Discovering the Path to Weight Health - Episode 324

In the pancreas, as you were just talking about beta cells. Right. That's where insulin is and that's also where GLP1. So it's really interesting about when we have the fasting, mimicking diet, what we're what is helping the body through autophagy and through helping the body's ecosystem connect better and the digestive support, it's giving your weight, health, hormones an opportunity to come up to more optimal functioning on that part, you know, so I think we really have to. I love the concept of, you know, ecosystem optimization, where when we look at that, the outcome is weight composition. The other part about it is we are never going to have the same weight composition throughout our lives. So that's right. That was. And I think that's a really important, you know, if you're going through a treatment for a disease, if you are sidelined from an injury, if you're very excitingly pregnant, if you're training for something, if you are, you know, whatever these ifs are. And so what we also need to do is we do need to learn into weight composition as a key performance indicator of health.

Welcome to the Gladden longevity podcast with Dr. Jeffrey Gladden, where our passion is helping you to become an AJ hacker. On this show, we want to help you optimize your life energy, longevity, health and human performance with impactful and actionable information by answering four questions. How good can we be? How do we make 100 the new 30? How do we live well beyond 120? And how do we live young for a lifetime? Now, here's today's episode of the Gladden Longevity Podcast.

Welcome, everybody, to this edition of the Gladden Longevity Podcast, where we're here answering life's big questions. How good can we be? How do we make 100 to new 30? How do we live well beyond 120? How do we live young for a lifetime? And how do we develop that 300-year-old mind? And in today's podcast, I'm meeting with a registered dietrician, Ashley Carr, who has written a book, you, Best Shot, and also runs an organization, the Better Nutrition Program. And we go into a really deep dive on her story with weight and weight gain and weight loss and lots of different elements there. We talk about GLP1s at length. We talk about different ways to reset physiology and psychology and all the different things. So if you're interested in optimizing body composition or body weight, this is going to be a great podcast for you to take in. She's really a lovely Guest with some really terrific insights. Ashley, welcome to. Welcome to the Glad Longevity Podcast. It's good to. Good to have you here.

Thank you so much. I appreciate it.

Yeah. So tell us a little bit about how you got into this space. I'm curious, you know, when you were in fourth grade and you were imagining your future, is this the future you were imagining or what? How'd that work out?

Yeah, I'm going to take us back a little earlier. I love that you hit fourth grade on that part, because fourth grade, I was writing a report on the brain and super into how the brain works, works. And so I actually think I was imagining this. I just didn't realize it was a. Gosh, I was this, like, super cute, very bossy, outgoing, happy young girl until about age 8. So I tell people I was a cross between, like, Shirley Temple and Spanky from the Little Rascals. Like, I was out there. I was a little bit of trouble, you know, definitely like the neighborhood gang, like, that kind of thing. But at age 8, and I'd always had a belly. I was cute, I was chubby, and never had any health issues per my doctors, you know, per everybody. But at age 8, a young boy, a bully in school, took me out back with another kid. And I was just reflecting on this the other day because my niece turned 8, and he ended up punching me in the belly, like, multiple times. And, you know, he was just being a bully all around, but it was definitely about being fat or, you know, that kind of thing. And I remember it was this, like, light bulb moment of my belly is now a weakness. And I started at that point to think of it as a weakness. And I was like, I'm so strong and driven that I'm going to get rid of any weakness. And so I started dieting. You know, I started being like, all right, how do you get rid of a belly? And society.

Eight years old.

Eight years old. Yeah. And society was ready to say, like, here are. You know, it was the 70s. I just, you know, it was the start of the 80s. And it was like, here's. Here's that. And an interesting thing happened, Jeff. For the next 20 years, I'll call it 12 years, I was always told by society that I was healthy, but that my weight was the issue. And it was really my issue. I need to manage it. I need to lose it. I need to. So I went. I did the things that one might deem healthy as a healthy weight loss, diet and exercise. I did a lot of things that were unhealthy and it wasn't until I at the sort of my rock bottom of unhealthiness, I ended up meeting a gastroenterologist in a bar. This is how the joke goes.

Sounds like a joke, right?

Yeah, totally. I met a gastroenterologist and he was a different kind of gastroenterologist. And he had me come to his office, he took my insurance, so he didn't charge me anything else. And he said to me, it's not, it was the first time anybody had asked me about being on antibiotics my whole life or being on birth control or what was, what were my skin issues or what was my anxiety like. And he said to me, you know, it's not what you're eating or really what you've been avoiding. Because at this point I was not eating like I was avoiding everything. He said. It's that your body doesn't have what it needs to run better. And that was the first time that I realized that we are in a. We have been, we're still in a weight or health society and we really belong in a weight health society and that we really need to see the body as an ecosystem and our protocols need to be about weight health. And now that we know that we have weight health hormones, we can actually do that. So I'll do that as the lead in and we can dive in. Yeah. Around eight, age eight. Yeah.

Yeah. Well, I'm interested to understand all the, some of the bad things that you tried. What, I mean, what were you doing? You know, because there's a lot of, there's a lot of body image things for, for boys and girls, but I think maybe girls to some extent a little bit more at least I think from what I understand. But that may not be true. But nonetheless, I think, you know, body image, identity, sense of self, sense of self worth, sense of lovability. You know, there's lots of different things that sort of factor into this sack of bones and organs. Right. That we move around in. Right. And I'm just curious. That sounds like there was probably a psychological roller coaster there going. Right.

Like 100%.

Being anxious, being.

Yeah.

Encouraged. Being, you know, like every emotion probably self, self loathing, self love, so, you know, self soothing, self, you know, whatever. It seems like there could be a whole range of things if you're, you know, kind of in that choppy soup, so to speak.

Yeah, yeah. And I agree with you on the boys versus girls. I would say around 2000, 20, 10, boys have caught up and really exponentially unfortunately caught up into diet culture But I think prior to that, it was much more, you know, I observed that it was unless. Unless a boy was significantly overweight or obese. It was more just, you know, taught more, not seen as an issue. So I love that you point out the roller coaster, because one of the things that the roller coaster did was trap so much trauma in my body and also my vagus nerve. And so I think, you know, we can talk about that. But I think the second piece is it also really led to a dual identity for me. Years later, I would go to the Kaiser Family foundation and work on a program called Talking with your kids about tough issues. And we were using some research that they had found that between ages 6 and 11, and this was back in the early 2000s or actually the late 90s, that you needed to talk to your kids about sex and sexual health because they really wanted to hear from you. I actually today think that's like in utero. Like we've completely, you know, it's. It's like we really have to have these conversations. But the interesting thing about the research was one of the reasons was that when girls did not feel good in their body, they were more likely to participate in risky behavior. So I was drinking alcohol from age 14. I was, you know, probably like, really confused about both, like, like, sexual identity and, you know, like, sort of the role of my body, you know, And a lot of it was fear based. Put myself in very unhealthy, you know, situations. When I met some folks that had eating disorders, I tried what they were trying. I failed. And then I carried with myself a sense of failure because I couldn't binge. Like, and I couldn't purge or I could binge. I just couldn't purge. I tried not eating. I remember as a lacrosse player in college, I was very, like, I played for fun, you know, it was a. But I remember one day my lacrosse coach saying, like, I passed out on the field, and he came up and was like, what are you eating? And I was so proud of myself. And I said nothing. Like, I was so, like, excited, you know, and he's like. So I had to like, sit for a week and have three, three meals a day monitored. You know, while, you know, on that part, I famously did a. Or infamously met a woman in yoga who was a healer who said to me, I know what's wrong with you. Took, went over to her apartment in New York City, let her prick my blood finger, take my blood, looked at it under. I'm sure a Fisher Price microscope diagnosed me With a worm. And she told, she's like, do you want to kill the woman? At this point, I'm 20. And I decide like it must be that I have this worm. Like, you know, I'm like having this alien like out of body experience. She had me do a seven day goat's milk only, raw goat's milk, only 40 ounces a day cleanse. So literally one of the things I'd love to, for people to break up with is the concept of the, the myth of the non compliant patient. It is not that we are not trying. Like I have tried, you know, I mean, like if there was intermittent fasting, I mean, I was trying that I was not eating until, you know, like all of these different things. And what's really interesting was years later. So I'm 52 now at 48, when my belly came back, you know, and here I am like a dietitian for 20 something years. I actually leaned into like, oh, and I've got to go down this path of like, how do I get rid of the belly? Maybe a different toolkit, but that same angst and like, and it brought up all of these like, like traumas and failures and you know, and all of those pieces. So yeah, it's deep. It's definitely deep, Jeff.

Yeah, yeah, it's very deep. I think, I think things like that are very, very deep. And we've all suffered traumas. There's. There's nobody listening that hasn't suffered trauma. And so I think that to your point, it does live in our, it lives in our system and shows up in the ways that we react, I think, to different stimulus in the environment. Right. Or stimuli in the environment. And we also. There's a, there's a conscious component which is kind of. You were realizing that as this was happening again at 48. And there's also an unconscious or subconscious or below the surface component that, that also dictates behavior and dictates biases and choices and even how we conceptualize what's possible. And all these kinds of things come into play. Right. So I think it's really, really interesting to, to unravel, if you will, what the trauma is and kind of get down to the root cause of it. And I think ultimately to heal it. Because I think the road to health is not about body weight or even body composition. Right. Which we tend to focus on body composition. It's not about that. It's really about reprogramming the nervous system to have a sense of equanimity and peace and A sense of self love, unconditional love for ourselves, a sense of feeling secure in relationships, giving ourselves a sense of safety, you know, and if we are able to do that, then all of a sudden we take a lot of pressure off the body. Right. And to your point about the vagus nerve, all of a sudden we can actually relax. And when we're not stressed, as you know, it's easier to have your body composition or body weight, whichever you'd prefer to talk about, come into alignment than it is when all that's happening with all the cortisol and all the, you know, all the stress hormones and all the neurotransmitters on top of that. Right. So I think if people are listening to this, it's really not about what you're looking at on the scale, it's really about what's in your head, I think is a place to start. Right. So I don't know how you feel. I see you nodding your head.

Well, I'm so nodding like this is such a heart filling conversation. I think one we need to have. I want to make two distinct points. You've first of all literally nailed it. The reason that I wrote my book, the reason I titled my book your best shot is not because I believe that you know, semi glutide or tirzepatite or retatrutide like that. There's a shot, a physical shot that you know, we need or to, you know, that that will, will help us all achieve some weight or composition. I the total number on the scale I could care less about but weight composition, it's that when we are struggling to optimize our weight health, when we're investing resources, yes, we care about money, we, we absolutely care about our time. But I'm talking about our hope, I'm talking about our emotions and be it being able to have a, our hearts open. When we're investing that and we're struggling and we're not seeing the outcomes or we're seeing the failures, we can't actually fulfill our life purpose. And I believe that your best shot at fulfilling your life purpose is actually learning about optimizing weight health. I want to pick up on something else that you said that I think is really so of the moment with the mass access. I know there are huge access issues, so I want to acknowledge that. But with a much more mass access and because it's on the medication side with semi glutide, tirzepatide, so like things like Ozempic and you know, others, you know Many, many people in particular, women in particular practitioners are commenting on social media that they're very triggered by how, and bothered by how thin, you know, whether how thin Hollywood is or how they feel like overnight all these people are thin. And I'm somebody who's worked in Hollywood for 20 years. I don't think that Hollywood is actually that much thinner. It's just that instead of like cocaine and Adderall, like they're actually using a medication, you know, that much of that other Americans are using and have access to. And I think what's happening in that part is we're seeing because of their trigger and their trauma and their own where they're not healed themselves, they're commenting and they're commenting on other people's bodies or on that side, that is another form of fat shaming. You know, when someone came up to me and said, you look amazing and, and you know, and then she said to me, like, I know you've got to be on the agonist. And then she's like, I also think that I saw you two months ago and I think you're looking really thin. Maybe you're on too much of it. And I was just like. And that to me is like, it was so invasive and inappropriate. And I actually said to her, I was like, if you just wanted to ask me if I'm on an agonist, I'm not. I'm like, I would have been happy to share, you know, my journey with you, but I was like, I actually have been sick for 10 days. Like, I haven't been out of the bathroom and I'm like, and I'm unhealthy right now. So this judgment that we're making, you know, I have a cancer patient who's a very, very well known celebrity and she is keeping her cancer quiet right now and intentionally for her family and for others. And she's lost hair, etc. And she, her face is all over the media right now as people being saying that she's an example of someone who's on semi gluten, you know, on too much Ozempic, you know, or that kind of thing. So I think we're really like, what we're seeing, what I challenge people to think about is when you have this reaction, I understand it like I am triggered as well. I wish I wasn't. I wish I didn't see someone and you know, if they were thinner or they were heavier and kind of wonder what's going on for them or maybe even have some envy at, you know, points in my life or. But it is what we have to acknowledge. And what I try to do a really good job of saying and reminding my patients is when someone is commenting about other people's weight, really whenever we're othering, it's about something that's not healed within us. So I just love that you brought that up because I think we, we right now really need to look at like how do we heal as a society and it's because we have been so focused on weight and believing that it told us anything about health and it just doesn't, you know, on that.

Yeah, I think that's really, really well said. Really well said. I don't think you can look at somebody and engage their, gauge their health by their weight. You know, you think about some gastric bypass patients and things like that that we saw and you know, in that case they're certainly smaller, but they don't look healthy either. Right. I mean they're malnourished and they're struggling with some of the issues that come from gastric bypass surgery.

And some did beautifully, like some of my, the day after my gastric bypass by watching patients who had. Had that. Some do beautifully. Yeah.

Yeah. I think what's interesting is that when we feel compelled to compare either ourselves or other people and there's a judgmental element to it as opposed to an empathetic, understanding, loving scenario. It's, it's in part because there's a self critic going on, right? There's, there's, there's criticism in your head about your own whatever it is, right. It could be your intellect, it could be your hair, it could be your, your weight, could be, you know, it could be the shoes you're wearing for. It could be anything, right? The car you're driving. But this kind of internal self critic ultimately is looking for external validation to feel good about themselves. And they're assuming that everybody else is looking for external validation. And therefore if they're looking thin, then they're obviously doing that because they're looking for external validation and they've gone too far and now we're going to criticize that person. Right? So it's a really interesting thing. I think one of the key things in life is actually to move away from external validation into self referencing, internal validation. I think, you know, you're actually making progress when you no longer care what anybody thinks about you. Because it's like, no, I'm internally validated, I'm doing, I feel aligned with what my purpose here. I love myself unconditionally I feel good about this. Right. I've made peace with the past. I've forgiven the people involved. Right. And I've actually now incorporate those traumas as an act of gratitude. I've transcended them to where they've made me more empathetic and more loving and more caring. Right. It's not more judgmental if those things are making me more judgmental. I haven't really either healed them or transcended them, either one. Right. And so I'm not judging those people. I'm just pointing out that the path is really one of how do you heal yourself and move away from external validation to internal referencing and validation.

Yeah, yeah. And I think, you know, there, I mean, we're in such a just dangerous society with a degree of bullying and othering that's occurring, you know, And I think sometimes we don't know what words. Words mean or how they make somebody feel not a part of. But then on our personal journey. I love what you're saying, which is to let it go. You know, one of the things totally switch gears for a second. But one of the things that was really important to me is chapter four of this book. After I go through patient stories and I tell my own story, hopefully have people laughing and like, understanding a little bit of, you know, all these different ways we can slice things. I created a chapter called SH T. And the blank or the asterisk is not an o. It's a different vowel to unlearn. And one of the things that I wanted people to realize is that as 25 years as a practitioner, we. We have never been in a place where we are. We have access to and are almost being forced to acquire so much knowledge about nutrition. Like, it's like, you know, it's almost like a sport. Like I was buying a car and the guy in the car was like trying to tell me, like about. He didn't know what I did. He was trying to tell me, like, tell me about new. Or maybe he did, and that's why he's trying to buy. Tell me about nutrition and like, all the things, you know on that part. And you know, with respect, like, we don't need to know anything about nutrition. Same goes for doctors. You don't need to know about nutrition. You have to be curious about a person. And we as individuals have to be curious about the insights that the body is sharing with us because our bodies are an operating system trying to get attention. And so what is interesting is when. And we, we know this with children like when children act out, you know, when my nephew, my five year old nephew yesterday, like kind of throwing a fit and saying like. And then he said his tummy hurts and it was like. And I said okay, well if you want to go inside and not come, you know, if your tummy hurts, like we, we can absolutely stop and we can pay attention to that. And he was like, oh no, I think it's all better. And I was like got it. Like you were trying to get attention. I was like, and it's not that I'm not listening, like whenever your tummy hurts, I want to ask that question, you know, and dive into it. But when we, when we learn that we can actually get attention, you know, or said differently, our body doesn't have ways to get our attention oftentimes or it does have ways, but often we fail to give it the attention that it's crying out for. We might band aid it, you know, so say that, say we're over producing acid or we're under producing acid and we see someone who gives us a, which is so common a misdiagnosis and we throw, you know, we start to take a proton pump inhibitor. Let's just shut off acid. Instead of asking the question why do we have high acid? Or what is actually going on for you? That's a situation of an antagonist in the body. Well, one of the things I need people to unlearn is that that is an abundance, appropriate way to optimize your weight health because what happens is for everyone and we have millions and millions of Americans on a proton pump inhibitor or an acid suppressing medication. When you are doing that, you are ignoring signals of digestive dysfunction and you're creating others. Now if I add on top the most common recommendation right now, which is to eat more protein, we have a full on hot mess. We have an inflammatory fat making blood sugar, you know, dysregulating mess in that part. And yet what would led us to a lot of that is how we feel and sometimes we actually are having that, that digestive feeling because of our trauma. So we can just see how this, it's this whole ecosystem, you know, that we need to dive into.

Yeah, yeah, I think it's, I think it's really important to understand how the psychology of it all plays into the health of it. And to, you know, to your point about acid production, you know, you can, you can have a disorder where you're, you know, making lots of acid.

Right, right.

And that's, that's a real, that's a Real syndrome. Right. And then you can have a lot of acid because you're full of a lot of stress. Right, right. And so is, is the answer to the, to the problem, you know, proton pump inhibitor, or is it dealing with the stress, finding ways to actually deal with the stress? Right. And so I think it's really important, as you listen to this, everybody wants sort of a quick fix. Like I looked in the mirror, I don't like what I look. Just give me something so I can look better, so I can keep going on what I'm doing. Right. And I think it's interesting that we sort of take our health for granted until. Right. Until we can't take it for granted to some extent. And then it's sometimes it's a little late to try to get it all back, and sometimes it's not. But I think it's really important to kind of have this curiosity that you're pointing out about, you know, how does this thing work? How does this whole thing work? Right.

How do I work?

How does the biology work? How does it interface with the psychology, the spirituality? How do all those pieces fit together? Because if you're curious about that, you're going to find some really, really interesting answers that may be n of one type. Answers like this may work for you, but it may not work for your sister or your brother or certainly your best friend or whatever. So I think as we go through

and well, and can I get curious?

Yeah, go ahead.

Oh, I want to double click on what you were saying is like. And as you're saying that one of the amazing pieces is. And we may have an insight that actually really does fix or get you started real quick, you know, in that way, like I have just as many people, like I have a woman who lost five or six pounds of fat in her first month on a program without the shot. And I've had people who have lost the same amount of weight on the shot, but where they've lost muscle and fat or where they've also had digestive issues. And I've also had people who have been on the shot, lost the weight and optimize things like their, their inflammation was better, their knee pain was better. So we can actually get insights about what is the most effective, what's the most efficient, what is quick in that when we actually look at the insights of what the body is telling us. I think the comment that you made about fixes is the problem. We're calling things fixes, right? We're calling, we're crediting a shot Like a semi glutide or, you know, zempic, et cetera, as in a solution in and of itself. Instead of saying it's a tool in a toolkit for a personalized recommendation that we need to see how, you know, works for your body. Sorry, I just wanted to make that point because it really.

Yeah, I think it's a great point. And I think to your point of it's a tool, it's actually, it's. If you're going to approach this effectively, you know, and get what I would consider a durable solution. Right. A durable answer. Not just a quick answer, but a durable one, you know, then you really have to, you really have to do justice to all the different components that go into it. Right. Well, sleep and stress and exercise and all those are important. But everybody that, you know, ate less and exercised, didn't really lose a lot of weight. So what are the other things that have to be tested? Well, you know, what's my thyroid doing right? Where are my hormones now? What's. There's so many. You know, we're complex biological organisms really. And I think the way we think about it over here, Glad longevity, is that you really have to deconstruct the individual.

Right.

And understand them deeply before you can make any recommendation. And we're not anti, you know, tirzepatide or retiglutide or any of them. Right. And we've come across callocurb here recently also Ameristate, and that's really fascinating, which is something that was discovered in New Zealand through some research that found that if you activate the bitter taste buds, which are located throughout the entire gastrointestinal tract, you can get similar results to using semiglutide, but you actually lose less muscle, more fat, and you can titrate it as well. So there's lots of. My point is there's lots of tools out there, but it's really about. It's really about how do you get a durable result. And that is a more comprehensive picture that requires more deconstruction, I think. So.

I love that. So we're gonna, we can dive in on, on this in particular. So somebody who has asked me, you know, because there's these comments especially about like nature's Ozempic, and they'll say, like, okay, there, you know, are there any supplements that work like an agonist? And the answer is absolutely not. Like, there's nothing that is going to be thousands of times thousands and thousands of times our own. So our own hormones stay on for about two to five minutes and then are deactivated. And these are thousands of times. But the other part about the medications, and I call them weight health hormone replacement therapy, so the thing to understand about those is that they circumvent your body's whole system and they go in just to the receptor sites and just activate it there and then they stay on for this longer time. So there's pros and considerations. On the flip side, there are tons of supplements, tons, some are of varying quality, but there are tons that are weight health optimizers, even ones that actually help to promote our own weight health hormones. So, you know, in understanding that, you know, you may need certain peptides to make them, you might need glutamine to repair the lining of the digestive tract, you might need Akkermansia to chew up the mucin and it needs polyphenols to feed off of. And we need essential fatty acids to reduce inflammation and to nurture. So there's all sorts of things that when there's a gap in the nutrition that you get in from food or therapeutically will use those. And then there's this tiny little window of weight health hormone activators. And I actually did some of the, with my patients, some of the initial research on amerisate and it's in the book, the case studies are in there because when I first walked by it at a 4M like three years ago, I was like, that is an FDA problem. Like what they are saying cannot actually happen. And then I dove into the research and what's really interesting is when we look at in particular and they looked at 400 different plant compounds and arrived at four and then found this one. And what's great about it Jeff, is also it doesn't just do GLP1, it also helps activate PYY CCK, we think now GLP2. So for anyone listening where that sounds like Alphabet soup, just understand that there are tools. And the woman that I was just Talking about, the 42 year old perimenopausal woman who didn't want to use Ozempic, I used Calicob with her because the Amerisate, I had come up with her whole plan, but she had told me as of 2 o' clock with her three little ones and her husband coming home and with her job and with the dog after two o' clock in the afternoon, it was just always off the rails. So we figured out what her body needed, but there was a break between what her body needs and what we could, what would probably Help her here with her weight, health and what she could actually do. And so I think what we're also, you know, what a lot of people are looking for are tools that can help them make this doable. You know, that this is. Is this moment. And one of the reasons that retatrutide, semiglutide, tirzepatide are successful is a lot. When used properly, it is actually working as a training wheels. It's helping people feel like they can make the other choices. When used inappropriately, it's really causing a problem.

Yeah, no, I think that's right. I think that's right. You know, one of the approaches that we've had here is we find that optimized body composition is kind of a side effect of doing a lot of other things properly, like optimizing hormones, thyroid, exercise programs, you know, a diet. That's right. For that individual working on their stress, you know, using things to increase the. Teaching them how to meditate, you know, things like this. Right. Using more theta waves, brain tap, all these kinds of things. And when you dial all that stuff in, then, you know, they jump on the inbody or, you know, DEXA scan or whatever, and their body compositions change dramatically. Right. In a very positive way. So we've, We've seen for so many of our clients that actual body composition, optim optimization is actually a side effect. Yes. Of doing all the other things properly. Right.

Like an ecosystem outcome.

Yeah, I love that optimization outcome. And I think part of the, part of the emphasis that we place on it is that it is the goal. Right. When in actual fact, it's actually a side effect of reaching the actual goals, which is optimizing the metabolism. And all the other pieces I mentioned, I think, I think the people that come in here, we have that conversation with them and some of them still want, you know, let me jump start this. Okay, well, we can help you jump start it, but just understand that we're not going to keep you on this because as these other things come into play, you know, you won't need them. Quite honestly, you won't need them.

I was just working with a patient where her doctor and I real. And she. And myself, and her doctor and I, I got. We kind of had it out. Like, we got. We had a pretty tough time because her doctor really wanted her to keep going up on the medication and she wanted to stay at the. At the dose. And the doctor's like, but you're not losing. And this was a really interesting thing. And I finally had to, like, have a Separate call with the doctor. And I'm just also going to say that she's not working with that doctor any longer. But the doctor was missing that the, the excess fat for this patient was covering up and helping her feel safe out into her world. And this is someone who has a lot goes back to the start of our conversation. A lot of things buried within her. A lot of things that were coming up in her own community and in her own home where people were starting to reject her, you know, as she was losing weight and some of these other pieces and she wasn't ready. She's on her own pace, you know. And one of the things for me was I was like, can I please just get you in with like a good, a therapist that understand, understands this, you know, on that part. And I, and I think that the therapy is doing, I know that the therapy is doing so much more work on that part. And we just, we pivoted plans for where she was getting prescribed the medication. And so, you know, I think like we, it is, there are many things about health care that are unfortunate today. And I think that there's an evolution that, that will and is occurring within the world that is known of as obesity medicine. But when you have a medicine and the, the mon, the, the, what do you call that, the modifier to that medicine is about. When we just talked about obesity, it's really just about weight for height. And we don't get in and we don't start to under unpack all of the different things that are actually going on for that individual and not look at the weight, you know, and just say like, hey, can we see like. And this was somebody whose health like was so dramatically improved that I really feel like she has like the long term fighting chance. The bigger thing for me that I'm so excited about is I also think her children do, you know, and the people in her community, community. So I think we really have to. I love the concept of, you know, ecosystem optimization where when we look at that the outcome is weight composition. The other part about it is we are never going to have the same weight composition throughout our lives. So.

That's right.

That was. And I think that's a really important, you know, if you're going through a treatment for a disease, if you are sidelined from an injury, if you're very excitingly pregnant, if you're training for something, if you are, you know, whatever these ifs are. And so what we also need to do is we do need to learn into weight composition as a Key performance indicator of health. So if, whether it's 5 pounds on somebody's belly or 50 pounds on someone's belly, you know, or 5 pounds of liver fat, and we're not even, you know, we don't see it externally on the, on the belly. We do need to unpack that and see that that's what's going on, you know, for their body. But we need to stop. Like, this is just the, the, you know, I wrote the book. I'm like, this is my best shot at literally changing the way the country looks at our health. And longevity is really rooted in weight health, whatever your size is, you know, on, on that part. Yeah, yeah.

No, it's. It's a really good conversation. I think I, I agree with your approach and your book. So what are some of the, what are some of the biggest insights that you've seen for your clients that you find is helping them?

Yeah, the big one for me is it takes me back to that, like fateful in the absolute best ways. Interaction with a doctor, a gastroenterologist, who also was a different kind of practicing gastroenterologist in the bar. Our digestion. So in my book, I use the analogy of a pizza. Our digestion is our crust. Like, we cannot have a pizza. We can't have anything that's going to be delicious to us. That's going to hold up. That's going to do. If your digestion, which I include hydration in that, if that's, that's suboptimal, that's where we have to invest our efforts. And the reason for that is that we give a lot of credit, especially in my world, we give a lot of credit for foods being healthy or foods being unhealthy. But your body actually doesn't say whether or not something was healthy or good for it until it actually is able to break it down and then have usable nutrients reach where they're supposed to go. Right. And that. Or eliminate the waste products. So, you know, the healthiness of something is really, is very much the, the end result. And so, so our digestion really needs to be optimized in the. When you add on top of the crust, you look at the sauce, and so the sauce of the pizza is better nutrition. Better nutrition being your body having today. So it's personalized and timestamped. What it needs to run better while reducing, avoiding what can irritate, overwhelm and disrupt its efforts. So really looking at your nutrition in those two ways, things like. And there are four pillars, quantity, quality, balance, and Timing. Things like fasting have gotten a lot of attention, you know, so adjusting the timing and creating this caloric window and saying when you eat and when you don't. But when we look at that, there are times where the timing could be beneficial for something in our body. But overwhelm, setting up a situation where it's overwhelming. As an example, if you don't eat, don't start your day with having any calories until 11 or 12 o', clock, like 11am 12, 12pm if you're trying to then get in everything that the body needs to be optimally resourced between 12 and, say, 6 or 7, or if you're backloading, extending back into, you know, 8, 9, 10 o', clock, you're overwhelming your digestion in that time period. You're overwhelming your body's schedule of what it has to actually get through before it can lean into its recovery efforts, which are what it does when it's. When you're. So I think we really have to look at, at everything and understand the pros and considerations and make choices that align with our body and not say, like, I mean, if I had a dollar for every time I've been asked in a media interview, you know, in the last, like 10 years, is intermittent fasting good or bad? You know, and now it's, is the shot good or bad? And I'm like, it's none of these. These are tools. They're tools. And, you know, a practitioner and an individual needs to understand the pros and the considerations, you know, of using them.

Yeah, I think that's right. I think, I think one of the interesting things for us is that, you know, it seems like most diets, apart from fasting, sort of tend to start with the food, but it feels like from our perspective that you really have to start with the individual. So, I mean, kale may be great, but it may not be good for you. It may have too many oxalates, for example. Right.

Or you may just not find it delicious. Like, you just may not like it or you don't want to chew it. Yeah, totally.

Totally. Exactly. I mean, you know, kale has some really great qualities, like really high dietary nitrate and, you know, really great for boosting nitric oxide and a bunch of other things. Right. But. But it may not be right for the individual, so.

Right.

You know, in our world, it's really. And if you're listening to this, understand that you're an n of 1 and that it's not what your sister's doing or your neighbor's doing what you really want to take responsibility for is getting tested so you can figure out, you know, what is my digestion, you know, do I have enough enzymatic, what's my enzymatic production from the pancreas and is my gallbladder working? Is the stomach acidic enough and do I have bacterial overgrowth in the gut and am I, you know, absorbing things properly? And you know, if, if you don't understand that first and then you understand your immune system and your food sensitivities and other things like that, you know, then you're, it's really hopeless that you're ever going to be able to find really the right quote unquote diet. I will say that in our world we found in certain circumstances and it's not for everybody, so this is not a generalized recommendation, but for some people, starting them off with something like a five day fast mimicking diet has been very, very helpful. Right? It resets the gut biome and of course the biome is actually driving a lot of appetite. Right? If you've been eating sugar and you've got bacteria that like sugar, they're going to crave sugar and send that signal to your brain and you're going to crave sugar now. So it's right, you're coming along for the ride. But, but I think it's really important to pay attention to the gut biome and then kind of go from there.

So anyway, I'll pick up on that. So I think so much of Prolon also is that or fasting mimicking. That happens to be the sort of like branded name. I also think that and it is when you don't have to make any choices about food, you actually are able to do what a GLP1 agonist is doing for a lot of people, which is remove all sorts of food noise. So I've had so many people that their first experience with an absence or a reduction of food noise is actually using the fasting mimicking diet that it also, when you don't have the option of going out to dinner or eating later or doing these other things, you lean into maybe going to bed earlier or you lean into maybe tuning into. Does my body actually have enough energy to go to do the kind of workout you know, in some of these things? I also want to acknowledge you mentioned the word testing and I just want to double click or amplify that one a little bit because one of the things that I found especially in this world right now of like everybody needs more tests, like we're making Testing more accessible. We're making it direct to consumers. So they're doing it without practitioners. They're getting answers with tests where AI is answering their results. They're buying supplements off of a test about their, you know, blood work like which doesn't tell us anything about their urine. Their body is, you know, bone out like all these other things. And I think testing is another form of, is a key. And the data that we can accumulate like wearables also is really driving a lot of the infobesity that I see where there is a lot of information and a lot of choices that are being made right from testing. So number one, I think that testing can be used in a right order. As an example, I don't test digestive health usually until and everything's a usual like it's a, you know, caveats usually until I've done some work to support digestion to see then like to get a level playing field to then see, you know, so I can dive deeper. But one of the things that I did in my book was I really leaned into all the tools that I've used over the years to help people understand the signals their body is sending without a lab test. So as an example, if you bite into an apple and on a scale of 1 to 10, you have to have a clean mouth. But if you bite into an apple on a scale of 1 to 10, it's not its sweetness isn't a 7 or greater. Then I know that your sweet taste buds are worthy of a reset. They need to that sweetness. And that might be too many artificial sweeteners, it might be too many non nutritive natural sweeteners. It may be your gut microbiome. It just tells us a place, you know, for us to go. It also helps me understand maybe why you've been having cravings. Maybe you're also from a disordered eating past avoiding anything sweet because you feel like you've even been told like not to eat fruit, things like that. We have the, the test are you a hose or a sponge where you know, I want you to drink a little bit of water and then see how long it is until you have to pee. And that helps me really dive into your hydration. And there are more of these, right. And then when we ask questions about your, when we actually assess your weight health hormone function, which I've created the first ever assessment of weight health hormone function, we can't lab test and even if we could lab test our GLP1 or we can gut test to see do we have the potential to make enough glp. We need to understand how the system of our weight health hormone is working. And that requires asking some questions about your. Your lived experience with food. You know, after you eat, do you feel full? I was told for easily 10 years of my life, Ashley, just stop eating when you feel full. So I thought it was permission to always have more because I didn't feel full. Right. You know, it's like, like okay. And on. On that part. So I think that one of the other pieces to this and it's really why I feel like the collaboration of an RD and a doctor like you and I on, on that part is so powerful in the weight health space and why I really feel like I am the person, you know, to have written this book and to create this playbook is that we need to do we really need to dive deeper and not just rely on like certainly don't want to rely on basic labs like iron, you know, just iron, nor just tsh. We want to dive deeper. But even with all of the data that we can gather today, we really need to also make sure that we're assessing the body's signals and looking at that as well.

Yeah, I think that's a really good point that you make. I like the fact that you're using really what I would call functional assessments. Right. To get at things. Yeah. And just to circle back to the fast mimicking diet, I'd meant to add also that it does reset taste buds, interestingly enough. Right.

Which is also very cool.

And it also we've seen it actually reset beta cell function in the pancreas and seen insulin resistance decrease.

So you know what those are tied to. Let's let for the listening audience that I'm sure if they're yours, is very savvy. We have on our, on our tongue we have taste receptors for GLP1. So we have for our weight health on that part in the pancreas, as you were just talking about beta cells. Right. That's where insulin is and that's also where GLP1. So it's really interesting about when we have the fasting mimicking diet, what we're what is helping the body through autophagy and through helping the body's ecosystem connect better and the digestive support, it's giving your weight health hormones an opportunity to come up to more optimal functioning on that part. You know, so I think that that's like that type of whether you start someone with it, whether you use it quarterly and there are some people for whom it's not a good tool at all. So, you know, I also understand that piece, but I love that because I think that, you know, we even on a parallel path, I use, have used fasting, mimicking for a lot of autoimmune patients and a lot of migraine patients. Well, what's one of the things that we're seeing with GLP1 agonist with the medications? We're seeing improvement in osteoarthritis, we're seeing rheumatoid arthritis, we're seeing migraine change, you know, and so like these benefits, what it's helping us. My favorite thing about Ozempic and this revolution of a GLP1 agonist is I believe that it's actually showing society how our body works, that we have these weight health hormones, that there are receptor sites all throughout, you know, in our blood vessels, on our heart muscle, in our brain, on our tongue and our pancreas and our gut, all of these different receptor sites. And our hormones haven't been getting there. We have an epidemic of suboptimal function of these hormones now that they're getting there with the medication we're able to. Any of us who approach a more. Take it from more of a functional approach are able to come back and be like, aha. This is just further emphasizing why I'm working on this and this to work on that, you know, that sort of thing.

Yeah, I think that's. I think you're right. I mean the data is really pretty astounding for, you know, the systemic effects of GLP1 beyond anything to do with weight loss or even appetite suppression. When you look at cardiovascular risk and kidney and heart health and even brain health and things like that is so to your point. You know, it's really interesting to kind of see the physiology played out in that sense. And I'll just add this, that you know, with a five day fast, and I'm not really on a five day fast mimicking diet bandwagon here, but it's just coming to mind, you know, when we do that and we reset the system, you're also triggering a lot of autophagy. Right. And autophagy is really a godsend to all the hallmarks of aging. Right. Everything improves when you have more autophagy, but it doesn't mean you want to be, be in that state all the time. There's.

Right, good distinction.

Right. So you want to be on that ampk side of the, the, of the, of the scale, if you will. And that's a nice time, quite honestly. To throw in something, I will say this and throw in some spermidine, which actually then upregulates autophagy on top of what you're already doing. So now you're kind of reinforcing autophagy. It's like, well, if we're gonna go through the quote unquote discomfort of a five day fast food diet, why don't we go the full benefit of it? Okay, we'll take some spermidine. Right. While you're doing that. Right. So that can be helpful too, just from a longevity perspective. So I think, I think it's, it's a really interesting topic and I think one of the things that we like about that diet is the reset element. And the question I would have for you is do you, do you think that this is also resetting the GLP1 balance, having an impact on leptin, adiponectin levels and things like that? Or what's your take that?

That 100%. I think that the concept there. Now to say that in the absence of, I'm sure the evidence will be coming down the pike, but in, in the absence of that evidence, I can say it's supposition or I can say it's experiential. You know, from my parent, my patients and even my own experience that I think that what, what we see in, in a reset like that is really the opportunity for the body to lean into. You know, as I said, it's, it's multifactorial. It may be like, like that you had better boundaries with your kids and your partner. It may be that you slept better, it may be like all of these different things, but in doing so the vagus nerve probably had some stuff cleaned out of its way. And so it can bring messages and it can and carry messages a little bit better the bloodstream. Also remember that glp1 gip less so pyy and cck, but they stimulate and regulate both glucagon and insulin and then also ghrelin and leptin. So these other hormones are going to be getting a more, you know, a better experience, you know, through that. Now where I think the rubber meets the road is not if you abuse yourself while you're on your five day fast. So not if you decide to like, not, you know, to just power through it. And I'm going to work at the same pace, I'm going to exercise at the same pace, you know, that kind of thing. Or let's say that you're unwell. Let's say that the body is trying to heal that you're fighting something. And you know, some people have argued this is a great thing to do when you're fighting something. I don't agree with that. I. When you're fighting, I'm like, you know, really nurture the body. Yeah. But I also like, you know, I, I mean, I recall I did it right before my colonoscopy. It was brilliant. I was like, this is great. Like, I didn't have to do that. Like, I mean, you have still have to do a prep, but, you know, I did on this part and you know, I think that what we can really appreciate from this piece is, is that fasting, mimicking is very restorative to the body's ecosystem. And I think that's a, you know, that one is a really big takeaway.

Yeah, yeah, I think that's right. I think that's right. Yeah, we, we like it. There are some people at whom we're doing it, you know, even monthly. We've had some people come in with that are really teetering on the edge of full blown diabetes, where the pancreas just can't, you know, make insulin anymore. And we've been able to kind of see the body rescue itself.

Yes.

In conjunction maybe with some peptides, whatever else we're doing. But yeah, the point is, it's really, it's really interesting to see that. And, and the, I will say this, the other thing, we've done a podcast with the, with the prolonged people here. They put just enough carbohydrate in the products. Right. So that you don't actually need to pull certain nutrients from your muscle. So it's actually muscle bearing at the same time you're doing it, which is interesting. Yeah. But anyway, it's just interesting to see that the body has the capability to kind of heal itself if we allow it some space to do that. It's a little bit like giving beta blockers to a congestive heart failure patient. You know, back when I was training in cardiology, everybody was giving, you know, things that would actually cause the heart to contract more vigorously. Right. And they found everybody dying sooner. So those studies all got stopped and then somebody put them on beta blockers. And it's like all of a sudden when the heart was rested, it actually started to recover function. Right. So there's kind of a takeaway here that sometimes what your body needs when you're trying to reset and all of this is just a rest. Right, right. And when you think about vagal nerve tone being able to Rest, you know, so that your parasympathetic nervous system tone comes up is really a wonderful complement to the other rest that you're doing. Right. So you want to be resting your.

Your.

Your nervous system at the same time you're resting your physiology. I think that's kind of the magic combination. That's kind of how we think about it. So.

Yeah, no, I love that. And I feel like it's just, again, it's the whole ecosystem and understanding that, you know, everything hasn't. I mean, I remember I. So I lived in Maine for. For a period of time, and one point, I was taking a taxi up to. Up to my, like, tiny little town, and it was just the start of this. Of the that. Where it was probably closer to summer, but it was where spring was breaking through. And I just was, like, awestruck. And I just said out loud to the taxi driver, kind of just, you know, in admiration. I was like, ah, Maine just shows up. You know, I'm like, look at these vibrant colors and look at everything he says. Yeah, see what happens when you take about nine months off, you know? And I was like, oh, you're right. You know, I was like, nailed on that part. Right. You know, it's like. That's right. And I think that's how we all felt, too, with the tourists, like, leaving, and we're like, we got nine months, you know, that kind of thing.

Yeah. Nine months to recover. But, yeah, it's. It's really interesting. I think a lot of really optimizing body composition is actually giving your body a rest, particularly when you're starting on that journey. Right. You know, psychically as well as physiologically. So that's a really interesting takeaway. Yeah. And then there's lots of tools out there. To your point, one of the things that I. That I stress for people here when they come in is, is to let them know that there is. That in medical testing, there is no one test that gives you the answer.

Right, Right.

It's really. We. It's really. Each test is its own lens, and in order to get something to come into focus, you have to look through it. You know, look at that organ system through multiple lenses or that subsystem or system. Right. And then. Then it actually comes into focus.

Yeah.

So it is. I. We think testing can be important. I think doing the, you know, sort of the physiologic testing that you're talking about, the functional testing, is super, super helpful as well, and you can start many places. But anyway, it's it's just good for the audience to understand because I think it's a. This is a really misunderstood area. If you really start to understand that body composition is a side effect of you getting healthy, then it's like, oh, okay, what do I need to do to get healthy? Right? You start asking a different question. And in life, we only get the answers to the questions we're asking. So it's really important to frame up the question. You can look in the mirror and it's like, okay, well, what question should I be asking? Right? It's like, okay, these are the questions that will actually take me where I want to go, as opposed to how do I fit into my pants again? Or how do I get ready for the. Whatever it is, you know, the dance next Saturday or something. Right? So anyway, those just some final thoughts on my part, so.

Oh, I love it. And I just. I'm so grateful. You know, I think that one of the journeys of this book has been being able to have conversations that, you know, take me to individuals like you and being able to really help people under, you know, dimensionalize and tap into maybe some of the things that they have been less comfortable exploring. So I'm excited about it. Thank you.

No, that's beautiful. No, I love that. I love the work that you're doing. Thanks for. Thanks for what you've done and all the things you're about to do. So that's good stuff.

Thank you.

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