Episode 29: Beyond GLP-1s, Diet Culture, and Self-Worth: A New Era of Weight Management with Stephanie Gort, PA

Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
I'm Christina and I'm t and thisis the Pretty and Pink Again
podcast where Motherhood meetsrediscovery.
Hello.
Hello.
We have a guest in the house.

(00:20):
Yay.
Hello.
We have our friend StephanieGort she's a physician
assistant.
She works in gastroenterology,ology and weight management.
And she's here to break down howthe diet culture has shaped us,
what difference there is now.
She's gonna talk about GLP onesweight loss and the fads now.

(00:40):
Yes.
So when we were on the phonedoing our prep call, we talked
about how we grew up in thenineties.
Yep.
And the height of this dietculture when you would see
special K for breakfast and aslim fast and low fat,
everything.
And you learn two things.
One, you're supposed to besmaller.
Yep.
And that's better.

(01:01):
And two, if you're not, it'syour fault.
Oh yes.
So even though I didn'tpersonally grow up like this,
because I talked about how mymom was European and we
literally ate everything fromthe house, from the garden, from
home.
Like my grandmother would kill arabbit.
And that was what was for lunch.
But that is not how my childrenare growing up.

(01:22):
My children are very American.
They reach for a box.
And so now I am so interested inthis personally, also, all of
the diets that you mentioned.
I did.
So I went to Weight Watcherswhen I was 11.
11.
Wow.
And 11 years old.
We had all the snack Wells Lingcuisine smart ones.

(01:43):
Eat this, not that.
Books, like all of that was hugein my household growing up
because thinness was such a bigthing and I was really
overweight as a childness was abig thing.
Being thin was like a badge ofhonor, like an unachievable
goal.
My mom always told us we werebeautiful and we were smart and
she would do anything for us.
But some message came that whenI was 11 I needed to be thinner.

(02:05):
And I think part of it was Iwould go to like field trips
when it was hot out and I'd wearlike a sweatshirt and shorts
instead of a tank top and allthe girls wearing jeans, skirts.
And my mom would look at me andbe like, I know she's
uncomfortable so gently, shewould bring me to Weight
Watchers and we would, you know,do the thing.
So I learned about caloriecounting.
Fat back then that was like theinitial fad before low carb and

(02:28):
before all this stuff came in.
It's crazy'cause we've talkedabout, on here, Tia and I have
talked about when that exactmoment is that you realize about
body image and it could beexternal, like you look at other
people and start filing thingsaway or like internalizing
things.
But it also could be when younotice your body.

(02:49):
And so do you feel like it wasaround, I think you had said
something around that.
It was around that.
Yeah.
I was eighth grade for me.
Okay.
Fifth grade.
Yeah, I was in, so I was tiny inmy early nursery school ages.
And then I gained weight inelementary school.
I was pretty overweight.
Sixth, seventh, eighth grade,ninth grade comes South Beach.
Diet was big then.
Yes.
So I started the South Beachdiet.
Everything was low carb and thenI lost weight and all of a

(03:12):
sudden you have boys noticingyou, your clothes are.
Fit better.
Like all this stuff comes.
So then in my mind I'm like,okay, thin is in thin is what we
need to keep, and I don't thinis in, I don't.
I think that also that messagingfrom the nineties and early two
thousands was so diet focused.
And I think that if you saidthat you wanted to lose weight,

(03:33):
it was almost like glamorized atthat point.
Like you're saying, a thin isin, it's a good thing to be
thin.
Yes.
And now I think the messaginghas shifted maybe in the
opposite direction where if youhad said, if you say out loud, I
want to lose weight, you're likeimmediately inundated with no,
you look great.
And it's all, so it's theopposite right effect.
And I think that both messagesare dangerous in their own

(03:56):
because obviously you want tofeel good about yourself.
And so I think that you justneed to get to a middle ground
where you're tuning out thenoise, but then you feel good
about your own body image.
I think that there has to belike a mix of that to be
healthy.
I still think thin is in.
I don't know, one person that'sactually does not want to be a

(04:16):
good weight.
But I think maybe the messaging,and you can, you're gonna speak
to this is more, it's morehealth based, right?
Yes.
Yes.
So it's less vanity and morehealth.
However, there are people likeLizzo and other clinically obese
women that are body positive inthat sense.
And I don't necessarily agreewith that either.
There's two extremes.
There's the th skinny, skinny,skinny obese, obese, obese.

(04:39):
And I feel like you have to findthat middle ground.
When you were younger Yes.
And you, your mom recognized mydaughter appears uncomfortable.
Yes.
I wanna help my daughter.
It came more from a vanity maybestandpoint at first.
Or do you think it was morehealth based?
I was,'cause Weight Watchers isgood, right?
'cause Weight Watchers, teachesyou how to eat portion control.

(04:59):
I gained weight on WeightWatchers, but I think hers came
from.
I'm seeing her with her peersand going into high school and
going into her dating years.
I want her confidence better.
And I think all of us can saywhen we're at our thinner weight
or when we feel better after welose the baby weight, after we
get to our wedding weight, wefeel better.

(05:20):
You're more excited to getdressed.
You are more excited to goshopping.
Being in pictures, you're nothiding your body.
So yes, thin is.
Cool.
But the way we used to do it isnot, so we used to starve
ourselves.
We used to do these crazy fatcleanses and diets like I did
the Cabbage Soup diet.
I don't know if either of youremember that I've heard.
Yes.
I feel like all of these, it waslike, and I always go back to

(05:41):
the magazines and the media andall of these things that were
circulating for everybody tolook at.
And so yes, these fads weretaken by storm.
And I think now though withsocial media, I feel like it's,
it depends on the algorithm andwhat you're in.
But I bet you if you're in thatspace, you're inundated with
that sort of fad diet.
And I'm shocked my algorithm haschanged.

(06:04):
And I think the only reasoneverything has changed is when I
had a kid.
And I remember being like 15 andtalking to a mom who was very
fit and always active.
And I said to her like.
Are you obsessed with yourweight?
Like how, and she was like, Iwas until I had a daughter.
And I was like, I don't believethat.
Like after I have kids, I'mstill gonna do that.
But now I see my kids and Iwon't say the word fat around

(06:26):
them, right?
I won't.
I'll eat dessert with them.
I make sure to try to eat everymeal with them so that they're
not like, why does mommy onlyeat salads?
So I think having kids reallydid it forces you to have
healthier habits because youwant them to, right?
Because you feel like you'rebeing watched.
Yeah.
And arguably what you'remodeling for them is probably
the best.
And now, arguably, probably thebest you've ever felt.

(06:47):
And look because you'repracticing I am on some of these
things.
A GLP one, but yes.
But so we'll also go into that.
Yeah.
Like now we're coupling okay.
So there was diet, there wasstarvation, there was all these
things.
Over exercising.
Over exercising 100 caloriepacks, like all this sort of
like negative messaging.
Part of it for your patients is,it's not all your fault.
You can diet and exercise allyou want, but there is another

(07:09):
like hormone and metaboliccomponent to this, and now
insert science, and now you canactually live this like shopping
the perimeter of the grocerystore and eating a balanced diet
because you can have access tosome of these medical weight
loss drugs that you areprescribing to your patients.
Yes.
So I wanna go into that a littlebit too.

(07:30):
We're gonna get right into it.
Yeah.
Because I think that's, I thinkthat's important and that's huge
right now.
So I feel like this is verytimely, but it's also very
important that people get thecorrect information about this
because we were talking, andthis is one of those things
where.
A lot of people are prescribingthese things and maybe and not
everybody's expert's not theexpert.
Yeah.

(07:50):
Not everybody's an expert andmaybe it's not the best method
just because somebody prescribesthese things, it's like Botox.
It's like just because somebodycan actually do it doesn't mean
they're the best and that you'regonna look the best and feel the
best afterwards.
So I think that sometimes whenthings get too big and you're
just, it's almost like you'reoversaturated with this
information.
Yeah.
You start.

(08:10):
Guess losing curiosity of likehow to go about doing it.
And so I think that's animportant message that we're
gonna talk about.
Also, I think the drugs got abad rap early on because again,
anybody on social media can havea voice.
You are a voice that I want ourlisteners to hear from, because
you are actually an expert inthis field.
You work for agastroenterologist, you day in
and day out, you prescribe thesemedical weight loss drugs to

(08:33):
your patients.
You work with them, they workwith nutritionists, they work
with dieticians.
Like you are the person to talkabout this.
And also you have a long historyin this.
It's why you went into it.
Yes.
So the, these drugs get a badrap.
I feel like when people, peoplelose weight, you're like, oh,
are you on ozempic?
Are you on this?
And nobody wants to share.
I saw someone the other day,it's not all bad.
And I was like, you lookamazing.

(08:54):
How long have you been onOzempic?
And she looked at me like, didyou just say that to me?
I'm like, okay, Manjaro.
Well, This is what I do for aliving.
Yeah.
But it shouldn't be shamefulbecause it shouldn't be
shameful.
It's not just eat less andexercise more.
We learned that, right?
You can starve yourself and youcan over exercise and you may
lose 12 pounds in a week.
The next time you have a regularmeal, you're gonna gain it back.

(09:15):
So these medications areallowing people not to.
Focus on counting calories andstarving themselves, and like
it's the first time in a lot ofthese people's lives that
they're allowed to enjoy Right.
Pasta and not worry aboutgaining weight.
It's probably also removing someof the guilt and the emotional
aspect of that.
Yes.
Like I feel like if you're just,if there's a little bit more

(09:36):
flexibility, just taking thatstress and that emotion out of
it, I'm sure helps a ton too.
Yes.
So a patient comes to you Yes.
And says, all right, I'm unhappywith my weight, or I'm going
through menopause and I'vegained like 15 pounds.
Where do we start?
So oftentimes patients arereferred from their primary

(09:57):
doctors or other GI doctorsbecause of fatty liver disease,
because of diabetes, because ofhigh cholesterol, high blood
pressure.
So what we do at our firstintake is we'll say, okay, tell
me your story.
I tell them a little bit of mystory just so they're not like
you.
Have a normal BMI you're finishlike what do you know?
So I try to disarm them and wetalk about that.
I'll say, what's the highestweight you've ever been?

(10:19):
What's the lowest weight you'veever been and what's the goal?
Weight?
And automatically, if their goalweight is much lower than the
lowest weight they've ever been,I wanna be like, okay, let's
stop there.
I don't know if we're gonna getthere, but we can go lower than
you are now.
And I don't love BMI because itdoesn't take into account muscle
mass.
Arnold Schwarzenegger has thesame BMI as some big fat guy and

(10:42):
they both have different, right.
And they both have differentbody types.
So they'll come in.
A lot of the stories are, I wasthin growing up.
I started the Depo-Provera shotand I gained so much weight.
What's that?
It's like a birth control.
Oh, I started birth control.
Okay.
Okay.
For some people have chronicconditions that they need to be
on.
Steroids and steroids are crazy.
Weight, gaining meds,depression, crazy weight,

(11:03):
gaining meds.
So for a lot of times thesepeople were dieting and
exercising, and their bodieswere working against them
because even though they weredoing everything right that
we've been told, they're notlosing weight.
And we now know it's acombination of hormones,
metabolism, genetics,psychology, environmental
factors, social factors, like somuch.
So that's, it's not one sizefits all.

(11:24):
It's not, no.
And that's why these medicationsare a game changer because
they're new, but we're learningall these new indications for
it.
So came out as a diabetic med.
Everyone who had diabetes wastaking this medication.
When it was prescribed to them,their blood sugars were going
down, but they also saw theywere losing weight.
So now people are looking fromthe outside and they're like I

(11:45):
want that.
And that's when people startedusing diabetic medications for
weight loss.
And that's where all the uproarcame because the shortages,
people were taking it away frompeople who really need it.
And then, which is no longer thecase, which is no longer the
case because the companies whocreated those diabetic
medications were brilliant andchanged the name Remarketed.
It changed the dosing, and nowthey're FDA approved for weight

(12:08):
loss and obesity.
So there's no competitionbetween them anymore.
It's So this is this, eventhough they're similar or the
same Yep.
They're one is branded this way.
Yes.
And the other one can still befor, so Ozempic is the first one
everyone got it Thinks aboutOzempic is a diabetes
medication.
You cannot get it covered unlessyou have diabetes.
The the weight loss medicationsthat you can ask your doctor

(12:31):
about are Zep bound and wegovyand do they work the same or are
they different?
So Zep bound is the exact sameas Moon Jro.
Wegovy is the exact same asOzempic.
However, they are differentindications, so insurance looks
at them differently.
Can you walk us through whatthose differences are for like,
those are the two big playersright now.
Yes.
So can you walk us through whatthose, like, how they would

(12:52):
affect your body?
Yeah.
So GLP ones are a hormone inyour body that regulate hunger.
They also work as aneurotransmitter in the brain to
regulate like food noise andcravings.
You might have heard that foodnoise a lot of people are
talking about for sure.
So it works by, yeah.
Bethany Frankel, I feel likecoined that turn term.
Yes.
And Oprah had a whole special onit.
And Okay.

(13:12):
So if you guys have never beenoverweight, you may not know
that food can control your mind.
You're like thinking all daylike, oh, I'm not gonna eat
today'cause I wanna have icecream tonight.
Or.
Ooh, what do you think the nextsnack I can have is?
Or, what am I, what are theygonna have at the baseball game
for food?
Sometimes food controls a lot ofpeople's thoughts and that it
controls my thoughts in adifferent way.
Me too.
Because if I don't eat, I feellike I get hangry.

(13:36):
Yes.
And I'm like, oh my God, if Idon't eat my blood sugar's gonna
drop and I'm gonna be angry.
And these help with the bloodsugar too, these meds.
So mine, mine food, and I feellike you're similar.
Mine is similar to that, butmine is probably the opposite,
which I know might come acrosscontroversial, but mine is when
I am stressed out or when I'mnot in a great place, I actually

(13:56):
have the opposite, right.
Where I don't have any, I, it'slike there's no sound.
Yes.
And I have to force myself tothink about eating.
And so that I, that has gottenme into a lot of trouble the
opposite way.
Yes.
Because if I am stressed out, Idon't eat right.
And some people say, I wish thatwas my response, because other
people I've heard that.

(14:17):
Of course.
Yep.
And but, so I can understand itfrom that perspective of, okay,
it's just the opposite.
Like you're thi overthinkingversus not thinking.
It also works directly toregulate hunger.
So food leaves your stomachslower.
Okay.
You get fuller quicker and sotherefore you end up eating less
at the meal and you end uphaving longer periods before you

(14:38):
get hungry again.
So it is like a physical andmental Yes.
Physical also.
Yes.
Exactly.
Okay.
Yes.
So it works both ways.
Okay.
And it's dose dependent.
So you start at a low dose andthen we increase it up.
The side effects are not alwaysso beautiful, people don't talk
about it, but nausea,queasiness, morning sickness.
Is one extreme.
The other extreme is vomiting.

(14:58):
Like some people vomit all day,other people have diarrhea.
And how long does that last for?
Like your entire time, your bodygets use of the dose and we
don't increase their dose untilthey're like comfortable at the
dose.
Wow, okay.
Yeah.
So you know that they'reeffective, you know that it
works.
Yes.
So now your patient's on it forthree to six months and they,
you're seeing weight loss.
What do you, how do you maintainthat?

(15:20):
So a lot of people come in andthey're like, I wanna lose this
15 pounds.
And then once it's off, Ipromise I'll be able to keep it
off.
I just need to get this 15pounds off.
Because it's also to jumpstart.
It's not just the 15 pounds,it's now their cholesterol has
gone down.
Yes.
Now they're at a less of a riskof stroke and heart attack.
Exactly.
And maybe their diabetes ismaybe under control.
So like it's not just theweight.
Yes, it is about the weightloss, but it also, like they

(15:40):
have all these other healthbenefits.
So those are the non-scalevictories that we also talk
about a lot, but.
The first thing before we startis I say, this is a chronic
medication.
You are gonna have to be on thislong term in order to continue
to see the weight loss andmaintain your weight.
And I have tons of people whoare like, no, I know myself.
I know my body.
I'm like, okay, this is what thestudies are showing.

(16:02):
And I use the example like whenyou have high blood pressure and
your blood pressure medicationhas your blood pressure
normalized, and now you're 120over 80.
Perfect.
You don't come off the bloodpressure medication.
Yeah.
You stay on it to maintain thathealthy blood pressure.
So there's nothing there thatcan, that you can take away from
it and then be able to do onyour own.
I know.
'cause I've heard that likepeople, it's, they're using it,

(16:25):
or at least they're saying it asthis is my goal.
I'm gonna start it.
It's gonna jumpstart me and thenI'll be able to take over.
Does that work in any instance?
Or is it really just for It'sjust something like you're
saying it's chronic, like you'regonna be honest.
Once you take it, if you likethe results, that's it.
Yeah.
So research is so new becausethey're newer medications.
So different doctors orproviders are doing different

(16:47):
things.
Yeah.
So when my patient reaches theirgoal, I'll start by decreasing
the dose back towards starting.
And we stop when we start seeingweight gain.
Or we spread out the interval.
Instead of taking it every sevendays, we'll do it every 10 days.
Okay.
And so none of us know right nowwhat is gonna work, but it's
patient by patient, so somepeople can get away with the

(17:07):
lowest starting dose once amonth and maintain their weight.
Is it so new that we haven'tseen any success getting off of
it where people are able to keepthe weight off?
It's so new that the researchstudy shows that you will gain
the weight back if you come offof it.
Interesting.
Okay.
Okay.
So you're still currentlyplaying around with dosing with
myself and timing even withyourself.
Yes.
So now you are not an overweightor an obese person.

(17:30):
And so now, but you were, whenyou started and I was
postpartum.
And you were postpartum.
So postpartum, I had gained ahundred pounds in pregnancy, and
this is from someone who studiednutrition and exercises, gained
a hundred pounds.
My body wanted to gain weight.
We did it.
I was left with a newborn and abody, which I didn't feel

(17:51):
comfortable in or recognize.
Luckily they were winter babies,so I could wear sweatpants.
But you have two.
I know, but still you have twogirls, two little that.
What did you gain the weight forwith both of the pregnancies?
Oh yeah.
I went up and then down and thenback up and then down.
And then you're left with allthe skin.
Yep.
So I started it even beforethat, I played around with
weight loss medications in NewYork when I lived in New York
City and worked at a weightmanagement center there because

(18:14):
I was like, I eat well, Iexercise well.
I have a family history ofdiabetes.
If I look at cake, I gain weightlike something else is going on.
And so that's when my doctorintroduced me to these
medications.
Was that in between pregnanciesor was that before?
Before, that was before I gotmarried.
Oh, okay.
Yeah.
Okay.
So these weight loss drugs havebeen around then for a while?
This, so I've been prescribingthem since 2018.

(18:35):
And weight loss meds have beenaround since the 1970s.
Like phentermine, fen.
Mm-hmm.
More stimulant type have beenaround.
But these GLP ones are newer tothe market.
Okay.
So you started using GLP onesand it was insane, the change
Pro, when did you start usingthem?
Probably 2018.
2019.
Wow.
So this was before babies, thisbefore babies before marriage.

(18:59):
And I used to be the friend whocould go out to Mexican with you
guys and eat my plate and theneat your plate in your plate.
But I was going to Barry'sbootcamp at the time so my
weight would stay the same whenI took this medication and I
didn't even finish my own plate.
I was like.
Game changer.
Like I've never felt thisbefore.
I've never experienced thisbefore.
And it's just so eye-opening forpeople who suffered for so long

(19:24):
and that's why it's changing theenvironment.
So do you have girls come in, orI should say men too, that are
not obese, but just wannacontrol their weight?
So insurance is the tricky thingbecause these medications are
approved for weight loss.
If you are overweight and have acomorbidity, like high blood
pressure, high cholesterol, orif you're obese, and that's

(19:47):
through BMI and otherparameters.
So if a normal weight womancomes in and she wants to lose
weight, I would not offer thismedication.
If a normal weight man who istraining for a marathon and just
wants to shred 10 pounds, thisisn't the right medication.
And so that's why we have aconsult first.

(20:07):
And that's also why thesecompounding medications are
dangerous.
'cause you can subscribe.
To a website and get themedication without a full
medical history without doingall the blood work.
So that's where you have tofigure out the right person,
because you are an expert, and Idon't like this, I'm, I don't
know, I don't like how I'm goingto say this, but I don't know
how it, how else to say it, butpeople are coming to you and

(20:29):
getting it prescribed the rightway, because they need it.
Medically, how is this sorampant then?
Like, how is this all over theplace?
Like how, why is everybody thatI know on this medication, like,
where is it coming fromotherwise then?
So it's a huge money maker,right?
So people took these brand namemedications, scientists

(20:50):
compounded them and reformulatedthem into compounded vials.
And all these medical spas are.
Prescribing or cell orinjection, how are they access
to these?
Like, how is this happening?
Because the patients just haveto know it's not an f FDA
approved source.
So similar.
So this is something thatsomebody really could get their
hands on if they're like a medspa, if they're in that
absolutely.
Field, like they can.

(21:10):
So other people can get theirhands on this and they may very
well work.
And I tell my patients, listen,if insurance isn't gonna cover
it, go to a reputable placethat, other people have had
success with.
I wouldn't buy it off the blackmarket, I wouldn't buy it
online.
But if you have people withsuccess, ask'em their success
rate, look at the research, makesure they tell you the side
effects, the warnings, thecontraindications, but then how

(21:32):
are these people who are givingthis?
And this is not to shade any ofthose people, but how are they
monitoring this in a safe way?
So I'm not sure how often theythey see these patients, right?
I like to see my patients onceevery three months in person and
then we speak once a month.
So I'm guessing the check-insare they weigh-ins?
Are you doing blood work or sowhat kinds of things are you

(21:54):
doing?
When they start with me, we'lldo blood work.
We'll look at cholesterol, we'lllook at blood sugar, thyroid,
insulin resistance, which is abig one with women who are like
postmenopausal or on certainmedications and like blood
counts, metabolic panel.
I do it all just so we have abaseline.
And then studies have shown thatafter you lose 10% of your body
weight, so if you're 150 poundwoman, 15 pounds, you're gonna

(22:17):
start seeing these healthbenefits.
So after about six months or so,I'll reorder these panels and
see what's happening.
If at any point the patientfeels stomach pain, if the
patient feels like intenseconstipation, you need to have a
red flag because there are thesewarnings of gastric paralysis
and all these lawsuits comingout.
Now, if you're with aprescribing provider that knows

(22:40):
these risks and follows youclosely, none of.
Should occur.
So that, I think that's, I guessthat from the outside,'cause I
have not taken these so I didn'tknow how people go about finding
that.
I think that's a red flag and ifyou're thinking about taking
something like that, I thinkit's great.
But I think that, how do you goabout getting this done
correctly?
So if you are somebody who justwants to quote unquote jumpstart

(23:03):
your weight loss, or maybeyou're not in that medical need
of this medication, how cansomeone go about finding this
safely?
So I'd say everyone, the firstperson you can start with is
your primary care provider.
Okay.
And they all should know this,everyone in the world knows this
right now, but it also shows howdesperate people are to lose
weight that they would take assomething that isn't safe for

(23:24):
their body.
Just to lose weight.
And I think that now that thisis becoming more of a thing
where it is socially acceptableand everybody is talking about
it.
I think it's more so than it wasmaybe a year ago or two years
ago.
I think now people are.
It's a little bit more known.
Mm-hmm.
And it's a little, maybe alittle less shameful saying that
you are right.
Talking about it.
But then that gets dangerousbecause then you just think oh,

(23:45):
I know somebody who offers this.
And you go to that person.
Yes.
Maybe without a referral orwithout knowing, you know that
Yes.
That it went well for some otherpeople.
And it starts to get a littlescary that way.
If everyone's offering it, thereare risks associated with it.
Yes.
And maybe the dosing isn'tcorrect.
Some people get started on thehighest dose.
Right.
And land in the ER withvomiting.

(24:07):
So I think my question is, froman expert, I would wanna know
what are the questions that youcould ask?
How could somebody go aboutasking for this in a safe way?
'cause I think you don't wannascare people off and say, that
something bad is gonna happen.
Yeah.
But people need to beresponsible using this.
Right.
I almost feel like kids andyou're the parent and like you

(24:28):
have to be like.
A parent that's still firm andstrict, but knows, okay, my kids
are gonna drink.
Yes.
And they're 16.
Yes.
You know those access out thereare looking for booze.
Where do you start?
So I'll share with you my, oneof my good friends owns a med
spa and she knows like I'malways hangry.
And she was like, I feel like ifyou try the microdosing, it'll

(24:49):
help with your hunger and you'lllose a few pounds.
Let's try this.
And I trust her.
This is what she does.
So I've tried it from her.
And it does, it works.
So I told you I tried it back inJanuary.
You had a good experience and Ihad a great experience with it.
And that's a safe success forus.
And I want it, and I wanna do itagain.
Yes.
It's amazing.
It's amazing because it does, itquiets the noise.
And not necessarily, I'm notsomebody that's oh my God, I

(25:09):
can't eat a cheeseburger.
I can't eat this.
I don't have that kind of noisewhen I go to a football game or
a baseball game.
Yeah.
It actually allows you to eatthe cheeseburger.
Mine is just more oh my God, myblood sugar shouldn't drop.
I'm gonna be hungry more.
I have to have purse snacks allthe time.
Maybe that's more anxiety thanit really is like actual blood
sugar.
Yeah.
But it helps with that.
It does because it almost makesit go away.

(25:31):
Christina's seen me, how manytimes do I need to have food
with?
Yeah, she really does.
While we're recording, shereally does.
It's and it happens fast,anxious, hang, it comes on fast.
Yeah.
So the medication, because it'sslowing down the rate foods
leaving your stomach, your bloodsugar spikes are not happening.
Yeah.
So it's steadying out your bloodsugar.
So that's why people feel somuch better on it.
You probably just feel likeyou're just in people a good
spot all the time.
So I don't, I can understand.

(25:51):
I don't wanna like completelyscare people away.
No.
Like my husband went to, hisprimary care physician for a
check-in.
And he was like.
His cholesterol was a littlehigh, his blood pressure was a
little high.
Like all of these indicationswere like a little high.
So he asked his doctor aboutthese drugs and she was like,
hard stop.
Absolutely not.
No.
And I was like, I don't feellike she should have just given

(26:12):
you a hard no.
I think she's afraid of themtoo.
But I think that gets scary.
And then that's when people goand they start looking for who
can prescribe it.
Yeah.
There's online and there's theblack market, and you're just
desperate for these medications.
And so that's where people canget into a lot of trouble.
We don't know.
I hate being like this, but nowI feel like I'm an anxious

(26:32):
person and a mom now.
And so I feel like I'm alwaysjust like 10 steps ahead being
what is gonna happen.
Yeah.
It's fun times in my brain, butI feel like it's one of those
things where now it's gonna be.
All over the place.
And are people gonna mix it withsomething just to sell it for
cheaper, to give it to, oh God,like that this is the road that
this could go down.

(26:53):
If this, it turns into buyerbeware.
Yes, it is a medication, yes, itis a drug just like opioid.
Just like other dangerousthings.
Yes.
And that, I think that's wheremy mind is going of okay,
sometimes when things are tooaccessible then you're just not
really thinking of like, wherecan I get this safely and where
can I verify this and make sure,because now it's just all over
the place and you're almostsaturated in the thinking where

(27:16):
you're like, some lawsuits arestarting Yes.
Against med spas against non FDAapproved compounds, and you're
finding them less and less.
So hopefully it's gonna be moreregulated, but it's also gonna
be easier for the generalpopulation to get them correctly
because of all the newindications.
That would be great.
Got it.
I feel like that's like apositive thing, so you can only
get it.
Prescribed.
If you have an indication, evenif you had a pocket, like I

(27:39):
couldn't come to you and say, Iwanna go on a microdose of this.
And I wanted to ask you whatthat meant.
Yeah.
Because it will help me regulatemy blood sugar.
So I would say that someproviders will prescribe it.
I've had patients come to me whohave diarrhea all the time, and

(28:00):
I'm in gi so I see diarrhea allthe time.
This medication slows down yourGI tract.
So naturally diarrhea might slowdown.
She's normal weight, but shewants to try this right now.
It might be behind the scenesbeing researched for diarrhea,
who knows?
But it's not an FDA indication.
So I What would you like lookinto first?
Why do you have diarrhea?
Yeah, so she would've had thecolonoscopy, she would've had

(28:21):
the stool studies.
You're in gi so that makes her,that's Sal bowel syndrome with
diarrhea.
Same with PCOS infertility.
A lot of these fertility centersare using the medications now to
boost fertility.
Interesting.
The new indications, fatty liverdisease, which pretty much
everyone has, there's chronickidney disease.
So as it gets more and morewidely distributed, the

(28:43):
insurance companies have tocatch up.
And that's where our biggest, Ialways say the worst side
effects is insurance.
So maybe it'll be safer.
Versus what the more accessibleis more.
In your opinion, who would begreat candidates for this versus
who would not be greatcandidates for this?
So automatically there's blackbox warnings or
contraindications.

(29:03):
You cannot take this if you havea personal history of
pancreatitis.
Which is inflammation of yourpancreas.
Or if you have a family historyof medullary thyroid cancer.
Okay.
Automatically cannot take it anddon't say, when you say family
history, is that like mother,father, mother, father?
What does family history consistof?
Grandmother, grandfather, likenot my dad's sister's cousin's
friend, but Okay.

(29:24):
Family history.
Okay.
And if medullary a specific typeof thyroid cancer is in your
family history, your prescribershouldn't even look at it.
What if you don't know?
So then you have to assume therisk and your provider has to
document.
Patient doesn't know.
And why?
Why medullary specific?
'cause in research in micespecifically, they did see the

(29:45):
thyroid receptor is associatedwith the GLP one.
And in mice they saw thatspecific type of cell, I
believe, grow.
I don't quote me on this, butthat type of cell was isolated
is medullary thyroid cancer?
Rare.
An aggressive type.
It's rare.
It's a rare type.
So you see like papillary andthat's more common.
People say I havehypothyroidism.
Can I take it?
Yes, you can take it.

(30:06):
Okay.
Hyperthyroidism.
My mom has hypothyroidism.
Thyroid issues aren't theproblem.
It's specifically medullarythyroid cancer.
Okay.
So I guess how important is itthat a screening is done before
you're on something like this?
Extremely important.
Okay.
So you order like an ultrasoundof people's thyroids.
So if people, when I see them,if I do a physical exam and they

(30:27):
have an enlarged thyroid, Imight I check their thyroid
level when I start witheveryone.
Another big one is lipase.
So the pancreas is a big thing.
So pancreatitis is inflammationof the pancreas.
It can happen with people whodrink alcohol.
It can happen when you have yourgallbladder removed.
It can happen from certainmedications.
These medications have shownthat it may cause pancreatitis.

(30:48):
Okay.
So if so, if you're predisposedto that.
So if you've had it in the past,you shouldn't be on it.
The way we could see it ispatients call, they have
significant stomach pain.
If you're on a GLP one, yourdoctor needs to order a lipase
to make sure that you don't havepancreatitis.
Okay.
When you discontinue the med,the pancreatitis goes away, but
you cannot continue it and youcan never go on it again.

(31:11):
How does pancreatitis go away?
So we use IV fluids, we use painmedications, but it's really
discontinuing the offendingagent, which in this case would
be the GLP one and GLP one stayin your system for how long?
So the dosing is once a week, soyou'd have to think the
half-life is at least severaldays.
Okay.
So if you've taken it in likeMay, and then you've having

(31:34):
stomach pain in October orNovember later on that year?
No, it's not related.
No.
But I still would never give itto you again, but never to,
yeah.
Wow.
Okay.
So that's if interesting, that'speople that should not take this
medication.
And I, that's not, I guess myfollow up.
Yeah, that's a not a greatcandidate.
What would you recommend as faras if I'm, I keep going back to

(31:55):
the same question, but ifyou're, if they don't qualify to
have somebody like you prescribethis for them.
There's other medications thatthey can prescribe to them,
right?
So if they come in and they havethe need to lose weight, they've
tried diet, they've triedexercise, there are other FDA
approved weight lossmedications.
But just that aren't in thiscategory.
That aren't in this category.
Okay.
And they don't work the sameway, but people want, they want

(32:17):
these medications.
They come and askingspecifically.
Yes.
They come in askingspecifically.
And so when there's a will,there's a way.
And so would you recommend thenmaybe starting with your primary
and getting a full kind of paneldone and a baseline maybe to see
if there is anything that couldbe missed before you start?
Because if you go to a med spaUhhuh, I guarantee you they're
not sitting there and probablyrunning your life.

(32:39):
Like to prescribe you thesemedications.
So I would first ask yourdoctor, do you feel comfortable
talking about weight lossmedications?
Some of doctors don't wantanything to do with it, or they
don't believe in them or theyall that.
Then I would say, is there amedical weight management
provider nearby that you canrefer me to?
Okay.
And in our area we do have afew.
I.
Then once they get to themedical weight management

(33:00):
provider, that's where thespecialty comes in.
Okay.
Okay.
So that would be like a good,that would be like the order
that you would probably referredto.
Yes.
Feel comfortable doing that?
Yeah.
Okay.
And then can you talk aboutpeople that would be great
candidates for this maybe fromyour perspective?
Yes.
My favorite candidates arepostmenopausal women.
Patients who have gained weightfrom starting a medication like

(33:22):
I mentioned before.
Patients who eat well, exercise,but still can't get to a healthy
body weight.
The thing is they have to trythemselves because it's in
adjunct with weight managementdiet, exercise.
So if I have a patient comingand they're sitting in front of
me eating McDonald's, but losingweight on the scale, I'm not
gonna continue prescribing youthis because.

(33:43):
You're not changing your, it'sthe lifestyle change that you're
after.
So that still means something.
Okay.
These patients remind you alittle bit of yourself too
because you were somebody whodid work out, who did eat well.
Yes.
You had these tools and youstill struggled And one of the
weirdest thing is I find myself,when I talk to these patients, I
get tears in my eyes sometimesbecause it's still like that

(34:04):
personal.
Yeah.
Oh wow.
That happened to me.
Do you wanna talk about that alittle bit?
My weight?
Yeah.
Just about your journey and Iguess how this ties into you
because I think that's alwaysvery powerful when you have
somebody who's somebody that youcan talk to about these things.
Just in addition to a medicalprofessional.
It's like nice when you have afull rounded somebody who just

(34:24):
understands and can lend an earand explain maybe they've been
on the side of this.
It's almost like a therapist inconjunction with Yeah.
So if I have a patient that Ican tell is skeptical of me.
I will automatically be like,listen, this is a no judgmental
zone.
Like I had french fries dippedin a milkshake last night.
Like I get their guard down.
I let them know I'm human.
I say I was overweight my entirechildhood growing up.

(34:47):
I show them a picture of myself.
I tell them I get it, and I'll,try to just disarm them because
a lot of people wear theirweight as like a shield and it's
their defense mechanism.
And so first, if we candismantle that,.
So my history I mentioned alittle bit is I just was
overweight as a child.
Did all the fad diets, got to ahealthier weight, but was never

(35:08):
thin by any means.
I was always a little bit biggerthan all of my friends.
I was never comfortable in abathing suit.
I was never the girl at the likecollege parties wearing a bra,
type of thing.
And then I always wanted to bethat girl.
I feel like you were that girl.
I feel like you are that girl.
Like in my mind you are thatgirl.
I mean I might've been thatgirl.

(35:28):
Yeah.
And then I met Nick and he waslike, can you maybe not be that
girl anymore?
Can you get down off the bar?
Can you?
Yeah.
Not so I never had that.
Can you not be that girl?
Because that girl's reallyannoying.
Yeah.
And so now I wear all these likecrop tops and stuff.
I never had that growing up.
I feel like.
I love that for you though.
Thank you feel.
I love that.
Thank you.
It's really fun getting dressedwhen you are comfortable with
how you look.
I love that you share it andyou're not ashamed of it.

(35:50):
You're like, I wanted to make achange, so I did.
Yeah.
Also I've.
Non-disclosure.
I've had a tummy tuck, I hadthose two children and I had my
stomach stretched out, and Ithink I saw you at Bar and you
were like, you look amazing.
And I was like, I like threwdown my pants.
And I was like, look at my scar.
Like I just got this done.
The trans parent is amazingbecause I think that's
important.
Same with parenting.
If you're pretending likeeverything's butterflies and

(36:11):
rainbows, it's not the truth.
And, but you can't connect withanybody like that.
No.
And I think as soon as I, you'rejust gonna push people away.
Yes.
You can be in your new crop top,but you're gonna be all by
yourself.
You're like unapproachable.
It's not interesting.
And not that I want you to haveto gain a hundred pounds and
have to have a tummy tuck tohave a conversation with you,
but you looked amazing that day.

(36:32):
Yeah.
And I wanted to be like, damngirl, you look good.
And I wish I could say thanks.
It's from exercise and eatingless, but that's not the reality
anymore.
It's always, yeah.
Appreciated if people aretransparent with things, I we
talk about you don't always haveto share, like we've said that
on this podcast.
It's a fine line of it's nicewhen you can share but you don't
have to share and overovershare.
I don't have a littleoversharing issues.

(36:54):
We do too on here.
You're sitting in our podcastroom.
We clearly have a lot to say.
I think it's, I think it's agood thing for the future.
Yeah.
So that helped shape you to gointo this field, obviously.
So then I started college and Iwas still in the phase of
dieting and I was like, I'mgonna be a nutrition major and
I'm gonna learn the trick tobeing thin.
So I started my nutrition majorand I started really liking the

(37:17):
medical side of it and learningabout the disease states.
And so I went that route and mymom always said to me like,
you're gonna be on TV one daytalking about losing weight and
helping people lose weight.
And I was just like, medicalweight loss wasn't a thing then.
There was no medical weightloss.
And so being able to do this nowis really nice.
It I feel like it's such a goodfit and I It is.

(37:37):
It's my, because it's my life.
Yeah.
But it's also, you live andbreathe it.
Yes.
Yeah.
You can just feel that and itfeels like you're somebody that,
somebody could trust in thisspace.
I hope so.
It feels like that.
It's a good feeling.
You are feeling, you are a verytrusting person.
Like talking to you.
I feel like it's talking tosomebody that I've known
forever.
Because you're so open, you'reso honest.
Talking about your weight andlike going down memory lane to

(37:57):
when you were like a teenager.
That's not like an easy thing tobring up.
And you do this with yourpatients so they trust you
instantly.
You're helping people.
Yeah.
You don't want them to feeljudged by you.
You don't want anybody to feeljudged by you.
No.
What is the fad now?
Yeah.
Healthy like the fad then.
So the fad now is healthy.
Yes.
Have you ever seen those memeswhere it's eat whole foods, but
also don't eat too much, butthen don't have coconut oil, but

(38:18):
also, so there is so manymessages coming that I think the
message now is less is more.
Yes.
So shopping the perimeter whenmy kids ask for a snack, my goal
is okay, but it has to be fromthe refrigerator.
We have our snack habits, I buythe mini muffins, I buy the
fruit roll-ups.
I think you'll feel better ifyou have X, Y, and Z.
So that's the messaging.
It's more about the feel less ofthe look.

(38:39):
Yes.
And I need to eat breakfast.
I eat throughout the day and Ithink that's the best thing I've
ever done for myself.
Instead of starving yourself allday.
And then overeating later.
I think your kids need to seethat, but need to see what
you're eating.
So it's not like snacking allday on Chex Mix and pretzels.
It's understanding protein makesyou.

(38:59):
Full protein also gives youmuscles like depending, like
changing it to age appropriatetalking about it.
And Devin now will start, mydaughter, she's five, will start
saying this steak is gonna giveme a lot of energy.
And I'm like, it absolutely.
Oh my gosh.
So we finally have, I love that.
Love that.
I feel like I am jumping outtamy seat because we've talked
about how we struggle with themessaging.

(39:20):
Yes.
There's like healthy messaging,I think now more so than ever.
But we don't know how the frickto talk to our kids about.
Food in general without, wedon't, it's like we don't wanna
shame them.
Yeah.
We don't wanna guilt them and belike, two more bites, three more
bites.
Four more bites.
'Cause we want them to have thislike intuitive eating, but also
it's very frustrating when theyare like, I don't wanna eat

(39:41):
this.
I'm full.
I'm like, no, you're not.
I know you're not full.
You only have one bite andyou're gonna have snacks later.
And we're worried that we'rebeing pushy and the snacks
aren't gonna give you good fueland you have hockey practice.
So we're in sync about energyand not the image.
Yeah.
But we don't know what to say.
Yeah.
And what I'm finding, becausethis is where I'm deeply
struggling, is that the messageI'm seeing right now, and again,

(40:04):
this could be a trap with thealgorithm, the message that is
I'm seeing right now on how totalk to your kids is to not make
food a big deal.
Like you basically put, and I'mnot gonna, you put the dessert
on the plate, the parenting, andI'm not gonna shame the
parenting experts, quoteunquote, that are talking about
this, but I could assume thatpeople could put two and two
together.
It's all food is created equal.

(40:25):
Put the cake with the apples andlet them have at it.
And you don't make a big dealabout one.
You don't say, oh, the applesare healthy, the cake is not
healthy.
That verbiage should not be usedin the messaging from the
parents.
And I think that's bullshit.
Like I think that's extremelydangerous because it's not the

(40:46):
same.
It is not the same.
And so I think that it would behelpful growing up to share that
information without makingpressure on it.
But how could you tell a kidthat cake is the same as fruits
and vegetables?
How this is a big thing in myhouse because when I had kids, I
was like, my kids are not gonnabe obsessed with food.
My kids are not gonna beobsessed with dessert.

(41:07):
So I said, Brandon, we areputting the cookie on the plate.
And he was like, this is insane.
We're not doing this.
I did it sometimes, buthonestly, no.
That's not gonna work.
Yeah.
So the biggest thing is fooddoes not have a moral compass.
There is not good food and badfood.
Okay.
Food does not do good things ordo bad things.
Food has a place in your diet atall times, but there's different

(41:28):
foods for different things, sodifferent foods for different
things.
Yes.
Okay.
I like that.
So there's food for enjoyment.
You go to a circus and you'rehaving cotton candy that is
nostalgic and environmental andyou're enjoying it, then you're
at a meal or you're watching amovie.
Yes.
And you're having popcorn.
Exactly.
Food for enjoyment.
My kids will always say, can wewatch a movie tonight?

(41:48):
And I know it's yeah.
'cause you want popcorn andcandy, right?
Yeah.
But so there's that, and there'sall of that, right?
And then there's food for fuel,and that's the food that is
proteins and fat.
So cheese sticks.
My kids like these beef jerky,there's food for fuel like that.
Oh yeah.
The chomps.
Yeah.
Yeah.
That's great.
And then there's just fillerfood that taste good.
And you should really only havethat if you've already had the.

(42:09):
Fuel food.
But it's hard with kids.
So yes, there's days where mykids go from goldfish to
pretzels to cookies, whatever,or snacking all day.
But all you can do is beconsistent in what you're eating
in front of them, making surethey have a protein option every
meal that they have.
And you choose what goes intoyour house.
They choose what they eat.
Okay.
So whatever's there, if I putout a plate of cut up peppers

(42:32):
and cucumbers, when my kid hasfriends over, they're all going
to it, as opposed to if I'mputting out chips and salsa.
Because they'll go to that too.
Yes.
They'll go to both.
If you put out pirate's, booty,they'll eat that.
They'll, but when I'm cutting upa melon or I'm cutting up, I
don't know how to cut a melon,but if I'm cutting up fruit or
vegetables, my kids will comeover to me and take it and start
eating it because it's there andavailable.
If you're eating it I'm justcutting it for the week and I

(42:53):
leave it in the fridge, so ifit's like exposure.
If they're exposed to it.
It's exposure.
Yeah.
And that's what you, so whatyou're doing is working.
They are obsessed with dessertand they love dessert, but yeah,
it's working.
So then how do you to them aboutthat then?
Okay.
With dessert, when it's dessert,if it has a name, this is
dessert.
This is we have this after meal,after the meal.
This is for like the social partor the fun part or the sweet

(43:16):
treat before we go to bed.
Like I'm okay with it being thatI'm not okay with it being an
part of the plate.
So since they were little, we'vealways fed them what we eat.
And I know people listening arelike, yeah, like my kid will
only have mac and cheese.
We just always did it.
And some nights Dana will lovethe steak and Devin will say,
gross and won't look at.

(43:36):
She wants to have the dessert,she has to eat the meal.
Okay.
If you're hungry enough, you'regonna eat the meal.
Like you cannot have the dessertif you're not gonna have the
steak.
Okay.
So you, it's safe to theboundary.
That's how you hold thatboundary.
I do.
You're firm on, I don't likethat.
Dessert is bad, but I say youneed to eat this first because,
this is what's nutritious.
Okay.
Okay.
I like say it's bad versus good,but this is what our dinner is.

(43:56):
This is the Q why.
So this is, there is no shamearound food and there's no
praise around food.
Is that are you, I'm not like,oh, clean plate club.
'Cause a lot of my patients comein and say, growing up we had to
finish our food.
We were so poor that we wereshamed if we didn't enjoy and
appreciate the food we had.
So a lot of people gained weightthat way and they never learned
that intuitive eating.

(44:17):
So they don't, my kids don'tneed to finish their plates.
They need to at least taste it.
It try it.
At least try it.
Yep.
Or know that if you're not gonnatry it, there's not gonna be a
snack after dinner.
Okay.
I that because you're going tobed.
In my mind, that is how I wouldlike to operate.
Yes.
And I think I do most of thetime operate that way.
But then I hear this talk aboutnoise, right?
Like you hear the social medianoise and the guilt and the

(44:39):
shame around food messaging andall of this.
And I'm like, I don't wanna belike sitting here screwing both
of them up and how they have arelationship with food.
So I'm trying to do the rightthing.
But then you feel like, yeah,but you wouldn't sit down to
dinner with Raj and put a cookieand Skittles on your plate.
No, it would not on your dinner.
I heard that and I have heard itseveral times from several
different platforms.

(45:00):
It's, I'm like.
What, like I actually wanna besomebody that comments on the
thing, like what the actual fare you talking about?
Like how I always come back tothe data and it's like, where
are the kids that had that sortof parenting now?
And can you verify that theyhave a healthy relationship with
food now?
And that's also how you talk tothem.
That same kid who's not eatingtheir salmon and green beans

(45:22):
after dinner is like, mom, I'mhungry.
I want a snack.
And we'll say that's, thathappens at my house all the day.
So what?
So what's a good message forthat?
Dinner was 15 minutes ago.
Yeah.
You told me you weren't hungry.
There'll be breakfast in themorning.
So that's it.
And I get it.
Oh, you seem mean.
They're like, but we're hungry.
If you were that hungry, you'regonna eat the plate and we'll
leave the plate on the table forthem.
If you're hungry, great.
Your salmon's waiting for you.

(45:42):
So you offer the same thing frombefore.
Okay.
See, I, but they, yeah, that'shard.
I'm struggling in this houseright now because yesterday I
made dinner at one o'clock.
I grilled pork chops.
I made couscous and then I madelike a salad that nobody eats
the salad except for me andNick.
We are the only ones that areeating the salad.
Sometimes the girls eat it, butthen it's okay, first wave, when

(46:03):
they get off the bus, they'rehaving something to eat.
Then second wave before we go topractice.
Third wave when we get home.
Yeah.
So I'm only eating once, sosometimes they're not always
seeing me.
You guys are busy reading.
We can sit down as a familybecause they're three and five
as like sports and stuff comein.
It's gonna be tougher.
But I don't know that life yet,growing up, I did sit down with

(46:25):
a family.
I guess by the time we've gottento this point now, my boys are
like pretty good.
And they know what they'reeaters.
Yes.
And if they're gonna gimme ahard time about it, I'm like, go
to your room then I don't wannahear about Yeah.
Maybe build the foundation.
They're a little, they're alittle older.
I also question myself, both ofmy kids are in the lower weight
category.
They're percentiles are thirdpercent.
And I wonder if I would have thesame message for them if they

(46:46):
were overweight.
And that's what I, and I hopethey never struggle with being
overweight, but I wonder if Iwould be as lenient or Sure.
Or have dessert or buying theminim.
I wonder And I'll hopefully,we'll never know.
But it's a hard life to beweight.
Yeah.
I it is.
I, so I have four kids.
They're all pretty much like.

(47:07):
Decent.
They're athletic too.
They're athletic.
My middle son is the best eaterout of all of them.
He eats in air quotes like thehealthiest.
Okay.
And he, so when you say best,you mean healthiest?
Not that he tries a variety.
No.
Like he eats the most ofeverything.
Like he'll eat the steak, he'lleat the salad, he'll eat the co.
He eats like how I want him toeat.
I'm like, oh my God, you're sucha strong Yes.

(47:27):
He naturally gravitates towardsgood things.
I'm such a strong boy.
Like you're such a good eater.
Yeah.
And he outta all my kids is likethe stockies.
And he'll say to me like, mom,I'm fat.
Like why am I so fat?
And that's the genetics andmetabolism, like it's not
anything.
Just keep doing what you'redoing.
In the end it's gonna work out.
It's hard.
I'm like hard told you at schoolthat you are, you could tell
them that you are healthy.

(47:47):
And at that age she's door.
Which we were just saying.
He's at that age where you'rebecoming aware of your body.
Yes.
And maybe what you're putting init and you're comparing and that
honestly, that breaks my heartto even hear that on the outside
because like you're saying, he'ssitting there.
Doing the right things.
Right, Eating the correct way.
And then his siblings aresitting there eating Skittles
all the time and he's probably,yeah.
We also shouldn't limit his foodbecause if in your mind, if

(48:09):
you're like, then I'll startgiving him less so he doesn't
need as much.
He's gonna start sneaking foodand then people, and then they
get obese that way, I know.
So what's gonna happen?
Try, I try to limit his sweets.
Okay.
Like the sweets.
Because sometimes he'll gooverboard on the sweetss, like
the other kids will grazethrough the meal and they'll go
off to their sports.
Vincent will eat his whole platelike a good, healthy boy.

(48:31):
Yeah.
And then he'll have, he'll wanttwo or three ice creams.
I'm like, can we maybe just haveone ice cream?
But then I don't wanna make it athing because I know, like you
said, he'll hard be sitting itin his room.
Like after all that, will heever be like, oh, I eat a little
bit too much.
I've never seen him do that.
So I, he's like a bottomlesspet, and now I'm like really

(48:52):
oversharing?
Now he's on, he has a DHD andnow that it's school time.
Yeah.
He's on the A DHD medication andhe, so you under eat during the
day, so he won't eat as muchduring the day.
So when I, he comes home andhe's binging Spamish.
I know it's because he hasteaten a thing the entire day.
The food is tricky.
It's so tricky.
And we, and it all comes down togenetics.
So if he's gonna be a stockylittle boy, he's gonna be a

(49:13):
stocky little boy.
Yeah.
And you're gonna love him.
And that's him.
He's not gonna have highcholesterol and diabetes because
he is eating well.
But if his body type is stockiergo have fun at football.
Embrace it.
Yeah.
I'm not like body positivity,obesity, I'm body positivity.
This is what you have.
Like this is your belt.
This is your belt.
Yeah.
And I used to hate my whatever,insert my stomach, my butt,
whatever I see on Dana.

(49:33):
Dana has my butt.
I love her little butt.
But I ever want to.
Talk to her.
Like I used to talk to myself.
I know.
Now I know.
It's, she's the cutest littlebutt in the world.
When you become a parent,especially when you become a
parent of girls, of a girl, you,it's crazy how your mind just
shifts about how you think aboutyourself.
I'm sure it could go to bothextremes, where maybe you become

(49:56):
harder on them if you'renoticing something about
yourself, Yeah.
If you see like a correlationthere, it's probably triggering,
oh, absolutely.
But it also makes you verysympathetic and it also makes
you more aware of how you speakto yourself and how you think
about things.
And you didn't like this aboutyourself, but now it's on your
kid and it's, it's hard.
Parenting's hard and the foodpart of it, you hope doesn't

(50:18):
become a thing.
You want it just to be naturaland you want it to be
dinnertime.
Kids let's have our chicken andbroccoli and rice.
But it's gonna become a thing.
So you just have to be equippedhow to deal with it.
And the best thing I could sayis never call a food good or
bad.
Okay.
I like that advice.
Food, good or bad.
I like that a lot.
And you are not good or bad foreating said food, right?
Like patients come in and say,oh, I was so bad yesterday.

(50:38):
Yes.
I was like, did you rob a bank?
And they're like, no, I had icecream.
And I'm like, no.
Walk out the door.
Yeah.
So you gotta talk to yourselflike food is food, you mess up,
you start over tomorrow.
But it doesn't have to even bemess up.
You're right.
Absolutely.
You mess up in your mind.
You mess up in your mind.
You didn't follow yourprescribed perfect plan in your
mind.
I'm a failure, you, ooh.

(51:00):
I shouldn't have had those m andms as I walked upstairs last
night for bed.
I'm a failure.
Tomorrow morning you wake up,you don't skip breakfast to make
up for it.
Those calories you start and youhave your eggs and you have your
toast and you go it's a reset.
Yes.
And that's part of what themedical weight management.
Practice does is because it'sreframing, it's psychological

(51:21):
medical, it's a whole new fieldthat we're learning about.
And these medications are agreat tool for that.
I love, so my mom grew up poor.
They were like immigrants fromItaly and they grew up poor.
So I wanted to eat like thesnack wells.
I wanted a Lunchable, I wantedto buy lunch.
And she was like, the processedfood.
No.
You cannot eat that.
That is crap.
And part of it was a, it was howshe was raised because that

(51:44):
other stuff cost money.
Whereas like the garden wasessentially free.
Yeah.
And B, it was like, she wouldcall it crap.
It was never like she was aheadof the game for weight loss it
was never like for aestheticspurposes, she was like.
No, this is actual shit.
Crap.
You are not eating this.
You have to eat this.
But that's how you, and that waswhat was available and that's
what you like now, right?
But I feel like I rebelled alittle bit.

(52:05):
'Cause I was like, when I becomea mom, I'm gonna give my kids
chips and snacks and this andthat, and I'm gonna, I'm not
saying it a big deal and I'mgonna do all the things.
And then I'm like, oh my God,they're absolute monster terrors
when they eat this stuff.
Like food really does affect Ijust prescribed the Thrive
Market.
Have you ever heard of ThriveMarket?
Yes.
Oh I just prescribed it and I'mgonna be like, does Red 40

(52:26):
really do anything?
I don't know.
And I'm not an expert, but I'mtrying the Oreos from Thrive
Market instead of the grocerystore and Right.
I'll let you know if it works,but you can report back to us.
But t do you feel like with thatmessaging being shared from your
mom, do you feel like you havean unhealthy relationship with
food?
I feel like no.
It's like she's a good one.
She I have a really goodrelationship with food.
Yeah.
Don't think it did any damage.

(52:47):
I think it was like probably oneof the best things that she
could have done for me.
And parents should put so muchblame on themselves, do the
best.
You We're all doing the best wecan.
With everything with parenting.
Yes.
So this is just another part ofit.
Yes.
I love that.
Yeah.
It's turned into a parentingpodcast again.
I know.
We, it always does.
It always circles back because Ialways like to come at
everything from all the momsthat are listening in.
Mm-hmm.
And just relating it back tothat in a way, if we took the

(53:10):
roof off of all of our house,the same shit is going on at our
house.
Oh, yep.
At the same time.
Or your daughter was yelling atyou?
Maybe not at four.
Mine was the night before, butshe called me like, I feel like
all of our kids won't sleep intheir own beds.
They don't wanna go to sleep atnight.
Then they're gonna grow up andthey're gonna have a husband.
Then they're gonna wanna sleepin their own room and like Dev,
I'll go in your bed like, youcan sleep with Brandon.

(53:31):
I'll go in your bed.
You're delightful.
We all have such similar thingsgoing on.
Yep.
And we don't all have theanswers.
Sometimes things work, sometimesthese don't work and we don't
all talk about it, which is wedon't all talk about our weight.
We exactly need to.
Yes.
No one wants to be friends witha thin girl at the table who
says no to bread, and you don'tknow why.
It's'cause you're on ozempic,right?
That's why.

(53:51):
But sometimes these medicineslet you do it.
So it's the first time in mylife that I can have the bread
basket and not worry aboutgaining weight, right?
I used to weigh myself every dayand I was like, oh, it went up a
pound.
Oh, I really shouldn't have hadthat peanut butter on the apple.
That doesn't matter.
Now, I tell my patients once aweek, every time, the same week,
once a week.
And if it's gonna mess with yourhead, don't ever do it.

(54:13):
And just do it here.
Turn around.
So some, sometimes thatmeasuring is like unhealthy
barometer, right?
For people's success scalevictories are great.
One thing, non-scale victoriesare better, right?
And we talked about thoseearlier, about lowering your
cholesterol, all those otherhealth benefits.
But also the grandma who can nowrun around with her grandkids or
the person who loves to travel,but never would because the

(54:35):
airplane seat belt didn't fitthem.
Those are non-scale victories.
Love having a, the reunioncoming up and feeling
comfortable going,'cause youmissed 20 and 25 because you
felt overweight.
Oh.
So like the, those are great.
I love that term.
Non-scale victory.
And they're big ones.
Like their knees don't hurt,they don't need to get knee
replacements surgery anymore.
Nick said for every pound youlose is 15 pounds off your knee.

(54:56):
Mm-hmm.
Or some like crazy.
I'll give equation people a 15pound weight and I'll be like,
you were carrying that aroundfor your whole life.
And now they're like, wow.
Yeah, I like that because thenI, again, it goes back to what
we were talking about thebeginning of the episode where.
There shouldn't be shame inwanting to change something
about yourself if you feel likeyou need to.

(55:17):
And I don't mean that from alook perspective as much as, I
mean from a within perspective.
Yes.
And I like correlating it tothis non-scale victory because
you know you're gonna feelbetter and it impacts your day
to day when you're feeling goodabout yourself going to the
beach with your kids.
Yes.
And feeling comfortable in thebathing suit and building the
sandcastle.
Yes.
Instead of wrap, being wrappedup and worrying about things.

(55:38):
Yes.
Like it is.
So I love correlating that tothe non-scale victories.
Sometimes if you do things tobetter yourself, you feel
better, and then you live yourlife better, yes.
And you're a happier person whenyou feel good about yourself.
And that's not, doesn't meanyou're wearing a size four
jeans.
It just means you're doingeverything in your power to make
yourself better and to feelbetter.
There shouldn't be shame inthat.

(55:58):
No.
And you should share how you doit for other people so other
people can do it.
I love that.
That's a great message to endwith.
Yeah, I love that.
I don't know how we could havegotten, I feel like we squeezed
all of our questions.
This was great.
Thank you so much for sharing.
We're gonna close our episodewith our pink spotlight.
And our pink spotlight is aperson, place thing, tip,

(56:19):
mantra.
Anything that we're doing tomake either life a little bit
better, or for t and i, it's theweek a little bit better.
So yeah.
Do you wanna start out, Steph,do you have one that you can
share?
So I've been thinking about thisfor weeks.
Oh my God.
Since I was asked to be on theSI was like, what's my pink
spotlight?
So today my pink spotlight is mysister and I were in Cape Cod
this summer.
Mm-hmm.
And we were walking aroundChatham and they had these charm

(56:39):
bars set up and you could makeyour own bracelet, your own
necklace.
And they had.
Like religious affiliations andletters and animals.
So we created these charms andI'm wearing one today that has
like a beach and my horoscopeand a ladybug.
And so my sister was like, thisis amazing.
We need to start doing this.
And she recently we startedcharmed.
I love it.
H-A-R-M-D-I love it.

(57:00):
D is for our mother.
Aw.
And we'll be having partiesaround the area.
So fun.
Yeah.
So I'm wearing a necklace and I,oh my God, I love this.
Oh my God.
Where can little, where can ourlisteners find you?
So it's charmed by dd.
Okay, perfect.
And you guys, you said you werebooking parties, like if
somebody was having a birthdayparty or like a girl's party,
you'll set up off to the sideand people that's, and they can

(57:20):
custom make stuff.
Oh, kids size bracelets with thelittle Taylor Swift.
I love it.
Cowboy boots is, this could bekeeper is the price point.
Don.
It's real.
So they're 18 karat gold filled.
It's not a fine jewelry line,but they're fun to mix and
match.
So I'd say the bracelets arearound like.
$30 and then each charm is likeseven to 10.
I love it.
So it's a very good price point.
Yes.
And they look, they're fun.
I love it.
They're beautiful.

(57:41):
I love it.
Like change.
And I like fun.
That you like can tailor it toYes.
I know.
'cause I feel like I'm all aboutlike the customization of things
and I feel like that's justreally fun.
Yes.
I just thought it look so cuteon all the Cape Cod girls and I
was like, I need to do this.
Oh, what a good idea.
I love that.
And I love when people lean intotheir creativity.
Yes.
That's all Emily.
But like you said, your sisterEmily, she's great, is very
creative.
She loves creating things andmaking things for people.

(58:03):
And and this is cool.
I feel like this is just anotherexample of having an idea,
putting it out there I'msurpris, I'm shocked do, she's
putting it to fruition.
I love for her.
Yeah, I was say Emily, I supportyou.
I do not wanna be a part of anyof the admin.
I Oh no, I think you're gonnahelp her.
You're gonna help her.
You're gonna help her go to allthe parties.
I would love to help her behindthis.
Behind the scenes.
Yeah, Christina does jewelry.
I know.

(58:23):
I would love, that's I know likea little collaboration.
She has a charm on now.
That's what made me think of it.
That's beautiful.
I have a little tennis track.
I love that.
Perfect.
And a got piece for my tennisteam.
Perfect.
Aren't they cute?
It's beautiful.
I love that.
And I love that.
That's something that's likecoming back.
Where I feel like when we weregrowing up, it was what did we
have?
I feel like, why am I blankingon the Pandora bracelet?
Pandora, you would just havestuff that you would like.

(58:44):
Alex and Ani bracelets were hugein college.
The charm was a big one.
Yeah.
Like where it's like you buildyour collection around things
that matter to you and I feellike this is fun.
Or just a good old fashionedlike charm necklace.
Yes.
Or if your kid's going to haveher recital, you'll get her like
an extra belly charm to add.
Like you can add things.
So it's fun.
That's really fun.
Okay.
That's adorable.
I love that video.
I love that great pinkspotlight.
Thank you for sharing us.

(59:04):
What about you?
So I just started putting outall my pumpkins and Fall girl,
which inspired me is that I am ahuge Mackenzie child.
You are.
Oh, you're girl.
I walked in.
I know.
I'm a huge Mackenzie childcollector.
And I that's been my go-to forgifts for you love.
I'm gonna give you a littlebackstory.
So when Joseph was born, I thinkhe was like.
Three or four months old, Istarted collecting Mackenzie

(59:27):
Child and I would go down theonly store in Connecticut at the
time, other than Lux Bond andGreen, which only had the black
and white check was MiddleburyConsignments.
My girlfriend Vanessa and Iwould drive down to Middlebury
and we would like, there was alittle cafe there and we would
get like one piece, we wouldpick it out.
'cause everything is handpainted.
So we would pick out the one wewanted.
And we met the owners of thestore, Dean and Rachel, who are

(59:48):
our age, who had just had ababy.
And we, they are best friends,they have four kids.
So we've been friends now withthem for over 12 years.
And so I love to get all mypieces at her store and I still
now I, you're so Maddy downthere, I get like one at a time.
Yeah.
'cause it's like a keepsake.
It's like a nice, yeah, it'slike special and they're
expensive pieces, but I'll getthey have great gifts too
though.
They're like such a nice gift toReese.

(01:00:09):
Have spoon to get, yeah.
It goes with every, it's great,but I just, you're the, you like
the black and white jack.
She has the pink and white,right?
Yeah, I have the ster.
I like the sterling, which islike the pretty gray.
Yep.
I'll sh I'll post pictures.
I just got the pumpkins arereally cute.
I just got a sterling pumpkin.
I have the green in my bardownstairs.
What about the pink, pink greenpinks right here.
I know what pink is right here.
I just got a pink.
The girls have a butterfly.

(01:00:30):
The butterfly ones.
I see that in there.
I love the picture as a giftthat I have.
I like the floral one.
That was like I don't know ifthat was limited edition, but I
like, like the floral one for mystuff outside.
They make a little kids' teaset.
They, I, oh, we have tea set.
My friend Ally has it for agirls.
I love it.
We have the tea set, but I loveMackenzie Childs and if you are
in Connecticut, you should godown to, and actually, I think

(01:00:51):
that they changed the name oftheir store.
I don't think that they're likeMiddlebury consignment anymore.
Yeah, I just wanted justMiddlebury Furniture.
Middlebury Furniture and HomeDesign.
They have a 40,000 square foot.
Warehouse and they moved thegift shop to there.
Yeah.
Their gift shop is out of thisworld.
If you wanna just go down andjust tell my sister and I'll
take a ride.
Yeah.
Oh my.
And they have a vineyard acrossthe street.
But anyways I'm in my fallMackenzie Child era.

(01:01:12):
Yeah.
'cause that's when you typicallybring out a lot of the stuff.
Yes.
'cause my the pumpkins are mypumpkin favorite pumpkin.
Yeah.
I know.
I just saw somebody unboxing abunch of those and I was like,
those are so pretty.
That's an investment I keepwanting to do.
I know.
I'm like at Home Goods gettingthe plastic ones, but one day
I'll do that.
Oh, they're beautiful.
I love it.
One a year.
One a year.
Yeah.
But it's, yeah.
But now you, but over time it'slike you start to build a little
collection.

(01:01:32):
Yeah.
And that's so nice.
And I love that the stuff, it'sjust the same pattern, so you
just keep adding Yeah.
It doesn't look old.
It's like very timeless looking.
Yeah.
So there you have it.
I love it.
So mine this week is I have beenon a rebuying denim kick.
Oh.
Because for the first time infour or five years, I am a
consistent size and I thoughtthis was a appropriate place to

(01:01:55):
share this because I've beenpostpartum out post just like
all over the place.
And so now I have a consistentsize.
So I've been rebuying my denimand I am obsessed with the pair
that I'm wearing right nowbecause I went back to investing
in some denim pieces because Ifinally feel like, okay, I'm a
consistent size, so this makessense to do it now.

(01:02:16):
So I have a pair of motherdenim, I believe these are
called the Rambler, and I don'tknow if I've just been out of
the denim world for so long.
They're great, but things arelike stretchy, but keep the
shape.
Now they look like the Levi, themain one today.
Yes.
Are those mother?
Mother?
These are mother.
I bought them for my sister, butI bought them for myself this
morning.
And they are an investment.
Yes.
But.

(01:02:36):
They always will look good.
Yes.
And they keep their form.
I've always been like in lovewith denim, like I'm a denim
girl.
But then when I just, I waseither like pregnant or
postpartum mm-hmm.
and wearing leggings and so Iwas really like, out of the jean
came for a really long time,think time.
Very expensive.
Over years.
I think they did this.
So first of all, the prices shotthrough the roof.
Like ag used to be like one 10,everything went up.

(01:02:56):
Like mother at least$50.
50.
Yeah.
They used to be 200 and nowthey're two 50.
So it, again, it was not thetime to invest in those pieces.
'cause I was like, I can't evenstay a consistent size right
now.
But I feel like the stretchyjeans that we used to wear, yes.
The jegging five plus years agoused to lose their shape a lot
more.
Yes.
And then I feel like then therigid styles became a little bit

(01:03:18):
more what you wanted notcomfortable for because you
could, like they do have a timeand a place like they suck you
in.
Yes.
You feel like they, you get alittle bit more shape maybe with
them, but you cannot stay inthem all day long.
No, those you could wear day,all day.
So now I feel like I'm likereentering denim and wearing
denim and I'm like, wait aminute, where did you get them
Locally?
I get, I bought these fromRevolve.

(01:03:39):
I had gone into anthropology.
About a month and a half ago andI did another denim, like I
went, I was looking for adifferent pair of denim and that
kind of started me off where Iwas like in there actually
trying on jeans and I triedthese on, but a different wash.
And so I knew that they fit andI was like, okay, if I see a
different wash somewhere elseI'll buy those too.
And so I had already tried themon.
So I feel like my first pinkspotlight,'cause I had shared

(01:04:01):
that I went into the store andactually tried on Cho in stores.
I think online is wonderful, butoh my god, going in and trying
on jeans, I find myself at themall.
All the sees you the headachetime.
Yes.
So that was huge for me was likefinding the size and the style
and like the brands that work.
And trying them on and havingfun with that.
But then now that I know my sizeand a couple different brands,

(01:04:23):
I'm like reordering things andI'm like, wow, okay.
So even in five years thingshave improved and I am wearing
these jeans and I will not takethem off.
I put them on first thing thismorning, like before the kids
got up, be in them all day long.
Like what?
Like usually I can't get out ofthem fast enough.
Like when I come in it's like wedo not wear jeans inside.
And now I'm actually like, thejeans are like sweatpants now.

(01:04:45):
I like they're more comfortablethan some of my sweatpants.
Okay.
I love that.
That's a stretch.
So in just like shameless pluginAvon, there's a store Coco Lily.
And she sells mother jeansthere.
I was gonna say KimberlyBoutique in West Har.
They do.
So Nordstrom has it.
Yeah.
It's nice to be able to golocally.
And try on jeans.
I love trying on.
Yes.
I feel like jeans are one ofthose things where you need to
and I feel like with ordering,how many jeans are you gonna

(01:05:07):
order at 250?
The jeans in the same wash looksso different On different, yes.
That's a good wash.
It's so true.
Same thing.
Medium wash.
So which one is that?
What style is it?
This is the ankle pipe jeans.
The jeans pipe.
Those are cute.
I like those too.
I love those because I'm likenot so tall, but I could wear'em
with all shoes.
I love those.
Yes.
That's what I got these,'causemine hit at the ankle.
When I'm standing and there's, Ican actually wear them with like

(01:05:29):
boots.
I can wear them with flats, withheels.
It's that's why when you make aninvestment in jeans, make sure
it's something that you can wearwith a lot of different things.
That's, you just gotta pull thetrigger.
You gotta just do it.
But yeah.
But then you won't buy anotherpair for a while.
That's why I feel like I'm like,or I could buy a bunch of
different kinds and I'm stillnot happy or invest in these
trends.
I go to the same too.
Anyway, I feel like this trends,like I love a wide leg right

(01:05:51):
now, but they might go out, so Imight go to Gap or somewhere
quick and stuff.
But like staple pans that youlike always can go grab.
I agree with you.
Yeah.
So that was, I wanna be a wideleg jean garage.
I love a pair of brown ones fromZara.
And I wanna, we need to Zarahere, you can do anything.
Get us a Zara.
I cannot on Zara feel like I'mtoo a short for them.

(01:06:12):
You're not a tailor.
Growing up my mom would bring usto the tailor there.
Nothing.
Think sometimes they can beelong, maybe need to bring them
to the tailor.
Yeah.
I try, you know what, I didn't,I boxed them up and I was gonna
return them, but I've beendriving around with a box for
two weeks.
'Cause I'm like, no, I thinkmaybe Spanx makes a really
spank.
I try, I want a brown pair andthey look and feel so good.

(01:06:34):
Spanx.
I could bring mine over for youto try because I have them, I
and I love them.
Those, that's a goodrecommendation.
Spanx for wide leg.
Spanx, if you're like on thefence because they hug you and
all the way know a jean.
Yes.
But they're like a fake gene.
It's like a chino denim.
Yes.
Like a navy that's want to workand stuff.
Yep.
They have brown, they haveblack.
Yep.
They're just like, they lookreally good on heels.
I'm in my brown era.
Hug.

(01:06:55):
Same.
I love brown.
Love it.
On that note, guys, this wassuch a good one.
Thank you for coming on.
Thank you.
Was easier than I thought.
It was very, I know that when wehad asked you, you were like,
no, I don't like publicspeaking.
Yeah no.
And I was like, we need you toshare your voice and your
knowledge here on this podcastbecause if you turn on
Instagram, just people don't.
What to know what they'retalking about or they think they

(01:07:17):
do or they're sharing some,they're not sharing the whole
story.
And we want our listeners whoare so invested in this to hear
everything.
So thank you for sharing it.
Great.
We appreciate all the knowledgeand you're on camera.
Awesome.
You did great.
Thank.
Shut up you guys.
You came in blow.
Oh my God, you got your hairblown out.
I love you and I love this.
Oh, I know.
And we got, I feel like me andyou get rejected sometimes when

(01:07:39):
we ask people to come on andthey get so nervous and I'm
like, you're gonna come on andyou're gonna do great.
And we've just, we're so luckythat we have these voices, like
in our pockets of people that wecan have come on and share their
knowledge.
And we're just so grateful foryou.
So thank you for being brave anddoing it.
Thank you.
Getting outta my comfort zone.
Yes.
Thank you for doing this.
We really appreciate it.
Alright.
We love you.
Thank you guys so much forlistening next week.

(01:08:00):
We'll see you next time.
Bye bye.

(01:08:32):
Did it crushed it?
That was I always say every timeI have someone on, I'm like,
that was amazing.
We're always like, this is gonnabe the best episode.

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