Lose the Weight Loss Meds with Dr. James Hill

Only about 20% of people who achieve significant weight loss are able to keep it off 5+ years. Right now, you have a better chance of regaining it than losing it.

The average person in the US, it's 3,000 to 4,000 steps a day.

It's pretty lame, and you're gonna have to increase that. You have to do planned physical activity. Sit for 1 hour less a day. People say, "Well, an hour a day? Oh my gosh." The 30 minutes a day will not do it. I guarantee you it won't do it.

No one's talking about this. Why do you think that is?

A couple of reasons. Because they're bombarded with strategies for losing weight. And there are a lot of companies that make money on their diet programs, not so much for weight loss maintenance. So people haven't really figured out how to make money with it.

So we cracked the code on how to lose weight and how to break through weight loss resistance. But here's the truth most people won't tell you. Keeping it off is a completely different game. And today we're going to go beyond quick fixes and trendy meds to talk about what it really takes to maintain your results. I have the expert in this, Dr. James Hill. He spent over 40 years studying the science of weight maintenance. He co-founded the National Weight Control Registry and he's published more than 650 papers. And now he's coming out with a new book on how to successfully transition off of GLP-1 medications with without the risk of weight regain. Now, here's the thing. Whether you are transitioning off a GLP-1 because you've hit your goal weight and you don't— you're not going to use them anymore, or you didn't use GLP-1s and you hit your goal weight and you want to maintain it, or you're at your maintenance weight and you want to maintain it, it doesn't matter. Meds, no meds, or even using a little bit of meds in maintenance, the principles are still the same and they're different from when you were losing weight. So we are going to unpack all of that. And what are the 3 things that you need to make sure you're doing? What are the success secrets of these weight loss maintainers? People who have maintained 70 pounds or more of weight loss for 7 years or more. What is it? That's what we're gonna be unpacking today with Dr. James Hill. Let me tell you a little bit about him. He is kind of my hero, I must say. He is a professor in the Department of Nutrition Sciences at the UAB School of Health Professions. He is literally one of the foremost experts in obesity and again written over 650 papers. He has been funded by the NIH since 1981 and serves again as the director and PI for the UAB Nutrition Obesity Research Center. He served as the director of the Colorado NORC and was the founding executive director of the University of Colorado Anschutz Health and Wellness Center, and again, the co-founder of the National Weight Control Registry. So the GOAT, the GOAT, and really one of the few people who looks at weight maintenance. So super excited about this interview. It was fabulous. It exceeded my expectations and they were high. So I will be right back with Jim. Stay with me. Dr. James Hill, Jim, I am super excited to have this conversation with you.

I'm really excited to be here and talk about my favorite subject.

I know, it's my favorite subject too.

We're gonna have a good conversation.

And I will say that I have never heard anyone talk about weight maintenance. And I heard you say, you know, what you need to do to lose weight is different than what you need to do to maintain weight. And it was like, well, duh, no one's talking about this. Why do you think that is? Like, how have you become this expert in weight maintenance? Tell me all.

A couple of questions. The first one, why aren't, Why aren't people more interested? A couple of reasons. Because they're bombarded with strategies for losing weight, and there are a lot of companies that make money on their diet programs, not so much for weight loss maintenance. So people haven't really figured out how to make money with it. And the other thing is, when people go into weight loss, they're so focused on losing weight, they don't want to think beyond that. So it's getting them to think about not just the short term, but the long term. And I got into this by studying people who have actually been successful in the National Weight Control Registry. So we identified and followed over 10,000 people that have kept off an average of 70 pounds for an average of about 7 years. So we learned from the successful people.

I think it's important for everybody to note, how unusual is it to be successful in maintaining weight loss?

It is rare, unfortunately. We don't have great numbers, but the rough numbers that I'm comfortable with are probably only about 20% of people who achieve significant weight loss are able to keep it off 5.

And from what I've heard, it can be even worse.

It may be even worse. I'm trying to be a little conservative here. Still, right now, You have a better chance of regaining it than losing it. And part of the reason is because people are trying to use weight loss strategies to maintain weight loss. It doesn't work.

So you created this National Weight Control Registry. I think the story of how this came to be is pretty funny.

How'd this happen? So it really did happen over a beer. You know, I've talked about this, but I was at a conference with Dr. Rena Wing, who's a very famous behavioral psychologist, and we were having lunch and Maybe we had an adult beverage, but we started talking about, well, you read in the press that nobody succeeds at long-term weight loss. I'm not sure that's true. And we kind of looked at each other and thought, wow, wouldn't it be nice to see if we could find people who succeeded? And we came up with this plan for a National Weight Control Registry. And we had all kinds of strategies for recruiting people. We're going to reach out to healthcare professionals. And it just so happened that while we were doing that, I got a request for an interview. I think it was a newspaper in Orange County, and I mentioned that we were doing this. The letters poured in. We got letters from all these people, and sometimes they were 10-page letters. These people want to tell their story. So being brilliant scientists, we said, well, let's use the media to recruit. And that's largely how we did it.

Amazing. And so that statement, which I wish this statement was everywhere, we know it in business, what got you here won't get you there. You know, it's like, yeah, you always have to be looking at each stage in business, what needs to shift, but yet we don't apply it to this. What, what is the difference? Like, what are these key metrics?

So look at weight loss. We spend so much time comparing this diet to that diet, to that diet. What we really learned is that weight loss is a function of food restriction. Okay, you can do it with exercise, but you have to do so much that it's not feasible. Really, the way that people are going to lose weight is to eat less food, and any diet they stick with allows them to lose weight. And weight loss is a short-term process, so you can sort of take time out of your life to say, okay, while I'm on this diet, I'm not going to go to this party and I'm going to, I'm going to get these special foods and I'm going to do this and this and this, which aren't things that you're going to do over the long term. Weight loss maintenance is you have to keep your weight off and you have to live your life. You have to go out and you're going to have the ups and downs and the highs and lows. So it's being able to deal with the long-term strategy. It's a short-term approach versus a long-term approach.

And let's face it, it's just like trying to sell prevention and health. You know, it's a lot more fun on the weight loss side of things, gets exciting.

It is. And I'll tell you, you know, so many people have come to me and, and they said, I'm going back— I'm not going to mention any names— I'm going back to this program because it worked before. And I thought, wait a minute, what's wrong with that statement? So yes, people see the weight loss as the end point, not the weight loss maintenance. And so one of the things that I try to get people to do if they're starting a weight loss program, medication, lifestyle, what's your long-term plan? Okay, let's assume you're going to be successful in getting the weight off. Now what? Now what are you going to do?

You said something interesting. I've been listening to a lot of your interviews. You said, you know, weight maintenance hasn't been that big of a deal because most people didn't get to their goal weight in the first place. What now has changed with these? I, I want to know your opinion on GLP-1 meds. I know you've got this book coming out I'm excited about, but, you know, how has this changed the landscape? What are your opinions on the meds? Let's dive into that.

So let's start with a very famous study that was done, gosh, 30 years ago by Drs. Tom Wadden and Gary Foster. And they did a simple thing. They produced behavioral weight loss programs and they asked people before they started the program, "How much weight do you want to lose? What would be your goal weight, your ideal weight, your happy weight?" And an acceptable weight, not even their dream or their ideal, an acceptable weight was about 15 to 18%, and a dream weight was like 30%. So people are going into programs that at that point could produce maybe a 10 to 12% weight loss, and their expectations were much greater. So the problem is people weren't reaching or nearly reaching their goals. So they never wanted to switch from weight loss to weight loss maintenance. Now, the new GLP-1 receptor agonists have changed that because the average weight loss that people are reaching on these meds, it varies depending on person and meds, but it's approaching 20% and sometimes 25%. So now people are reaching or nearly reaching their goals. So they're a little bit more willing to say, okay, I have a weight now I would be happy to live with the rest of my life.

I think it's interesting now with these medications because we're making a joke about that person going back on that diet because it worked before. But if the reality is that what you do to lose weight is different than what you do to maintain weight, then it would make sense. You use these diets And now we do have to think about whether you're staying on a GLP-1 or not, what do you need to do to maintain the weight? Because maybe you're going down on that GLP-1. So what are these things? What's the difference?

Any diet you stick to works. You can go and pick up any book in the bookstore about how to lose weight because it tells you, it gives you a plan for eating less. And if you stick to the plan, you're going to lose less weight. The problem is you're in a situation where your body unfortunately is really fighting weight loss. It adapts and wants to promote weight regain. To, to keep the weight off, you have to have some specific strategies. And in the book, we talk about 3 major pillars. One is your appetite. You have to manage your appetite. Two is your physical activity. You do not need to be physically active to lose weight. But you absolutely have to be physically active to maintain your weight. And the third one is a term we've coined called mind state, which is your mental approach to this, how you look at the future, how you deal with setbacks, your resilience, your meditation habits, these sorts of things. So we give people— we call them— we call it a playbook because we give people different plays for each of those three. That will help them to sort of strengthen those skills. And those skills aren't needed for weight loss, you know, in weight loss, sort of hold your breath for a while, get the weight off, and yeah, it's there. In weight loss maintenance, you've got to bring your— you've got to live your life on top of this. So it has to be something that is integrated into your life, not something you go and do separate.

So before we go into that, because you've been studying weight loss for so long, I know You know, when you look at weight loss, you can look at all these different types of diets, whether it's, you know, carnivore, paleo, whatever. Again, caloric restriction is the thing that seems to be the thing, right?

Right.

And however you get there. But I would argue that there must be something on the back end, looking at things like the metabolic adaptation and what's happened with some of these, that if someone were to do, say, more protein in their diet and resistance training as they were going through the weight loss phase, Don't you think— I'm hypothesizing— that they would have an easier time in maintenance than someone who just went gangbusters, maybe lost, you know, more muscle and kind of ended up a little bit metabolically disadvantaged when they went into weight maintenance?

You know, you're exactly right, because that combination is a really important combination: resistance exercise and high protein. High protein alone isn't enough because you're not doing anything with it. The resistance training combined with the protein positively affects muscle mass. So you may not lose more weight, but what's likely gonna happen is more of your weight loss is going to be fat and less is muscle. Now, why is that important? It's important because muscle burns a lot of calories. Fat burns a tiny amount of calories. So if you can minimize your muscle mass, it sets you up much more to be able to maintain the weight loss.

I also wonder if, if someone's moving into optimizing their protein, I have them eat protein first, that if this could help them as they make that shift over from weight loss into weight maintenance, that they'll have that higher thermic effect from the protein, that they'll have the satiety from the protein. You know, what's your thought there?

That's one of our strategies is higher protein. Higher protein does several different things. It promotes satiety, number one. So makes you feel fuller. And if you stop the medications, your appetite's gonna come back. So what we want is to give you a strategy to deal with that. You are going to eat more after the meds, no question. But the goal is to what we call reset your appetite. It was too high before you lost weight. It's low on the weight loss meds. Now we want it somewhere in the middle to come back, and increased protein can help on the appetite side. It can also help in maintaining lean muscle mass. And again, we're very high on the combo of protein combined with resistance exercise.

And when you say high protein, what, what do you consider high protein?

It varies, um, what people are down around 1.2 grams per day. Some people even go up to 2 grams a day. We don't get into specific amounts. What we talk about is planning your meals that contain protein, particularly when you start out in the morning. So we talk about a morning kind of appetite reset meal with high protein and high fiber, two of the things that make you feel full which will help you manage your appetite during the rest of the day.

And do a little GLP-1 bump.

Yes.

I mean, I know it's short term. It's not like the meds.

It's short term, but every little bit helps. I mean, we're talking about tiny differences here. So you're right.

And you mentioned breakfast. Yeah. So was this one of those habits of the maintenance people or not?

Yeah, it was. And this is one where there's been a lot of research about breakfast, and I've kind of changed my opinion. The people in the National Weight Control Registry pretty much uniformly ate breakfast, but they did a lot of other things. And so focusing on one thing, I think, is a little bit not the right thing to do. So I think people can vary in their meal patterns. So what we've done in the book is to say, look, Breakfast is the first meal you eat, whether you eat at 6 o'clock, 8 o'clock, or 10 o'clock, that's okay, but make it a high protein, high fiber meal. So I think I've changed my mind a little bit about breakfast.

It was interesting. So I worked on these weight loss challenges on Dr. Phil for 2 years, and there were a couple similarities, and everybody who was on was obese or morbidly obese. And they had a couple things in common. No one ate breakfast. Yes. Everyone seemed to drink Mountain Dew. It was like Mountain Dew. I was like, Mountain Dew.

That's the big one right there.

Yeah. It's like, ooh. But, you know, a lot of fast foods, but everyone was a breakfast skipper. And it seems like one of the things I've, you know, over the years, it seems like breakfast at some point in the morning, I like it about 2 hours after you wake up, tends to make a big difference. So I'm still not a fan of breakfast.

Yeah, and I think you're right. I think a lot of people who are overweight have the pattern of nothing in the morning, a little bit of lunch, and then in the evening you start eating and basically eat until you go to bed. Yeah. And that's probably not a good pattern. So I'm a fan of eating something early on. Something in the morning, but people differ. I guess one of the things that we're learning is kind of the concept of precision nutrition. What's best for you may not best for me, but generally we do find in the people who maintain their weight, they tend to be breakfast eaters.

80% of the people are doing this thing and have this result, then you can make a pretty good generalization. And there's always going to be the outliers because there's always the outliers. Before we get into these other ones, I actually didn't ask you that. So GLP-1s, what are your thoughts on them as a long-term obesity researcher?

So GLP-1s have been very positive game changers for treatment of obesity because for the first time people are reaching weights that they only dreamed of reaching before. And what the GLP-1s emphasize is The reason people fail before was not simply willpower. There was physiology, biology going on. And so what the GLP-1s do, I think, is level the playing field. They take people that had so much of a difficulty managing their intake because of their biology, and the GLP-1s even that out a bit and give them a chance of keeping the weight off. We hear people say, for the first time in my life, I know what it feels like What's it like not to be hungry? So that's a huge deal. And I think it gives people hope. So I think the GLP-1s are great tools. Now, I think we have to figure out the right way to use them with all the other tools that we have.

Yeah, I think they're a game changer, too. And, you know, when I hear people saying negative things about them, I go, I don't know. I've worked in weight loss for 40 years and I've seen people struggle and have so much shame around this. And, you know, if you can give them a tool to help them as they're doing the other things, That's the key.

See, I think that if, if you rely totally on the meds, you're missing out on, on a lot of things. Like, the meds don't do anything to your metabolism, so there are other things you can do. So if you use the meds in the right way and do some other things, then whether you stay on the meds or not, it's going to optimize your health.

If you had someone who was going to go on GLP-1, what would be some of the key things you'd want to see them doing alongside medication.

The medications are going to do the heavy lifting on the food intake side. Basically, you take these medications, you eat less. So we can rely on the medications to do that. Now, what nutritionists need to do is to say, you know, you're going to eat less, you're going to lose weight that way. Let's look at the quality. Let's increase your protein. Let's look at things we can do to make sure you get enough micronutrients, etc. But the other things that you need to work on that the meds don't do is your physical activity. So the meds don't increase your physical activity, but a lot of people, hopefully, when they start losing weight, they feel a little bit more able to exercise and they move more. And then the final one is the mind state, to think about using your mind as medicine and looking at how you think about the future, just simply looking at long term. What's your plan? How do you see the challenges? How are you going to manage the setbacks that are almost certainly going to happen? And you can work on both of those. You can increase your physical activity and you can strengthen your mind state.

You know, I was just thinking about how, you know, the failure rates of diets and then the big, you know, the big complaints about these meds really are that you'd have to be on them long term. But what's worse, you know, like I look at it and go, okay, if you've got someone who's failed at so many different diets and they're carrying around this extra weight that's now contributing to issues with diabetes or heart disease or any of these other things, and they can be on a low level of a medication to not have that. What— why is that a problem? I don't—

I agree with you totally, and I think staying on these meds long-term is one option for people if you don't have problems with the side effects, if you're feeling good, etc., and you decide that you want to stay on them. We do it for other medications. We do it for diabetes and cholesterol and blood pressure. So it's absolutely a viable way forward. And the other thing that comes up, some people have told us, well, it feels like cheating when you're taking the meds, and that is so wrong because you are simply getting a level playing field. So the meds are important, and I think we're very lucky to have this new round of medication.

It really feels like to me too, someone who's maybe high body fat, insulin resistant, probably isn't producing GLP-1 or is resistant to it anyway. So you see these other issues with high fasting insulin and not being able to burn fat. So it just feels like, again, what you said, level the playing field. So you wrote this book, what a timely thing to write. And it really is how to maintain your weight if you're going to get off a GLP-1. Walk us through what you recommend for this.

Yeah, and again, this is the book we've always wanted to write, but the timing wasn't right. As we said before, people weren't interested in weight loss maintenance. Now I think they are. So we've talked to so many people who had to go off the medications, side effects, cost if the insurance stopped covering it, or wanted to go off the medications. They missed food. They felt like they didn't want to be on medications. There are a number of reasons, and that's okay. It's individual. If you decide to do it, fine. So we wrote the book because the data are very clear. If you go off the medications without a plan, you're going to regain the weight. Okay, we know a lot about weight loss maintenance, so we wanted to use this book to give people their best chance of keeping the weight off when they stop the weight loss medications. So the first thing we talk about is your appetite. When you go off the medications, Your appetite is going to increase. You're going to eat more. What we want to do is give you some strategies to keep from eating the amount you were when you were in the overweight situation. So we want to reset that appetite lower than it was, but higher than it was on the meds. And we use, um, protein and fiber and different strategies for the kinds of diets you can do to manage your appetite.

Wouldn't it be smarter to either taper off, go slow? Like, I don't know how people are getting off these GLP-1s if they are, but it seems like going from a higher dose to nothing would, would be a really problematic—

Absolutely. I agree. The problem is we don't have a lot of data on that, but I think people are looking at that and I do think it makes sense to taper off. But the other thing that helps us here is the medications actually last a little bit longer than some medications. Some medications, when you stop them, the effects come back right away. You have some time, a few days, maybe a week or two, where the meds are still gonna be having some effect, so you can get a little bit of that natural tapering. But I agree with you totally. If, uh, sort of weaning people off slowly while they're doing these other things is a— Pretty good strategy.

Yeah, that makes sense. What else can you do for appetite? That seems like that would be the big issue.

With appetite, we talk about several different strategies. One is managing your insulin glucose. So preventing big excursions in glucose and insulin seem to be associated with greater satiety, and you can do that with fiber and protein. We recommend anytime, Don't eat carbohydrate alone. Make sure carb and protein are together. The other ones are things we've known about for a long time. Energy density. Choose foods that have a lot of weight and fewer calories. Like carrots would be a low energy density. Little Debbie's cakes would be high energy density. I mean, those are extremes, but the idea is choose foods that give you a lot of volume, not so many calories. A big one is portion size. We have data over and over, the more food in front of you, the more you eat. So simple things like this can really help. And we give people several different ways that they can incorporate these kinds of strategies.

I wonder too, since the GLP-1s can help with a little insulin release and some blood sugar stabilization, would you have a, you know, would that create that problem too coming off of them?

It helps, yes, because the meds do that. I mean, they slow gastric emptying, they reduce insulin. They started out as diabetes medication. Yeah, they're very effective at managing glycemic control. So we want food strategies that are going to continue that as much as possible. Not as powerful as the drugs, but there's still a lot you can do with diet. Yes.

Well, especially when you combine it with exercise. I'm just thinking Add those air squats after you eat.

Exercise is the second one. People used to come in and tell us, "I'm overweight because my metabolism's all messed up," and we would measure their energy expenditure and it was very appropriate. And we said, "No, you're fine." But what we realized is, in fact, they were probably right, because what happens as you become overweight and particularly sedentary, all your metabolic systems are functioning less optimally than they should, from mitochondria in your muscle how you store fat. And there's this concept of metabolic flexibility. People who are sedentary and overweight tend to have low flexibility. It helps maintain the obese state. Exercise fixes that. Weight loss will fix it a little bit, but exercise— what we say in the book, it essentially optimizes your metabolism. Everybody's metabolism is different through genetics, but you can make it as optimal as possible. So you make your body work as well as possible through physical activity. And we talked about the ways to do that. You have to do planned physical activity. That's one of the things all these people in the National Weight Control Registry do. They plan physical activity every day. Reducing sedentary time. We tell people, sit, sit for 1 hour less a day. Well, where am I going to find time to do that? Well, give up an hour of those 5 or 6 hours you watch television or computer. And a third one is move more in daily living. We talk about increase your movement by 4,000 steps, and then we talk about resistance exercises being important and changing it up, doing different kinds of exercise. And we spend a lot of time trying to help people who— we've heard it all— I don't have time to exercise, I don't like to exercise. So we have whole sections where we talk about how you deal with the motivation of doing the exercise.

The weight maintainers, you said they had an hour planned exercise every day.

Yes.

Which lies in the place— you look at the recommendations by the CDC and then you go, okay, well, this is a problem, right? Because the CDC is half that. And no wonder we have, you know, 75% of us overweight or obese.

For keeping weight off, The 30 minutes a day will not do it. I guarantee you it won't do it because again, when you lose weight, your energy expenditure goes down with your reduced body size. Means you need less energy. You have to eat less. If you add exercise back, you both burn calories, allowing you to eat more. You improve your metabolism, which allows you to burn calories more efficiently. And it's just, it's absolutely essential for keeping weight off.

Did they track in this, the weight registry, like how many, what the average steps were a day that people were getting?

Yeah, it was about, I think it's, if I remember right, it's about 12,000. We did that.

Which the average person in the US, I don't know if you know these, it's 3,000 to 4,000 steps a day.

We actually did work on that and published some work on that and our, I think we found it was somewhere between 4,000 and 5,000. But so the idea is pretty lame. It's, it's pretty lame.

Yeah.

And you're going to have to increase that. And again, people say, well, an hour a day. Oh my gosh. At 1 hour out of 24 hours. And these people are keeping off 70 pounds. I mean, we're, you know, you're your choice.

All right. So exercise and a variety of different things with some focus on resistance training. Moving throughout the day. Yep. One of the interesting things that I saw early on in my career was that as people were losing weight, sometimes their vision of themselves wouldn't catch up and they'd sabotage themselves to go back to where they were.

Now you're talking about the mind state part of this, which may be the most important. I've spent my career looking at diet and physical activity, and in recent years I actually think the mind may be the most important part at all because we can tell people what to do, but helping them do it and helping them maintain it in the face of other things is the key. And so we talk about optimizing your mind state. In our work, we've dealt with a lot of people who've lost weight and kept it off, and we've observed 3 different kinds of mind state. The first one we call a victim mind state, and these are the people that come in and say, Okay, I'm gonna try this program, but I know it isn't gonna work because I've tried before, you know, I tried, tried. It's not my fault, my wife brought the cookie, you know, it's never me. Those people are gonna fail. One of the things we try to do is get them to go from a victim mindset to a victor mindset, to say, you know what, you can solve these problems. These problems are gonna come up, but we're gonna give you the skills to change them. But what we've seen occasionally is a third one that we call the Voyager mindset. These are interesting people because they see this not as overcoming barriers. They see it as a way of growth and dealing with the challenges and so forth. They recognize that it's making them a better person. And those are the ones that not only achieve weight loss, but they're the ones that actually get the most pleasure out of it. And so what we do in the book is try to show you how to go from a victim to a victor to a Voyager mind state.

How important do you think it is for them to be hanging around other people? You know, I think of that, that study that showed that weight loss was contagious. Remember that headline?

Totally. We have a whole section in the book on the environment. First of all, we talk about the physical environment. Environment, just like what's in your kitchen, how's your kitchen arranged, do you have— are your exercise clothes handy, little things that you could do. We also talk about the social environment. You tend to behave the way people you hang out with behave. So, if your friends are going out 3 nights a week for beer and pizza, you're not going out and eating steamed broccoli when they're getting beer and pizza. You're doing the beer and pizza. And in the National Weight Control Registry, it's really interesting because people actually changed their friend groups. And again, we're not telling people to give up their friends, but they realized that they needed to be hanging out with people who were doing and valued the behaviors they were trying to do. So dealing with both the physical environment and the social environment is very, very important.

What are some early signs that they might be heading regain?

So one of the things we talk about is, is monitoring. Now, people in the National Weight Control Registry weigh themselves regularly. I would ask them, "Why do you weigh yourself regularly?" They said, "Well, how am I going to know I'm gaining weight if I don't weigh myself?" So we have a whole section where we talk about weighing yourself. We recommend that you weigh every day, but that you look at weekly averages. Your individual weight, depending on who you are, can vary up to 5 pounds from one day to the other. That's not a change in fat. If your weight goes up 5 pounds in a day, that's water, not fat. So what we talk about is we actually suggest people write it down so they can track it and they look at patterns. Most people who are in the registry tell us they have a range and they have a take action weight. So here's the range I want to be. But if I get to this weight, it means I have to do X, Y, and Z. But I have a plan for X, Y, and Z. So they actually pay attention to that. It's an early warning system, but they know what to do when they reach their take action weight.

I used to own a gym and wellness center, and I remember one winter, you know, you wear— and I bet this happened over the pandemic too— you wear leggings, right? I'm at a gym wearing leggings every day. Yeah. And I— someone invited me to go somewhere and I went in my closet to put on a pair of jeans and they were too tight. And I thought they must have just come out of the dryer. Go try on like all the pants. And from that moment on, I'm like, uh-oh. And what I teach people to do is use a bioimpedance scale and have it tracked to your phone and watch the trend.

Yeah, it's, it's a matter of looking at trends. Don't get hung up with any single change in weight. Look at the long-term strategy. If the long-term is bouncing around, but it's basically stable, you're fine. If it's going up, you have a concern.

I totally agree with that. And I think it's so important because there's been so much against all of that. I'm like, well, if someone had issues with their blood pressure, you wouldn't tell them not to track it.

The scale is a tool. You do not put any emotional value in your—

Well, you're a guy.

Yeah. You see all those cartoons about don't step on it, it makes you cry kind of thing. But Don't. It's a tool. Use it as a tool. It has no— it shouldn't affect you emotionally. It's data that you need to make a decision.

Amen. Yeah, well, that's why I really like the bioimpedance one, because then you can really see that fluctuation and not be crazy with the total body water.

And the other thing we talk about under mind state is, you know, people start out and their goal is to reach a number on the scale. That's not really what people want. The number on the scale isn't what they want. What they want is a higher quality of life. They want to be happier, and weight is a part of that. But while you're losing weight and maintaining weight, you can work on other aspects of your life. Social— new social relationships, Thinking about yourself different. We talk about identity. A lot of people, they see themselves always as a former obese person. No, there's a, there's a different identity. See yourself as a traveler or an athlete. So that's part of the whole mind state. The value of having a Voyager mind state is not just you're going to be more successful in keeping the weight off. You're going to enjoy it more. You're going to be happier.

I love that. So this book coming out, Losing the Weight Loss Meds: A 10-Week Playbook for Stopping GLP-1 Medications Without Regaining the Weight. When is this out?

It's out December 15th.

All right.

And it'll be available anywhere people get their books. One of the things that Holly Wyatt, who wrote the book with me, we've learned over many, many years of working with people there's no one-size-fits-all. So that's why we've given people options and we give you what we call plays, which are strategies. And we say, try this. If this works for you, keep doing it. If it doesn't, here's another one you can try. And what we're gonna keep doing, we also are gonna have a website where we follow up and continue to provide more help and support for people who are in weight loss maintenance.

And here's the thing, this you've targeted towards people on GLP-1s, I'm sure, because they actually do need to go into weight loss maintenance. But this really is for anybody who's looking to maintain their weight.

Thank you. That is something I say over and over. It's really everything we've learned from 40 years of research around people who keep their weight off. And again, we don't know everything, but I truly believe I believe this book is your best chance of weight loss maintenance once you achieve weight loss.

I love it. Thank you for doing this. Thank you for all the work you've been doing. This is— it's such groundbreaking information. And again, I just want everybody to hear what got you there won't keep you there. You've got— they're different strategies, you know, so you've got your diets, you know, everyone's got those diets. They know the diet that works for them, but it's the, it's the maintenance that makes all the difference. And it's been this, this area that no one's talked about for so long.

This is a lifestyle that people will love. It's not something you say, "Oh my God, I have to live the next 30 years this way. It's going to be awful." When you see these people in the National Weight Control Registry, they're not there saying, "I'm living this awful lifestyle and I hate it." It's like, "My God, I love this lifestyle." So the idea is you are going to achieve a lifestyle that makes you happy, not a lifestyle where you say, "Oh my God, I have to do this forever." That isn't gonna work. If you don't like doing it, if it makes you unhappy to do it, you're not gonna do it.

It's funny you said that 'cause I think of people going on diets and they don't wanna go on the diet 'cause they don't wanna have to stay on the diet. And it's like, well, you don't stay. So that's really the big message is you use a diet short-term therapeutically. I always look at these diets as tools for whatever you're addressing. It's a short-term therapeutic tool you have in your toolbox to get you to where you want to go. And then you have this as your long-term strategy. And within this, there's things you can do because you shift over time. Anything from, you know, exercise on down, right?

We've studied so many people in the National Weight Control Registry. I think 98% of people say their life is much better now than it was before. So, This isn't something that you're going to be unhappy with. If you achieve this lifestyle, trust me, you're going to be very, very happy.

Great. Well, it sounds like there's no reason you can't now with, with these weight loss medications that do so many other great things for your health. Like, I'm a big proponent of them. And again, whether you decide you want to use them or not use them or use them, taper off them or use them at a lower dose, this works well because you will get to that point where you're in maintenance and you have to shift what you're doing. Absolutely.

And, you know, you can go off the meds at any point. You don't have to decide. You can try them. If it's working well, fine. If a year or 2 years later you decide to go off them, we've got a plan for you. So it's up to you. You now have tools that can be very effective in helping you reach and maintain the weight you want to.

It's amazing. I will put all of this— I'm going to put it in the show notes and also at JJVirgin.com/Hill. With links to the book and links to anything else. I found some other great podcasts you've been on, so I will link it on up there. And I wish you the best of luck with this book. It's sorely needed, and I appreciate you doing it because I know what a labor of love books are.

Well, this has been a lot of fun. Thank you for, uh, for giving me the time to talk about something I dearly love.

Oh, my pleasure. You are welcome back anytime.

Thank you.

Hey, JJ, back here because I wanted to give you a couple action items, takeaways after that interview, because this is really near and dear to my heart. It's actually worse for you to lose and gain and lose and gain than just to stay the same. So I want to make sure that if you are doing the work to drop fat, build muscle, shift that body composition, that you are then know what to do to keep it there. Number 1, I got asked this once, what do I need to do to— in order to maintain my weight loss success, I said find fitter friends. And what I mean by that is find people who are going out to different workout places, eating healthy food, hang out with them, especially people that challenge you, push you to do more. One of the things that I do in exercise is I travel all the time, so I'm trying different things. I'll go to different types of classes like super hard yoga classes or a HIIT class, and I especially try to find classes where I'm the oldest person and hopefully less fit than other people in the room. So I'm always looking for that. How do I find the class that's got like the 25-year-old ripped, lean, fit people in there? And then they look at me and they think I'm not going to be able to keep up. Haha. Anyhow, that's the first one is find those fitter friends, find those challenging situations for yourself, set yourself up for success. Don't invite the enemy into the house. You heard Jim talk about how the pantries and kitchens were set up. Make it easy for yourself. That's super important. And that hour a day of planned exercise and the 12,000 steps— I was at 10,000 steps. I guess I need to up my game a little bit. But that hour a day of planned exercise, it's half of what the CDC recommends. And realize there's probably a reason that 25% of the population right now is actually normal weight. I'd argue that probably a lot of them are actually skinny fat because What, 7% of the population is metabolically healthy. So let's, let's just move more. Okay. So there's some of the things that you can put into practice. And again, of course, shifting that mindset. If you think and act like a healthy, lean person, guess what? You'll become one over time. All right. I will see you in the next episode. Thanks for tuning in.