Dr. Rocio Salas-Whalen
Appearances
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
And when a patient hears this, I can almost physically see it how they feel relieved. I've had grown men in my office cry when they hear this for the first time because they've lived decades thinking that it was their failure.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So when we talk about genetics, we're talking about family history, right? If your parents struggle with weight, if your grandparents struggle with weight, then you are at higher risk of also struggling with weight. Again, we know the preconception weight of your parents impact. Even the food that they eat, consume highly palatable food that can be transmitted to you. What's palatable food mean?
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
food, processed food, ultra processed food that will lead to wanting to consume more. Right. Then when we talk about also there's some mutations that may also cause obesity. Right. And then when we talk about hormonal, so through a person's life, there could be hormonal changes, shifts, imbalances that is going to promote waking.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
We can talk about hypothyroidism, right, which thyroid hormone controls your metabolism. Then we can talk about PCOS, polycystic ovarian syndrome, when there's hyperinsulinemia, insulin resistance, and this promotes visceral fat. Visceral fat promotes insulin resistance, insulinemia, and it goes into a vicious cycle.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
We also talk about perimenopause and menopause with the changes of fluctuations or the drop of estrogen. This promotes visceral fat. The subcutaneous fat that you had in your fertile years in your hips and your breasts goes intra-abdominally. This visceral fat promotes insulin resistance, and then you go into that vicious cycle again.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Also, because of the drop of estrogen, we see a decrease in lean muscle mass. Muscle mass is your burning calorie machine. If you lose it, then your metabolism slows down. Then we go into aging. Aging also, as we age, we tend to lose muscle mass. It's harder to build muscle. And also it promotes waking. And then we go into environmental factors.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
As we talk, the food industry, industrialization, plastic, pesticides, all of those things disrupt your endocrine system. We call them endocrine disrupting chemicals because they disrupt the function, the normal function of your hormones. They mimic your hormones. So they occupy the receptors where your hormones should go and do a function. And this can promote obesity and fertility.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So they're real things that are impacting people's life on the day-to-day basis.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Knowing this and understanding this, you move away of anxiety. putting the pressure on the patient, right? You move away of being a one participant in this equation. It goes more into a team, what you can do for the patient and educating the patient. It becomes a team. Let's talk about, as an example, diabetes, type 2 diabetes.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
We know it's a chronic multifactorial disease, but we have no trouble prescribing and treating medications for it, right? It's widely accepted from the patient side, from the physician side. Let's talk about hypertension. Same thing, right? We know that lifestyle can help it or make it worse. but that is not causing the disease.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Therefore, we feel comfortable treating it and the patients accepting treatment. And when we provide treatment for type two diabetes, hypertension, high cholesterol, we always talk about eating healthier and exercising, but it doesn't replace the treatment. So if we see obesity as a disease, we can act the same way.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Understand and support the patient and their lifestyle, but also provide a medical treatment.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
But also there's other things like medications that patients may take for certain particular disease that can promote waking, right? There's a lot of antidepressants that can promote waking, blood pressure medications that can promote waking, right? And many times there's no other option for the patient. And this can also lead to obesity.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
The first FDA-approved GLP-1 was in 2005.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Yes. The FDA name, it was by Eli Lilly. It was called Bayera. And this was twice a day subcutaneous injection. So it was a daily, twice a day injection that patients had to do. Okay. And the first indication was for type 2 diabetes because GLP-1 is a hormone.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Glucagon-like peptide. And it's a peptide or a hormone.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
No, peptide is... what we call a short chain of amino acids. A long chain of amino acid is a protein. So before protein, it's a peptide. Peptides can help to produce or inhibit the secretion of hormones. The most important finding of this drug, and I actually met the person, the doctor, the researcher who isolated this, the GLP-1 outside the human body. It was in a lizard.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
called the Gila monster. And the lizard, the venom of this lizard, caused pancreatitis on its victims. So Dr. Eng, John Eng, being an endocrinologist and researcher at the VA hospital in the Bronx, wondered what in the venom affected the pancreas. And he isolated GLP-1.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
It causes pancreatitis, so the prey dies from pancreatitis.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So it stimulates to produce insulin. The problem in type 2 diabetes is insulin-resistant and hyperinsulinemia. So with time, with frequent stimulation of the pancreas, every time you eat, every time you eat anything that has glucose, your pancreas produces insulin. But with time, it overworks. Your body stops responding the same way to the insulin that you make.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So you become resistant to your own insulin. The pancreas in response tries to overcompensate and make more insulin overworked. but your body is resistant to it. So you have hyperinsulinemia and insulin resistance. So these are the two main pathologic factors that lead to somebody to develop type 2 diabetes.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
And this is the beauty of medicine, right? One thing is made or developed for a particular disease or reason. We find out later that it has other benefits like GLP-1.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
I've seen people's lives change. I've seen more acceptance to the medication. The drugs are becoming safer, less side effects. I like to compare them with the iPhone. We have different versions of the iPhone, right? We have the iPhone 1, the iPhone 10, and now we have the iPhone 16. Same is happening with this class of drugs. Their versions are newer, safer, less side effects, and more effective.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Okay. So I feel like people are getting the message one or accepting the message that obesity is a disease. They feel like giving up. For many patients, I'm the last stop of the journey. And when I talk about a journey, I'm talking decades of journey. I'm talking about doing diets that I've never even heard about. I always learn about a new diet from my patients.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
being with nutritionists, being in fat camps that they call them. So I've seen patients struggle through their life and how this medication are changing their lives and giving them their life back, basically.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
First of all, the initial versions of this drug, they cause more side effects. And they were more cumbersome for somebody. People had to inject themselves twice a day, every day. So even for many patients with type 2 diabetes, it was hard to accept because patients with diabetes... They think and feel that once they're on insulin, they're failed, right? Or it's just more severe.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So having a medication that is injectable, it was hard to dissociate them with insulin. Got it. Or with failure.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So patients didn't like to inject themselves. And it was a twice a day injection and there were a lot of nausea. So it was harder to tolerate back then.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
It stimulates your pancreas to make more insulin when your sugar goes above normal. But if somebody who doesn't have diabetes and their glucose is normal, it doesn't touch the pancreas. Interesting.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Again, as with any drug we see, we have off-label uses. And what's happening is when we started somebody with type 2 diabetes on these drugs, when they were coming back to their follow-ups, not only was their glucose improved because they're great anti-diabetic drugs, but they were losing weight.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
And to have that as a diabetes treatment, a drug that lowers your sugar and also helps with weight loss, it was unseen because most medications for diabetes promote weight gain.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
It is fantastic, especially for type 2 diabetes, that weight gain or obesity goes hand in hand with diabetes. And before, with the medications that we had, we had to choose. Either we help with the glucose or we help with the weight. And many times we wanted to bring the glucose and that's what we had available.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
They started back in 2000. So, I mean, even for 2005, for the FDA approval, they're starting in the 90s. right, with the first one. But in regards for weight loss, it started around 2005, 2006. Gotcha. And then the first one approved for weight loss was in 2012, named Saxenda, also a daily injection.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So we moved from the twice a day injection to the once a day injection, but it's still severe side effects where we're nausea or vomiting. And it was hard to get to higher doses where we see most of the weight loss because of the side effects. Then eventually in 2017, we have the poster child of these drugs, which is Osempek. That was when it was approved for type 2 diabetes.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
In 2021, Osempek became also approved for weight loss independent of diabetes and then renamed it as Wegovii. Wait, what, Gove and Ozempic are the same thing? It's the same drug, yeah. When a GLP-1 gets approved initially for type 2 diabetes and then eventually gets approved separate exclusively for weight loss, they're rebranded.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
They just changed the name, but it's the same drug, same pharmaceutical, same dosing.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Well, if you don't have diabetes... you don't want to take a medication that is for diabetes and also for insurance purposes, right? Got it. Insurance will approve one drug for type 2 diabetes and will approve one drug for obesity, but unlikely that it's going to approve one for both things.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
GLP-1, I like to explain to my patients, target the two reasons that humans eat. We eat for fuel, survival. And we eat also for reward, for a reward. And the fuel part or the survival part, what this medication does, it suppresses your appetite hormones and it increases your satiety hormones.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So if for somebody who's on this drug and you're going to start eating, you get fully satisfied with a third or half of what you normally would need to feel full. And then in between meals, it suppresses your hunger hormones. So for most patients, it looks like two small meals a day, feeling physically content. That's for the survival part.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Now, for the reward part, we have receptors for this hormone in our brain in the hedonistic eating and drinking area of our brain where we anticipate or associate our reward either with food or beverages like alcohol. And it blocks that reward response. So let's say if somebody's anticipating having a meal that they know is going to relieve or a certain reward.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Once you're on these medications, you see that meal and you don't get the same feedback. So their behavior change. You enjoy your food when you're hungry and eating. Once you're full and satisfied, it's out of your mind.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
It doesn't touch your pancreas if your glucose is normal.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
First, I think we need to backtrack a little bit before we dive into that answer. Sure. We as a society tend to associate being thin as being healthy. So whenever we see somebody that you can think they're slim, they're thin, they don't need this medication, we're assuming that they're healthy. Yep. That they're metabolically healthy. Yep. Yep.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
But we don't know by just looking at somebody, right? When I do body compositions on my patients, and this should be done on every patient. And basically, I would say even patients that don't need weight loss medications, just to know what's your body composition. Because whenever we're talking about weight loss, we're really talking about fat loss, right? We're not talking about a bulk number.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
We're talking specifically, we want to reduce what can cause disease or increase your risk of disease, which is Fat, not muscle. So by doing a body composition, we can see what's the percentage of somebody, right? What's their visceral fat and what's the muscle mass?
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So many patients that we may see slim or thin, they could be what we call a skinny fat or sarcopenic obesity, that they may have a very low muscle mass. and high body fat, there's still a risk of disease. They're still in a pro-inflammatory chronic state, right? There can still develop type 2 diabetes or even be a risk of developing cancer.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So just by looking at somebody, we cannot say what the body composition is and what they need or don't need to lose. Got it, right? So we first need to stop associating thinness with health, right?
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Many times when I see patients that think they need to lose 10 pounds or 5 pounds, when we do a body composition, surprise, surprise, they actually have to lose 20 or 25 because they're under muscle, right? So to really say who needs this medication or not, we cannot assume by looking at somebody that they do or they do not.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So we have machines, right? So the gold standard for a body composition is an MRI, but we're not going to do MRI on every patient on every visit. The second is DEXA. And then the third, which is the more accessible, is body impedance, also known as InBody. There's different versions of it. So those are the ones that are more easy, accessible, and they offer no radiation to the patient.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
And we do body compositions on initial visit and every visit when somebody starts on a weight loss journey.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
No. No. Most patients that come is because they need them and because they've done their work and it's just not working. It's just not happening.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So first, starting with a very thorough weight assessment. So I need to know at what age were they conscious about their weight, at what age were they trying or being consciously about the eat or they were told they need to lose weight. For many patients, they tell me nine, ten. Also, I need to know their medical history.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Are there comorbidities that can contribute to obesity or medications that they're taking that can contribute to obesity? Then I go into a deep family history. I need to know up to two generations before. What was your parents', your grandparents' weight, your uncles' weight? If they have children, how is your children's weight? I need to see if there's a familial factor contributing to obesity.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
And then I look at their gynecological history, right? Are they in perimenopause, menopause? Do they have PCOS? And then we move to the physical exam. And in that, also, we do the body composition. And there, we can really target what is it that needs to be improved or doesn't.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So what we consider obesity and percentage body fat is 32 and above. Normal in women is 18 to 28 percent, in men is 10 to 20 percent. So anything above those numbers, we either fall in the overweight range or in the obesity range.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Definitely. What we see in perimenopause and menopause with the drop of estrogen is that your body composition changes. You tend to store more body fat, central visceral body fat, and then you drop more your muscle mass. There's less lean muscle mass.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Also, in this stage of life, when somebody, let's say, that didn't struggle with weight in their 20s or in their 30s, anything that they were doing to maintain a weight once they enter midlife, perimenopause and menopause, is not going to help because of that hormonal fluctuation or drop of estrogen.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So in this time of a woman's life, and we hear it all the time, everything that I'm doing is not working. I used to do it before and the weight used to come off, but now I even have to work harder and it's still not happening. Yes, because of aging and the changes in estrogen or the drop of estrogen. So here, GLP-1s have a huge place for...
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
for patients that need or that have gained weight doing perimenopause and that it's just going to become even harder to lose it and easier to gain weight.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
The only absolute contraindication that we have for this medication is a personal or first-degree family history of medullary thyroid carcinoma, which is a very rare and aggressive type of cancer. Now, if somebody has other versions of thyroid cancer, papillary, follicular, that's not a contraindication. Exclusively medullary thyroid carcinoma.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Above that, patients that are pregnant and breastfeeding is not recommended.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Or how does this work? So we have to remember what is obesity, right? What causes a patient to require this medication? It's a chronic disease. multifactorial disease, right?
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So if we assume that we can use this medication to take them to a goal and then we stop it, we didn't fix, we didn't cure the other things, the familial history, the genetics, the hormonal changes, the aging, the environmental factors, those factors are still there. Chronic diseases, we don't cure, we control. So that's why these medications were designed to be used long term.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Now, that can change. If somebody has history of obesity since childhood in their midlife or later decades of their life, then most likely they will require this medication long term.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
But if it's somebody, as an example, who gained weight after pregnancy and hit midlife and they gained 30 pounds, but they never struggled with their weight, then maybe those patients will not need to use them long term. Huh. That's interesting. But you have this patient that had children late in life, and then they hit midlife.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Then, yes, they didn't struggle with weight in the past, but now their surrounding is not going to be helpful for them to maintain the weight loss. So they may benefit from long-term use.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Yes, I have a very personal family member myself. I used this medication after I had my kids. I didn't struggle with weight growing up. I always used to lift weights since my early 20s. I fell in love with weightlifting, but I had my children late in life. I had my first one at 38 and my second at 39. After that, I hit my 40s. I started with perimenopause.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So what I was doing before, it didn't help me. I ended up with 30 pounds that I couldn't lose. I used the medication. I used for six months. I got back to my weight, and I have not needed it since then. I take back exercising and all of that, and I've been able to maintain my weight with that. It was just a combination of late pregnancy hitting midlife at the same time.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Mm-hmm. To not worry about your weight or punish yourself for not getting back on track so soon. I always tell women, give yourself one or two years before you start doing that because just having a child at that age is hard enough. After that, I think when us doctors go through certain situations, it does makes us a better doctor or more empathetic doctors, right?
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Because it's very hard to identify with something that you don't know necessarily. It made me more understandable. I was better to relate possible side effects and what to do about it and definitely to be more empathetic. Beautiful. How long ago was that? I was 42, so seven years ago, I'm 49.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
I know what causes waking. I knew in what place I was in my life. And I knew that I didn't want to exhaust every other possible situation that at the end was not going to help me. I'm a very proactive person personally and professionally. So I really wanted to be very proactive at that time.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So as with any diet or anything that causes a restricted caloric intake or decreases how many calories you're going to eat, there's always a risk of muscle loss, right? Because it's hard to just exclusively lose body fat without lowering muscle mass.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So one of the risks of using this medication is muscle loss. And there's no direct effect of the drug towards the muscle mass. It's an indirect effect of you eating less that you may lose muscle.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Yes. Got it. But it's not a dead sentence. So by informing the patient and teaching them about what is it that they need to consume while they are on this treatment can prevent muscle loss and even gain muscle for those that need to gain muscle.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Before we go into that, I just want to explain why we're talking about muscle. Why is so important muscle? It's not because we want to see all people bulked up and Arnold Schwarzenegger-like, right? Muscle is your biggest metabolic organ.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
It's your calorie-burning machine.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Muscle.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Muscles burn calories and muscle regulate your glucose. Because every time a muscle contracts, it's physically being used, it sucks sugar from the bloodstream to provide its energy.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
For your glucose? Yes.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Yeah, whenever we hear, oh, if you lose weight, your metabolism slows down. One of the reasons is because you lost muscle along the way and that's slowing your metabolism. You're burning less calories. And I see that all the time with body compositions. When patients lose muscle... They don't lose significant amount of fat. It's harder for them to lose fat.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
When patients maintain muscle or gain muscle while on these medications, the body fat drops rapidly and significantly. So really your muscle is going to determine how you lose the body fat. And that's why we need to have that conversation of muscle on day one.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
On your first appointment, your doctor needs to discuss with you what exercise you should be doing, which is strength training, hitting the weights, and increasing your protein in your diet. Because you can lift as heavy as anybody and you will still lose muscle if the protein is not there.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
One gram of protein per pound for ideal body weight. That's what they should aim. So I would say the sweet spot that I've seen for most patients is between 90 to 100 grams of protein a day, which without a weight loss medication, without a medication that is suppressing your appetite, it's hard enough to eat that amount of protein.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
I mean, it's very hard to, it becomes mission impossible when you're giving somebody a medication to suppress their appetite. Oh, that's true. But then you want them to eat 100 and more grams of protein, right? So we have to find a medium point to patients to not lose muscle, and that's around 100 grams of protein a day in their diet.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Twice a week, we can do this. One day upper body, one day lower body. I love a formula that I actually feel like I could actually achieve. But I would say for many patients at the beginning, my main, main baby steps, right? Baby steps. If I want them to do one thing is to increase their protein in their diet, because at least with increasing the protein in their diet, they won't lose muscle.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Then we can, once the patient starts losing weight, feels a little bit more stimulated or more encouraged or physically able, then we can start incorporating exercise.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Well, it's not the GLP-1 is the drop of rapid weight loss or significant weight loss. And why is this? Because of not eating enough protein. So if you're losing muscle because you don't have enough protein in your diet while on this medication, you're not only going to lose muscle, you're going to lose hair.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
You're going to lose elasticity in your skin because we need protein to make collagen, elastin, right? Also, you need muscle to fill the gaps of the fat loss, right? The goal here is not skinny. It's strong. It's fit. So you need to fill those pockets with muscle. Now, if you're not losing muscle by increasing your protein intake, then you're going to make enough collagen.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
You're losing weight slowly, so you're allowing your skin to adapt to the changes. But if you lose weight rapidly, it means that you're also losing muscle. It means that you don't have enough protein in your diet, so you're not making collagen and elastin.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So I'm going to, there's a phrase that I use a lot and I'm going to repeat it until I don't have to, but the efficacy and the safety of this medication is going to depend on the expertise on who is prescribing it to you.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Yes. It means that it's a medication. It's a medical treatment. And you need medical supervision to decrease side effects and to achieve weight loss to have the most results from this medication, right? I've never had to stop the medication for any of those symptoms that you mentioned. It's very important to take the time to explain to the patient.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
To have this conversation, to talk about weight with a patient, you need time. It's very hard to have such a vulnerable conversation with somebody in 15 minutes, let alone then explain to them about medications and how they work. Okay. You need to build trust, right? And you can only achieve that if you take your time to talk to a patient.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
And that's one of the reasons that I decided to do private practices because I knew I could offer more patients if I had the time. To decrease the possibility of side effects, you really need to make your research, do your research, do your due diligence before you go to somebody to get this medication done. And they should be a medical doctor.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Ideally, they should be a medical doctor, but it could be a nurse practitioner, it could be a PA that they're specialized in obesity.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Yes. So every patient should come into a visit every eight to 10 weeks. when they are taking these medications, right? Because to see if it's working, what's not working, how is your muscle mass? Are you losing mass? Do we need to slow down the medication? Do we need to decrease for the greater good of muscle?
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So every patient is individual and we try to adjust their lifestyle, but we need to see those frequent visits to see where the patient is, right? Are they tolerating it? Can we go up? Do we need to go up or do we need to come down on the dose?
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
That obesity, that weight gain is complex. It's not as straight line as we used to think. And that most importantly, that weight loss is should not be a full-time job. Weight loss should not consume your life mentally or physically.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So the first thing to look is that we, as medical doctors, we don't sell FDA-approved medications in our offices. We send a prescription to your local pharmacy. It could be a commercial pharmacy, but we don't sell it in our office. If you encounter somebody who does, they're not, they're selling you the compounded version, right?
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Also, many of those med spas or mail order or telemedicine platforms, what they're offering you is the compounded version of the drug.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
The FDA-approved medications are evidence-based. They're from the clinical trials. They're heavily, heavily regulated. For a drug to be FDA-approved, they sometimes have to show 10 years of research, right? Efficacy and safety to get FDA approval. Compounded medications are not regulated. They're not FDA-approved.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So many times what you're getting, it may not be exactly what they're promising, right? Many times they put fillers on the medications. So safety should always be above anything. Granted, these medications, the FDA versions are expensive, right? But I always tell people safety should not be jeopardized by cost. And second, because there's always the risk of self-administrating more medication.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Oh. The current FDA versions, they're pre-dose medications. So there's no way that a patient can inject themselves more or less. With the compounded medications and what we've seen and there's studies showing that most of the hospital visits for severe side effects of GLP-1s are from compounded medications from overdosing.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So you leave it to the patient many times to figure out the dosing or to run the risk of underdose or overdose, right? And this can lead to severe side effects.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So we have to understand how a medication or how the doses are recommended, right?
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Medications go through clinical trials, clinical studies, where many doses are tried. Then we reach a therapeutic dose, which is a dose that exerts an effect. That's what we call therapeutic doses. That's what, when medication is approved, they come with therapeutic doses.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
It exists. It is possible and reachable.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
If we think about microdosing or using less amount of the actual therapeutic dose, well, we're not going to get the effects that the drug was designed for, right? Number one. Second, if you do need this medication and you have obesity, then you need the therapeutic doses, not the soup therapeutic doses. Now, the other thinking is, well, I don't need to lose weight.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
I just want the positive effects of the medication. Well, if you don't need to lose weight, then if you are already in a healthy metabolic weight, then you don't need the, you're already getting the benefits, right? You're already, just by being fit, you have that. You don't need another medication.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
And third, the problem with microdosing is that it's based on compounded medication. Oh. Currently, the FDA approved drug, they come pre-dose. So there's no an easy way to give yourself a lower dose. It's a single-use pen for most of them, pre-dose, so you cannot really play around with the dosing.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Now, when Eli Lilly came with the bile of the lowest dose, that may potentially have a use for patients that reach a healthy weight goal that don't require higher doses, that can maintain a weight with a small dose, then we can do a lower dose. But currently, we only have terceptide in a bile, right? Got it. Another reason of the microdosing was to avoid the side effects that people were having.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
What are the big side effects? The problem with those side effects... were that they were initially created by people using compounded medication and that didn't have expertise on that. So their thinking was, well, maybe if you use less, you'll have less of the side effects. But that's not a problem of the actual drug of itself, right?
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
It's an actual problem of who was prescribing it and also using compounded medication.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
If you're using the FDA-approved drug the right way by somebody who knows how these medications work, you won't have those side effects that will make you use a microdose. Wow.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
They're not heavily regulated. We don't know exactly what you're getting in the medication. There's the risk of overdosing yourself. There's higher risk of side effects, one, from not knowing what it is in the medication and not doing the right dose. And third, there's no evidence-based research that says that microdosing is effective.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
That they're easy way out, that is cheating, that you can sit back and not worry about how you eat and if your exercise or not.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
patients are more involved in exercising. They're eating better. They're increasing their protein intake. They're working out. Because when you explain to a patient the possibility of muscle loss, and when they see it physically, when they come and do their body compositions and they think, oh, I lost three pounds. Great.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
And then they go into the body composition and they saw that half of it was muscle. They get it. They understand.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
And they become part of the treatment. They start working out. They start lifting weights. They start eating better. And then halfway the journey, which for me is what drives me of what I do every day, is there's a switch. There's a switch from when the patient comes thinking of something externally, physically, and then halfway it becomes something internally. They like how they feel strong.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
They start to worry more about muscle in every visit than weight loss. How did I do on my muscle? Did I gain muscle? Once a patient feels strong, understands on how to eat, there's no turning back. When a patient comes to me, they struggle through decades. exercise program, personal trainers. Some have personal chefs. They're doing what we're recommending. They've been doing it.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
They've been listening to us. Also, when somebody says, oh, if they wanted to lose weight, if they really wanted, they would have done it. They want it. They know. But unfortunately, it was not their sole responsibility. I have yet to meet the couch potato that is just eating, sitting, and not doing anything. And that's why they gain weight.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
And I learned this through my patients and not in my medical training. I learned through my patients how they... I've seen how they struggle through decades for many. I have patients all ranges of age. I have from teenagers to 70, 80-year-old patients, how they've struggled through since childhood for many of them, and it consumes their life. And every plate in front of them
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
It's, I think there's no, anything I say is not going to be comparable to what a patient experiences. You have to understand patients with obesity, they think about their weight 24 seven, how everything that they do or put in their mouth is going to impact their weight or feel guilty about it later. When you remove that from a person, it changes their life. They feel liberated.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
The possibilities are endless. That's incredible.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
It's liberating. Some patients tell me, oh, so this is how it's supposed to be. This is what is normal. And then it opens your eyes, right? It's like removing a blindfold when you're on these medications and you go out with somebody who's not on this medication and you think about like, whoa, We were overeating. You don't really need to eat that much to feel physically satisfied, right?
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
And then it has a rippling effect too, right? I mean, you can discuss this with family members or family members see the effect, see the positive effect, and then it's just... They want it too.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
And people say, well, some people with exercise and diet, they lose weight. The key is how much, how restrictive does it have to become to reach that goal? And can it be sustainable long term?
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
could be causing guilt, anxiety, shame. And this is 24-7, seven days a week, 365 days in a year.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
It's a difficult conversation to have, even for us doctors, that that may be the sole reason a patient is coming to see us. Some patients are not ready to have that conversation. It could be the same with a family member, with a friend. I would say if it comes from a place of love, in authentic care, people perceive that, people feel that and don't feel attacked.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
I think the most important thing that we have to remember with patients with obesity is that they've learned to feel blame and to feel attacked. So you have to be very, have a lot of tact on how you're going to bring the subjects with that feeling or putting more blame into the situation.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Both pharmaceuticals that produce these medications, they have manufacturing coupons. Okay. Meaning that if your insurance, if your commercial insurance didn't approve it, you can use a coupon that cuts the cost about 50 to 60%. So they become a bit more accessible. Now, one of the current pharmaceuticals just came out with a vial of the medication.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Currently, we have injections that are pre-filled pens. And this drives the cost very high. But now the medication is coming in a vial, like an insulin vial, but it's not insulin. And it had cost the price significantly more. So that's another option.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
And then also going to a specialist, right, that is going to do and take the proper measurements to make the diagnosis and to be able to justify the need of the use of the medication.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
To share what impacted you the most about this conversation, right? I think our duty and our responsibility is to share the information.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
I would add to what you say that one, it's not your fault. And two, it's okay to receive help. It's okay to ask for help. That doesn't make you a failure. Doesn't mean that you're cheating. It means that you understand and that you are human and that for the first time, we actually have help beyond exercise work and eat less.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
I am originally from Mexico, and that's where I studied medicine. I graduated from medical school. And once I graduated from medical school, I decided to venture to the United States by myself. wanting to become a doctor in New York City. And then after nine years of training, residency, fellowship, I completed my specialty in endocrinology and then the following year in obesity medicine.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
And originally, endocrinology takes over what's metabolism and obesity. But we've learned that obesity is complex and it requires its own specialty just to be solely dedicated for obesity. And endocrinology is the management of hormones. And yes, hormones impact weight, right?
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
I want to say that I'm sorry on behalf of the healthcare providers. We didn't know better and we failed you and I've been humbled by my patients. I've learned and hear their stories and we got it wrong. We got it all wrong, but there is help. We're learning more. Science advances like everything, right? Medicine is an evolving science and we are aware and we will do everything we can to fix it.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
obesity increases your risk of mortality. There's more than 15 cancers that obesity is their biggest risk, including breast cancer. You have more risk of developing breast cancer than alcohol, hormone replacement therapy, or genetics. It's obesity. Obesity is the number one cause of pancreatic cancer, colon cancer, prostate cancer, thyroid cancer. The number one cause?
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
The highest risk for developing, yes.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So... By reducing obesity, by treating obesity, we are going to have less chronic diseases. We've built specialists. We created medical specialties from the complications of obesity. So we will have less diabetes, less hypertension, less cardiovascular disease. If we treat obesity now, we will have less incidence of the cancers that I mentioned.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
And this is a very interesting thing because you as a non-medical professional have felt like that, judging and assuming we as a healthcare providers, as doctors, we did the same, right? When patients were coming to us for help and to play devil's advocate, we didn't have the training. We didn't have the knowledge that obesity is not a self-inflicted disease, right?
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So what we've learned is that obesity is a multifactorial chronic disease. And I'll deconstruct that. Multifactorial, meaning that there's more than one cause leading to somebody to struggle with weight or have obesity. I like to break them into five pieces. One, lifestyle, exercise, sedentarism, diet. but that's one piece of the five. The other one is genetics, right?
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
You can have a genetic mutation, but also it can run in the family. So it's two different, right? Then the third one, hormonal changes. We have PCOS, perimenopause, menopause in women. Then we have aging. That's unchangeable. Nothing that we can do about it yet. But as we age, our metabolism slows down. We lose muscle mass. We tend to store more body fat. And then we have environmental factors.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
And those are on its own. We can deconstruct that too, because in environmental factors, we can talk about the food industry. Right. We can talk about obesogenic environments. So meaning places where the walking is not available or accessible or easy, where people have to drive everywhere or even working from home now. Right. So there's less opportunities to being active.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
That leads to more sedentarism. So we call that obesogenic factors, things that promote obesity in how we live. Also, we can talk about endocrine disrupting chemicals. Like BPA, what's found in plastics, pesticides, right? We live in an industrialized world that really promotes obesity.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
So if you think of all those five factors and you think of what the patient has control, pretty much only on one, right? What we're talking about lifestyle, exercise and eating healthy. And before or when we do that, we tried or we put a lot of pressure on the patient to overcome all the other factors that are not in their control. Let's talk about genetics.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
We know now there's research showing that the parent's preconception weight can impact the weight of their child.
The Mel Robbins Podcast
#1 Weight Loss Doctor: The Truth About Obesity, Ozempic, Dieting, & How to Feel Better Now
Yes.