July 10, 2024

Weaning Off Obesity Medications with Aliza Olive and Kellie Bader [Ep. 103]

Are you currently or considering taking a GLP-1 drug to help you lose weight? These include the semaglutide (like Ozempic and Wegovy) and tirzepatide (like Mounjaro and Zepbound).

What happens if you want to wean off? This is precisely the question we set out to answer in this week’s episode. Of course not everyone that uses these medications has the desire to wean off. And that’s ok. But if you are thinking you’d like to try a weight loss medication, but are worried about the after effects, this episode is for you!

Even if weight loss medication isn’t your jam, this episode is all about weight loss truths, whether you are taking a medication or not.

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Transcript

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This is the well think.

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Well, Well live well podcast.

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I'm Lisa Salisbury, And this is episode 103 weaning off obesity medications with Aliza Olive and Kellie Bader.

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Aliza and Kellie are the co-founders of med free maintenance.

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Aliza is a pediatric intensivist and Kellie.

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He is a pharmacist, but they both have extensive backgrounds in macro coaching and nutrition.

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In this podcast, they are functioning only as coaches, not as medical professionals, as they make it clear, they are not prescribers of these medications.

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However, I do think it's interesting to note their professional background.

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They founded med free maintenance as a tool for women and men coming off GLP one medications to prevent weight regain today, Aliza and Kellie, and I discuss what it takes to lose weight, regardless of medication status, what it's like being on these medications and especially what to do.

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If you think you might want to try weight loss medication, but you don't want to be on it forever.

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Please note this is not medical advice and you definitely should consult with your own doctor to see if you are a candidate for weight loss medication.

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You may also need to ask her or him if weaning off is reasonable and in your best interest.

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Now, please enjoy this episode.

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Welcome to Eat Well, Think Well, Live Well; the podcast for women who want to lose weight, but are tired of counting and calculating all the food.

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I'm your host, Lisa Salsbury.

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I'm a certified health and weight loss coach and life coach, and most importantly a recovered chronic dieter.

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I'll teach you to figure out why you are eating when you aren't hungry, instead of worrying so much about what you are eating.

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Welcome back to the eat well, think well, live well podcast.

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I am super delighted to welcome Aliza Olive and Kellie Bader here.

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They are the co founders of Medfree Maintenance and they are all about helping women and probably men.

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I'm not sure.

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Um, I'm getting some nods.

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Yes.

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Wean off some of the weight loss medication.

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So I'm really excited to have a great conversation about These medications that a lot of us are curious about.

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So if you guys could just introduce yourselves, tell us a little bit about what you do, and then we'll just jump into our conversation.

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Yeah,

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Sure.

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So I'm Kellie.

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we started this business to help women that decided that they wanted to use these medications, but never really intended to be on them long term have a solution to be able to transition off of medication without that big fear of the weight gain.

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And we hear in the studies that, weight gain statistics are so incredibly high and it's, it's okay.

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Common question, like, can we avoid this?

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Is that the way it has to be?

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And so we've found a solution for that.

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I'm Aliza.

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I'm Kellie's partner.

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I personally took some aglutide to lose about 20 pounds, uh, postpartum, after I finished breastfeeding my second baby.

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and same as Kellie, we both have a macro coaching background, and really just wanted to have a space for people who don't want to be on the medications forever, for whatever reason, to be able to wean off without gaining their weight back.

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Okay, perfect.

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So my first question is always when I talk to someone about these.

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drugs.

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First of all, let's kind of define, if you would, what class of drugs we're talking about.

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So I think we've seen a lot.

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There's so many now because it used to just be Ozempic and now there's a lot.

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So if you could speak to what these drugs are, and then maybe who should consider using them.

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Yeah, so, we are generally working with people taking any version of a GLP 1 medication.

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So, the brand names are Ozempic, Wegovy, there's a ton, and then the more generic names, I always pronounce it wrong, but Semaglutide, uh, Terzepatide, In general, we're going to be working with people who are on the compounded medications because if somebody's getting it from a physician and their insurance is covering it for diabetes or some reason where they should be on it long term, we are not here to tell anybody stop taking your medication against your doctor's advice.

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We're just here for people who are using it for weight loss and want to come off at some point.

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I think that's an important distinction that you're not really coaching people that are on these drugs for the type two diabetes.

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You're, Really looking to the folks that are using it for weight loss, and those are my clients as well.

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I'm not a type 2 diabetes coach, and so, yeah, I'm definitely coaching folks that are, generally their blood work is okay, but they want to drop weight.

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And I think the 2nd, half of your question was.

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Who should be taking the medications.

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Kellie and I both agree that these medications are a great tool for your toolbox.

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We have so many tools out there that can be used for weight loss.

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There's macro coaching, there's calorie counting, there's 8 million diets out there that generally fail and people gain weight back when they come off of them.

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Um, and this medication is here and it's easy to get at this point and it just really.

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Helps people who have struggled to lose weight, get the weight off with a lot less.

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don't want to say hard work because there is still mental work and everything that needs to be done and that's what we're here to help with, but the actual weight loss is just much physically easier because you don't have that constant.

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I'm in a calorie deficit and I'm hungry.

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When can I eat next?

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How much can I eat right now?

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And so on.

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still lose weight.

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It just takes away that component and helps you get the weight off.

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And it's a really great launching point for people.

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I

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So, that kind of answers my next question, which is, what are the benefits?

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Why, why do we want to take these?

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So, clearly, what you're saying is it helps you feel not as hungry.

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When you're in a deficit, anything else that you find as benefits over and above, just most people try to lose weight by managing their nutrition, which is.

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the tried and true method, right?

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That's how we, that's how we lose weight.

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what are the benefits on top of that?

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I think that this works really well for people to gain momentum.

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So when you're trying to lose weight and you're in a traditional diet, a lot of times, like Aliza was just saying, you're struggling every knuckling to, and as a coach, like, We don't want you to be struggling through that.

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So we help you build momentum.

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These drugs help you build momentum.

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So once you start seeing that weight loss, you're like, Oh, wow, this is, this is working.

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And so then that feels really, really good.

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Right?

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And so then you start building these habits alongside of the medication so that you can, Make this sustainable long term and not sustainable as in using the med, which like I said, like we already said, we're not against you continuing to use the medication, but most people that we are talking to are trying to get off the medication.

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So if you can gain that momentum, you know, we talked to so many people and they've tried everything and then we get someone that's like, oh, you just don't have enough willpower and determination.

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And it's like, no, These people do have enough willpower and determination.

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It's just not working.

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It's, and so now we have this drug in our toolbox that we can use to start to build momentum and start to see some of those wins so that we can gain that momentum to start drinking more water, start exercising regularly, start strength training, start eating your protein, start eating your fiber, do all those things that merely make you feel good.

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And then you're like starting to sleep better.

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You have more energy.

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It's just like this wonderful cascade so that you're building those habits while you're on medication so that you can eventually transition off.

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Does that make sense?

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Yeah, definitely.

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I, I always wonder too, if when you're on these medications and you start to see some of the portions that are actually, you're fine with basically, you're like, Oh, I guess I don't need an entire, like a whole sandwich.

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I guess really what is fine for me is a half sandwich or three quarters of a sandwich.

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And I actually feel fine as far as energy levels and concentration and those kinds of things, not like all of the other things that are.

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Not associated with hunger, because a lot of times I think, well, if I don't eat enough, I'm going to have low energy, or I'm going to have this afternoon slump, or I'm going to, like, other reasons besides I'm going to be hungry if I don't eat enough, and so I wonder if it helps people realize, like, wow, I really don't need as much food as I thought I did.

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Do you find that to be true?

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I think that sometimes people on the medications do struggle with getting enough, and we really have to work on that.

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So, making sure that you're not it.

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just eating 800 to 1200 calories.

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So getting enough so that you have those energy levels so that you're not losing your hair.

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So like all those side effects, disrupting your hormones that can come along with not eating enough.

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It's very important.

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So, but yes, you're also seeing that like, okay.

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This is maybe what a correct portion could look like and I now I have the time because I don't have this enormous food noise to look at the label and see what's the serving size even what what does that mean and how much is that because a lot of time like before.

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I started looking at labels.

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I thought peanut butter was a great source of protein.

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I was like loading up on the peanut butter.

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And then when I started looking at the label, it's like, Oh, wow.

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Okay.

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No wonder I was gaining weight.

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so it gives you that opportunity to slow down, look at those food labels.

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And another, you know, points that I want to make is This is your opportunity while you're on medication and you don't have as much food noise to address some of those, like, emotional eating things that come up that we deal with as coaches, stress eating.

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Why are we stress eating?

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Because that's, that's a possibility that it still happens even with the medication.

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And so when you can identify it and start making those changes while you're on medication, it'll make coming off of the medication so much easier.

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You can go, okay, when I was on the medication.

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When I was in this super stressful situation, what did I turn to?

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Because I wasn't hungry.

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How did I deal with my stress in a different way then and starting to, um.

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Pick up on some of those things is certainly, I think, an advantage and is another way that the medication can make you gain some momentum.

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If that makes sense.

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Definitely.

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Speak a little bit, if you could, about food noise.

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This is something I hear a lot about the benefits of taking this medication.

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And I do have clients on this, and they, they tell me, like, the food noise is reduced.

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But for people that maybe, you know, If you don't have that, or they wonder, is what I'm feeling termed, quote unquote, food noise, if you could just speak a little bit about what you believe that to be and how, how it reduces that.

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personally don't think I have food noise.

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I am hungry all the time.

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I am just one of those people.

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I probably have a relatively high metabolism.

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and I could eat All day.

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I'm one of those, like I had breakfast, it was full of fiber, full of protein.

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And two hours later I'm like, okay, well I need second breakfast.

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I need my protein bar.

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and so the main benefit for me was not feeling like I needed that and being able to actually space my meals out more appropriately.

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So I had breakfast and then I had.

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Lunch.

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Um, and maybe I had a smaller, you know, protein snack in between, but not like a full second breakfast.

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and, you know, I personally never went on a very high dose.

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I didn't want to be on a very high dose.

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I didn't want, as Kellie said, I didn't want to be in that 800, 000 calorie point where your metabolism is really just Um, and so I ate breakfast, lunch and dinner and probably a little bit of dessert and still had red wine in the evenings while I was on the medication.

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so I can't personally speak to the food noise, but I know a lot of people who struggle with their weight have that where They just think about food all day.

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I think about food all day, but it's because I'm actually hungry and I just want to eat because I have that feeling.

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But I think the food noise part of it is a lot more mental where it's just like, I love food or I love that feeling that sugar gives me and being on the medication, as you said, sort of can train your brain where you're not having that feeling all the time where it's like, Oh, I need candy.

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I want candy.

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I want soda.

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I want this.

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And you realize.

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I don't need that.

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I've lived for however many months you're on the medication without having that feeling.

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And so then when you come off, you can use what you learned from having coaching while on the medication to then change the way you feel about that.

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Or it may just go away entirely.

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Yeah, and to add on to that, like, I think the food noise, it has so many levels to it.

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Like, I don't know that there's like a true.

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Exact definition of it, but I think it's a combination of emotional eating stress, you know, which is also stress cravings and hunger.

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Like it's this combination, this triad of all the things.

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And so if we can, while we're on medication, we don't feel that.

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And so we can start to, okay.

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Okay.

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I don't feel hungry now.

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If I go off medication, some of the food noise is going to come back.

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But how can we prevent as much as possible with your fiber with your protein?

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kind of like spacing out your meals.

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Another thing to go along is while you're on medication, we don't want you skipping meals because that's not something that's going to be done in the future because otherwise it's going to cause that food noise to be even higher.

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what I've heard people explain that come off the medication, they still have the food noise.

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They've learned to deal with it better while they were on medication and they've improved their relationship with food.

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So, I think that that piece of it is really important.

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That's why, that's why coaching while you're still on medication is really, really valuable and while you're transitioning off because we've got to get past that.

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This is me in the past.

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I'm either on a diet or I'm F it.

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It's either one of those two, right?

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And so it's like, on or off, the food is good or bad.

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And you can discover while you're on the medication that like, Oh my gosh, I still can have some of these things and still lose weight.

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Oh my gosh.

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That means that I should be able to maintain my weight while still having, you know, 20 percent some fun foods and, and then making sure I'm getting enough.

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I like to use the word enough and getting nourishment.

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Because getting that enough, getting all that protein, that fiber and those vitamins from fruits and vegetables and all those good things, that's going to reduce that food noise a little bit because your body is nourished the right way.

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So just like Aliza said, like it's a combination of all of this stuff together that really makes it work.

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I like that.

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You talk about not skipping meals because that's not how we're going to maintain.

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Yes.

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You're talking to women who don't want to be on medication long term, but you're also trying to create lifestyle change, which is what this, these medications and what, I mean, frankly, what I'm trying to do with coaching without the medications.

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Which works great for a lot of people, but since we have this other tool, if I have a client ask about it, I'm like, yeah, totally ask your doctor.

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Totally, you know, like, obviously I can't make a recommendation because that's I'm not a doctor, but when we work on changes, I'm always working on things that we want to do as a lifestyle, not as a short term thing.

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If you don't think that you can exercise six days a week, like let's not make that a goal just for the weight loss period.

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If you want to be a person that goes on a walk every single morning, great.

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But Only if that's the way you think you're 60 and 70 year old self lives as well, right?

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So, I think that's really important that you're building a lifestyle even on these medications.

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It's not just a short term diet The other thing I want to just bring up is you're talking about enough This I think is such a key when people are on the medication, so many people, when we talk about some of the side effects, which I do want to ask about, but one thing I think that has been really scary to people is the muscle loss.

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Oh my gosh, you're going to lose muscle.

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And I'm always like, Hey, you're going to lose muscle.

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If you drastically diet any kind of way, if you cut.

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Your calories, any kind of way, if you're going to eat like a toddler and only eat 1200 calories, you're going to lose muscle.

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Like, I'm sorry, that's just the way it is.

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Am I correct?

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Absolutely.

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not the medication causing you to lose muscle.

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It's because you're not eating enough protein.

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Because you're not eating enough.

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Period.

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Yeah?

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Absolutely.

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Yes, you're absolutely correct.

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This happens on all like all low calorie diets.

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This will happen.

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So it's not specific to the drug.

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Yeah, it's not the medic, it's not the medication that causes muscle loss.

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It's a low, low caloric intake with not enough protein and no strength training that's going to cause muscle loss.

00:17:46.549 --> 00:17:46.980
Perfect.

00:17:47.420 --> 00:17:51.640
tell me a little bit about why protein helps preserve muscle,

00:17:51.880 --> 00:17:58.019
That's the whole concept behind macro counting and what makes it superior to pure calorie counting.

00:17:58.029 --> 00:18:03.650
So, you know, back in the eighties and nineties, it was count your calories, eat as little as possible.

00:18:03.799 --> 00:18:04.759
You will lose weight.

00:18:05.160 --> 00:18:05.549
Sure.

00:18:05.589 --> 00:18:10.690
You're going to lose pounds on the scale, but you're going to be losing muscle along with fat as well as water weight.

00:18:10.730 --> 00:18:18.079
And macro counting really came from more of the, CrossFit bodybuilding worlds where people wanted to have a lean physique.

00:18:18.545 --> 00:18:24.184
With muscle mass, and they realize that the thing that you need in that calorie deficit is protein.

00:18:24.664 --> 00:18:26.795
Our muscles are made out of protein.

00:18:27.005 --> 00:18:38.654
So if you are eating 1200 calories a day and 40 grams of protein, your body is going to preferentially break down muscle because it's more available to the body to break down what it goes to first.

00:18:39.115 --> 00:18:43.035
So if you're eating protein and feeding your muscles, what they're built of.

00:18:43.734 --> 00:18:48.345
your body will then start preferentially breaking down your fat cells instead of the muscle.

00:18:48.664 --> 00:18:51.255
and so that's really where this whole concept comes from.

00:18:52.164 --> 00:18:54.105
Most Americans don't eat enough protein.

00:18:54.305 --> 00:19:00.984
We've actually had arguments on social media with people who say, well, the ADA says, you know, you only need 60 grams of protein.

00:19:00.984 --> 00:19:02.922
So why are you telling people to eat more than that?

00:19:02.922 --> 00:19:04.224
Well, because the ADA is wrong.

00:19:04.295 --> 00:19:08.904
Like some of our government bodies and the recommending, you know, we have the food pyramid for how long?

00:19:08.914 --> 00:19:12.039
And that That's just not how life works either.

00:19:12.329 --> 00:19:16.144
so, we really think that people need to be getting about 0.

00:19:16.183 --> 00:19:18.953
8 to 1 grams per pound of ideal body weight.

00:19:18.963 --> 00:19:24.804
If someone weighs 250 pounds and they want to weigh 150 pounds, no, they should not eat 250 grams of protein.

00:19:24.814 --> 00:19:26.759
That's just, you know, That's crazy.

00:19:27.209 --> 00:19:38.439
Um, but getting over a hundred grams a day doable and a huge shift for your goals and your ability to be able to keep on, losing fat and not muscle.

00:19:38.588 --> 00:19:40.778
And our big thing is slow, sustainable changes.

00:19:40.788 --> 00:19:43.628
So if you're eating 40 grams a day, let's get you to 50.

00:19:44.134 --> 00:19:45.173
And then we'll take it from there.

00:19:45.183 --> 00:19:46.114
We'll go to 60.

00:19:46.173 --> 00:19:47.114
We'll go to 70.

00:19:47.483 --> 00:19:51.814
But having that protein intake is going to be so important for preserving your muscle mass.

00:19:52.269 --> 00:19:53.430
I hope that answered your question

00:19:53.480 --> 00:19:54.599
that's actually perfect.

00:19:54.619 --> 00:19:57.160
And honestly, it's like the way I explain it as well.

00:19:57.160 --> 00:19:57.474
I just.

00:19:57.984 --> 00:20:00.884
I just like to hear other people say it too, to confirm my own biases.

00:20:01.015 --> 00:20:01.674
right.

00:20:02.319 --> 00:20:03.059
It's not a bias.

00:20:03.059 --> 00:20:04.299
It's actually biology.

00:20:04.400 --> 00:20:05.130
So there you

00:20:05.275 --> 00:20:05.904
That's true.

00:20:05.934 --> 00:20:07.924
I better, better way to say it there.

00:20:07.924 --> 00:20:08.454
Thank you.

00:20:08.474 --> 00:20:17.934
Well, and then the other thing that she was saying about, the recommended amount that they're recommending right now, that's the minimum to like, just sustain.

00:20:17.944 --> 00:20:19.494
Like, that's not what we're going for.

00:20:19.494 --> 00:20:23.075
We're, we're trying to optimize, like, we're not trying to like, just.

00:20:23.775 --> 00:20:25.045
Prevent deficiency.

00:20:25.924 --> 00:20:27.674
We're not trying to prevent deficiency.

00:20:27.684 --> 00:20:28.825
We're trying to optimize.

00:20:28.825 --> 00:20:30.484
We're trying to be effective and efficient.

00:20:30.835 --> 00:20:39.551
So that's like, when I get that argument, it's just really hard to, it's really hard to hear that one because we're talking about the same things here.

00:20:39.551 --> 00:20:41.872
We're not talking about what you should get it.

00:20:41.872 --> 00:20:44.471
Like, we don't want to prevent it to deficiency.

00:20:44.481 --> 00:20:46.457
We want to, we want to, Optimize.

00:20:46.467 --> 00:20:46.826
So,

00:20:47.328 --> 00:20:52.929
I think there's such a big difference between normal and optimal, like on anything, like what's normal cholesterol.

00:20:52.929 --> 00:20:54.019
What's optimal cholesterol.

00:20:54.019 --> 00:20:56.088
What's a normal a one C what's optimal.

00:20:56.358 --> 00:20:58.608
So I think it's the same thing with protein intake.

00:20:58.618 --> 00:21:04.459
Well, what's normal isn't necessarily what's optimal, especially when you are Actively lifting weights.

00:21:04.459 --> 00:21:06.288
You're actively trying to build your muscle.

00:21:06.308 --> 00:21:19.144
And for those of us women in midlife, I hope that we are all, I mean, I'm constantly saying this, trying to build our muscle mass as well as bone health by strength training so that we have that.

00:21:19.164 --> 00:21:21.904
It's an insurance policy going into menopause and going

00:21:21.910 --> 00:21:24.019
So you don't break your hip when you're 75.

00:21:24.335 --> 00:21:24.855
Seriously.

00:21:24.855 --> 00:21:25.345
Yeah.

00:21:25.365 --> 00:21:27.894
Like we must have enough protein to do that.

00:21:27.894 --> 00:21:35.134
And I think that's why we see so much frailty in our mothers because they lived through the 80s and 90s because

00:21:35.400 --> 00:21:37.539
aerobics and all

00:21:37.585 --> 00:21:39.464
SEPA aerobics and snack wells.

00:21:39.704 --> 00:21:40.214
Right?

00:21:40.214 --> 00:21:41.624
I mean,

00:21:42.029 --> 00:21:43.818
Yeah.

00:21:44.204 --> 00:22:04.650
we had a subscription to Cooking Light magazine for years and years, and come to find out Cooking Light and, I mean, I still make some of their recipes, but one of the ways that those types of things made their recipes lower calorie or fit into what they qualified, it had to be lower fat.

00:22:04.680 --> 00:22:15.839
And so what they would do is they would jack up the sugar so that the overall fat percentage, the calories coming from fat met their requirements to be in the magazine.

00:22:15.849 --> 00:22:24.519
So, I mean, I make literal cakes that I still enjoy as a dessert from cooking light, but I have to cut the sugar because they're so sweet.

00:22:26.144 --> 00:22:28.085
I'm like, that makes no sense.

00:22:28.115 --> 00:22:28.855
That makes no

00:22:28.910 --> 00:22:29.779
Exactly.

00:22:29.789 --> 00:22:30.430
Yes.

00:22:30.740 --> 00:22:33.740
So, okay, let's talk a little bit about the side effects.

00:22:33.759 --> 00:22:39.559
I do have some clients that have had one client in particular that finally decided to go off just because of the vomiting.

00:22:39.940 --> 00:22:43.049
So just could not tolerate, could not find a dose that worked.

00:22:43.059 --> 00:22:44.089
And, and that's okay.

00:22:44.089 --> 00:22:53.519
Like, you know, we're still working on, other things but tell me a little bit about why that happens and percentages and that sort of thing.

00:22:53.559 --> 00:22:56.640
Like what, what can we expect for negative side effects?

00:22:57.563 --> 00:23:11.272
So I'll, I'll clarify with this, with the caveat that Kellie and I do not write for these medications, and we are here for nutritional support, but the physiology behind how these medications work is important to understand how they work.

00:23:11.702 --> 00:23:13.232
So they do two things.

00:23:13.242 --> 00:23:16.472
They act on your brain, and they slow stomach emptying.

00:23:16.692 --> 00:23:22.643
So there are medical conditions that also come with slowed stomach emptying, and people don't want that, right?

00:23:22.643 --> 00:23:23.873
It's called gastroparesis.

00:23:23.873 --> 00:23:26.762
It's something that can come with diabetes or other medical conditions.

00:23:27.292 --> 00:23:29.042
And it's not good, right?

00:23:29.103 --> 00:23:32.782
It's not ideal, but the medication does it so that you feel full.

00:23:32.932 --> 00:23:41.442
it works in conjunction with the changes in your brain to take away that food noise and the hunger to actually have the physical feeling of being full.

00:23:41.942 --> 00:23:44.292
And some people react differently than others.

00:23:44.323 --> 00:23:48.343
My husband and I both took some of glutide from the same compounded pharmacy.

00:23:48.712 --> 00:23:56.428
And the dose that he started on And I was on three times of a higher dose.

00:23:56.597 --> 00:23:57.748
He weighs a lot more than me.

00:23:57.867 --> 00:24:00.268
He's, you know, eight inches taller than I am.

00:24:01.442 --> 00:24:11.123
For all intents and purposes should have been on a much higher dose than me and he could not tolerate even going up from the initial dose that he took he had to go down and he eventually stopped the medication.

00:24:11.133 --> 00:24:12.792
He could not eat.

00:24:13.290 --> 00:24:17.891
I'm not trying to scare people away from the medication, but everybody reacts differently.

00:24:17.901 --> 00:24:22.480
And so that's why Kellie and I want to stay very far away from dosing recommendations.

00:24:22.480 --> 00:24:26.790
You know, that is between you and your provider and what works best for your body.

00:24:28.230 --> 00:24:30.990
the higher the dose you're on, the more side effects you're going to have.

00:24:31.020 --> 00:24:32.250
That's just a given.

00:24:32.621 --> 00:24:36.171
And the vomiting and the nausea comes from that slowed gastric emptying.

00:24:36.230 --> 00:24:39.820
So again, the higher your dose, the slower your gastric emptying, the worse you feel.

00:24:40.636 --> 00:24:43.426
I personally didn't have the vomiting that my husband had.

00:24:43.636 --> 00:24:46.686
I did have a little bit of nausea and I just took some medication for it.

00:24:46.686 --> 00:24:49.836
And that's why one of the many reasons why I stayed on a lower dose.

00:24:49.886 --> 00:24:53.767
But there are a whole host of, you know, some more serious side effects.

00:24:53.811 --> 00:24:55.701
Some just the nausea, vomiting.

00:24:55.912 --> 00:24:58.971
I had fatigue probably because I wasn't eating enough.

00:24:59.122 --> 00:25:04.442
Um, and so that's another reason to stay on a lower dose so you can get enough calories.

00:25:04.446 --> 00:25:08.372
You know, you don't need to be eating eight to 1200 calories to lose weight.

00:25:08.372 --> 00:25:11.311
You can lose weight on 14, 1500 calories.

00:25:11.771 --> 00:25:21.116
but you know, we have the nausea, we have the vomiting, we have fatigue, and then there's things like pancreatitis, some of the more scary things that people talk about that you obviously want to avoid.

00:25:22.751 --> 00:25:27.652
And are there any regular blood tests or anything that you have to do while you're on these things?

00:25:27.652 --> 00:25:31.402
Or are you just mostly looking for symptoms that might indicate other issues?

00:25:32.497 --> 00:25:36.946
I would say that's more of a provider prescribing provider question.

00:25:36.957 --> 00:25:38.787
We, um, do not.

00:25:39.017 --> 00:25:39.707
No, that's okay.

00:25:39.876 --> 00:25:41.396
We don't monitor lab values.

00:25:41.416 --> 00:25:44.017
We're just here to make sure people are getting enough nutrition.

00:25:44.731 --> 00:26:08.646
so, let me clarify, we were looking at Accutane for my daughter, and that's something where it's like, okay, when you're on this, you have to have a regular blood test, it's just kind of like part of the medication, there isn't anything like that, that's just kind of a standard that your provider will be like, because you're on this, we should standardly check this, it's more like patient specific, meaning what your history is, would determine what you might need to check.

00:26:09.892 --> 00:26:18.741
I would assume that yes, for the most, like, you hear me say assume, because we are not prescribing, but You know, if, if it's a little bit symptomatic.

00:26:18.741 --> 00:26:27.392
So if you're throwing up all the time, if you're not eating enough, like you might want to have like your regular just electrolytes check to make sure things aren't getting out of balance.

00:26:27.801 --> 00:26:30.291
but again, that's just like what I would assume.

00:26:30.291 --> 00:26:33.991
I don't think that there's any, like, you must check your liver.

00:26:34.082 --> 00:26:37.201
Like, there's nothing like that I am aware of at this time.

00:26:37.944 --> 00:26:43.115
I will say with the side effects, we're not like telling you how to manage them.

00:26:43.125 --> 00:26:50.444
But a lot of times, like the general recommendations would be getting in your fiber so that prevent constipation.

00:26:50.454 --> 00:26:52.015
That's another common side effect.

00:26:52.595 --> 00:27:00.585
Eating small meals and regular, like more often sometimes can help when you, a lot of times people, like we talked about, aren't hungry.

00:27:00.835 --> 00:27:09.085
So when you're skipping meals, it eventually is going to backfire and eventually later in the day, you're going to get enough hungry that you're eating a bigger meal.

00:27:09.224 --> 00:27:17.055
And then that's when all these side effects, and if we could just keep this a little bit more level and that's also practicing for maintaining as well.

00:27:17.065 --> 00:27:28.144
So having small, regular meals of, you know, all of the macronutrients, carbs for energy, fat for hormones, protein, we've talked about protein in depth.

00:27:28.494 --> 00:27:33.515
That's all very helpful for, the side effects of nausea, vomiting.

00:27:34.519 --> 00:27:35.980
making sure you're getting enough water.

00:27:36.359 --> 00:27:43.480
that probably doesn't get talked about enough, but you need to keep things like it slows your stomach down.

00:27:43.500 --> 00:27:46.450
And so you need enough water to keep pushing things through.

00:27:46.460 --> 00:27:52.900
So, um, keeping yourself hydrated because you're not eating as much is really going to be important as well.

00:27:53.859 --> 00:27:55.119
Trying to think of some other ones, but.

00:27:55.680 --> 00:27:59.089
Obviously, like everyone has a little bit different side effects.

00:27:59.089 --> 00:28:01.690
So each side effects a little different to treat.

00:28:01.740 --> 00:28:05.779
And so we don't have like a going list of like, these are the best ways to do this.

00:28:06.289 --> 00:28:10.240
Definitely talk to your provider, so that you know, what your options are.

00:28:11.305 --> 00:28:13.255
no, your answers have been really helpful.

00:28:13.255 --> 00:28:17.855
I think because I mean, you do see some things just kind of commonly.

00:28:17.855 --> 00:28:18.795
So that's great.

00:28:19.174 --> 00:28:22.355
so let's get to the big question, which is, is weaning off possible?

00:28:22.535 --> 00:28:23.404
that's the biggest thing.

00:28:23.414 --> 00:28:31.902
I think that's the main reason why people don't want to start because they're like, I don't want to do this forever.

00:28:31.942 --> 00:28:42.176
And I think for some people, they think You know, I don't want to be on a quote unquote medication forever, but I mean, for me, I would just be like, I'm afraid to give myself a shot.

00:28:42.787 --> 00:28:45.717
Oh, there's that that I don't want to do.

00:28:46.207 --> 00:28:49.717
but they feel like, well, if I'm on this, I'm going to be stuck.

00:28:50.086 --> 00:28:52.022
What would you say to that?

00:28:52.964 --> 00:28:54.755
Well, I'm our poster child for that.

00:28:54.765 --> 00:28:57.404
So Kellie, as we mentioned, has not taken the medication.

00:28:57.414 --> 00:29:05.214
She did this the old fashioned way, lost 40 pounds with macro counting and has maintained, with the same method that we use to get people off.

00:29:05.674 --> 00:29:08.934
I lost 20 to 25 pounds, on the medication.

00:29:08.934 --> 00:29:11.744
I have also done it the old fashioned way after my first baby.

00:29:12.095 --> 00:29:14.424
but I agree, people don't want to take it forever.

00:29:14.865 --> 00:29:25.734
You didn't mention expensive is one of the other big things, you know, um, Even with insurance, some people are still paying 500, 500 or more dollars a month.

00:29:25.765 --> 00:29:34.775
And then when you're looking at the compounded ones through more of a, a med spa or some, a clinician, it's I think three to$500 a month.

00:29:34.805 --> 00:29:36.575
It, it can be very expensive.

00:29:36.845 --> 00:29:42.595
So this is not something that financially people want to stay on forever and the side effects.

00:29:42.805 --> 00:29:43.914
And also, yep.

00:29:44.095 --> 00:29:45.894
I mean, I'm fine giving myself shots.

00:29:45.894 --> 00:29:47.214
That actually doesn't bother me at all.

00:29:47.214 --> 00:29:48.535
I'd do that once a week forever.

00:29:49.384 --> 00:29:50.835
You know, there was no other problem.

00:29:51.224 --> 00:29:53.765
Um, but some people obviously don't want to do that either.

00:29:54.015 --> 00:30:01.384
So absolutely, it's possible to come off as we said before, it is the same as any other calorie deficit that you're in.

00:30:01.944 --> 00:30:03.164
It does help with the food noise.

00:30:03.164 --> 00:30:05.875
It helps with the satiety, but otherwise.

00:30:06.345 --> 00:30:09.424
Coming off is the same as coming out of a calorie deficit.

00:30:09.845 --> 00:30:13.055
Your metabolism goes down when you're in a calorie deficit.

00:30:13.384 --> 00:30:19.664
And so you cannot go from eating 1200 calories a day to 2, 500 calories a day.

00:30:20.035 --> 00:30:24.335
In one step and expect to keep the weight off because your metabolism is lower.

00:30:24.535 --> 00:30:28.355
It's not used to having a high calorie intake and you will gain weight back.

00:30:28.634 --> 00:30:33.805
And so you need to be much more mindful about what you're doing when you come off the medication.

00:30:34.055 --> 00:30:36.855
You need to pay attention to your calories.

00:30:36.894 --> 00:30:43.724
You need to eat enough protein and you need to have a slow stepwise increase so that your metabolism has time to catch up.

00:30:43.984 --> 00:30:45.204
And you need to do the mental work.

00:30:45.265 --> 00:30:46.734