 00:44:03,240 it worked so well and it was such a life changing epiphany 816 00:44:03,240 --> 00:44:07,920 for me because all of a sudden I had that balance, right. 817 00:44:08,280 --> 00:44:10,920 I was able to function in my everyday life, fulfill my 818 00:44:10,920 --> 00:44:15,000 responsibilities, exercise, enjoy food when I was hungry, 819 00:44:15,280 --> 00:44:18,840 lose weight in a way that was controllable and also not fight 820 00:44:18,840 --> 00:44:21,400 my appetite. And so I, you know, at the same 821 00:44:21,400 --> 00:44:25,360 time, I'm in the ER taking care of patient after patient after 822 00:44:25,360 --> 00:44:28,520 patient after patient after patient with nausea, vomiting, 823 00:44:28,520 --> 00:44:32,720 diarrhea, gastroparesis, suffering terribly with these 824 00:44:32,720 --> 00:44:36,000 medicines, many of them coming in saying, you know, I couldn't 825 00:44:36,000 --> 00:44:39,600 eat, but my doctor doubled my dose and now I'm super sick. 826 00:44:40,320 --> 00:44:43,760 And then going like I've had pages, I asked my doctor, please 827 00:44:43,760 --> 00:44:45,960 don't go up. Like I'm already, I feel 828 00:44:45,960 --> 00:44:48,640 terrible. And I said, well, that's what it 829 00:44:48,640 --> 00:44:51,960 says to do to maximize your outcome, to get the, you know, 830 00:44:52,080 --> 00:44:54,120 it's not from a place of being malevolent. 831 00:44:54,320 --> 00:44:55,800 It's like, no, you need to lose weight. 832 00:44:56,080 --> 00:44:58,240 Being at the highest dose is how you're going to get there. 833 00:44:58,240 --> 00:45:00,520 We got to push through. We got to persevere. 834 00:45:00,640 --> 00:45:03,200 Like you'll adapt that, you know, you'll just feel bad for a 835 00:45:03,200 --> 00:45:06,360 while. OK, Well, what happens is you 836 00:45:06,360 --> 00:45:09,760 feel bad for a long time and then you Max out your dose and 837 00:45:09,760 --> 00:45:11,760 you plateau and you have nowhere to go. 838 00:45:11,920 --> 00:45:14,080 That's what really happens in real life. 839 00:45:14,760 --> 00:45:18,920 And so I'm seeing that in the ER and I'm going, OK, my life has 840 00:45:18,920 --> 00:45:22,320 forever changed. I've somehow stumbled upon the 841 00:45:22,320 --> 00:45:26,880 key to sustainable GLP one use to get the outcome that I 842 00:45:26,880 --> 00:45:30,560 actually, you know, need. And I see all these people that 843 00:45:30,560 --> 00:45:34,960 are just being mowed down by standard dosing and by this 844 00:45:34,960 --> 00:45:37,960 relentless accumulation of drug levels that overshoots their 845 00:45:37,960 --> 00:45:42,480 individual sweet spot. And so I basically, you know, 846 00:45:42,480 --> 00:45:44,960 quit. I retired from ER essentially. 847 00:45:45,040 --> 00:45:48,400 I still work one shift a month. I opened my own clinic and I 848 00:45:48,400 --> 00:45:51,920 opened it specifically to see if this worked for other people 849 00:45:51,920 --> 00:45:55,960 too, and to figure out how I could help to make this like 850 00:45:55,960 --> 00:45:57,960 scalable and part of the standard of care. 851 00:45:58,080 --> 00:46:01,480 Again, not scalable at all. The way I did it for a an entire 852 00:46:01,480 --> 00:46:05,000 year as I accumulated patients and took care of patients, I 853 00:46:05,000 --> 00:46:09,200 calculated every patient's levels at every single dose for 854 00:46:09,200 --> 00:46:12,120 every patient for a whole year. OK. 855 00:46:12,720 --> 00:46:15,960 The amount of patients I was able to do that for, it resulted 856 00:46:15,960 --> 00:46:19,160 in a cohort of 114 patients because anything more than that, 857 00:46:19,840 --> 00:46:22,000 like it was taking up every minute of the day, OK. 858 00:46:22,320 --> 00:46:27,920 But I ended up with a cohort of 114 patients that we did level 859 00:46:27,920 --> 00:46:30,200 based dosing on that. We found their minimum effective 860 00:46:30,200 --> 00:46:33,800 level and we didn't increase until until they plateaued and 861 00:46:33,800 --> 00:46:36,360 when they plateaued would increase by approximately 2%. 862 00:46:36,680 --> 00:46:40,200 Well, what was the outcome? We punched the numbers and I'm 863 00:46:40,200 --> 00:46:43,360 so like, I just get happy every time I say these things. 864 00:46:44,040 --> 00:46:48,880 They lost weight faster than the trials on half the medicine. 865 00:46:49,000 --> 00:46:50,680 Incredible. They lost weight faster than the 866 00:46:50,680 --> 00:46:55,280 trials shooting for a Max dose on half the medicine and some 867 00:46:55,280 --> 00:47:00,640 people on 1/10 of the medicine, a 20th of the medicine. 868 00:47:01,320 --> 00:47:04,000 We had patients that literally I've been have anecdotes I can 869 00:47:04,000 --> 00:47:06,480 share all day. I had a patient that I started 870 00:47:06,480 --> 00:47:08,800 her on, you know, she told me, hey, I'm really sensitive to 871 00:47:08,800 --> 00:47:10,280 medicine. So like maybe start me on like a 872 00:47:10,280 --> 00:47:12,400 really low dose. And he says, don't worry, I got 873 00:47:12,400 --> 00:47:14,360 you. We'll start you on .9 of 874 00:47:14,360 --> 00:47:16,480 tirzepatide. That's like a third of the 875 00:47:16,480 --> 00:47:19,000 starting dose. And she got violently sick. 876 00:47:19,160 --> 00:47:20,720 She had nausea, vomiting, diarrhea, didn't leave the 877 00:47:20,720 --> 00:47:22,760 bathroom for three days. Lost like 10 lbs in the first 878 00:47:22,760 --> 00:47:24,240 like week. And none of those are pounds you 879 00:47:24,240 --> 00:47:27,320 want to lose, right? Well, understand her dosing. 880 00:47:27,480 --> 00:47:29,920 Well, imagine what she would have done at 2.5. 881 00:47:30,200 --> 00:47:31,560 Let's think about that. OK? 882 00:47:31,920 --> 00:47:35,840 I already cut her to a third. Well, you know, under the old 883 00:47:35,840 --> 00:47:38,320 school mentality, you go, well, let's at least just hold you 884 00:47:38,320 --> 00:47:39,960 there. Let's not increase. 885 00:47:40,600 --> 00:47:45,040 Well, jokes on her because if I had kept her at .9, she wouldn't 886 00:47:45,040 --> 00:47:47,520 have been at .9, she would have been at 1.4. 887 00:47:47,640 --> 00:47:51,280 OK, I really want the listeners to understand that if you hold 888 00:47:51,280 --> 00:47:55,000 someone's dose, you don't stop the accumulation. 889 00:47:55,280 --> 00:47:58,640 OK, So what did I do for her? We calculated her level. 890 00:47:58,640 --> 00:48:03,640 What was her peak at .9? And let's drop from there. 891 00:48:03,920 --> 00:48:05,880 I'm not going to give you a dose that's going to put you there 892 00:48:05,880 --> 00:48:07,040 because that made you really sick. 893 00:48:07,480 --> 00:48:11,840 Well, the numbers came out. That dose was actually a tenth 894 00:48:12,080 --> 00:48:16,360 of the starting dose. It was like .25 of tirzepatide, 895 00:48:16,560 --> 00:48:20,640 so a tenth of the starting dose. And wouldn't you know, she lost 896 00:48:20,640 --> 00:48:22,960 a pound a week, every week after that. 897 00:48:23,560 --> 00:48:27,600 And she reached her goal weight, which was like 25 lbs down in 898 00:48:27,600 --> 00:48:31,000 about two to three months. Never had another bad day, 899 00:48:31,400 --> 00:48:33,880 didn't have any more side effects, and exited to 900 00:48:33,880 --> 00:48:36,880 maintenance, never having taken the starting dose of 901 00:48:36,880 --> 00:48:39,280 tirzepatide. OK, she's the exception. 902 00:48:39,520 --> 00:48:42,600 OK, she had, she was extraordinarily sensitive to 903 00:48:42,600 --> 00:48:47,600 tirzepatide, but when you think about that, she lost 25 lbs on 904 00:48:47,600 --> 00:48:50,120 1/10 of the starting dose of ters appetite. 905 00:48:50,280 --> 00:48:52,640 Why would she ever take more than that? 906 00:48:53,000 --> 00:48:56,000 Like if you can find that level for that person, why would you 907 00:48:56,000 --> 00:48:58,360 ever go up? There's nothing but downside if 908 00:48:58,360 --> 00:49:00,320 you're already, if your appetite is suppressed enough to lose 909 00:49:00,320 --> 00:49:03,760 weight, there is nothing but pain on the end of going up, 910 00:49:04,040 --> 00:49:05,760 right? So being able to find that 911 00:49:05,760 --> 00:49:10,560 level, stay there and hold is the key to sustainability. 912 00:49:10,640 --> 00:49:14,360 Because if you go up unnecessarily, I, I want you to 913 00:49:14,360 --> 00:49:16,320 really understand this, There's a cost. 914 00:49:16,720 --> 00:49:20,440 You drive your body to adapt to that higher level of level of 915 00:49:20,480 --> 00:49:24,360 medicine and you drive your body to be dependent on that higher 916 00:49:24,360 --> 00:49:26,320 level of medicine. We've all seen it, right? 917 00:49:26,320 --> 00:49:29,200 You have a patient who's on 15 milligrams of tirzepatide and 918 00:49:29,200 --> 00:49:33,840 they stop, they are absolutely ravenous and they will eat 919 00:49:33,880 --> 00:49:37,000 absolutely everything inside and they will regain weight faster 920 00:49:37,000 --> 00:49:39,880 than they would have otherwise because their body is now tuned 921 00:49:39,880 --> 00:49:41,960 to need that degree of GLP one stimulation. 922 00:49:42,680 --> 00:49:45,520 The answer is keep your level as low as possible for as long as 923 00:49:45,520 --> 00:49:49,680 possible to give yourself a chance to taper down and taper 924 00:49:49,680 --> 00:49:50,960 off these medicines successfully. 925 00:49:51,280 --> 00:49:54,520 It's a lot easier to maintain on one milligram per week of 926 00:49:54,520 --> 00:49:57,680 tirzepatide than it is to maintain at 15, right? 927 00:49:57,840 --> 00:50:01,640 But once you March yourself up to 15, it's really hard to come 928 00:50:01,640 --> 00:50:03,720 down. And then you get stuck. 929 00:50:04,000 --> 00:50:07,960 And you have this huge cohort of patients who are like prisoners 930 00:50:08,120 --> 00:50:11,280 of high doses of GLP ones, and they can't come off. 931 00:50:11,720 --> 00:50:14,840 But they're also not making progress because they plateaued. 932 00:50:15,000 --> 00:50:16,880 They've, you know, shredded their metabolism. 933 00:50:17,080 --> 00:50:21,240 They've lost all their muscle mass, and they just can't make 934 00:50:21,240 --> 00:50:22,560 any progress. So then they're they're really 935 00:50:22,560 --> 00:50:24,360 stuck. They can't come off, but they 936 00:50:24,360 --> 00:50:26,480 also maxed out the benefit. Does that make sense? 937 00:50:26,760 --> 00:50:29,800 100% and Speaking of percentages, This is why you've 938 00:50:29,800 --> 00:50:32,680 achieved a 0% patient dropout rate like that. 939 00:50:32,880 --> 00:50:35,680 I heard that statistic from Doctor Melissa Peterson and it 940 00:50:35,680 --> 00:50:39,640 blew my mind because I mean, in the trials we're having a 27 941 00:50:39,640 --> 00:50:42,520 percent, 34% dropout rate with. Oh, it's worse than. 942 00:50:42,640 --> 00:50:44,200 That it's. Crazy real life. 943 00:50:44,200 --> 00:50:46,520 It's 40 to 70% of people quit within the first year. 944 00:50:46,520 --> 00:50:48,840 Wow. It's not because they've reached 945 00:50:48,840 --> 00:50:51,920 their goal, it's because they either are too sick and can't 946 00:50:51,920 --> 00:50:55,520 tolerate it, or they plateaued and they're not making progress 947 00:50:55,520 --> 00:50:57,640 anymore, or it costs too much money. 948 00:50:58,120 --> 00:51:00,960 Well, guess what? All three of those are solved 949 00:51:01,200 --> 00:51:03,760 with level based dosing because you take the minimum amount of 950 00:51:03,760 --> 00:51:06,760 medicine, which results in the in the fewest possible side 951 00:51:06,760 --> 00:51:10,320 effects and cost the least money because you're buying the least 952 00:51:10,320 --> 00:51:13,200 medicine. OK, so yes, 0%. 953 00:51:13,200 --> 00:51:17,000 We did not have a single patient in our entire clinic quit due to 954 00:51:17,000 --> 00:51:20,440 side effects since since the first day of level based dosing. 955 00:51:20,440 --> 00:51:23,680 Because if they experience side effects, we don't tell them, 956 00:51:24,000 --> 00:51:26,320 tough it out, hold there and see what happens. 957 00:51:26,680 --> 00:51:28,680 We go, you know what, let's turn it down. 958 00:51:28,840 --> 00:51:32,160 You don't need to be vomiting all day long and unable to eat 959 00:51:32,160 --> 00:51:33,800 to lose weight. So we go, if that's your 960 00:51:33,800 --> 00:51:35,280 experience, we don't tolerate it. 961 00:51:35,680 --> 00:51:38,080 You turn it down and make sure that they find that sweet spot 962 00:51:38,080 --> 00:51:38,680 again. Yeah. 963 00:51:38,680 --> 00:51:40,640 So we never had a single patient drop out due to side effects. 964 00:51:40,640 --> 00:51:43,400 Now in Full disclosure, of course, we have had people leave 965 00:51:43,400 --> 00:51:45,960 the clinic due to cost. They lost their job. 966 00:51:46,280 --> 00:51:48,080 You know, they had a change of experience, They reached their 967 00:51:48,080 --> 00:51:49,800 goal weight, they wanted to cycle off the medicine. 968 00:51:49,960 --> 00:51:53,600 But those are elective choices. They weren't forced off because 969 00:51:53,600 --> 00:51:55,960 they couldn't tolerate it and they weren't forced off because 970 00:51:55,960 --> 00:51:58,520 they were jacked up to the highest possible dose and then 971 00:51:58,520 --> 00:52:00,680 got stuck. And so it's a, it's a huge 972 00:52:00,680 --> 00:52:03,440 advance for sure. And it's made an enormous 973 00:52:03,440 --> 00:52:05,240 difference in in our patient population. 974 00:52:05,440 --> 00:52:07,600 Really, it's incredible. And we were talking before we 975 00:52:07,600 --> 00:52:10,160 hopped on here to record and you said your your clinic is just 976 00:52:10,160 --> 00:52:13,760 inundated like you, you have too many people to be able to serve 977 00:52:13,760 --> 00:52:16,840 at this point. So obviously this is brilliant 978 00:52:16,840 --> 00:52:19,040 information to get out to other physicians. 979 00:52:19,040 --> 00:52:22,360 What advice do you have for clinicians who are prescribing 980 00:52:22,360 --> 00:52:25,560 GLP ones but struggling with patient adherence or side 981 00:52:25,560 --> 00:52:26,360 effects? Yeah. 982 00:52:26,640 --> 00:52:29,280 So the first thing I would say is I have several things I'll 983 00:52:29,280 --> 00:52:32,520 try to stay organized. 1 is just know that this happens. 984 00:52:32,640 --> 00:52:36,120 Understand the pharmacokinetics of these long acting medicines. 985 00:52:36,600 --> 00:52:40,000 Understand that just because you hold someone at the same dose 986 00:52:40,160 --> 00:52:42,440 does not mean that you are giving them the same amount of 987 00:52:42,440 --> 00:52:44,920 medicine as far as their bodily experience. 988 00:52:45,040 --> 00:52:48,760 So just understand how it works and then start to formulate a 989 00:52:48,760 --> 00:52:52,800 plan for how to deal with it because it is it just is these 990 00:52:52,800 --> 00:52:56,240 is is how what happens when you give fixed doses on a standard 991 00:52:56,240 --> 00:52:58,360 schedule for these medicines. So how are you going to deal 992 00:52:58,360 --> 00:53:01,120 with it? Well, I would suggest that you 993 00:53:01,120 --> 00:53:04,520 deal with it by calling me because we did develop an app 994 00:53:04,680 --> 00:53:08,120 that does all of this for you, calculate your drug levels, 995 00:53:08,320 --> 00:53:10,840 calculates the amount of medicine you need to take with 996 00:53:10,840 --> 00:53:14,360 every dose to hit that drug level, and allows you to up 997 00:53:14,360 --> 00:53:16,960 titrate and down titrate with precision. 998 00:53:17,480 --> 00:53:19,600 The app exists. It took me a year to build. 999 00:53:19,640 --> 00:53:21,280 We don't use Google Sheets anymore. 1000 00:53:21,600 --> 00:53:24,840 All this happens relatively automatically in our patient 1001 00:53:24,840 --> 00:53:28,240 population and we are to the point where we can allow other 1002 00:53:28,240 --> 00:53:29,680 clinics to use it. OK. 1003 00:53:29,680 --> 00:53:32,760 So if you're interested, if you have a clinic and you want to do 1004 00:53:32,760 --> 00:53:35,760 level based dosing with your patients, absolutely give me a 1005 00:53:35,760 --> 00:53:39,360 call. We will show you what it is, how 1006 00:53:39,360 --> 00:53:41,800 it works and you can decide if it's something you want to use 1007 00:53:41,800 --> 00:53:44,240 for your patients at this point in time. 1008 00:53:44,680 --> 00:53:47,280 This is not forever, but it is free, OK? 1009 00:53:47,280 --> 00:53:51,600 We're not selling it or licensing it in any way because, 1010 00:53:51,800 --> 00:53:55,840 and this is just the reality, I built it for myself and my 1011 00:53:55,840 --> 00:54:02,000 clinic and it is not built to any particular specification of 1012 00:54:02,000 --> 00:54:05,840 any sort of like, you know, SoC 2 compliance, you know, 1013 00:54:05,840 --> 00:54:09,240 healthcare, you know, technology, whatever. 1014 00:54:09,640 --> 00:54:13,080 It's a bootstrapped app that I built myself, all right. 1015 00:54:13,400 --> 00:54:16,080 So it's not something I can really sell, but it certainly is 1016 00:54:16,080 --> 00:54:17,520 something that other people can use. 1017 00:54:18,040 --> 00:54:20,760 Now we are developing an app that will be a commercially 1018 00:54:20,760 --> 00:54:24,280 available version that is built to spec, that actually checks 1019 00:54:24,280 --> 00:54:28,080 all the boxes that the FDA reasonably really cares about 1020 00:54:28,520 --> 00:54:31,040 for a piece of software that helps patients making medical 1021 00:54:31,040 --> 00:54:33,840 decisions. OK, That's not something you can 1022 00:54:33,840 --> 00:54:37,280 just put out in the world and let people use, you know, 1023 00:54:37,280 --> 00:54:40,640 without some rigor. All right, but in a limited 1024 00:54:40,640 --> 00:54:43,840 fashion for specific clinics who want to, you know, trial this, 1025 00:54:43,840 --> 00:54:46,320 we absolutely can make it available with appropriate 1026 00:54:46,320 --> 00:54:49,520 caveats and think sign just saying, hey, this is what it is. 1027 00:54:49,760 --> 00:54:52,360 It's an in house clinic developed app. 1028 00:54:52,760 --> 00:54:56,160 It's not, you know, a Google product you can just download 1029 00:54:56,160 --> 00:54:58,680 and pay for and it's going to work perfectly every time. 1030 00:54:58,680 --> 00:55:01,640 Like that's not the reality. It's what I would describe as an 1031 00:55:01,640 --> 00:55:06,760 advanced beta product, but it is available and we are onboarding 1032 00:55:06,760 --> 00:55:09,440 clinics to allow them to try this on their patients as long 1033 00:55:09,440 --> 00:55:10,800 as they walk into with eyes wide open. 1034 00:55:11,280 --> 00:55:13,960 And hopefully I've learned with technology, the timelines are 1035 00:55:13,960 --> 00:55:17,240 very tricky, but within three to six months, hopefully we'll have 1036 00:55:17,240 --> 00:55:20,200 a piece of software that anyone can license and actually use 1037 00:55:20,200 --> 00:55:21,360 that scale. Amazing. 1038 00:55:21,520 --> 00:55:24,880 Literally amazing. If you're a patient, we do have 1039 00:55:24,880 --> 00:55:28,680 capacity to take care of people that are interested in dosing 1040 00:55:28,680 --> 00:55:31,360 this way. It just depends what state 1041 00:55:31,360 --> 00:55:33,840 you're from. You know, like for example, I'm 1042 00:55:33,840 --> 00:55:38,080 licensed in, you know, 42 states, but I can't take care of 1043 00:55:38,240 --> 00:55:40,920 all of these patients myself. So I have a team of nurse 1044 00:55:40,920 --> 00:55:43,040 practitioners and, and other people in my clinic that also 1045 00:55:43,040 --> 00:55:45,560 take care of patients, but we're not all licensed in all 42 1046 00:55:45,560 --> 00:55:47,720 states. So it's like we can, we can take 1047 00:55:47,720 --> 00:55:52,200 care of the patients that come to us from states we're licensed 1048 00:55:52,200 --> 00:55:55,800 in that we have schedule availability for. 1049 00:55:56,440 --> 00:55:59,320 So I guess what I would say is if you're a patient, please 1050 00:55:59,320 --> 00:56:01,800 reach out. We will tell you if we can see 1051 00:56:01,800 --> 00:56:03,280 you. And if we can't see you, we'll 1052 00:56:03,280 --> 00:56:05,320 tell you when we can see you. Very helpful. 1053 00:56:05,320 --> 00:56:08,200 So we have a waiting list and you know, we're, we're getting 1054 00:56:08,200 --> 00:56:12,680 through people as as much as we can as quickly as we can. 1055 00:56:13,080 --> 00:56:14,760 You know, we're a, we're a small clinic. 1056 00:56:14,960 --> 00:56:19,000 You know, we're not a franchise chain with 100 clinics and 200 1057 00:56:19,000 --> 00:56:21,600 clinicians. It's me and two MPs, you know, 1058 00:56:21,600 --> 00:56:24,120 trying to do a cool thing with an app that I developed to 1059 00:56:24,200 --> 00:56:28,280 really solve my own problem, you know, But it's turned into 1060 00:56:28,280 --> 00:56:31,680 something really important. As most brilliant inventions are 1061 00:56:31,680 --> 00:56:34,920 to solve a very real personable problem for people. 1062 00:56:34,920 --> 00:56:37,840 So I mean, I was just, I was enamored by it the first time I 1063 00:56:37,840 --> 00:56:39,000 saw it. You know, reading your white 1064 00:56:39,000 --> 00:56:40,880 paper, that's something else that people can do. 1065 00:56:40,880 --> 00:56:43,080 They can go to your website, they can download that white 1066 00:56:43,080 --> 00:56:45,400 paper. They can read all of the data 1067 00:56:45,400 --> 00:56:48,640 that you've collected from those 114 patients over the year and 1068 00:56:48,640 --> 00:56:51,320 how the, you know, basically that the science of the app, 1069 00:56:52,160 --> 00:56:55,480 I've looked at it, it's incredible and I'm just sad you 1070 00:56:55,480 --> 00:56:57,920 guys aren't in California yet, so keep me updated. 1071 00:56:57,920 --> 00:57:00,480 Well, so my California license came through this week. 1072 00:57:00,640 --> 00:57:02,840 Did it now. Congratulations. 1073 00:57:02,840 --> 00:57:05,240 All right, stay tuned after. Yeah. 1074 00:57:05,240 --> 00:57:06,920 So stay, stay tuned. And you know, we're working 1075 00:57:06,920 --> 00:57:09,600 towards getting our entire team license in as many states as we 1076 00:57:09,600 --> 00:57:11,160 can to serve as many people as we can. 1077 00:57:11,360 --> 00:57:14,880 But I think that the the shortest term answer for most 1078 00:57:14,880 --> 00:57:18,560 patients is talk to your doctor, talk to your clinician, share 1079 00:57:18,560 --> 00:57:21,360 this podcast, you know, refer them to my website to learn 1080 00:57:21,360 --> 00:57:22,800 about it. Give them a copy the white 1081 00:57:22,800 --> 00:57:25,080 paper, help them understand there's a different way of 1082 00:57:25,080 --> 00:57:28,240 dosing these medicines that is extraordinarily more effective 1083 00:57:28,600 --> 00:57:31,680 than the standard ladder. And here's the thing, and I know 1084 00:57:31,680 --> 00:57:35,120 we're overtime, I don't blame doctors for doing this. 1085 00:57:35,400 --> 00:57:38,120 They don't have the time to do what I did. 1086 00:57:38,160 --> 00:57:42,000 What I did is completely not scalable in any way, shape, form 1087 00:57:42,000 --> 00:57:43,480 or fashion. OK. 1088 00:57:43,880 --> 00:57:46,720 I made a lot less money that year than I worked in the in the 1089 00:57:46,720 --> 00:57:50,960 ER because 100 patients isn't really enough to keep the doors 1090 00:57:50,960 --> 00:57:51,840 open. All right? 1091 00:57:52,200 --> 00:57:54,680 Primary care practices, you have to see a lot of patients. 1092 00:57:54,680 --> 00:57:55,880 You have to see them really quickly. 1093 00:57:56,200 --> 00:58:00,400 And the only way to really do that without this technology is 1094 00:58:00,400 --> 00:58:02,880 to see them really fast, to give them a standardized set of 1095 00:58:02,880 --> 00:58:04,840 instructions, and to see them in three months. 1096 00:58:05,200 --> 00:58:08,400 That's just the way the system works, and it's not their fault 1097 00:58:08,560 --> 00:58:12,560 they don't have time to go through and calculate every 1098 00:58:12,560 --> 00:58:15,480 single patient's levels and make these intelligent, personalized 1099 00:58:15,480 --> 00:58:19,040 decisions without a piece of technology that will do it for 1100 00:58:19,040 --> 00:58:21,080 them. So that's kind of the unlock 1101 00:58:21,080 --> 00:58:24,520 here is giving them a tool where they don't have to do the math. 1102 00:58:24,880 --> 00:58:27,920 The patient just knows what to take because the app does all 1103 00:58:27,920 --> 00:58:31,280 that math for them. OK, that is scalable. 1104 00:58:31,360 --> 00:58:34,080 That is something that my dream genuinely is for this to be the 1105 00:58:34,080 --> 00:58:36,680 standard of care for every single person, whoever takes an 1106 00:58:36,680 --> 00:58:42,080 injectable GLP 1 to dose in this method because it is so superior 1107 00:58:42,600 --> 00:58:45,320 to just throwing darts in the dark. 1108 00:58:45,680 --> 00:58:50,000 So if you're interested, go to voafit.com, VOA, fit.com. 1109 00:58:50,240 --> 00:58:53,920 If you go to voafit.com back slash my level, there's an 1110 00:58:53,920 --> 00:58:55,320 explainer in there. It goes through all the 1111 00:58:55,320 --> 00:58:58,320 pharmacokinetics, how this works, how the app kind of helps 1112 00:58:58,320 --> 00:59:00,720 to make these decisions. And there's also links to the 1113 00:59:00,720 --> 00:59:03,720 clinical white paper that I wrote just described in this 1114 00:59:03,720 --> 00:59:07,320 cohort how we did it, why we did it, what the outcomes are and 1115 00:59:07,320 --> 00:59:08,520 kind of what the future holds well. 1116 00:59:08,760 --> 00:59:09,960 That's going to be my next question. 1117 00:59:09,960 --> 00:59:13,560 So you preempted it, which is perfect. voafit.com, yes. 1118 00:59:13,720 --> 00:59:17,040 And I've been to the website, fantastic resources there. 1119 00:59:17,240 --> 00:59:19,880 I mean the case studies that you have are phenomenal. 1120 00:59:19,880 --> 00:59:22,120 They really are. So hopefully this isn't the last 1121 00:59:22,120 --> 00:59:25,080 time you're on the podcast. I cannot wait to get an update 1122 00:59:25,080 --> 00:59:28,120 with the next cohort and the next data set that you get 1123 00:59:28,120 --> 00:59:31,000 because I just think this is this really is the future of of 1124 00:59:31,000 --> 00:59:32,240 GOP ones. So. 1125 00:59:32,560 --> 00:59:35,680 For the this to become the future of GOP ones, you have to 1126 00:59:35,680 --> 00:59:38,120 actually prove it in a prospective fashion. 1127 00:59:38,200 --> 00:59:39,400 And so that's what's coming next. 1128 00:59:39,400 --> 00:59:41,480 You know, we're going to register an IRB trial. 1129 00:59:41,480 --> 00:59:43,960 We're going to get as many clinics as possible to treat as 1130 00:59:43,960 --> 00:59:45,800 many patients as possible in this way. 1131 00:59:46,280 --> 00:59:50,840 And if we can get a cohort big enough and reproduce those 1132 00:59:50,840 --> 00:59:55,240 outcomes at scale, then big pharma will have to listen. 1133 00:59:55,920 --> 00:59:58,920 And the reason they will have to listen is because they are in 1134 00:59:58,920 --> 01:00:02,560 crisis with the attrition rate of these medicines. 1135 01:00:02,800 --> 01:00:05,880 If 70% of your customers can't stay on the meds. 1136 01:00:06,360 --> 01:00:10,520 That's a big, big problem. Just makes me laugh to think 1137 01:00:10,520 --> 01:00:13,160 like any other illness, you know, people will be like, Nah, 1138 01:00:13,520 --> 01:00:16,320 maybe not, but weight loss people are like just just give 1139 01:00:16,320 --> 01:00:17,520 me a little bit more, let's try it. 1140 01:00:17,520 --> 01:00:18,640 Let's. Try it a little bit right 1141 01:00:18,640 --> 01:00:22,320 Exactly, exactly. And so if we can reproduce this 1142 01:00:22,320 --> 01:00:26,800 at scale and prove that you need half a medicine or less to lose 1143 01:00:26,800 --> 01:00:31,040 weight, even faster if you right size the dose of these medicines 1144 01:00:31,040 --> 01:00:34,520 to the individual person. I, I really do have that dream 1145 01:00:35,000 --> 01:00:40,040 that they will be open to making this a legitimate FDA approved 1146 01:00:40,040 --> 01:00:42,760 someday, the method of dosing these medicines that will just 1147 01:00:42,760 --> 01:00:45,000 open it up to the whole world and we'll see. 1148 01:00:45,080 --> 01:00:48,280 But the good news is it doesn't have to be FDA approved for 1149 01:00:48,280 --> 01:00:51,280 individual clinicians to do it. If you're a clinician who wants 1150 01:00:51,280 --> 01:00:53,720 to do this, you can do it today. Give me a call. 1151 01:00:53,800 --> 01:00:55,760 We'll set you up in the app. We'll get you started taking 1152 01:00:55,760 --> 01:00:57,320 care of your patients since. We'll see how it goes. 1153 01:00:57,640 --> 01:01:00,040 And we'll use it to collect a lot of data and hopefully make 1154 01:01:00,240 --> 01:01:02,120 the world a lot better for a lot of people down the road. 1155 01:01:02,480 --> 01:01:05,720 I love the idea of people being able to feel good on their 1156 01:01:05,720 --> 01:01:08,480 medication. As a former drug Rep, I feel 1157 01:01:08,480 --> 01:01:11,320 hesitant about the possibility of some of these larger 1158 01:01:11,320 --> 01:01:14,280 pharmaceutical companies, you know, buying into something that 1159 01:01:14,280 --> 01:01:17,480 cuts into their profits, even if it's more efficacious and better 1160 01:01:17,480 --> 01:01:19,480 for them. So I'm definitely curious the. 1161 01:01:19,640 --> 01:01:23,360 Only way is if it cuts the attrition rate to the point 1162 01:01:23,360 --> 01:01:26,160 where it's it's revenue neutral. Sure, that makes sense, You know 1163 01:01:26,200 --> 01:01:28,080 that? That's the the beauty is though, 1164 01:01:28,440 --> 01:01:32,240 I think the math actually works because if they take half the 1165 01:01:32,240 --> 01:01:35,640 medicine, but they still get the equivalent, you know, degree of 1166 01:01:35,640 --> 01:01:38,800 weight loss and you cut your attrition rate from 70 to 0. 1167 01:01:39,160 --> 01:01:41,280 And that's an exaggeration. Of course different people will 1168 01:01:41,280 --> 01:01:44,080 quit for other reasons, but there's a chance for that to be 1169 01:01:44,680 --> 01:01:47,560 economically viable and if that is the case, then there's a 1170 01:01:47,560 --> 01:01:50,320 chance for it to be accepted. So love it, We shall see. 1171 01:01:50,480 --> 01:01:52,320 We shall see. Best of luck and 1172 01:01:52,320 --> 01:01:55,200 congratulations, Doctor Ellis. Very cool work. 1173 01:01:55,280 --> 01:01:58,240 Just really incredible stuff that you're getting out to the 1174 01:01:58,240 --> 01:02:00,320 community of GOP 1 users. Thank you. 1175 01:02:00,640 --> 01:02:02,840 I'll just enter this. You know, I am a doctor. 1176 01:02:03,000 --> 01:02:05,880 I'm treating patients. But this was a passion of mine 1177 01:02:05,880 --> 01:02:09,120 because I was a patient and I still am a patient. 1178 01:02:09,200 --> 01:02:12,040 I still take GOP ones. I still am not willing to go 1179 01:02:12,040 --> 01:02:14,920 back to a world where I have to battle my appetite every single 1180 01:02:14,920 --> 01:02:17,360 day and be toxic and obsessive to have a healthy physique. 1181 01:02:17,960 --> 01:02:22,760 But what I've arrived upon with a lot of, you know, toil to get 1182 01:02:22,760 --> 01:02:25,920 to this point is where I know my levels. 1183 01:02:26,080 --> 01:02:29,640 I know exactly what I need to take to feel the way that I want 1184 01:02:29,640 --> 01:02:32,320 to feel for that particular season in my life. 1185 01:02:32,960 --> 01:02:36,600 I can go up, I can go down. I can cycle down, cycle off. 1186 01:02:36,680 --> 01:02:41,320 I can cycle back on I it puts me in control of my day-to-day 1187 01:02:41,320 --> 01:02:44,120 experience and allows me to live my life in a way that's 1188 01:02:44,120 --> 01:02:45,680 balanced. I feel like with these 1189 01:02:45,680 --> 01:02:48,720 medicines, so often people are controlled by the meds. 1190 01:02:48,840 --> 01:02:50,560 The Med doesn't allow you to eat. 1191 01:02:50,680 --> 01:02:54,360 The Med doesn't allow you to, you know, do XY or Z. 1192 01:02:54,360 --> 01:02:58,040 And I think that's also wrong. So the goal is for you to be in 1193 01:02:58,040 --> 01:03:00,760 control of your own appetite, for you to be in control of your 1194 01:03:00,760 --> 01:03:03,520 own day-to-day experience. That doesn't mean take as high 1195 01:03:03,520 --> 01:03:04,840 of a dose of medicine as possible. 1196 01:03:04,840 --> 01:03:08,800 So you can't eat for six months. You know, it's really the goal 1197 01:03:08,800 --> 01:03:11,160 here, I think is freedom. If anyone that struggle with 1198 01:03:11,160 --> 01:03:14,280 obesity, it's like, I just want to live life and be healthy. 1199 01:03:14,440 --> 01:03:19,280 Like please and have it not be so hard and with level based 1200 01:03:19,280 --> 01:03:22,200 dosing I think that's legitimately possible for almost 1201 01:03:22,200 --> 01:03:24,040 day one. It does sound like a very 1202 01:03:24,040 --> 01:03:26,120 exciting stuff. I appreciate you, Doctor Ellis, 1203 01:03:26,120 --> 01:03:29,560 coming on and sharing all this fantastic information and giving 1204 01:03:29,560 --> 01:03:32,600 us a little glimpse into the future of of healthcare with 1205 01:03:32,600 --> 01:03:35,400 regards to peptide. So thank you for your time today 1206 01:03:35,400 --> 01:03:37,880 and thank you everyone for listening to the podcast today. 1207 01:03:37,880 --> 01:03:40,240 It was wonderful. Thank you so much for having me 1208 01:03:40,240 --> 01:03:40,440 on.