Be Where You Are Today
Fitness expert Amy Kiser Schemper, MS, CPT, interviews guests and helps you make sense of the latest in the fitness and nutrition world. Amy is known for her positive energy and no-nonsense approach while encouraging her clients to show up, keep moving & be where you are today.
Be Where You Are Today
Understanding Ozempic and GLP-1 Drugs for Weight Loss
Join Amy as she and Vivian Schemper, the registered dietitian nutritionist for the BodyFit Athletic Club, dive into the popular topic of GLP-1 drugs, like Ozempic and Wegovy, which have been making waves for their impressive weight loss and diabetes management benefits. Vivian provides a comprehensive breakdown of what GLP-1 drugs are, why they have become so popular, and their effects on appetite and weight loss. They also discuss the importance of proper nutrition and exercise, especially strength training, when taking these medications. Additionally, they explore the ethical considerations and the potential long-term use of these medications. Tune in to learn more about this fascinating subject and how it impacts fitness and nutrition.
[00:00:00] Amy: Hi everybody. I'm Amy from BodyFitbyAmy and welcome to the Be Where You Are Today podcast, where we connect with fitness and nutrition professionals to help you wherever you are on your journey. Today, we are talking to Vivian Schemper, registered dietitian nutritionist. She also leads the BodyFit Athletic Club with me.
[00:00:27] So you have your trainer and your dietitian. She's the nutrition. I'm the fitness, obviously. And today we're talking about a topic that I know most of you have been hearing a lot about and as trainers and dietitians, we get a lot of questions about. We are talking about Ozempic or more specifically GLP ones, because there are a lot of different, uh, names out there on the market.
[00:00:48] And, uh, we know that you have questions. So Vivian is very knowledgeable on this subject as well as, uh, all things nutrition. And I'm excited to talk about it with Vivian today. So Vivian is a licensed and registered dietitian nutritionist. She graduated from an accredited dietetic internship program. at the Penn State University.
[00:01:10] She also has a Bachelor of Science in Human Nutrition and Dietetics and a Bachelor of Arts in Public Health. So she has worked all over. She has experience in epidemiology, food safety, clinical nutrition, weight management and health coaching. And I know many of our body fit athletic club members will credit Vivian with, uh, not only helping them achieve their nutrition goals, but shifting their mindset around food, helping them develop a healthy relationship with food, um, amongst many other things.
[00:01:40] So, uh, I'm very excited to have Vivian here today. Welcome Vivian.
[00:01:45] Vivian: Thank you. Thank you for having me. Thank you for such a lovely introduction.
[00:01:51] Amy: I love to brag on her. One of the smartest people I know, one of the most educated people I know, but also, uh, as we talk about a lot in the BAC, um, she's able to give the information in a way that we can understand.
[00:02:02] We love to talk science, but, uh, it's important that the general public can, um, get the information that we need. So hopefully that's what we're doing today. So. Let's just dive right in. Let's talk about Ozempic. It is all over the news. We're hearing about it all over. We're certainly talking about it a lot in the fitness and nutrition world.
[00:02:24] So maybe just to start, because I know there's a lot of confusion, I would love if you could explain what are the GLP 1 drugs, um, and what has made them so popular? Whew. Okay.
[00:02:36] Vivian: So that already is such a big question.
[00:02:39] Amy: Right.
[00:02:41] Vivian: GLP 1 drugs. Are a class of medications that were originally developed to treat type 2 diabetes.
[00:02:49] That's the big umbrella answer. GLP 1, which stands for Glucagon like Peptide 1, is a hormone that your body naturally produces. And one of its main roles is to regulate blood sugar levels. This hormone helps the pancreas release the right amount of insulin when blood sugar levels are high. And you may already know that insulin helps move sugar from the blood into other body tissues.
[00:03:20] This is a good thing. We want that sugar to be moved out of the blood and into our tissues to be used for energy. Besides helping us out with insulin and blood sugar, this hormone also slows down digestion, which can make you feel fuller for longer. And it can also help send signals to the brain that say, I'm full, causing you to eat less.
[00:03:45] So this hormone is powerful for blood sugar management, but also it helps with satiety by slowing down digestion and sending the I don't need more food signals to the brain. And slowing digestion means we feel hungry less often. And if the brain is getting signals saying we don't need any food, we eat less.
[00:04:08] And any time we eat less, we create a calorie deficit. And any time we create a calorie deficit over a consistent period of time. So what are GLP 1 drugs? They are a medication that mimics the GLP 1 hormone that we humans produce. And why are they so popular? Well, a couple of reasons.
[00:04:35] Amy: Obvious reasons.
[00:04:37] Vivian: Okay, a couple of reasons, yeah.
[00:04:40] So their rise in popularity comes from their impressive results. So when this medication was in clinical trials, people were improving their blood sugars, their kidney function was getting better, their heart health was getting better. Of course, our blood sugars were looking really great, but they were also, also, losing a tremendous amount of weight.
[00:05:06] Not like a half a pound, not like a pound. Tremendous amount of weight. We know, you and I know, that weight loss is a highly searched topic, and it is desired by many people. So the fact that this medication was having impressive weight loss results, it got people's attention, right? It got, people were curious, the media was definitely also very happy to feed into that curiosity.
[00:05:32] The second reason for why these medications are so popular, you may know this, Amy, I think I talked about this briefly in the BodyFit Athletic Club, but in 2022, Ozempic went viral on TikTok. Famous people like Elon Musk and Chelsea Handler endorsed this medication and they were singing the praises of the drug, saying it was really helpful in their weight loss journey.
[00:05:58] Next thing you know, when somebody that has a very large social media presence starts to share this stuff, of course we start to hear all sorts of stories and questions and then that's when I would say I really noticed this huge surge in popularity. People were asking questions. People were talking about it.
[00:06:21] It seemed like it was all over my social media feeds. And sure enough, people were interested. Next thing you know, we start to hear that all sorts of celebrities and wealthy people, many of whom are already thin, which is annoying, are taking Ozempic and paying for it out of pocket because They can and also taking it to be the thinnest version of themselves.
[00:06:45] So AKA really taking them for vanity reasons. So I know I heard several interviews of different celebrities like, um. The, uh, what is it? The housewives,
[00:06:58] Amy: um,
[00:06:59] Vivian: you know, that very popular TV show that I clearly don't watch, but you started to hear of a lot of these individuals. So these celebrities, again, people with money who really are already.
[00:07:12] Fin, who don't actually struggle with chronic obesity in any way, taking this medication just to lose an extra five pounds, an extra ten pounds. So between going viral on TikTok and the fact that the rich and the famous were hoarding a pretty large portion of the drug for, again, vanity reasons, a shortage was officially declared in 2023.
[00:07:38] It was a mess, and we can definitely talk more about the shortage and where we are today with that. Wow, yes.
[00:07:48] Amy: That is a lot. Thank you. Again, what did I say? Vivian can break it down in a way that we can all understand. And I guess that leads to the next question, which I think a lot of people have is, Is it okay to be taking these drugs or asking our doctor about these drugs if we are not diabetic?
[00:08:06] So for, you know, when it first came on the market, right, it was pretty exclusive to diabetics. And then as you were just talking about, it became popular for its weight loss effects. Um, when you get asked that question as a dietitian, what, um, how do you respond?
[00:08:22] Vivian: Yeah, I love this question, and yes, absolutely.
[00:08:26] Should people use GLP 1 drugs for weight loss if they don't have diabetes? I would say, yes, GLP 1 drugs can be used for weight loss in people who don't have diabetes. But you do have a significant need to lose weight. Um, in fact, the FDA here in the United States has approved certain GLP 1 medications like Wigovi, which I'll, which I'll talk about here shortly, specifically for weight management.
[00:08:57] So 100 percent of these medications can be used only for weight loss. But I do strongly. feel that these medications are meant to help people that need to lose a significant amount of weight to people who have struggled with that weight their entire lives. It is definitely not a medication that is meant to be used for people who are looking to lose 10 to 15 because it would just be so great if I could just drop a pan size, even though I don't technically need to.
[00:09:32] Uh, you know, obviously, absolutely. Using medications in that sense creates a shortage and it can create a lot of issues and it takes it away from the hands of people that could really use it and benefit from them, which are the individuals who are trying to manage their blood sugars or are really trying to address a significant weight problem.
[00:09:54] Amy: Yeah. And I think you and I both have seen that a lot and, and talked about it in the body fit athletic club and with individual clients. Um, I know. And when, when you see patients in your work, uh, because I, I personally have seen, I know you have a two people who have struggled their entire lives and we're not talking those last 10 or 15 pounds.
[00:10:16] We're talking to people who have a significant amount to lose and these drugs have been And not only life changing, but I truly believe life saving, we've seen that with people. And then on the flip side, we've seen people who don't have that much to lose who are using it and it's, you know, I think as, as You know, individuals in the fitness and as experts in the fitness and nutrition field.
[00:10:39] Um, we know these struggles of people, right? We've had these clients who have done all of the quote unquote right things of nutrition. Exercise, um, all the things that for many people traditionally work and when they don't, it's, it's devastating and, and it can be really detrimental to people's health. So I totally agree with you on that and I think that is such a common question of, you know, where is the line of, you know, I do have, feel like I have a lot of weight to lose and I think both of us would say, you know, it's also a big discussion to have with your doctor.
[00:11:14] Um, where are you in that category?
[00:11:16] Vivian: Absolutely. And to, to add to that, I will say. I have met with several clients individually, and I have had clients who have come in, like what you're saying, Amy, who have dealt with weight struggles their entire lives, and they have tried everything, and it seems like Nothing is working.
[00:11:40] So they have a conversation with their doctor, they get on this medication, and finally it seems like all of the efforts and the hard work that they have been putting in is finally paying off. So it's a tool, and it can be a really useful and helpful tool for individuals where their bodies on their own just don't seem to help them out in this weight management business.
[00:12:05] Alternatively, I have also met with clients who have come in and they're like, Hi, I've been hearing about this medication on TikTok and I don't really want to exercise or eat healthy or do any of that. I just want to get on the medication, but my doctor said that I have to come meet with you first. That is definitely a different story and a little bit more of the, I don't know if this is appropriate.
[00:12:32] We're talking about losing 15 pounds and mainly we just don't really want to engage in any lifestyle behaviors. We mainly just kind of want the medication to sort of do the thing on its own. That would be an example where maybe I'm a little bit more or maybe a lot more hesitant to uh, Say, yeah, this is a really good fit for you,
[00:12:54] Amy: right?
[00:12:55] Yeah. Yeah. I think that's, that's something we talk about. Both of us talk a lot about is it's not going to replace the exercise, the strength training, some things that we're going to, we'll talk about in a few minutes. Um, and the, you know, the, the things that we need from our nutrition, the weight loss is one thing what's happening, uh, internally is another thing.
[00:13:17] So, uh, before we get to that, I, I do know that, you know, we just You just touched on it, that there are so many different drugs out there. It started with Ozempic and the ones that were specifically approved for diabetes. And then these others came on the market, Wigovi, Manjaro, ZepBound, I think is one of the other ones.
[00:13:35] Can you talk a little bit about the differences? Are they all the same? Are they all doing the same thing? Are there things that people should be aware of if they're, you know, looking at one versus the other?
[00:13:45] Vivian: Yes, there are so many. So many of these medications, and we're probably going to see a lot more of them show up in the markets.
[00:13:56] They're very high in demand, so I would not be surprised if we see other versions of them. So, a common question, a great question that you ask me is, are they all the same? And one way that I like to describe these medications is, They're all in the same family, and some of them are siblings, and then some of them are cousins.
[00:14:15] And that's probably the best way to describe that, uh, in a way that people can understand. So, all of these drugs are going to be GLP 1 agonists. So that means that all of these drugs are working to help mimic that hormone that we naturally produce, that helps us feel full, that regulates our blood sugar, that decreases our appetite.
[00:14:39] All of these medications are doing exactly that. And so then we have medications like Ozempic and Wegovy, who are siblings, and they're the exact same thing, the exact same drug, but the difference is the dose. So at a specific dose, this drug can help you out more in the blood sugar department. At a specific higher dose, This drug can help you out in the weight loss department.
[00:15:06] Uh, so Ozempic is typically prescribed to help people manage their blood sugars. Um, and Wigovi is typically prescribed strictly for weight management. Uh, they're the exact same drug, uh, just different names and just different dose. Um, so lower dosage, it's called Ozempic, higher dosage, it's called Wigovy.
[00:15:29] Osempic for type 2 diabetes, blood sugar management, Wigovy for weight loss. There are many others, so Trulicity, Victosa, Bayera, Monjaro, Cepbound, many others, and they all, again, kind of do the same. thing. Ozempic has been the one that has been talked about the most, because that's kind of the one that started it all.
[00:15:54] That's the one that really got the attention from some of the celebrities, but in reality there are many options out there. And in terms of differences, some may be tolerated a little bit differently. Most of these medications are injectables. So, for most people, this is going to be a situation where they have to go in and get an injection once a week, depending on, you know, there are certain other medications that are also injectables, but you may be getting two injections a day.
[00:16:28] But again, they all kind of do the exact same thing. They are all working to mimic that GLP 1 hormone that your body naturally produces. And something that is really interesting that is not talked about enough that I want to point out here is this GLP 1 hormone, it gets cleared by the body very quickly.
[00:16:51] So our bodies produce it and it gets cleared by the body very quickly. So it would be really nice if this hormone kind of hung out and stuck around for a while when it was produced because then that would mean that we get, uh, Longer time with the, with the benefits of blood sugar management, the satiety, so forth.
[00:17:12] But this hormone is produced and it's quickly cleared out by the body. This is why these medications can help us out because they are essentially able to prolong How long this hormone is able to hang out in our bodies so that they can help us out in this blood sugar satiety department. Another thing that's really interesting is a lot of individuals with type two diabetes and with the chronic obesity who People who are struggling with their weight, uh, studies have shown that these individuals actually don't produce a whole lot of this hormone naturally.
[00:17:57] So in a way, they almost produce less than someone who would be thinner or maybe not struggling with blood sugar or weight management. So that's also a really interesting thing and something that has. Maybe not been such a part of the conversation, but it should be is that are we discovering that there are a lot of individuals who actually have a deficiency in this hormone, that they just don't produce it in the ways that they should.
[00:18:26] And this is the reason why they are struggling so badly with blood sugar or with weight management, not a willpower discipline thing.
[00:18:36] Amy: Yes, I thought, I mean, this is why this class of drugs is. Fascinating to me just in, you know, where it feels like we're learning something new every day about them. Um, and it is, you know, again, you and I have spent our careers working with individuals who have tried everything and feel like a failure.
[00:18:56] And they do feel like. Certainly diet culture is sending them the message that it's because they're lazy. It's because they don't have willpower. It's because they're overeating and not moving enough. And I think what we're learning is there's, there's more to it. We don't necessarily know the science is evolving.
[00:19:12] It's still relatively new, but, um, there's, there's a lot more going on inside our bodies than we are talking about in the fitness and nutrition side, certainly, but also on the healthcare side. Okay. Moving on. Magic question. Let's talk about nutrition, which clearly is your specialty, but I know this is a question that you get a lot that I get a lot and something that is talked about a lot.
[00:19:41] What in terms of nutrition? Are there certain changes people need to be making if they are on one of these GLP drugs? Are there certain things we need to be thinking about that maybe we weren't before? Um, is there a specific diet that someone on one of these medications should be following? What is the approach, uh, on the nutrition side from your You know, from your expertise as a registered dietitian.
[00:20:07] Vivian: Yeah, absolutely. Really, the diet stays the same. Uh, the principles are the same. We want to make sure that we're having a colorful diet that is rich in fiber, that is rich in protein, healthy fats, uh, all of the things. So, that's important. And, uh, I would say that the majority of people are interested in, yes, I want to take this medication because I need help.
[00:20:33] I need additional support here. But I also really do want to work on my habits. I want to work on the health behaviors as well. So, uh, For most people, I will say then, yeah, let's make sure that we're prioritizing protein, that we're prioritizing fiber rich carbohydrates, and that we are prioritizing lots of colorful, non starchy fruits and vegetables.
[00:20:56] So that's the diet. Something that has come up a lot that I was Sort of not prepared for as a dietitian is the fact that a lot of people are not eating enough of anything. And, you know, I think in the beginning I'm like, hey, this is great. You're going to be on this medication and that's wonderful. Now let's talk about this very nice, well balanced plate and balanced snacks and balanced smoothies.
[00:21:26] And then I met with, I'm just never hungry. And I'm like, okay, so what did we eat today? Water. Oh no. This is not good. So, um, so a lot of what I've been needing to counsel people on is, How can we make sure you're getting enough food, period? Because I know this feeling of, oh, I'm not hungry, this is easy, I never have to eat.
[00:21:56] That's, I, I get that it probably feels very exciting, but you do still need to eat, you do still need to function. Food is very important. Do you need to eat less because you're in a weight loss journey? For sure. Fair. Does that mean you need to just not eat? No. Or eat very little? No. And perhaps you've heard on social media and TikTok because this has been such a Such a hot topic.
[00:22:25] Uh, maybe you've heard of things like ozempic butt or ozempic face. And really, a lot of that stuff is people have a bit of a sagging appearance in their face or a sagging appearance, um, in their butts. And a lot of that tends to happen sometimes when we lose weight very rapidly. But also when we don't really prioritize some of the other things like making sure that we are preserving our muscle mass while we are on a weight loss journey.
[00:22:58] So even though that appetite may not be there, and it's really easy to just say, I don't want food, I don't need food. No, thank you. It is important to make sure that you're getting. enough protein. And I tell my clients if anything, if anything, can we at least just prioritize the protein? I'd love to see all the things, but if anything, can we at least just get protein in, please?
[00:23:22] As that is going to help you out in preserving your muscle mass. We do know that with medications like Ozempic or Wigovy, any of those, the weight loss can be pretty quick, but it's not always just fat that is being lost. Some individuals are losing a lot of muscle mass and some fat. Some other individuals are losing a nice amount of fat and a little muscle mass.
[00:23:51] And what's the difference between the two? The ones that are losing mostly fat with little muscle mass are those that are prioritizing strength training, the behaviors, and their protein intake. So I would say as a registered dietitian, I think in the beginning, I thought that I was going to just be talking about all of the components of nutrition, but really the appetite.
[00:24:16] It can be fully gone, and then one of the side effects of these medications, because again, they slow digestion, which means that food can hang out in your stomach for a little bit longer, and if we have food kind of hanging out in there for a little while, sometimes we can kind of have a bit of a, oh, I'm kind of nauseous, I'm kind of hungry, so there's also the nausea component.
[00:24:38] And so, now I'm nauseous, and then I don't really have an appetite, and it's quite easy to not eat. And then, of course, you get the positive reinforcement of, Oh my goodness, I'm just losing so much weight so quickly. And it's like, Oh, be careful. I know we like quick. I know it feels exciting, but if it's too quick, it's probably not just fat we're losing.
[00:25:01] So with the nausea, the slow digestion, something that I often recommend is Smoothies. You can pack a lot in there. You can pack a decent amount of protein in there. They're cold, so they don't have a strong scent, which is helpful if you're feeling nauseated. And again, you can add some fiber into it, and it's something that you can kind of sip on throughout the morning or the day or whatever.
[00:25:25] to help you out.
[00:25:26] Amy: That's really helpful. I think certainly on the fitness side, we're seeing a lot of that as well of just, there have been studies done on these drugs with the DEXA scans where they're, you know, they're taking a control group on the drug. They're taking a placebo group, not on the drug and seeing how their bodies are responding.
[00:25:44] And we are seeing what we sarcopenia, right? Which is losing. Muscle mass, something that naturally happens as we get older, but certainly happens a lot quicker if you are not getting enough protein, if you are not strength training, and if you were experiencing a quick weight loss, which as we've been talking about often happens on these medications.
[00:26:06] So it's something we're talking a lot on the fitness side. And I guess just to ask myself as a trainer, that question, what do we want to be prioritizing on fitness? Just like you said. strength training. So when it comes to fitness on these drugs, we need to be strength training. What we don't need to do is, and I have heard this is people say, well, not a now that I've lost the weight or I'm losing the way I don't need to exercise anymore.
[00:26:33] I understand where that comes from because a lot of these are individuals who have been over exercising for years or just You know, overdoing the cardio, trying to get the weight loss to happen and have not seen it happen in that traditional way. So, you know, to that, I say nobody needs to be overdoing the cardio.
[00:26:51] Um, you know, unless you're an endurance athlete, try, you know, training for something specific. It is a time that we can pull back a little on the cardio. We still want to get the endurance, the cardiovascular training, the strengthening of our hearts and lungs, but strength training needs to be prioritized, which again is advice I give most people, especially as we're getting into our forties, fifties, sixties and beyond.
[00:27:14] But what we're seeing is if you're not. strength training, just like you said, then people are losing that muscle mass, losing that, um, that strength and we're seeing the health effects that we would see whether you're on the drug or not, that people are less mobile that are not moving as well. They're more susceptible to injury.
[00:27:36] They have a higher risk for many other things. That's why we talk about. skeletal muscle being the organ of longevity. It's so, so important for everybody. Even more important to be prioritizing strength training when you're on one of these drugs. And I think, you know, like you said, some people don't feel like working out.
[00:27:53] I had a client who actually chose to go off of the medication, um, because she wasn't able to work out. She was feeling the, a lot of the nausea and diarrhea and just not feeling well in her workouts. For some people, it's a matter of when you take the medication and how you structure it within your day and within your meals.
[00:28:13] And that can really aid in how you feel in your workouts. You may have to shift your schedule on when you work out. Um, but. The bottom line is we need to be strength training and it doesn't have, you know, you don't need to train like a bodybuilder. I think that's the other thing is people think, well, when you say that, and again, a lot of these are people who've been told their whole lives, they need to work out more.
[00:28:34] It's not about that. It's about prioritizing it, making it the thing that you're getting. At least two to three times a week. Just a little plug. As many of you know, I have tons of strength training, uh, workouts for free on my YouTube channel. We have a lot more structured strength training program, um, over in the body fit athletic club and also structured more nutrition help over in the body fit athletic club.
[00:28:58] So we're here for you for that. And I think Vivian and I would both say we specialize in, you know, making it fit into your lifestyle. So it is not about. overdoing it or feeling like it has to be a huge shift in what you are doing. But because losing muscle mass is something that is happening to a lot of people on this drug, um, we need to be prioritizing, like Vivian said, the protein and like I'm telling you.
[00:29:23] The strength training. So that could be like its own podcasts. Um, I feel like both of us could talk about this for hours and we probably will talk about it again because again, there's something new every day. It's being, uh, consistently researched, which is great. And we're learning new things, um, about the bodies and how people are responding.
[00:29:43] But if there's one thing I can say when it comes to exercise is one. You got to do it. It doesn't, you don't have to overdo it, but strength training should be the priority. So one last question, because I think it's something, it's just a commonly asked question. What about people who say, Oh, I just want to take it for a short amount of time and go off it.
[00:30:04] I just want to use it to lose the weight that I'm unable to lose. And then I'll stop. Um, What, what are we seeing with that? Is there a risk in that? Is that something that people are able to do? Uh, I would love to hear your thoughts again as a dietician and someone who's worked with many people, um, on these drugs and off.
[00:30:23] Is it something that can be a short term thing?
[00:30:26] Vivian: That is a tricky, tricky question. I don't fully know the answer to that. Um, for some, Individuals, it may be the case where they get on the medication and they start working with a dietician and personal trainer and they start really getting the habits down.
[00:30:46] They're, they're doing the workouts, they're drinking the water, they're eating the protein, they're eating the veggies, they're doing the things. They're prioritizing their sleep, stress management and so forth. And they really build those habits and then let's say they get off the medication. And they continue those habits and maybe they will be able to continue to maintain that weight loss that does happen, but also what can also happen is I think I mentioned earlier in this episode that for some individuals.
[00:31:20] They may just not produce enough of that GLP 1 hormone. So if this is a, an issue of a deficiency of something that the body's just not doing that the body's supposed to be doing, and it's not doing for them, then this medication may be that thing, that missing link that they so desperately needed. And it does happen for some of these individuals where they get off the medication and they do regain the weight.
[00:31:51] Something that really makes my blood boil is when people say that Anyone taking these medications, they're just looking for a crutch. They're just looking for a quick and easy fix. So, um, they just don't try hard enough. Um, so many of the individuals that I have worked with individually who have struggled with weight.
[00:32:19] are actually some of the most disciplined individuals I have met who have tried and have had the most willpower that I have ever seen. And it is unfair and rude and fanphobic to just assume that anyone who struggles with weight is lazy, they don't try hard enough, or they haven't tried, or they don't have enough discipline or willpower.
[00:32:41] The reality is, it could be that deficiency issue that I talked about. Maybe their bodies just don't produce enough of that hormone. It could also be a thing of the food noise. When we take these medications, it can, again, because you're feeling fuller for longer and the brain is getting the signals that say, I'm full, we're good.
[00:33:04] Then you're not thinking about food all the time. And for many individuals, when they're not on this medication, that food noise is incredibly loud and overwhelming and never ending and just It's really difficult to manage and tame. It's impossible for many people. And the medication actually can help to quiet down the noise so that people can follow through with the things that they want to follow through.
[00:33:33] They just can't because of this sort of overwhelming food noise. And that could be due to the fact that maybe their bodies don't produce enough of that hormone or maybe something else that we're not exactly sure. And I've also heard people say things like, well, you know, you could just ignore the noise.
[00:33:52] And to that, I will say you must have never experienced that noise because if you did, you would know how intense. I mean, this is your biology screaming at you, telling you you need to do this, and it's really hard to fight against that. And I often like to use the example of the, let's say ADHD for instance.
[00:34:21] We've heard of things like if somebody struggles with ADHD, Is it helpful to just tell them, well, just do the thing. I know they know perhaps that they should, they should do certain things, right? But they don't, uh, because there's something else happening here that makes it really difficult for them to follow through and perhaps medication can help to bridge that gap, uh, to help them.
[00:34:48] with doing the thing that they desperately want to do because they do want to do it, but there's just, there's a missing link that just makes it really hard for people to follow through. Can weight loss medications Can they not just be that support that connects this thing so that it makes it work often when I think of other medications that people take that they just need and that they may need for the rest of their lives because of the, again, a deficiency or just something that their bodies don't naturally do.
[00:35:27] We generally seem to have more acceptance towards some of these other things. But why do we have such a hard time accepting that individuals who struggle with weight may also need some additional support? And I think it brings up, this is a whole nother conversation that we could have around just, uh, The stigma that people in larger bodies face, um, are fat phobic society because in a way it's almost like people can't win, right?
[00:36:01] Because if you are in a larger body and you're doing all of the things, nobody believes you because look at you. And then if you finally decide because you've tried absolutely everything under the sun and somehow you just can't win, and then you get on the medication, oh now you're lazy. So what's the answer?
[00:36:17] Right? And then if you try to, if you figure out that you need to stay on this medication for the rest of your life because it helps you, because you need that tool because your body has a little something missing and this, this medication is helping you out to complete that, then now we just, we don't like that either.
[00:36:38] Amy: Right?
[00:36:39] Vivian: But then if you get off the medication and then you gain all the way back, then well. Why didn't you just go harder anyway, that's another round I could go on that
[00:36:48] Amy: is yes. That's a whole conversation
[00:36:51] Vivian: Quickly answer some people may need to be on this medication forever and that's okay And there's no shame in that Some individuals can try the medication and they can get off and they may find out.
[00:37:03] Hey, I'm good. I'm okay I'm maintaining For some individuals that food noise or that weight may just come back so quickly that they may need to get back on and that may be that time that they're like, Hey, I do need to be on this medication for the rest of my life. And there is no shame in that. Even though maybe the world will try to shame you for it.
[00:37:23] Amy: And I think that's the tricky part. And I think that's the place that you and I come as fitness and nutrition professionals of, you know, this is a tool that again is for so many people, life changing and life saving. Um, You know, the one thing I worry about is that we have changed the conversation that we were kind of moving away from weight loss being the main goal, even though it is an important goal for a lot of people, and it's a health goal for a lot of people and something we talk about a lot here at body fit by Amy is that we support all your goals, even though we prefer that health strength.
[00:37:58] Longevity, health span, all of those things be the main goal. It has shifted the conversation back to weight loss as the goal. And there's a lot of things I don't love about that, but again, it's like everything that we talk about so often, I would say in our jobs, we're Vivian and I specifically in the BAC are saying.
[00:38:19] Most of these things when it comes to fitness and nutrition and health are not black and white and they never will be. So there has to be context, there has to be nuance and you have to look at the individual and I am with you. I am so angry when I see people in, especially when they are experts in the, or.
[00:38:39] you know, professionals in the fitness world claiming that this is the easy way out or it's a quick fix or it's, you know, to me, that is a trainer who has not listened to the stories of these individuals. And like you said, seen how hard people are working and not, maybe not experiencing the same results.
[00:38:56] Um, Externally or internally as someone else, that person is really out of touch. I think if they're going to say that, and on the flip side, like you said, for a lot of people quieting the food noise. Is the tool that they need to be able to do the other things that we talk about. I think on the fitness side, it's been fascinating to watch people who now are falling in love with exercise because it's not about the weight loss.
[00:39:23] It's not a punishment for their body. It's not about how many calories can I burn? They are experiencing maybe that side of things, the weight loss, the other changes, the health changes because of the help. Because this being a tool being on the medication, but then they can approach exercise from a strength perspective from This is this just makes me strong.
[00:39:46] This makes me feel good. This improves my mental health and that is amazing to me That is a win in my book. We can get more people moving which we know is Going to benefit your health in so many ways and they're coming at it From enjoyment from a place of joy, instead of hating it, instead of it being punishment for their body.
[00:40:06] I mean, that's everything. So I think the takeaway from this podcast, if you take anything from Vivian and I, it's that it's not black and white and there's not a one or the other. And I hope that most of us can approach this, um, one, looking at the information. And again, it's exciting because we're seeing new research and we're seeing learning something new every day, but also You know, treating this as a tool like anything else to improve the health and the life of someone and using it in the way that it's helpful to people.
[00:40:38] And for those of us on the other side, approaching it with compassion and really listening to people's stories and understanding that they may be coming from a completely different place. takeaway people get from this is it's not going to be something that we can say. Yes or no. It's going to be based on the individual.
[00:40:58] And I think what we're seeing is there's a lot out there, we're seeing a lot in social media, and it's important to one, look at the science and also listen to the professionals, listen to the health care providers and have compassion for the individuals who are in this place. As you know, Vivian, this is the be where you are today podcast.
[00:41:19] So we like to end the podcast asking where you are today. So, uh, we've had you on before. We'll have you on again because you're part of our team, but I would love to know where you are today. With regards to ozempic and these glp 1 drugs, maybe it's different than where you were a couple years ago And it might change again in a couple years as we learn more But as a registered dietitian nutrition and someone working with many people on and off of these drugs, where are you today?
[00:41:49] Vivian: So I am right in the middle, right? And, uh, you know, I wonder and I, and I always get this, uh, this sort of pushback of, uh, are you promoting these medications? Are you into it? And, uh, I, I'm not promoting them, but I'm also not against them. I think it just depends on the individual and their circumstances.
[00:42:11] So I support my patients who decide that that is the best course of action for them. And as a dietitian, I will support them with talking about the nutritional components to make sure that they are well nourished, getting enough protein, all of the things that as they are. on the medication.
[00:42:34] Alternatively, of course, am I a big huge fan? If people say I don't really want to pursue medication and I really would like to try to do things without that support. I want to start changing my diet and changing different health behaviors. I love that. Amazing. Let's give it a shot. Let's try it. Let's And if we come down to a place where it's like you've been doing all of the things for a year and a half, and your blood sugars are just not improving, and that weight is not budging, and you're ready to have that conversation with your healthcare provider about whether you need some additional help, Then I, I support you.
[00:43:20] I absolutely will support you. So I'm right in the middle. And of course, like I said, if somebody's going to come to me and kind of ask me, um, I'm trying to lose five pounds for a wedding and, uh, I want to be on this medication. I will say you should probably talk to your doctor about that, but I'm not a fan.
[00:43:38] Yeah,
[00:43:38] Amy: this is not for you. Yeah. Yes, and I think that's so important to note that just because we say we're in the middle and, you know, it depends on the individual and the conversation with your doctors, that does not mean that it is a replacement for Strength training, endurance training for making sure that you are getting protein and plants and all the other things we talk about just in our jobs, but certainly in the body fit athletic club of health behaviors that are going to support your health for the long term again.
[00:44:11] Weight loss doesn't have to be the goal. And if it is for you, then this could be another tool in your toolbox, but we are still here to support you with all the other things that we hope you are making a part of your life and we are here to help you with. Thank you so much, Vivian, for being here. This, of course, has been very informative.
[00:44:32] I just appreciate you breaking it down in a way that I think most of us can understand. And also coming at this conversation not only with the education and the expertise, but also with compassion and grace, which is something we talk about a lot here at Bodyfit by Amy over in the Bodyfit Athletic Club, that we are all on our own journeys.
[00:44:53] That is where be where you are today comes from, and it's not on us to judge. We are here to support. So we have lots of tools for you on the fitness side, on the nutrition side at the body fit by Amy YouTube channel. Certainly with our membership in the body fit athletic club and more podcasts to come with Vivian.
[00:45:12] So make sure that you subscribe to the podcast and that you're following us in all of the places.
[00:45:18] Vivian: Thanks so much. Thank you so much for having me.
[00:45:22] Amy: Thank you so much for joining me today. I'm Amy reminding you to show up, keep moving and be where you are today.
