Ozempic & GLP-1s: The Future of Obesity Treatment?

So these drugs, initially they were made for the treatment of diabetes. And, and they're in a class we call GLP-1, which is a chemical inside the body that when you stimulate this, it actually decreases increases the release of sugar from different parts of our body where it's stored and helps with the metabolism of sugar that's coming into the body. Incidentally, what they found when they initially started using these drugs, with Ozempic being the classic example, is that not only did it improve people's blood sugars, but also they found that people who might were at greater risk for cardiovascular disease events, i.e., heart attack, things like that, and strokes, non-fatal strokes, the incidence of those occurrences in this patient population decreased. And as a side effect of this, they realized, wow, many of these patients were losing weight.

Hello and welcome. In this episode of the Wellness Musketeers podcast, the Musketeers explore the complex world of weight loss drugs from three unique perspectives. Dr. Richard Kennedy shares insights from his experience as a physician working with patients using these medications. Ozzy Mike James discusses how these drugs intersect with fitness and long-term wellness strategies, while Kettle Hiding provides an economist's view of the financial drivers behind the obesity epidemic and financial implications for individuals and society of these new drugs. Through personal stories, professional insights, and engaging conversation, The team tackles key questions: What do weight loss drugs really offer? Are they accessible and affordable for all? And what do they mean for the future of health and wellness? Whether you're considering weight loss medications, curious about their societal impact, or just love a good discussion on health and economics, this episode offers something for everyone. And whether you're seeking practical tips or exploring big wellness topics, We're glad you're here. We hope you enjoy today's episode. Please like, share, and subscribe, and let us know what you think. So let's get right into today's episode. Perhaps we could just start with Dr. Kennedy. The common question, I guess, Dr. K, is what are these weight loss drugs and how do they actually work?

So these drugs are drugs made initially, they were made for the treatment of diabetes. And they're— almost all of them are injectable drugs. And they're in a class we call GLP-1, which is a chemical inside the body that when you stimulate this, it actually decreases the release of sugar from different parts of our body where it's stored. And helps with the metabolism of sugar that's coming into the body. Incidentally, what they found when they initially started using these drugs, and with Ozempic being the classic example, is that not only did it improve people's blood sugars, but also they found that people who might— were at greater risk for cardiovascular disease, events, i.e., heart attack, things like that, and strokes, non-fatal strokes, the incidence of those occurrences in this patient population decreased. And as a side effect of this, they realized, wow, many of these patients were losing weight. And that is where this class of drugs has taken off to in the last 2 to 3 years, for sure. And now these drugs are specifically being prescribed to treat obesity, meaning a BMI greater than 30. And that— and 30 to 35 BMI is what we call overweight. A greater than 35 is morbid obesity. And so what they found is by decreasing the weight of people, you, again, you improve their health by getting rid of their diabetes, which is a major risk factor for cardiovascular disease, kidney disease, stroke, et cetera. So that's sort of how this started. And now it has become one of the classic drugs because it has been proven in several studies that patients who take these drugs lose much more weight than doing lifestyle changes, lifestyle modifications, and they maintain that weight loss better than if the person did lifestyle modification, i.e., diet and exercise.

Quick question on that, Dr. K. Has there been any side effects, nausea and so forth? I've heard.

Yes. The most common side effects are gastrointestinal. So nausea, upset stomach, vomiting in extreme cases, some diarrhea, all of that. And so, and that's why when they initiate treatment with this in anybody, they start at the very lower doses. They continue it for a week to see if the per— because like any drug, and it's important to understand There is no drug that has ever been developed, be it prescribed or an over-the-counter, that doesn't have side effects. And so not everybody who's going to take it is going to have the side effects. But if they do, many of the side effects, if the patient takes it consistently enough, the side effects will become less significant and even go away.

Are there issues with loss of muscle mass, strength, or issues affecting bone density?

Well, I would— I don't know if it's not really clear on this, but I would say that muscle mass might be an issue. And I always say that's a two-pronged problem to me because sometimes when you give a person a drug that you tell them it's going to help you lose weight, which means you're going to burn calories, you're gonna burn fat. If you are not simultaneously doing some kind of workout regimen, yeah, your muscle mass will decrease. It's, it's like anything else. If you don't use it, you will lose it.

Yeah.

And the fact that we don't know whether this is worse when you use the drug relatively to just weight loss in general?

I don't think so. It's possible, but I don't think so.

Okay. That's an interesting perspective. I know in the fitness industry, and I've looked at the position statements of groups like the American College of Sports Medicine, American Council of Exercise, and the American Health Clubs Association, which represents the largest industrial group, if you like, of health clubs throughout the world. They all have a pretty similar position statements, if you will, saying that one, that the use of them has to be under medical supervision. And two, they really emphasize weight training because of the evidence of muscle loss. And it's, I think, reading into that a little bit more, I think for a long time, the standard guideline was that you lost it by 1 or 2 pounds a week over a long term. Hence you'd have a lot of people drop out because they couldn't keep that sort of discipline up and they don't see immediate results. So I think the groups are realizing that these drugs are here to stay. So you've got to work with them because they're not going to be stopped going down in usage or anything. Weight training is an essential part of the fitness regimen. And I guess they're really promoting that to help the decrease in muscle loss that's been evident.

And that makes perfect sense.

Yeah. Yeah. I think that's one thing you'd notice visually from people who you've seen on it, that there's sort of a look, if you will, you know, that makes them look like they've lost muscle weight.

Are there different considerations for someone starting a weight loss medication like this if they're a younger person, a middle-aged person, or an older person? Like, what kind of, what does sarcopenia, is that relevant? Could that, something like that be impacted?

Well, it is, but I'd say that the best thing always, and what should be happening anytime they start a new drug, is that you have an in-depth discussion with your provider who's going to prescribe it. One, the benefits of taking the drug. Two, the problems that you might have taking the drug. Three, how this drug may affect your overall wellness in life. Because all drugs have an effect. So, you know, drugs are like no different than exercise, diet, rest, sleep. It is part of the formula for a person becoming healthy.

So, you know, you, you mentioned overweight. So I am just overweight a little bit. Would that be okay to start with the drug, maybe microdosing it?

I would probably, at least for me, I probably would then overweight because to me, I think that there's, to me, it's the conflict of what we use as the measure of obesity. The BMI is essentially measuring your body weight and your height. It does not take into account your fat. My, my, and what we always see is that you technically could take any— in the United States, any football player. Yes, football player, many basketball players, basically by default they are overweight and, and some morbidly obese, except for the fact that when you look at their muscle mass compared to their body fat content, it's very different than Ever. So we have to— now again, that's because it's hard to, you know, it's not difficult to measure body fat. Take— it takes some effort to do it. There's some simple tools that we can use to measure body fat. And so all I have to say, I'd have a discussion with your doctor. I wouldn't— knowing as active as you are. That it would be fool's gold to be putting you on a medicine to make you lose 10 pounds.

I, I wanna look like fitter. I wanna have those six packs.

Yeah.

But the, but being on those medicines not gonna give you a six pack.

But you know, I can also work out a little bit. I have Dave and, here they can kind of, uh, put me on a strict Regimen.

Yeah. 6, regimen of 6-packs for sure. Yeah.

Yeah. And then I'd get some fat off, then I go.

Yeah.

I know.

I'm joking. I mean, that's—

for the short term, anything is okay. As they say, everything in moderation is okay. It's the extremes that get us into trouble.

Well, let's—

the microdosing, what do you think about that? Is that, uh, something that's relevant or can be done or—

I'm sure that people are considering it. I personally wouldn't do. Microdosing. I would only— I would tell my patient, I say, look, you're, you're pretty close to be an ideal weight, but you're no longer 25. And so the real issue is, is if you get back to your weight of when you were in your mind most physically fit, that might not be a good weight for you now because your body has changed. Your metabolism has changed. You hold on to things a little bit more now than you did before.

I have more muscle. Yeah.

So, so it's not necessarily— and muscle and muscle mass is heavier than fat. So technically you could actually be overweight but be fit. So I, that's why I say that. Microdosing would not be what I would recommend unless the person has told me, look, you know, I've been doing this workout regimen for the last 6 months, eat like I eat like a little rabbit, and I still can't, I still can't, I still can't lower things down. So I have to be able to work on that. And to get what I need, what I need best for me.

Do, do you think that people have a realistic expectation about what they should expect, or that this may be a lifetime commitment to the medication when they start, or that they think, well, I'll use it to get through this, this hump in my weight situation, and then I'll, I'll get off it once I lose my weight?

I think people do it for different reasons. There are gonna be those people who, I'm gonna be in a wedding in 6 months. I need to get into this now. I need to get into this. I need to fit into this tuxedo. So what I'm going to do is I'm gonna go talk to my doctor and say, look, I need to lose weight fast.

And you know, and I mean, well, yeah, haven't seen, I mean, no, we, I think we all know by now people who've been on this drug and seeing some of the potential side effect, but it's, I wonder whether it's even more than side effects because as you said, it affects the metabolism. I mean, the body goes through a big change because of these medication. So it wouldn't, it would kind of seem foolish to have the body going through all of these things and then just kind of drop off it and then go back and forth. That's kind of, so you get this kind of yo-yo effect again. That would probably not be good for the body.

There's a, there's a weight loss program at GW Hospital. It's sort of like one of the last places on the bus before you go to gastric bypass surgery or something else, or it had been before this. And I, I knew a man that you're on a calorie-restricted diet, less than 1,000 calories a day. They have a behavior modification part of the program, but all these people are really busy and they don't take advantage of this. And I knew a man, his, his issue was wine basically. He would, he and his wife would have 2 or 3 bottles of wine a night. His wife wouldn't drink anything. And, and he, and, and he went on this program, his, you know, all these holidays and family events where he was having his smoothie and, or a bar and, and not eating. And his wife was angry with him 'cause she didn't think he'd do it in the first place. And then he, he did it. He lost like 60 pounds. And then he got off of it. He didn't, and he didn't do any kind of gradual reintroduction of food. And then in a couple of months, he drank it all back. You know, he spent thousands of dollars to be in this program.

Yeah.

I mean, yeah.

What, what turning to, to personal stories and real life experiences, guys, um, and I guess we've all got anecdotes, maybe we could share a few. But one quick question, is it still, is there still reticence in the community to sort of say, listen, I'm on these drugs? Are there still a lot of people who go on them without telling anyone? We've found that in the fitness world that there's quite a few people will go on these without really telling you, you know, is it, are people happy to share it now or is it dependent on the individual?

I think it, there's a little of both. I think they're, it's become more acceptable because they advertise it. And I always say you have to look at it from the perspective they advertise, they, they stop sort of using the providers as the ones to introduce drugs to patients. They went straight to the consumer. So there isn't, you know, there isn't a— every time you watch a television show, when the commercial comes on, there's a Wegovy, there's a Rybelsys, there's an Ozempic commercials. And so what they're doing is they're advertising it to the patient. So by default, once you do that, you make it acceptable to the community as a whole. That it's an acceptable thing, that it's not a bad drug, it's not that it is. And, you know, they, you know, they know how to highlight and accent this person lost 25% of their body weight, that this person lost 10% of their body weight. And, you know, they show the before and the after photos sometimes. So with them now, that being said, yeah, there are people who don't. I have patients who clearly don't tell their family members that they're on it. Now, it's pretty interesting. It becomes obvious that you could have something that you have to inject all the time. You know, so, you know, okay, again, you know, once people get used to sticking themselves, because it's not, it's not a deep stick, it's a very superficial, uh, sticking, uh, injection. So, and you only have to do it once a week. So there are ways you can do this and nobody be aware of it. Then of course what they want is the, the results. Wow, you look Good. Wow, you look great. You know, I have, I've had a couple of patients over the years who are in the public, in the public image. They're in front of the camera. They're public speakers, et cetera. For them, it's good business.

It takes us a little bit to the whole thing about image, body image, as well as what it means to be then, because always this thing about having the willpower to go through a regimen, that's considered to be good. Now you can do it without the willpower.

Yes.

So that changes all of that.

Mm-hmm.

Yeah.

It's interesting. I, I knew this one woman who did this same program at GW. She lost about 100 pounds, may need to lose 100 more, unfortunately. And she noticed that she was getting depressed. And they, she talked to the people there and she said that it said it was very common for people to lose weight and have depression. They, they said the reason was that people thought once they lose the weight, all the problems in their life will go away. Then they realize they've lost weight and they're just thinner.

Yeah.

And all the other issues.

Yeah.

And there might be many explanations, but I think that, and that could be other explanations as well because, you know, we are being constantly bombarded by Tentations, you know?

Yeah.

And as you know, for, I mean, the, the industry, the food industry has incentives to sell us whatever we want. And one of the things we are primed to eat are sugars. It's very easy. It's fast. It's something that, you know, when you are hunting and you see something that's sweet, you're gonna go for it because it's gonna give you a lot of energy. You can fight better, everything. So we are primed for that. Refusing and rejecting it is strenuous for us. It's hard. It also intervenes in our social activities. Think about all the parties. It involves, I mean, from childhood, involves sugar in some way or another. Then it goes from sugar to alcohol, which is another form of sugar. Not partaking in this as well is also hard. Now, this drug comes in there, and I'm not sure we have really understood how it affects the whole thing because in a way, maybe no. What you probably will see is that, for instance, the food industry, they're gonna see losing sales of candies, for instance. They're gonna have to figure out something.

Yeah.

Yeah.

And they will.

I mean, it's interesting, like, uh, this, this, um, like I've known people, they were, they had gastric bypass and they did, it didn't address the craving. And so they were, people who've managed to find a way to gain weight while having had gastric bypass, their physical capacity's limited, but they can't eat a box of M&M's, bag of M&M's in 5 minutes, but they can eat 3 in 4 hours. And then people I've known that have taken the drug, they, they just don't have that interest in eating. They're done when they're done. Mm-hmm. And that, it seems to me to be the primary distinction between the two.

Kinds of treatments. Turning to the, like the real nuts and brass of these things, uh, as a manager of fitness centers in two different countries, if there was one constant I used to see, it was that scenario we talked about before about people wanting to get fit for an event in six months, whether it's being fit into a wedding dress or something like that. And the amount of people I could almost pick them, they would come in, you would see they'd start yawning. And they hadn't eaten breakfast, they hadn't eaten hardly the day before, their blood sugar's low and they, they faint and you just almost, I could almost catch them before they fainted. I got to see it so often.

Yeah.

So I would think taking something like Wegovy would be a hell of a lot healthier in the long term. I mean, you wouldn't have these sort of episodes. Jumping to conclusions here, Dr. K, or?

No, that makes, that makes perfect sense.

Um, yeah.

Well, and again, I would tell you there are there aren't as many people on these drugs just for the short term. And for short term to me is 6 months or less. Whereas this is because these people have, have reached a point where they and the medical establishment has said to them, yes, you're overweight, you're obese. You need to lose weight. I have an option for you here now that might be helpful. And we can, if you can tolerate this, you'll be able to lose the weight. And so for some people initially, particularly for those who haven't really tried, you know, that there are lots of people who will go on diets, you know, that, Yes. That's right. Diet. And that's the problem. Diets are, as they say, self-limited by nature. Even if they work, you have to eventually go back to some form of a regular eating routine for you. And I always say that's mainly the dilemma. Most diets work because technically you are eating less. The bottom line is you're eating less. So by default, what happens is, remember, the stomach is a big, is a tube that expands and contracts based on the amount of substances coming into it. If you decrease the amount of substances coming into it, the stomach will get smaller. I mean, it's, it's essentially the principle of what bypass surgery is. They literally make the stomach smaller. So therefore, and again, they cut out other things, but they make the stomach smaller. And by default, if you have less, if the stomach won't expand but so much, you get full quicker, then you'll eat less. But and it's why when they have the people go through this bypass surgery, before you go through bypass surgery, you have to go through mental health therapy, you have to go through exercise programs, you have to go through a diet regimen because they want you— they want to prove that you're motivated enough because they know once the surgery happens, just doing the surgery itself, when you come out of the operation, you've lost quite a bit of weight almost always. So the question is, how do you sustain that? Going forward. And so, so now we found a solution.

This is a, this is pretty much the wonder drug.

No, even with that solution, but yeah, it serves the purpose.

And partly because we have in front of us on the, on the movie screen, in the theaters, and that we have the, the bodies and faces of people who we saw them when they were in this role and they were 220 pounds and now they're 107.

Yeah. And now they're starting, there is this influence that they said, oh, thin is good.

Yes.

And now suddenly, uh, you know, this is less of a problem to talk that way.

Yeah.

But I mean, I, so is this though also, is it one of the drugs only for the rich?

That's, that's the next point I thought we should bring up, Kettle. Cost and affordability. I mean, how affordable is it for the average person and discuss like Medicare and all of this. I mean, how much does it cost, say, for the average person to undertake a course of Wagovi?

It's expensive. Yeah.

It's, I mean, it's in the $1,000 a month or more.

Without insurance. $1,200 to $1,300, $1,200 to $1,400 per month.

Wow.

Per month. So what happened is, is when the drugs came out, they knew that they— so they said they made— they, they partnered with the health insurers and said, look, okay, we will make this drug, but you have to be able to give us something back., and what they do is they give an ins— they give to the patient, if you have commercial insurance in the United States, different in Europe, but commercial insurance, the Aetnas, Blue Crosses of the world, if you have that, the big— they're gonna pay a percentage of it. So based on what your plan is, you're gonna pay, it's gonna cover 80% or whatever. And what, what the Govee company says, we're gonna give the patient a card that says $25 per month, we're going to charge you and that's all you're going to pay out of pocket for the, for the medication for a year. And so that mitigates the cost. Now that, that you don't have, that doesn't help If you don't have insurance, if you don't have insurance, it doesn't help. If you have insurance and right now Medicare not being a commercial insurance, it wasn't being covered. So the only way you could get it covered is if, okay, this person needs to take it not just for obesity, but because they happen to be diabetic. Because they had a cardiac event that they survived. And so this is to promote their wellness and wellbeing going forward.

So then we have a situation where still a, a certain percentage of United States population is uninsured and it's towards the lower range of income. Mm-hmm. Uh, that will not benefit from this. And these are actually the, the part of society where you find more obesity. They're living in food deserts where you probably only can get McDonald's or other kind of fast food providers and no fresh food. Whereas the rich, wealthy, uh, can gobble up these things that are, by the way, also in short supply. So it's a risk, it's kind of. Increasing differences in society.

Is there a possibility of that changing, at least in the US, so that it becomes more affordable? Are there any indications of that?

Well, with Medicare being the largest insurer in the United States, with them now, it appears that— I know the Biden administration has put into place ways that they can— Medicare will be able to negotiate with the drug companies to be able to get a more affordable price. But we'll, but we'll see. I, you know, the jury's still out. It will be, it will be better. I don't know how much better and when.

Hasn't this been one of the big issues about the actually allowing Medicare to negotiate with providers on the prices? And because the industry has been pushing back on this and they've done this only for a few drugs so far. They might include this and we'll see whether the new administration would allow that to go forward. Yeah. I mean, just looking at Europe where most countries have, as you said, or have some kind of national health insurance and they negotiate with the companies. And I also think there's some kind of pan-European possibility there. And there the price is about 10 times less or Yeah.

Uh, so, um, which is still expensive here.

Still, still expensive there too. And that takes us to the other issue that even with reductions, this is the cost that the insurance system, however it's organized, will more or less have to bear. And it's going to affect budgets. Now, on the other hand, of course, having much less obese people, if that is gonna be the result, it gets actually rolled out, will save money for the society.

Yes.

So, you know, it's gonna be interesting to see how this, this pans out.

Well, and, and from the standpoint that the, the drug companies will, they're always looking at a way to use their, at use their drug as a way to treat a condition. And so if you just think about these drugs in particular, how they started out specifically to treat diabetes, then they found out, wow, people's cardiac events and stroke events decreased. So then they had another indication to promote it. Then they found out, oh wow, obesity is a, is a big disease in the United States. We now have a drug regimen that can actually help to reduce that and promote wellness at the same time. So they'll, you know, cuz to me the issue is, is what's the endpoint? Do you keep people on the, on the drug for the next, 5 years.

And then there's actually something I think is not discussed a lot. The, we are talking now about the United States, Europe, and the, the obesity epid— epidemic that you talked about is also, it's spreading. It's not only United States.

Yes.

But you also having a large part of the world being affected by it. I mean, you can have less, I mean, emerging markets, relatively poor countries where Obesity is also a problem because yes. What are we pushing them? Soft drinks often. Okay. Soft drinks, for instance, in a lot of, uh, Middle East, soft drinks. Same in Mexico, for instance. Obesity is becoming a big problem as well.

India.

Uh, I, but they don't, I don't, I, I haven't actually, do you know anything about the rollout of the drugs in, in these parts of the world?

No, not off the top of my head, but I would suspect because as expensive as they are, most of the health insurance plans that do exist, and again, a lot of the developing world countries don't even have them. Um, there's no way to pan it out. Now they'll eventually figure out a way when the poorer countries so that they can benefit from it like we've done with many other drugs over, over the years.

And also, I think if I am not wrong, but I understand that for instance, in India, they've been producing, and India and Brazil in particular, been producing medication that is actually not, it's still on patent, but they're, they're producing it. So I am not sure what, I haven't actually seen that they actually started with this. I would expect them to.

Isn't India where many drugs are formulated anyway already, like for global distribution?

Yes, they are. The problem is, is the quality of the drugs that come out of there, whether it's real or not. So it, a lot of times there are drugs that come from different parts from India and other places, but people are not so sure that they are as effective. Because they don't go through the same scrutiny that they would in Europe or they would in North America.

There is, there is even in the United States now, I, I understand some pharmacies are compounding the drugs.

Yeah.

Yes. I, I know a woman who's going to a compounding, uh, facility to get her medication starting next week. And because she's, she's a pretty affluent person, but it's cheaper for her to get the formulation than it would be for her to get a prescription.

Look, does it—

how much cheaper is it, Dave? Do you, do you know how much cheaper it is?

I don't, I don't know how the, what the difference is, but it's substantial enough to, to make that arrangement. Okay.

Okay. But if I, I understand that that can only be done as long as there's supply constraints because the, the, the companies have patent on this. Yeah. And I understand the patent lasts for about 10 years. Is that, Doc?

Yeah, 10. In the US, 10 years.

Well, it was interesting, like I was in a prescription study a few years ago, and as it turns out, what it was trying to do was for an ADD medication, was that the medication lasted 4 hours, and if they changed the formulation so it lasted 6 or 8 hours, they could extend the patent.

Right.

So rather than having it expire and go generic, by changing the formulation, they could extend the life of the exclusivity of the patent. I dunno if there's similar kind of considerations.

Oh, they always are. They did the same thing with Viagra. The Viagra patent lasted almost 20, 25 years.

Yeah. There's another one that's like, yeah. Yeah. So we have Viagra and we have Ozempic. We are, you know, if you have the money, you can. Be a new person.

But what about the long-term, uh, yeah, that's a whole other talk show there, uh, Kettle.

Sorry.

I'm keeping on with this though.

Um, hard to believe.

Turning to the long-term effects, we looked at the economic sustainability, but Dr. K, is there, many listeners wonder about the safety and effectiveness of these drugs over time. Has there been any long-term studies on, or is there gaps in research on these studies about long-term effectiveness and any side effects?

Well, I mean, they've done studies that have gone on for 8 years with the people being on the drug for 8 years.

Oh, okay.

They've been pretty effective. 4-year studies, 8, 4-year have been pretty effective. And the side effect profile that you get at the very beginning of taking the drug is pretty much the same across. And seems to dissipate.

They, the side effects seems to dissipate.

Yeah, that tends to dissipate except in, in some people when you increase the dose. So let's say you start out with the, you know, 0.5 milligrams, which would, depending on the drug, or it, or, or 1.3 milligrams. I can't remember what it is. Let's say as an example, once a week for 4 weeks and If the person tolerates it, then, but they're not getting the desired effect, meaning that they haven't really lost much weight or no weight at all, then they'll bump it up to the next level of the dose of the drug and try that for a month. Come back and measure whatever parameters are they measure, and they'll always— easy to measure sugar, easy to measure on a scale what the person's weight has become. So you can do that and you can see along. And the people who discontinue the drug because they can't tolerate it, you know, one of the things you tend to always see is that even though the drug was helping them to lose weight, they couldn't tolerate it because of the side effects. So they stopped it and would go right back to their pre-weight, pre-treatment weights. So they would gain the weight back that they might have lost, you know? And this is no different than when, you know, you have people on these different diets back in the day.

Yeah.

And they go back to whatever is normal and do the same thing.

And if they lasted that long to go through the regimen, that, that's, that's the difference, I think. Yeah. You know, and that's, Takes discipline.

In the case. So, yeah, you know, they used to have this television show, Big Fat Loser.

Yes.

Where people would get— there was incentive. There were these intensive programs where they got them to cut back on what they ate, exercise, do all these other things, and they would get— they would win money for losing the most weight. But what they found is those same people who all lost about 15 to 20% of their body weight during the course of the show, they would regain the weight within a year. Yeah.

Yeah.

I had someone say to me that the whole thing about weight loss is it's sort of like mountain climbing, that people think that the hardest thing is the losing of the weight, but really like the most dangerous part of climbing a mountain often is coming down from the mountain. And that once you've lost the weight, finding a way to keep it off.

Yes.

Is the most difficult thing.

It still falls back on lifestyle.

Yeah. Yeah. I think it's not gonna change exercise habits. I mean, in fact, I guess in, in the gym culture, the people on Wegovy will be sort of clapping their hands because they'll be saying all the people who wanted to put on muscles, they've had steroids for years and they're walking around with these bulging, at least we've got our own back, you know, we've we've got our own drug now. But I think people, that sounds trivial, but it's true.

You know, people want to get out of jail free card.

Yeah.

I mean, you want to have the benefit and not have to do the work, you know, in a way.

And yeah, but I think, one thing I kind of wonder about is that, yeah, I do say though, when I alluded before to the visuals of people have been on Ozempic and have lost a lot of muscle, I always refer to the Sydney Harbour Bridge effect. You've got a big suit. People have had suits that they previously wore. Yes. They no longer feel like a suit and it's just like a big hanger sitting off them. Yes.

And as you said, a few of the recent politicians who I won't name, who you can tell with that, but as, as you said before, these drugs don't, I mean, it's, it's the weight loss, the fast-based loss.

Yes.

Problem. So, and how would you actually deal with that? And these drugs don't enter a new thing in the equation there. So they should have a chance to build up muscles after.

Yes. Yeah.

Yeah.

And that's important. Willing to, they should be willing to work on it and realizing that they could, because in many, what you'll find is in the people who do the muscle toning and the muscle building who happen to be on these drugs, what'll happen is they'll plateau where it won't look like they're really losing any weight, but These are the same people who will tell you that they're 1 or 2 sizes smaller in clothing because they've reduced the fat, toned the muscle. So they've gotten fitter in that regard. And so, yeah, but their weight on the scale may not have changed very much.

You guys, I have to run out to get the drug now.

But run to the gym, run to the weight training gym straight after.

That's jiu-jitsu and fencing. What are you talking about?

Well, you know what I'm going to say.

Okay. Guys, should we, should we, I mean, edit? Should we sort of wrap it up now? Yeah, I think we'll wrap it up and maybe we should think about having another episode and take questions from, uh, maybe, maybe I'll wrap it up with saying that the 3 The 3 things that we should look at are, uh, doctor supervision, weight training. Yes. And life and general lifestyle modification.

Yes.

Yeah. Okay. Just, we just wrap it up.

I'm, I'm cutting. And then when you start, that's where we'll redo it. If you wanna do something with questions, like I could take like family members, like, you know, your spouses and they could ask questions.

I think it would be great to get some questions. We might even be get question from India since you have your Yes. You have the biggest podcast in India.

Yeah, just, yeah, we're, we're, we're 130th in the health and wellness space in India.

Well, so I think we need to figure out how they actually been there gonna get there.

There's only 131 in there.

I'm gonna look at it.

There's over a billion people in India and we're 130th.

I think that's pretty good.

Yeah.

Okay. Can I, we're gonna go up.

I'm, I'm leaving back.

Wait, wait, kettle. Um, Can you just wait till he wraps it up, then we'll close that way we don't lose you.

Yeah, until he wakes up. I'll close it up now and I'll just finish off with that close. Well, okay, guys, I guess the real takeaways from this, just to, if I can get verification from you, Dr. K, is that one, if we take these drugs or if you, you know, get them prescribed, they should be under a, definitely under a doctor's supervision. Absolutely. Weight training should be included, or at least some sort of strength resistance work. And 3, general lifestyle modification. Yeah. It, that, it's not just the drug that's gonna do the work. You have to actually work with the drug, so to speak. So on that note, and we're gonna talk more on this and we'll get some questions from our listeners and maybe discuss this in a future episode, but thanks for tuning in, folks. We'd love to hear your thoughts, and if you have any comments or questions, connect with us on our social media. With links in the program notes or visit our website at wellnessmusketeers.buzzsprout.com. Don't forget to like and share this episode. Subscribe to Wellness Musketeers for more insights. Your support helps us reach more listeners, spreading wellness to everyone. Stay healthy, stay inspired, and we'll see you for the next episode of Wellness Musketeers coming soon.