Fat Loss Drugs w/ Brenna Thompson, RD

WEBVTT 1 00:00:09.940 --> 00:00:11.350 Twin Cities Kettlebell Club: I'm 2 00:00:22.380 --> 00:00:36.410 Twin Cities Kettlebell Club: alright. Welcome back to the platform. Podcast. I'm host, Jordan Kunde-Wright. Right? And with me I have my good friend Brenna Thompson, Rd. Registered dietician. Thank you for coming back, Brenna. 3 00:00:36.480 --> 00:00:38.070 Brenna: Oh, I'm happy to be here. 4 00:00:38.510 --> 00:01:01.329 Twin Cities Kettlebell Club: So for today's topic, I decided to bring Brenna in because we're gonna talk about the hot topic of 2023 and 2024, which are injectable weight loss drugs. So this is like the great weight debate that's going on right now, out in the space of weight, loss, and diet, you know, in the nutrition fields and personal training. And 5 00:01:01.360 --> 00:01:08.279 Twin Cities Kettlebell Club: you're hearing a lot about it. At least, I'm hearing a lot about it. Bren, are you? Are you hearing a lot about this in your practice as well? 6 00:01:08.500 --> 00:01:12.839 Brenna: So since I work for psychologist and I 7 00:01:12.910 --> 00:01:36.779 Brenna: I do treat all ages but a lot of what I see are mostly like teens, kids, and adults struggling with anxiety, depression, and Adhd I've had a few patients, the adults who have been on it, or who have asked about it a little bit. But it's not not the main thing. I'm hearing, however, in the podcast Lamb that I listen to, it is all over the place. 8 00:01:37.100 --> 00:02:02.039 Twin Cities Kettlebell Club: Yeah, you go Google, you go Google, search. You know, for any of these. Or you go look in the podcast. And you're probably gonna find a whole bunch of stuff out there. So we're gonna wait into that and put our own spin on it a little bit. But that was part of the reason I wanted to bring in Brenda's is as a dietician. She brings a little bit more authority to the discussion than I do. But with that said, I'm always gonna put the I'll put the the caveat out there. 9 00:02:02.390 --> 00:02:32.219 Twin Cities Kettlebell Club: We are not doctors. This does not constitute medical advice. Your own individual situation may vary. Please speak with your own medical provider. This is for entertainment purposes and educational purposes etc. Now that we've sufficiently covered our butts, I will, I will ask you first, what are the what are the weight loss? Injectable drugs that we've heard about? We know we'll Govi and Ozmik are 2 are 2 big ones, and we were just talking before we started recording that they're they're basically the same except well. 10 00:02:32.220 --> 00:02:49.959 Brenna: well, Govie is new, and it's different than Ozmik. So can you give us a little bit about. What are these these kind of families of weight loss drugs that that are out there? So they're actually basically the same thing. So Ozmik came out in 2,017. But we've had these Dlp. One receptor Agnus around since 2,005 actually. 11 00:02:49.980 --> 00:03:01.089 Brenna: And so Ozmik was, and is only used as a treatment for diabetes. We go. V is the same medication, but marketed for weight loss. 12 00:03:01.130 --> 00:03:31.129 Brenna: A couple of other drugs that people here are the man Jarro, and the rebels are basically the same things. They're all part of that semi glutied family of medications. Okay, you just said really big words, dlp semigides Glucagon like Peptides. So what are Glucagon? So G stands for Glucagon like Peptides, Glucagon, Glucagon like Peptides what what is it that these Glucagon, like Peptides. 13 00:03:31.200 --> 00:03:33.419 Twin Cities Kettlebell Club: do? For the body? 14 00:03:33.630 --> 00:03:48.420 Brenna: So we make this glp, one or a Glucagon like Peptide? So we eat our food, and it sits in our stomach, and then it moves into your small intestine, and when it hits that small intestine, this glp is released 15 00:03:48.830 --> 00:04:02.219 Brenna: by those cells in that small intestine, and they go to your pancreas, and they tell your pancreas they also go to your liver. They tell your pancreas to make either Glucagon or to actually 16 00:04:02.740 --> 00:04:06.279 Brenna: to suppress the Glucon and to make or to make more insulin. 17 00:04:07.410 --> 00:04:09.770 Brenna: That's kind of the the basic function there. 18 00:04:09.790 --> 00:04:24.839 Twin Cities Kettlebell Club: And so these. So these all started because this functionality is the same, and it's all dealing with the pancreas and insulin secretion. As far as I understand it, all of these started as diabetes medications. They were to treat people with either type, one or type 2 19 00:04:24.840 --> 00:04:43.390 Brenna: diabetes, and help and help the performance of their pancreas right in in this, in this pathway. Is that correct? For the most part. So what I learned in the last couple of weeks is that they actually like people started studying this peptide as a when they were looking at and trying to treat peptic ulcers. 20 00:04:43.590 --> 00:04:56.680 Brenna: Interesting, I did very interesting. And then they also noticed that it had some effects on the brain. And so there's there was a lot of research around its use, or its role in Parkinson's 250, 21 00:04:56.740 --> 00:05:04.550 Brenna: and they are still now looking at going down that rabbit hole of how could these affect the brain for Parkinson's and Alzheimer's disease 250. 22 00:05:04.940 --> 00:05:07.529 Twin Cities Kettlebell Club: That's very interesting. I 23 00:05:07.570 --> 00:05:34.029 Twin Cities Kettlebell Club: I will have to follow up on that cause. That that's really interesting. It's it is. It is interesting to me how much we're seeing the connection between insulin response, insulin response, insulin management and brain disorders and brain dysfunctions. Right? They're digging into that more and more, and trying to figure out, what is that connection? Is it all the gut, or is there some other? Is there some other function that's that's going on there. So would these be considered 24 00:05:34.030 --> 00:05:52.240 Twin Cities Kettlebell Club: off label uses then, or would they now be considered on label uses because they have been like Wagovi, for example, is specifically prescribed as a a as a weight loss truck. So what would using it for weight management be considered an off label use or an on label use for this. 25 00:05:52.320 --> 00:05:58.250 Brenna: So Ozampic is is used to treat diabetes weight the way Gov 26 00:05:58.320 --> 00:06:00.809 Brenna: is used to treat obesity. 27 00:06:01.340 --> 00:06:16.030 Brenna: So somebody goes to their doctor, and they say, I want to lose weight, I and you know, if they're checking their Bmi or their body fat mass index. They're like, I qualify for it. I need to lose weight then. Way Govi is being used 28 00:06:16.060 --> 00:06:41.620 Brenna: on label like it's being used for what it's supposed to It was designed what it was designed for. And it's and just, however, so we're clear off. Label doesn't mean that it's bad or negative. There are so many drugs that started, for one thing, that are as their primary on label use. And then they found side effects of the drugs ended up being ended up being very beneficial in a certain area. The most the most 29 00:06:41.800 --> 00:07:06.750 Twin Cities Kettlebell Club: obvious one that I can think of would be the little blue pill which started as a blood pressure management tool. That was what it was originally prescribed for. It was to help people with with high blood pressure get improved vasodilation, and they found that when you took it for improved vasodilation to lower your blood pressure it improved vasodilation and other areas 30 00:07:06.750 --> 00:07:41.810 Twin Cities Kettlebell Club: of the body. And suddenly things started working again. So now we can jack up the price and market it to a whole lot of men. Yeah, yeah, exactly. And I think I think we're seeing a little bit of that, too, with with these, especially with with Wagovi, specifically being marketed to people that are looking to lose weight. As opposed to just manage their insulin. But I'll ask a I'll ask an easier to answer. Question, why is it that managing insulin would help with people losing weight? So it's a it's a benefit that people are seeing. But the intended effect 31 00:07:41.810 --> 00:07:46.940 Twin Cities Kettlebell Club: UN originally was to help people manage their insulin. Why would those 2 things be correlated? 32 00:07:47.050 --> 00:07:50.569 Brenna: So when we, when we think about insulin, when we 33 00:07:50.660 --> 00:08:00.149 Brenna: eat our carbohydrates specifically those starchier carbohydrates. So things like potatoes, rice, pasta crackers, cereal. 34 00:08:00.580 --> 00:08:28.219 Brenna: you know. Some of your winter squashes would go in there ice cream cheesecake all of these delicious things. We eat those. They spike our blood sugar, and we can't have high, circulating, glucose levels that blood sugar, and we have to get it down, and the way the body does that is, the pancreas kicks out insulin, and that insulin acts like a key. It unlocks your cells, and then your cells able to pull that sugar into itself and use it to either burn energy or 35 00:08:28.790 --> 00:08:36.710 Brenna: it gets stored as fat. If our if we've just completely saturated both our muscle and our liver glycogen stores. We start storing it as fat. 36 00:08:37.669 --> 00:09:04.970 Brenna: but the problem is over time. Our cells can become insulin, resistant. And so they're kind of they're starting to tune out that insulin message, and our pancreas has to start putting up more and more insulin. And as we do that, we become more and more insulin resistant. We don't wanna hear that message. We don't wanna bring in that sugar, that glucose into our cells. And so we continue to just store it away as more fat. That's the easiest thing for us to do with that excess energy. 37 00:09:05.230 --> 00:09:30.270 Twin Cities Kettlebell Club: I'm I'm I'm chuckling to myself because I just had a I just had an image of an analogy. It's like when my son is on his pad, and he puts his headphones on, and he can't no longer can hear anything I'm saying, because now he is fully engrossed in his pad, and he had. And so it's like the only way I can get him to pay attention to be like pause that take your headphones away from their head. And you're like, Hello! I'm speaking to you. 38 00:09:30.270 --> 00:09:59.620 Twin Cities Kettlebell Club: So it's kinda like it's kinda like that. When when we become insulin resistance, the signal is no longer being heard from the outside, because other things other things, blocking those receptive, those reception channels. And so we become insulin, resistant. And what we want is insulin sensitivity, because that then decreases the amount of insulin that's necessary for our body to perform its functions the way it's supposed to regulate its blood sugar. So it goes to working muscles and working cells and not being stored as fat. Is that? 39 00:09:59.760 --> 00:10:09.329 Brenna: Yes, yes, fair summary. Now here's the interesting part. So when the job of glp is to 40 00:10:09.390 --> 00:10:18.679 Brenna: our blood, sugars are high or elevated is to tell the pancreas we need insulin, so it makes it spit out some more insulin. So this is kind of the weird part that 41 00:10:18.830 --> 00:10:30.339 Brenna: I'm still trying to wrap my head around is, how is it that when we're telling the pancreas to make more insulin? Because that's what the glp. One Agnes do is, they tell you, to make insulin 42 00:10:31.010 --> 00:10:40.139 Brenna: is, how is it not making us more insulin resistant? Well. there's another piece in here is where, after a while, for some people. 43 00:10:40.180 --> 00:10:50.369 Brenna: it's like their pancreas has been making so much insulin over time, is it? It just kind of even loses that message of like you're supposed to even make it and so now we've got 44 00:10:50.460 --> 00:10:59.710 Brenna: mit Ctl, and you know some people are going to be insulin resistant with high insulin levels. And then some people, we start seeing them insulin, resistant, and down the road we start seeing them, not even producing 149, 45 00:10:59.740 --> 00:11:01.840 Brenna: enough insulin to 46 00:11:02.770 --> 00:11:10.369 Twin Cities Kettlebell Club: so how much, how much weight loss is actually associated with these types of drugs. 47 00:11:10.530 --> 00:11:12.469 Brenna: people are losing 48 00:11:14.110 --> 00:11:17.400 Brenna: basically 15 to 20% of their body weight 49 00:11:18.160 --> 00:11:30.359 Brenna: these medications. And this is the first time there has ever been a weight loss medication on the market that has seen numbers like that. So it's it is impressive when people are on it, and it works for them. 50 00:11:30.560 --> 00:11:43.209 Brenna: They do lose weight problem and a fairly substantial amount of weight. And for some people that can make a massive difference in the quality of life that they are able to live 51 00:11:43.610 --> 00:11:52.289 Brenna: pain, management, and ability to get around. And just do you know, tasks of daily life? 52 00:11:53.360 --> 00:11:56.030 Twin Cities Kettlebell Club: Okay, yeah, that that makes sense. And now 53 00:11:56.080 --> 00:12:21.039 Twin Cities Kettlebell Club: it's also expensive. If I'm if I so one of the one of the negatives. If we're if we're talking so positives, I it's gonna it's gonna improve your. It's gonna improve your your insulin response. You know, a A in in. We're not quite. We're not quite sure why. Why, the why, the making more making more insulin is is necessarily a good thing, but it's getting your pancreas to make more insulin, and it's helping, and it is helping reduce helping reduce 54 00:12:21.040 --> 00:12:33.470 body weight, which we know will then improve insulin sensitivity over time as well. Right? So we know there's all sorts of associated benefits with with reducing your body weight and and life expectancy, quality of life, all of those things. 55 00:12:33.470 --> 00:12:53.650 Twin Cities Kettlebell Club: But the some of the negatives here are. It's expensive. It's typically at least at this point, unless I'm mistaken. And it it could change but as far as I understand it, like very few insurance plans will cover this this drug. So it's it's expensive, and it usually comes out of pocket. Is that your understanding, too? 56 00:12:53.680 --> 00:12:55.750 Brenna: Depending upon your insurance? 57 00:12:55.770 --> 00:13:22.539 Brenna: I don't know how much somebody's gonna pay for it. If your insurance pays none of it. We're looking at over 800 to over a thousand dollars per month. Medication? And these are once a week injections. Yeah, we should. Yeah, we should. We should specify that. Thank you. That's yeah. So this is one of the nice things about this is, it's a once a, it's a once a week thing. It's not a thing that you need to do every day or multiple times a day. So it's as far as ease of implementation 58 00:13:22.630 --> 00:13:35.780 Twin Cities Kettlebell Club: fairly easy to implement, because it is only one injection per week. Dosage varies based on the size of the human. I would, I would assume. So it starts out at a pretty low dose of I think it's like 59 00:13:36.090 --> 00:13:45.119 Brenna: like 0 point 5 ml's. And then depending upon the practitioner you're working with. And that's the big thing is, if you want, if somebody wants to try it. 60 00:13:45.470 --> 00:14:03.209 Brenna: they have the funds to do it, or the insurance to do it. Finding a practitioner who knows how to dose it, how to increase doses appropriately and then keep somebody on it or bring them off of it safely, and so typically start out at that point 5 ml, and then they will work up to the top dose, which I believe is 2.5. 61 00:14:04.550 --> 00:14:05.390 Twin Cities Kettlebell Club: Okay. 62 00:14:06.340 --> 00:14:36.070 Twin Cities Kettlebell Club: alright. So now now I'm curious. Part of the reason I wanted to talk about this is is because I am getting questions about it like you said, we're we're hearing about it. You don't work with with people in this space as much because you focus more on on people with behavioral behavioral issues and and things that you mentioned before. I, personally have been getting a ton of questions about. Well, I was thinking about trying this. Should I try it? Should I not try it? What are the side effects? 63 00:14:36.070 --> 00:14:58.240 Twin Cities Kettlebell Club: etc., etc. And people often think that I have a that. I come with a preconce. They come with a preconceived assumption about what? My, what my positions are. I'm curious, based on what you know of that right now, how do you feel generally about the use of of these drugs for for weight loss and for people that are using it for that purpose like they wanna they wanna lose weight. 64 00:15:00.580 --> 00:15:14.120 Brenna: I think we always talk about it depends. we had to go with the nuance answer. I think for some people it could. I would almost put it in the category of it could be life-saving for them 65 00:15:14.640 --> 00:15:17.610 Brenna: in that if they have legit 66 00:15:17.680 --> 00:15:31.810 Brenna: tried to lose weight. I'm talking about my patients where they have been on every diet. They have tried to lose the weight. Maybe they've been successful in the past, and they've lost 30, 5,100 pounds in the past, and then they try to keep it off. 67 00:15:32.610 --> 00:15:43.149 Brenna: and for so many reasons they can't. It's hard life happens. We can also talk about the fact that when people lose a lot of weight like that 68 00:15:43.160 --> 00:15:48.420 Brenna: we have this thing called our extracellular matrix around our fat cells, and it does not like to be empty. 69 00:15:48.490 --> 00:15:53.000 Brenna: It does not like to have to remodel. The easiest thing to do is refill it with fat. 70 00:15:53.770 --> 00:15:58.710 Brenna: our bodies very good at that and so whether somebody's lost 71 00:15:58.960 --> 00:16:10.040 Brenna: mit Ctl. And 2030 plus pounds, and maybe they keep it off for a while, and then it comes back. But then what do they have to do to try and keep it off, or to try and lose it again? 72 00:16:10.760 --> 00:16:15.479 Brenna: So II start thinking about that for my patients. But then 73 00:16:16.610 --> 00:16:25.920 Brenna: I'm just thinking of one woman that I did work with, where she said when she was on the medication she was for the first time in my life. I'm not thinking about food all day long. 74 00:16:26.250 --> 00:16:44.959 Brenna: she goes. I can actually think about the stuff I'm supposed to be thinking about at work. I can. I have the energy to clean my house and to think about doing other things, and to actually live my life versus all day, just being like, am I hungry? Am I not hungry? When am I gonna eat? What am I gonna eat? And you know, and then eating and then feeling guilty about it. And she was 75 00:16:45.030 --> 00:16:50.049 Brenna: the food noise is gone. and for her that was just liberating 76 00:16:50.430 --> 00:17:15.409 Brenna: interesting. I'm really curious. If that ties to Ghrelin secretion, then, because that to me decreased level of Ghrelin is being is being present in her in her brain. Okay, you said it. You said it does, did, or did you see a study that I didn't see? So what it does is it does so these medications. They decrease blood sugar, they slow gastric emptying. So food stays in the stomach longer, making you feel full. 77 00:17:15.540 --> 00:17:22.889 Brenna: It helps decrease, overall inflammation in the body. And then it does help decrease growing levels. 78 00:17:22.890 --> 00:17:45.990 Brenna: Yeah. And I could see if it if it slows the rate of gastric emptying those, those typically they're fairly correlated gastric, empty, the rate of gastric, empty emptying, and an inverse relation with the increase in growing right. As your as food leaves the stomach, your body starts producing more of the then Ghrelin is the the ho! The hunger hormone. II always tell people Ghrelin makes your stomach could go gur right. That's how that's how I remember 79 00:17:45.990 --> 00:18:11.630 Twin Cities Kettlebell Club: is when Ghrelin goes up. That's when you start getting the stom. The stomach grumbles that tell you tell you that you're hungry, so that to me that makes sense that tracks logically with, if we know that it slows gastric emptying, that it would also slow the rate of of Ghrelin production. So that's really interesting. That's the first. That's the first story. I've heard of of a a anecdot of somebody saying it because they weren't hungry. It it's 80 00:18:11.630 --> 00:18:20.049 Twin Cities Kettlebell Club: allowed them to focus on something other than food. That's that's really really interesting. I feel like that's potentially powerful, too. 81 00:18:20.930 --> 00:18:23.120 Yeah. And I think that's where 82 00:18:23.460 --> 00:18:33.639 Brenna: I see the benefit of it now. Are there plenty of people who are going to go to their doctors and ask for it when maybe they don't need to, or I don't want to say they haven't actually tried to lose weight the 83 00:18:34.220 --> 00:18:36.209 Brenna: the healthy way. 84 00:18:36.580 --> 00:18:40.179 Brenna: I think a lot of people go on diets. But I it's a little bit half-hearted. 85 00:18:42.530 --> 00:19:01.159 Twin Cities Kettlebell Club: So how do we? Yeah, how do we bounce? I cause that's that's always the thing that that that concerns me about it right? And so I've had. I've had a number of. I've had a number of clients ask me about it, and even people that I have been working with on on losing weight and people that have successfully lost weight in the past. And so I'm I'm usually 86 00:19:01.420 --> 00:19:14.389 Twin Cities Kettlebell Club: II don't want to say bipolar about it, but I've I've asked like back and forth, and this part of the reason I can never give people a clean answer on it when when they're like, Well, how do you feel about it? Because there's a part of me that's like, well, if you've been successful. Losing weight in the past 87 00:19:14.600 --> 00:19:30.689 Twin Cities Kettlebell Club: is the problem really something that you need an exogenous substance to help you know, in to introduce into your body to to help. Is it really something that you need? Because if you've been successful in the past, then you should be able to be successful in the future. 88 00:19:30.920 --> 00:19:38.850 Twin Cities Kettlebell Club: But then I toggle to. But were they really successful if they regained the weight, and then is the source of the problem actually 89 00:19:38.900 --> 00:20:02.430 Twin Cities Kettlebell Club: biological, or is it psychological? Or is it psych psychosocial? Right? It becomes, it becomes this really challenging like, how do you unpack and unravel whether or not you, you know, when somebody asks you as a pre pract practitioner, if somebody asks you, and I'm when I say you I mean me right. But for either of us right? If somebody asks you should I do this? I've been really thinking hard about it. Should I do this like 90 00:20:02.810 --> 00:20:15.510 Twin Cities Kettlebell Club: it? It's a. It's a tricky answer, because there's there's the part of me that is with you. It's like, Well, how hard have you tried in the past? Have you been successful in the past? Is this really? Is this really the right answer? Right? And 91 00:20:15.910 --> 00:20:33.920 Twin Cities Kettlebell Club: I don't know. I the it. It always depends on the person in front of me is kind of how I is kinda how I feel about it. But there's a part of me that, like there are people that really piss me off in this space? And part of the reason I want to talk about this, and it's it. There are trainers and nutritionists and Podcasters, and whatever 92 00:20:34.050 --> 00:20:58.910 Twin Cities Kettlebell Club: influencers that will say, no, this is terrible. You absolutely shouldn't do this. You're not working hard enough. You're not trying like you don't need these drugs like anybody that anybody that needs these drugs just hasn't tried hard enough, or they're not strong enough, or, you know, there's a very judgey type of perception. Listen. Even the people that have asked me have honestly felt like I was gonna be like, oh, no, you absolutely shouldn't do it that way, like, because people know I'm like the sustainable weight loss Guy, like. 93 00:20:58.910 --> 00:21:13.669 Twin Cities Kettlebell Club: I'm all about like, you know, building habits, and you know, like, don't, don't do crazy, and you know, lose it slowly and lose it steadily, you know, but at the same time, like people that are telling others 94 00:21:13.670 --> 00:21:38.640 Twin Cities Kettlebell Club: without understanding what their experience has been like or how hard it's been, or how like, yeah, maybe they successfully lost a hundred pounds. But maybe that entire time, like the person you're talking about. They were fucking, obsessed with food, and stop thinking about it because they were always hungry, or even when they weren't hungry. They were still thinking about like, Okay, I'm full right now, but I can't. What do? When do I get to eat again? When do I get to eat. What do I get to eat? Oh, shoot I 95 00:21:38.640 --> 00:21:44.329 Brenna: too much! And now I'm just gonna go down the the shame rabbit hole, and just 96 00:21:44.430 --> 00:21:49.059 Brenna: maybe it's binge purge. What? What does it, Trigger? 97 00:21:49.340 --> 00:22:02.569 Twin Cities Kettlebell Club: I don't know. I don't feel. II definitely feel I'm not in that camp where it's like you absolutely shouldn't do it. I'm definitely not in that camp, but I'm also not in the in the campus, like, Oh, we'll go. V for everybody. 98 00:22:02.680 --> 00:22:15.559 Brenna: I think, when people, whether they're listening to this, and they're considering it. or they're just want information, or they're asking you. The other question is to ask them, okay, so let's say you lose 30 to 60 pounds while you're on the medication. 99 00:22:15.960 --> 00:22:25.999 Brenna: Then what? What's the exit strategy? What is like? Are you going to have an exit strategy. Or are you going to be somebody who titrates down? And you're on this for the rest of your life? 100 00:22:27.120 --> 00:22:30.380 Brenna: And that's okay. And that's okay, like, here's the thing. 101 00:22:30.560 --> 00:22:40.020 Brenna: If if you're like, you know what. I'll be on this until I'm 70, 80 years old, because it means that I don't go back to whatever place I was at 102 00:22:40.270 --> 00:22:49.840 Brenna: cool. Just know that that means that for the rest of your life, once a week you have to give yourself an injection. And is that the worst thing in the world? No. Are they fun? No. But 103 00:22:49.900 --> 00:23:12.349 Brenna: what are the side effects? I guess that we didn't talk. We didn't touch on that like, what are the side? I know what some of the side effects are, but I'm gonna I'm gonna ask you, cause you're the one with the credentials here. So so the main side effects are naja, vomiting, diarrhea, heartburn, abdominal pain. Those are the big ones when they first start the medication, and then, when they increase their doses, 104 00:23:12.350 --> 00:23:28.610 Brenna: some of the, they can also feel very fatigued, but also get headaches. However, one of the shows that I was listening to with an endocrinologist talked about the fact that most of those headaches and the fatigue comes because they're not drinking enough. 105 00:23:28.700 --> 00:23:44.279 Brenna: because not only does it shut off our hunger queues, but it shuts off your thirst queues. And so people stop drinking. So the big thing is, if you're gonna start it. Make sure you are drinking enough, I'd say, like, use some salty water get on the electrolytes 106 00:23:44.390 --> 00:23:55.980 Brenna: element but making sure they were like, if people stay hydrated when they're on it. The fatigue and the 107 00:23:56.020 --> 00:24:02.619 Brenna: cut, a little bit of the nausea and the headache will start to go away just by staying hydrated. And then 108 00:24:03.700 --> 00:24:12.450 Brenna: some of the other, like that feeling of nauseous sometimes is just because people like, Oh. I'm actually full, or they're learning how much they need to eat 109 00:24:12.550 --> 00:24:18.570 Brenna: to not feel over full and stuffed. So there's there's a learning curve with it. 110 00:24:18.710 --> 00:24:39.810 Twin Cities Kettlebell Club: Yeah, I. And I mean, those are going to be similar symptoms to what you're going to to experience, if like, cause that I've also had people that got like a gastric sleeve, or, you know, got stomach surgery. This is far less invasive than that. And there are people that asked me about that that I was like, yeah, you absolutely should go through with that surgery because it was going to be life saving for them right like that's that's the thing is like, I think part of it is. 111 00:24:40.370 --> 00:24:58.429 Twin Cities Kettlebell Club: we have to measure this against what is the benefit and what is the potential risk of not changing right like if somebody is morbidly obese, and they've tried number of different ways. And they're like this is II need to get this under control, like, if you're 100 pounds plus overweight like 112 00:24:58.560 --> 00:25:28.009 Twin Cities Kettlebell Club: you're on, you're on a a curve that's not great, right? Like your life. Expectancy goes down significantly right. And for a lot of people they just know that they're headed down a path that is not great. And so for me, I feel like it's irresponsible as a practitioner for anyone, as a practitioner to discourage somebody from from leveraging all possible options. Of course you have to weigh the risks and benefit, and you have to assess the the person that's in front of you, and and talk to them, and make sure that they that that it's not a 113 00:25:28.350 --> 00:25:41.309 Twin Cities Kettlebell Club: it's not a parachute right like this isn't well, maybe it is a parachute like if we're talking about, if it's potentially life-saving like you're falling to the ground. And you're gonna die right like, if if they're not in. But if they're not in that level of severity right where it's where it's. 114 00:25:41.550 --> 00:25:42.540 you know. 115 00:25:42.840 --> 00:25:59.060 Twin Cities Kettlebell Club: vanity, right people. That's another thing. I hear people as well. Well, this is just a vanity thing it's like, is it really a vanity thing to to wanna lose 60 pounds? If you know you need to lose 60 pounds to be healthy. I don't necessarily think that's a vanity thing. But you know, that's that's neither here nor there. I just I feel like it's one of those things that 116 00:25:59.100 --> 00:26:08.749 Twin Cities Kettlebell Club: you have to look at it from the perspective of. I equate it to like, would you tell somebody that has cancer that they shouldn't do chemo 117 00:26:09.240 --> 00:26:09.960 Brenna: right 118 00:26:10.380 --> 00:26:18.609 Brenna: most back from that and say, Well. 119 00:26:18.680 --> 00:26:20.450 Brenna: if somebody has high blood pressure. 120 00:26:21.180 --> 00:26:38.429 Brenna: are we going to offer them a blood pressure medication like along with. And here's the thing is, if you're working with a good with a skill practitioner who knows how to dose this and use it appropriately. Not only should they be dosing it appropriately, they should also be telling you to eat a helpful diet 121 00:26:39.480 --> 00:26:47.330 Twin Cities Kettlebell Club: and and exercise, because here's the other thing is, yes, you will lose weight on it. But if you are still eating. 122 00:26:48.250 --> 00:26:49.949 Brenna: mostly carbs 123 00:26:50.100 --> 00:26:54.589 Brenna: and processed foods, and you're not exercising, what are you going to lose 124 00:26:54.810 --> 00:27:05.939 Brenna: muscle muscle, not fat, and that's part of the other problem is then, if people go off of it now, we've lost muscle. We haven't lost fat. We've lost some fat 125 00:27:05.950 --> 00:27:31.540 Brenna: but then, when we regain the weight. But yeah, if you focus too much on just losing weight, and you're not focused on changing body composition, which is a conversation you and I have had a lot of times about. People are overly focused on losing weight. And we're not thinking enough about? What does that weight comprise? You can be skinny fat at 150 pounds, or you can be lean and mean at 150 pounds right, like either of those things can be true. 126 00:27:31.540 --> 00:27:59.209 Twin Cities Kettlebell Club: Weight is just the gravitational force applied to your body. Right like that's all that that's measuring. It doesn't tell you what you're actually made up of, and that sarcopenia which is just muscle wasting is that's just the medical term for muscle wasting. Usually it's associated with age, but one of the side effects they list for these medications is sarcapenia. You may lose muscle tissue as you as you train these, but or as you or as you take these but one piece of a meat emerging research, that that I that I read recently was that 127 00:27:59.250 --> 00:28:22.950 Twin Cities Kettlebell Club: when you pair, this drug, any of these drugs with a high protein diet and by high protein I'm talking like one gram per pound of body weight, target body weight. So like, if you're if you're 300 pounds trying to get to 200 pounds, the prescription would be 200 grams of protein a day, right, if you if you pair it with a high protein diet and resistance training. 128 00:28:23.470 --> 00:28:27.510 Twin Cities Kettlebell Club: the level of sarcapenia is negligible 129 00:28:27.600 --> 00:28:53.770 Brenna: right? There's no more. There's no greater sarcapenia when using this drug. If you keep your protein high and your resistance training high, than there is associ than there is associated with any other type of caloric deficit. You are always going to lose some muscle tissue when you put yourself in a state where your body is losing tissue like you put yourself in a caloric deficit, so you can reduce your body stores. That's what we do. When we want to lose body fat. There is always an associated level of muscle loss that goes with that. 130 00:28:53.770 --> 00:29:07.410 Twin Cities Kettlebell Club: But the way that we mitigate that and make it as small as possible. We resistance train, and we eat a high protein diet. Guess what those things work, whether you're doing it with with the assistance of a drug or without. So if you, if you're hearing from people that these things 131 00:29:07.540 --> 00:29:31.980 Twin Cities Kettlebell Club: don't aren't good because they you lose a bunch of muscle. That's not fully true, right? But that's why it's important that you have a holistic perspective on this. And this is not the only tool in the toolbox. This is a holistic approach to changing your body composition. This is one tool. That's part of that, along with a healthful diet along with resistance training. And I would also argue along with some type of 132 00:29:31.980 --> 00:29:48.849 Twin Cities Kettlebell Club: identity work, and like internal work, either working with a therapist or working with a coach, or doing self-help, or some type of other thing to work on. The psychology of what got you to this place? In? In the first place, what is your relationship with food? And maybe that relationship with food is is 133 00:29:48.920 --> 00:30:01.220 Twin Cities Kettlebell Club: triggered by some of some of the growling effects that we were talking about, but like I feel like all of those things, need to be encompassed in a in A, in a plan. If we're going to introduce something like this. Sorry I'll step off my soapbox. 134 00:30:01.670 --> 00:30:04.590 Brenna: I don't even know where to go. After that 135 00:30:05.990 --> 00:30:19.659 Brenna: you just tell me to calm down. That's always acceptable. 136 00:30:20.230 --> 00:30:28.970 Brenna: you know, and then I think somebody could come back at you and argue. Well, why do you need a medication if we should just be eating, you know, 200 grams of protein and lifting weights. 137 00:30:29.580 --> 00:30:32.939 Twin Cities Kettlebell Club: And my response to that would be, have you tried that yet. 138 00:30:33.020 --> 00:30:51.729 Twin Cities Kettlebell Club: If you haven't tried that yet, that's always. That's always part of the conversation I have with somebody. If they're talking about this like well, what have we tried right? And so for people that for people that I that I personally have recommended. When they asked me that, I said, Yeah, I think you should. I think you should give it a shot. It was usually people that have spent like you said many years 139 00:30:51.770 --> 00:31:04.499 Twin Cities Kettlebell Club: have either successfully lost weight, but then regained it multiple times, or they've tried a ton of things without success, right and like, there is nothing worse. And 140 00:31:04.750 --> 00:31:29.540 Twin Cities Kettlebell Club: one thing that people need to be aware of. There is a biological portion. There is a portion of the population that biologically does not respond well to resistance. Training, like everybody thinks that resistance training works for everybody to change your body composition. There is a there is a small percentage of the population that just does not respond well to exercise that just it doesn't affect them one way or the other, right? Like it. It's really interesting. But there is a group of. 141 00:31:29.540 --> 00:31:35.910 Twin Cities Kettlebell Club: and maybe there are people that are like that. It's like they've never responded to diet and exercise right? But like. 142 00:31:35.910 --> 00:31:50.210 Twin Cities Kettlebell Club: if you haven't tried those other areas like you haven't worked with a coach before, and you know you haven't worked with a good nutrition coach. You haven't done it. You haven't done a a strong resistance training program. Rightly, I would go down that route first. 143 00:31:50.290 --> 00:31:59.729 Brenna: But like for a lot of people, they've tried that. They've tried. They've tried working with coaches. They've tried resistance programs. They've hired a nutritionist. They've hired a dietician right? 144 00:32:00.270 --> 00:32:09.039 Twin Cities Kettlebell Club: Maybe they had some success, but then they fell off, or whatever it wasn't sustainable for them, or they didn't have success at all. Right. If you haven't had success with those things. 145 00:32:09.180 --> 00:32:17.320 Twin Cities Kettlebell Club: I don't feel like if there's anything wrong with trying an exogenous approach that that might that might help paired with these other things that we know work. 146 00:32:17.520 --> 00:32:27.449 Brenna: Yeah, it just because somebody decides. Well, I've tried the things in the past. And now I'm gonna do. The medication doesn't mean like, I'm just gonna do the medication and go get chick fillet all the time. 147 00:32:28.580 --> 00:32:41.770 Brenna: So you're saying it's not a magic bullet. It's not a magic bullet, because then it you know, people talk about like Oh, I mean, some people will say I want to use the medication as a kickstart, or as a way to lose the weight 148 00:32:41.990 --> 00:32:54.790 Brenna: mit ctl. And lose the fat, so that then I can continue with like different habits, or I want to try and lose some of the weight so that I can move better. So I can do more at the gym and do more of the exercise. 249. 149 00:32:55.110 --> 00:33:06.250 Brenna: Because I mean you and I have talked before, like what I can do for a yoga pose is gonna be very different than what you can do for a yoga pose. Just based on our physiology. 150 00:33:07.420 --> 00:33:26.919 Twin Cities Kettlebell Club: I have a whole playlist on on my Youtube channel called Big Man mobility, and I've sent it to other people are like, I'm not sure this applies for me. I'm not. I'm not a I'm like, yeah, I was poorly titled. I need to re retitle that. But these are just General Yoga poses. But it was just me doing them. So that was why I titled it the way I did didn't mean that that was prescriptive. But 151 00:33:27.020 --> 00:33:28.500 yeah, it's 152 00:33:29.080 --> 00:33:54.550 Twin Cities Kettlebell Club: yeah. II find I find this to be really interesting. And I I'm I'll be interested to see what the longitudinal data starts to look like, cause. That's the other thing that I need to. I think we need to call out and couch this in is like these are still relatively new medications. So there's not a ton of longitude, and especially, and how they're not now being applied is now being marketed as a weight loss drug. So now we're not going to see a much larger sample size. And we're gonna see what are the effects of people over 153 00:33:54.550 --> 00:34:01.770 Twin Cities Kettlebell Club: periods of years where they've been on this, or they've tried this. They were on it for a period of years, and then off of it, right? We'll start to be able to hopefully see some 154 00:34:01.770 --> 00:34:24.789 analysis of the longitudinal effects of these, but I think I think in in summary, my my feeling on this is that it is a useful. It is a useful tool to consider. If you have tried many other interventions without success before, and that you should work with a professional to who who has a well rounded holistic approach to it, and that it might be useful if if you can afford it. And 155 00:34:25.139 --> 00:34:29.509 Twin Cities Kettlebell Club: and it's I think it's worth considering, depending on your situation. 156 00:34:30.580 --> 00:34:33.890 Brenna: I think that's the best thing. I've heard 157 00:34:34.159 --> 00:34:37.849 Brenna: many podcasts so far. You know. I 158 00:34:38.179 --> 00:34:47.309 Brenna: the other thing. II would caution with it is it's, you know, we're cutting people's food intake by one to two-thirds. Most people end up eating one to 2 meals a day 159 00:34:47.380 --> 00:34:48.490 Brenna: when they're on it. 160 00:34:48.699 --> 00:35:00.529 Brenna: and with a decrease in food intake comes a decrease in micronutrient intake. So then, I start looking at okay, like, what are people going to become deficient in, or what were they already deficient in. 161 00:35:00.550 --> 00:35:04.640 Brenna: And how are we gonna see that manifest down the line? 162 00:35:04.910 --> 00:35:06.139 Twin Cities Kettlebell Club: yeah, so. 163 00:35:06.180 --> 00:35:32.209 Twin Cities Kettlebell Club: and that's a that's a really good call out. And that is something I had thought about as well. So I'm curious. I'm putting you on the spot here. I know I didn't. I know I didn't prep you on this. But, like, if we're thinking about it, you're we decide, you know. You've got somebody that to that tells you like, I've decided I'm going to do this, what would be the tips that you would give them to help mitigate what we, what the known side effects are like if if I came to you and said, Yeah, I'm gonna start doing. We'll go. V. You know, we'll go v injections because I wanna lose. 164 00:35:32.210 --> 00:35:46.869 Twin Cities Kettlebell Club: you know, 80 pounds. What would you? What would you tell somebody as as your tips to like, mitigate those those negative side effects that we're, you know, potentially aware of, or or that we're aware of, or or think, or potentially there, just based on the mechanism of function that we know exists. 165 00:35:47.940 --> 00:35:57.549 Brenna: So I think we're gonna go with what we already talked about, which would be just eating enough protein. So when they sit down to the meals that they're going to eat is eat your protein. First, veggie, second, have your starch last 166 00:35:57.690 --> 00:36:02.190 Brenna: so that as they are eating, we know that we're hitting their protein targets 167 00:36:02.570 --> 00:36:20.219 Brenna: first and then we can fill up on some of those nonstarchy veggies just for the the fiber, the vitamins, the minerals that come with them get the starch if they're hungry enough for it. And go on from there and then, if we're talking about supplementation, I mean, I right now I'm putting everybody on vitamin d 168 00:36:20.570 --> 00:36:34.140 Brenna: because it's Minnesota in the winter. So so vitamin d. But then I'm also going okay. If people are eating less overall and is. 169 00:36:34.380 --> 00:36:51.829 Brenna: even if we're having them eat their protein. They're probably gonna end up being lower in their b vitamins. So I'd probably just put people on a really good either be complex or a higher dose multivitamin. So we just have a lot of our bases covered as an insurance policy. 170 00:36:52.420 --> 00:37:04.699 Twin Cities Kettlebell Club: Would you recommend? Would you recommend, like any type of blood work or mineral test like any anything like, would you? Because there's the like money, if no, if money is no object, there's the scientist in me that would be like. 171 00:37:04.700 --> 00:37:28.920 Brenna: let's do blood work on everything. See? Do you have any? Do you have any vitamin and mineral deficiencies at the start right. Get all of the data that we can start them on there, you know, on the specific supplements they need for any deficiencies they have. Right? Do the protein thing like monitor that like, how how far would you go down that rabbit hole? Because you can. You can spend, you know, just as much money on supplements a month as you are on the injections. If you're if you're not careful. 172 00:37:30.030 --> 00:37:43.890 Brenna: you know we're going to your physician. And do we just have a baseline on your cholesterol, your A. One C. Do we have a fasting insulin on somebody? Where is your vitamin d level for women in particular. I'd want to see their iron, their ferritin. 173 00:37:44.540 --> 00:37:54.450 Brenna: get a B 12, unless somebody. I don't ever really order B 12 or folates on people unless they are like vegetarian or vegan. 174 00:37:55.270 --> 00:37:56.240 Brenna: it's not it. 175 00:37:56.730 --> 00:38:01.170 Brenna: But I mean, that would be something to look at that. Or if they've had gastric bypass surgery. 176 00:38:01.480 --> 00:38:08.779 Brenna: Most people are deficient in magnesium. So I put just about everybody on that one, too. 177 00:38:09.420 --> 00:38:10.210 Brenna: so I 178 00:38:11.820 --> 00:38:37.370 Brenna: you can't. The problem with trying to test things like magnesium through just a regular serum blood test is the fact that your electrolyte, so magnesium, calcium, phosphorus, potassium, and sodium are so tightly regulated in your body that unless you are going through some like big metabolic shift, they're basically gonna look normal. They might look a little bit high, normal or a little bit low, normal. But if they're in range, your doctor is like, it's fine. 179 00:38:37.530 --> 00:38:45.189 Brenna: So unless you're gonna do something like a spectra cell intracellular test. 180 00:38:45.630 --> 00:38:47.199 Brenna: It's not going to tell you much. 181 00:38:47.540 --> 00:38:49.270 and that's I think that's why we 182 00:38:49.830 --> 00:38:51.420 Twin Cities Kettlebell Club: we both just are like. 183 00:38:51.700 --> 00:39:18.559 Brenna: take one pack of element a day to just just to cover your bases. Keep your electrolytes kinda in balance, and where and where we need them, cause we know most people probably don't don't consume enough of, especially of of magnesium and calcium phosphorus. And I will say this, I have been recommending element to so many people. I know it was created for more like the low carb, the keto, the fasting, the like highly athletic. 184 00:39:18.570 --> 00:39:33.420 Brenna: But I have so many patients that I have taking it because what have we been told for so many years? Salts, bad salts, bad for you. Don't salt your food, and a lot of people have gotten that message so they don't do it. The other message we get is, how much water are we supposed to drink 185 00:39:33.700 --> 00:39:47.820 Brenna: like gallon plus a gallon a day? I think there's what is it? The like? 75. Something. Challenge the 75 hard, and you're supposed to drink a gallon of water a day, Jordan, if I drink that much water. Do you know how I feel? 186 00:39:47.890 --> 00:39:49.770 Twin Cities Kettlebell Club: Probably bloated and like 187 00:39:49.830 --> 00:39:58.019 Brenna: you're you're probably on the toilet peeing. II feel terrible like you already know. It's hard enough to get like one and a half leaders in me. 188 00:39:58.690 --> 00:40:05.019 Brenna: But so we have this message of Don't salt your food and over hydrate all day long. 189 00:40:05.270 --> 00:40:15.820 Brenna: And so I have patients who are like, well, I'm just kind of like tired and fatigued all day, and like I get these random headaches, and I take their food inventory and then what they're drinking and, like 190 00:40:16.470 --> 00:40:22.820 Brenna: your electrolytes, are way out of balance like it would probably look normal on a lab, or maybe their sodium's a touch low. 191 00:40:23.150 --> 00:40:27.760 Brenna: I get them starting to use one or 2 packets of element and to quit drinking a gallon of water, and they feel better 192 00:40:27.960 --> 00:40:28.790 Twin Cities Kettlebell Club: weird. 193 00:40:28.930 --> 00:40:49.400 Twin Cities Kettlebell Club: I know it's crazy. The more is not always better. That's the whole thing like, that's the thing like that's the thing that always. Yeah, III maybe could do a whole other podcast on the 75 hard thing. But like that, like that whole thing of like, Oh, you need to drink a gallon of water. It's like says, who right like, and if that like, I'm literally 2 of you like 194 00:40:49.540 --> 00:41:02.550 Twin Cities Kettlebell Club: I should drink a gallon of water, and you should drink a gallon of water like I'm twice your size, like there's no reason we should have the same water prescription that makes 0 sense like that. That. Just yeah. Sorry. Tan Tang. 195 00:41:03.850 --> 00:41:12.599 Brenna: No. And and if people are wondering, the basic recommendations for water is to take your body weight in pounds, divide it in half, and that's how many ounces you should drink 196 00:41:13.290 --> 00:41:28.890 Brenna: a day a day. Now that doesn't take into account. If you live somewhere where it's really hot. If you have a job where you're extremely physical, and you're sweating a lot or doing whatever then there's a bunch of other calculations you can do on top of it. But that's your starting point. 197 00:41:29.060 --> 00:41:52.810 Twin Cities Kettlebell Club: Oh, Mike, I just I just did a a a you know, a nutrition, a nutrition seminar for for fueling and for for fueling, for athletes. And one of the things that's in there is about hydration is our body has a built in feedback mechanism for our level of hydration. It's called our urine. Like all like you, you really just ultimately like need to be king like light, yellowish to clear 198 00:41:52.810 --> 00:42:06.750 Twin Cities Kettlebell Club: couple of times a day. And so long as that's happening you're probably adequately hydrated. If you're peeing clear all of the time. You're probably hyper hydrating right and like, and if your pee is like, you know, Rusty, then that's a whole other thing, you know, like that's a 199 00:42:06.750 --> 00:42:16.660 Twin Cities Kettlebell Club: then you would. Then you're then you're dehydrated. But like, for most people like, so long as you use that feedback mechanism that your body is already giving you multiple times a day like 200 00:42:16.660 --> 00:42:29.409 you're probably all right and supplementing with some type of electrolyte or making sure that your electrolyte stay in balance because it's not just about water that keeps your cells actually hydrated, your electroly super super important? As well. 201 00:42:30.470 --> 00:42:48.209 Twin Cities Kettlebell Club: yeah, yeah, I'm good for those. Thank you very much. Brenna. Any other, any other things that you want to make sure that we call out that I didn't ask you about that you want to make sure we call out about the injectable weight loss drugs before we wrap for for this episode. 202 00:42:50.380 --> 00:42:54.659 Brenna: I mean, I guess the only other thing that we didn't really cover was like, who is 203 00:42:55.120 --> 00:43:05.599 Brenna: we? People will say, like, I need to lose weight. I have a lot of weight to lose. But who's actually qualifying for using the medication. Technically. 204 00:43:05.780 --> 00:43:18.100 Brenna: people should be 30 pounds over fat, meaning that they are carrying 30 pounds of extra fat. Not, you know, somebody who's extremely muscular is not going to be given this medication 205 00:43:18.260 --> 00:43:29.900 Brenna: but also looking at their other metabolic risk. Factors. So having high triglycerides, low hdl, high blood pressure high a one C, would also be qualifying factors for it. So 206 00:43:30.530 --> 00:43:51.109 Twin Cities Kettlebell Club: yeah, that is, that is a good, that is a very good call out, because I think with that with that filter you can say it rules out a lot of the people that that people would be judging, for these are these are vanity vanity seekers right like it is not something that that you should seek to use. If you just wanna lose 15 pounds, and I don't think there's a physician out there, at least not a reputable physician out there that would prescribe it to somebody that's like, Oh, I'm 207 00:43:51.110 --> 00:44:06.550 Twin Cities Kettlebell Club: II need this to help me lose weight. And they're like, Well, you're you, don't. You're you don't have 30 extra pounds of fat that you need to lose right like that that helps qualify out people that that are just looking to lose that little bit of extra, or that that stubborn 15 pounds that they can't get rid of. It's not for that. 208 00:44:06.640 --> 00:44:07.960 Brenna: Nope. Nope. 209 00:44:08.500 --> 00:44:32.890 Twin Cities Kettlebell Club: Awesome. Well, thank you very much. I apologize for my tangents, but this triggered. This gives me this gives me triggered in in a number of ways. But thank you so much for for coming on and bringing your expertise and your your professionalism to it, because I can't be trusted with these types of topics. II really I really always appreciate you being willing to hop on with me. And love love having you on so. Thank you so much, Brenda. We'll talk again soon.