October 3, 2024 • 27 mins
Discover the truth behind weight loss myths and misconceptions with the insightful Dr. Vahid Yeganeh from Healthy Conditions. With half of Americans striving to lose weight each year, Dr. Yeganeh shares his expertise on cutting through the clutter of misinformation, particularly on social media. Get ready to learn the significance of evidence-based strategies, the energy balance theory, and how oversimplified solutions can mislead those on their weight loss journey. Dr. Yeganeh provides a comprehensive look at the complexities of obesity and the importance of making informed choices for lasting health.
We also take a closer look at the fascinating world of weight loss medications like Ozempic, Wegovy, and Tirzepatide, which are making headlines for their effectiveness against type 2 diabetes and obesity. Dr. Yeganeh discusses their benefits, including potential cardiovascular advantages, while also addressing their high cost, limited availability, and the risk of misuse. Understand why resistance training is crucial to preserving lean muscle mass during weight loss, and why these medications shouldn't be a quick fix for those with minor weight concerns. Responsible use and personalized treatment plans are key.
Finally, we explore the seductive yet dangerous allure of fad diets such as the ketogenic, detox, and carnivore diets. Dr. Yeganeh sheds light on the potential pitfalls of these diets, including micronutrient deficiencies and cardiovascular risks. He advocates for sustainable and individualized dietary patterns, encouraging a healthy relationship with food by focusing on fiber, whole foods, and balanced lifestyle factors like sleep and stress management. Join us as we uncover the path to achieving lasting health benefits through thoughtful, evidence-based choices and sustainable lifestyle changes.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
This is the Good Neighbor Podcast North Atlanta,
where local businesses andneighbors come together.
Here's your host, stacey Risley.
Speaker 2 (00:11):
Hello friends and neighbors, welcome to North
Atlanta's Good Neighbor Podcast.
Today we have Dr Vahid Yaganawith Healthy Conditions, which
is a concierge lifestylemedicine clinic in Buckhead.
He is back with us today.
He is our expert contributorfor both Dunwoody Neighbors and
(00:31):
North Buckhead Neighborsmagazines and he's here today to
discuss one of his most recentexpert article, which is on
surrounding the topic of weightloss and myths, medications and
making informed choices.
Welcome, dr Vahid, I'm so happyto have you back.
Thank you, thank you for havingme back.
(00:52):
We're glad to have you.
This is such a topic that somany people affect so many
people that I think one of thestats that you had in the
article was that 50% ofAmericans report, you know,
trying to lose weight every year.
So that's a huge number Most ofus, really.
(01:16):
So I'm glad that you're here todiscuss this topic and really
going to let you kind of take itaway.
Speaker 3 (01:24):
Yeah, sure, Kind of like you said, it's definitely
something that's on the front ofmost people's minds at some
point in the year, at some pointin their life.
So you can imagine it comes upquite a bit in my day-to-day.
Being an obesity physician,that's kind of part of what I do
anyway.
But even if that weren't thecase, I feel that just in
(01:44):
general primary care, that'skind of part of what I do anyway
.
But even if that weren't thecase, I feel that in just in
general primary care, it'sprobably one of the concerns
that comes up quite a bit, andso that's why I chose that topic
for the article.
I feel like it's something thateverybody can maybe glean a
little bit of information from.
These days we have a lot ofmisinformation out there,
especially on social media, andso it gets difficult to separate
(02:08):
fact from fiction.
What, you know, what isactually going to benefit me and
I think there is unfortunatelyprobably not intentionally, but
there's a lot of harmfulinformation.
So that was another goal ofthis article was to just briefly
touch on a few things and makesure that folks are, you know,
approaching this from an anglethat keeps them safe and, you
(02:29):
know, looks at things morecomprehensively.
Speaker 2 (02:31):
Yeah, and that's really important.
I like what you said in thearticle about you know everyone
thinks they're an expert youknow, and this is a subject
that's it's dangerous to topretend that you are more
knowledgeable than you are oryou know, you think that someone
you know there's a TikTok videoabout this bad guy I mean,
(02:52):
that's really dangerous with,especially with so many people
you know looking for that quickfix and, you know, without
really knowing how this affectsyour body and long-term health
risks.
Speaker 3 (03:07):
You can imagine that, with it being such a popular
topic and a very common painpoint, if you're someone who's
trying to sell a product or aservice, that's an easy sell
right.
You just pick on a thing thatis on most people's minds and
you offer a very simple solution.
That's an easy sell right.
You just pick on a thing thatis on most people's minds and
you offer a very simple solutionthat's going to solve all their
(03:30):
problems.
And so, again, I don't thinkfolks are intentionally trying
to be harmful.
You know, I want to be clearabout that.
I think the vast majority ofpeople are trying to help, maybe
sell their product or service,but what ends up happening is
some of this information is waytoo reductionist and folks take
it to heart and they apply it intheir lives, you know, without
(03:52):
even thinking twice about it.
So, yeah, that's kind of whereit gets dangerous.
I don't think anybody'sactually trying to harm anyone,
but it does happen, yeah.
Speaker 2 (04:00):
Yeah, for sure.
Well, and so you talked aboutin the article, you know, energy
balance and weight loss in thecontext of overall health.
You know, before we kind of getinto some of the myths and pros
and cons of medications and allof that, what?
What do you mean that when yousay in context of overall health
(04:22):
?
Speaker 3 (04:27):
when you say in context of overall health, yeah,
so the energy balance theory sosome folks might know it as
CICO or CICO, which is caloriesin calories out right, it is a
very kind of simplified way oflooking at it, because I can
tell you that overweight,obesity, this whole field is
very, very complex.
Every case is a little bitdifferent.
You know you've seen 10 casesthere.
You've seen 10 different cases,right, but I think it's
(04:50):
important to remember that ifyou're looking at the data and
you know I always recommend, ifyou're going to get health
advice or do anything with yourhealth, make sure it's backed by
robust, you know, scientificevidence.
That's step one.
And so, if we're looking atevidence-based medicine, this
theory does hold true thatcalories being expended so the
(05:12):
calories that we use and thecalories that we're bringing
into our body if there is asurplus or a deficit, we are
going to see changes in weight.
And really I think about it as asuperpower.
It's part of our ability tosurvive is the ability to store
energy.
I mean, if we weren't able todo that in our history as being
(05:33):
humans, we wouldn't havesurvived because for the vast
majority of our time on Earth,we were in a food scarce
environment and so being able tostore energy in the form of fat
, I consider that a superpower.
What's happening today is thefood environment is different.
You know, at least in ourcultures here in developed
countries, we have, you know,not just you know access to food
(05:57):
, it's just the type, thequality.
All of that impacts it.
So the energy balance theorydoes hold true, I you know.
The caveat with that is thatthe quality of things does
matter.
But overall, if you equatedcalories across different
dietary patterns and you werejust looking at weight loss,
(06:18):
yeah, there wouldn't be anysignificant difference between
them, as long as the calorieswere equated.
Now those dietary patterns canbe very different in how easy it
is to adhere to them and howthey impact your overall
metabolic health, and then wecan get into the weeds on that
stuff.
But yeah, overall, that's whatI mean by the energy balance
theory and that does still holdtrue.
Speaker 2 (06:36):
Yeah, and you mentioned in the article too,
that taking in a certain amountof calories in the form of candy
is going to be obviously verydifferent than than if you're
eating nutrient rich foods thevegetables and different things.
So well, let's go ahead anddebunk these outdated myths that
people just need to to forgetor ever ever thought to be true
(07:01):
by anyone.
Speaker 3 (07:02):
Yeah, um, I I mentioned two in the article.
There's a lot.
There's not a lot of room forme to go on and on and on, as I
tend to, as you well know, but Ithink these two because they
come up often, and so I thoughtlet's stick with the two that
come up pretty frequently.
The first one I mentioned isthat losing weight is only about
(07:24):
willpower.
Honestly, if it was, more peoplewould have success, right, and
I would probably expand that,extrapolate to anything you're
trying to do.
If it was just about willpower,not just weight loss, then
you'd be more likely to succeed,because at some point we all
have quite a bit of willpower todo things.
(07:44):
We have this energy, thisenthusiasm, this motivation.
It is not the case.
There are so many factors atplay.
Everybody's physiology is alittle bit different.
You know the different hormonesthat are up or down in our
bodies, the way we respond tofood, how easily we are satiated
by our food food, how easily weare satiated by our food.
(08:06):
There's so many factors that gointo what food environment are
we in, what work do we conductduring the day, what our
relationships are like.
The list goes on and on.
It is not just about willpower,and why I mentioned it here is
because I feel like there's alot of shaming that goes on
still.
There's still this sort ofthought that, oh well, if you
(08:27):
could only just eat less andmove more.
You know it's up to you.
You are making this choice tobe overweight or to be obese,
right, and I think that's really, really harmful and it's, quite
frankly, very inaccurate aswell for most people, and that's
why I mentioned I think, thatthat's something that everybody
(08:47):
needs to get really clear thatit is not just about willpower.
The second myth is this one Icould probably write a book on
this one, Maybe I should Is thatcarbs are bad for you.
So I, you know, okay,Throughout, you know throughout
at least our lives, if you thinkas far back as you want.
There's always been differentdiets, different things, and you
(09:09):
know carbohydrates being badfor you is something that keeps
popping up.
You know, you think back tothings like the Atkins diet and
whatnot.
That's exactly what popped intomy mind.
Speaker 1 (09:19):
Is it yeah, when I think of that.
Speaker 3 (09:21):
yeah, Today you could think of maybe keto is like the
new version of that stricterversion of that and it's not
true.
Carbs are not all carbs are badfor you.
The quality of thecarbohydrates are what makes the
difference.
I mean if you think about howbeneficial fiber is, and fiber
is a component of carbohydratefoods right, or the carbohydrate
(09:43):
macronutrient, and focusing onthe quality makes all the
difference.
Whether we're talking about yourmetabolic health, you know so
things like blood sugar, buteven when we're thinking about
things like, you know, surplusenergy, and these processed
foods do wreak havoc on our body.
So processed, highly refined,processed carbohydrates are not
(10:04):
the same thing as whole,unprocessed carbohydrates,
things like whole grains,legumes, fruits, vegetables all
these are wonderful for you.
Those are the two myths that Iwould say it's important to
distinguish.
Yeah, yeah.
Speaker 2 (10:20):
Well, so now the next portion of the article really
got into the pros and cons ofusing medications to help aid in
weight loss.
Do you want to touch on those?
For sure, I think that that Ithink a lot of people want to
turn to medication, I think, forbefore they try other things a
(10:40):
lot you know, they um they wanta quick fix, a pill that's going
to fix everything.
you know, so I can know thatthat can be dangerous and I
would think, in a weight losscapacity to you know, that that
could be something that wedefinitely want to caution folks
about.
Speaker 3 (10:56):
but whatever, I'll say a few things about.
You know again, very um.
We can go into the weeds onthis but you know, just on the
surface, important things aboutum medications that are
currently in the market that aregetting a lot of media
attention.
So we're talking specificallyabout the glp-1 agonist, the git
agonist.
So these would be like um azampic wegovi they're the same
(11:19):
drug, just different fdaapprovals and um terzapatide,
which is man Manjaro or Zepboundit's the sort of the weight
loss FDA approved name.
These are wonderful medications.
Now I'll say I don't have anyemotions around these things,
right?
So for me it's just the fact,and these medications can be
life changing.
(11:39):
They definitely have been gamechanging in the medical world
when it comes to type twodiabetes, when it comes to
overweight and obesity.
So they've definitely changedthe game and, as far as what has
been available, these tend tobe the safest and quote-unquote
cleanest options that we have,at least in the history of
medications that have been usedfor overweight and obesity.
(12:02):
Are they for everybody?
No, there's definitely.
You know cases where it's notgoing to be the right fit, and I
think that's where we startgetting into problems.
So I guess the pros here wouldbe that they're generally really
well tolerated.
The most common side effectstend to be gastrointestinal, you
know might have some stomachupset, maybe a little bit of
heartburn, so you can have thatbecome severe too, right?
(12:25):
Some folks have a bit moreviolent vomiting, typically if
they already have a slowmovement in their intestine.
But anyhow, that's somethingthat you know can be managed and
individualized.
Other pros of these medicationsis, as they study them, they're
noticing that there might becardiovascular benefits to using
these.
So there's interesting researchgoing on about the use of these
(12:48):
medications.
In case you're wondering, we'vebeen using that class of
medication probably since theearly 2000s for type 2 diabetes.
Speaker 2 (12:54):
I was about to ask that there was a big, I know, in
the late 90s.
You know there was a lot ofpeople taking and I'm not going
to remember the name of it.
You may know.
Speaker 3 (13:08):
We've had quite a few medications and a lot of them
no longer exist on the marketbecause we still have things
like Fenterman or combinationswith Fenterman that are, you
know, in the right case, arestill used fairly widely.
But, yeah, so these, thisparticular class, you know the
Ozempic, wegovy class ofmedications we started those
(13:30):
about around the early 2000s andthen that's kind of evolved.
I think Ozempic probably came alittle bit later than that,
maybe later in the 2010s, maybea little, I don't know exactly
when and we've used them, uh,you know, with pretty good uh
safety profiles, uh, across theboard, the cons, okay.
So this is the part where Iwant to just touch base um, they
(13:52):
are very expensive.
Not all insurances cover them,so that's something to consider.
Uh, we also don't have easyaccess to them, necessarily,
because they are so popular theycan't keep them stocked on the
shelves, right?
So, um, people need to be uh,running around shopping around.
Okay, I need to make sure theydon't I don't miss my next dose,
because then everything kind ofum goes backwards.
(14:15):
So that there's that.
I think that can be addressed.
Um, the the concern I mostlyhave is there have been a lot of
I guess I don't want todisparage anybody's work, but
there have been a lot ofopportunities.
There are a lot ofopportunities for you to just
get these medications prescribedto you without a whole lot of
(14:38):
evaluation.
I mean, you can even get themonline or a lot of places that
have popped up.
Yeah, they'll give you thecompounded versions.
They're happy to charge you forthem and the compounded
versions are cheaper than theFDA approved versions.
They are not FDA approved.
I personally don't recommendthem.
Again, it's science, it's data.
(14:59):
I look at it, you know, as thatposition evolves.
If the medical communitychanges their position on that,
then I'll change mine if I'mpresented with new data.
But currently I don't.
I don't send my patients to getthe compounded version.
I guess that would tell youkind of where I sit on that
argument.
And so there's been a lot ofunscrupulous use.
So folks that maybe weren'tgood candidates for these
(15:23):
medications are getting to usethem and unfortunately then they
get into problems such asbecoming malnourished or just
losing a whole lot of musclemass, because you're not just
losing fat, you're also losingmuscle if you don't do something
to mitigate that right.
And so, along with thesemedications, it's important to
be doing things like resistancetraining to preserve as much
(15:44):
muscle mass as you can while youthe peripheral fat or the
surplus fat that's on your body.
But because it takes awayhunger, so it will make you feel
full faster.
It will make you feel lesshungry.
If it's someone who said youknow what.
I just want to lose 10 pounds,these last 10 pounds, I'm going
(16:04):
to go take this medication.
I don't think that's necessarilythe best scenario, because you
can fall into this position ofnow being malnourished.
So I say all of that.
You know it is complex, it hasto be individualized.
I will end my kind of commentson these medications by saying
that it is not an easy way outeither.
(16:25):
I think that's important toclarify.
Some folks, this will changetheir life.
This will give them a new leaseon life and they have tried
everything.
They have done all those thingsthat you think that they
haven't tried and nothing wasworking, and this just changed
their life.
I don't think there's any shamein that.
I don't think it's a quick fixfor people and I think that
(16:48):
they're very viable medicationsin the right context for the
right patient.
Speaker 2 (16:51):
Well, and I love hearing you say that there are,
you know, some cardiovascular,there's some, you know, data
pointing that there arecardiovascular benefits, you
know, to these medications, youknow, helping with blood sugar
levels and different things.
So you know that they aren'tjust suppressing your appetite
but they're also benefiting youin other ways, you know.
(17:12):
So that shows a lot to how muchthese medications have evolved,
you know, and that someone suchas yourself would recommend
them, so that you know, incertain situations, not everyone
so I think that that does say alot to our medical community
that they've come a long waysince they first were released
(17:34):
for those purposes.
But let's touch on the faddiets and I know that there are
probably a ton more especiallythe really the short lived fads
that you can, you can find on onany social media platform,
probably super easily.
But if they're, you know which,which are the ones that you
(17:56):
want to kind of really steerpeople away from.
Speaker 3 (18:01):
Yeah, I mean I'll just say something about.
I picked three for this articlethe ketogenic diet, detox diets
and the carnivore diet.
I just picked them becausethose are the ones that I get
asked about most often.
I don't know that I'm going tosit here and say everybody needs
to steer clear.
Again, I don't really have alot of emotions around these
things.
It's my job to provide thefacts and make my
(18:26):
recommendations to my ownpatients.
So, since we're just having aconversation, you know, if
someone came and sat in myoffice it might be a different
conversation, obviously.
But I will say what I thinkabout them and take that with a
grain of salt.
You know, do with thatinformation what you will, right
, so it is big.
So earlier, you know, Imentioned the Atkins diet.
So the keto diet really is kindof a evolved if you could use
(18:49):
that term a more restrictedversion of an Atkins diet.
Basically, what's going on isyou are having a lot of fat and
you're having very, very, verylittle carbohydrate and the idea
is that you're going to keepyour body in ketosis or using
ketones for energy.
The issue that we run into withthe keto diet or at least
(19:12):
anecdotally what I have run intowith folks that I see in the
office that have been on it orare currently on it is one there
is a tendency to becomedeficient in certain
micronutrients, vitamins,minerals, that sort of thing,
because, if you think about it,it's a restrictive diet, so
you're restricting a whole lotof stuff and you're restricting
a lot of good stuff.
(19:33):
You know, earlier I mentionedhow carbs are not all bad for
you, so you're really cuttingout a whole bunch of fiber.
Fiber only exists in plantfoods, by the way.
It doesn't exist in other foodsthat are not plant foods, so
you are taking away things thatare good for you from your diet.
So that's one issue I have withthe keto diet.
Two, it is very strict.
(19:53):
Therefore, it's not sustainablefor the vast, vast majority of
people, I have yet to meetsomeone that has been able to
sustain a ketogenic diet.
And then, thirdly and finally,on the keto diet, because you
are having such a high ingestionof fats, it can affect your
cholesterol levels, right?
So you can run into trouble.
As far as cardiovascular eventrisk right, your risk for heart
(20:15):
attacks and strokes and thatsort of thing I'll move off of
the keto diet in case anyonethat's listening is on it.
I don't want to upset anybodytoo much, but I'll move to detox
the detox diet.
So here's the bottom line.
On detoxing your body isamazing.
(20:36):
Your liver detoxes your body,or everything that goes to your
body.
That's one of the functions.
The liver does a lot of things,but one of the things is it
detoxes, it deals with toxins,and so these dyes typically they
are they tend to be just liquid.
You know I'm going to go onthis.
You know, detox for a week ortwo weeks and whatnot.
(20:57):
Again, we fall into this realmof now maybe we're we're not
consuming enough calories, orwe're not consuming enough
variety of nutrients, and so Ithink that we can end up in a
situation that can be harmful aswell.
So that's why I'm not a big fan.
I don't think they're necessary.
There's absolutely no robustscientific evidence to back up
(21:20):
their use, no matter what yourfavorite TikTok influencer says.
And I'm like you know, I'm ascientist.
If tomorrow the data comes out,I will change my tune and I
will prescribe them.
So I have no issue, you knowdoing that.
Next I'll talk about thecarnivore diet.
You know I'm, you know I'm abig sort of I promote a whole
(21:41):
food, plant-based diet.
So the carnivore diet, youwould think, is sort of like the
polar opposite.
Honestly, even the folks thatare promoting the carnivore diet
, I think they'rewell-intentioned and I feel like
they probably have sensed somebenefit, because you are
essentially eliminating a lot ofthings for your diet from your
diet when you do the carnivorediet, and so by eliminating so
(22:03):
many things, a lot of the thingsthey eliminated might have been
causing inflammatory issues andall kinds of issues.
So you might actually feel abenefit to some of these.
But, same thing, veryrestrictive.
Now you're cutting out prettymuch all fiber.
So we run into issues in termsof risk for cancers like
colorectal cancer.
We also run into issues withheart attacks and strokes
because now you're increasingyour saturated fat intake, which
(22:25):
there's robust evidence to linkit to these events increased
saturated fat in your diet.
So that's my issue with that.
And by decreasing fiber, notonly are you increasing your
risk for colorectal cancer, butyour blood sugar gets impacted.
All kinds of intestinal issuescan pop up.
So again, I'm not saying do ordon't do, I'm just saying those
(22:49):
are the facts as I know them.
As the data evolves, you know,I'll reevaluate these things,
but I will add to that I didn'tput this in the article.
I don't think there's a magicaldiet out there that works for
everybody.
I think there are things thatgenerally should be consumed.
You know, we should have a goodamount of fiber in our diet, we
should be careful aroundsaturated fat, we should stay
(23:10):
away from processed foods.
But I don't think there's onemagic pill out there.
I think cases need to beindividualized and we need to
think about what dietary patternis sustainable for you, you
know, because a lot of these faddiets are not sustainable.
Speaker 2 (23:24):
And I think that that's the key, you know,
finding something that issustainable, that's something
that you're able to implementand, you know, become something
that you can live by, ratherthan it being a diet, so so to
speak, you know.
So speak to that for a minute,Dr Fahid.
Speaker 3 (23:49):
Yeah, absolutely so.
My approach, and one that Irecommend, is to look at weight
loss from a wider angle.
Right Is not to just look at itin a vacuum as all I'm
interested in losing weight.
No, we have to think abouteverything that goes into that
how we're sleeping, how we'removing, the relationships we're
in, do we have any level ofchronic stress All of these
(24:10):
things impact our weight, ourhealth in general, but our
weight, you know, or if we areof a weight of these or
struggling with any of thoseconditions, this is impacted as
well.
So I would look at those things.
I would think about nurturing myrelationships and, speaking of
relationships, nurturing yourrelationship with food forward
(24:43):
into a healthier future foryourself.
You need to really look at foodas the nourishment that it is,
and not this evil thing that, oh, you know, oh, I misbehaved, I
ate such food or such and suchfood, or or oh, I was really
good, I deserve X, y, z.
I feel like those are verybroken relationships with food
where we need to just look atthis is.
This is nourishment, this ishealing my body, this is I need
to eat.
You know you can't just restrictyourself from all food and
(25:04):
focus on just one one parameter.
So there's a lot that goes intoit.
You know, like I said, allthese different pillars of
health and sleep is a big one.
You know, looking at how you'resleeping and when you look at
it in that sort of comprehensiveway, I feel like it becomes
more and more real that this canbe sustainable.
Maybe I can actually dosomething different, because you
(25:27):
know those of us that havetried to lose weight.
You know it's not the firsttime.
We've probably done this foryears and years and years and
kind of cycled and yo-yoed backand forth, and the idea is to
break that cycle and moveforward in a way that that is
sustainable.
Speaker 2 (25:41):
Yeah, and I just want to in a way that is sustainable
.
Yeah, and I just want toreiterate one thing that you
said that people have a brokenrelationship with food and to
use food as a reward to yourselfor to restrict yourself.
Oh, I was so bad when I didn'teat that.
That really does.
(26:02):
We've had that all of our life.
We've heard that you getrewarded with dessert as a kid.
Speaker 1 (26:12):
It's a part of our culture.
Speaker 2 (26:13):
Yeah, it really is.
I guess when you said fixingrelationships and you're working
on the relationships in yourlife, it's a relationship with
food.
It's really at the root of itall, I guess.
Well, thank you so much, andyou talked about the importance
of sleep and maybe that could bea future article, that we, that
(26:36):
we do a sleep on our overallyeah.
Speaker 3 (26:41):
I would say that, of all the pillars of health, if I
had to pick the most underratedsleep.
It impacts more things thanpeople realize it impacts.
So yeah.
I think that would be a reallygood.
Speaker 2 (26:52):
Yeah, I would love that and that would that would
that would apply to 100% ofpeople, right?
I mean, seriously, it reallydefinitely affects every aspect
of your life, whether yourealize it or not, and I would
(27:12):
love some information about that.
So well, Dr Fahid, thank you somuch for coming back on with us
today.
It was a pleasure, as always.
I look forward to the next timealready.
Thank you, Well, that's all fortoday's episode, Atlanta.
I'm Stacey Risley with the GoodNeighbor Podcast.
Thanks for listening and forsupporting the local businesses
and nonprofits of our greatcommunity.
Speaker 1 (27:34):
Thanks for listening to the Good Neighbor Podcast
North Atlanta.
To nominate your favorite localbusinesses, visit
gnpnorthatlantacom.
That's gnpnorthatlantacom.
This is the Good Neighbor Podcast North Atlanta,
where local businesses andneighbors come together.
Here's your host, stacey Risley.
Speaker 2 (00:11):
Hello friends and neighbors, welcome to North
Atlanta's Good Neighbor Podcast.
Today we have Dr Vahid Yaganawith Healthy Conditions, which
is a concierge lifestylemedicine clinic in Buckhead.
He is back with us today.
He is our expert contributorfor both Dunwoody Neighbors and
(00:31):
North Buckhead Neighborsmagazines and he's here today to
discuss one of his most recentexpert article, which is on
surrounding the topic of weightloss and myths, medications and
making informed choices.
Welcome, dr Vahid, I'm so happyto have you back.
Thank you, thank you for havingme back.
(00:52):
We're glad to have you.
This is such a topic that somany people affect so many
people that I think one of thestats that you had in the
article was that 50% ofAmericans report, you know,
trying to lose weight every year.
So that's a huge number Most ofus, really.
(01:16):
So I'm glad that you're here todiscuss this topic and really
going to let you kind of take itaway.
Speaker 3 (01:24):
Yeah, sure, Kind of like you said, it's definitely
something that's on the front ofmost people's minds at some
point in the year, at some pointin their life.
So you can imagine it comes upquite a bit in my day-to-day.
Being an obesity physician,that's kind of part of what I do
anyway.
But even if that weren't thecase, I feel that just in
(01:44):
general primary care, that'skind of part of what I do anyway
.
But even if that weren't thecase, I feel that in just in
general primary care, it'sprobably one of the concerns
that comes up quite a bit, andso that's why I chose that topic
for the article.
I feel like it's something thateverybody can maybe glean a
little bit of information from.
These days we have a lot ofmisinformation out there,
especially on social media, andso it gets difficult to separate
(02:08):
fact from fiction.
What, you know, what isactually going to benefit me and
I think there is unfortunatelyprobably not intentionally, but
there's a lot of harmfulinformation.
So that was another goal ofthis article was to just briefly
touch on a few things and makesure that folks are, you know,
approaching this from an anglethat keeps them safe and, you
(02:29):
know, looks at things morecomprehensively.
Speaker 2 (02:31):
Yeah, and that's really important.
I like what you said in thearticle about you know everyone
thinks they're an expert youknow, and this is a subject
that's it's dangerous to topretend that you are more
knowledgeable than you are oryou know, you think that someone
you know there's a TikTok videoabout this bad guy I mean,
(02:52):
that's really dangerous with,especially with so many people
you know looking for that quickfix and, you know, without
really knowing how this affectsyour body and long-term health
risks.
Speaker 3 (03:07):
You can imagine that, with it being such a popular
topic and a very common painpoint, if you're someone who's
trying to sell a product or aservice, that's an easy sell
right.
You just pick on a thing thatis on most people's minds and
you offer a very simple solution.
That's an easy sell right.
You just pick on a thing thatis on most people's minds and
you offer a very simple solutionthat's going to solve all their
(03:30):
problems.
And so, again, I don't thinkfolks are intentionally trying
to be harmful.
You know, I want to be clearabout that.
I think the vast majority ofpeople are trying to help, maybe
sell their product or service,but what ends up happening is
some of this information is waytoo reductionist and folks take
it to heart and they apply it intheir lives, you know, without
(03:52):
even thinking twice about it.
So, yeah, that's kind of whereit gets dangerous.
I don't think anybody'sactually trying to harm anyone,
but it does happen, yeah.
Speaker 2 (04:00):
Yeah, for sure.
Well, and so you talked aboutin the article, you know, energy
balance and weight loss in thecontext of overall health.
You know, before we kind of getinto some of the myths and pros
and cons of medications and allof that, what?
What do you mean that when yousay in context of overall health
(04:22):
?
Speaker 3 (04:27):
when you say in context of overall health, yeah,
so the energy balance theory sosome folks might know it as
CICO or CICO, which is caloriesin calories out right, it is a
very kind of simplified way oflooking at it, because I can
tell you that overweight,obesity, this whole field is
very, very complex.
Every case is a little bitdifferent.
You know you've seen 10 casesthere.
You've seen 10 different cases,right, but I think it's
(04:50):
important to remember that ifyou're looking at the data and
you know I always recommend, ifyou're going to get health
advice or do anything with yourhealth, make sure it's backed by
robust, you know, scientificevidence.
That's step one.
And so, if we're looking atevidence-based medicine, this
theory does hold true thatcalories being expended so the
(05:12):
calories that we use and thecalories that we're bringing
into our body if there is asurplus or a deficit, we are
going to see changes in weight.
And really I think about it as asuperpower.
It's part of our ability tosurvive is the ability to store
energy.
I mean, if we weren't able todo that in our history as being
(05:33):
humans, we wouldn't havesurvived because for the vast
majority of our time on Earth,we were in a food scarce
environment and so being able tostore energy in the form of fat
, I consider that a superpower.
What's happening today is thefood environment is different.
You know, at least in ourcultures here in developed
countries, we have, you know,not just you know access to food
(05:57):
, it's just the type, thequality.
All of that impacts it.
So the energy balance theorydoes hold true, I you know.
The caveat with that is thatthe quality of things does
matter.
But overall, if you equatedcalories across different
dietary patterns and you werejust looking at weight loss,
(06:18):
yeah, there wouldn't be anysignificant difference between
them, as long as the calorieswere equated.
Now those dietary patterns canbe very different in how easy it
is to adhere to them and howthey impact your overall
metabolic health, and then wecan get into the weeds on that
stuff.
But yeah, overall, that's whatI mean by the energy balance
theory and that does still holdtrue.
Speaker 2 (06:36):
Yeah, and you mentioned in the article too,
that taking in a certain amountof calories in the form of candy
is going to be obviously verydifferent than than if you're
eating nutrient rich foods thevegetables and different things.
So well, let's go ahead anddebunk these outdated myths that
people just need to to forgetor ever ever thought to be true
(07:01):
by anyone.
Speaker 3 (07:02):
Yeah, um, I I mentioned two in the article.
There's a lot.
There's not a lot of room forme to go on and on and on, as I
tend to, as you well know, but Ithink these two because they
come up often, and so I thoughtlet's stick with the two that
come up pretty frequently.
The first one I mentioned isthat losing weight is only about
(07:24):
willpower.
Honestly, if it was, more peoplewould have success, right, and
I would probably expand that,extrapolate to anything you're
trying to do.
If it was just about willpower,not just weight loss, then
you'd be more likely to succeed,because at some point we all
have quite a bit of willpower todo things.
(07:44):
We have this energy, thisenthusiasm, this motivation.
It is not the case.
There are so many factors atplay.
Everybody's physiology is alittle bit different.
You know the different hormonesthat are up or down in our
bodies, the way we respond tofood, how easily we are satiated
by our food food, how easily weare satiated by our food.
(08:06):
There's so many factors that gointo what food environment are
we in, what work do we conductduring the day, what our
relationships are like.
The list goes on and on.
It is not just about willpower,and why I mentioned it here is
because I feel like there's alot of shaming that goes on
still.
There's still this sort ofthought that, oh well, if you
(08:27):
could only just eat less andmove more.
You know it's up to you.
You are making this choice tobe overweight or to be obese,
right, and I think that's really, really harmful and it's, quite
frankly, very inaccurate aswell for most people, and that's
why I mentioned I think, thatthat's something that everybody
(08:47):
needs to get really clear thatit is not just about willpower.
The second myth is this one Icould probably write a book on
this one, Maybe I should Is thatcarbs are bad for you.
So I, you know, okay,Throughout, you know throughout
at least our lives, if you thinkas far back as you want.
There's always been differentdiets, different things, and you
(09:09):
know carbohydrates being badfor you is something that keeps
popping up.
You know, you think back tothings like the Atkins diet and
whatnot.
That's exactly what popped intomy mind.
Speaker 1 (09:19):
Is it yeah, when I think of that.
Speaker 3 (09:21):
yeah, Today you could think of maybe keto is like the
new version of that stricterversion of that and it's not
true.
Carbs are not all carbs are badfor you.
The quality of thecarbohydrates are what makes the
difference.
I mean if you think about howbeneficial fiber is, and fiber
is a component of carbohydratefoods right, or the carbohydrate
(09:43):
macronutrient, and focusing onthe quality makes all the
difference.
Whether we're talking about yourmetabolic health, you know so
things like blood sugar, buteven when we're thinking about
things like, you know, surplusenergy, and these processed
foods do wreak havoc on our body.
So processed, highly refined,processed carbohydrates are not
(10:04):
the same thing as whole,unprocessed carbohydrates,
things like whole grains,legumes, fruits, vegetables all
these are wonderful for you.
Those are the two myths that Iwould say it's important to
distinguish.
Yeah, yeah.
Speaker 2 (10:20):
Well, so now the next portion of the article really
got into the pros and cons ofusing medications to help aid in
weight loss.
Do you want to touch on those?
For sure, I think that that Ithink a lot of people want to
turn to medication, I think, forbefore they try other things a
(10:40):
lot you know, they um they wanta quick fix, a pill that's going
to fix everything.
you know, so I can know thatthat can be dangerous and I
would think, in a weight losscapacity to you know, that that
could be something that wedefinitely want to caution folks
about.
Speaker 3 (10:56):
but whatever, I'll say a few things about.
You know again, very um.
We can go into the weeds onthis but you know, just on the
surface, important things aboutum medications that are
currently in the market that aregetting a lot of media
attention.
So we're talking specificallyabout the glp-1 agonist, the git
agonist.
So these would be like um azampic wegovi they're the same
(11:19):
drug, just different fdaapprovals and um terzapatide,
which is man Manjaro or Zepboundit's the sort of the weight
loss FDA approved name.
These are wonderful medications.
Now I'll say I don't have anyemotions around these things,
right?
So for me it's just the fact,and these medications can be
life changing.
(11:39):
They definitely have been gamechanging in the medical world
when it comes to type twodiabetes, when it comes to
overweight and obesity.
So they've definitely changedthe game and, as far as what has
been available, these tend tobe the safest and quote-unquote
cleanest options that we have,at least in the history of
medications that have been usedfor overweight and obesity.
(12:02):
Are they for everybody?
No, there's definitely.
You know cases where it's notgoing to be the right fit, and I
think that's where we startgetting into problems.
So I guess the pros here wouldbe that they're generally really
well tolerated.
The most common side effectstend to be gastrointestinal, you
know might have some stomachupset, maybe a little bit of
heartburn, so you can have thatbecome severe too, right?
(12:25):
Some folks have a bit moreviolent vomiting, typically if
they already have a slowmovement in their intestine.
But anyhow, that's somethingthat you know can be managed and
individualized.
Other pros of these medicationsis, as they study them, they're
noticing that there might becardiovascular benefits to using
these.
So there's interesting researchgoing on about the use of these
(12:48):
medications.
In case you're wondering, we'vebeen using that class of
medication probably since theearly 2000s for type 2 diabetes.
Speaker 2 (12:54):
I was about to ask that there was a big, I know, in
the late 90s.
You know there was a lot ofpeople taking and I'm not going
to remember the name of it.
You may know.
Speaker 3 (13:08):
We've had quite a few medications and a lot of them
no longer exist on the marketbecause we still have things
like Fenterman or combinationswith Fenterman that are, you
know, in the right case, arestill used fairly widely.
But, yeah, so these, thisparticular class, you know the
Ozempic, wegovy class ofmedications we started those
(13:30):
about around the early 2000s andthen that's kind of evolved.
I think Ozempic probably came alittle bit later than that,
maybe later in the 2010s, maybea little, I don't know exactly
when and we've used them, uh,you know, with pretty good uh
safety profiles, uh, across theboard, the cons, okay.
So this is the part where Iwant to just touch base um, they
(13:52):
are very expensive.
Not all insurances cover them,so that's something to consider.
Uh, we also don't have easyaccess to them, necessarily,
because they are so popular theycan't keep them stocked on the
shelves, right?
So, um, people need to be uh,running around shopping around.
Okay, I need to make sure theydon't I don't miss my next dose,
because then everything kind ofum goes backwards.
(14:15):
So that there's that.
I think that can be addressed.
Um, the the concern I mostlyhave is there have been a lot of
I guess I don't want todisparage anybody's work, but
there have been a lot ofopportunities.
There are a lot ofopportunities for you to just
get these medications prescribedto you without a whole lot of
(14:38):
evaluation.
I mean, you can even get themonline or a lot of places that
have popped up.
Yeah, they'll give you thecompounded versions.
They're happy to charge you forthem and the compounded
versions are cheaper than theFDA approved versions.
They are not FDA approved.
I personally don't recommendthem.
Again, it's science, it's data.
(14:59):
I look at it, you know, as thatposition evolves.
If the medical communitychanges their position on that,
then I'll change mine if I'mpresented with new data.
But currently I don't.
I don't send my patients to getthe compounded version.
I guess that would tell youkind of where I sit on that
argument.
And so there's been a lot ofunscrupulous use.
So folks that maybe weren'tgood candidates for these
(15:23):
medications are getting to usethem and unfortunately then they
get into problems such asbecoming malnourished or just
losing a whole lot of musclemass, because you're not just
losing fat, you're also losingmuscle if you don't do something
to mitigate that right.
And so, along with thesemedications, it's important to
be doing things like resistancetraining to preserve as much
(15:44):
muscle mass as you can while youthe peripheral fat or the
surplus fat that's on your body.
But because it takes awayhunger, so it will make you feel
full faster.
It will make you feel lesshungry.
If it's someone who said youknow what.
I just want to lose 10 pounds,these last 10 pounds, I'm going
(16:04):
to go take this medication.
I don't think that's necessarilythe best scenario, because you
can fall into this position ofnow being malnourished.
So I say all of that.
You know it is complex, it hasto be individualized.
I will end my kind of commentson these medications by saying
that it is not an easy way outeither.
(16:25):
I think that's important toclarify.
Some folks, this will changetheir life.
This will give them a new leaseon life and they have tried
everything.
They have done all those thingsthat you think that they
haven't tried and nothing wasworking, and this just changed
their life.
I don't think there's any shamein that.
I don't think it's a quick fixfor people and I think that
(16:48):
they're very viable medicationsin the right context for the
right patient.
Speaker 2 (16:51):
Well, and I love hearing you say that there are,
you know, some cardiovascular,there's some, you know, data
pointing that there arecardiovascular benefits, you
know, to these medications, youknow, helping with blood sugar
levels and different things.
So you know that they aren'tjust suppressing your appetite
but they're also benefiting youin other ways, you know.
(17:12):
So that shows a lot to how muchthese medications have evolved,
you know, and that someone suchas yourself would recommend
them, so that you know, incertain situations, not everyone
so I think that that does say alot to our medical community
that they've come a long waysince they first were released
(17:34):
for those purposes.
But let's touch on the faddiets and I know that there are
probably a ton more especiallythe really the short lived fads
that you can, you can find on onany social media platform,
probably super easily.
But if they're, you know which,which are the ones that you
(17:56):
want to kind of really steerpeople away from.
Speaker 3 (18:01):
Yeah, I mean I'll just say something about.
I picked three for this articlethe ketogenic diet, detox diets
and the carnivore diet.
I just picked them becausethose are the ones that I get
asked about most often.
I don't know that I'm going tosit here and say everybody needs
to steer clear.
Again, I don't really have alot of emotions around these
things.
It's my job to provide thefacts and make my
(18:26):
recommendations to my ownpatients.
So, since we're just having aconversation, you know, if
someone came and sat in myoffice it might be a different
conversation, obviously.
But I will say what I thinkabout them and take that with a
grain of salt.
You know, do with thatinformation what you will, right
, so it is big.
So earlier, you know, Imentioned the Atkins diet.
So the keto diet really is kindof a evolved if you could use
(18:49):
that term a more restrictedversion of an Atkins diet.
Basically, what's going on isyou are having a lot of fat and
you're having very, very, verylittle carbohydrate and the idea
is that you're going to keepyour body in ketosis or using
ketones for energy.
The issue that we run into withthe keto diet or at least
(19:12):
anecdotally what I have run intowith folks that I see in the
office that have been on it orare currently on it is one there
is a tendency to becomedeficient in certain
micronutrients, vitamins,minerals, that sort of thing,
because, if you think about it,it's a restrictive diet, so
you're restricting a whole lotof stuff and you're restricting
a lot of good stuff.
(19:33):
You know, earlier I mentionedhow carbs are not all bad for
you, so you're really cuttingout a whole bunch of fiber.
Fiber only exists in plantfoods, by the way.
It doesn't exist in other foodsthat are not plant foods, so
you are taking away things thatare good for you from your diet.
So that's one issue I have withthe keto diet.
Two, it is very strict.
(19:53):
Therefore, it's not sustainablefor the vast, vast majority of
people, I have yet to meetsomeone that has been able to
sustain a ketogenic diet.
And then, thirdly and finally,on the keto diet, because you
are having such a high ingestionof fats, it can affect your
cholesterol levels, right?
So you can run into trouble.
As far as cardiovascular eventrisk right, your risk for heart
(20:15):
attacks and strokes and thatsort of thing I'll move off of
the keto diet in case anyonethat's listening is on it.
I don't want to upset anybodytoo much, but I'll move to detox
the detox diet.
So here's the bottom line.
On detoxing your body isamazing.
(20:36):
Your liver detoxes your body,or everything that goes to your
body.
That's one of the functions.
The liver does a lot of things,but one of the things is it
detoxes, it deals with toxins,and so these dyes typically they
are they tend to be just liquid.
You know I'm going to go onthis.
You know, detox for a week ortwo weeks and whatnot.
(20:57):
Again, we fall into this realmof now maybe we're we're not
consuming enough calories, orwe're not consuming enough
variety of nutrients, and so Ithink that we can end up in a
situation that can be harmful aswell.
So that's why I'm not a big fan.
I don't think they're necessary.
There's absolutely no robustscientific evidence to back up
(21:20):
their use, no matter what yourfavorite TikTok influencer says.
And I'm like you know, I'm ascientist.
If tomorrow the data comes out,I will change my tune and I
will prescribe them.
So I have no issue, you knowdoing that.
Next I'll talk about thecarnivore diet.
You know I'm, you know I'm abig sort of I promote a whole
(21:41):
food, plant-based diet.
So the carnivore diet, youwould think, is sort of like the
polar opposite.
Honestly, even the folks thatare promoting the carnivore diet
, I think they'rewell-intentioned and I feel like
they probably have sensed somebenefit, because you are
essentially eliminating a lot ofthings for your diet from your
diet when you do the carnivorediet, and so by eliminating so
(22:03):
many things, a lot of the thingsthey eliminated might have been
causing inflammatory issues andall kinds of issues.
So you might actually feel abenefit to some of these.
But, same thing, veryrestrictive.
Now you're cutting out prettymuch all fiber.
So we run into issues in termsof risk for cancers like
colorectal cancer.
We also run into issues withheart attacks and strokes
because now you're increasingyour saturated fat intake, which
(22:25):
there's robust evidence to linkit to these events increased
saturated fat in your diet.
So that's my issue with that.
And by decreasing fiber, notonly are you increasing your
risk for colorectal cancer, butyour blood sugar gets impacted.
All kinds of intestinal issuescan pop up.
So again, I'm not saying do ordon't do, I'm just saying those
(22:49):
are the facts as I know them.
As the data evolves, you know,I'll reevaluate these things,
but I will add to that I didn'tput this in the article.
I don't think there's a magicaldiet out there that works for
everybody.
I think there are things thatgenerally should be consumed.
You know, we should have a goodamount of fiber in our diet, we
should be careful aroundsaturated fat, we should stay
(23:10):
away from processed foods.
But I don't think there's onemagic pill out there.
I think cases need to beindividualized and we need to
think about what dietary patternis sustainable for you, you
know, because a lot of these faddiets are not sustainable.
Speaker 2 (23:24):
And I think that that's the key, you know,
finding something that issustainable, that's something
that you're able to implementand, you know, become something
that you can live by, ratherthan it being a diet, so so to
speak, you know.
So speak to that for a minute,Dr Fahid.
Speaker 3 (23:49):
Yeah, absolutely so.
My approach, and one that Irecommend, is to look at weight
loss from a wider angle.
Right Is not to just look at itin a vacuum as all I'm
interested in losing weight.
No, we have to think abouteverything that goes into that
how we're sleeping, how we'removing, the relationships we're
in, do we have any level ofchronic stress All of these
(24:10):
things impact our weight, ourhealth in general, but our
weight, you know, or if we areof a weight of these or
struggling with any of thoseconditions, this is impacted as
well.
So I would look at those things.
I would think about nurturing myrelationships and, speaking of
relationships, nurturing yourrelationship with food forward
(24:43):
into a healthier future foryourself.
You need to really look at foodas the nourishment that it is,
and not this evil thing that, oh, you know, oh, I misbehaved, I
ate such food or such and suchfood, or or oh, I was really
good, I deserve X, y, z.
I feel like those are verybroken relationships with food
where we need to just look atthis is.
This is nourishment, this ishealing my body, this is I need
to eat.
You know you can't just restrictyourself from all food and
(25:04):
focus on just one one parameter.
So there's a lot that goes intoit.
You know, like I said, allthese different pillars of
health and sleep is a big one.
You know, looking at how you'resleeping and when you look at
it in that sort of comprehensiveway, I feel like it becomes
more and more real that this canbe sustainable.
Maybe I can actually dosomething different, because you
(25:27):
know those of us that havetried to lose weight.
You know it's not the firsttime.
We've probably done this foryears and years and years and
kind of cycled and yo-yoed backand forth, and the idea is to
break that cycle and moveforward in a way that that is
sustainable.
Speaker 2 (25:41):
Yeah, and I just want to in a way that is sustainable
.
Yeah, and I just want toreiterate one thing that you
said that people have a brokenrelationship with food and to
use food as a reward to yourselfor to restrict yourself.
Oh, I was so bad when I didn'teat that.
That really does.
(26:02):
We've had that all of our life.
We've heard that you getrewarded with dessert as a kid.
Speaker 1 (26:12):
It's a part of our culture.
Speaker 2 (26:13):
Yeah, it really is.
I guess when you said fixingrelationships and you're working
on the relationships in yourlife, it's a relationship with
food.
It's really at the root of itall, I guess.
Well, thank you so much, andyou talked about the importance
of sleep and maybe that could bea future article, that we, that
(26:36):
we do a sleep on our overallyeah.
Speaker 3 (26:41):
I would say that, of all the pillars of health, if I
had to pick the most underratedsleep.
It impacts more things thanpeople realize it impacts.
So yeah.
I think that would be a reallygood.
Speaker 2 (26:52):
Yeah, I would love that and that would that would
that would apply to 100% ofpeople, right?
I mean, seriously, it reallydefinitely affects every aspect
of your life, whether yourealize it or not, and I would
(27:12):
love some information about that.
So well, Dr Fahid, thank you somuch for coming back on with us
today.
It was a pleasure, as always.
I look forward to the next timealready.
Thank you, Well, that's all fortoday's episode, Atlanta.
I'm Stacey Risley with the GoodNeighbor Podcast.
Thanks for listening and forsupporting the local businesses
and nonprofits of our greatcommunity.
Speaker 1 (27:34):
Thanks for listening to the Good Neighbor Podcast
North Atlanta.
To nominate your favorite localbusinesses, visit
gnpnorthatlantacom.
That's gnpnorthatlantacom.
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Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
Las Culturistas with Matt Rogers and Bowen Yang
Ding dong! Join your culture consultants, Matt Rogers and Bowen Yang, on an unforgettable journey into the beating heart of CULTURE. Alongside sizzling special guests, they GET INTO the hottest pop-culture moments of the day and the formative cultural experiences that turned them into Culturistas. Produced by the Big Money Players Network and iHeartRadio.