Dr. Rocio Salas-Whalen
speaker
288 appearances
3 recordings
2 series
first heard Apr 2025
last heard May 2025
Dr. Rocio Salas-Whalen’s voice in public audio — every appearance, attributed to the second.
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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
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?
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?
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 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.
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.
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.
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.
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