Power of Diet and Lifestyle for Health: 95

Hi everyone, welcome to the Heal, Nourish, Grow podcast. Today I am joined by Dr. Elizabeth Sharp and we are going to talk about all different kinds of aspects of health, but a couple of things that I think you guys will really appreciate, especially since we're coming into this busy time of year with the holidays and stuff coming up, a lot of stress. So we're gonna talk about that. Um, but before we get into all that, Dr. Sharp, I'd just love if you would share with people how it's kind of a little bit about your personal, um, background, cuz you have a lot of interesting things that you've done. You've done some amazing hiking. You're also a yoga instructor. So you're obviously really passionate, as am I, about health and wellness. So I'd love to just hear some of that background so that people can get to know you a little bit and understand why you've become so passionate about helping people on their personal health journey.

Yeah. So I would say I've always been interested in primary care, and that's why I did the internal medicine training that I did, and I knew that I wanted to go into primary care in residency. But as I started to practice, I really started to appreciate the importance of diet and lifestyle and also the impact overall and kind of wellness and a general feeling of well-being in terms of the mind-body connection. And I think also that ties in with the gut-brain axis. And so I try to tie in all of those things with my practice because I've noticed the difference in my own personal health when I'm active, when I'm eating a healthy diet, it makes a big difference, right? And so that's kind of part of what got me into functional medicine is GI-related conditions generally. I had a lot of patients coming to me with some kind of, you know, symptoms that were all very similar. So, you know, gas and bloating, abdominal discomfort that weren't really explained by the traditional medical workup. And so I just thought, you know, there has to be more that I can do for these patients, more that I can offer. And so once I opened up that door, I really started to explore a bit more in terms of lifestyle medicine, a little bit more with expanded testing and understanding how you can incorporate general internal medicine with, you know, botanicals, nutraceuticals, supplements, that kind of thing. And, and ultimately how you can create a healthy lifestyle, which is really what sustains people for the rest of their lives with their health, as opposed to just treating symptoms.

Yeah, love that. And it's definitely a paradigm that this audience is used to hearing about, kind of this, um, functional health approach where it's not just, okay, take this pill. It's more like, hey, you're gonna probably have to do a little more work than that to move on and really have an optimally healthy life. So before we get into that, because you said you were noticing that your patients had a lot of similar things going on, and I definitely wanna chat about that. Um, but Did you, I'm just kind of curious, did you find yoga during medical school, before medical school, or is this something that you kind of took on after as you realized that this, um, you know, overall wellness thing was really something that was gonna help your overall practice? Yeah.

So I actually, I've, oh, I've had a yoga practice for a long time, like through college and, and, um, before med school. And then I would say it was something that I was really doing, you know, I would say more and more consistently as I got older. Um, but I noticed that it helped in all aspects of my my health. So it made me a better runner, and I like to run. It helped keep me grounded. It really helped with mobility and flexibility, and I liked the meditative component of it. And so I actually didn't become a certified yoga instructor until COVID. Um, I had some time to do it, and, uh, and then I really wanted to incorporate it into my practice. Even when I was in residency, I had initially had this dream of like having a, a medical practice attached to a yoga studio. But, you know, I, I would say ultimately, I think now being able to incorporate exercise into your life in a way that's sustainable and easy is really the best way for most people, and myself included. I used to go to classes all the time, and now I, I practice mainly on my own or with a yoga instructor. Um, and so I just kind of do it like when I can fit it into my schedule. And so I really wanted to be able to bring that to my patients, and that's part of the reason I wanted to get certified, so I could, you know, design classes for them that they could use as a way to not only treat symptoms but also invite daily movement into their life.

Yeah, that's awesome. And that's, that's what I've always loved about it too, is that you can do it anywhere. And I also found it during college, which was, you know, a really important time because, you know, we're talking about stress going into the holiday— the holidays and stuff. I mean, students are a ton of stress, medical school's a ton of stress, grad school is a ton of stress. It's like you've got to find some outlet for that. And I'm so glad that you kind of found— because I found over the years I've just thought that that's one of the easiest things to go back to. You can do it anywhere, and it's just so accessible really for everyone. So, um, all that being said, I'm sure other than yoga and meditation that you probably have some other practices and ideas around stress. And since we kind of just led into that with the yoga discussion, maybe let's focus on that first. So I would love it if you'd share with people, um, what you've been imparting to your patients as far as daily lifestyle practices that they can do to kind of mitigate some of the stress. And I'm assuming that helps them relieve some of these hormonal symptoms that you mentioned and also the gut symptoms that you mentioned. So that's a big question there.

Yeah, yeah. I would say, you know, generally daily movement is one of the easiest and simplest things that people can start to incorporate for stress management. I always say walking is the most underrated form of exercise and just, you know, even getting 10 or 15 minutes of walking in every day will add up to a lot over the course of the week. And then that really moves the needle over the course of the month and then the year. So I kind of start there. And then I would say yoga is another Another thing that I typically do like to recommend if people are open to it, because it has that meditative component, so it can really help with stress and help with people feeling grounded. And then also taking some time where they're not on their phones and they can kind of just really focus on themselves. So time for self-care is another thing that I really try to focus on. And then in addition, I would say having wellness routines. So in the morning or at night, it may be getting up, taking a minute just to kind of get centered, then have your coffee, kind of habit stacking is one of the things I recommend. But I also think that having a routine helps people stay grounded when they get stressed, 'cause oftentimes what happens is people get stressed and then things start to fall off because you're focused so much on all the other stuff that you have to get done during the day. So carving out a little bit of time for yourself and to keep that consistency and routine, I think helps a lot in terms of reducing cortisol levels, helping people feel more in control, 'cause stress can, you know, and anxiety can make people feel a little bit out of control, and then help to prioritize things for the day. So those are just a few kind of like lifestyle things that I typically do like to recommend. And then as much exercise as possible in terms of getting at least that 150 to 300 minutes a week that the American Heart Association recommends really actually helps with reducing cortisol levels, reducing stress levels, and helping with cardiovascular health and hormone balance. So I would say those are the biggest things that I would start to recommend. And then One last thing I would say is just with eating. So a lot of times eating is impacted by stress, right? So people are eating at their desks, they're eating really quickly, they're eating on the go. So I do try to recommend as much as possible having at least some time where when you're eating, you are focused on what you're eating. You're sitting down, you're relaxed to rest and digest, because that really actually does impact then your gut, your digestion, and and how you feel.

Yeah, I'm so glad you brought that one up because I think it's such an easy habit to fall into. Like, my husband and I both work from home, and so quite often he'll come down to, you know, have his first meal of the day, which is usually brunch-ish time. We tend to eat, you know, twice a day usually. Or— but anyway, all that's to say that he'll come down and he'll still have his phone and he's reading work articles and stuff while he's eating. And, and I always have to remind him, I'm like, honey, just take a break from it for like 10 minutes while you're eating, you like, let that go and be, you know, mindful. Actually, there's a— there's also an article on my website at HealNourishGrow called Mindful Eating. I'm a big proponent of that. I think it's— there's so many reasons why that helps your digestion, but also just gives you a little break, I think, related to stress in the middle of your day. Like, you don't want to keep working while you're trying to eat.

Exactly, exactly. But it's tempting because you feel like, oh, I want to just get everything done, but Yeah. Then you don't enjoy the food.

Yeah. So speaking of food, you mentioned that a lot of your patients were coming to you with gut problems. So maybe this is a good time to talk about that. Can you share maybe what you were observing in people and then some of the methods that you were able to use to help them get in a better place with their gut health?

Yeah, sure. So when I first got into functional medicine, I had a lot of patients that ended up being diagnosed with IBS. And so, you know, they had a lot of gas and bloating, alternating or maybe sometimes one or the other in terms of constipation and diarrhea and some food sensitivities. And so what I did with a lot of those patients is identified some food sensitivities. And there's a couple of different ways that I would do that. One would be an elimination diet or modified elimination diet if patients were open to doing that. It requires some commitment and, and, and/or I would also do some food sensitivity testing. And that would kind of depend on, you know, the patient's appetite for wanting that data, wanting to do the testing and/or being able to do the elimination diet because the eliminate— I would say the elimination diet can be very diagnostic. It's a really great way to identify food sensitivities. But again, it requires a lot of dedication from the patient. So it's not easy to necessarily do so. And then the other thing is I started to explore microbiome testing. And as I was finishing my functional medicine training, I also had a lot more tools to be able to understand how to treat dysbiosis, how to diagnose SIBO and gut dysbiosis, and how to treat them. So I worked on, on that as well with patients, and then also did a lot of nutritional counseling and worked a lot on diet, um, you sometimes using probiotics, sometimes using other supplements like ginger for digestion, peppermint oil, things like that, enteric coated. Um, so, you know, different different things of that nature, I would say were really helpful in terms of helping to control symptoms. And then one of the big things I really like to do is empower people with their health, right? So just even understanding that, you know, maybe someone has a sensitivity to broccoli and they might want to go out and eat broccoli, but then they can, you know, take something beforehand so they feel better after, or at least they know what's going on. So when they get those symptoms of bloating and a little abdominal discomfort, they've been intentional with their food choices, right? And so I think that, that was really helpful. And also just feeling like there were tools to give patients or things to do in terms of their symptoms as opposed to just sort of saying, well, the workup was negative, so everything must be fine. Right. And so I think that was a big turning point for me in, in my medical practice. And, you know, I definitely still like to practice guideline-based care in terms of using antibiotics when appropriate, cancer screening, all that stuff. But at the same time, I think there's so much more we can do, as I was just kind of explaining, in certain situations. Um, I would say also with hormone health as well.

Yeah. And the, the food thing's interesting cuz I think, uh, you mentioned, you know, food sensitivity testing and things and, and, you know, every individual has different things that they may be sensitive to, but I'm just kind of curious if there are any foods or categories of foods or, um, types of foods that you have noticed that across the board tend to give people symptoms, or is it just kind of everywhere based on the individual?

Yeah. So, you know, it's interesting. I would say I've noticed, especially with IBS, you know, there's the acronym FODMAPs for the specific types of foods or saccharides in particular that tend to be more irritating for patients. I definitely have noticed cruciferous vegetables, while they have a lot of health benefits, can be gas-inducing. So, you know, broccoli, cauliflower, Brussels sprouts, that kind of thing. I've noticed also sometimes onions and garlic can can be irritating for some patients, and oftentimes it can be like a dose-dependent response depending on how much is added into the food. Um, and then the other thing I would say that I try to, to talk about a lot is just a lot of food additives, right? So, um, as much as you can, eating a whole food-based diet and cooking so you know what's going into your food helps to identify food triggers a lot easier, um, and then understand what might be impacting different feelings in your gut, whether you know, slowing digestion or feeling bloated or, you know, also just generally feeling fatigued or having a lack of energy. So I would say, you know, generally those things. So artificial sweeteners are a big thing that I try to, you know, talk about. And then one other thing I would say I always ask about is caffeine, because caffeine can really impact digestion and and a lot of people will slowly, slowly, slowly start drinking more and more coffee, um, or strong coffee. So that's something I like to talk about as well. Yeah.

And then wonder why they're running to the bathroom after they've had 5 cups of coffee. I would think that's definitely not good for people with IBS in particular.

Yeah, exactly.

Yeah. And one thing I like that you mentioned, um, because I think it, you know, it's, first of all, it's kind of interesting to sometimes tie your symptoms to What you ate that day or, or, you know, keeping a food diary so that you can really go back and notice like, oh, well, every time I eat this specific thing, this happens, whether it's an IBS thing or bad sleep or whatever it is. Because sometimes, you know, for even people that are really aware of that stuff and very focused on it, like I find I'm like, if I would've just, if I would keep a food diary, I could maybe tie this together a little better. You know?

Right. But you know, the tricky thing is when people go out to eat, then you don't actually know everything that's in the meal. So let's say you order like chicken with sweet potatoes and rice, like, who knows if they put butter or olive oil or, you know what I mean? So it's hard to know.

Most likely canola oil though, or something like that if you're eating out. So probably the seed oils, which I have been able to, you know, some people, I know that's a whole kind of controversial topic in the health and wellness space. But I have definitely been able to tie not good symptoms in my body because I never use those things when I'm in control of the food and we don't eat out that often. And so I'll notice if I'll go somewhere that, that that, you know, that most of them, 90% of the restaurants are using that type of thing. That definitely doesn't make me feel good. Like sometimes it's really like a negative effect, like on my gut and just not like feeling right, kind of headachy and stuff. So I think there's definitely a little something to that for some people. It's, but it's just again, being aware enough to kind of realize, well, what would, what would that extra thing that we're not seeing, what could that have been?

You know? Yeah, I agree. I agree. I notice a big difference also. I know it's, it's hard to identify, but once you do, it's very empowering. And you're like, okay, I know what's going on. Yeah.

Except the problem is if you go out to eat, you cannot avoid that. You just have to know that you might not feel so good, which is unfortunate. I agree. So talking about gut health, I mean, one of the things that you mentioned is once people kind of, you know, and IBS is, I think, somewhat more common today, but how that ties into hormones, because I know one of the things that I was noticing, like on your content, one of your— I think it was an Instagram video. It was basically like kind of like debunking TikTok myths and talking about hormone health. So maybe if we could chat a little bit about that and how improving your gut may also help some of these hormonal issues.

Yeah. So I would say, you know, in terms of gut overall and gut health, there's a lot that I think we're still exploring and discovering, but I think it's definitely more widely recognized now that the gut-brain axis. And so you know, your gut talks to your brain. I would say even if you look at like the class of GLP-1 medications, for example, we can see how incretins, which are hormones that are released in your gut in response to food, actually impact the pleasure center or pleasure and reward center of your brain and, you know, impact feelings of satiety and feelings of hunger, right? And so that's just like a simple example of how hormones are really interacting in our gut, just even in response to food. But Beyond that, when you have, you know, leaky gut or you have inflammation in the gut, let's say from a bacterial overgrowth, it also then changes hormone balance and changes the way that your gut is interacting with really the rest of your body. And I think that it's important to recognize that there's such a complex interplay between all of the hormones in the body that nothing's acting in isolation, you know, so that can start to impact impact thyroid health and can impact, you know, hormones for your menstrual cycle, for example, or things like that. Or, for example, could be that PCOS as a diagnosis then is impacting your gut health. Or, you know, it's hard to sometimes say it's not a bidirectional relationship with all of these hormones, especially if— I'll just take another example, but let's say you have dysbiosis and leaky gut, and then it's impacting your GLP-1 levels, and then it's changing your hunger and satiety cues, and then it leads to weight gain, and then that changes other hormones in your body. You know, it's just very easy to see how everything can, can all be mixed together. And that's why I really think that focusing on diet and exercise actually has such a big impact on all areas of your health, but mental and physical health.

Yeah. And that, you know, when you were saying that and describing, I was thinking how, you know, for those of us who are kind of in this space, you get used to thinking about that and it it doesn't seem as overwhelming just because I think we're used to it. But somebody on the outside hearing all that, like, oh, I have this and I have that and it's all tied together. Like, what am I going to do? You know, it sounds overwhelming, but then, but then you just summed it up right there at the end, which is just like focus on your diet, cleaning that up and exercise. Would you say that that's really one of the best places to start if you are experiencing these kind of things?

Yeah, of course. And obviously I don't want to oversell it in the sense that it's not like a cure-all for everything, but it definitely, I would say moves the needle in the right direction and it helps to establish those diet and lifestyle, I would say, behaviors that can really sustain your health. So it's really important to do that kind of in combination with treating other things that you may need to treat so that once your body is back in balance, you can maintain that.

Yeah. And I was thinking, you know, going back to the stress component and the connection with with gut health, but it's all connected as you described. But I think for a time you said that you were working at Google, which I would imagine that there are plenty of stressed out people there that you were working with. I was just wondering if you could share any, um, stories or, um, revelations that you had in working with people that are in a particularly high stress environment. And if you found like, was there anything extra that they needed to do to move the needle when it came to their health?

Yeah, so, so that was an interesting position that I had. So I worked actually for One Medical, and then I worked in their corporate partnership office with Google. And so it was really interesting for me to be able to see how they set that office up because it was very different from other One Medical offices. Um, one thing in particular that I thought was great is that they had mental health and they had physical therapists in the office, which is an unusual thing. In other One Medical offices, they don't— didn't have that. But that particular to that corporate partnership. And I think that really speaks to how stress can impact the body and also how having a job that requires you to be seated most of the day really impacts the body as well. There's a lot of back pain, of course, with anyone who's has a more sedentary job. That's one of the first things, or one of the, you know, it's one of the most common complaints in primary care generally. Um, but it's definitely something that I think has increased with, with jobs that require extended periods of sitting or working at a computer. I think an additional thing to just consider with anyone who's under a lot of stress is, you know, counseling is really helpful in terms of helping with stress management. So that's why in my practice now I do really focus on health coaching. That's not the same as, as a therapist, of course, and it's not the same as a psychiatrist, of course, but it helps a lot with behavior patterns and routines that can help with stress management and help mitigate stress before it gets to that point where it is negatively impacting your health. And so that's why I do really focus on a lot of, I would say, habits and behavior patterns that can help in terms of taking stress down to a lower baseline level so that even if it does increase, you're not reaching that critical mass amount of stress where it starts to really trickle down and impact everything else. Because as we know, you know, chronic stress is a killer. Chronic stress really will start to impact everything in terms of, you know, cardiovascular health, cholesterol, blood sugar, weight, and then it's just a cascade effect, right? And so really being able to intervene in the preventative stage or in the more acute stress phase is really important for impacting people's health and being able to, as I was saying, just sort of like prevent some long-term impacts of chronic stress where then you're dealing with a whole host of other things that have happened as a result of that chronic stress.

Right. And I, I think one of the, um, and I'd love for you to expand on this a little bit because you mentioned one of my favorite things. I think people don't think of it as a stress management tool, but I do because you mentioned habit stacking. And again, for me, it does two things. It takes away decision fatigue, which to me adds stress. Like if you're already in a stressful life and then you just have to make all these like micro decisions all day long.

Yeah.

What am I eating? What do I do? This and this. To me, it takes some of that away. And then the habit stacking too, it just becomes this— I feel like it kind of like the habits become like a little security blanket. Like, they're just things that you do that you don't even have to think about them. That's just who you are now. Like the exercise, like, just like brushing your teeth, it becomes the same thing. So I'd love it if you could talk about how you see habit stacking and how you've seen that impact people in their health.

Yeah. Yeah. So I think you touched on something that I love to kind of highlight, which is that it becomes part of you, right? So when you start to habit stack and then have a wellness routine, which is what that turns into, then it just starts to become part of who you are and what you do every day. And I always talk about how those little things that you do every day actually are what move the needle with your overall health. For example, those are typically the things that tend to lead to weight regain, where it's like small changes that happen over time, and then you fall off of your exercise routine and your eating patterns, and then you gain a small amount of weight over the course of the year, and all of a sudden in the year you've gained 5 months. And then, you know, in 5 years, you know, it adds up, obviously, right? And that's how it kind of happens, right? And so in terms of maintaining your health, it's really the things that you do, I would even say 80% of the time, that really move the needle. So I focus on that a lot in terms of moderation, because the reality is, like, you want to recommend a healthy diet to someone, they're still going to go out to eat with their friends, they're going to want to go out to restaurants. We talked about that. You're still going to go out to eat even if canola oil bothers your stomach, right? It's happening. So setting patients up for success is one things that I really try to focus on, because if you make a plan that is not achievable, it's not going to feel good for anyone, right? And so being able to have a sustainable plan is the key to long-term success. And that's why I do like habit stacking, because generally you're focusing on things you're already doing, so you can easily kind of incorporate that into your routine, you know, doing something after you have coffee in the morning or something that you already like and enjoy doing. So you have that positive reward from— and then you add some of those other things that just, I would say, compounds that positive feedback.

Yeah, totally agree. And one of the— I'll just give— this is like a silly example, but it's one that I've done, started in the last probably 4 months, and it just made it so easy because it's stacked with my coffee. Like, that's one of my things that I do every day, have a whole ritual about it. I do a pour over and I put this lovely Keto Cream in that I love that makes it taste so good. It's like a whole, like, routine, right?

Yeah.

So then when I wanted to start taking, um, taurine and, um, creatine, I was like, okay, I could do it later in the day like mix it in water or whatever, take it with my vitamins. But to me, I knew, I'm like, if I really want to do this consistently, I'm going to do it with my coffee because I know that I'll do that every day. That thing about taking the vitamins later in the day and stuff, sometimes, I mean, that's mostly ingrained now too, but it's just like, I knew that that one would stick. And so it really has made it super easy to just, you know, add those ingredients to the coffee, have them at that moment. And so there's other things that you could add. To that, say it's, you know, you need extra protein in your life. So maybe in the morning when you're doing your coffee, you do a protein coffee or something like that. You know, it's like just those little things. It really does help it stick. So I'm glad that you're a fan of that as well.

Yeah, definitely. No, I feel like it really does move the needle and then you start to feel good because you're like, okay, I'm taking the supplements that I wanted to take. And exactly.

Yeah. It all feeds on each other. And it's definitely helped with my muscle mass stuff. So that's pretty amazing. I love that.

Yeah, that's a big win.

Yeah, it's a big win. So big win all the way around. So you mentioned, so you have now a practice and I know that you see patients in your office, but you also see them virtually. And I think what I was reading is that you have kind of a three-prong approach. So we've talked about two of them strongly already, the nutrition component, the Lifestyle. Can you kind of describe that system a little bit to people and how you like to work with your patients?

Yeah, sure. So I developed the Health Meets Wellness method, which is basically combining medicine, exercise, and nutrition for all of my patients. So everyone that comes into the practice gets a medical program or plan, they get an exercise plan, and they get a nutrition plan. I have dietitians in the practice, and so since I'm a membership model-based practice, I wanted to make it inclusive so that everyone wants to do everything in the, in the membership and in the program. I found that sometimes when things are à la carte, it's sort of like, ah, do I really need to pay for that or do it? And so I just want to make it easy because I feel like if people really do benefit from talking about their nutrition, and then as we were talking about before, sometimes it's easy to just have the decisions taken out, uh, the decision-making, like, need taken out a little bit to remove the friction and essentially just to make make it easy. And so we do meal planning, um, and it's not mandatory obviously, but if people want it, then what happens is we can plan your meals for the week around your preferences and your health and wellness goals, body composition optimization, you know, other symptoms, gut health, etc. And then tie that in with the medical plan, with medication, supplements, and things like that I might recommend, and then with an exercise plan. And I believe that that's what really sets my patients up not only for success in the short term, but in the long term with their health and, and overall wellness.

Yeah, that's amazing. I mean, we could have a whole nother podcast for hours about all the issues with our healthcare system, but I really believe if the system in the whole in the US could move towards that model where it's a more, um, preventative and holistic way of, of approaching it, I think we'd have far, far better health outcomes, spend way less money, and everybody would just be much better off. But I, um, I don't know if you can convince whoever the next president is to do that.

I know, I know. I totally agree. I think this is the way medicine should be practiced, you know, and, and one of the things, so, so I do general primary care, um, taking a more integrative approach, of course. Um, and then also weight management because medicine, exercise, and nutrition really lends itself to that. And so it's been fun to really work with patients in that capacity because, you know, when, when people feel empowered with their health, when they feel like they're getting the results that they want, it can be really life-changing. And so that's been an exciting area to be working in as well.

Yeah, especially now with the new tools. And I think I'll just ask this one final question just out of curiosity, since you mentioned it before. You mentioned the GLP-1s, which for people that haven't tied those together yet, GLP-1s are things like Wegovy, Ozempic, these new drugs that are, you know, helping people lose weight. Do you— I guess two questions— do you use those in your practice? And if so, how do you have people implement them to have have the best outcomes from those and, and avoid any of the unwanted side effects, I guess?

Yeah, sure. So I do prescribe them in my practice, and I would say I prescribe them for the medically appropriate patients. Um, and I always do— I would say I, I always make sure that everyone has a medicine, exercise, and nutrition plan. And what I like about the medications is that with diet and exercise, especially with weight loss in particular, it can take a long time to see the When you introduce the medication, it can actually help in terms of shifting some hormone imbalances and helping to promote weight loss quicker. So it's a positive feedback loop with those other behavior changes that you're making at the same time. So as you start to see the results that you want, it makes you want to continue doing the exercise and nutrition program. And then the goal is to be able to have the medication, not need the medication or take the medication away, and then still sustain that weight loss with the exercise and nutrition program. So that's my approach, and I've had really good success. And the biggest thing too that I really do like to focus on is not even just the weight, but we do body composition analysis and strength assessments in the office. And so we focus on maintaining that muscle mass, which is, I think, really one of the biggest game changers in the way that I practice, because it helps people actually be set up for success. Because as we know, if you lose weight and you lose muscle mass and end up with a higher body fat percentage, you need to actually consume less calories to maintain that lower weight. And that can be really challenging if you're in more of like a weight loss phase. Maybe you're eating a little bit less than you normally would. When you stop that intervention, you may eat a little bit more, right? And so that's kind of a natural shift that happens. If you need to continue maintaining eating a significant amount less than you were eating before, the propensity to regain the weight or yo-yo diet is there. And what happens is you end up in a worse place than you were initially in terms of your body composition. Because you have weight regain and you have higher body composition to start with. So it's this kind of negative feedback loop where you regain the weight, then you want to lose it again. And so in, in my practice, we really protect against that by maintaining muscle mass and helping to maintain a higher basal metabolic rate as you lose weight, allowing for maintenance with that current nutrition plan that you have while you're working together, you know, with me and and with our nutritionist in the weight loss phase. So when we take the medication away, essentially, if you maintain exactly what you're doing, you'll maintain your weight.

That's amazing. And I love that you approach— I think that's the way anybody that's on that drug should be strength training. I mean, I just have heard so many people, so many experts talk about this, and I'm sure you've seen that study that showed it was one of the initial trials, I think, with those drugs that people, you know, they lost a lot of weight, but something like up to 40% of that was muscle mass that they were losing as they were doing this because they They weren't strength training. They're eating so much less. They're probably not eating the right amount of protein as they're losing weight. So I would, I wish that every doctor would approach it that way just so that people like get this wonderful benefit from the help of the drug, but don't lose their valuable muscle mass on the way, which like you said, will help them maintain that weight loss after they're finished with that initial loss phase. So that's amazing. Well, all that being said, it's like all you have all these wonderful paradigms that I think people that are out there, especially in this space and that are kind of more forward-thinking or looking for. So can you share how people can— like, are you taking on new patients? How can they work with you? Where are you located? The virtual stuff, all the good things.

Yeah. So my practice in New York City is on 60th Street between Park and Lex. So you can find the practice there. You can go to our website, healthmeetswellness.com, and you can see all the information about the primary care memberships and the— or membership, sorry— and the weight loss membership or weight management membership. Um, and then you can find us on Instagram at Health Meets Wellness. That's the handle. Um, you can find me on Instagram at Dr. Elizabeth Sharp, and then you could call our office. The odd number is 917-833-5234, or you can email us at info@healthmeetswellness.com. And I'm licensed in New York, New Jersey, Wisconsin, Wyoming, Florida, uh, many, many states. So doing telehealth in a lot of other states, um, but seeing patients in person in New York. So So come check the practice out.

Awesome. Love it. And just because I'm in Ohio, are you licensed in Ohio yet?

I'm not, unfortunately.

I know I have some listeners here, so we'll just have to wait until you get licensed in Ohio. But I'm sure if they call or go to your website, they'll, they'll know if you can work with them virtually or not. But anyway, Dr. Sharp, I appreciate you so much coming on today. I've really enjoyed our conversation and I love the type of work that you're doing and I just really appreciate it. So thank you.

Oh, likewise. Thanks so much for having me on. This has been really fun and I love chatting and, and doing this. So hopefully we'll get to do it again soon sometime.

Awesome. Thank you.