November 19, 2024 โข 32 mins
Welcome to Season 3 of the Essence of Health Tea Time podcast!
Studies show that over 70% of Americans have a metabolic condition including overweight and obesity conditions. We now have medication therapy available to treat these conditions. However, studies show that less than 8% of Americans are using an anti-obesity medication for treatment, despite their proven effectiveness when used as part of a comprehensive weight management plan. Certain injectable medications have gained widespread notoriety amongst weight management medication options. However, many Americans simply are unable to access these medications due to lack of availability and cost. This highlights the need for greater awareness of the available FDA-approved medications beyond the injectable medications that are effective and accessible to help more individuals who are challenged with the condition of obesity to achieve their health goals.
On today's episode, Dr. Shayla will be joined by a special guest, Dr. Lindsay Ogle and they will be spilling โ๐๐ก๐ ๐๐๐ ๐๐ง ๐๐๐๐ข๐๐๐ญ๐ข๐จ๐ง ๐๐ฌ๐ฌ๐ข๐ฌ๐ญ๐๐ ๐๐๐ข๐ ๐ก๐ญ ๐๐จ๐ฌ๐ฌ ๐๐ข๐ญ๐ก๐จ๐ฎ๐ญ ๐๐ก๐ ๐๐ก๐จ๐ญ.โ
Lindsay Ogle, MD is a Board Certified Family and Obesity Medicine Physician whose goal is to help patients stay healthy so they may live longer and fuller lives. She recently started a telehealth clinic called Missouri Metabolic Health where she helps adults all throughout the state of Missouri treat and prevent metabolic conditions through lifestyle optimization and utilizations of safe and effective medications.
Synopsis:
- Discover the four main FDA-approved medications for treatment of Obesity that donโt require an injection
- Understand the importance of finding an Obesity Medicine Specialist to manage your care safely and effectively
- Explore sustainable, long term, cost effective options for medication assisted weight management
- Get Dr. Lindsayโs โSuccess Teaโ on how to combine comprehensive lifestyle changes with medication options to optimize your success with your weight management plan
Connect with Essence of Health:
โ FREE Nourish & Flourish 5 Day Challenge at www.DrShayla.com/NFchallenge
โFREE Class โDitch The Diet: Mindful Strategies for Lasting Metabolic Healthโ at www.DrShayla.com/DTD
โ Essence of Health Wellness Clinic & Coaching: www.DrShayla.com/EOH
โFREE "Healthy Tips For A Healthy Lifestyle" Guide: https://essenceofhealth.link/e-book
โFollow Dr. Shayla on social media at Essence of Health Wellness Clinic on Facebook, Instagram, and YouTube and at DrShayla on TikTok.
โ-----------------------------------------------------------------
Connect with Dr. Lindsay Ogle:
Missouri Metabolic Health: https://missourimetabolichealth.com/
Instagram: @dr.lindsayogle
YouTube: @Dr.LindsayOgle
Facebook: @Lindsay Ogle
TikTok: @dr..lindsay.ogle
The Essence of Health is in You!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Welcome to the Essence of Health Tea Time podcast. I am your host, Dr. Shayla Toons-Whithers.
(00:15):
As a double board certified family and obesity medicine physician with over 12 years of experience
in medicine, I teach motivated individuals how to achieve their desired quality of life
while preventing and reversing chronic diseases. It's tea time!
(00:37):
What part of your health journey is most challenging? Is it the actual effort of sticking to a plan?
The cooking and the meal planning? The exercise routine? Not enough time for everything you
think you need to do? Or the confusion of it all? If you said yes to any of these obstacles,
(00:58):
then keep listening to learn how you can smash these problems just by checking your email.
You check your email inbox every day already, but what if checking your inbox brought you
better health instead of the stress it sometimes can bring? Well, I have news for you. You
can improve your health, get a jump start on improving your health conditions, and start
(01:21):
to feel like a better version of you just by checking your email inbox over the next
five days when you join the free Nourish and Flourish 5-Day Challenge. You'll get health
tips, actionable videos, a goal and habit tracker, and healthy recipes every day for
five days. Better health is the best investment you'll ever make, and this is only a small
(01:46):
investment of your time. You have nothing to lose, but everything to gain. The Nourish
and Flourish 5-Day Challenge was designed to set the foundation for healthy habits for
life. Say yes to yourself today and sign up now at drshayla.com forward slash nfchallenge.
(02:07):
I'll also place these details in the show notes. The essence of health is in you. See
you in your inbox.
On today's episode of the Essence of Health Tea Time podcast, I have a special guest,
Dr. Lindsay Ogle. Dr. Ogle is a board certified family and obesity medicine physician who
is passionate about preventative health. Her goal is to help patients stay healthy so that
(02:31):
they may live longer and fuller lives. She recently started a telehealth clinic called
Missouri Metabolic Health, where she helps adults all throughout the state of Missouri
treat and prevent metabolic conditions like diabetes, fatty liver disease, metabolic syndrome,
and overweight and obesity. She does this through lifestyle optimization and utilization
(02:53):
of safe and effective medications. Welcome to the show, Dr. Lindsay. I'm excited to
have you join me today.
Thank you so much for having me here. I'm excited to talk with you and your audience.
Yeah, yeah. So first, before we even talk about weight loss and medications, just even
share with us why you went into the field of obesity medicine. What really motivated
(03:16):
you in terms of that field?
Yeah, absolutely. So I went into family medicine because, like you introduced, I have been
passionate about preventative health. And so that was always my goal was to help patients
become and stay healthy so they can live longer and fuller lives. And so I chose primary care.
(03:40):
And during my residency program, I was exposed to obesity medicine during some elective rotations
and worked with some really amazing doctors who introduced me into the field. And I was
able to see what a improvement in their patients' lives they were able to make. Their patients
were very happy when they were coming into the office and they were able to get off lots
(04:04):
of their medications, their blood pressure was improving, diabetes was better controlled,
cholesterol numbers were better. And like I said, yeah, able to stop other medications.
It was just really wonderful to see. And so I wanted to explore that more and then did
my own studies in obesity medicine and took the board exam last year.
(04:25):
Awesome, awesome. That's exciting. Yeah. And so even for you, what are some of the things
that you're even excited about that has even evolved over the years in the field of obesity?
Yeah, yeah. So obviously, I'm pretty new to the field, having taken the exam last year.
But even in a couple of years that I've been aware of it and involved in it, it's really
(04:51):
exploded in popularity, which I think is wonderful. So more patients are aware of this specialty
and are seeking care with obesity medicine specialists, which I think is very important,
especially because some of the newer medications are also exploding in popularity. And sometimes
(05:11):
they are prescribed without the appropriate guidance. And so when people are able to work
with a specialist, they are getting, I think, more well-rounded care that is going to actually
improve their health long term with those health focused goals, rather than just a goal
of reaching a number on a scale or a pant size or a particular BMI. I know that my colleagues
(05:37):
that are trained in obesity medicine are really focusing more on health related goals, which
I think is ultimately the most important. Yeah, I totally agree with you on that one.
As well, I finished my fellowship in obesity in 2018, so a little bit longer. But yeah,
I agree because even then there were still such stigma about obesity and about weight,
(06:00):
so much weight bias. But I think it is becoming more readily apparent that we're focusing
on those health measures and those health goals and not even so much what that particular
number looks like on the scale, but what that person, looking at that person as an individual
in their health status and helping them improve their health by managing the condition of
(06:22):
obesity that way. So yeah, I agree with you there. But it has been exciting just to see
the trends change over the years in obesity and just what that looks like and how we understand
it as a health condition. Yeah, absolutely. And you mentioned the bias
and obesity, and that's another thing I'm constantly seeing in our field is that we
are really focused on trying to mitigate and eliminate that bias, both with the terms that
(06:49):
we use as clinicians, but also with the advocacy work that is being done.
Yeah, yeah, for sure, which is good. I've met, and I'm sure you probably have too, a
lot of patients who said that for so long, they were afraid to go to the doctor because
every time they went, it was a negative type of connotation that was placed upon them and
(07:11):
a negative interaction. And so just making that more positive for people by having more
obesity medicine specialists in the field, I think has helped for sure.
Yeah, absolutely. Yeah. All right. And so in that same vein, we
know that there are many ways to promote weight loss, but we also know that obesity is a chronic
health condition. So even when weight loss does occur, so does weight regain on just
(07:37):
too many occasions for a lot of folks. And so this is really where that medication therapy
comes into place for individuals. Now we know that the GLP-1 medications have gained quite
the news press lately, but I feel like it's to a point where our other available medication
options have gotten forgotten or even dropped off, but they are still viable resources for
(08:01):
individuals. And so this is what we really want to talk about today is these other options
outside of the GLP-1 medications that are out there. So Dr. Lindsay, just tell us, what
are some of those available FDA approved medication options for treatment of obesity that are
not GLP-1 medications?
Yeah. So I think of four FDA approved medications. The first one, the main one in this category
(08:30):
is ventromine, but it's part of the sympathonimetic amines, but most commonly prescribed is ventromine.
Next on the list is QCMEA, then there's contrave, and then Orlistat. So those are the four main
FDA approved medications that I think of. And we can kind of go over how they work and
(08:53):
their effectiveness and who it may or may not be good for.
Yeah, that would be good. Yeah, just tell us even ones that you found to maybe show
the most promising results and then maybe a few factors that even determine what may
be a good choice for certain people.
Absolutely. So I'll start with ventromine. It is the one that has been around the longest.
(09:16):
So I think it was like around 1960 it was approved.
It's a nice and old drug.
Right, right. So we have a lot of data and decades of use to back up its effectiveness
and its safety. There are some people who are concerned about the safety because in
the past it was combined with another medication which that combination was proven to be unsafe.
(09:40):
But ventromine alone, we have been prescribing it for decades and it is safe to use for weight
management.
Dr. Lindsey is being nice. Finfin was the one folks that we do not use anymore and that
we do not want you to use either. So ventromine and not Finfin, they are two different drugs.
(10:01):
Right, right. So thank you for clearing up that confusion because it can be confusing.
Ventromine is a controlled substance. So it is a stimulant medication and that is something
to be aware of. So this is something that you do need to see typically an in-person
doctor for so they can check your vitals, your blood pressure, your heart rate and they
(10:24):
can monitor that over time because those are some of the side effects that we think of.
So making sure that it is not affecting your heart rate and your blood pressure. Even though
it is a stimulant, it is not one of our very strong stimulants. I typically compare it
more to a caffeine level of a stimulant rather than something like Adderall that we use for
(10:46):
ADHD. So most of my patients who can drink a couple or two of coffee in the morning can
tolerate ventromine. So that is more of what I am looking at for that comparison. But if
you do not tolerate caffeine, then maybe this one is not for you. Like I mentioned earlier,
there are some other medications in that class that we could try that may be better tolerated
(11:11):
which could be another reason to work with an obesity medicine specialist because we
are aware of those options. But the whole class as a whole really helps with appetite
suppression. So I use this for patients who are telling me I am just constantly hungry
every time I reduce my calories or go on a new nutrition plan. It is difficult to maintain
(11:33):
that because I am constantly hungry and this medication can really help with that appetite
suppression. I will say that there are a few states that limit the use to three months
at a time because that technically is what is FDA approved is a three month period of
(11:53):
ventromine. But us in the obesity medicine world who have been trained using this medication,
we know that it is best when it is used long term because once you stop the medication,
then the hunger comes back and weight regain can occur. So we typically use it longer term
when we are able to if we are not in one of those states that limit it.
(12:16):
Yeah, exactly. I am glad you pointed that out as well. Some of that stems from the old
thought that obesity was just a willpower disease and it was not a true health condition.
But now we know that that is not true. So yeah, these medications can be used long term
and can be safely for those who are under the care of an obesity medicine specialist
(12:41):
like yourself so that they can be closely monitored for safe use of these medicines.
And I feel like ventromine is pretty popular too because it is old. So I see a lot of people
who will come on ventromine but I also feel like a lot of people do not realize what ventromine
can do. So I am glad you pointed out those other potential side effects so that people
(13:03):
can be aware of that because sometimes people say, well, you can get ventromine on every
corner, every spa or whatever, but it should be monitored carefully.
Yeah, absolutely. And that makes me think of another benefit of it being older medication
is that it is very inexpensive. So if cost is a concern, if your insurance is not covering
(13:26):
weight loss medications, then ventromine is usually $10, $20 out of pocket.
Yeah, yeah, for sure.
If you're frustrated with your weight, taking more medications than you'd like to, have
been told that you are at risk for the development of a chronic preventable disease or just are
not feeling in the best of health, then I'm talking to you. Why? Because you're tired
(13:51):
of fat dieting, you know it's time for a change and you want a sustainable plan to improve
your health. If you have found yourself at this place in life, well, I have developed
a program that's just for you. It's called The Essence of Health and it's your prescription
for transformation. My goal with this program is to give you the tools needed to create
(14:14):
sustainable lifestyle changes within a group coaching setting along with one to one individualized
coaching to give you a personalized path to health that's just for you. The benefits
are priceless. So join today. Head on over to eohcoaching.com to learn more. The Essence
(14:35):
of Health is in you.
So what else do you pull out of your pocket there?
Yeah, so next on the list, Acusemia is a brand name of a combination of ventromine and topiramate.
And so that combination of using two different medications makes it a little bit more effective
(14:58):
than the ventromine alone. And so the ventromine, I typically or we typically see a weight loss
of like seven, 10%. And then with Acusemia, it's a little bit more of like nine to 15%.
And these are averages, some people, you know, don't respond to them, some people will respond
more. But that's what we're kind of looking at. So we talked about the ventromine portion
(15:24):
of Acusemia, but the topiramate, that's a medication we use for lots of different reasons.
So we can use it for migraine prevention, we use it as an anti-seizure medication, it
can be a mood stabilizer at times, and it can help decrease alcohol cravings. There's
lots of things that we use it for. So if I have any patient who has those conditions
(15:47):
as well, or those goals, then Acusemia is a great option for them. One important thing
with Acusemia and topiramate specifically is that you do not want to take this medication
if you are pregnant or have the potential to become pregnant, because it can be associated
with birth defects. And really any of our anti obesity medications we do not want to
(16:09):
use during pregnancy, but specifically topiramate and Acusemia is there. So I kind of think
of it as like a next level to ventromine, and that's kind of how I use it for my patients.
Yeah, yeah, I agree. Yeah, it is. It can give folks just a little something extra there
in terms of their weight loss support as well. Yeah.
(16:34):
And then next is Contre. This is another combination medication of Wellbutrin and Naltrexone. And
these are other medications that we use for other reasons. So the Wellbutrin we use for
depression, it's a non-simulant ADHD medication. It is used for patients who are trying to
(16:55):
cut back or stop smoking. And then the Naltrexone, it's an anti opioid, meaning that it turns
off the opioid receptors. So that's important to know. So you cannot take opioids with this
medication. And we also often use it for people who are trying to cut back or stop alcohol
use. So again, if my patients have these conditions or goals, this is a great option. And combined,
(17:22):
they really help with like emotional eating. That's what I see the benefit for my patients.
So people who, when they're really stressed, they turn to food to help manage that stress.
The Contre can be helpful in those situations. Of course, I'm working with like a coach and
a therapist along with that for help creating better alternative coping mechanisms for stress
(17:47):
management can be helpful, but the medication can really help augment that as well.
Yeah. Yeah. I also like Contre and folks who tend to have a lot of cravings because we
know the bupropion and the Naltrexone, the way that they hit within the brain receptors
as well to help for those cravings. So I tend to use it as well in those types of individuals
(18:10):
who, you know, I just can't help but eat that ice cream bar or whatever it is. I'm going
to need some support there. Yeah. Yeah, absolutely. Absolutely. Yeah. Yeah. Well, thank you for
sharing those with us. And something else to just touch base on, I think a lot of people
don't realize is that these oral options, they actually come from very old medications.
(18:34):
The medications that we use for years that were then combined to create some of these
weight loss medications for the FDA indication for just for weight loss. But for listeners,
you can still feel comfortable from a safety perspective because these medications, even
as individuals have been used for so long too.
(18:56):
Yeah, yeah, absolutely. And that also brings up a thought is that I often if a patient's
insurance does not cover these medications, then I often prescribe them individually.
As you mentioned how they've been coming for a long time. So that is an option as well
(19:16):
for a more affordable half. Right. Yeah, for sure. The same as well, because
yeah, you can generically just break them up, you know, it's more feels to take. Yeah,
but it is more affordable by breaking them up that way as well. And so Dr. Lindsay, what
are some of the other medicines that may not necessarily be just FDA indicated for obesity
(19:40):
treatment, but can also promote weight loss? Yeah, so the first one I think of is metformin.
This is something that we use often. It's a type two diabetes medication. So it can
help with anybody who has insulin resistance. So if you have insulin resistance, it can
(20:00):
make it harder to lose weight. And so taking them at foreman, I've heard it described as
evening the playing field. So it takes down that barrier of weight loss. And so while
it's not going to suppress your appetite, it's not going to help with fullness. It's
going to make those lifestyle efforts that you're implementing more effective and and
(20:26):
like it would be if you did not have insulin resistance.
Right. Yeah. And I like that explanation as well to say, yeah, leveling the playing field.
It does, you know, it helps your body to get that balance out in terms of what it should
be doing naturally to support your hormonal balance there in terms of insulin release.
(20:48):
Yeah, yeah, for sure. And then are there a lot of times and you touched on this a little
bit earlier, where people think, well, you know, I reached my weight goal. So, you know,
I'm going to take this country for three months and hey, I'm at goal. So I can just go off
of it. Right. So what are your thoughts on long term use and why that should be supported?
(21:11):
Yeah, yeah, absolutely. This is one of the most common questions I get from patients
is how long do I need to take the medication? When we're first starting off, it can be a
little intimidating to start a new medicine. So I always emphasize, you know, if you're
having side effects, it's not working for you, we can always stop it. This is not something
(21:31):
that you're not you're signing a contract that you have to take it long term, you have
control over whether or not you take the medication. But if it is working for you, and you're going
to end your tolerating it well, then the my recommendation is to continue it long term,
because once you stop the medication, then those benefits that it was giving you are
(21:54):
going to go away. They don't stay in your system. After you stop the medicine, just
like any other medication that we use, like if we're using a blood pressure medication
and it's and it's controlling your blood pressure, when you stop the medication, your blood pressure
is going to go back up. So we see the same thing with weight management. I also share
that, you know, if somebody is taking other medications for chronic conditions that may
(22:18):
be weight related, even though they're going to take their weight medication long term,
they will likely be able to reduce or go off of their other medications, and ultimately
be taking less medication if their weight is managed.
Right. Yeah, that's true. That's a good point as well. And then, you know, another way to
(22:39):
think about it, there are even some medications that we prescribe, we have the example of
mental health medications that can actually promote weight gain. And so for someone, if
that was their reason, contributing factor to them gaining weight, then it would still
be helpful for them to continue their weight management medication as well long term so
(23:02):
that they can continue to manage their weight, which is also supportive of their mental health
too with that. So, so yeah, so folks, you know, listening, you just don't necessarily
have to go off of these medications. Now, there are lifestyle things that can help and
we know that and as you know, Dr. Lindsay spoke to that point of, you know, once you
(23:23):
do achieve certain goals within your health, which is also the point of helping with weight
loss to to help you achieve certain health goals. But then the lifestyle factors do come
into play as well in terms of helping you to reduce medication use and helping you to
stay at that goal that you achieved for a longer period of time as well. So tell us
(23:44):
about some of those lifestyle modifications that you typically recommend with the medication.
Yeah, absolutely. So the way that I view medications, and I like to explain this with my patients,
is that they're really a tool to help you implement those lifestyle changes. So the
medications can can take away or can make it potentially easier to implement those lifestyle
(24:09):
changes. But that is what really is going to help your health long term. And so and
I'm also somebody who really emphasizes the importance of small changes over time. So
I'm not going to push anybody to, you know, change their whole routine and their whole
diet and everything at once. I'm looking for sustainable changes that that they can
(24:32):
continue long term because again, we're looking big picture. But the things that we talk about
are nothing new. You've heard it before, but you've heard it because they're they're
effective. So as far as nutrition goes, focusing on whole food, limiting added sugars, making
sure you're getting enough fiber and protein to help you stay full and improve your gut
(24:55):
health, making sure that you're drinking plenty of water, being physically active, and I encourage
any activity that you enjoy. Because again, we're wanting to do this long term exercise
is is not punishment exercise is is for your health. And we do know that the people who
are able to maintain their weight loss long term, they are exercising on a very regular
(25:20):
basis on average of an hour most days per week, which sounds like a lot, but most of
these people are walking and so walking counts as exercise. So definitely just moving your
body is very helpful. And then sleep and stress. For a lot of people, these are the can be
the most difficult to to improve. So always talking about sleep hygiene to help get six
(25:45):
to nine hours, you know, depending on what is best for your body. And then stress, not
stress management can look different for everybody. But carving out some time for yourself and
doing something that you enjoy. It may also be mean working with a coach or a therapist,
someone that you can lean on and talk to building community around you friends and family, or
(26:09):
if you're involved in church, that's a great opportunity as well. So so all of those things
to help support you and your health journey. Yeah, yeah, for sure. Yeah, piggyback off
of that. One thing I like to tell people when they think about movement and exercise is
to think of it as intentional movement. Because I do think a lot of people equate exercise
(26:31):
to this chore, this, you know, punishment, like, oh, I gotta go exercise kind of thing,
you know, but think of it as intentional movement. So you're moving your body with intention
of achieving some type of goal. So whether that goal be you want to take one less blood
pressure medication, or you want to lower your blood sugar, you're moving your body
with the intention of that in mind. So like Dr. Lindsay said, do something that you enjoy,
(26:56):
whether it be going dancing, running a bicycle, walking, you know, what have you, but do that
activity with with intent. Even if it's, you know, saying I'm going to take the stairs
more often, we'll do that, you know, instead of getting on the people mover, moving with
intention. And I'm glad you touched on that stress and sleep piece as well. For the listeners,
(27:17):
I did a whole episode on how stress can affect your waistline. So you can take a listen to
that one. But it is it's just so important. And I think, you know, a lot of us don't tend
to realize that because, you know, we have people who are, you know, you're working every
day, you whether you have a spouse or partner, if you have a couple of kids, and life your
(27:38):
plate's full. And those factors can definitely compound and affect your weight and affect
your overall health. So managing that healthfully as well is just so important to achieving
and sustaining that goal for your weight and for your health. Okay, now, can you share
with us just one of your patient success stories that really illustrates just that comprehensive
(28:02):
approach or effective weight management?
Yeah, absolutely. So I have a patient, she's about in her early 60s, she started seeing
me January 2023. So it's been a little over a year and a half. She started gaining weight
and then post menopausal period and has really struggled with losing that weight that she
(28:25):
gained. He did end up starting a medication. But she also started exercising as well along
with that and focusing on her nutrition. As far as the exercise, it started off with with
walking. But as the weight started to come off, she was able to be more physically active
and then started doing pilates as well. And when I saw her a couple of months ago, she's
(28:49):
now doing ab exercises. So she's increased what she can do during this this period of
time, she's felt so much better. She's had her quality of life has drastically improved.
She's sleeping better, has more energy. She's becoming more connected with her community.
She's actually been working with advocacy groups to help get these weight medications
(29:11):
approved through insurance. And she's Yeah, and she's active on some Facebook groups giving
encouragement to others. So I'm just love love that patient story. Because like I said,
she's felt so much better. And it's really changed her quality of life. And she's hoping
to give back and help others.
Yeah, that's awesome. And you know, it does. I love the work, you know, that I do as well
(29:35):
in the field of obesity and metabolic health. Because it is it's so great to see people
improve their quality of life. And even just when you know, patients come and say, Oh,
I just feel amazing. I feel great. And it's not they're not even focused on saying, Oh,
you know, I feel I'm 150 pounds, but it's no, I feel great. You know, that number, you
(29:57):
know, that's there, but it's just, it's helped their overall their health and their wellness,
truly what it's about, you know, for us, while we even do this work. I know for me, especially
feels good. Yeah, yeah, absolutely. It feels amazing. Yeah. Yeah. All right, Dr. Lindsay.
So any other points you wanted to touch on before we wrap up today?
(30:21):
Yeah, I just want to empower patients to talk to their provider about their weight, if that
is a concern that they have. And if they're not getting the answers that they want, or
the guidance that they need, then it is okay to search for another provider, and maybe
look into someone who has been trained in obesity medicine. So you can get the tools
(30:45):
and the support that you need to improve your health.
Yeah, for sure. For sure. All right. And tell our audience how can they connect with you
more?
Yeah, so I am on Instagram, TikTok, and YouTube all under my name, Dr. Lindsay Ogle. And I
think that the links will be included. So you'll be able to find those. And then my
(31:10):
telehealth clinic in Missouri is called Missouri metabolic health. And the website is just
Missouri metabolic health.com. Okay. And so you're able to see folks all across the state
of Missouri, correct? Yeah. All right. Awesome. For sure. So listeners, we will definitely
put those links for Dr. Lindsay in the show notes. So if you are in the state of Missouri,
(31:30):
you can give Dr. Lindsay a call and get that support that you need. Well, thank you, Dr.
Lindsay, for coming on the show today.
Thank you so much for having me. This has been a pleasure.
Thank you for joining me today on the Essence of Health Tea Time podcast. Click the subscribe
button on your favorite podcast platform so that you never miss a moment of the Essence
(31:51):
of Health Tea Time podcast. Check out the show notes to obtain your free tips for Healthy
Living God to get you started on your health and wellness path. Follow me on social media
at Essence of Health Wellness Clinic on Facebook, Instagram, and YouTube and at doctor.tw at
(32:12):
eohwc on TikTok. Interested in becoming a member of the Essence of Health coaching program?
Well head on over to www.eohcoaching.com. The Essence of Health is in you.
Welcome to the Essence of Health Tea Time podcast. I am your host, Dr. Shayla Toons-Whithers.
(00:15):
As a double board certified family and obesity medicine physician with over 12 years of experience
in medicine, I teach motivated individuals how to achieve their desired quality of life
while preventing and reversing chronic diseases. It's tea time!
(00:37):
What part of your health journey is most challenging? Is it the actual effort of sticking to a plan?
The cooking and the meal planning? The exercise routine? Not enough time for everything you
think you need to do? Or the confusion of it all? If you said yes to any of these obstacles,
(00:58):
then keep listening to learn how you can smash these problems just by checking your email.
You check your email inbox every day already, but what if checking your inbox brought you
better health instead of the stress it sometimes can bring? Well, I have news for you. You
can improve your health, get a jump start on improving your health conditions, and start
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I'll also place these details in the show notes. The essence of health is in you. See
you in your inbox.
On today's episode of the Essence of Health Tea Time podcast, I have a special guest,
Dr. Lindsay Ogle. Dr. Ogle is a board certified family and obesity medicine physician who
is passionate about preventative health. Her goal is to help patients stay healthy so that
(02:31):
they may live longer and fuller lives. She recently started a telehealth clinic called
Missouri Metabolic Health, where she helps adults all throughout the state of Missouri
treat and prevent metabolic conditions like diabetes, fatty liver disease, metabolic syndrome,
and overweight and obesity. She does this through lifestyle optimization and utilization
(02:53):
of safe and effective medications. Welcome to the show, Dr. Lindsay. I'm excited to
have you join me today.
Thank you so much for having me here. I'm excited to talk with you and your audience.
Yeah, yeah. So first, before we even talk about weight loss and medications, just even
share with us why you went into the field of obesity medicine. What really motivated
(03:16):
you in terms of that field?
Yeah, absolutely. So I went into family medicine because, like you introduced, I have been
passionate about preventative health. And so that was always my goal was to help patients
become and stay healthy so they can live longer and fuller lives. And so I chose primary care.
(03:40):
And during my residency program, I was exposed to obesity medicine during some elective rotations
and worked with some really amazing doctors who introduced me into the field. And I was
able to see what a improvement in their patients' lives they were able to make. Their patients
were very happy when they were coming into the office and they were able to get off lots
(04:04):
of their medications, their blood pressure was improving, diabetes was better controlled,
cholesterol numbers were better. And like I said, yeah, able to stop other medications.
It was just really wonderful to see. And so I wanted to explore that more and then did
my own studies in obesity medicine and took the board exam last year.
(04:25):
Awesome, awesome. That's exciting. Yeah. And so even for you, what are some of the things
that you're even excited about that has even evolved over the years in the field of obesity?
Yeah, yeah. So obviously, I'm pretty new to the field, having taken the exam last year.
But even in a couple of years that I've been aware of it and involved in it, it's really
(04:51):
exploded in popularity, which I think is wonderful. So more patients are aware of this specialty
and are seeking care with obesity medicine specialists, which I think is very important,
especially because some of the newer medications are also exploding in popularity. And sometimes
(05:11):
they are prescribed without the appropriate guidance. And so when people are able to work
with a specialist, they are getting, I think, more well-rounded care that is going to actually
improve their health long term with those health focused goals, rather than just a goal
of reaching a number on a scale or a pant size or a particular BMI. I know that my colleagues
(05:37):
that are trained in obesity medicine are really focusing more on health related goals, which
I think is ultimately the most important. Yeah, I totally agree with you on that one.
As well, I finished my fellowship in obesity in 2018, so a little bit longer. But yeah,
I agree because even then there were still such stigma about obesity and about weight,
(06:00):
so much weight bias. But I think it is becoming more readily apparent that we're focusing
on those health measures and those health goals and not even so much what that particular
number looks like on the scale, but what that person, looking at that person as an individual
in their health status and helping them improve their health by managing the condition of
(06:22):
obesity that way. So yeah, I agree with you there. But it has been exciting just to see
the trends change over the years in obesity and just what that looks like and how we understand
it as a health condition. Yeah, absolutely. And you mentioned the bias
and obesity, and that's another thing I'm constantly seeing in our field is that we
are really focused on trying to mitigate and eliminate that bias, both with the terms that
(06:49):
we use as clinicians, but also with the advocacy work that is being done.
Yeah, yeah, for sure, which is good. I've met, and I'm sure you probably have too, a
lot of patients who said that for so long, they were afraid to go to the doctor because
every time they went, it was a negative type of connotation that was placed upon them and
(07:11):
a negative interaction. And so just making that more positive for people by having more
obesity medicine specialists in the field, I think has helped for sure.
Yeah, absolutely. Yeah. All right. And so in that same vein, we
know that there are many ways to promote weight loss, but we also know that obesity is a chronic
health condition. So even when weight loss does occur, so does weight regain on just
(07:37):
too many occasions for a lot of folks. And so this is really where that medication therapy
comes into place for individuals. Now we know that the GLP-1 medications have gained quite
the news press lately, but I feel like it's to a point where our other available medication
options have gotten forgotten or even dropped off, but they are still viable resources for
(08:01):
individuals. And so this is what we really want to talk about today is these other options
outside of the GLP-1 medications that are out there. So Dr. Lindsay, just tell us, what
are some of those available FDA approved medication options for treatment of obesity that are
not GLP-1 medications?
Yeah. So I think of four FDA approved medications. The first one, the main one in this category
(08:30):
is ventromine, but it's part of the sympathonimetic amines, but most commonly prescribed is ventromine.
Next on the list is QCMEA, then there's contrave, and then Orlistat. So those are the four main
FDA approved medications that I think of. And we can kind of go over how they work and
(08:53):
their effectiveness and who it may or may not be good for.
Yeah, that would be good. Yeah, just tell us even ones that you found to maybe show
the most promising results and then maybe a few factors that even determine what may
be a good choice for certain people.
Absolutely. So I'll start with ventromine. It is the one that has been around the longest.
(09:16):
So I think it was like around 1960 it was approved.
It's a nice and old drug.
Right, right. So we have a lot of data and decades of use to back up its effectiveness
and its safety. There are some people who are concerned about the safety because in
the past it was combined with another medication which that combination was proven to be unsafe.
(09:40):
But ventromine alone, we have been prescribing it for decades and it is safe to use for weight
management.
Dr. Lindsey is being nice. Finfin was the one folks that we do not use anymore and that
we do not want you to use either. So ventromine and not Finfin, they are two different drugs.
(10:01):
Right, right. So thank you for clearing up that confusion because it can be confusing.
Ventromine is a controlled substance. So it is a stimulant medication and that is something
to be aware of. So this is something that you do need to see typically an in-person
doctor for so they can check your vitals, your blood pressure, your heart rate and they
(10:24):
can monitor that over time because those are some of the side effects that we think of.
So making sure that it is not affecting your heart rate and your blood pressure. Even though
it is a stimulant, it is not one of our very strong stimulants. I typically compare it
more to a caffeine level of a stimulant rather than something like Adderall that we use for
(10:46):
ADHD. So most of my patients who can drink a couple or two of coffee in the morning can
tolerate ventromine. So that is more of what I am looking at for that comparison. But if
you do not tolerate caffeine, then maybe this one is not for you. Like I mentioned earlier,
there are some other medications in that class that we could try that may be better tolerated
(11:11):
which could be another reason to work with an obesity medicine specialist because we
are aware of those options. But the whole class as a whole really helps with appetite
suppression. So I use this for patients who are telling me I am just constantly hungry
every time I reduce my calories or go on a new nutrition plan. It is difficult to maintain
(11:33):
that because I am constantly hungry and this medication can really help with that appetite
suppression. I will say that there are a few states that limit the use to three months
at a time because that technically is what is FDA approved is a three month period of
(11:53):
ventromine. But us in the obesity medicine world who have been trained using this medication,
we know that it is best when it is used long term because once you stop the medication,
then the hunger comes back and weight regain can occur. So we typically use it longer term
when we are able to if we are not in one of those states that limit it.
(12:16):
Yeah, exactly. I am glad you pointed that out as well. Some of that stems from the old
thought that obesity was just a willpower disease and it was not a true health condition.
But now we know that that is not true. So yeah, these medications can be used long term
and can be safely for those who are under the care of an obesity medicine specialist
(12:41):
like yourself so that they can be closely monitored for safe use of these medicines.
And I feel like ventromine is pretty popular too because it is old. So I see a lot of people
who will come on ventromine but I also feel like a lot of people do not realize what ventromine
can do. So I am glad you pointed out those other potential side effects so that people
(13:03):
can be aware of that because sometimes people say, well, you can get ventromine on every
corner, every spa or whatever, but it should be monitored carefully.
Yeah, absolutely. And that makes me think of another benefit of it being older medication
is that it is very inexpensive. So if cost is a concern, if your insurance is not covering
(13:26):
weight loss medications, then ventromine is usually $10, $20 out of pocket.
Yeah, yeah, for sure.
If you're frustrated with your weight, taking more medications than you'd like to, have
been told that you are at risk for the development of a chronic preventable disease or just are
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(14:35):
of Health is in you.
So what else do you pull out of your pocket there?
Yeah, so next on the list, Acusemia is a brand name of a combination of ventromine and topiramate.
And so that combination of using two different medications makes it a little bit more effective
(14:58):
than the ventromine alone. And so the ventromine, I typically or we typically see a weight loss
of like seven, 10%. And then with Acusemia, it's a little bit more of like nine to 15%.
And these are averages, some people, you know, don't respond to them, some people will respond
more. But that's what we're kind of looking at. So we talked about the ventromine portion
(15:24):
of Acusemia, but the topiramate, that's a medication we use for lots of different reasons.
So we can use it for migraine prevention, we use it as an anti-seizure medication, it
can be a mood stabilizer at times, and it can help decrease alcohol cravings. There's
lots of things that we use it for. So if I have any patient who has those conditions
(15:47):
as well, or those goals, then Acusemia is a great option for them. One important thing
with Acusemia and topiramate specifically is that you do not want to take this medication
if you are pregnant or have the potential to become pregnant, because it can be associated
with birth defects. And really any of our anti obesity medications we do not want to
(16:09):
use during pregnancy, but specifically topiramate and Acusemia is there. So I kind of think
of it as like a next level to ventromine, and that's kind of how I use it for my patients.
Yeah, yeah, I agree. Yeah, it is. It can give folks just a little something extra there
in terms of their weight loss support as well. Yeah.
(16:34):
And then next is Contre. This is another combination medication of Wellbutrin and Naltrexone. And
these are other medications that we use for other reasons. So the Wellbutrin we use for
depression, it's a non-simulant ADHD medication. It is used for patients who are trying to
(16:55):
cut back or stop smoking. And then the Naltrexone, it's an anti opioid, meaning that it turns
off the opioid receptors. So that's important to know. So you cannot take opioids with this
medication. And we also often use it for people who are trying to cut back or stop alcohol
use. So again, if my patients have these conditions or goals, this is a great option. And combined,
(17:22):
they really help with like emotional eating. That's what I see the benefit for my patients.
So people who, when they're really stressed, they turn to food to help manage that stress.
The Contre can be helpful in those situations. Of course, I'm working with like a coach and
a therapist along with that for help creating better alternative coping mechanisms for stress
(17:47):
management can be helpful, but the medication can really help augment that as well.
Yeah. Yeah. I also like Contre and folks who tend to have a lot of cravings because we
know the bupropion and the Naltrexone, the way that they hit within the brain receptors
as well to help for those cravings. So I tend to use it as well in those types of individuals
(18:10):
who, you know, I just can't help but eat that ice cream bar or whatever it is. I'm going
to need some support there. Yeah. Yeah, absolutely. Absolutely. Yeah. Yeah. Well, thank you for
sharing those with us. And something else to just touch base on, I think a lot of people
don't realize is that these oral options, they actually come from very old medications.
(18:34):
The medications that we use for years that were then combined to create some of these
weight loss medications for the FDA indication for just for weight loss. But for listeners,
you can still feel comfortable from a safety perspective because these medications, even
as individuals have been used for so long too.
(18:56):
Yeah, yeah, absolutely. And that also brings up a thought is that I often if a patient's
insurance does not cover these medications, then I often prescribe them individually.
As you mentioned how they've been coming for a long time. So that is an option as well
(19:16):
for a more affordable half. Right. Yeah, for sure. The same as well, because
yeah, you can generically just break them up, you know, it's more feels to take. Yeah,
but it is more affordable by breaking them up that way as well. And so Dr. Lindsay, what
are some of the other medicines that may not necessarily be just FDA indicated for obesity
(19:40):
treatment, but can also promote weight loss? Yeah, so the first one I think of is metformin.
This is something that we use often. It's a type two diabetes medication. So it can
help with anybody who has insulin resistance. So if you have insulin resistance, it can
(20:00):
make it harder to lose weight. And so taking them at foreman, I've heard it described as
evening the playing field. So it takes down that barrier of weight loss. And so while
it's not going to suppress your appetite, it's not going to help with fullness. It's
going to make those lifestyle efforts that you're implementing more effective and and
(20:26):
like it would be if you did not have insulin resistance.
Right. Yeah. And I like that explanation as well to say, yeah, leveling the playing field.
It does, you know, it helps your body to get that balance out in terms of what it should
be doing naturally to support your hormonal balance there in terms of insulin release.
(20:48):
Yeah, yeah, for sure. And then are there a lot of times and you touched on this a little
bit earlier, where people think, well, you know, I reached my weight goal. So, you know,
I'm going to take this country for three months and hey, I'm at goal. So I can just go off
of it. Right. So what are your thoughts on long term use and why that should be supported?
(21:11):
Yeah, yeah, absolutely. This is one of the most common questions I get from patients
is how long do I need to take the medication? When we're first starting off, it can be a
little intimidating to start a new medicine. So I always emphasize, you know, if you're
having side effects, it's not working for you, we can always stop it. This is not something
(21:31):
that you're not you're signing a contract that you have to take it long term, you have
control over whether or not you take the medication. But if it is working for you, and you're going
to end your tolerating it well, then the my recommendation is to continue it long term,
because once you stop the medication, then those benefits that it was giving you are
(21:54):
going to go away. They don't stay in your system. After you stop the medicine, just
like any other medication that we use, like if we're using a blood pressure medication
and it's and it's controlling your blood pressure, when you stop the medication, your blood pressure
is going to go back up. So we see the same thing with weight management. I also share
that, you know, if somebody is taking other medications for chronic conditions that may
(22:18):
be weight related, even though they're going to take their weight medication long term,
they will likely be able to reduce or go off of their other medications, and ultimately
be taking less medication if their weight is managed.
Right. Yeah, that's true. That's a good point as well. And then, you know, another way to
(22:39):
think about it, there are even some medications that we prescribe, we have the example of
mental health medications that can actually promote weight gain. And so for someone, if
that was their reason, contributing factor to them gaining weight, then it would still
be helpful for them to continue their weight management medication as well long term so
(23:02):
that they can continue to manage their weight, which is also supportive of their mental health
too with that. So, so yeah, so folks, you know, listening, you just don't necessarily
have to go off of these medications. Now, there are lifestyle things that can help and
we know that and as you know, Dr. Lindsay spoke to that point of, you know, once you
(23:23):
do achieve certain goals within your health, which is also the point of helping with weight
loss to to help you achieve certain health goals. But then the lifestyle factors do come
into play as well in terms of helping you to reduce medication use and helping you to
stay at that goal that you achieved for a longer period of time as well. So tell us
(23:44):
about some of those lifestyle modifications that you typically recommend with the medication.
Yeah, absolutely. So the way that I view medications, and I like to explain this with my patients,
is that they're really a tool to help you implement those lifestyle changes. So the
medications can can take away or can make it potentially easier to implement those lifestyle
(24:09):
changes. But that is what really is going to help your health long term. And so and
I'm also somebody who really emphasizes the importance of small changes over time. So
I'm not going to push anybody to, you know, change their whole routine and their whole
diet and everything at once. I'm looking for sustainable changes that that they can
(24:32):
continue long term because again, we're looking big picture. But the things that we talk about
are nothing new. You've heard it before, but you've heard it because they're they're
effective. So as far as nutrition goes, focusing on whole food, limiting added sugars, making
sure you're getting enough fiber and protein to help you stay full and improve your gut
(24:55):
health, making sure that you're drinking plenty of water, being physically active, and I encourage
any activity that you enjoy. Because again, we're wanting to do this long term exercise
is is not punishment exercise is is for your health. And we do know that the people who
are able to maintain their weight loss long term, they are exercising on a very regular
(25:20):
basis on average of an hour most days per week, which sounds like a lot, but most of
these people are walking and so walking counts as exercise. So definitely just moving your
body is very helpful. And then sleep and stress. For a lot of people, these are the can be
the most difficult to to improve. So always talking about sleep hygiene to help get six
(25:45):
to nine hours, you know, depending on what is best for your body. And then stress, not
stress management can look different for everybody. But carving out some time for yourself and
doing something that you enjoy. It may also be mean working with a coach or a therapist,
someone that you can lean on and talk to building community around you friends and family, or
(26:09):
if you're involved in church, that's a great opportunity as well. So so all of those things
to help support you and your health journey. Yeah, yeah, for sure. Yeah, piggyback off
of that. One thing I like to tell people when they think about movement and exercise is
to think of it as intentional movement. Because I do think a lot of people equate exercise
(26:31):
to this chore, this, you know, punishment, like, oh, I gotta go exercise kind of thing,
you know, but think of it as intentional movement. So you're moving your body with intention
of achieving some type of goal. So whether that goal be you want to take one less blood
pressure medication, or you want to lower your blood sugar, you're moving your body
with the intention of that in mind. So like Dr. Lindsay said, do something that you enjoy,
(26:56):
whether it be going dancing, running a bicycle, walking, you know, what have you, but do that
activity with with intent. Even if it's, you know, saying I'm going to take the stairs
more often, we'll do that, you know, instead of getting on the people mover, moving with
intention. And I'm glad you touched on that stress and sleep piece as well. For the listeners,
(27:17):
I did a whole episode on how stress can affect your waistline. So you can take a listen to
that one. But it is it's just so important. And I think, you know, a lot of us don't tend
to realize that because, you know, we have people who are, you know, you're working every
day, you whether you have a spouse or partner, if you have a couple of kids, and life your
(27:38):
plate's full. And those factors can definitely compound and affect your weight and affect
your overall health. So managing that healthfully as well is just so important to achieving
and sustaining that goal for your weight and for your health. Okay, now, can you share
with us just one of your patient success stories that really illustrates just that comprehensive
(28:02):
approach or effective weight management?
Yeah, absolutely. So I have a patient, she's about in her early 60s, she started seeing
me January 2023. So it's been a little over a year and a half. She started gaining weight
and then post menopausal period and has really struggled with losing that weight that she
(28:25):
gained. He did end up starting a medication. But she also started exercising as well along
with that and focusing on her nutrition. As far as the exercise, it started off with with
walking. But as the weight started to come off, she was able to be more physically active
and then started doing pilates as well. And when I saw her a couple of months ago, she's
(28:49):
now doing ab exercises. So she's increased what she can do during this this period of
time, she's felt so much better. She's had her quality of life has drastically improved.
She's sleeping better, has more energy. She's becoming more connected with her community.
She's actually been working with advocacy groups to help get these weight medications
(29:11):
approved through insurance. And she's Yeah, and she's active on some Facebook groups giving
encouragement to others. So I'm just love love that patient story. Because like I said,
she's felt so much better. And it's really changed her quality of life. And she's hoping
to give back and help others.
Yeah, that's awesome. And you know, it does. I love the work, you know, that I do as well
(29:35):
in the field of obesity and metabolic health. Because it is it's so great to see people
improve their quality of life. And even just when you know, patients come and say, Oh,
I just feel amazing. I feel great. And it's not they're not even focused on saying, Oh,
you know, I feel I'm 150 pounds, but it's no, I feel great. You know, that number, you
(29:57):
know, that's there, but it's just, it's helped their overall their health and their wellness,
truly what it's about, you know, for us, while we even do this work. I know for me, especially
feels good. Yeah, yeah, absolutely. It feels amazing. Yeah. Yeah. All right, Dr. Lindsay.
So any other points you wanted to touch on before we wrap up today?
(30:21):
Yeah, I just want to empower patients to talk to their provider about their weight, if that
is a concern that they have. And if they're not getting the answers that they want, or
the guidance that they need, then it is okay to search for another provider, and maybe
look into someone who has been trained in obesity medicine. So you can get the tools
(30:45):
and the support that you need to improve your health.
Yeah, for sure. For sure. All right. And tell our audience how can they connect with you
more?
Yeah, so I am on Instagram, TikTok, and YouTube all under my name, Dr. Lindsay Ogle. And I
think that the links will be included. So you'll be able to find those. And then my
(31:10):
telehealth clinic in Missouri is called Missouri metabolic health. And the website is just
Missouri metabolic health.com. Okay. And so you're able to see folks all across the state
of Missouri, correct? Yeah. All right. Awesome. For sure. So listeners, we will definitely
put those links for Dr. Lindsay in the show notes. So if you are in the state of Missouri,
(31:30):
you can give Dr. Lindsay a call and get that support that you need. Well, thank you, Dr.
Lindsay, for coming on the show today.
Thank you so much for having me. This has been a pleasure.
Thank you for joining me today on the Essence of Health Tea Time podcast. Click the subscribe
button on your favorite podcast platform so that you never miss a moment of the Essence
(31:51):
of Health Tea Time podcast. Check out the show notes to obtain your free tips for Healthy
Living God to get you started on your health and wellness path. Follow me on social media
at Essence of Health Wellness Clinic on Facebook, Instagram, and YouTube and at doctor.tw at
(32:12):
eohwc on TikTok. Interested in becoming a member of the Essence of Health coaching program?
Well head on over to www.eohcoaching.com. The Essence of Health is in you.
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