64: We Got Weight Loss Wrong - The Real Meaning of GLP-1s and Metabolic Health with Ashley Koff

We are chatting with Ashley Koff, registered dietitian, the founder of the Better Nutrition program and author of upcoming book your Best Shot, which is released early early 2027. It's focused on GLP shots and weight health. She has been a practitioner for over 25 years. Cough is a leading a transformative movement in personalized nutrition, turning better, not perfect choices into practical, sustainable, sustainable strategies that deliver real health outcomes. She's brilliant. She's incredible. Excited to dig into this conversation with you. Welcome to Modern Thyroid and Wellness, the podcast that explores the intricate dance between health, wellness and thyroid, unraveling the threads that weave our vitality together. I'm your host, McCall McPherson, and I'm so thrilled to guide you on this journey to. To optimal wellness. So I'm so excited to chat with you today, Ashley. I'm just a big fan and supporter of your infinite knowledge, especially about the topic of metabolism, weight, GLPs, whether it's natural, whether it's injected, whatever it is. So let's dig in. I know everyone is going to be on the edge of their seat, but let's start with the little basics, like, tell me foundationally, what, what even is a GLP in terms of our own body and even a GLP that maybe we can get exogenously or from somewhere else.

Yeah, I love this. And thank you. I feel like from the second that we met, like that jj, like throwing us together on a panel, I'm just like, how did I not know this person? So I'm so excited about this. So one of the things that's so interesting is, isn't it great that we're asking the question, what is a GLP, right? So 97% of America in the world will answer, it's a medication for weight or maybe for diabetes. And if we go back to the moment that I had, which was not in school, not when I was going back to become a dietitian, not doing any of my medical training, but when I was actually working with bariatric patients, basically, like after my maybe like fourth or fifth in 2004, I turned around to this doctor and I was like, this is just crazy. Like, day two, diabetes gone. Like, literally, like our diabetic patients, this change. And then like a week, two weeks later, it's like satiety, hunger, not just appetite and conditioning, but like, all that is just going away. And he said, yeah, those incretin hormones. And I was like, pause. What are you talking about? What is an incretin? Like, it sounded like ingrown hair. Like, I was like, what are you talking about? And so at that point, it was the medical school and medical studying was really about these, looking at something called the incretin effect and incretin hormones. And what we then understood was we have insulin and glucagon, which I think people are more familiar with, which are hormones that regulate blood sugar. So they either tell the insulin goes in when it's queued up, insulin goes into the bloodstream and picks up sugar and takes it into the cells for use. That's very important so that we know how important that is, so that sugar doesn't hang out in the blood. Or glucagon is when, hey, we don't have sugar, so let's liberate it from where it's stored and let's make that available and bring that over. But these incretin hormones, it turns out they actually tell insulin and glucagon what to do. So that's GLP1 and GIP and when we look at that, we understand just how big of a deal that is. And that's 2004. This was like, not written about, like, unless you were deep in diabetes, like especially type 1. This was not talked about. And these hormones, we have these hormones that are made in the lining of our digestive tract that are going to be deployed based on signals from our brain from a variety of different things. Sight, smell, appetite, taste buds, like, all sorts of different things that are going to go. When they're told that they're going to go to work, they then actually tell insulin to go to work. So it would be like, I'm real bad with cars, so I can't use that. But it would be like, if we've been trying to have insulin go to work, but nobody's been sitting there being like, setting the alarm and being like, hey, insulin, time to go to school, it's time to get up and go. So we now knew that we had these hormones and this big light bulb went off for me just with that, where I was like, wait a second. I've been successful to this point for a couple of years, helping people get healthy by and really what I'll call weight healthy by optimizing their digestion. I'm now understanding in a very, very basic way that I've been helping these hormones work and going to do that work. And I now also understand why all the gazillion different things that people have been trying when our weight health hormones don't work effectively, why those aren't working. So we have GLP1 we have GIP, turns out we have GLP2, we have CCK, we have PYY, we have Amylin. There's no quiz here, people. But basically because of the invention of these agonists, which I'll come to in a second, these medications, we're now learning all about these hormones. Well, the most important thing that we can understand is that these hormones that we make in our body, they last for about two to five minutes. Some may last for closer to an hour, but about two to five minutes. So they're what we call emotion detector. Their whole job is to tell these to go to work. When science figured out that there's a way that they can extend these and they could keep them on for a whole day, maybe where so that the receptor sites throughout our body would get these and would be like, yay, you've got this locked down for 24 hours. Or now where we have them for 24, 7. What actually has happened is these are bio similar hormone replacement therapy. So your world, your entire audience knows we know about hormones. Thyroid, right? So we're like, we might replace thyroid hormone if we don't have enough, or we might try to optimize how our own works, or we might do both of those things together. We all know diabetics and diabetes, and we use insulin. There we are learning more about estrogen, progesterone, testosterone. But those hormone replacement therapies are what we call bioidentical, where they work the same way and they work for the same amount of time. They're made synthetically, but they come in and the body does that. Biosimilar weight, health hormones, GLP1, GIP. Now we have glucagon also in that part. When we're doing those, they're very different. The dissimilarity is very important. Instead of two to five minutes, they're on for about 24 hours, seven days a week. So when we see different them working, they do the same thing. They go into the receptor site, they tell insulin to go to work, they tell leptin to go to work, ghrelin, like all these things we can unpack, but they're staying on for a long time. So that means that any approach where we're using them, lower doses, higher doses, et cetera, needs to understand that we're throwing our body, which is an ecosystem, we're throwing it into a sustained state of activity where it normally only has a motion detector. It's kind of got a force field going on. Lot of advantage to that. But as you and I can unpack. There's also some things we have to consider for sure.

Absolutely. And obviously we went from kind of a 0 to 100 in popularity of these medications. Right. They've been around for decades. It's so cool that you worked with them previously in their past life use for diabetes, which they're still being used for today. But obviously most people are more familiar with them from a weight loss perspective. But because this is such a popular thing, because it is essentially sweeping the nation by storm, because I feel like even in my experience, in a practice where women are, like, invested in their health, they exercise, they eat well, but they're still not able to effectively. Many of them lose weight. Obviously, they have thyroid issues with appropriate amounts of effort. What do you think that says about society in general today? And do you think we're having some metabolic shift that maybe we need to account for?

Yeah. So I think there's two things I'm going to take us back to. I was a super cute kid. I was, I'd like to say, a cross between, like, Shirley Temple and Spanky from the Little Rascals. Like, I had a belly, but I had a personality, and I was out there, and I loved to help people. And I was an entrepreneur, and I was, like, selling stuff and all this other stuff, and my belly was never like. And I was deemed, like, in my family, no health issues. Like, you know, you go in, great. Ashley's great. Here you go. She has this weight issue, like, and in the beginning it was like, okay, she's a little bit bigger. Maybe puberty and it'll shift. And then it's like, puberty's happening and it's not shifting. Well, I remember, too. And very sadly, at age 8, I was bullied in different ways many times. I hope that I was not a bully, but I appreciate, you know, how these things, you know, I think I was pinpointed as you have this belly. And I remember Even at age 8 in particular, a boy dragging me out back and trying to get another boy to kiss me, which was, like, scary, you know? But then, because I wouldn't participate, he ended up punching me. And he punched me a couple of times in my belly and called me fat and was just like, well, no one wants to kiss you, you know, and all. And this is eight, right. And I remember at that moment in time having this, like. And I'm putting that awareness that I have today on that kid at that moment in time. I was traumatized, of course, but I had this, like, dual life where I Was like, wait, you're strong. Like, you have a family. You can do anything. You have brothers. Like, you're not like, this is. I wasn't raised as, like a girl who needs to be like, do anything differently. I was like, you go get them. Like, you can do this. But I knew that my belly was a weakness. And in that moment, so I'm like, I gotta do everything I can to get rid of that belly. And society then continue to reinforce that. It's like you do. You have to do everything you can to get rid of that belly. So here's the issue that we have, because I am not alone in that space. The issue that we have is that when we segregate weight out as something other than an indicator of our health, that it is a key performance indicator. And when we look at weight, not our total weight, but when we look at our weight composition, a belly, whether you've been thin and you suddenly gain a belly, or whether you are not able to make muscle or you're losing bone, or you have water outside the cells instead of water inside the cells. When we look at our weight composition, we understand it' signal that the body is trying to send us. Then we start to treat it in that capacity. What we've done, unfortunately for society for so long in medicine and everything else is we've treated weight as its own thing, as something to manage and as something to lose. And so for me, in that time period, that entire time, I went for probably about another 15 years under resourcing my body and making choices that were so unhealthy for me mentally and physically, because I was just looking at, like, how do you lose weight? The belly on that part, why do I share that? Because it is now like, I'm 52. So if we look at that 40 years later, we have access to all these resources and we still. I was talking to a woman yesterday. She's laid up, has hurt. She hurt, I think hurt her patella, something else. And she's like, I just don't want to gain weight while I'm. While I'm home, you know, recovering. Maybe I need a GLP one. And I'm like, Because we're so focused on this weight issue, I was like, what you actually need is to optimally resource your body so that you heal right now. And how are we going to do that? And we may use a GLP1 as part of it, but we have to understand. So we are in a different place. We have the opportunity today to understand that our body is a Weight health ecosystem. That weight is one marker of our body's function. If we look at that and we understand these hormones I was just talking about as weight health hormones, we then can understand that any suboptimal function of those hormones will mean that you cannot be weight healthy. So it means that we need to know the function of our weight health hormones and then have a process for optimizing them. And this is where I think your question gets really appropriate. In the space of understanding modern day, we don't just have suboptimal function that all looks the same. We have some people where there's true dysfunction, where something is not working, their digestion's not working, the vagus nerve, like thyroid's not functioning, any of this stuff. We also have delay with our weight health hormones where maybe they're working but they're not fully working. Right. And so they're not getting where they're supposed to go. Transport might be a little slower. You know, we need to work on some of that stuff. And then we also have suppression where they could be working, but they're suppressed because of our other choices. So I think there's a valuable question which is the human body is brilliant in design, but we're designed with motion detectors. And do we in modern day, because of access to food, because of how we've been treating our bodies, because of medication, like all the different things that impact our bodies and how they function, and because of suboptimally functioning weight health hormones, we may need closer to that force field than say, just having the motion detector. So even if your weight health hormones are working at 100%, maybe that's not enough for you, right, to be able to reverse or heal from what you're trying to deal with. So that brings the question then, well, isn't the shot the GLP1 agonist, the force field? And the answer there is no. There's no medication or supplement or food or protocol that you can do. That is the solution. The solution is how do you optimize the whole body but using the tools that are right for you?

Yeah, I love that. You know, a couple things that I think about in that part of the conversation. One is like, we still have so much work to do to unravel all of this thought lines that we have, especially as women around weight and food and how it sort of invades our entire life and being in so many cases. And I think that we're on the right track, thankfully. But clearly we do still have so much work to do. And you know, you talk a lot about weight health versus weight loss and I love that idea. I love that concept. I think that's part of the evolution of this conversation that needs to happen. Can you tell me kind of the difference between weight health, weight loss, and what weight health can mean for the rest of the aspects of our health when it comes to risk for diabetes or blood sugar, how we feel on a day to day basis, or even how your thyroid's working, et cetera?

Yeah, weight loss as a goal is just a dumb goal. Let's move over to the world of smart goals. And I struggle a bit because we have some really, really great medical practitioners who are in the world of obesity medicine. But the fact that we have obesity medicine is part of the problem. We have an entire type of medicine that just looks at somebody's weight for. And I don't want to diminish anyone's efforts in that space, but that looks at you and says your weight based on your height and puts you in this category. And we're not unpacking, like, why is your weight in that space? And like your, your total weight actually doesn't tell us anything. It's just dumb. On that part, then if we add weight loss as the goal, I mean, I've worked with so many cancer patients during treatment where weight loss is happening, like on Repe, but we're losing bone, we're losing muscle, you know, all of this other stuff as a result of their treatments. And I'm sitting here going, okay, how do I optimally resource your body? Because we are in the fight for your life. Right? So with the body, like when we try an approach where we just lose weight, we end up. There's almost always a compromise from a health standpoint. And that's one of the things I want to point out about the medications that this version of the medication, from the time that semi glutide has come onto the market and people are highlighting, oh my gosh, I'm actually able to lose weight. There are so many great things about that, and the same with tirzepatide, et cetera. But when you just lose weight, you are often creating a situation in your body that is actually going to invite more health issues. And said differently, we're not looking at those health issues. So things like that are being called a side effect, like hair loss being called a side effect, or doctors that are saying, like, when my patients go on this and then when they stop, they regain all of their weight. I was like, you should not be allowed to prescribe this. If I have a patient that after a week or a month of going off the medication has gained five pounds back, I'm like, stop. All hands on deck. What is not going on here? Are you not able to do what you were doing before that was working for you? Or are we missing something? So let's definitely not use this in a weight loss weight gain. It's like this horrible cycle that we've had. We also are missing the connection, the underlying, from a weight loss standpoint of just. It's such a bad concept of like loss, like, just losing, like, you know, the biggest loser, like all this other part. It's like when we talk about weight health, we're actually talking about the body having what it needs, when it needs it, and being able to use it so that your body, which is legitimately just an operating system, it is just a car with a soul, right? Like, so let's just. If it's an operating system, it has what it needs and it can now run better in that part. It can operate the way that it's intended to. So when we're going through all of that, if we actually take an approach where we say we have to build, like, here's what we're doing is we're. A weight health approach is a building approach. It's a what I call an optimally resourcing the body. It helps us understand why so many of the nutrition pieces of information. It's why you and def. Like, for me, absolutely, this is my life's work. It's like, I have tried, including being in D.C. for eight years, to try every which way to change government guidelines to say that things like 1200 calories for a woman who is 40 is like the worst idea. Or an RDA for magnesium. That's from 1997. We're still using it. We're just calling it a DRI where women have 20% less magnesium than men. And then we understand that magnesium turns off the stress response and helps to alleviate things like uterine cramps and headaches. I'm not looking for women to need more than men. I'm just saying, like, hey, maybe we could be equal, you know, like in that part. So when we look at this, we have all of these bad ideas because they're like, we've been giving people all these bad recommendations because it was about loss. Like, how can you get the body to eliminate this? And what we want to be thinking about is, when I give your body the optimal amount of resource, let's use magnesium, or let's use calories in that space. Then it turns around and it says I don't have to deprioritize anything. I can heal what needs healing, I can give what you know, I can fuel whatever wants to be done for the day, you know, et cetera in that part. So weight health is the foundation of longevity, it is the foundation of healthspan. And I think we're at. I'm cautiously optimistic with you. The reason that I'm here today, the reason, the only reason I would go back and write another book and be out here doing all of this at 52, is because we have this opportunity to finally understand weight health and usher in weight health hormone optimization to achieve and maintain weight health with the drugs. We're in a place where there's a dangerousness, where we could still have them being called weight loss drugs. And if we call them weight loss drugs, then we're screwing with the same system that has been creating so many problems. And it's not just an adult problem, this is a generational problem. Right? So I lean into. We can create generational weight health. And this is this huge opportunity. And an eight year old girl like me is. It's not about whether an 8 year old girl like me has access to a GLP1 Agonist. It's about whether or not an 8 year old girl like me has access to resources that says, hey honey, your belly is actually because we've had you on antibiotics every month of your life since birth because you have ear infections and throat infections and your gut is not working and that's where your weight health hormones are. And so the fact that you literally don't feel full and people are telling you to stop eating when you're feeling full and you don't know how to do it and you feel like a failure. That's not the situation. The situation is we're going to find the right tool to help you feel full. We're going to nourish your body and as a result your body's going to be able to grow and run better. You know, from 8 on on that part. Right?

I read a study probably close to 10 years ago that showed after one round of antibiotics it can be 18 months of changes in hunger and cues and satiety feelings feeling full after you eat, 18 months to recover from one round of antibiotics. And how many people are out there walking around in the world taking antibiotics chronically for their skin, or of course giving them to their kids if they need whatever it is, but they don't know the ramifications of that and the lasting, lasting impacts that it can have on our weight health, our metabolism, all of it.

Yeah. And it's why like, and I love this, like when I look at, you know, I think like just the concept of like modern thyroid or modern, like looking at weight health in this modern way. Like there's a way that we have to look at modern times and be like, we've, I chose in my book, I was like, there's all this modern stuff that's been created that are like solutions to problems like we shouldn't have or we don't really have. Like, it is not actually a problem for 97% of us to get up from the couch and go change the channel on the television. Like that should be something like. So when we created the remote, we created like, oh, you can do this, you can do this faster, you can do like all this and you can just be sitting for longer. Well, sitting for longer led to problems of our digestive system, led to vagus nerve issues, led to weight issues, like all of these different, you know, et cetera. So we have all of these modern inventions and you know, one could argue like, do just get rid of those. And some people do, they go off the grid and they're like, I'm not doing that. But I will also say like, I've spent some time working with the Amish and these diseases permeate their, their society too, you know, and it's so, it's not so there's something about modern day, the access to the type of food we're eating, the type, the what modern living is doing to our digestion and to our vagus nerve and to the whole system of weight health, et cetera. And so I think it's one of those pieces where first of all, for the majority of people that two to five minutes is not happening on time at the right pace, you know, et cetera. But even when we repair that, there's opportunities to say like, maybe in life stages, like for me at 48, when my belly came back and I was like, oh my gosh, I thought I made peace with you, I'd learned to love you. I'm like, I did all this stuff, it's love that eight year old girl, all that and then your hormones shift and you're like, I don't love this at all. And I tried all the, I'm like, oh, I'm shrinking my eating window. That was a disaster for me. I'm like, I'm gonna have coffee, not do that for the first time in my life, I saw thyroid antibodies. I'm like, well, it's. What's this about? You know, like, all these. I started endurance training and moved away from fitness. And I was like, I'm going to climb mountains. Like, all these different things, and nothing that I was doing was wrong, but I felt like I was just back in that space. And I'm like, okay, let's work with this. And I thankfully had some great people in my ear. And I was like, all right, so here's the situation. Your hormones shifting are totally impacting your gut again. You now need to lean into. And how do you fix it? How do you do that repair work? And what are the tools that are here? Continuous glucose monitor showed me that, like, fasting. I should have known just by how, like, rude I was to people in the morning, but I was like, oh, continuous glucose monitors. Like, you have the dawn effect. Like, Ashley, just eat in the morning. My. One of our colleagues was Lara Zachary, was like, I think you need to eat. Like, this is like, we can't handle you on coffee. And I'm like, noted. And you started to see your body shift. And I was like, oh. And I had to give up alcohol. I was like, this has never been my friend. But, like, you know, and I had to go lean into. Go into bed, like, and do all of these things. And, you know, for me, there are, like, different time periods in there. I used a GLP1 agonist. I only was able to use a very low dose of semi glutide because I have such slow motility, even when I, you know, take care of it. And so that was great. That was actually the. The thing for me, you know, for three to four or five months, and then found out that my lovely little uterus was not little and was five times the size, and I had to get my, you know, have my hysterectomy. And I'm like, all these pieces come together and every personal story for a woman, as you're going through and you're picking up all these clues, these are the clues your body is trying to send us. But in modern day, like, they're hitting us in a way where we almost have too many choices for how we could deal with it. And as a result, like, we've got to come back and be like, let's not do everything all at once. Otherwise I think we can create, like, a worse mess, you know, rather than a better one. Yeah. Yeah.

What are some other clues that maybe people are deviating outside of Metabolic health, health, weight health, etc, that, yeah, listeners could be like, yeah, maybe I need to look into this.

Totally. Well, one of the things that happened to me when I started, like, diving, this is 2004, guys. I was still at the time trying to convince doctors that, like, digestion mattered for things like ibd, like, you know, for Crohn's and ulcerative life. So, like, this is in 2004. I'm like, you guys, did you know that when you do this, like here, you know these other things? And so when we looked at, I was like, you know what? I'm not going to be able to convince anyone of suboptimal weight, health, hormone function or even incretin hormone if I can't show it to them. So I actually created an assessment and I've used that assessment for 15 years. It's available free for anyone. It is in my book. But it's also, I just want to caveat, you're smarter to work with someone like your team, like, or other people, because it is a clinical assessment. So this isn't one of those things that, like, you answer a bunch of questions and you're a number eight and like, go live your life that way or you're a tiger. And here's what it means. This is. We're looking, we're asking questions about your lived experience. So for me, like, dead ringer, when I eat, I didn't feel full, right? And so that's an important one. Do I keep eating even when I feel full? Or does it, you know, depending on what I'm eating, does it take, you know, different time? So some questions about your eating. Am I thinking about, like, even if I don't eat all day, am I thinking about what I'm not eating or am I thinking about, like, and am I planning and am I trying to structure, you know, kind of that orthorexia or that almost a compulsive, you know, thinking about it on that part. Then we want to look at labs. And I think there are what I would call better labs, but they're also basic labs. So a basic lab might be a hemoglobin A1C to understand at least your average blood sugar. I don't like to use that for really anything, but I'd like to see, like fasting insulin and maybe see a continuous glucose monitor, but I'll look in there. We'll also look at things like markers of inflammation. I think ferritin is often too frequently associated with iron level. And thinking about iron, if we want to really look at it and in terms of inflammation and things like your crp, vitamin D status, because we know your thyroid needs it, we know your bones need it, we know your blood sugar need, like there's a lot of need for vitamin D. So we go through the labs, then we do some assessment of breathing. So many people don't know their BOLT score. And just understanding how is oxygen being used in your body, we might look at your heart rate variability if we have access to it. We may just look at your pulse and understand when your pulse is changing and, you know, things like that. We're going to ask questions about digestion, we're going to look at your poop, we're going to also assess your smell. Somebody might do that for you if they're going to be honest. Things like, do you have bad breath? Like, are you constantly having, you know, chewing gum or having mints or doing, you know, different things for those purposes? And then I include under digestion, hydration. And so I will have people drink a little bit of water and see how long it is till they have to pee. And so we'll. We'll see how your hydration are you absorbing water, which is what hydration truly is about. And then the final one is we're going to look at your weight composition in the best way that we can. So we might have access to a dexa, we might have access to bioelectrical impedance, like all the stuff that we use. We might just use your weight for and look at your waist to your hip. We might look at different parts of your body. We might give you, have you give us feedback on how your clothes are fitting and different things like that. So that assessment is actually going to tell me optimal or suboptimal. Then it's also going to help us go in and map where suboptimal. Like, is it dysfunctional? Is it more delayed, Is it more suppressed? If you have any underlying digestion or hydration issues, you're in dysfunctional or delayed. Like, your hormones cannot work if there's anything in there. So that's often a place that we lean into. And then from there we can map. I had somebody the other day where she's like, I know I want to stop drinking at night. It's affecting my sleep. It's doing all this other stuff. And when we kind of got into ultimately being able to unpack it, what we realized was we really had to look at how she was nourishing herself throughout the day because as she said to me, she's like, I have one glass of wine for my husband, one for my kids, one for my boss, and sometimes one for my dog. And I'm like, I gotcha right? So I can't just say, don't have your wine and not give you. So when we were working on her and we went through her assessment, I was like, first of all, we have to work on your digestion. But the second thing is, and it kind of helped with her digestion, we did a more, you know, we were looking at those lived experience questions. A lot of the reasons that she was drinking at night was because she had no turn off time between being done with work and feeding the kids and then moving into what does she need to do for everybody for night? So she goes and she takes a magnesium bath like almost every day at this point. Like, I mean, we joke about it, but she goes and does an Epsom salt bath. Every woman and mom that I've talked to about this one is like, that's genius. You know, 30 minutes, like, here you go. And that for her is her turn off cue. Right? Like where she's like, okay, I've shifted. And she's like, I like the way I show up with my kids, I like the way I show up, you know, that kind of thing. So assessment is going to be so important to do in a thorough way. And it's one of the reasons that I don't love where GLP1 agonists are being provided to people. I love that there's greater access than insurance is making available, because I think that's a real issue of how insurance and, you know, and who can pay for what and that sort. When you have companies out there that are providing access and, you know, maybe a physician is signing off from a script standpoint of, okay, this, you probably qualify for this. When the assessment isn't happening, then somebody is coming in. We don't know we're using this medication like a solution as opposed to using it strategically as a tool in an informed way. And we're not measuring things. So I think that's, you know, certainly why your business and why I wrote my book. Like, I'm like, we have got to be able to do this in an ongoing, informed, fully assessed way. Yeah.

And supported. Yeah. And I will absolutely. I have the link to your assessment and I will put it in the show notes. I think that's such an invaluable tool for people. So thank you for just being willing to share it and putting it together. How genius that you put it together. 20 years ago.

Yeah.

Not surprised with your level of process.

Yeah, no, it's been in process because you have to like I didn't know about the vagus nerve 20 years ago. I mean like that's, you know, learning a lot about those pieces. But yeah, it's great to have that and for people to be able to use and also to, to. I think one of the biggest pieces of all of this is a weight versus health approach or a weight loss approach is extremely disempowering. Like you're consistently disempowered because you being a success or failure is really just like this. It's like an out of body. I step on the scale and what does it say? You know, and something may work and something may not work. When we do it this way, when we take a weight health approach and we go from assessment and we move through and we do experiments just to see like, hey, how does your body do with a magnesium bath? And you know, with, without the alcohol, we're actually. People really become empowered. Word. And I think that that's the other piece of this, which is why I think there's a huge societal opportunity is to drive that empowerment. Yeah.

No, I agree in not just this aspect, but in every aspect of our health and medicine and wellness. For people listening that maybe struggle with the constant food noise. And if you're listening and you experience that, I don't even need to describe what it is. I'm not sure we would need to for anyone. And they feel confused about what to eat, when to eat, how much to eat, what are some strategies that maybe they could use to be able to come like tune into these signals because it's so misleading on a biological level even. How can we unwind that a little bit?

Yeah, I love that because, you know, I don't like to. I, I so understand anyone who has taken issue with diet culture and has said like, let's get, you know. But then I've had also struggled with. People are like following what's deemed more of like an intuitive approach. And I'm like, so my intuition failed me right, left, right and center. Like I did not know what to eat, when to eat. And sometimes I couldn't get my intuition to shine through because my gut was so problematic. So I think it's really important for us to do this to give some guardrails and also to recognize that food noise, even though I love that we have that term, may not be the better term because the noise in there is like everything we've ever been Told about who we should be, what we should be doing, how our body like, it's just like noisy in there, right? So one of the things that I think we can do as part of this is to, to recognize the modern day presence of what I'll call infobesity that we have the disease is. And we're pushing it, we're trying to teach people or tell people that if you know more about nutrition that you can actually be healthier like that. Actually the sheer am of knowledge or quote unquote, knowing a right answer is going to make you actually be healthier on that part. It's not. It's going to maybe help you pass a test, like maybe. And so if you're like me and you have to pass those every couple of years, okay. But we actually have to ditch all of that information and what you want to lean into for better nutrition and how. The strategy for this is, number one, we've got to always consistently be assessing and optimizing our digestion. Like, because food is not healthy, our body doesn't high five us for a food until it gets broken down and it gets delivered where it needs it, when it needs it, and it can use that. So, you know, saying that like kale is healthy or salmon is healthy is like presenting a paper to your teacher and being like, here it is and I get an A, right? You're like, no, like, and they go off and they read it and they're like, actually you got a C minus and I'd like you to redo these different paragraphs, you know, or that kind of thing. Your body is going to tell you what it likes. And so what we actually need are instead of knowledge, we need insights. So the first thing to do when you're thinking about the food noise is to recognize this is not you. And your brain is no longer going to be a really good partner for you. Let's set the brain aside and let's actually say, how is my body feeling? How's my body showing up based on what I'm consuming? And then better nutrition. I created a definition for that too, because I learned that there wasn't a definition definition. I call it giving your body what it needs today while reducing what can irritate, overwhelm and disrupt those efforts. So essentially it's two parts. It's not bringing in things or too much of something that will overwhelm it at one time and it is giving it what it needs to run better today. So it's very, it's personal to you in Timestamp, and there are four pillars. You nailed them. It's going to be the quantity, the amount that you're consuming. It's going to be the balance. So there's some nutrient balance in there. We'll talk about the timing when you are consuming versus when you're not. And then there's also going to be. When we look at the quality, quality is probably the hardest one, but it is important. And quality does not mean that you have to eat organic. Quality means that you should be giving your body more often than not, as often as possible, what it recognizes and can use. So an easy example is if I have something that has red coloring in it versus something that actually has lycopene in it, which is the red antioxidant from tomato or in tomato sauce. My body knows what to do with lycopene. It doesn't know what to do with that red color. Right? So that red color goes in, and it might look like what the body needs. Like, my. The body might be like, oh, cool, I got that red. I'm going to use it over here to do all, like, great stuff for my heart health. And then it's like, wait, you've, like, faked me out? Like, I don't actually have what I need on that person. So when we work on the quality side of what we're consuming, and the most important area to focus is on the quality of what you consume most often. So as much as it's great that there's like the Dirty Dozen and the clean 15 and these other resources out there, most of us don't consume all of those Dirty Dozen vegetables as often as we have coffee, or as often as we have chocolate, or as often as we have a slice of bread, or as often as we have a salad dressing. So what I like to do with my patients, and this is why I really believe that weight health belongs in the nutrition space and not in just the doctor prescription space, is that we got to come in here and we need to unpack this, and we need to say so of the stuff that you're getting in, how can we do better quality? Now, your body, I said to you, as an operating system, from a quantity standpoint, you can't fill up a gas tank with three tanks worth of gas with one tank. Like, you cannot give it too much at one time. So think about your body like a race car and just be like, okay, I'm going to give it some, and then I'm going to go a couple, three laps, and I'm Going to come back and I'm going to give it some again. In my book, I famously share the story of Mr. Pizza Pop, a big Hollywood executive who was a failure on every front from a weight standpoint, every diet under the sun. I met him somewhere close to about £500 and he needed to lose at least 50 to be cleared for weight loss surgery. And he was eating a large pizza every night. Great quality, by the way. Moza from Los Angeles. Amazing. He was having diet soda all day long. The reason he was eating the pizza at night was he had failed on low calorie diets. And so somebody had said, make sure at least for you, that you're getting in 1200 calories. So he had actually figured out that that pizza gave him that. And he was trying to wait as long as he could until he got hungry to eat. Right. Intuitive like on that part. So he's using diet soda, which is cheating the body. It's saying, like, you're getting a bunch of really sweet stuff and you're getting a bunch of energy, quote unquote. But that caffeine is stimulant and it's keeping him from being hungry until he was like starving. So the body was operating all day under resource, and his diabetes kept getting worse, but his weight wasn't getting worse. And he was like, so maybe like, I don't understand what I'm doing, you know, from a diabetes standpoint. So they all made fun of me. But what I did for his weight loss plan, that was I basically took three slices of pizza for him to have. So he ordered his pizza at night, and starting within about an hour or two of waking, every morning, he had three slices of pizza. So he did that three at that point, and then three hours later, he had three slices of pizza. Three hours later, we got rid of the diet soda and we also added in there some nutrients to support his gut. In six weeks. Now, remember, this person was close to £500, and I'm not suggesting anyone needs the pizza diet, but in six weeks, before six weeks, his blood sugar had gotten so good that we had almost gotten him off of all diabetes medication. And the second thing that happened was he was moving. He lost 51 pounds and he was happy. He's like, I don't know how to describe it other than this, but I am actually, I think it might be that, like, I'm on your crazy diet and like, this is working and like, this feels so weird. And he had hope, right? You know, and I was like, I've been Right there with you. I didn't have hope. So when we look at what we should be eating, when we're talking about the timing, it was. I needed him to, first of all, eat earlier in the day, not wait and backload till the end of the day, not try to have coffee or whatever and not eat. Then I needed him to have the amount that was better for his body, which was about the three slices of pizza. And we had some balance in there. We had carbohydrates, we had protein, we had some fat in there. You know, we had a little bit of vegetables, you know, some different colors coming in. And for him, I didn't need to, like, change everything under the sun at once. I just wanted to see, you know, could we get you to the surgery? So for anyone that's thinking about that, like, you could look at. And this is, again, why, like, the tools that we provide for you are, you know, when we look at the quantity, maybe I'm consuming too much at one time. And maybe it doesn't feel like that because it's easy to drink a whole latte or a cappuccino or, like, a lot of something in a liquid form and not like, it's very easy to digest that. Right. Or maybe I'm having a really big salad, but it actually doesn't have a lot of nutrients. But because it's so big and a lot of fiber, I actually feel like my friend would say with sweet green salad, she's like, I get tired halfway through. You know, I'm like. She's like, I got too much in there. So what we need to look at is that amount. You know, are we getting in the balance of the nutrients there? And that's your quantity, quality, balance, and timing on that part in terms of the pillars. So a lot of opportunity. I think the last one to make sure we factor in there is nutrition is not food. And then over here, we have supplements. So remember that your total nutrition is your food and supplements. So we also want to build your supplement program to address any gaps that arise or prevent any gaps. But we might also use supplements therapeutically, maybe to help you. Like, maybe we use a fiber supplement because it just doesn't feel possible right now to get in the amount of fiber. Or maybe we use a protein supplement, or maybe we use a vitamin D supplement because no one's getting in enough from food, that kind of thing. Yeah, yeah.

Absolutely incredible information. And that's what I think is so unique about you, your approach. It's what makes me so excited about your book, your Best Shot. So I would love for you to share with listeners a little bit about the approach of your best shot. I will absolutely put the link for it in the show notes, but please tell people too, where they can go to find it, because when this airs, it will have been released two days before this, which is so exciting. And it's information that I know people won't find anywhere else. So give us all the details.

Yeah, sure. So I do share patient stories, not because you should follow anybody's plan, but I think we learn from understanding the stories. And I also lean into humor because I find that, like, for me, like, I. My favorite quote is from Jimmy Buffett, if we couldn't laugh, we'd go insane. And there was just a point where I had to laugh about a lot of this. So hopefully you'll find it funny. The front of the book is actually to help us understand this weight health and the weight health, hormones and that part. And then there's a chapter and it's called shit to Unlearn. And it goes into in detail the stuff that I was just talking about here. Like, we cannot judge people based on their size. We can't look at total numbers, like total number on the scale A1C, you know, et cetera. And then the second half of the book is all Playbook. This is how you do this. And my idea with the book was, yes, it could be a DIY tool. You could probably lean in and say, like, I'm going to do this by myself. And in fact, I know that there are going to be places where you're going to be able to test things out and do. Because I put the quizzes in there and I'm like, hey, drink this water and see. And here's what this means. But I also really wanted to create a bridge between practitioners and patients because I also recognize that we all have access to different kinds of healthcare. And what we don't want to do is have the healthcare that we have access to not be able to deliver this. We don't want this to be disempowering. And so what the Playbook does is it also lets you go back to your doctor and say, say, hey, doctor, this is me at like age 45 talking to, you know, and I'm like, there's a little bit of ego. I'm like, I'm kind of like a really good at my job as a nutritionist. And he's like, well, he's like, I still, you know, would recommend 1200 milligrams of supplemental calcium and I was like, I'm showing you my calcium evaluation. I'm showing you my calcium intake. I'm also showing like my bones. Like I had a Dexa. I'm like, I'm strong. Like here, here's this. And I don't poop easily. I was like, I need more magnesium, you know. So like I had to fight him to like, because I just didn't want in my chart like non compliant with calcium recommendation, you know. Right. So when we come in on that part, I also did teach him that the reason we do vitamin D with K is so that the calcium goes where it's supposed to go. So I was like, all right, we're going to change some things here. I want you to have in this book a playbook. And I also felt when I wrote it a little bit worried that if I am sharing this with you and then you don't feel like you get it from the book standpoint or from like from listening to it or reading it. So there's also a QR code in there that then brings you over to our HIPAA compliant platform. This is intentional where you have access to the tools that can help you with assessment of these different things and you have access to coaches who you can talk to that will then say like, hey, I actually think a great resource for you is to go have this conversation about your thyroid over here or you know, what's coming up over here is go do X. And so I wanted the human and the digital, you know, capability. So it really is, I use the word system, the personalized system for optimal weight health health very specifically because I wanted people to know that this is a system. And the final piece is there is no crystal ball in health care. So anyone who tells you if you go on a medication, you're gonna have to stay on it for the rest of your life is, doesn't. Like, there's two things. First, if you make no other changes and you just use a medication as a solution instead of a tool, you probably have to stay on that medication for the rest of your life. The second thing is we do not know, like I don't know what's going to happen in your life. I don't know if you're going to go train for something, get pregnant, have a disease like, like any of these other. You don't do the underlying. If you're not able to do and don't know how to do that underlying work, you are going to need to stay on something. So why not do the underlying work and be able to optimize and then see how your body does and, you know, make different choices. So I leaned into the statement glp one shot or not. I know now we have oral ones, but GLP one shot or not is really important because I want you to. I want anyone who feels like. Like the goal either that they've set for themselves or that someone else is setting is for them to use the medication to then come off of it, to break up with that mentality, to basically say, we have tools and we are going to have more tools. And as all these tools come onto the market, it's really important that you work with somebody that understands and helps you select what are the better tools for you and that you continue to question. You know, one of the things about that I've seen with patients on GLP one agonist is I've got them off of almost many people, off of almost all their other medications. And that's a win financially, and that's a win from a physiologic standpoint. And I know you see that. And so I think this concept of really from a book standpoint, to be able to talk about and reframe the conversation around the GLP1 shot is going to be great for you, whether you never have a relationship with it or whether someday something pops up and you're like, you know what? I think this is the right tool for me. I'll that part.

Yeah, absolutely. Amen. 100%. I couldn't agree with you more. Well, I am so grateful that you've taken the time to just share your knowledge, brilliance, and humor with my people, and even more grateful that you, I know it takes tremendous work and dedication to put all of this and compile it together in a book to share for everyone. So thank you for doing that. Please let everyone know where they can find you, where they can keep up with you and your adventures, and where they can buy your book once and for all.

Well, one of the things I've been saying about buying my book is it should be everywhere. So if it's not somewhere, that's a great thing to let me know. I love local bookstores. So if it's not at your local bookstore, please lean in and tell them. If it's not on your part of your book club, please tell your book club folks that this would be great. I should hopefully be found wherever you find Ashley Kauf on social media or the better nutrition program. Through that, I hope I'm found more times in person with you in the coming year, because that'll get me excited, you know, as we run around the country and get to talk to people. But thank you so much for this. And I just have to say, like, even when I. When we met, like, which is only so recently, which is just, you know, crazy to think of a couple years ago, but I was so impressed with what you were doing with modern thyroid and how you were scaling that, because we're seeing just so much bad information and care going, especially in the perimenopause space, like, with what's happening with the thyroid. But then when I discovered that you were like, wait. I'm like, I've got all this, like, experience with the GLP1s, and now I'm doing all this, you know, and the other piece. So I just think it's such a gift, you know, nationally, for people to be able to come in and say, like, I actually have a place where I can get this kind of approach. So one of my goals with writing the book is to help people find places like yours and help them understand why that's different than somebody who's like a script and send you on your way kind of approach. So thank you.

Well, thank you. And people need to know that there is a difference, and it impacts outcomes, you know, and how successful or miserable they are throughout the whole process. But this was delightful. Thank you again. I just so value you, and I can't wait to get my hands on the book myself.

Go. Thank you.