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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Appearances
So we have to understand how a medication or how the doses are recommended, right?
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.
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.
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.
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.
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.
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?
It's an actual problem of who was prescribing it and also using compounded medication.
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.
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.
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.
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.
And then they go into the body composition and they saw that half of it was muscle. They get it. They understand.
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.
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.
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.
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 possibilities are endless. That's incredible.
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?
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.
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