Live Free or Go Broke: A Financial Rebel's Guide to Risk, Retirement & Real Wealth

0:00 The topics and opinions express in the following show are solely those of the hosts and their guests and not those of W FOURCY Radio. It's employees are affiliates. We make no recommendations or endorsements for radio show programs, services, or products mentioned on air or on our web. No liability explicit or implies shall be extended to W FOURCY Radio or it's employees are affiliates. Any questions or comments should be directed to those show hosts. Thank you for choosing W FOURCY Radio. Welcome to to Ask Good Questions Podcasts, broadcasting live every Wednesday, six pm Eastern Time on W four CY Radio at W fourcy dot com. This week and every week, we will reach for a higher purpose in money and life, as well as a focus on health and wellness. Now, let's join your hosts, but ned up Belle Anderson, as together we start with Asking Good Questions.

1:01 Welcome to the Ask Good Questions Podcast. I am your host, Benita bell Anderson, and we have a fantastic show today that I think you are going to really everybody seems to be interested in this talkic topic. We are going to be talking about jailp drugs, We are going to be talking to a doctor that has a very fantastic whole outlook on this, so you are going to want to stay tuned and listen in on this. So with that, I'd like to invite doctor William Summers to the podcast stage. Thank you, Benita, thanks for having me. Thank you so much for joining us today. Well let me tell you a little bit about him.

1:43 He is. You know this, this whole thing with JLP one drugs has gone from a diabetes treatment to a cultural phenomenon, really and with that fame comes a flood of miss scare stories, sales pitches. We are going to get of all that today. Doctor William Summers brings four decades of medical experience and a clinic owner's front row view to a candid discussion about weight loss as a medical issue, right, not a matter of willpower. We're going to tackle the muscle loss debate. We're going to talk about the side effects the new pills. Actually I never do this because I usually don't want to say a date, but today is July first, twenty twenty six. Medicare has made this available and so there's some ramifications around that that we are going to talk about so welcome, Dtor Summers.

2:43 Thank you. Tell me where you coming from. Uh, I'm sorry, I'm from Birmingham, Alabama, And I let everybody know I'm double boarded. I say double boring. I'm boarded in obg in and obesity medicine and have had the privilege of practicing AIN for about fifteen years as a major part of my clinical practice. Wow awesome. Well for someone who's heard the brand names, how could they not? There's all these things on TV, isn't there? Yes, So exactly what exactly is that GLP one drug and how do they work in the body? Well, I think the best place to start for people to understand what we're talking about. It was discovered in recent years that when anyone is overweight, we can measure four neurochemicals and our body that are messed up. And when they are messed up and we eat, and we all have to eat, and these chemicals are messed up, we gain weight unfairly. So the first one a very important one. GLP one stands for glikagon like peptide one, a small peptide, and this is made in our intestines and every time we eat a meal, this peptide goes inside our brain and makes us feel satisfied or full, the satiety hormone, and it goes outside the brain to help regulate blood sugar. Blood sugar regulation is critical to normal weight gain. So with the GLP one being messed

4:13 up and that was identified, then this medicine came along that will help fix that to actually put that back into our body, elevating the GLP one that is low and you get full, quicker regulating your blood sugar. And this was just a huge breakthrough in the medical science for weight gain and obesity management. It came also secondarily that another chemical identified called GIP gastro inhibitory peptide made in the intestine is really helps regulate blood sugar is messed up. So then they have a medicine I just call them four buttons are messed up. We have the medicine zema glue type known as ozipic we Goobe fixes one button. We have the terzeppatide known as Monjoro for type two diabetes rename zet Bound fixes two of the buttons, and the fantastic drug which will be released fully next year, also made by Eli Lilly, will fix three the buttons.

5:03 It's known as ratitude tried. These are all injections and they all have pretty much we could talk about one, two, or three and they have pretty much the same side effect profile. But they are definitely all in the sense good for the heart and heart disease and stroke are the number one killer in this country. They treat the abdominal obesity and two hundred diseases are associated with abdominal obesity. So I think we are onto something like the pedicillins of weight loss, just getting started with a great future ahead. Well, one of the things that somebody said to me, not just recently, was, you know, being overweight is a side effect of you know, it's like people are we're going to be talking about the side effects today, but just being overweight is a huge side effect and risk to your health in and of itself.

5:52 And almost all circumstances. That is true. There is such a there's a clinical entity called the healthy obese patient. So I just want to clarify that not everybody with obesity has medical issues, and let's put that out there, but most of us with obesity, we do have medical issues, and it's good to just be educated about that and understand what is available, and then choose options individually, lifestyle options and even if it goes there to medical options, but to have an understanding what we're doing, what we're taking, and what to expect. So you've you've been practicing for forty years, Yes, how did a medication that was originally meant for diabetes become a weight loss tool?

6:40 Well, if we it's interesting because it was all developed, as you just mentioned, with the beginning of advanced studies for type two diabetes and the path of physiology, we gain weight, chemicals are messed up, we gain more weight, chemicals messed up, and as we go up the weight gain ladder, the top of the hill, we have type two diabetes. So the po physiology for obesity and type two diabetes it's pretty much the same road. So we have a drug that will fix that road. But the drug gets two names. One drug will get two names if well, for a diabetic patient it's called ozipic or and for a diabetic patient Manjo road. But for a white patient we go or zet bound. So it was just by I think incidental or accidental or observational studies that hey, when we do everything for diabetes, we're also doing the weight loss, and then the sort of the parallel path of physiology was recognized, and so those two are studied together.

7:34 Well, you know this whole thing with treating obesity, because I think a lot of times people have been shamed thinking it's just a willpower problem. It's you know, I'm I'm just a bad person, I you know, And so there's a distinction between it's all your fault and this is a medical problem. So does that just think should matter to you when you're trying to treat patients. This is where I get in my soapbox. My passion goes off the chain. This is a disease. Obesity is a chronic disease. Just like if you had some type of strap throat and problems and we now know, well we can use medicines or treatments for that. This is no different. And this whole stigma and this and this discriminating and shaming people anywhere anywhere for any reason, it's wrong, and I just get so frustrated and passionate defense just like the understanding the disease. Education to understand the disease will help us take the blame and shame which should never exist in obesity or anywhere in our culture period.

8:44 Well you originally, I mean, you're an obgun, right, but did this I mean, I just want to, you know, walk us through. Did you kind of start moving in this direction as you I mean you were you know, you basically start out with traditional medicine, but this is kind of taken over right. Well, as you mentioned, I've been had the privilege of having a practice for forty years with obg WAN my patient population or women of all ages, and we've had a lot of medical training and surgical training to get to just start a practice. But what we never got trained in is what we're talking about right now. And when women come in to my practice, from the beginning of the get go, they would ask me about their weight problems and their weight gain, and it became very frustrating because I didn't have any tools in my toolbox, and so going in and trying to dive deeper into what we had, we had very very limited tools, many of which we thought were good and turned out later not to be good. So the discovery of now what we know the facts about the disease of obesity excites me because we can target that like any other disease, so that it was just by the patient population and the problem that women now and I always will mention this, and it's really unfortunately true. Men gain weight and we don't like the weight, but women gain weight and don't like themselves, and that's misogyny driven. It's wrong. It should never be a double standard, but it is real, and you can ask men and women this is true. So with women with a population affecting their confidence, socialization, sexual responsivity,

10:17 been there with something. So I've always been looking for something to help. And now when we had tools that really do sort of parallel the path of physiology treating, like any of the disease efficacy driven studies, it excites me to have something in a toolbox to help a patient that comes to me. Right, well, let's talk a little bit about some of the myths that are out there. Let's talk about what's really true here. So what's the single biggest myth that you wish you could just cut through right now, get rid of it? Oh wow, there's so many of these. I think that the biggest myth overall is that when people say, well, if I use these medicines, then if I stop them, I will become a diabetic, and I'm like, oh okay, and it's like what you know, we you know, we are all sort of on the diabatic hill. Remember that an A one C in nineteen sixty four was five point nine and you were a type two diabetic. And we have all been going up to diabetic hill. And so now an A one C six point five is the type two diabetic. And we're as we get bigger and more belly fat and more insulin resistance and we're belly fat. We're just on this snowball getting bigger. So people have this something in their head that since the medicines are used to treat diabetes, that and the path of physiology overlaps are used to treat weight loss. In their head they think, well, I just don't want to be on these medicines forever. No, you don't have to be well if I stop this, am I going to be a diabetic? No, you're not going to be a diabetic.

11:42 So that's it's it's I understand where the confusion comes from. But all of this, Hey, we're going to prevent diabetes with these and losing weight will put you lower on the hill, and that yes, if we don't make health style changes to maybe keep us in a better place. We're all going to be diabetic because fifty fifty percent of our population today would be type two diabetes to type two diabetic if we use the original five point nine A one C, that's considered pre diabetes. Now wow, okay, so that's the one that I just want to educate to clarify. I get all types of questions about well, my hair will fall out, and people read about that, and there's sort of a and there is, unfortunately a small population of people when they use one of these medicines, there's a direct effect on the hair follicle. It's not permanent, but it scares them. And then there's an indirect effect because the weight loss that occurs, and this you can say compared to bariatric surgery and weight loss, the weight loss is a stress to our body. We are designed physiologically to gain weight. Our body wants to gain weight, so lousy waight, we go into like a little mini shock in a way affecting hair. But for the most most people, we don't need to worry about that, and we address that individually as a real problem. When people have concerns about it. There have been a host of compound medicines in the past, things that should not have been on the market eligible for use by patient's research grade medicines being given, and desperation salted version of semi glue tide, which is not the formula, that is the

13:14 base type peptide that they make. But so a lot hit the market fast, and that created a lot of confusion. But just and people have a needle aversion, and I probably do, but I would say this is, this is, this is if I could do an if I can do it, because you don't it's really you don't feel this. But if you hear the word needle panic, the pill forms are available. So what messed to you here? Let me ask you that because I address this all the time. But the one that I get most common. If I'll be on these forever, I'll get diabetes. If I stop, my body will be dependent on these. No, when you get to a normal weight, we go back to normal physiologic functioning, and your GLP one will function on its own normally. And the GIP and the glickagon and the ambulin, these chemicals that I said four buttons are messed up.

14:04 Well, talking a little bit more about the mental side of it. Sometimes people will say, oh, you're cheating or you're just taking the easy way out. That's even I mean, I can't imagine that. I mean, I know what happens. Well, penicillin was discovered in nineteen forty one, and if people had strapped throat in nineteen thirty they got leeches, if they had a severe infection, and when we understood, hey, that's the bacteria, and now we have an antibiotic to treat that bacteria. In nineteen forty one, penicillin the first antibiotic to treat a bac to infection. So that would be like saying, now that we understand this disease and we have a medicine. If you have strep throat and you say, well, I'm going to prescribe penicillin, it will fix that for you. And they said, oh, you're taking your a sign of weakness. You should not do that. Well, of course we should do that. Everybody understands that the thing that is most common and very common ten percent of all women is a low thyroid hypothyroid. And if a patient comes in and I do reaching lab and I say, oh, you're thyroid's low. I need to put your own thyroid medicine. No one says a word like, of course you do. I need a normal functioning thyroid.

15:09 So I say, hey, you're JP wants low and you put your messine. They're like, oh, wait a minute, wait a minute, because if it's new and I understand that, and we have a right to question. I love that people don't just do as doctors say. Process, educate, make your own decisions. But we just got to look at this as the disease that it is, and don't start with medicines, but start with understanding the disease and what can I do to make it better for me. Not to be more accepted, not to be less shame, which should never happen. It's really just to have a higher quality of life. Yeah, and that's our goal. You. Okay, here's another one for you in Dutch summers. Okay, I'm going to lose a lot of muscle if I take.

15:51 One of these. Okay, all right, now, there are there There is some truth to this. If we don't understand the disease. When we are having our meals store as fat, we make fat that is called lipogenesis. Make fat. Now, when we lose weight. What is fat in the first place. We all you can't build live if you don't have subc fat. We use it as a reserve fuel. So anytime we don't have enough intake, then our body will use that fat. We use it between meals to get us. Between meals, we store fat and use the fat as fuel. And then we store fat and use it as fuel. But now we're storing too much. So anytime we go from sugar to fat lipogenesis, that's easy. But when we go fat to sugar, we must have amino acids in that process to make the sugar gluceneogenesis if you want the big medical word bat to sugar and to lose weight, that's what happens. We take the fat fuel reserve fuel.

16:41 We got too much reserve fuel. Let's let's start using get and get rid of it. And when we get rid of it, amino acids are needed. Amino Acids live in one place in our body, that's muscle and at all the organs in our body. If you think how fast is my motor running, what is my basic metablock rate is the term that is used, but say speed, this is muscle dependent. So just to understand it in a simple way. If you wanted to eat a lot lot more, just gets you a little bit of muscle. But if you want to get in trouble and get in a hole and quit losing the weight, lose a little bit of muscle. But what I'm telling you as is we lose fat, we have to lose muscle or we can't lose fat. But that's where here comes the superhero protein. And I would say for all women, one hundred and twenty grams a day, that's extraordinarily higher than any probably meal that you would fix for men one hundred and sixty grams a day. And why that the three macros fat, protein and carb sugar. You put fat in your blood's gone, and if you put sugar in your blood is gone. But protein brings you amino acids and they stay in our blood a long time. The macro that stays. So why proteins give us sotiety that stays in our blood. So if we can increase the superpower of taking protein, keeping amino acids all available in our blessed we will not break down muscle. So the secret to success really with all of this is not medicines.

18:05 It's understanding the types of sugars. And it's not just calories. You know, there's four calories four grams of the calories sugar and four calories and a grammar sugar excuse me, and none calories a gram of fat. But there's types of sugars. And you get a lot more weight game with the with the simple, refined processed sugars than you do with the complex sugars found in fruits and vegetables. So I don't want I can probably spinning all off the rail here with this discussion, but the point will be with maintaining muscle. It's just a it's a super amount of protein requiring all those protein little drinks between meals to maintain so that when we do lose weight and go batch to sugar, when we will not break down our muscle and we can take the amino acids available in the blood to create what we call gluconeogenisis batch sugar.

18:50 I have. Yeah, that makes sense, But I think something practical to take away from that is it's probably a good idea. To be doing some strength training absolutely, you know, cardia for the heart resistance and street training for muscle building, for weight loss and they're both applicable and our health needs. But we're talking about weight. We're going to talk about building muscle. And the point what you just mentioned is if we don't really pay attention and just start losing weight, we're going to look like in the quote ozimpic face is what was called, and the muscle loss in our face. And that can be prevented by not allowing the muscle loss occur with that loss, which in eavily will So we get that. So that's a fair concern. And it's not a myth, but a myth that the discussion out there that can definitely definitely be controlled with the education of this. That's what I'm trying to say.

19:41 So let's I mean, man, it's on TV, it's everywhere, all the information about this. How can a regular person tell the difference between solid medical information and all the noise that we're seen on social media? There is so much noise. And when I got into this in a serious sort of with a serious look, I decided the best thing for me is to offer no gimmicks. I'm not trying to sell anybody anything or advice. Everybody take medicines, but there are evidence based studies clinical trials done with control groups, double blinded perspective, going forward to look at results, so we can show population results that are great to sort of make these discussions. So I think anything outside of a scientific, double blinded perspective control trial with results, it's hard for me to endorse.

20:34 I mean, so the noise is try this and make this, you know, Jebby one jello, and I mean, I just try to just put that aside. There are I'm trying to say, there's evidence based medicine. We have a disease, and I can give you sort of population studies, but population studies are not necessarily applied to every individual. So I can say, well, there might be this percent of nausea, but you might have higher than that or lower than that. But we can get we can we can base what's real from evidence based studies. FDA Approved generally is the strictest sort of committee, and I'm proud of them for being strict to make sure that what is told to the patient is actually coming from adequately the properly corrected collected information.

21:20 Well, what do you feel is the biggest What side effects are the ones that you most commonly see? Okay, you know, I Just to clarify, we mentioned three medicines simpically tied turds, evitide, and Reditude Tribe. All right, I would just say in the general bucket for understanding, the side effects of these are all going to be about the same plus termized number one side effect by far is nausea. All right, Now, every one of these medicines are going to have dose titrations. You'll do a level one dose a shot once a week. No nausea or side effects. You go to level two of the loud, level three, level four. And when I give you these numbers, let me clear, and I do clinical trials phase two clinical trials in dosing. When a patient enrolls in a study, they are there's algorithms, they are forced to go up the ladder, up the ladder, or they have to get out of the study, so they make them week one, week two. So I'm going to tell you in population studies, nausea is about forty percent in real life, and my patient population has a much lower number, and it is something we have to watch for. And with there's antiemetics like fendergan on doncitron pro methazine. I shouldn't say finnergan now, but you do level one. If somebody's like, I'm a little nauseous, we keep on level one for three months if we need to. It's all about dose titration, So nausea number one. All three medicines simplue tide, seventide redit tribe.

22:46 Constipation is number two, and with women in general, there's a constipation cavit IBSC. We call it it will bowl syndrome constellation, and that's real. And there are over the counter preparations you could take, and I always recommend mirror like may relax the new thing that people are using, and it's been found in some observation studies magnesium glycinate is good for this to take along with it if you tend to have constipation. But the third most common side effect is diarrhea. And it's very nice when you have somebody that has a little bit of the c problem and it gets a little bit of the deep problem and they are normal on the medicine, So you have to see all again. People might do level one on any of these, go to level two and then start having constipation. Then it's time to go back down to level two and let that sort of rest a while.

23:31 Most of these occur because of the dose gets a little bit too strong, and the fourth one will be vomiting. So the nausea is number one. Voluiting is down four or five. Indigestion is pretty common on these medicines, and you can take tons or relates and just to say gourd in itself gastrosophageal reflux disease, we call gourd bad heart burn dingestion. Well, people have that and they'll think, well, this indigestion is bad. Can I take this medicine? And any GI doctor will tell you the best thing for long term management of GIRD is to lose that belly fat. These medicines target. So even if they're already on these h sheet blockers like fermatidine, or if they're on a PPI we call a maprazol or naxium, the protonics medicines, even through on those these medicines may increase intergestion. Take some extra tomes or rolaids because losing weight will helpfully hopefully get you off medicines altogether. So those are the big ones, and there are we can go down there.

24:26 I mean, there are some that we've kind of you know people have kidney disease, they're good to take these medicines. I always say, you can be on You could be on a list for a kidney transplant and take these medicines. You can be on a list for a liver transplant and take these medicines because they don't get metabolized or excreted through the ken your liver like about every medicine. And when you're on medicines, these don't get into the bloodstream and grab them too other proteins and bump other medicines off of protein, so we don't have to worry about drug drug interactions and protein bonding. They go to their receptor sites and when they get their job done, there's an enzyme that effectively removes them and peptizer are put back into the meno acid where they came from, so we can talk about lesser So so any sort of we call it an adverse event, any sort of thing that would happen when you're on a message, lets your provider know. Because there are some things that are not as common we don't need to talk about. But anything like if you start itching on bind your left ear and you never did that, let your doctor know.

25:18 That and that's just hypothetical. I just made that up. But anything that would be new on E medicine, let your doctor know. And sometimes there's. Another tweak to this, and that's compounded versions with mystery additives that are claiming to fight like side effects or muscle loss. Yes, how should people be worried about that? I would this is just maybe more my opinion, and I would think I could extrapolate this a bit from when I read about what the FDA likes and doesn't like. I'll go to symbic glue tide. Sympiclue tide is made by Nova. Notice a Denmark dude is one who developed the process base comminant process to make this peptide, and Nevi Nordis bought that. And all this is made in Denmark, except for more recently factories in our country in North Carolina based were competent and I could describe it it was made. I used to be a chemist, but it's a certain way now. When the compounds first came out, they were doing they added salt to it, and like assault version symboluetide acetate or simplue tide additives, I will just not get in the chemical terms, but that wasn't exactly what nev Nord has made. The compounders now here's here's here's the legal part of these sometimes bought my Nevinoris and they put up millions and millions of dollars into studies, so they owned the patent on that drug.

26:40 When they ran out of the drug, then we saw this surge of like an early generic it is the best way to understand it, and it was coming from everywhere and not really regulated. Going back to your question, the simp blue tide that was being made all of a sudden, Hey we got these salt versions. We got these research grade and not really quality inspected, and everybody was maybe they were effective. I don't can't comment, but that needed to stop and it did stop. Now some of these bigger pharmacies I'm not going to mention names started making this themselves. Are manufacturer for purchasing manufactured, and now they're going to be in a patent infringement because when semi glue tide, no of a notice, branded ozamic we got their storages are packed back up. We should not be legally using anything with that branded medicine. But it's been out there and everywhere and hard to control.

27:23 So some of these places started adding chromium to it or B twelve to it with it and justifying it through a lot of lines of rationale the FDA, And this is why I'm extrapolating, and it's not a law, and every state has variations of what they can do, but the f Day's like, dump any crap in there, just use the stuff that's supposed to be used. Based for combinants in blue tide, trus epetide had a shortage and compounds came out, and so it's kind of like, well, you've got a patent on trus epetide, but you don't have a patent for trus aptide B twelve by six chromium that we add to it to make it our own. And I think that it's all kind of in the gray zone of legalities. And I'm not going to mention the name of the pharmacy that's meant very national with Super Bowl commercials had to settle an agreement with Novan Notice to quit doing those things. So, in other words, so added things. I can't say that they are bad, but I don't think they're offering any advantage. And if somebody needed B twelve for they think more absorption efficiency.

28:23 I think that's what they say. They put that in there. We can get B twelve without putting it in that matter, they're trying to make it their own so they won't have a patent violation. And I think that's where that I'll stem from. But it's not like better. I mean there's some crazy stuff. I mean, people take a little bit of this compound and makes it a little bit of that symbolsign, makes it some reptile. Let's put some two tried and then we'll make it our own. Oh yeah, I mean people I'll come in, they'll say, they'll come in like this is half simply tied and half trus appetite. I can't even have no clue what that's doing, you know. And so it's just there are some things out there like microdocing. Think that is a very very legitimate thing for patients to do that if smaller doses were pay save money, use smaller doses. But I think the quality of the medicines, the branded medicines I always prefer, and in cases where it's allowed, a source compound from the right place that's inspected through all the agencies and the farm agencies that have to say, okay, this is good enough to use, then use those. But we don't need to change it to make it our own in my opinion.

29:30 So doctor Summers, who is a good candidate? Okay, if they do. This in a smart, intelligent way and they ask some good questions, who's a good candidate? All right? Well, all right, First of all, I want anybody that feels like they need to lose weight, and by the way, that's seventy six percent of our population. I think, first to educate, how do we go from ten percent obesity at War two and be it forty percent of BCD today? In other words, like if there's something that causes let's get rid of them, you know, let's let's get the let's get the button mold out of our house and know what's really caused us to escalate that that sort of intensity of an incident's frequency.

30:12 But so health style changes. I call health style because I like that term better than lifestyle. But let's look, how do we get there? We're all doing it. What's in our food that we need to know and make choices individually work for us? And if these kind of things and maybe we're all screen timing and less active, and maybe we just consciously try to say a few more of this, a few more steps of maybe some resistance here, and if these things are not working. Here are the eligibility requirements for most medicines. Body mass index is the term that we use. You know when you put the heightened the weight in the formula. But a BMI of eight of nineteen eighteen to nineteen to twenty four point nine is normal. Nineteen to twenty four point nine. Your BMI at twenty five you're overweight. At twenty seven you're more overweight. At thirty is considered obesity. Thirty five would be class to obesity. So let's put these numbers.

31:04 If you have a BMI of twenty seven and you have what's called a comorbidity, and there's a string of things hyghpertension, diabetes, sleep at in the types of authorunities, gird own, there's a list. If you have twenty seven and something wrong with you because of that weight, then you would qualify for medicine. All right, If you have a thirty obesity by definition, then you have no questions asked. If you want to use a medicine for These are the FDA requirements nationally, a twenty seven comorbidity and a thirty no questions asked. I believe you already introduced sorry about the Medicare and we'll talk about that. Now. Let's talk about Medicare because that is like today. I would stand up and applaud the congressional team that has recognized this is a disease. Our insurance and health insurance covers diseases, and this is a disease. It's not just like we'll do your favorite thorty. This is a disease.

31:55 It should be like hypertension disease, diabetes disease. I mean, but they are now covering for Medicare patients with Part D mess the drug coverage and it's not one hundred percent of all plans, but it's a great percentage. And I just went through eligibility. Medicare will say if you have a bm I of twenty seven and only one bm I of twenty seven and pre diabetes an a one c over five point eight or nine, depending on your lab If you have a twenty seven and pre diabetes, they will offer you coverage for medicines if you get to a thirty which like no questions asked typically across the board commercially, if you get to a thirty, you must have at least one comorbidity, higher pretension, diabetes, sleep at in me a gurd something that's recognized that will get better. But it's that at thirty is not no questions asked. You must ask something wrong with you. Add a thirty five or higher, then no questions asked. So it's a little bit different for the providers. And as we mentioned, with this new coverage, I want to give them a standing ovation. This is so needed. These are safe medicines at any age their f They have proved down to ten years, and some of the medicines add up to any because losing belly fat will give us the highest quality of life. And I could talk all day about how that happens and why and how that messes up our bodies protectors when we have this sort of fat right here and our body and they target that.

33:12 But eligibility, So who's the candidate for somebody that feels like their efforts have failed? And this okay, let's use the penicilins of weight loss and target the disease because there's some still things on the board that are not necessarily things that target the disease per se. But there's other issues with emotional eatings and things that we can get into. But what we're talking about JLP one medicines. If nothing has worked for you, let's do this. Neurochemicals are messed up when people have bariatric surgery as the well, let's just go to surgery. Neurochemicals are messed up the surgery and the weight loss. The surgery itself normalizes these chemicals. Through a discussion I could have with you, chemicals are messed up, and when they move part of the stomach, the negative influencers normalize these neuro intercom buttons. And when they do the WI the rude why bypass removing that piece of intestine normalizes the chemicals, so weight loss will be ultimately concluded in normalization of the neuro indagrine chemicals.

34:11 Is why the three button hitter is going to give us the same now results that we get with a gastric bypass or a gastric sleeve or gastric bypass. And it's really fascinating, But who needs medicine? The question failed efforts qualifications understanding education look at what we're eating. What we can do, Maybe we can move this and over eat what you like, change it and like it with boundaries and medicines and understand what to look for. And I consider these the safest medicines of any medicines I've ever used, if for any reasons in a g wan ob population of patients. And now we loss these are safe medicines and it's exciting they are safe. And yes we hear all about the anecdotal this happened to be and some reals, some not real, but always understanding that anything individual can happen to you needs to be presented and talked about to make sure it's just could be like something more serious or not. There really only serious things I tell people that we really need to watch for with these medicines would be pancreatitis. They work on the pancreas, and if you get a nausea, that's pretty common.

35:08 But you get nausea and epigastric pain or pains in your stomach, shot to your back, or you're sicker than you should be with nausea, we need to do some blood tests very very early. And I would say in my practice and obesity for fifteen years. I've never had a patient to develop pancreatitis, but I stopped the medicine and prevented a lot of cases. It could have been over that many years. Well, I think what you're saying, you're what you are saying is if people are going to be taking this, they should be they should be followed. They should have a medical professional that is. Following them, a person that understands what they're prescribing and then and responses from the patient. And it shouldn't. I mean, I'm not I mean, I can't comment good or bad.

35:53 I'm not a I don't do telehealth, but I lose that three dimensional contact when I see a patient, which I prefer and my practice. But the telehealth agencies that are just sort of meling these to you, they might be great, So I'm not saying they're not good, but it's probably not for what I would prefer as a practice. But I like, I mean, my patients, I mean, they know they can call me twenty four seven and a lot of them unfortunately have my phone number. But I do want to know if they're experiencing something because a lot of times it's really reassurance. But there's times that I need to you know, we need to say, hey, don't do the next dose you come in here. And by doing clinical trials with some of the bigger pharmaceutical companies, I've kind of learned through experiences outside of my clinical practice, like what we things that I have taught me to be safety always first, more careful, then the boundaries, like they'll let certain anambulies go three times normal. If my mblace and a pation goes one point over normal, I stop and we have to discuss So safety first, always, safety first. I'll say it again, safety first, three times.

36:55 Everybody hear that. It's always the most important. So, I mean, we've been talking about medicare and how this is becoming improved through Medicare plans. A lot of the people that are going to be listening to this are that age. Is there anything? Is there anything that an older listener should be understanding or be aware of with considering doing this. Okay, okay. When I talk about age, I think we're all beautiful, healthy and wonderful at any age, and we all deserve a high quality of life at any age, and that in per se and as we age, the cardiovascular risk is way increased and the number one killer in the population we're talking about is going to be a heart taking stroke. Well, if we can do anything to reduce that, and that's a whole nother discussion. But these medicines, if you get on medicines lower clinically evidence proven lower the incidive heart tanging stroke, definitely can claim by the simply Typanov and noticed people takes a while to do the studies, the transapatite Eli Lilly, they're finishing their studies. But I'll just say, and I'll put my name out on this one, all these medicines will lower our incidents of partanking stroke, which is affecting the population.

38:09 We're talking about anybody that's aging and most of the weight we get a little belly thought, and we wake up and there seems to be more the next day, and the more they stay because the buttons are messed up. And if we can fix these buttons and have a tolerant and just where people, I mean, I'll let you say, if you take these medicines, you shouldn't even really know your own except for you can't eat very much. I mean, I don't think people should walk around burping and sulfur verbs and you know GI symptoms. I mean, we're need too much medicine and we need to stop it. But because these are common side effects, but so I would say, get rid of the fear, and they'll be scared at least a discussion and an education. So do these patients in the population we're mentioning have inclusivity for these medicines because lowering that weight that just seems to body well, just as part of aging. No it's not. It's a part of our culture. Going from ten percent of b city to forty percent of bcity. But these these inflammation and immiological problems in quardybascular risk affect the population greater.

39:05 So don't be scared of the medicine. It's not necessarily for everyone. But don't be scared of the medicine. But look at our life. Because we have become we can all be a little bit more careful and we can all, like you just said, do some resistance training, some muscle building, preservation, not like exhaustion stuff, just everyday stuff that will make a difference. Well, another thing, and this is just me noticing this all over the place. There's pills and there's injections. What what where? What? Do you think is the best way to do it the injections or if people don't like sticking themselves with a needle, is it going to be better?

39:45 Is there a difference between the two different methods. Well, let's talk about this when we talk about these medicines like GLP one, GOP, glucygon. Let's go. Let's say it with Jill. Let's say with gleeg on the PETI one and GIP. These are peptides. Peptides are pieces of a protein. If I say, if your house is a protein, your front door is a peptide. These are small things. So in insulin is a peptide. Peptides have never ever been able to be swallowed. Because we swallow a peptide, that little bit piece of little amino acids attach each other, break down and there's nothing to go into the bloodstream. So it's all about what do we get into the bloodstream. So any peptide, all through history, any peptide is injected, you cannot swallow it. It will be degraded and stomach acid.

40:32 So they've got this now new revolutionary way to put this peptide into a pill, simpically tied. It started with right bouses. They kind of tweaked the capsules put in. So here's the thing. The medicine. What is in our bloodstream is what's going to get to the brain and then go outside in regular but sugar when you swallow a pill. And the people that didn't put a peptide into a pill, My question was, why didn't they put insulin in a pill because everybody these insulin. It'd be a lot easier to get that to where it needs to go, you know what I mean. But but they put these pep pides in a pill, and so we started out with now cyemically tie with roebulsis for diabetes. They tweaked it a little bit. Now they're gonna get rid of robelsies and they're gonna have oral we go V and oral o zimpic because they tweaked it. It's a little bit better absorption than the old version, but you've got to get it into your bloodstream, and so I know when people do an injection, it's going into the bloodstream. I've always preferred that the diva part of oral we gov is that when you swallow that pill, you got to read. They don't they don't really announce this but you gotta swallow that pill, and they'll tell you not to eat for thirty minutes. I tell every one of my patients swallow that pill and don't eat for one hour, because the absorption efficiency is at about ninety something percent, closer to an hour, not thirty minutes.

41:49 But they're trying to sell the drug and people, well, I don't want to take that pill and wait an hour. But if you're gonna take the oil, if you canna take or we GOV, wait, wait at least wait to thirty minutes, no medicines, no SIPs of coffee, water or jeee. You got to take that with us. The many ounces of water, the least amount of water you can take and swallow that and wait. Found DEEO is now made by Eli Lilly. It is also just a single button hitter. It's AJLP one receptor agonist, and they got this sort of absorption thing down, so you can swallow foundayoh and eat breakfast coffee, you know, go whatever. It doesn't matter what time of day it's absorbed, even in the context of competition. But and so we have now two single button hitter oral pills, we GOVI FOUNDEO, and it makes sense to me like, well, if I could just say anything, we're given free, give me some FOUNDEO. There might be in population studies a little bit more GI upset. I haven't seen it in my patient population, but I always worry about are they getting the medicine in their bloodstream to do the job. And I know when they do the injections, I know they're getting a constant dose each time because it gets into the sub carticular picked up by the capillaries, gets into the bloodstream and they got their dose that day. And there's no Diva application with that and the needle. Listen, I'm the biggest wish you'll ever meet. Seriously, I scream at bugs and I did never do a shot, and I can do this injection.

43:09 I think, Okay, if I can do it, America, you can do it. Because I am a whuss. Well doctor, wiss doctor or Summers, I'm a woos too. I'm a whist. We're out of time, you know what. I think I'm going to have to have you come back because there's I really think that we should get into behavior around eating and all of that, and so we've run out of time right now. So for our listeners who want to explore this. Honestly, what would you say would be the first thing that they should do, as you know, just your closing remark. Now, because we're out of time, believe in yourself. If you believe in yourself, you can do it. Don't do anything to make yourself better, Gouse, You're already great. Do anything to make you have the higher quality of life to see your kids, grandkids, your puppies, all their grandpuppies quality of life. Believe you can and it will happen. Awesome.

44:09 Well, Okay, we're gonna call this part one. We'll do another part two, and we'll kind of we'll kind of see how things go. I think I'm gonna call my insurance company and I'm just gonna find out what they tell me. Okay, absolutely, yeah, and. Then we'll come back and we'll revisit more. I want to get more into behavior, what you're actually putting into your mouth, you know, so that you have long term. Success with this. Yes, yeah, I don't do anything self promotional. But I did put a video series out which is nothing but education. I will not know ifybody watched it. It was just help providers even and patients understand the disease of obest I discussed these medicines basically, just simple principles of what types of sugars, and we talked about the protein and kind of just what to expect. And so if I thought, what we're really missing the big picture is just everybody, Hey, we need to understand this is a disease, and we don't make fun of people with diseases, and we approach that medically. And if your thought was messed up and I said you needed someway medicine, you would say thank you, doctor. And I would like to think that we would understand that in the same conceptualized way that we treat this as the disease. It is not all diseases need to start with medicines, bring none do. But we need to do medicines before we do any surgery. That's the fact.

45:25 Right. Well, we are out of time, so doctor Summers, thank you so much for joining me today. I think we've asked some good questions. I think that we've hopefully cleared the air on this and UH, as always, there will be an information sheet about doctor Summers. And I go out to YouTube and look at his I've been out and looked at his uh informational series. It's really useful. It's on YouTube. So with that, thank you all for joining us today on the Ask Good Question Jen's podcast, and we will see you next time.

46:06 Today's episode is over, but we did ask good questions again, didn't You don't miss out as we broadcast live every Wednesday, six pm Eastern Time on W four CY Radio at w fourcy dot com. Joined Benina Bellan. We're sing next week for more conversations with experts on finances, retirement, behavioral finance issues, health and wellness and more. Until then, remember to ask good questions.