December 1, 2025 • 29 mins
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We unpack new GLP-1 pricing, coverage hurdles, and whether cash-pay programs make these meds more reachable for diabetes, obesity, and sleep apnea care. Along the way we share candid pros and cons of injections, tease future oral options, and weigh real tradeoffs.
• current cash-pay pricing from major manufacturers
• differences between Wegovy, Ozempic, and Zepbound
• tighter insurance coverage and prior authorization burden
• fears about injections and route-of-administration bias
• potential oral GLP-1 timelines and cost impact
• framing obesity as a chronic, treatable disease
• practical tips to explore HSA or FSA options
• how to decide if the monthly cost is worth it
Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN
Artwork Rebrand and Avatars:
Vantage Design Works (Vanessa Jones)
Website: https://www.vantagedesignworks.com/
Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr
Original Artwork Concept: Olivia Pawlowski
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_01 (00:07):
Hi, welcome to your checkup.
We are the patient educationpodcast, where we bring
conversations from the doctor'soffice to your ears.
On this podcast, we try to bringmedicine closer to its patients.
I'm Ed Delesky, a familymedicine doctor in the
Philadelphia area.
And I'm Nicola Rufo.
I'm a nurse.
And we are so excited you wereable to join us here again
(00:27):
today.
I have it on good authorityafter our last week's What are
you gonna say?
That the Michelin stars, theMichelin people, is the same as
the tire selling company.
Good authority.
SPEAKER_00 (00:46):
Who told you that?
Mike from his basement?
SPEAKER_01 (00:48):
Yes.
Exactly him.
He sent me a picture and all.
And it's probably not doctored.
And that Michelin guy, you know,the guy with the white rolls.
Yeah, he's up there.
He's on that stage.
SPEAKER_00 (01:03):
Oh, really?
Yeah.
That's cool.
Yep.
Well, Mike is good with RD, so.
SPEAKER_01 (01:08):
I told you.
Well, he said that and he'slike, I have an idea how the uh
December.
SPEAKER_00 (01:12):
Is this what you were gonna light me up about on
the podcast?
SPEAKER_01 (01:15):
Yeah, that's about it.
The Michelin is like too big ofa it's so niche of a name that
like it can't possibly be likeused there's Michelin tires and
separately Michelin stars.
SPEAKER_00 (01:31):
How did the tire people like get into raiding
restaurant business?
Um I uh what else are they upto?
SPEAKER_01 (01:41):
Oh, that I don't that I don't know.
SPEAKER_00 (01:43):
Now we're you are like the Michelin family.
Do you know?
SPEAKER_01 (01:48):
Well is there no I I didn't come that prepared.
SPEAKER_00 (01:51):
Like heirs to the Michelin throne.
SPEAKER_01 (01:54):
We're not gonna talk you know, Michelin people, but
we're gonna talk about it.
SPEAKER_00 (01:57):
I'll do some research.
It'll be part of Nikki's Cornernext week.
SPEAKER_01 (02:00):
Yes, yeah.
Please do.
Um catch us up for Nikki'sCorner, which you can look
forward to next week.
SPEAKER_00 (02:07):
Um there was only like one little thing I wanted
to talk about.
SPEAKER_01 (02:11):
Yeah, no, I think you know, it can't be every week
because then it's not special.
SPEAKER_00 (02:16):
No like breaking news of the world, except that
everyone's mad that Robert Irwinwon Dancing with the Stars and
not Alex Earl, but people thinkthat it's rigged because um
Bindi won like 10 years ago,which I didn't realize there was
I don't know what that age gapis between the two of them.
(02:39):
Hmm.
Anyway, yeah, people are madabout it, and I can't stop
watching Alex Earl's like finaledance.
It was so good, don't you think?
SPEAKER_01 (02:50):
I do.
SPEAKER_00 (02:50):
Uh I think we watched both of them and Alex
was better.
SPEAKER_01 (02:54):
Yeah, uh her is the star.
SPEAKER_00 (02:56):
Crawl slide thing.
SPEAKER_01 (02:57):
That was funny.
Yeah, that was great.
Yeah, I gotta try that.
But uh the you know, like bothdancers were great, but she
looked like she was doing moreof the work.
SPEAKER_00 (03:07):
And then when he came to watch- I mean, the girl
is always doing more of thework, and then the guy is just
like they're supporting.
SPEAKER_01 (03:13):
Like when he was doing his, like she was doing
all the stuff, and he's the one.
SPEAKER_00 (03:18):
Well, that's why it's also like not fair because
the professional dancer in thatduo was the girl who's always
doing more work, and then theprofessional dancer in the Alex
Val duo was the man who justlike inherently does less work.
Right.
SPEAKER_01 (03:36):
Yeah, I don't know.
It looked like she had thebetter performance.
Yeah, maybe there's like there'ssomething technical.
SPEAKER_00 (03:43):
She's the people's mirror ball winner, that's what
everyone is saying.
SPEAKER_01 (03:46):
Is that the award?
Mirror ball.
Yeah.
This has been on for a while.
SPEAKER_00 (03:52):
I know, I never actually watched it.
Like, I feel like I watched thisseason just via TikTok.
Like, I've seen all the dances,I feel like, but I never
actually sat down to watch theshow.
SPEAKER_01 (04:02):
I mean, like, I pulled it up for us to take a
look at, and then then I waslike, I mean, there's like 23
seasons, like it's a bigcommitment.
SPEAKER_00 (04:09):
That's maybe next season we'll depending who's on
it.
They had a lot of good peoplethis season.
SPEAKER_01 (04:15):
They did.
It was very like uh let's see,cohesive with our content plate,
if you will.
SPEAKER_00 (04:23):
Yeah.
SPEAKER_01 (04:24):
So it made a lot of sense.
Um yeah, shout out to SteveIrwin.
I think he died, right?
He died from touching astingray.
Is that the thing?
Yeah, that's tragic.
Yeah.
Do what you love until it killsyou.
That's damn.
If I say damn, is it gonna putus as an explicit podcast on
Apple Podcasts again?
(04:45):
That that was that was crazy.
Um, well, that, you know, toeach their own.
Thank you for sharing.
Um, Christmas gifts.
You know, it's tricky to decidewhat someone gets.
Um, you know, some people saylike you should write out what
you want, like you should putyour what you want on a list to
let people know.
(05:06):
But it hasn't always been likethat.
Um, you know, what did Jesus do?
SPEAKER_00 (05:11):
Oh my god.
I was like, where is he goingwith this?
Did Jesus ask for for all that?
Okay.
So what happened was we were atThanksgiving, had a great
Thanksgiving, and we're alltalking about like Christmas and
Christmas gifts and da-da-da.
And my one brother, for somereason, is just like a weirdo
(05:32):
about receiving gifts.
And he hasn't like let anyoneknow anything that well, he
actually has, he added to thelist.
But on Thanksgiving, he waslike, I don't know, I don't need
anything, whatever, like I don'twant anything.
Or did he say I don't needanything or I don't want
anything?
Whichever one he said.
SPEAKER_01 (05:51):
He said, I don't need anything.
Because then we were like, no,you you're allowed to want
things.
SPEAKER_00 (05:54):
Yeah, and we're like, Well, what do you want?
He's like, Well, nothing, Idon't really want anything.
And then I was like, Do youthink baby Jesus wanted gold
frankincense and myrrh?
No, but he got it.
And he was dying laughing.
It's like the funniest thing.
(06:15):
Probably had to be there.
I think it probably had to bethere.
SPEAKER_01 (06:18):
I, you know, we um the greatest, I'll put it this
way, the greatest complimenteither one of us could receive
is that we're funny.
Um, I think that's one thing wealways at the risk of our like,
you know, professionalism,always chase.
SPEAKER_00 (06:33):
And yeah, so always strive to be the personality
higher.
SPEAKER_01 (06:37):
Yeah.
So at whatever, at what at whatwhatever it costs.
And we um we do this at home.
Like we go back and forth.
And like I objectively think welike serve each other great
material all the time.
But you know, when you live withsomeone, it's like and you're
laying there and you're like,whip out a good one, and maybe
(06:58):
like you don't laugh the way Ihope you laugh.
And I'm like, you know what?
If this was a set of people whodidn't know us, this would have
killed.
SPEAKER_00 (07:06):
Yeah.
I know, or sometimes I'll saysomething and I'll be like, that
was funny.
Why aren't you laughing?
SPEAKER_01 (07:12):
I know.
And I'm like, objectively, itwas hilarious.
And I it doesn't, it's not fair.
It's not fair, is what it is.
Um got a house of comedians overhere.
We'd like to think so.
I'm not sure if that's the case.
Um, you tell us if you'relistening.
But yeah, gold, frankincense,and myrrh.
We know what gold is, but Idon't know what frankincense or
(07:33):
myrrh are.
SPEAKER_00 (07:35):
Myrrh.
SPEAKER_01 (07:36):
Myrrh.
Frankincense.
So hit us up.
Um, you can send us an email orsend us some fan mail.
It's in the show notes how toaccess that if you um have a
burning understanding of whatfrankincense and myrrh are.
Because we already understandwhat gold is.
Um, we watched a good show thisweek.
SPEAKER_00 (07:57):
Oh, yeah.
This was a good one.
We did it.
It's on Peacock and it's calledAll Her Fault.
Dakota Fannings in it.
It was so good.
SPEAKER_01 (08:05):
And Shivroy.
Uh she has a name, but Shivroyfrom um the business like show.
SPEAKER_00 (08:13):
Huh?
Uh the business like succession.
SPEAKER_01 (08:16):
Yeah.
Oh like I didn't watch it.
She hasn't she has a name.
I'm I'm being bad right now.
But that's a bit of a.
Yeah, the mom.
Oh.
The redhead mom.
Marissa.
Marissa, correct.
Marr.
SPEAKER_00 (08:27):
Marr.
SPEAKER_01 (08:28):
Um, and then that other guy who's like in a lot of
things now.
SPEAKER_00 (08:31):
Yeah, with the chin.
Yeah, if he He was in White thefirst season of White Lotus, he
was like the kind of likeannoying husband.
SPEAKER_01 (08:41):
He seems to be typecast in that role.
If there was a fairly oddparents remake, he could
definitely be the Crimson Chin.
SPEAKER_00 (08:47):
Oh my god.
SPEAKER_01 (08:48):
Uh no, this was good.
SPEAKER_00 (08:50):
Um Yeah, it's about a boy who goes missing, and then
like within the first like twominutes of the show, and then
everything that happens after,and there's like a twist, and
then you think that that's thetwist, and then there's another
twist, and then there's anothertwist on that twist.
SPEAKER_01 (09:05):
Yeah.
SPEAKER_00 (09:06):
It's crazy.
It was so good.
SPEAKER_01 (09:07):
It was entertaining.
SPEAKER_00 (09:08):
Even up until like the very end, and then that like
final scene with the detectiveand the mom.
SPEAKER_01 (09:12):
Right.
And it was good.
And there was like uh it was alot too.
SPEAKER_00 (09:16):
Like we it was like eight or nine episodes, and they
were all like 45-ish minutes.
SPEAKER_01 (09:22):
Maybe even a little longer.
It was good.
I kept I was entertained and itkept me coming back for more.
Yeah.
And then we get into a lull, andI'm like, oh, like, you know,
where are we gonna find the nextthing?
Like, are we?
SPEAKER_00 (09:36):
What's that other one on Netflix I want to watch?
SPEAKER_01 (09:39):
Oh, you mentioned this.
Yeah.
Tonight we're gonna watch aChristmas movie, though.
SPEAKER_00 (09:43):
We're having Crab Capitelli.
SPEAKER_01 (09:45):
I feel like a la Eddie.
We record this Crab Cabotelli.
SPEAKER_00 (09:50):
Even though we probably should have just had
like salad tonight, it's okay.
We had Thanksgiving, then wewent to dinner on Saturday.
unknown (09:55):
I know, yeah.
SPEAKER_00 (09:57):
Lots of leftovers.
It's okay.
We didn't really eat today, Ifeel like.
SPEAKER_01 (10:00):
So no, we were skinny legends.
We um spasos in media.
It was good.
SPEAKER_00 (10:06):
Yeah.
SPEAKER_01 (10:06):
Shocked that you could walk into a restaurant
after living in center city forso long.
You just say, Hey, do you have atable?
And they say, Yes.
Like this way.
Follow me.
I'm like, oh my God.
Wow.
It was good.
Um I got essentially what feltlike a bolognaise, which was
good, but you had a very uniquedish, this like brown, brown
(10:27):
sugar sage.
SPEAKER_00 (10:28):
Yeah, it was barata stuffed tortellone in like a
brown butter sage sauce thingsituation.
Yeah.
It was delicious.
SPEAKER_01 (10:38):
It was good.
It was great.
And the muscles were alsodelicious.
They like the actual muscleitself was meaty.
It was good, but it made me veryproud of the muscles I make.
SPEAKER_00 (10:48):
Yeah, your your muscles are better.
SPEAKER_01 (10:51):
Yeah, like if you could give if I could get those
muscles, like the actual muscle,but like the gravy and the
sauce, yeah.
It was cool.
I'm like, wow, I feel good aboutthis.
And they had a nice, and nowthis is gonna trigger me to make
mushroom soup at some pointsoon.
Um, a nice mushroom soup.
SPEAKER_00 (11:09):
Yeah.
SPEAKER_01 (11:10):
So I'm looking forward to making some of that
soon.
Maybe not immediately, but thatis on the list.
So that was the show we watched.
And then there's a piece oftechnology that I don't
understand.
Grocery shopping today.
Um, occasionally we go to Sam'sClub.
SPEAKER_00 (11:24):
Oh, yeah.
SPEAKER_01 (11:25):
And we do the scan and go.
And so all the items in yourcart are accounted for.
You pay for it on the app.
In the old Sam's Club, they usedto have these people who would
stand by the exit and they wouldhave their scanner.
Nice people.
They say, Hey, how you doing?
I got scan three items.
They beep, beep, beep.
Okay, see you later.
But then they installed prettyubiquitously in all of the Sam's
(11:45):
clubs.
It's like the stat at the beach,too.
They've got these like archways,and I think they have a bunch of
cameras, and you walk throughthe archway, and it seems like
something gets sent to theirdevice, and you hear a beep, and
then they look at you and say,See you later.
And I don't understand how itworks.
(12:06):
Items are stacked on top of eachother in your cart, and it
doesn't make sense to me howthey're able to just say, Yeah,
you're good.
SPEAKER_00 (12:19):
I know.
I can't wrap my head around it.
SPEAKER_01 (12:23):
Things are underneath behind things.
I can't take a picture of all ofit, so that makes me wonder.
I don't know how that technologyworks.
Well, there was that.
Um, any other thoughts on that?
I have one more thing I want tomention.
So we went to this place calledCypress Coffee, which was great.
(12:44):
Um, yeah, it was really good.
SPEAKER_00 (12:47):
That was really good.
SPEAKER_01 (12:47):
Very new.
Um, gonna try to put a it was itwas just really great.
We walked in there.
There was one person workingbehind.
She said she runs the place.
I asked, like, if is this yourlike place, and she said she
runs it.
So I don't know what I guessmaybe, yeah.
Um, and she like makes all ofthe she called it cream.
Um it was delicious.
We had like a cold Vietnameselatte, I guess.
SPEAKER_00 (13:11):
Yeah, Vietnamese coffee is good.
I feel like I think I've onlyever had it like once.
Yeah, I think there's condensedmilk in it.
I think that's the like wholething with that, huh?
SPEAKER_01 (13:21):
And then a CG signature, which it wasn't too
sweet, but it was like creamyand savory, and it was
delicious.
And I thought it was good, brandnew, you know, you gotta support
your places, so that was nice.
But there's like a bunch ofcoffee places in the area now.
There's like good karma, there'shabitat house, that's what it's
(13:45):
called.
But yeah, all really cool stuff.
Um, but that new place wasawesome.
So I just wanted to say that outloud, because you know, what if
someone goes and tries it now?
SPEAKER_00 (13:55):
Yeah, I would go back.
SPEAKER_01 (13:56):
I would definitely go back.
And we told her we were, so wecan't not show up again.
Okay, what do you think?
Any other burning thoughts ordesires?
SPEAKER_00 (14:08):
Nope.
SPEAKER_01 (14:08):
All right, Nikki, why don't we dive in and give
the people what they came herefor?
Unless they came here for thebanter, anyway.
So, what are we gonna talk abouttoday, Nick?
SPEAKER_00 (14:17):
Today we're talking about price changes on GLP ones
and what's going on.
SPEAKER_01 (14:23):
Yeah, these um, these are slippery meds to get
um get a hold of, so it wouldseem.
Um, it seems like they're reallywell covered for diabetes in a
lot of circumstances.
Um, not particularly if you'reit's a little tricky if you're a
Medicare patient, but you know,when there's a lot of trouble
getting access to them becausethey are so effective at what
(14:46):
they do, treating diabetes,treating sleep apnea, treating
obesity, and a lot of otherthings that they've become to be
understood that they help with,access is kind of tough.
And insurance companies are kindof tightening their grip when it
comes to coverage of these medsbecause as it currently stands,
(15:06):
they're expensive and they'reexpensive to make, they're
expensive to purchase.
So we'd had a previous episodewhere we talked about like
compounding pharmacies and howthey're not like super, they're
not good.
You should you should probablyavoid them if you can.
Um, you know, everyone is anadult and can make their own
choices about their body.
But this led to the rise of NovoNordisk and Eli Lilly, the two
(15:31):
companies that make Wagovi andZeppound, the two GLP1 receptor
agonists plus.
Um they led to direct toconsumer pricing.
So, well, so in November 2025,Novo Nordisk, the company that
makes Wagovy and Ozempic,changed prices from$4.99 a month
(15:54):
to$349 a month for existing cashpay customers.
And they also offered atemporary introductory rate of
$199 a month for new cashcustomers in the first two
months.
So uh these cash pay offers areavailable for Wagovia Nozempic
(16:15):
on their websites, as well asother platforms, which this is
kind of interesting, likeCostco, Good RX, Weight
Watchers, and several othertelehealth providers that you
see advertised on TV.
And these groups all workdirectly with Novo Nordisk.
So this is all in the back ofEli Lilly dropping their prices.
(16:39):
They dropped the price ofZEPBound to$350 per month and
made a promise.
Now I don't have to do any ofthis, I guess, but they made a
promise that in the course ofthe next two years, they would
drop the price to$245 per month.
This is also recognizing thatZEPBound is more effective at
weight loss than and othertreatments than Wagovi and his
(17:02):
fewer side effects.
So these price cuts come at aperiod where insurance coverage
is becoming increasinglyrestrictive.
They are tightening the grip.
Uh, it is challenging to getthese things covered.
Um, you need staffs of people tobe able to process the paperwork
that goes along with thesemedicines by way of something
(17:24):
called a prior authorization.
And the costs of even paying forthem is becoming increasingly
high, um, including theout-of-pocket costs.
Coverage also varies by plan,like whether they do or don't
cover them for people withdiabetes, or especially those
who just are trying to treatobesity.
(17:45):
And so all of this offers a doesthis finally move the needle on
GLP1 receptor agonists beingmore accessible and
cost-friendly.
Um these medicines have becomeso incredibly important.
And when you look at someone whohas just metabolic disease, like
diabetes, hypertension,hyperlipidemia or high
(18:08):
cholesterol, or metabolicdisease of the liver, we're
finding like everything kind ofcan narrow down.
Like, yes, your lifestylechanges are extremely important.
They're the first things youshould do, but for people where
that doesn't work, thesemedicines have been
life-changing and completelypractice changing.
(18:28):
So I think it's a move in theright direction, but I don't
know if it's it solves everyproblem.
Because what$350 a month?
I mean, that's still a lot ofmoney, I feel like it's a lot of
money,$350 a month for Wagovyitself, which you know, I think
(18:49):
they hang their hat on it.
And I I do not think that ZetBound has that at this point.
So I think that's why theycontend with it and they can
like offer the same price.
But$350 a month is a lot ofmoney for an out-of-pocket cost
(19:13):
for a medicine, um, especiallyfor the average person.
Now, I don't perhaps youcouldn't I agreed if you
couldn't hear his woof in thebackground.
Part of me wonders, are you ableto use a flexible spending
account or a health savingsaccount to use pre-tax dollars
(19:34):
to help pay for this?
Um, I don't know.
I you know, it's something youcan explore on their websites,
but we just thought that thiswas interesting news to share
because I think things like thisare going to be happening.
Um, while the healthconversations around this
administration have been umdisappointing to say the least,
(19:55):
I think recently there werediscussions with this
administration that there wouldbe more Medicare coverage for
GLP1 receptor agonists becauseit's a huge population of people
where there is just a starkdrop-off of coverage for these
medicines that are chronic.
Chronic in the way that like ifyou were taking their blood
pressure for high bloodpressure, you would take that
(20:18):
for as long as you needed to.
You would take this as long asyou need to.
So is there a price you thinkthat it would become like
actually reasonable for cash payfor people?
SPEAKER_00 (20:32):
I mean, I think that's all like relative.
SPEAKER_01 (20:35):
Yeah.
That's a good point.
SPEAKER_00 (20:36):
I think me personally, I feel like it feels
like a hundred bucks a month.
SPEAKER_01 (20:41):
Yeah.
A hundred feels way better.
There's um I think part of thecost is the pens, like actually
producing the auto-injector penitself costs a lot of money.
And there they are coming outwith more oral ones, and they
are re-examining oral options athigher doses for varied purposes
(21:07):
and effectiveness.
So specifically, Eli Lilly hasone coming out that is oral, um,
that is in the late stages ofclinical trials and may hit
prime time in early 2026 at somepoint.
So when that final data comesout, we'll talk about that more
so that people are aware of it.
But if you didn't know therewere these price cuts, yeah, a
(21:30):
hundred it might be wishfulthinking.
I feel like they might, I mean,they've even said like they
would get down to 245.
That's a big commitment everymonth, though.
Especially when you got a lot ofother things going on.
SPEAKER_00 (21:42):
Yeah.
SPEAKER_01 (21:45):
On the other hand, it does it can truncate all of
the other options.
Like if you're on a medicine foryour diabetes, if you're on two
to three separate medicines foryour blood pressure, you have
your CPAP machine, and like youcan just theoretically, if you
take this and it's as effectiveas it needs to be for you, can
you get off all those otherones?
I've seen it plenty of times.
(22:07):
So then you have to weigh,right?
I guess like you have to weighis this once weekly medicine
that costs X amount of dollarsworth it for me.
SPEAKER_00 (22:19):
Or you're taking like four other meds every
single day.
Sleeping with a CPAP everynight.
Right.
That's what I like.
I don't know.
It's like so annoying whenpeople are like you're already
on like maybe a handful of medsfor whatever like chronic
(22:41):
condition that's like probablydirectly related to your weight.
And then they're like, Oh well,I don't want to take anything
forever.
If I stop, if they stop takingthat, they're gonna gain weight.
Like, yeah, if you stop takingyour blood pressure medicine,
your blood pressure's gonna behigh.
SPEAKER_01 (22:55):
I know.
SPEAKER_00 (22:56):
If you like are uh you have diabetes and you take
insulin for that, if you don'ttake that, worse things are
gonna happen.
I know.
I know, and then like doingsomething once a week, and I
think people are really turnedoff that it's an injection.
SPEAKER_01 (23:13):
Me too.
SPEAKER_00 (23:14):
And aside from it, like if you're like scared of
needles or whatever, likeregarding the actual needle, I
think people think because it'san injection, it's like I don't
know, like more like aggressive.
I guess.
SPEAKER_01 (23:33):
I think so.
SPEAKER_00 (23:33):
And like you're still like putting the
medication into your body,regardless of how it gets there.
Like I know that there aredifferent things that you know
happen after and how it's likesure absorbed and blah blah
blah, but like you know what Imean?
SPEAKER_01 (23:48):
When push comes to shove, like you're still taking
medicine.
SPEAKER_00 (23:50):
Like, what would make an oral better than a than
an injection?
SPEAKER_01 (23:56):
I think it's just because it's more commonplace.
It's just what people are usedto.
SPEAKER_00 (24:00):
Yeah.
SPEAKER_01 (24:01):
And I think that's it.
I I've seen a healthy number ofpeople with the fear of needles
or just like conceptualizingthat exact thing that you just
described there.
And it's a little bit of asticking point, and some people
are totally freaked out by it.
Um, some people who would likereally benefit from taking this,
(24:23):
and I'm like, please reconsiderand like give it an open mind
and at least try it.
And if you don't like it, stop.
SPEAKER_00 (24:30):
But like Yeah, you can always stop.
SPEAKER_01 (24:33):
Yes, that's a good point.
SPEAKER_00 (24:35):
And it's like not one of the meds where like you
really can't stop cold turkeyand you have to like kind of
like titrate it down, you know.
Like, if you don't like it, youjust don't take it that week,
and you just don't.
SPEAKER_01 (24:50):
Yeah.
That's a I think that's animportant thing that like people
also should recognize is thatlike it is your body, and you
should always let your whoever'staking care of you know that
you're thinking about makingthese decisions, but like at the
end of the day, it's you and youget the chance to do this.
So, like I oftentimes I justlike people to know their
options when it comes to thingsand like when it comes to
(25:13):
treatment options for anyvarious thing.
But I know there I think it'sbecause back to your point about
why people get so bent out ofshape, it's because they people
don't think of obesity as achronic disease, and it is.
That's one piece of this.
And I think it's because it'snot invisible.
(25:35):
Like so many of the things thatwe talk about here and that I
talk about every day areinvisible risks.
And someone who has a certainbody size that's like increased
or larger than an averageperson, it's a lot more visible,
and they may or may not havemetabolic disease that is
(25:58):
invisible, but I guess maybethat's why, and this is like all
on the back of like so much ofour culture about size and
what's valued and how it'sviewed, which is just
problematic in general.
But maybe because it's notinvisible, diabetes invisible,
(26:20):
hypertension invisible.
These are like abstract conceptsall in an effort really to like
get someone to pay moreattention to their health and
like make healthy choices moreoften than unhealthy choices.
And I don't know.
I think these these medicines inparticular offer a lot for us to
(26:41):
think about as like where wevalue what are we actually
treating when we're looking atstuff.
I don't know.
And like I think studying forthe obesity medicine boards like
was really enlightening aboutlike what are we actually doing
here when we're taking care ofall these things?
When like if someone losesweight, all of these other
(27:02):
things very often fall in line.
SPEAKER_00 (27:06):
Yeah, what do you mean?
It's doing a lot.
SPEAKER_01 (27:08):
No, I know, but like before this, like we didn't
there were no there wasbariatric surgery.
SPEAKER_00 (27:14):
Yeah.
SPEAKER_01 (27:15):
And like someone could have a BMI of 45 and
snoring at night, stoppingbreathing, and like they're
getting their blood pressuremeds, which they need to keep
them safe.
But the real underlying thing isthe class three obesity.
I don't know.
I just think this stuff is soimportant.
That's why I'm like getting anextra specialty in it.
Well, hopefully this wasfruitful.
(27:37):
Um, did you have any otherthoughts?
SPEAKER_00 (27:39):
Nope.
SPEAKER_01 (27:40):
Um, so anyway, thank you for coming back to another
episode of your checkup.
Hopefully, you were able tolearn something for yourself, a
loved one, or a neighbor.
You can find us on our websitewhere we have our whole
collection of episodes.
Um, you can find some that arerelevant to you.
You can check out our women'shealth collection about
menopause, osteoporosis, breastcancer screening, PCOS, and
(28:01):
more.
You can find our pediatriccollection and several others
about hypertension, diabetes.
You can share with a loved oneor a neighbor.
But most importantly, stayhealthy, my friends.
Until next time, I'm MattDoleski.
SPEAKER_00 (28:14):
I'm Nicolas.
SPEAKER_01 (28:16):
Thank you, and goodbye.
SPEAKER_00 (28:17):
Bye.
SPEAKER_01 (28:19):
This information may provide a brief overview of
diagnosis, treatment, andmedications.
It's not exhaustive and is atool to help you understand
potential options about yourhealth.
It doesn't cover all detailsabout conditions, treatments, or
medications for a specificperson.
This is not medical advice or anattempt to substitute medical
advice.
You should contact a healthcareprovider for personalized
guidance based on your uniquecircumstances.
(28:41):
We explicitly disclaim anyliability relating to the
information given or its use.
This content doesn't endorse anytreatments or medications for a
specific patient.
Always talk to your healthcareprovider for a complete
information tailored to you.
In short, I'm not your doctor.
I am not your nurse.
And make sure you go get yourown checkup with your own
personal doctor.
Hi, welcome to your checkup.
We are the patient educationpodcast, where we bring
conversations from the doctor'soffice to your ears.
On this podcast, we try to bringmedicine closer to its patients.
I'm Ed Delesky, a familymedicine doctor in the
Philadelphia area.
And I'm Nicola Rufo.
I'm a nurse.
And we are so excited you wereable to join us here again
(00:27):
today.
I have it on good authorityafter our last week's What are
you gonna say?
That the Michelin stars, theMichelin people, is the same as
the tire selling company.
Good authority.
SPEAKER_00 (00:46):
Who told you that?
Mike from his basement?
SPEAKER_01 (00:48):
Yes.
Exactly him.
He sent me a picture and all.
And it's probably not doctored.
And that Michelin guy, you know,the guy with the white rolls.
Yeah, he's up there.
He's on that stage.
SPEAKER_00 (01:03):
Oh, really?
Yeah.
That's cool.
Yep.
Well, Mike is good with RD, so.
SPEAKER_01 (01:08):
I told you.
Well, he said that and he'slike, I have an idea how the uh
December.
SPEAKER_00 (01:12):
Is this what you were gonna light me up about on
the podcast?
SPEAKER_01 (01:15):
Yeah, that's about it.
The Michelin is like too big ofa it's so niche of a name that
like it can't possibly be likeused there's Michelin tires and
separately Michelin stars.
SPEAKER_00 (01:31):
How did the tire people like get into raiding
restaurant business?
Um I uh what else are they upto?
SPEAKER_01 (01:41):
Oh, that I don't that I don't know.
SPEAKER_00 (01:43):
Now we're you are like the Michelin family.
Do you know?
SPEAKER_01 (01:48):
Well is there no I I didn't come that prepared.
SPEAKER_00 (01:51):
Like heirs to the Michelin throne.
SPEAKER_01 (01:54):
We're not gonna talk you know, Michelin people, but
we're gonna talk about it.
SPEAKER_00 (01:57):
I'll do some research.
It'll be part of Nikki's Cornernext week.
SPEAKER_01 (02:00):
Yes, yeah.
Please do.
Um catch us up for Nikki'sCorner, which you can look
forward to next week.
SPEAKER_00 (02:07):
Um there was only like one little thing I wanted
to talk about.
SPEAKER_01 (02:11):
Yeah, no, I think you know, it can't be every week
because then it's not special.
SPEAKER_00 (02:16):
No like breaking news of the world, except that
everyone's mad that Robert Irwinwon Dancing with the Stars and
not Alex Earl, but people thinkthat it's rigged because um
Bindi won like 10 years ago,which I didn't realize there was
I don't know what that age gapis between the two of them.
(02:39):
Hmm.
Anyway, yeah, people are madabout it, and I can't stop
watching Alex Earl's like finaledance.
It was so good, don't you think?
SPEAKER_01 (02:50):
I do.
SPEAKER_00 (02:50):
Uh I think we watched both of them and Alex
was better.
SPEAKER_01 (02:54):
Yeah, uh her is the star.
SPEAKER_00 (02:56):
Crawl slide thing.
SPEAKER_01 (02:57):
That was funny.
Yeah, that was great.
Yeah, I gotta try that.
But uh the you know, like bothdancers were great, but she
looked like she was doing moreof the work.
SPEAKER_00 (03:07):
And then when he came to watch- I mean, the girl
is always doing more of thework, and then the guy is just
like they're supporting.
SPEAKER_01 (03:13):
Like when he was doing his, like she was doing
all the stuff, and he's the one.
SPEAKER_00 (03:18):
Well, that's why it's also like not fair because
the professional dancer in thatduo was the girl who's always
doing more work, and then theprofessional dancer in the Alex
Val duo was the man who justlike inherently does less work.
Right.
SPEAKER_01 (03:36):
Yeah, I don't know.
It looked like she had thebetter performance.
Yeah, maybe there's like there'ssomething technical.
SPEAKER_00 (03:43):
She's the people's mirror ball winner, that's what
everyone is saying.
SPEAKER_01 (03:46):
Is that the award?
Mirror ball.
Yeah.
This has been on for a while.
SPEAKER_00 (03:52):
I know, I never actually watched it.
Like, I feel like I watched thisseason just via TikTok.
Like, I've seen all the dances,I feel like, but I never
actually sat down to watch theshow.
SPEAKER_01 (04:02):
I mean, like, I pulled it up for us to take a
look at, and then then I waslike, I mean, there's like 23
seasons, like it's a bigcommitment.
SPEAKER_00 (04:09):
That's maybe next season we'll depending who's on
it.
They had a lot of good peoplethis season.
SPEAKER_01 (04:15):
They did.
It was very like uh let's see,cohesive with our content plate,
if you will.
SPEAKER_00 (04:23):
Yeah.
SPEAKER_01 (04:24):
So it made a lot of sense.
Um yeah, shout out to SteveIrwin.
I think he died, right?
He died from touching astingray.
Is that the thing?
Yeah, that's tragic.
Yeah.
Do what you love until it killsyou.
That's damn.
If I say damn, is it gonna putus as an explicit podcast on
Apple Podcasts again?
(04:45):
That that was that was crazy.
Um, well, that, you know, toeach their own.
Thank you for sharing.
Um, Christmas gifts.
You know, it's tricky to decidewhat someone gets.
Um, you know, some people saylike you should write out what
you want, like you should putyour what you want on a list to
let people know.
(05:06):
But it hasn't always been likethat.
Um, you know, what did Jesus do?
SPEAKER_00 (05:11):
Oh my god.
I was like, where is he goingwith this?
Did Jesus ask for for all that?
Okay.
So what happened was we were atThanksgiving, had a great
Thanksgiving, and we're alltalking about like Christmas and
Christmas gifts and da-da-da.
And my one brother, for somereason, is just like a weirdo
(05:32):
about receiving gifts.
And he hasn't like let anyoneknow anything that well, he
actually has, he added to thelist.
But on Thanksgiving, he waslike, I don't know, I don't need
anything, whatever, like I don'twant anything.
Or did he say I don't needanything or I don't want
anything?
Whichever one he said.
SPEAKER_01 (05:51):
He said, I don't need anything.
Because then we were like, no,you you're allowed to want
things.
SPEAKER_00 (05:54):
Yeah, and we're like, Well, what do you want?
He's like, Well, nothing, Idon't really want anything.
And then I was like, Do youthink baby Jesus wanted gold
frankincense and myrrh?
No, but he got it.
And he was dying laughing.
It's like the funniest thing.
(06:15):
Probably had to be there.
I think it probably had to bethere.
SPEAKER_01 (06:18):
I, you know, we um the greatest, I'll put it this
way, the greatest complimenteither one of us could receive
is that we're funny.
Um, I think that's one thing wealways at the risk of our like,
you know, professionalism,always chase.
SPEAKER_00 (06:33):
And yeah, so always strive to be the personality
higher.
SPEAKER_01 (06:37):
Yeah.
So at whatever, at what at whatwhatever it costs.
And we um we do this at home.
Like we go back and forth.
And like I objectively think welike serve each other great
material all the time.
But you know, when you live withsomeone, it's like and you're
laying there and you're like,whip out a good one, and maybe
(06:58):
like you don't laugh the way Ihope you laugh.
And I'm like, you know what?
If this was a set of people whodidn't know us, this would have
killed.
SPEAKER_00 (07:06):
Yeah.
I know, or sometimes I'll saysomething and I'll be like, that
was funny.
Why aren't you laughing?
SPEAKER_01 (07:12):
I know.
And I'm like, objectively, itwas hilarious.
And I it doesn't, it's not fair.
It's not fair, is what it is.
Um got a house of comedians overhere.
We'd like to think so.
I'm not sure if that's the case.
Um, you tell us if you'relistening.
But yeah, gold, frankincense,and myrrh.
We know what gold is, but Idon't know what frankincense or
(07:33):
myrrh are.
SPEAKER_00 (07:35):
Myrrh.
SPEAKER_01 (07:36):
Myrrh.
Frankincense.
So hit us up.
Um, you can send us an email orsend us some fan mail.
It's in the show notes how toaccess that if you um have a
burning understanding of whatfrankincense and myrrh are.
Because we already understandwhat gold is.
Um, we watched a good show thisweek.
SPEAKER_00 (07:57):
Oh, yeah.
This was a good one.
We did it.
It's on Peacock and it's calledAll Her Fault.
Dakota Fannings in it.
It was so good.
SPEAKER_01 (08:05):
And Shivroy.
Uh she has a name, but Shivroyfrom um the business like show.
SPEAKER_00 (08:13):
Huh?
Uh the business like succession.
SPEAKER_01 (08:16):
Yeah.
Oh like I didn't watch it.
She hasn't she has a name.
I'm I'm being bad right now.
But that's a bit of a.
Yeah, the mom.
Oh.
The redhead mom.
Marissa.
Marissa, correct.
Marr.
SPEAKER_00 (08:27):
Marr.
SPEAKER_01 (08:28):
Um, and then that other guy who's like in a lot of
things now.
SPEAKER_00 (08:31):
Yeah, with the chin.
Yeah, if he He was in White thefirst season of White Lotus, he
was like the kind of likeannoying husband.
SPEAKER_01 (08:41):
He seems to be typecast in that role.
If there was a fairly oddparents remake, he could
definitely be the Crimson Chin.
SPEAKER_00 (08:47):
Oh my god.
SPEAKER_01 (08:48):
Uh no, this was good.
SPEAKER_00 (08:50):
Um Yeah, it's about a boy who goes missing, and then
like within the first like twominutes of the show, and then
everything that happens after,and there's like a twist, and
then you think that that's thetwist, and then there's another
twist, and then there's anothertwist on that twist.
SPEAKER_01 (09:05):
Yeah.
SPEAKER_00 (09:06):
It's crazy.
It was so good.
SPEAKER_01 (09:07):
It was entertaining.
SPEAKER_00 (09:08):
Even up until like the very end, and then that like
final scene with the detectiveand the mom.
SPEAKER_01 (09:12):
Right.
And it was good.
And there was like uh it was alot too.
SPEAKER_00 (09:16):
Like we it was like eight or nine episodes, and they
were all like 45-ish minutes.
SPEAKER_01 (09:22):
Maybe even a little longer.
It was good.
I kept I was entertained and itkept me coming back for more.
Yeah.
And then we get into a lull, andI'm like, oh, like, you know,
where are we gonna find the nextthing?
Like, are we?
SPEAKER_00 (09:36):
What's that other one on Netflix I want to watch?
SPEAKER_01 (09:39):
Oh, you mentioned this.
Yeah.
Tonight we're gonna watch aChristmas movie, though.
SPEAKER_00 (09:43):
We're having Crab Capitelli.
SPEAKER_01 (09:45):
I feel like a la Eddie.
We record this Crab Cabotelli.
SPEAKER_00 (09:50):
Even though we probably should have just had
like salad tonight, it's okay.
We had Thanksgiving, then wewent to dinner on Saturday.
unknown (09:55):
I know, yeah.
SPEAKER_00 (09:57):
Lots of leftovers.
It's okay.
We didn't really eat today, Ifeel like.
SPEAKER_01 (10:00):
So no, we were skinny legends.
We um spasos in media.
It was good.
SPEAKER_00 (10:06):
Yeah.
SPEAKER_01 (10:06):
Shocked that you could walk into a restaurant
after living in center city forso long.
You just say, Hey, do you have atable?
And they say, Yes.
Like this way.
Follow me.
I'm like, oh my God.
Wow.
It was good.
Um I got essentially what feltlike a bolognaise, which was
good, but you had a very uniquedish, this like brown, brown
(10:27):
sugar sage.
SPEAKER_00 (10:28):
Yeah, it was barata stuffed tortellone in like a
brown butter sage sauce thingsituation.
Yeah.
It was delicious.
SPEAKER_01 (10:38):
It was good.
It was great.
And the muscles were alsodelicious.
They like the actual muscleitself was meaty.
It was good, but it made me veryproud of the muscles I make.
SPEAKER_00 (10:48):
Yeah, your your muscles are better.
SPEAKER_01 (10:51):
Yeah, like if you could give if I could get those
muscles, like the actual muscle,but like the gravy and the
sauce, yeah.
It was cool.
I'm like, wow, I feel good aboutthis.
And they had a nice, and nowthis is gonna trigger me to make
mushroom soup at some pointsoon.
Um, a nice mushroom soup.
SPEAKER_00 (11:09):
Yeah.
SPEAKER_01 (11:10):
So I'm looking forward to making some of that
soon.
Maybe not immediately, but thatis on the list.
So that was the show we watched.
And then there's a piece oftechnology that I don't
understand.
Grocery shopping today.
Um, occasionally we go to Sam'sClub.
SPEAKER_00 (11:24):
Oh, yeah.
SPEAKER_01 (11:25):
And we do the scan and go.
And so all the items in yourcart are accounted for.
You pay for it on the app.
In the old Sam's Club, they usedto have these people who would
stand by the exit and they wouldhave their scanner.
Nice people.
They say, Hey, how you doing?
I got scan three items.
They beep, beep, beep.
Okay, see you later.
But then they installed prettyubiquitously in all of the Sam's
(11:45):
clubs.
It's like the stat at the beach,too.
They've got these like archways,and I think they have a bunch of
cameras, and you walk throughthe archway, and it seems like
something gets sent to theirdevice, and you hear a beep, and
then they look at you and say,See you later.
And I don't understand how itworks.
(12:06):
Items are stacked on top of eachother in your cart, and it
doesn't make sense to me howthey're able to just say, Yeah,
you're good.
SPEAKER_00 (12:19):
I know.
I can't wrap my head around it.
SPEAKER_01 (12:23):
Things are underneath behind things.
I can't take a picture of all ofit, so that makes me wonder.
I don't know how that technologyworks.
Well, there was that.
Um, any other thoughts on that?
I have one more thing I want tomention.
So we went to this place calledCypress Coffee, which was great.
(12:44):
Um, yeah, it was really good.
SPEAKER_00 (12:47):
That was really good.
SPEAKER_01 (12:47):
Very new.
Um, gonna try to put a it was itwas just really great.
We walked in there.
There was one person workingbehind.
She said she runs the place.
I asked, like, if is this yourlike place, and she said she
runs it.
So I don't know what I guessmaybe, yeah.
Um, and she like makes all ofthe she called it cream.
Um it was delicious.
We had like a cold Vietnameselatte, I guess.
SPEAKER_00 (13:11):
Yeah, Vietnamese coffee is good.
I feel like I think I've onlyever had it like once.
Yeah, I think there's condensedmilk in it.
I think that's the like wholething with that, huh?
SPEAKER_01 (13:21):
And then a CG signature, which it wasn't too
sweet, but it was like creamyand savory, and it was
delicious.
And I thought it was good, brandnew, you know, you gotta support
your places, so that was nice.
But there's like a bunch ofcoffee places in the area now.
There's like good karma, there'shabitat house, that's what it's
(13:45):
called.
But yeah, all really cool stuff.
Um, but that new place wasawesome.
So I just wanted to say that outloud, because you know, what if
someone goes and tries it now?
SPEAKER_00 (13:55):
Yeah, I would go back.
SPEAKER_01 (13:56):
I would definitely go back.
And we told her we were, so wecan't not show up again.
Okay, what do you think?
Any other burning thoughts ordesires?
SPEAKER_00 (14:08):
Nope.
SPEAKER_01 (14:08):
All right, Nikki, why don't we dive in and give
the people what they came herefor?
Unless they came here for thebanter, anyway.
So, what are we gonna talk abouttoday, Nick?
SPEAKER_00 (14:17):
Today we're talking about price changes on GLP ones
and what's going on.
SPEAKER_01 (14:23):
Yeah, these um, these are slippery meds to get
um get a hold of, so it wouldseem.
Um, it seems like they're reallywell covered for diabetes in a
lot of circumstances.
Um, not particularly if you'reit's a little tricky if you're a
Medicare patient, but you know,when there's a lot of trouble
getting access to them becausethey are so effective at what
(14:46):
they do, treating diabetes,treating sleep apnea, treating
obesity, and a lot of otherthings that they've become to be
understood that they help with,access is kind of tough.
And insurance companies are kindof tightening their grip when it
comes to coverage of these medsbecause as it currently stands,
(15:06):
they're expensive and they'reexpensive to make, they're
expensive to purchase.
So we'd had a previous episodewhere we talked about like
compounding pharmacies and howthey're not like super, they're
not good.
You should you should probablyavoid them if you can.
Um, you know, everyone is anadult and can make their own
choices about their body.
But this led to the rise of NovoNordisk and Eli Lilly, the two
(15:31):
companies that make Wagovi andZeppound, the two GLP1 receptor
agonists plus.
Um they led to direct toconsumer pricing.
So, well, so in November 2025,Novo Nordisk, the company that
makes Wagovy and Ozempic,changed prices from$4.99 a month
(15:54):
to$349 a month for existing cashpay customers.
And they also offered atemporary introductory rate of
$199 a month for new cashcustomers in the first two
months.
So uh these cash pay offers areavailable for Wagovia Nozempic
(16:15):
on their websites, as well asother platforms, which this is
kind of interesting, likeCostco, Good RX, Weight
Watchers, and several othertelehealth providers that you
see advertised on TV.
And these groups all workdirectly with Novo Nordisk.
So this is all in the back ofEli Lilly dropping their prices.
(16:39):
They dropped the price ofZEPBound to$350 per month and
made a promise.
Now I don't have to do any ofthis, I guess, but they made a
promise that in the course ofthe next two years, they would
drop the price to$245 per month.
This is also recognizing thatZEPBound is more effective at
weight loss than and othertreatments than Wagovi and his
(17:02):
fewer side effects.
So these price cuts come at aperiod where insurance coverage
is becoming increasinglyrestrictive.
They are tightening the grip.
Uh, it is challenging to getthese things covered.
Um, you need staffs of people tobe able to process the paperwork
that goes along with thesemedicines by way of something
(17:24):
called a prior authorization.
And the costs of even paying forthem is becoming increasingly
high, um, including theout-of-pocket costs.
Coverage also varies by plan,like whether they do or don't
cover them for people withdiabetes, or especially those
who just are trying to treatobesity.
(17:45):
And so all of this offers a doesthis finally move the needle on
GLP1 receptor agonists beingmore accessible and
cost-friendly.
Um these medicines have becomeso incredibly important.
And when you look at someone whohas just metabolic disease, like
diabetes, hypertension,hyperlipidemia or high
(18:08):
cholesterol, or metabolicdisease of the liver, we're
finding like everything kind ofcan narrow down.
Like, yes, your lifestylechanges are extremely important.
They're the first things youshould do, but for people where
that doesn't work, thesemedicines have been
life-changing and completelypractice changing.
(18:28):
So I think it's a move in theright direction, but I don't
know if it's it solves everyproblem.
Because what$350 a month?
I mean, that's still a lot ofmoney, I feel like it's a lot of
money,$350 a month for Wagovyitself, which you know, I think
(18:49):
they hang their hat on it.
And I I do not think that ZetBound has that at this point.
So I think that's why theycontend with it and they can
like offer the same price.
But$350 a month is a lot ofmoney for an out-of-pocket cost
(19:13):
for a medicine, um, especiallyfor the average person.
Now, I don't perhaps youcouldn't I agreed if you
couldn't hear his woof in thebackground.
Part of me wonders, are you ableto use a flexible spending
account or a health savingsaccount to use pre-tax dollars
(19:34):
to help pay for this?
Um, I don't know.
I you know, it's something youcan explore on their websites,
but we just thought that thiswas interesting news to share
because I think things like thisare going to be happening.
Um, while the healthconversations around this
administration have been umdisappointing to say the least,
(19:55):
I think recently there werediscussions with this
administration that there wouldbe more Medicare coverage for
GLP1 receptor agonists becauseit's a huge population of people
where there is just a starkdrop-off of coverage for these
medicines that are chronic.
Chronic in the way that like ifyou were taking their blood
pressure for high bloodpressure, you would take that
(20:18):
for as long as you needed to.
You would take this as long asyou need to.
So is there a price you thinkthat it would become like
actually reasonable for cash payfor people?
SPEAKER_00 (20:32):
I mean, I think that's all like relative.
SPEAKER_01 (20:35):
Yeah.
That's a good point.
SPEAKER_00 (20:36):
I think me personally, I feel like it feels
like a hundred bucks a month.
SPEAKER_01 (20:41):
Yeah.
A hundred feels way better.
There's um I think part of thecost is the pens, like actually
producing the auto-injector penitself costs a lot of money.
And there they are coming outwith more oral ones, and they
are re-examining oral options athigher doses for varied purposes
(21:07):
and effectiveness.
So specifically, Eli Lilly hasone coming out that is oral, um,
that is in the late stages ofclinical trials and may hit
prime time in early 2026 at somepoint.
So when that final data comesout, we'll talk about that more
so that people are aware of it.
But if you didn't know therewere these price cuts, yeah, a
(21:30):
hundred it might be wishfulthinking.
I feel like they might, I mean,they've even said like they
would get down to 245.
That's a big commitment everymonth, though.
Especially when you got a lot ofother things going on.
SPEAKER_00 (21:42):
Yeah.
SPEAKER_01 (21:45):
On the other hand, it does it can truncate all of
the other options.
Like if you're on a medicine foryour diabetes, if you're on two
to three separate medicines foryour blood pressure, you have
your CPAP machine, and like youcan just theoretically, if you
take this and it's as effectiveas it needs to be for you, can
you get off all those otherones?
I've seen it plenty of times.
(22:07):
So then you have to weigh,right?
I guess like you have to weighis this once weekly medicine
that costs X amount of dollarsworth it for me.
SPEAKER_00 (22:19):
Or you're taking like four other meds every
single day.
Sleeping with a CPAP everynight.
Right.
That's what I like.
I don't know.
It's like so annoying whenpeople are like you're already
on like maybe a handful of medsfor whatever like chronic
(22:41):
condition that's like probablydirectly related to your weight.
And then they're like, Oh well,I don't want to take anything
forever.
If I stop, if they stop takingthat, they're gonna gain weight.
Like, yeah, if you stop takingyour blood pressure medicine,
your blood pressure's gonna behigh.
SPEAKER_01 (22:55):
I know.
SPEAKER_00 (22:56):
If you like are uh you have diabetes and you take
insulin for that, if you don'ttake that, worse things are
gonna happen.
I know.
I know, and then like doingsomething once a week, and I
think people are really turnedoff that it's an injection.
SPEAKER_01 (23:13):
Me too.
SPEAKER_00 (23:14):
And aside from it, like if you're like scared of
needles or whatever, likeregarding the actual needle, I
think people think because it'san injection, it's like I don't
know, like more like aggressive.
I guess.
SPEAKER_01 (23:33):
I think so.
SPEAKER_00 (23:33):
And like you're still like putting the
medication into your body,regardless of how it gets there.
Like I know that there aredifferent things that you know
happen after and how it's likesure absorbed and blah blah
blah, but like you know what Imean?
SPEAKER_01 (23:48):
When push comes to shove, like you're still taking
medicine.
SPEAKER_00 (23:50):
Like, what would make an oral better than a than
an injection?
SPEAKER_01 (23:56):
I think it's just because it's more commonplace.
It's just what people are usedto.
SPEAKER_00 (24:00):
Yeah.
SPEAKER_01 (24:01):
And I think that's it.
I I've seen a healthy number ofpeople with the fear of needles
or just like conceptualizingthat exact thing that you just
described there.
And it's a little bit of asticking point, and some people
are totally freaked out by it.
Um, some people who would likereally benefit from taking this,
(24:23):
and I'm like, please reconsiderand like give it an open mind
and at least try it.
And if you don't like it, stop.
SPEAKER_00 (24:30):
But like Yeah, you can always stop.
SPEAKER_01 (24:33):
Yes, that's a good point.
SPEAKER_00 (24:35):
And it's like not one of the meds where like you
really can't stop cold turkeyand you have to like kind of
like titrate it down, you know.
Like, if you don't like it, youjust don't take it that week,
and you just don't.
SPEAKER_01 (24:50):
Yeah.
That's a I think that's animportant thing that like people
also should recognize is thatlike it is your body, and you
should always let your whoever'staking care of you know that
you're thinking about makingthese decisions, but like at the
end of the day, it's you and youget the chance to do this.
So, like I oftentimes I justlike people to know their
options when it comes to thingsand like when it comes to
(25:13):
treatment options for anyvarious thing.
But I know there I think it'sbecause back to your point about
why people get so bent out ofshape, it's because they people
don't think of obesity as achronic disease, and it is.
That's one piece of this.
And I think it's because it'snot invisible.
(25:35):
Like so many of the things thatwe talk about here and that I
talk about every day areinvisible risks.
And someone who has a certainbody size that's like increased
or larger than an averageperson, it's a lot more visible,
and they may or may not havemetabolic disease that is
(25:58):
invisible, but I guess maybethat's why, and this is like all
on the back of like so much ofour culture about size and
what's valued and how it'sviewed, which is just
problematic in general.
But maybe because it's notinvisible, diabetes invisible,
(26:20):
hypertension invisible.
These are like abstract conceptsall in an effort really to like
get someone to pay moreattention to their health and
like make healthy choices moreoften than unhealthy choices.
And I don't know.
I think these these medicines inparticular offer a lot for us to
(26:41):
think about as like where wevalue what are we actually
treating when we're looking atstuff.
I don't know.
And like I think studying forthe obesity medicine boards like
was really enlightening aboutlike what are we actually doing
here when we're taking care ofall these things?
When like if someone losesweight, all of these other
(27:02):
things very often fall in line.
SPEAKER_00 (27:06):
Yeah, what do you mean?
It's doing a lot.
SPEAKER_01 (27:08):
No, I know, but like before this, like we didn't
there were no there wasbariatric surgery.
SPEAKER_00 (27:14):
Yeah.
SPEAKER_01 (27:15):
And like someone could have a BMI of 45 and
snoring at night, stoppingbreathing, and like they're
getting their blood pressuremeds, which they need to keep
them safe.
But the real underlying thing isthe class three obesity.
I don't know.
I just think this stuff is soimportant.
That's why I'm like getting anextra specialty in it.
Well, hopefully this wasfruitful.
(27:37):
Um, did you have any otherthoughts?
SPEAKER_00 (27:39):
Nope.
SPEAKER_01 (27:40):
Um, so anyway, thank you for coming back to another
episode of your checkup.
Hopefully, you were able tolearn something for yourself, a
loved one, or a neighbor.
You can find us on our websitewhere we have our whole
collection of episodes.
Um, you can find some that arerelevant to you.
You can check out our women'shealth collection about
menopause, osteoporosis, breastcancer screening, PCOS, and
(28:01):
more.
You can find our pediatriccollection and several others
about hypertension, diabetes.
You can share with a loved oneor a neighbor.
But most importantly, stayhealthy, my friends.
Until next time, I'm MattDoleski.
SPEAKER_00 (28:14):
I'm Nicolas.
SPEAKER_01 (28:16):
Thank you, and goodbye.
SPEAKER_00 (28:17):
Bye.
SPEAKER_01 (28:19):
This information may provide a brief overview of
diagnosis, treatment, andmedications.
It's not exhaustive and is atool to help you understand
potential options about yourhealth.
It doesn't cover all detailsabout conditions, treatments, or
medications for a specificperson.
This is not medical advice or anattempt to substitute medical
advice.
You should contact a healthcareprovider for personalized
guidance based on your uniquecircumstances.
(28:41):
We explicitly disclaim anyliability relating to the
information given or its use.
This content doesn't endorse anytreatments or medications for a
specific patient.
Always talk to your healthcareprovider for a complete
information tailored to you.
In short, I'm not your doctor.
I am not your nurse.
And make sure you go get yourown checkup with your own
personal doctor.
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