Fix Your Metabolism, Save Your Heart: Dr. Philip Ovadia on Preventing Disease the Natural Way

If you're like me and you are scared of having a heart attack or having any cardiovascular health issue, then you're going to be very excited by my next guest. His book, Stay Off My Operating Table. Yes, I am speaking to Dr. Philip Ovidia. So conducting over 3,000 heart surgeries taught Dr. Philip Ovidia that good health comes from lifestyle and nutrition. Not surgery and medication. Huh? It's very rare to hear this message from a person or a product of our medical industry. Sadly, many of his patients considered their heart attacks inevitable. He overcame a lifelong obesity, and it's now his mission to help people stay off his operating table by teaching them how to never need a heart surgeon. Dr. Ovadia works as an independent cardiothoracic surgeon, and he runs Ovadia Heart Health, a telehealth practice that focuses on the prevention of heart disease. Welcome to Everyday Ancestral. I'm your host, James Barry. Please enjoy our guest, Dr. Philip Ovadia. Phil, it's such a pleasure to have you. Thank you so much for joining us here at Everyday Ancestral.

Yeah. Good to see you again, James. It's been a while since we've been together in person, but always nice to reconnect and have a great discussion with your audience.

Yeah. Well, it couldn't be more poignant, right? I mean, all the conversations right now with the Maha talk, it's almost like it's finally on people's tongues. Like we got to make our health a priority, but I feel like there's just such an immense resistance going on, and I can't tell, is it people with money or is it just the general public? What sense are you getting?

I was actually fortunate enough to be up in Washington, DC for the inauguration, attended RFK's inaugural ball, very much the epicenter of the Maha movement. And I'm certainly on board with it. This shouldn't be like a contentious political issue, right? Make America healthy again.

It shouldn't even be political, right?

Yeah, exactly. Exactly. We should all want it. I'm excited to see that it's, you know, reaching that level now that there was, you know, a lot of energy around it and so many people that are committed to the movement. I think RFK can be a great leader for that. But in, I guess you could say there are many people that take issue with some of the things he talks about. But, you know, his overall message is let's make America healthy again. He talks a lot about food quality. And I think, you know, he has the right approach. And, you know, I think the controversial part around the pharmaceuticals and the vaccines, right? All he really says is, let's see the data.

Yeah.

If these things work, great. But we need to be more transparent around this, and we need to be more scientific about what we are telling people to take and the stuff that doesn't work or the stuff that the science doesn't ultimately support. Yeah, we need to rein that back. We need to get some things perhaps off of the market or just change the messaging around them at least. And that's all he's asking for is let's look at the data, let's get the data around these things. And I think that makes a lot of sense when it comes to health. Now, obviously, like you said, you know, there's opposition to that. There are people that are making a lot of money off the current system. One of the things I say about the healthcare system, right, today is it's working great for everyone except the patients and the doctors. And so there are a lot of people that really don't have any motivation to change the system. But those of us in this community have been shouting about this for a long time. Let's start looking at the food that's being put in front of us and that we're being told to eat. Let's acknowledge the fact that health is a major issue and it's moving in the wrong direction.

You have personal experience, right? I mean, I would love to talk about the perspective of the doctor, cuz you have that unique perspective, which is you are very much trained in Western medicine. You're a surgeon background, and yet something wasn't working. And you took the steps to change that. So can you kind of bring us back to what wasn't working? What were you taught? And then what was the catalyst for change for you? Yeah.

So again, you know, I've been a heart surgeon now for over 20 years. I've done over 3,000 heart surgeries. Quite frankly, I make a very good living as a heart surgeon and could continue doing so without trying to disrupt things, right? My incentives are not towards disrupting the healthcare system and making people healthier. But, you know, on the flip side of things, I was very unhealthy. I was getting progressively more unhealthy, morbidly obese, pre-diabetic, and I recognized that I was headed for my own operating table, so to speak. And I also recognized that the advice that I had been taught to give, it wasn't working for me and it wasn't working for my patients. At first, it was a matter of fixing my own health, and I learned about low carbohydrate, eliminating processed food. Ultimately have come to a mostly carnivore dietary approach, which I don't think is the only dietary approach that works, but it's what's been working for me now for many years. And along the way, I came to realize that what I thought I knew about heart disease, what I had been taught about heart disease, was not correct. We're incorrect about what the primary cause of it is, with the mainstream belief being that cholesterol is what causes this disease, and it isn't. And we're incorrect, more importantly, on the fact that it is not preventable, not reversible. And it is. And that the way to do that is not through a pharmaceutical-based approach. It's not with surgeries. It's with addressing diet and lifestyle first and foremost. And we need to do a better job of that.

You mentioned it's to your advantage to kind of follow the status quo. You make good money, you keep getting people on your table. Was the catalyst for change, was it just you suddenly waking up one day and going, oh, I'm obese? What exactly happened that made you challenge or question what you had been taught?

Yeah, like I said, the original catalyst was my health, right? And I was, you know, young father who wanted to be around to see his children grow up, right? I knew all too well what my future was because I saw it every day in the people that I was operating on. That's what opened my eyes initially and got me asking different questions and being open to this different information that I discovered.

And what kind of response did you get once you started asking those questions? 'Cause I imagine you first started asking your peers, right? The people that you're around.

Really, that wasn't the first part, right? So the first part for me was first coming across this different information. And, you know, the start for me was actually, ironically enough, I'm at a meeting of surgeons, the Society of Thoracic Surgeons, right? And the guest speaker that year happened to be Gary Taubes. And, you know, at that time Gary had just written The Case Against Sugar. And of course, prior to that, you know, he wrote Good Calories, Bad Calories and Why We Get Fat. And, you know, Gary was really the first person I heard some of these concepts from, right? This is not something I had learned in medical school about, you know, the effects of carbohydrate on insulin and insulin resistance and how that is what drives us to eat more and store more fat ultimately. That's how it started for me. Now, once I kind of learned about this, and then I started talking to my colleagues about why don't we know about this? Why weren't we taught this in school? Why aren't we telling our patients, you know, that this is a way that we can effectively manage not only obesity, but it turns out heart disease and much of the rest of the chronic disease that we face. And I got a lot of blank stares back because The sad reality is, is that most doctors never hear this information. They don't know about it, and they're just so programmed, right, with what we learned in school. And then they're so busy taking care of sick patients that they really don't have the time to stop and think, why are there so many sick patients? I consider myself blessed to have woken up to that fact and to now try and spread that word. And more and more other physicians are listening to this. I was just this past weekend at one of the low-carb conferences, and there were more physicians there than ever, more specialties of medicine represented by the physicians. And so I think this is growing. I think increasingly doctors are waking up to the fact that our medical system is failing And that we just have too many sick people to deal with.

Where do you think it has to start though? Do you think it has to start in the medical schools? Like, do they have to shift and recognize, hey, people want more nutritional background. They want to understand how these different foods are affecting our bodies, anything like that, sugar, whatnot. Do you think it has to start there or is it just keep the status quo with the medical school and then it's more about post-education? Yeah.

So right now, I really think the best place to start is just more and more people doing this, right? And the more people that do this and get success with this, and then they go to their doctors, right? And their doctors start to see that. It's interesting, the physicians that were there at this conference this past weekend, right? They have one of two origin stories, how they got there. Either like me, they had personal health issues that they needed to deal with, or they had patients that woke them up. They had patients that did this and got better, which is something that doctors don't see a whole lot of, things like reversing type 2 diabetes. And thankfully, those doctors that were there were curious enough to follow up on that. A lot of doctors aren't. A lot of doctors just kind of shrug their shoulders and say, Well, that's some anomaly. And they just, you know, put their head back down and they keep plugging away the way they've been trained. But more and more, I think doctors are either being woken up by their patients or by their own health challenges. And I think that's really where it starts. You know, the problem right now is the medical education system is still largely captured by the pharmaceutical industry. And even, you know, if you said, okay, more nutrition in medical schools, the leading dogma around nutrition these days is still based on the food pyramid and low-fat diet. And so, getting more of that isn't really going to help things.

Right. So, you get a lot of nonfat Yoplait yogurt, you know, whatever, you get sponsorship.

Very much true. So, eventually, again, I hope going back to, you know, what we started talking about, right, from the politics, down can come those policy changes that can then be implemented in the schools. But right now, I think the greater potential is the bottom-up approach and that more patients, more people do this, and that wakes more doctors up. And then we can start to influence the system that way.

I like that because you're really talking about, you know, it starts with the person in the mirror, right? That we have to start on ourselves and then it progressively reaches, you know, eventually, hopefully, The institutions, the bigger businesses, big ag, whatever. I've heard that many times actually, that, that it just takes that one person who even has some power sometimes within the system to make change. But you, you have to first believe it's possible. You have to believe in the modality, whatever it is we're talking about, you know? So you were a surgeon, you had your big wake-up call, you lost a lot of weight and you did it. Naturally, right? You did it with diet because Ozempic wasn't going on back then. So you weren't doing it that way. So how has that shifted in how you deal with patients, like, or even how you initially interact with them? What's changed?

Now, as a heart surgeon, right, I can take a more holistic approach with my patients. Yes, unfortunately, by the time they get to me, They still usually need the surgery. That might not be avoidable, but I can be open with them, right? And I can explain to them that the surgery that I'm going to do isn't going to correct why you ended up here in the first place, why you need this surgery. And if we don't address that, ultimately you're going to continue to have issues with heart disease. The sad reality is, is that The majority of patients that undergo heart surgery or have a stent placed, for instance, or even have a heart attack, right? They still die of heart disease. Now, yes, our treatments can prolong their life, can improve their life, but they still end up dying of heart disease because putting a stent in or doing bypass surgery like I do doesn't change the heart disease. Right? It just is basically putting a bandaid on the problem. And so now I can, you know, explain to them about why they're actually here, what insulin resistance is and how it led to their heart disease. And then I can tell them, we're going to do the surgery, but you can also do this other thing, right? You can change how you eat and change how you live and fix the underlying problem. And then you have a much better chance of heart disease not being what kills you. It's a much more complete approach in my role as a surgeon. Now, I also have expanded how I practice these days, and I have a preventative practice where I try and keep people off the operating table. I'm able to really start to attack this problem at all its different stages.

I've always noticed in my 20 years in the health field that most people don't change their diet unless they get sick or someone they love gets sick. So how compliant are you finding people? Not obviously the people that are coming to your telehealth, cuz hopefully you're hitting them early, right? You're getting them a little earlier, but how compliant are you finding the people that do come to the surgery table? Is it a 100% success rate after they have the surgery of like, okay, I'm gonna do what Dr. Phil says. I, I'm in. Or do you still see resistance?

Yeah, you know, there, there's certainly still some resistance. Some people ultimately don't want to change, right? No matter what you tell them, right? They don't want to give up their habits. And you know what? I'm okay with that. This is an individual choice. I'm not here to force anyone to do this. I just want to be able to inform them. The sadder thing to me though, is the situation I run into where The patient is enthusiastic, right? And they start doing it and they even start to see some good results from it. And then they have other doctors tell them that they can't continue doing this, that it's unhealthy for them because of those doctors' misunderstanding, misconceptions, miseducation around what is really causing heart disease. A big part of my approach, right? I tell people to eat whole real food and mostly animal-based foods, animal proteins. And of course, red meat is still widely considered to be a contributor to the development of heart disease. Now, the science shows us otherwise, and certainly the experience I'm having with lots and lots of patients and the bigger community that's out there around this shows us otherwise. But it is still a very deeply, widely held belief that red meat is a driver of heart disease. And therefore, oftentimes, despite the success that patients are having, losing weight, improving their diabetes, getting off medicines, they get scared out of continuing it by their other doctors.

Eggs are on that list as well, right? Egg yolks specifically. And yet look at what's happening. Finally, the Is it the USDA or FDA? They're finally saying, oh, eggs actually are healthy. They're finally kind of taking some ownership of what people have suspected for a long time, that the data was incorrect. And they're finally saying, oh, actually these should be added to the healthy list. It hasn't happened long enough for us to truly see the ripple effect of that, but I do think it's, we're going to see a ripple effect and maybe, I don't know, 10 years from now, maybe. Finally, we'll get people not splitting up the egg, you know, maybe.

I agree with you. I think it is gonna take quite a while. We see this all the time that the institutions, right, the, the systems like the healthcare system, they're very slow to change. And unfortunately, right, this information doesn't really get communicated far and wide like it should. Something like, you know, eggs are not bad for your health. Right? That should be very widely communicated, but it's not. And a lot of people still just never hear that message. For a lot of doctors, right, it's just too hard to change. When you tell a physician that most of what we understand around heart disease is wrong, that can be kind of jarring. That can be difficult. And a lot of doctors, like a lot of people we talked about earlier, right, they just don't want to change.

And it's going to be hard to get them to I mean, I think still people are struggling with the fat is good for you, right? What was it that, that devil's food cookie came out? I think it was Kraft or something like that. It was in the '90s and it was fat-free, but yet it was a cookie. I remember my mom was buying them all the time. Everyone was freaking out thinking, oh, I can eat these because I'm not gonna get fat on it. Not realizing that actually when you get excess sugar, that converts into fat, of course, right? Like people didn't know this. Which kind of begs the question of like, we only know what we know. So as someone who is a product of the medical industry, in terms of that you were educated by the medical industry, but you're also a product of it where you've now had contrast of the industry and it's spun you in a different direction. So in many ways you have the duality of you were educated by it, but you've also been reeducated by it, which is pretty cool in my opinion. I guess the question is, is that we only know what we know. And so if you now look back at the medical industry and you go like, well, gosh, they've had so much wrong. How do you fully let what we're currently doing land as it being right when it also could be wrong? Do you, do you know what I mean by the question?

I understand that completely. Right. And I'm not, I don't know what the right word is, egotistical enough, right. To say that, yeah, I know I'm absolutely right. I see more and more, right? I know how it's helped me. I see how it's helping the patients that I'm working with. I see, you know, all of the great health improvements that are going on within our community. And I also see that the old previous recommendations just did not work. And that's something that's very hard to ignore. The messaging around low-fat cholesterol as the primary cause of heart disease, right? That's been our focus for 70 years now, right? Going back to the 1950s, and it's just not working. And so that's one of the other things that gives me the confidence to carry on with the message that I'm trying to bring and how we're trying to change that messaging. You're right. I might be wrong. We might all be wrong. But clearly what was being done before was not the right approach and was not working. And so that's why I think it's time for us to change.

What do you think we are getting right right now? Like for example, seed oils, do you think they are as bad as, you know, social media influencers are telling us now? Are they probably the bigger culprit of inflammation than, you know, saturated fats, for example?

Well, they're definitely a bigger problem than saturated fat is because saturated fat is not a problem when it comes to our health. The real question is, right, are, are seed oils more harmful than sugar essentially, right? Or more harmful than refined carbohydrates? And the honest answer is, I don't know the answer to that. I just know that processed food, which combines those 2 things, is very problematic. And so that's kind of the first focus that I hope to see, right? Let's eliminate the processed food. Let's get back to eating whole real food. I think that's where this starts with. Over time, I guess we can then work on the nuance of, you know, was it the seed oils or, you know, was it the sugar and the refined carbohydrates? But I don't think it matters if you just get back to eating whole real food. The problem is fixed. And neither of those things are essential in our diet. And neither of those things are really necessary for us to be able to have enough food and good nutrition, right? And enough nutrients to sustain ourselves. So that's kind of where I start with. That is an area that I think we're making some headway in. I think people are truly waking up to the fact that, you know, all of this processed food is not good for us. And that's where I think we need to focus on and think we need to start.

When you were at your heaviest, before you started making your dietary changes, what were your, I don't know, your 2 or 3 crutch foods that you were kind of overindulging in? And then technically it's probably the same question as what did you cut out? What were the first few foods that you cut out as you started down this journey of weight loss?

Yeah. So I was definitely, you know, very heavy on bread and pasta. Didn't think that was problematic, right? You know, the candy, the cake, the cookies, right? We all know that that's not healthy for us, right? But bread, pasta, you know, this is the base of the pyramid, the food pyramid, and, and we think that's healthy for us. That's really what went first. My intro to this was low carbohydrate approach, right? And eliminating sugar. And like I said, I wasn't a real big sugar person. I didn't drink soda by the gallons like I know some people do. I was never one to put sugar in my coffee or anything like that. For me, the biggest thing that needed to go and, you know, did go and had big effects was things like the bread and the pasta that I thought was not harmful for my health.

What did you find as you cut those out though? Because sometimes we, we eat to Kind of numb any feelings going on or anything. Do you mind sharing like what came up for you as you cut out these comfort foods? Did your shadow side kind of rear its head and you're like, oh, I didn't, I didn't realize I was trying to keep this down. Or, or was it effortless for you? Yeah.

I mean, I wouldn't say it was effortless, but I don't necessarily think I had that real strong element of sort of comfort eating, food addiction, you know, and that is a real issue for many people. I was able to do it. I saw pretty quick results, right? And that's kind of self-reinforcing. The flip side of this, and this is a lot of what I talk to people about, right? It's not even so much about restricting those things. It's reintroducing those other things like steak and ground beef that I would shy away from in the past. And eggs, you know, another great example. And those are foods that I actually love to eat. So, You know, I guess in some ways I was able to replace with those, and that kept me satisfied and satiated. And that was my experience. Now, yes, I acknowledge that many people, right, they have to deal with the emotional eating and the stress eating. Yes, if you're going to have long-term success, those issues do need to be addressed. What's most interesting to me that I noticed and many other people notice, right, is when you start getting metabolically healthy, it has a positive effect on your mental wellbeing in addition to the physical effects, right? And again, I'm not someone that had a diagnosis of depression or anything like that, but I just noticed my mood being more stable, right? And so, Even the stress. Listen, I'm a heart surgeon. I have a high stress life by nature. I just deal with it better these days when I'm metabolically healthy. And I know a lot of other people have experienced similar changes in their mental wellbeing as well as their physical wellbeing.

I love that you just brought up metabolic health. Let's dive into that a bit, because I think that's a term that's being thrown around even more right now with the Maha stuff. But let's pretend myself or anyone listening doesn't know what that means. Can you talk about what is metabolic health? Yeah.

So, you know, the way that I refer to metabolic health is it simply refers to your body's ability to properly use the inputs that you're giving it, right? And the primary input we give our bodies is the food that we eat. Now, you can talk about, okay, how do we measure that? Because again, if you can't measure something, how do you improve it? How do you know where you stand? And so, I always point people to start with to the 5 basic measures of metabolic health. And those 5 measures are your waist circumference, your blood pressure, your fasting blood glucose level, your HDL cholesterol level, and your triglyceride level. People can look up the numbers if people want to go to my website, ifixhearts.com, right on the front page, free. You can just go through the quiz, put in your numbers, and find out where you stand. That's a very simple thing that everyone can and should do, right? Find out those 5 measures, find out where you stand regarding your metabolic health. Because the shocking statistic is that 93% of the adults in the United States are not metabolically healthy. They don't meet those 5 metrics of good metabolic health. And so chances are that you're not metabolically healthy, and that can be the wake-up call to get you start to working on, you know, making the changes.

Because when you're not metabolically—

93%. 93%. And when you're not metabolically healthy, It means that you're at increased risk of not only heart disease that I focus so much on, but cancer, Alzheimer's disease, diabetes, all of these chronic diseases that are plaguing us today. They basically all track back to metabolic health.

What I like about your measurements too, and I know of course you mentioned, you know, waistline, but it's not the only measurement. And I think that's one thing that needs to be dispelled. And maybe you can even talk about it, is that just being obese or not obese does not determine whether you are healthy.

Correct. You know, in that same study looking at metabolic health among US adults, they looked at people specifically that were not obese. These were normal weight people, and they still had 50% incidence of metabolic disease. So, Yes, not being obese is better than being obese, but you can't assume that you're metabolically healthy just because you're not obese.

Let's talk about insulin resistance. I feel like I read somewhere that you find that one of the root causes of heart disease is insulin resistance. Can, so can you talk about that?

Insulin resistance is really the sort of biochemical manifestation of poor metabolic health. And what insulin resistance means at the cellular level, right, is that your body isn't able to properly process sugar and carbohydrates. And yes, this is a root cause of heart disease. And yet the vast majority of doctors out there dealing with heart disease don't know that. They don't know what insulin resistance is. They don't know how to evaluate for it, and they don't know how to treat it. Right? Because it's pretty intuitive if you figure out a patient has a problem with insulin resistance, and that means that they can't process carbohydrates properly. The answer is pretty simple. Stop eating carbohydrates. Stop putting carbohydrates into the system, and that's how you fix the problem. But unfortunately, the concept of insulin resistance does not get talked about in the heart disease space. And so we missed the root cause, right? We became focused on cholesterol, which is a downstream problem from the insulin resistance.

Cholesterol is typically a buffer, right? It's trying to protect your body from the inflammation that's going on, right?

Exactly. It's trying to repair what the insulin resistance is causing, right? The insulin resistance causes damage to the blood vessels. And it does that in a couple of different ways, but high blood sugar being one and inflammation being the other. And the cholesterol is supposed to repair that damage. What happens is, first of all, you keep doing the damage, right? And the cholesterol has to keep coming and it sort of can't keep up with the process, right? And it starts to build up on the vessel walls and form the plaque that we talk about. And the other thing that happens is that the insulin resistance damages the cholesterol itself. So when you have undamaged cholesterol particles, cholesterol carrying particles, the LDL that everyone focuses on, right? When those are undamaged and the marker of them being undamaged is that they're large and fluffy, right? And so they go and they repair some damage to your blood vessel wall, and then they're able to basically just kind of melt away, right? They repair the wall and they disappear, and we don't have any issues. However, the insulin resistance damages those cholesterol particles, and they become what we call small dense particles. And now when they go to repair the wall, they actually set off more of an inflammatory response because the body is reacting to this damaged particle, and that compounds the problem. And that's when, again, when we start to see this buildup of inflammation and the plaque starts to form. But it's only when you have the damaged cholesterol-carrying particles, the small dense LDL, in the presence of vascular damage that we see this. If you have healthy cholesterol, large LDL cholesterol particles floating around in your bloodstream, And you're not insulin resistant and you're not damaging your blood vessels, cholesterol does not cause problems.

That was such a great explanation, by the way. But it's so frustrating to me because as I mentioned, I've been in this field 20 years as a chef, but in the health field, right? I've been hearing about insulin resistance from the beginning. So why the F is it taking the industry so fricking long To acknowledge this? Is it because they're co-opted? Is it because they, their egos are so firmly entrenched in it's cholesterol, it's cholesterol? Like, what is going on, man? It's been 20 years plus.

You're exactly right. Right. And I think back in the same way to, you know, why did the first time I hear these concepts, it came from, you know, a journalist, and that is in no way a knock on Gary Taubes, but, you know, Why did I hear it from him first instead of, you know, the professors and my colleagues? And you're right. Honestly, I do think ego is a big part of this, right? I think the leaders of the field, the leaders that have been saying this for so long, cholesterol, for them to admit that they were wrong, right? That's a big shift. And beyond the individual people there, right? It's the institutions that have been built around this. Institutions like the American Heart Association. And then, yes, you're right. We have to acknowledge the role that funding from the pharmaceutical companies, funding from the food industry play in all of this as well. That is very real. People look at this in different ways, and some people think it's a grand conspiracy that maybe started with one or two people. I don't think that's true. I just think this is a kind of what we see in society, right? When institutions are built around a certain concept, it is very hard to get that to change. But we're starting to see the cracks in the foundation of this belief and of this system. And I am optimistic that we're going to be able to make these real changes. And I'm very hopeful that 20 years from now, People aren't still having this conversation. The conversation has become, how did we ever think that cholesterol was the primary problem or that a low-fat diet was gonna fix the problem?

Well, it makes me think of bloodletting, right? I, I remember reading in a book that George Washington's doctors bloodlet him. Mm-hmm. Because that was the modern medicine of the time of how to handle the sicknesses. And yet now when we look back, they realize, oh, he probably just had a common cold. Had they left him alone, he would've survived.

I've read that same story. And yes, we have many, many examples we can go back to, right? And that's another thing that I think is problematic these days because all too often we think we know the answer and we're not willing to change and consider contrarian information. Medical history is littered with situations where what we were convinced was true turned out not to be true. We do need to be more open-minded around medicine and not be so dogmatic. And this unfortunately has showed up in many different ways, you know, in our recent history. And it's very problematic.

Oh, I love hearing you say that with your background. So it's very encouraging, as we've already mentioned, that if one person can change, then many, many others can as well. What's your whole take then on weight loss drugs like Ozempic? Are, do you see those as a potential disaster or do you see those as like, well, the way Prozac was when it initially came out for people that were extremely depressed, you know, it gave them the ability to just get their head above water so they could deal with some things. 'Cause some people are just drowning in, you know, weight or depression or whatever it may be.

Yeah, a little bit of both. So I do think these medications can be useful and can play a role, but I do see an impending disaster because of the way that they're being used. These medications do appear to be effective, and I, you know, have seen effectiveness, right? When they are used as a short-term adjunct to making the diet and lifestyle changes, right? They can help people that are really struggling at the beginning of this. To be able to make some of these changes more effectively. But you gotta have an exit ramp. You gotta be able to, at some point, say, we don't need the medications any longer, and the diet and lifestyle changes are now firmly entrenched, and that's our long-term plan. And unfortunately, that's not the way they're being used. You know, they are being seen and used as, this is the long-term solution. And people are just going to be on these medications for long periods of time at dosages that are probably higher than they should be or need to be because people sort of build up tolerance to these over time. And that is what I think is unfortunately going to lead to a wave of disaster around these medications.

Well, it brings up what you mentioned earlier about how now you talk to your patients. You know, a lot of times they're coming to you and it, they do need the surgery, but then you're explaining to them, but this is how you don't come back. And I think about gastric bypass, for example. So they, that was the quick fix, but they still didn't deal with the emotional and physical reason why these people were overeating. And so I think that the number, the percentage is extremely high in terms of the people that eventually regressed right back to the weight or higher that they were before. did gastric bypass. So I have to assume that's the case as well, that if you're taking something like Ozempic, you may not have actually been dealing with why, what caused you to be obese, right? You're not dealing with the reasons that you were feeling motivated to overeat or to live a certain lifestyle, right?

Yeah, definitely so. And you know, it's interesting, these medications do seem to have some effects in the brain, right? There are GLP-1 receptors in the brain, we know. And we're seeing that they seem to have effectiveness with addiction disorders, right? And, and again, food addiction, like we said, is a big part of this, but other things like alcohol addiction, they're showing promising results for. The question then becomes, what's your exit strategy, right? You gotta be addressing those underlying issues ultimately, or, you know, your only option is staying on these things lifelong. And A, we see waning effectiveness of these things over the long term. And B, I think there are very good reasons to be concerned about the long-term usage of these medications and what effects that's going to have. So like I said, I think they can be a good tool if they're used properly and they're used as sort of a crutch as people are starting this journey. But I do have patients, I don't personally prescribe them, but I have patients that come to me on them in my preventative practice. The discussion we have is, okay, let's set a plan for getting you off of them. And we have been successful in doing that. They implement the right diet and lifestyle changes, and then over a period of time, we wean 'em off of these medications. And they're having success maintaining the diet and lifestyle because we've addressed Those underlying issues, and we're giving them a sustainable long-term plan.

So let's leave the audience with 2 or 3 diet and 2 or 3 lifestyle changes they can make right upon finishing this episode. You mentioned one diet, which was just don't eat ultra-processed foods, focus on real nutrient-dense foods. So we got one of the dietary changes. What would you say Is another 2 for the diet?

I would say another big one is increase your protein, animal protein primarily. That I think is a very powerful tool helping people to avoid hunger, right? And hunger is a big driver of why we eat poorly. Eat real food, lots of animal protein. That's kind of my basis of how we get people on a sustainable and successful dietary approach.

What would be a couple lifestyle changes that you, you right off the bat would recommend someone do?

Yeah, so number one is just move more. And that doesn't mean you need to go join a gym and spend hours on the treadmill or, you know, on the bicycle. It just means move more, right? Just find those simple things you can do throughout your day. To get some extra movement, you know, take the steps instead of the elevator when you can, park further away for work, you know, or if you're out shopping or just after you eat, take that 10 or 20-minute, you know, walk break and get some more activity in your day. And the other one I would say, you know, around lifestyle is to examine your sleep. I tell people better quality sleep, right? It's not necessarily about more sleep. It's about better quality sleep. So be thinking about some of the things you can do to make that happen.

Yeah. Something that have really helped me is like, one, make sure your room is dark, not a lot of light coming in, try to limit screens or have zero screens before bed. And then even keeping lots of those electronic things out of the room, like, or even business. Like my wife and I really try to keep that room sacred and so that we're not even talking business there because we don't want our brains turning on, you know, when we're in the bedroom, but more getting ready for sleep. Before I let you go, I do want to ask you, because I don't know you well enough to know this answer, how much does energy work or like less scientific stuff, the more ethereal kind of stuff, does that come into play for you? And if so, how?

Yeah, I mean, I certainly make efforts to get sunlight. That's a big one for me. I've played around with things like cold plunging, right? I was still a little bit on the fence there, but I think getting good sunlight is definitely a priority. Trying to just get out in the fresh air. I'm fortunate to live where I live in Florida by the beaches, and so You know, I always find it recharging to get to the beach and I guess I'm doing grounding, right? And I'm in contact with nature in the water. I think that stuff is important. Now, what I tell people is if you're not getting the diet, you know, right, and you're not getting the lifestyle stuff, I don't think you can overcome it by focusing only on the energy stuff and their circadian stuff. But I think it certainly is a powerful tool that can help beyond the more typical diet and lifestyle stuff that we talk about.

And what about meditation? Have you, do you do it that, that at all?

Honestly, I don't. I've tried it. Just, it's not something that resonates with me. But, you know, I do do other things to just try and offload the stress, right? And I do have other things that can help with that. Meditation. I tried it and it doesn't mean it's not good. Just never quite sunk in for me or resonated for me. Maybe, maybe it will in the future and that can make me even better.

Yeah. Yeah. Well, I'll be curious. So what new practices you kind of discover in 2025 that you start incorporating in your practices? Your book, Stay Off My Operating Table, is available, but will you please share how else people can find you? how they might get connected with your telehealth as well?

Yeah, definitely. iFixHearts is really where to find me everywhere. So on all the socials, I'm @ifixhearts, and then you can go to ifixhearts.com, connect with my team and I. And like I said, I have a telemedicine practice. It's focused on prevention. We see patients throughout the US and even international patients. The goal there is really Like the book says, to keep people off the operating table. We're happy to connect with people and figure out if working with us is the right thing for you.

Well, thank you again, Phil, for showing up and sharing your gold with us. I look forward to seeing you at Hack Your Health 2025. We saw each other in 2024 too. That's a great event. And hopefully I'll see you at some other events as well. It was a joy meeting you last year and getting to talk further with you today. So thank you so much.

Yeah. And thank you for all the great work you've been doing in this space, James. And, you know, you've been talking about it for a long time as well. And you bring, you know, such a unique aspect with your background as a chef though. So thank you for hosting this podcast and for all the work you're doing.

Thank you. And thank you all for joining us on this episode. Make sure to share with your friends and stay curious. Thank you so much for joining me on Everyday Ancestral. If you enjoyed this episode, hit subscribe so you don't miss the next one. You can find the show notes, links, and resources mentioned at eatpluck.com. That's eatpluck.com. And hey, if you know someone who'd get something out of this, share it with them too. Stay curious, live well, and keep it ancestral.