Will Ozempic Put An End To Weight Loss Surgery? | Dr. Christine Ren-Fielding

[@xoBetsyhy12-y2y]

I'm glad Dr Christine is talking about PCOS and insulin resistance. Few people understand, and there needs to be increased awareness.

[@jbobb4546]

Stolen ass comment

[@lillycollier7915]

What time do they talk about it so I can watch?

[@lamzahs]

So nice to listen to an actual doctor interviewing other scientists/doctors and not just Joe Rogans of the world. Respect, Doctor Mike. I will show you to my little cousin instead Joe.

[@Alton7771]

Unfortunately, those videos get more clicks

[@jasongrundy1717]

Joe Rogan has experts on. You have JRDS.

[@Stealth1919]

Rogan has some experts but a lot of charlatans too, and he doesn't have the expertise himself to push back on misinformation. Also, he's has a supplement company selling snake oil for 15+ years

[@saikrishnan6316]

​@@Alton7771 challenge accepted!!

[@Lock484]

​@@jasongrundy1717 yeah, he does have great experts on... And sometimes even NOT so great "experts" on, and he just affirmatively says "mmm" to whatever is being shoved to his face, even if it contradicts the person that sat in front of him last week. Incapable of intelligent pushback most of the time. But my personal favorite occurrence on JRE is, when he invites a world class expert on, and then proceeds to cut him off 30 minutes into the conversation to go on an hour long tangent about "the trans", wokeness, women's sports and "the radical left", it doesn't really matter who the guest is, Joe manages to fit his favorite topic into any conversation 😇. Add on mandatory topics he has to touch regularly as well, such as chimps, bow hunting, DTM and aliens, and no egaggeration, I have seen him derail half or even more time that could've been an interesting discussion 😕. Crazy just how much that podcast fell off, used to be a regular listener 6-8 years ago, but it has been gradually declining, to the point where it is now, politically heavily biased embarrassment 🧐

[@RevereShin]

Something I learned from you, Dr Mike, is to appreciate when a doctor can and is willing to say, "I don't know." And this episode re-emphasized the importance of that.

[@pjgamber]

Three years Post-Op RNY Gastric Bypass. I have zero regrets, even with an option today of medication, I wouldn't change my decision at all. 400lbs to 220lbs. I've ran 4 marathons since then. This has saved my life. No more apnea, my cholesterol is under control, my diabetes is gone. literally Best decision ever.

[@Metroid250]

Congratulations! It's a life changing surgery with long term benefits, and people shouldn't be shamed for getting it. Do people get shamed for thyroid removal for hyperthyroidism? or a coronary bypass to treat blocked arteries? Absolutely not. They won't tell you to just "diet and exercise like a true person with effort," so why bariatric surgery getting all the flack? The conditions all these surgeries are treating are CHRONIC

[@heatherholzhaus7013]

That's amazing for you. Congratulations on getting your life back!

[@evilherbivore13]

That's phenomenal. Congratulations on your success. I'm sure that wasn't easy to go through, recover from, and adapt to.

[@pjgamber]

@@evilherbivore13 it was a couple months of adjustment but well worth it. I have anr entire new lease on life at 40 where I may not have made it to 50

[@illise]

Same for me. Got bariatric surgery in july. Have lost almost 80 pounds since then. My hyper tension is under control, cholesterol levels are way better and I sleep way better since I don't snore anymore. Best money I have spent

[@SandraWinn22]

I love that Dr. Christine Ren-Fielding isn't tainted by social media and only provide scientific facts. Also kinda cute she's not aware of what's going on on social media. Glad she's not about the trend and just about science and experience. Thanks for this episode. Well done.

[@Marie-s6g]

The concept of health in "The 23 Former Doctor Truths" book completely explains this. I wish I read it sooner.

[@Dreamerlilly]

I’m a year and a half out from VSG (gastric sleeve) and I’ve lost 100 lbs. I didn’t want to get it done to start, needed it. I can now get a kidney transplant and I feel so much better. This weight loss surgery saved my life.

[@Beautuiful_Happy28]

That's amazing 😊

[@CHEFPKR]

Set point theory is fascinating. I was 300 pounds around the age of 13. From maybe 11-15 years old I was around that weight. I dropped to 190 in a single year during my Junior year of high school. To this DAY, 20 years later, I still feel like it's so easy for me to gain weight and it's WHY I train every single day and track what I eat.

[@theluschmasterinc]

you do heavy training everyday or like 30 minutes each day? what kind of stuff do you eat?

[@CHEFPKR]

I do weight lifting 4x per week and try to increase my lifts 5-10% when I'm able. I also do 1-2 days a week of "free training". Yoga, hiking, martial arts etc​@@theluschmasterinc

[@mikehrt]

​@@theluschmasterincI don't know about him, but I eat 1400 calories a day, train 30-60 minutes a day and weigh 330. If I have a new health problem like sleep apnea I gain a lot of weight. If I add any sugar to my diet like apples or bananas, or eat high carb foods like broccoli, carrots, or squash I gain weight. My exercise these days is body weight squats, stairs, walking, and some stretching. I used to do 100 pushups and situps and do bench and curls, but I got a hernia lifting an old water heater by myself, and I can't get it fixed because of my weight.

[@CHEFPKR]

I weight train 4x per week about an hour a day, then 1-2 days of yoga/martial arts/walking ​@@theluschmasterinc

[@mfn1311]

But ease of gaining weight could also be why you got to 300lbs in the first place, not that you created a set point when you gained the weight. Not too familiar with the theory though. If I were to guess I’d say you maybe just have high amount of Grelin or something making you more hungry. Personally I do get pretty hungry even after eating a lot, but specifically it takes a lot to make feel full.

[@KMD-qj1qc]

I love it when Dr Mike has other doctors on and talks medicine ! 😃, hope we get more of these kind of podcasts

[@aubreyjohnson3466]

I love how soothing Dr. Mike's voice is! The way Dr. Christine educates us about weight regulation without being judgmental is quite refreshing as well.

[@michaeldeats328]

How many educators do you know that are judgemental

[@alyssamiller6122]

I had bariatric surgery 13 months ago - best decision I ever made! I have to work every day to make good choices to keep the weight off but so thankful science has allowed this for my health, family and future.

[@milicapejovic8766]

Dr. Mike, thank you for always being so curious and inclusive. I truly enjoy listening to your podcasts. As a dietetic student and a future dietitian, I was wondering if it would be possible to have a Registered Dietitian on the podcast? Many people do not know what RDNs do, who they are, how they can help patients, how they differ from nutritionists, etc. A lot of pressure has been put on medical doctors and other healthcare providers to know everything about food and nutrition and to advise people on how and what to eat when a) they barely have time for a regular appointment and b) there are others (khm khm RDNs) whose educational background and experience are exactly that - food and nutrition. Thank you!

[@NkaujNtximHlub]

Im happy that Dr Christine is talking about PCOS and insulin resistance. Not many people understand and this needs to have more awareness

[@nickib.8364]

AMEN! And according to that lipedema... Even my doctors say... well... your body just says ... no. I am able to lose some weight if I live on 1500kcal PLUS intermittent fasting... Who knew.. I am only able to keep that up a few months.. I will have surgery next year.. and I have major respect... it's a huge deal for me.. 🙈

[@Metroid250]

​@nickib.8364 wishing you the best of luck and a speedy recovery. You got this!

[@camouflage6245]

After losing motivation about losing weight, perfect timing, thanks for this.

[@gohawks3571]

You can do it! I believe in you (and also get the struggle✌️)

[@dez6278]

High protein and fiber keeps you full longer and prevents blood sugar spikes and then crashes that make you hungry again. Eating carbs with these things still does the same thing. I track calories and weight daily and have lost a lot this way.

[@MeowMeow-sy2mi]

As a 4 ft 10 woman who is 174 lb (started at 187) and trying to lose 45 more lbs, this came at a perfect time. I won't be using ozempic or surgery personally but this is a fantastic talk!

[@andreamerlin223]

I wish you willpower.

[@5Seed]

Well done on the first 13 lbs. 🎉 Wish you luck and success for the rest.

[@littlerocker121314]

Great Job!

[@aa1231txstate]

I went from 350 to 170. I started my bariatric journey Nov 2018 and I only wish I did it sooner. I look at myself in the mirror or in pictures now and I still can’t believe what I see. I not only can do more physically and feel generally better but I am so much more confident in how I operate in the world.

[@EVWOW13]

Doctor Mike brings joy to everyone’s day. He is not only a phenomenal person, but also an understanding and overall kind human. He is open and teaches so much. Continue the great work Mike. We all love you and your content! ❤❤😊

[@Beautuiful_Happy28]

It was incredibly kind and thoughtful of you to take the time to write such a lovely message. I hope he sees it 🤠

[@bethechange07]

Doctor Mike, you make a really great podcast host. You remain patient and respectful, and you pick really great guests who are informed and willing to discuss. Cheers

[@Jem4u90]

Bariatric surgery saved my life! I've had some regain I've been working on however, still the most impactful decision I've ever made next to managing my mental health.

[@laraco]

God is good! I am in the process of having surgery due to the fact that I have a hard time maintaining weight loss. I have PCOS and I’m actually having surgery at this very same hospital. I appreciate Dr. Mike and Dr. Christine for bringing his topic to the forefront. Thank you for the information and for your medical professional information.

[@SanaSana_626]

Best of luck to you!! I also have PCOS and had the sleeve done in august. No regrets.

[@DeniseSkidmore]

Calories in, calories out is physics, but how we store calories matters for driving the behavior that influences those inputs and outputs. When energy is locked into fat it isn't available to increase base metabolic rate or energy for non exercise activities. So the macronutrients and the speed of various metabolic pathways matters. Humans are not just buckets of calories, they are complex systems with multiple steps to store and retrieve calories in multiple ways.

[@dang1099]

So, are you suggesting bodies dont use fat for NEAT? That sounds absurb, i need to see a source on that. Maybe for people with metabolic disorders, but thats an exception not the rule. If you dont or limit carb intake, you will most certainly use fat stores.

[@Michelle_Lynnn]

It’s risk versus benefit. Bariatric surgery has been around longer and we’re more familiar with its long term risks/benefits. Ozempic has his own blessings and curses, though we have had less time compared to surgical options, to see it through.

[@cindyrobertson6723]

I've had the lap sleeve and then I needed to have a bypass because of the acid reflux. I've lost over 100 pounds and found a new life. I have zero regrets.

[@notfound_humanexe]

I gained 180lbs on prednisone over a year and a half period. I was 12 when it started and in total kidney failure. My skin stretched so much I have striae on 80% of my body because of it. I lost some weight after I got sick but continued to be overweight despite many years of trying to lose it. Medical trauma and chronic illness are never discussed in weight gain situations. I have high blood pressure from my kidneys being bad. I was forced to be overweight and then kind of left to figure it out on my own. My doctors always attribute to me being overweight to me eating and it was never that. I had a job last year where I walked 30,000 steps a day for 3-5 days per week (worked in trade shows.) I wasn’t eating anything and working 65-70 hours a week. I went from 221 to 170. Then when I had to quit because my kidneys were failing again and I started eating normal meals not even bad ones, I blew back up to 230 the heaviest I have ever been. I lost about 25lbs now and am in a research study which I work with a nutritionist and my nephrologist/rheumatologist and the materials they give me are actually dumb and unhelpful. I don’t understand where the disconnect is with doctors and my experiences medically. I am trying so hard every day and it’s like everything is against me. I really want to change this part of the medical industry and I’m hoping I can contribute to this study and help others with lupus and lupus nephritis who are struggling to lose weight.

[@BoringTroublemaker]

I have been on prednisone for 6 years since my kidney transplant. I gained 100lbs in a year. I tried to lose weight for 5 years and only managed to lose 20lbs. I went on Ozempic in December 2023 and have lost over 100lbs. I eat around 1400 calories/day and lift weights 3 days/week. I’m not ever planning to go off this medication. Not ever.

[@tammywhiddon3088]

gastric bypass 6 yrs ago lost 150 lbs, doing well no need for meds. i am 150 pounds still, considered overwt. but dont care. i am 5'4". so happy that I did surgery. Have / had diabetes, hypertension, cholesterol issues gone or better. was overwt since i was 11 yrs old and now i am 59

[@AlphaBlessing3636]

i it done nov last year i was 301 now im 187 as of today

[@erisisthename]

I cried while watching this. I’ve struggled with weight gain for years. My body has plateaued around 250, and stayed there give or take 5 pounds over the last 15 years. Im 42. While not struggling to find a doctor that won’t tell me to simply loose 80 pounds, my weight has consistently been an issue. I can’t tell you how many times I’ve received the side comment of “loosing 10 pounds will make it easier.” While true, it doesn’t help battle the societal lessons I’ve learned over my life, coupled with ADHD and CPTSD. To hear two doctors not fat shame me or people like me, or resort to medicine first is quite refreshing and hopeful. Thank you.

[@jasongrundy1717]

Just lose 80 pounds. If you can't do something that simple, you're not a person, you're an animal.

[@robichag]

As someone who reached 1 year post op gastric bypass last week, I found this conversation amazing. She is right. My satisfaction is very high. My life is much bettter. lost over 120 pounds. Amazing video. Thanks.

[@EthanStandel]

I'm in a program right now scheduled to get agastric sleeve surgery. When I think about surgery compared to GLP1 meds, I think about a life without dependence on a particular medication. For me, that trade off just can't really be beaten.

[@Metroid250]

Loved this episode. It was such a fruitful discussion that has a lot of science, honesty of not knowing what's unkown, and nuance of what IS known.

[@PaterQualitatus]

Hi Dr. Mike, I sincerely want to thank you for all the information that you have given me, a viewer over the years. Today I had my first midterm exam in medicine about a subject named PCM (professionalism, communication, and morality) and as the name suggests it teaches Ethics, the connection between a patient and his physician etc. , when I first started studying this subject, I was shocked to find that I already have a rudimentary understanding of the majority of its content, thanks to you. You are truly one of the most inspiring people on this planet and an amazing role model for myself, and for anyone with a dream to help people. I truly wish you happiness in life. Sincerely, a child you inspired.❤

[@ElGatoManny]

I love these episodes. More so than the fun ones. Thank you Dr Mike

[@Kenkasan]

I love hearing you both talk. So professional, sympathetic and calm. ❤

[@dogwithsunglasses4051]

i was thinking about the surgery, but honestly, what put me off the most was long term implications. Not only is the procedure permanent as far as my doctor told me, what he didnt tell me was that i would need to take suppliments for the rest of my live. I am thinking about trying Ozempic and I am aware that its not gonna fix me magically, but my appetite is my worst enemy and I cant focus on anything if it wents "beast mode". And as far as I know, thats the thing Ozempic is good at aside from being a diabetes medicin, to kill appetite. To clearify, i am not demonizing the surgery. Yes, my weight impacts my life, but I am still able to almost everything. This isnt true for some other patients and i am well aware of that, and for them the surgery might be the best choice. For anyone else fighting the good fight, wish you good luck. Just remember that there is no easy way to get thin, only to get worse. And obesity is never healthy.

[@linachaouki1621]

My sleeve saved my life. It was the hardest experience I have ever lived. Not only for the physical and mental endurance you will go through years after your surgery but also for the stigma you carry. My mother was called a monster for supporting my decision. She was and is my rock.

[@Levi-ev2gi]

Unrelated, but Dr Mike please give us your take on DR OZ being appointed as administrator for Centers for Medicare and Medicaid Services!

[@jasongrundy1717]

More qualified than many previous appointees. The fact that Trump did it doesn't automatically make him bad.

[@happygabe496]

Wow, what a great episode. Very insightful!

[@Lucas-H-Meireles]

They forgot to mention about dropping the weight before the surgery because the possible difficulties is doing anaesthesia in a too heavy person and decreasing the possibility of cardiac events

[@cateheart7565]

This was so interesting to watch! My BMI is about 48 and considering glp1 meds myself. Surgery scares me so much, but this helps ease my mind a bit! I'm in my mid 30's and so far do not have any other health issues, so I need to get this tackled now. I was able to lose 50lbs on WW before covid but it was so hard, took over my life. Anything to help!

[@demgphix]

Imagine having zero $ in your bank account, and someone tells you you really need to start saving your money... It tough, but doable if you figure out how to budget correctly, now imagine you have zero $ in your account, but you have 100k in debt to pay off... waaay more difficult to mentally handle, knowing you will try your best every month, and still see zero in your account. That's what it's like losing weight.

[@aych5865]

What is the debt a metaphor of in this analogy?

[@blazenfate]

Bad comparison.

[@Triceratots]

@@aych5865the debt is a significant amount of excess body fat. OP is likening a person with zero debt to a relatively normal sized person losing 20-30 pounds, and the 100k indebted individual as someone with 100+ pounds to lose before they see changes to health and physique. Hope that makes sense/is accurate to OPs intended message :)

[@demgphix]

@aych5865 Starting from zero is like being skinny, and wanting to build muscle. Having debt is like having alot of weight in your fat cells, you have to put in way more work for a longer period of time before you can be fit.

[@Tracey66]

I think a better analogy is to compare overeating to alcoholism - you have to stop drinking to stay alive/you have to eat less to stay alive. But you can't stop eating altogether; you have to have three drinks every day (three meals), but not go overboard into alcoholism again. Now add all the psychological and emotional baggage into food and eating and meals, and it's a wonder *anyone* can ever lose weight!

[@hannahmclaughlin348]

I had SADI-S bariatric surgery three years ago and it was the best decision I've ever made! I'm glad my doctor at the time really encouraged me to do that and not all the weight loss meds. I loved this discussion!!

[@evelynneufeld7610]

Thanks for posting Dr. Mike❤

[@SHOCKWAVE237]

Well...Dr.Mike im here to stop kids from saying first

[@illusory87]

🙇🙇🙇

[@heatherholzhaus7013]

😂😂😂

[@MidnightGD5]

That’s just saying first with extra steps

[@SaltyGuava]

I would love to hear @AbbeysKitchen give commentary.

[@kmpkmt]

I've debated this surgery, I'm so excited to watch this. Thanks Doctor Mike!

[@AbrahamsAnt]

My late mother only ate food she cooked herself. No “convenience” crap, never too much fat (she didn’t like fatty food, it made her feel sick - just like me) and never snacked. She was much too busy. She didn’t like sweets. I never saw her eat candy/chocolate or crisps. She literally ate like a model preparing for a Viktoria’s secret show. No cereals, never alcohol, no soda/coke or any other sugary beverages. No artificial sweeteners either. She didn’t restrict her intake of calories - she just was not a great eater. She liked bread though and baked it herself. Delicious whole grain bread. The only food she craved were leafy greens. We still commemorate her by snacking on parsley 😌 She was always busy and always went for long walks. Almost every day. She was overweight (not severely, but still..) and it annoys me that the calorie-restriction-doctrine is still something society and even doctors consider an indisputable truth. “The body is not a machine” - so very true! If it were that easy, medical school would be easy and you’d get a degree in about a year. Of course calories matter. With her genetics… if she ate 2500-3000 calories daily and was sedentary, she would have been severely overweight and probably diabetic or would have had high blood pressure etc. She was overweight but not 200 or 300 (maybe 180 - she was not tall..) pounds. Very healthy, vibrant, fit woman.. until Glioblastoma took her at a young age. Guess what: when I eat more than 1200 calories I put on weight and I was never thin - although I was hungry and ate very little my entire youth. I was on a 500 calorie diet for 16 months once, worked out twice a week (not very much, I know..) as a young woman, lost maybe 20 pounds and still was slightly overweight. Nobody believed me how little I ate. Of course I couldn’t maintain that diet and I still struggle. I am not “fat” (slightly overweight) but still struggle with my weight and the “image” it represents. Very little visceral fat and quite healthy though. It took a very sensitive and competent endocrinologist (most are useless…) 2-3 years ago (“it is not your fault! It’s genetics”!) to stop hating and blaming myself. Thank you, Dr. Mike ❤

[@BionicMilkaholic]

In high school, I had a friend in the same activities so we were about equally active. She easily ate more than I do. I was already obese. My friend was so underweight she had to take medicine to gain weight. That's enough to show me there are factors beyond what you eat and how much you exercise. And knowing that unexplained weight gain or loss is a sign of illness shows there are other factors at play.

[@andreamerlin223]

I was so glad to see this. I'm a 200 lb. 67 year old formerly bulimic woman with one lung awaiting knee replacement surgery. I was able to get my weight down to 164 last year through healthy eating and walking 5 miles a day. I began gaining the weight back in January when my knee became bone on bone and I could no longer walk. Now I spend most days lying on the couch eating. My knee replacement is scheduled for March 2025. I need to lose weight and cannot find the motivation to do so. I'm on mood stablizers and antidepressants which makes it more difficult. I can't take nsaids for my knee pain due to bad kidneys. My PCP has offered a version of Ozempic but it scares me. I'm already taking a lot of medications that have messed with my metabolism. I need help to decide what to do to lose the weight.

[@5Seed]

I think it's worth talking through your fears with your PCP. Your history of Ed makes things like sleeve surgery tricky because it could trigger some stuff. I struggled with bulimia too but luckly I've been OK for the past 10 years, so I'm a less risky patient for surgery now. Time restricted eating and a low carb diet might help move a small amount of the weight to help with the knee.

[@BionicMilkaholic]

My new knees have made a world of difference! I've lost weight for the first time in my life just because I can be more active again. My personal, non-medically trained opinion is to get your knee taken care of first, then think about your weight. I'm 5'6" and my weight peaked at 256lbs right before surgery. Less than a year out, I'm at 238lbs and still trending down. I'm just now working on adjusting what I eat. I've stopped taking ibuprofen. I went from struggling to walk my dog a half mile once a week to hiking 8 miles. I did find acupuncture helpful for pain relief until I could have surgery. Also, topical lidocaine.

[@pamelas9]

I'm diabetic and have been on a few GLP1s, ozempic currently. I'm pretty sure ozempic is generally reported to be helpful for kidney problems if you stay hydrated. It has definitely affected my desire to eat and made it possible for the first time since I was a child to set my food down and say (and truly mean) that I was done before my plate was empty. If you start, just go very slow on dosage and don't let them bully you into higher doses if you are feeling any side effects (which is mostly nausea).

[@knitswithdirt]

Did Fen Phen in the 90's. Lost over 100 lbs. Never had the heart valve issues thankfully. LOVED how it cut off the "food chatter." Found it impossible to lose or maintain for long once I came off it and I tried everything! I had gastric sleeve surgery because I didn't want my innards re-routed (but in hindsight, I wonder if it would have been better....) 7 years ago. Only lost around 70 or so pounds of the 125 goal. I have regained 55 pounds or so. Regardless of one's weight, my bariatric office has everyone on 1200 calories. Not so much low carb, but high protein. I'm now on Oz which also shuts off the chatter. That makes a huge difference and it's something someone who doesn't KNOW....just can't understand.

[@emtorres4063]

This is such a great episode. Thank you for all you do Dr Mike!

[@Tsubvn]

i feel like there are definitely cases for staying on ssris long term, i have ocd and it’s the only thing that keeps me sane - regular talk therapy exacerbates my symptoms. to be fair dr mike was probably referring to less complex scenarios.

[@kaseface4492]

As someone who is about 100lbs overweight at 5’2 I’ve been seriously considering bariatric surgery but so scared of the backlash from friends and family.ive failed multiple ways of losing weight and I just want control over my life again…this episode came at the perfect time and appreciate the insight ❤

[@20thcenturyrelic]

Thanks, Doctor Mike and Dr. Ren-Fielding. This was a very interesting and informative discussion. And I think Dr. Ren-Fielding is correct in that patients with extremely high BMIs will continue to need bariatric surgery.

[@mzdrea9468]

6 years postbariatric surgery and i have zero regrets. Going from 350 to 170 has changed my life. Unfortunately i gained 50 pounds back last year. However, the classes i took as a result of the surgery have helped me loose 30 of regain. I love that Dr. Chistine talked about treating obesity. I genuinely believe we should have a real convo about treating obesity. Getting the weight off and to Dr. Mikes point of eating exercising. There is a big missing point mental. Why are they obese. Why are we, i say we, overeating.

[@gadler87]

I had rny gastric bypass 18 months ago and it’s the best decision I ever made. I went from 300 to 120 lbs, I’m 5’3”. I was pre diabetic with sleep apnea and now my a1c is 5.0 and my apnea is gone and I have so much more energy. It’s a lifesaving procedure.

[@nyxcha0s]

I am a Duodenal Switch WLS patient, I am 5'10"... I went from 350lbs down to 150lbs today. This was the single best thing that has ever happened in my entire life, i would make this choice a million times over

[@dIggl3r]

Point of view from a canadian here: I've been on Ozempic for 4 months now, at 1mg only. Why 1mg only, because its the maximum the gouvernment will pay for mainly control diabetes. I can confirm that 1mg has totally took control of my glucose numbers. For people wanting to know what about weight lose: I lost almost 30 pounds in 4 months. I don't exercise at all, and to be frank I still eat too much sugar from time to time. So while I was happy to get Ozempic "for free", that 1mg maximum is certainly not a super weight lose at my current rate. I am not gaining weight and I even started buying some clothes 1 size smaller and it fits, so very happy about that. Just wanted to share my (short) experience with the drug, thank you.

[@YourFriendKevin]

this was a fantastic episode. shout out to special guest mike's dancing bang.

[@sabinasartwaves]

Really helpful for us this podcast....keep going.... I as a Science student I can learn so important term from your video....which is really important for me..

[@AlphaBlessing3636]

iv had Gastric bypass surgery last November i was 301 pounds now im currently 186 as of this morning and i had it in Mexico best decision of my life all y food addiction gone and not drinking sodas or energy drinks

[@drabberfrog]

11:22 I think a good comparison to "calories in calories out" being incorrect, is how a heat pump can be over 100% efficient while still not violating the 2nd law of thermodynamics. Heat pumps move heat from the outside of a building to the inside, warming the inside and cooling the outside. Each calorie of energy you give a heat pump can move around 4 calories of heat from the outside to the inside. This means that from a human perspective, the heat pump is 400% efficient while from the universe's perspective the heat pump is only 100% efficient at converting electricity to heat. It's all about perspective. "Calories in calories out" is true from the universe's perspective, the human body cannot violate the 2nd law of thermodynamics or reverse entropy, but from the much more relevant human perspective, where basal metabolic rates and cravings dictates the flow of energy, "calories in calories out" ignores how the body actually interacts with energy.

[@decktigerplays7685]

Exactly what was I was thinking

[@ThisIsJessPaul]

CORRECT ME IF I'M WRONG: I learned a long time ago that once you produce new adipose (fat) tissue, the cells in the mesh or net of adipose can fill or empty/expand or shrink as you fluctuate weight, but if the adipose is still there, it will always want to fill those holes with fat cells and that is the "set point" or tissue "memory". That's why liposuction can change this function.

[@brandon50199]

I was curious about this too, and I'm in no way medically inclined, just been reading some studies of bodies after lipo and the physiological conditions of the subjects. It seems to me, from what most of the studies have stated, is that the body doesn't say to itself 'I have 10 empty fat cells, I must fill them' it says 'I need 10 fat cells and I need them to be full'. So whether you have 10 fat cells that are empty, or you get liposuction and remove all 10 fat cells completely, the body still sees a loss that it absolutely must replace for survival. Again, I want to say I'm no doctor so this was just my interpretation, but all of the studies I came across said that liposuction doesn't affect (or affects very slightly) the metabolic rate, hormonal balance etc etc and so it's very common for liposuction patients to have to return several times throughout their life, or also utilise other weight reduction options in conjunction with lipo (such as bariatric surgery or medications). However, the initial reduction of weight can very much make the subjects ability to exercise much more approachable, losing 10-15kg means less stress on joints, you won't fatigue as quickly, etc. But I don't think, from what materials I've come across, that the surgery actually affects the set point.

[@glaciergirlv2265]

I'm 5'10" and have gone from 329 to 287 as of yesterday via calorie restriction. I've done calorie restriction before and Gained back far more than I lost when I got off track. I don't have insurance just yet, and though I will be getting insurance soon through my employer, I fear it will not cover surgery, neither will it cover weight loss medications, neither can I afford either on my own. Not only does this not give me hope, but things like access to healthy foods, access to nutritionists and doctors who can help, and access to weight loss in general is truly for the wealthy, which most of us are not.

[@lauravazquez1017]

Please bring dermatologist Dr Idriss to talk about the new trend of Sephora tweens and all the young kids thinking they need skincare

[@annwilliams6438]

Gut biome: would love to have heard about the impact of both surgery and the drugs on the gut biome.

[@PS5Pro4K60]

I hope so. I want surgery to be the last course of action. But medicine also needs to be more affordable, and insurance needs to start covering it.

[@Tcrror]

Unfortunately, that's not going to happen under the Trump administration. In fact, a lot of life saving medications or medications that make life easier will probably become impossible to get. Anxiety meds, ADHD meds, etc. And of course vaccines. Ugh. It's going to be a nightmare.

[@ParaplegicKeanuReeves]

Yeah good luck with that. Too much money in people being sick

[@debrajones4840]

That’s what RFKJr. Is taking about​@@ParaplegicKeanuReeves

[@shineizzle1817]

This was so interesting and eye opening! Thank you both.

[@IAmNotYourProblem]

I believe the set point can be changed but it takes a LONG time. I’ve been dieting for years, went from 220 down to 170, regained to 190, and now I fluctuate from 180-190 (I’ve been 185 for weeks now, despite eating like crap). This range is my new set point. I believe in a few years, I’ll be able to get back down to a healthy set point weight

[@Ironpanda]

Top of the show. I'm sure this will be interesting and informative. But he got that Superman hair today! 🎉❤

[@cupcakelikes]

I was on Mounjaro for a year and lost some weight and my A1C came down. However I was still overweight. I had gastric sleeve last December. After a few months my A1C started to uptick and food noise came back. So now I am on Ozempic and the food noise is gone and my A1C is now down to 5.6. Losing the weight is still slow but it's going down slowly. I do exercise, prioritize protein and track my food.

[@baileybasinger3455]

Howdy, thoughts on weight loss surgery for individuals with IBD issues like Crohn's disease? Worth it, too much risk, etc.?

[@voltaireon]

I’m over 10 years post RNY and am so glad I did it. However- I was born with a weird abnormality where my intestines were twice as long as the average person. My surgeon joked that I could eat sand and my body would find a way to gain weight. I was 330lbs and got down to 145-155 and stayed there until I had a baby this year. I’m 10 years post op and don’t regret it at all.

[@FloridaSunshine3]

Excellent information! Thank you.

[@av8r22]

I've been on Zepbound for 10 months and I've lost 64 pounds and I feel absolutely terrific. The food chatter is gone, and I finally can stop eating mid dinner and feel full. it wasn't until I started taking the GLP1 was I ever able to feel satisfied or been able to quit eating. Will I bet on this for the rest of my life? Probably.

[@FranciscoOyola94]

as someone getting ready for a bariatric surgery, I feel like social media did a great job at fighting the bullying against fat peaple, but it also did a great deal of harm when it then tried to turn it around and pretend that being fat or obese is not a problem. The whole "fatphobic" thing is really stupid and can prevent people from getting the help they need

[@llaftsewyelrebmik5103]

Bypass in 2015. I felt like all of the pre requirements for my bypass surgery were good. If you're not motivated enough to do the classes, two week liver shrinking liquid diet, and losing some weight, you're unlikely to keep yourself eating well, taking your vitamins and staying at a weight. I was glad to get my mind and motivation straight before surgery!

[@Theo_Yt1530]

I don’t understand why some people don’t like Dr. Mike so heavily, he’s just a cool doctor spreading good medical information

[@Alton7771]

I’m so glad Dr. Mike doesn’t get out or buzz words and his videos to get clicks.

[@wakigrl]

I had my sleeve in 2013 to treat my gastroparisis. Best decision of my life. I had a lower body lift in 2015 to get rid of my excess skin. Again, best decision. I had been struggling for years and I am so happy with both decisions. They are tools not easy ways. I still have my mental struggles. I still have to watch what I eat and all that. It's a tool, and thats it.

[@BibiRoxs]

In the main, this was a great episode.

[@michellerichard9776]

I love these conversations, I take away a lot.

[@vinicastro9292]

I've been walking and running in the treadmill for a while now but started dieting only monday now and I've been seeing results already

[@Tuti23-yt1vw]

Mostly water loss in the start lol 😂

[@taylorssland.13]

This Video is so fascinating! thanks for posting btw im one of ur BIGGEST fans❤

[@type.one.tess23]

I'm a Type 1 Diabetic, I have PCOS, I'm one of the most insulin resistant patients my doctors have ever seen. I'm five foot on a good day and as of September, I weighed 240lbs with very little success in losing weight by diet and exercise alone. My PCP was able to get my insurance to cover Ozempic in late September and since I've been on it, I've lost around 10lbs. This is the first time I've lost weight since I was a young adult. It has made me want to eat better, healthier, exercise more, and take better care of myself. I love how my body and my mind are changing for the better. All from a weekly shot.

[@ApolloArrow]

wow this is so depressing. As someone who was an obese child, I feel like it's so difficult to keep weight off as an adult. What solution is there for someone who is overweight as an adult, diets and exercises like crazy, but wouldn't be a good candidate for either GLP-1s or weight loss surgery because they are JUST overweight, not obese? Like, I'm probably 20-30 pounds overweight, and workout like hell, but it's so, so difficult for me to get in a normal range. I've only ever done it through severe calorie restriction, and it caused so much burnout after time. Once I let me guard down for a couple months, all of the weight came back. What do people do? I can't get GLP-1s, and I won't get surgery. What do I do with my set point? I'm just locked into this for the rest of my life because I was an obese kid?

[@Edwardhyoo]

I worked out a lot and tried restrictive dieting on and off. I totally hear you. It's hard to wrap your head around the fact that you're changing your life forever. I lost about 70 pounds this year through calorie restriction, increasing protein in my diet, and heavy resistance training 3-4 times a week. I generally don't deviate from my diet too much, but here's the thing. If you build moderation into your lifestyle, it can become sustainable. It's ok to have a high calorie day during the week. Just turn around and get back on track. Make sure you're adjusting based on your activity level. If you're working out hard 5-6 days a week (elevated heart rate 45+ minutes a day) you need more calories than if you're doing light workouts a few times a week. Also try to work with a nutritionist if you are able to. Idiots like me on the internet are also not the answer. Good luck to you, I know where your head is at and I know how hard it can be.

[@hebrewmama]

I agree, this bit of info made me depressed. So weight loss surgery or not my body will always fight to get back up to my highest weight!???? It actually made me cry

[@Edwardhyoo]

@@hebrewmama I wish they had explained this a little better. This is referring to set point theory. And yeah, the theory is that your body is constantly fighting to regain homeostasis. So if you're severely restricting calories and starving yourself your body tries to compensate for it. There's studies of Biggest Loser contestants that shows how this works. But it is possible to change your set point through diet and exercise that isn't harmful/restrictive!

[@FaithBelinsia]

​@hebrewmama I'm sorry this hits you so hard. She is an expert, but we have SO many examples of people who have lost and kept weight off "naturally". I don't know what would work best for your situation, but don't give up! Something I've learned recently is that exercise isn't the biggest factor to fat loss. Diet is the most important part of the equation. Maybe less gym time and more calorie control would help it not all be so overwhelming? I would never suggest anyone stop working out all together, it's beneficial on SO many levels, but burning calories is SO hard and it's so much work. Taking in less calories (while getting enough nutrition) is generally more effective that smashing Cardio to burn those calories.

[@Ema-k9i]

I was able to lose over 80 pounds with the support of Noom; it has been life changing. If someone wants to lose weight and is struggling to do so, then surgery and/or medication should be an option. I think some therapy, like that which I consider Noom to offer, should be provided in conjunction with that treatment.

[@sreyan2014-h5e]

Hello buddy looks like u posted this about 28 secs ago, great to see u again make such nice videos !!

[@goeshen4359]

Thank you both ❤

[@NurseMadDbee]

Great episode Dr. Mike!

[@jackbruno4748]

For me, I understand my dad's problem getting off smoking and drinking now. It's very hard and frustrating when you body is just fiending for food. It's only gotten worse when I found a job that pays double of what my previous job made and with all of that extra money my mind continues to try to justify me going out to dominos everyday. Ya know...I have the money, why not spend it? What makes it harder is that I can just go and get fast food or whatever and that makes me far lazier because it's easier to just wait 3 minutes then to just make the food myself which would be healthier.

[@MilkDishwasher]

Definitely an interesting discussion...just came off as an Ozempic ad at times. People do remain the weight lost and bounce back higher than they originally were, but to say that this is not something that can be controlled by acquiring information and building proper habits is insane. When was the last time you heard of an impressive weight loss journey that didn't involve practices massively hurtful to the body. Thinking of diet and exercise as a temporary change and trying to speed run the weight loss hurt more than anything else.

[@rmonogue]

It’s not that simple. Restricting calories for a long time causes a reduction in your metabolic rate and a big increase in hunger hormones. It’s not a matter of willpower. Yes, building proper habits is vital, but it’s not like everyone who loses weight goes crazy with junk food immediately after. They have to eat a lot fewer calories just to maintain their weight.

[@MilkDishwasher]

@@rmonogueI’m well aware the caloric restrictions reduce metabolism and the lost weight makes it so you burn less for the same movement/exercise. But so what? If you burn less calories you should be eating less anyway. Correct me if I’m wrong, but doesn’t ozempic simply…reduce hunger signals? It’s not likes a stimulant like Meth that will amp calories burned throughout the day.

[@gugg2216]

I find it interesting that this was posted during my fast

[@miashinbrot8388]

Also, if you can, please tell your guest that I love her attitude -- especially the fact that she truly understands the impact of fat shaming, which I don't think the doctor in "My 600 pound life" does.

[@BeckaStella]

Very interesting discussion! I will have the Gastric bypass surgery in February next year and I have been very unsure if it is right for me, but I think it is. I have to give it a chance. 👍

[@maygullordali9157]

Hello Doctor Mike ☺️ Appreciate you, and the work you put into your videos🙏🏼 Would love to see a video on tips on good communication with patients. How to keep the time frame of a consultation, yet getting the most out of the little time you have as a doctor🙏🏼☺️

[@chelliebelliexd]

I'm not sure if others experienced this, but every primary care doctor I've had always pressured me to take a medication or get bariatric surgery...why go to the extreme without referring me to a nutritionist? Spending 2 minutes telling me to exercise and eat right doesn't teach me anything. Educating pateints seems to not be a priority.

[@lokipokey]

I asked my PCP why he doesn't send his GLP med patients to a dietician. He said that when insurance pays for the meds, they usually refuse to pay for a dietician. Go figure

[@MotoManDan1]

I was on a diet for 3 weeks of 1000-1200 calories per day. male now 185lbs. It's totally possible.

[@vincecanino6119]

My take: We can definitely say it’s barbaric. But we are also living in unprecedented times with foods and our relationship with them. We have foods that are not only more often processed, but are designed/crafted to be tasty and appealing (in many cases addictive). It’s unfortunate, but once we decided to manipulate food, it means our bodies either have to evolve in a way to handle this or humans have to intervene (drugs, surgeries). Ultimately, a good diet and fitness is needed so our bodies can thrive off what we provide it. Quality in; quality out.

[@ThePiggiestOne]

I enjoyed this

[@jennigee51]

I found this very interesting! I've been morbidly obese for most of my adult life (I'm 73) After I had my third child, the gynaecologist told me that I needed surgery, because I had stress incontinence but, I needed to cut down on the amount of food I ate, I started to tell him that I really didn't eat much...I didn't get any further, he told me that nobody came out of Belsen looking like me, I still have stress incontinence!

[@Valintinus]

Thank you, Dr. Mikhail.

[@nora768]

I reduce the size of my plate or bowl and have eaten healthy or meals. I have lost 15 kg over a three month period. It just put me in a very good bodyweight now.