Dr. Alexandra Sowa, author of The Ozempic Revolution, joins to dive into the rise of GLP-1 medications like Ozempic and their impact on health and culture. While Dr. Sowa shares why she believes in the benefits of these medications, she also raises concerns about the way our society is using them as a "quick fix." Her book offers a strategy for users to not only address obesity but also shift toward a lifestyle of prevention and long-term wellness. In this episode, Dr. Sowa challenges common misconceptions about obesity, explaining why it’s a disease, not a failure, and explores why it has become so prevalent in America.
Book: The Ozempic Revolution
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:11):
All right. If you guys haven't heard about g lp ones,
which are weight loss drugs like ozimpic, I would say
you're probably living under a rock. Many people have seen
these life changing weight loss from these drugs, but there's
also a lot of people who are skeptical, and I
can be included in that, as you know, what is
the longevity of this situation, what are the side effects?
(00:32):
And once again, are we just throwing a pill at
something that seems to be rooted in a deeper issue.
So I always love to do these deep dives so
we can set our intentions for the year. So doctor
Alexandra Soa is here. Hi, Doctor Soa, Hi.
Speaker 2 (00:45):
Thank you so much for having me.
Speaker 1 (00:47):
So I wanted to first and foremost just give listeners.
Like I said, if you haven't heard of ozimpic, I mean,
you even brought up to me earlier before we started
the podcast about the Golden Globes last night, and immediately
there's a joke made about, oh, look at all the
ozembic phases. It's a huge thing happening in our society.
So if you haven't heard of it, it would be crazy.
But if someone hasn't, can you just say tell the listeners.
(01:09):
What is a GLP one?
Speaker 2 (01:11):
Yes, So my book is called the ozembic Revolution because
we've kind of come to lump all these drugs under
the name ozempic, but really we're talking about GLP one drugs.
Glp One is a hormone that occurs in the body
and it has to do with hunger and satiety regulation
in fat storage. And we've now figured out a way
(01:34):
to make it and actually make it lasts longer than
it does in our body, and it's become a very
effective tool for blood sugar management, weight management, and now
we're getting even more indications about how it's helping. So
GLP one medications they mimic a hormone that's naturally occurs
in the body, and that hormone acts all over our body.
(01:57):
But really the three big ways that it works are brain, gut,
and pancreas at the level of blood sugar. So we've
had weight management tools before, and we were practicing this
field long before these weekly injectibles came to fruition, but
we've never had anything quite as effective. And that's why
we're all talking about it, because for the first time ever,
(02:19):
we have a weight management tool that's non surgical that's
helping people lose incredible amounts of weight, upwards of twenty
five percent or more of their total mindyweight. So that's
what it is.
Speaker 1 (02:30):
Well, you mentioned blood sugar. Weren't these drugs created initially
to help with diabetes.
Speaker 2 (02:36):
Yes, and they've actually been on the market since two
thousand and five this type of medication, first for type
two diabetes management, and then actually about ten eleven years
ago we had our first drug to market in this
class for weight management. So we've had them around for
a while. That's a misconception that people say, oh, they're
(02:57):
just brand new, they're not. The science was looking for
a better answer for blood sugar management other than insulin,
which has a whole host of complications, and we were
able to find that, and with new iterations of the drug,
they've gotten more effective and along the way we realize
actually there is an independent weight management effect. And then
(03:22):
now we've discovered other independent factors like management for sleep
apnea and cardiovascular and kidney protection. But yes, it did
start with blood sugar.
Speaker 1 (03:32):
We mentioned the book it's called the ozembic Revolution, and
we will get to that a little bit more. But
why do you think now, so if this drug has
been around forever, why are we seeing this massive uptick
in the use of things like o zimpic.
Speaker 2 (03:46):
So, as I mentioned, it's been out for a while,
but with every new iteration of it, it's gotten more effective.
And the first drug that we had to market for
weight management, sex Senda, was a daily injector and it's
weight loss percentages were okay, about ten percent. With the
(04:07):
advent of ozembic, which was a weekly injectible, which makes
it a lot easier for people to take a one
time a week shot versus a daily shot, that one
puts it in its new class. And secondly, it just
became a lot more effective at both blood sugar management
and weight management. So we're starting to see fifteen percent
total body weight and then the newest iterations of the drug,
(04:29):
which are two hormone agonists, so two types of hormones
are in it, Minjaro or zep bound, we see upwards
of twenty three to twenty five percent total body weight loss.
So that's what's happened is that kind of with every
new drug release, they've gotten better ways to give the
drug and just even more efficacious. So that's what we're
(04:51):
starting to see. Also, I will tell you I think
the creator economy, I think TikTok and Instagram over the
past few years have really shifted the way that people
are talking about weight management and obesity. I was screaming
from the rooftops for years that this is a disease,
we have tools to treat it. And people would be like,
(05:11):
look at me, like I was crazy, and I like,
I don't know, I don't know what you're talking about.
That sounds like quackery. And then when these drugs, I know,
something magical happen. Like with this availability of people to
share their story and people feeling empowered to share their story,
people went from being kind of very very private about
these journeys. I've even seen this in my practice. People
(05:33):
are like, I don't want anyone to know I'm on
these medications too. I'm going to share it, and i
want everyone to know, and I'm going to be so
proud that I'm on these injections and I'm going to
share the highs and the lows and create a whole
community out of it. So I really do think that
that's another big part of the cultural shift. It's people's
willingness to share and embrace that this is a disease
(05:56):
and I'm not to blame here and I'm not going
to take on the shame anymore. I'm using a tool
to treat my disease, and I want other people to
embrace that too.
Speaker 1 (06:05):
I want to get to that disease point because we
were talking a little bit about that before the podcast,
and your book was very helpful to me and understanding
a bigger aspect of obesity than I've ever actually even
considered personally. But you just kind of mentioned something that
I thought was so interesting about the sharing and all
of that stuff, and I was thinking, right, well, I've
seen a million fad diets and like the weight loss
(06:28):
surgeries like you mentioned throughout my lifetime. You remember the
days of like Atkins and all of those things. People
were seeing massive weight loss from those kind of things,
but they felt very temporary in a way, or something
that wasn't able to be maintained. So why is this different.
Speaker 2 (06:45):
Because this is getting to the bottom of the biology component,
and so you had spoken a little bit about it,
but my book it's a user guide to these medications,
so it's how can people be successful on them? But
before we get to that, I explain about the biology
of weight gain and why it is so hard to
often lose weight on your own, and why the mantra
(07:08):
of eat less exercise more it's a good way to
start your life and to prevent it doesn't really work
once we've gotten to a place of metabolic dysfunction, and
obesity really is a disease. Once excess weight comes on,
it is very very hard to get off and sometimes
(07:29):
we and I talk about this actually in the book,
about how low carbon kytosis can be an effective way
to get to kind of fix some of the hormones
that have become dysregulated when we put on weight. The
problem is is that we as a society and as
a species aren't really made to just eliminate whole elements
(07:51):
of our diet long long term. And I believe in
particular targeted diet interventions. I do, and I really do
think that whole foods is the absolute best way, and
sometimes I will put people on low carb and I
believe in it. The problem is, and I've seen this
over the course of my career, is that at year three,
(08:14):
maybe even sooner, people just get very tired of it,
and the hormones start to outweigh and like, talk to
you more. The hormones in your brain say I'm hungry.
I don't want to do this anymore. You can't do
this anymore. And what's so different about these medications is
that these medications are getting to the crux of the
(08:36):
metabolic dysfunction and helping fix them, and they are fixing
our behaviors and our brain too. They give people the
ability to take a pause and do the work that
they knew that they might have needed to do, but
we're just unable to. And we don't need as strict
(08:57):
a food dietary intervention, So we don't need to eliminate
whole food groups. Now, we need to eat very well,
and that's like the second tenet of my book. It's
a whole nutrition plan, but you're able to kind of
just live a little bit more normally and not as
strict on these medications because the medication is even more
powerful than our ability to restrict that we would be
able to achieve just through diet alone. And the evidence
(09:20):
on these medications is so strong for long term sustained
weight loss, far beyond what we can see with short
term fixes through diet and exercise. Now there are people
who are listening to this, or people say I know somebody. Yes,
as a population, we are on a big old bell
curve and their outliers on both sides, and so yes,
(09:41):
five ten percent of people will be able to keep
off weight through diet and exercise alone, but that leaves
about ninety plus percent who are unable to. And this
medication has become the tool to override all of the
hormones that have gone hey wire due to the environment
(10:02):
we are living in.
Speaker 1 (10:04):
Yeah, which is a whole nother conversation. Obviously, especially in
our country, it feels like we really aren't set up
to live a healthy lifestyle and at the affordable or
things like that, like you really have to make a
conscious effort. At the beginning of your book, you state
(10:26):
obesity is a fact of biology. And it kind of
hit me because, and I'm sure this may sound ignorant
to some, but I've always been thin, you know, like
that is how I've was born. I came into this
world very long and lean, and I've been very active,
and my parents both eat very healthy, so I grew
up just like living that way, and so I've never
(10:47):
personally struggled with obesity. So it is hard for me
to go, well, get off your couch or eat better,
you know, like that is a mentality that I've had before,
and I mean I hate thinking that now. It's hard
for me to sometimes have empathy for that because I've
never gone through it personally. But your book was stating
it so clearly to me, of like, no, there's way
(11:09):
more to it than just you have to go exercise
or you have to eat better for a lot of people.
So are you seeing that a lot where there's these
people who just cannot relate and so they're kind of
hating on these perspectives, and then the people who are
struggling with it really finding some finally finding a voice
(11:30):
for Hey, I've struggled and I've tried the diets and
I've tried the exercise. I need something more.
Speaker 2 (11:35):
Yes, thank you for sharing that, because I think it's
not something we want to admit, but all of us
are giving me. As an OBC medicine doctor, we all
carry some element of weight bias. It's inherent to how
we came to be in this world. Right, It's just
it's very, very hard and when we are lean and
(11:56):
I actually love the youc you say it came out
long and lean. Lean is actually the word we should
be after it's it's a leanness. It's not a skinniness, right,
it's a fit, it's a fitness. Yeah, and you have
done things in your life to hold on to that.
But also probably genetically you were set up for it,
and then environmentally and epigenetically you were set up for it.
(12:16):
So if your parents were fit, you know, actually a
mother passes on just even by proxy of in utero
children that are born to parents of obesity. If a
mother has bariatric surgery in between her first few children
and her second children, the children after bariatric surgery, after
weight loss, will have a lower incidence of obesity growing up,
(12:39):
even though they're raised the same household with the same genes.
Speaker 1 (12:42):
I believe it. I do.
Speaker 2 (12:43):
Yeah, So you know, some of us are fortunate. I
come from a family where you know, probably let's go back,
let's go back up just a little bit forget different
family Like whyman, But up until the nineteen forties, we
still had pole in this world who had obesity about
(13:03):
ten percent. And that's genetics. And I was to say
I come from one of those families, right, I just
come from a family that are hardier. They're not the
long and lean, they're the short and hardy. And that's genetics.
But what's happened is that something around nineteen eighty we
just started seeing this obesity rise, rise, rise, rise, And
(13:24):
that has to do with our environment and the world
around us, and some genetics could outsmart that. Right. And
now we're not saying that your genetics kept up in
one or two generations, but you were just kind of
primed and ready to be able to keep hold on
to the leanness. But so many others just could not
handle the insults that came at them, right, the high
(13:46):
fructose corn syrup that start to creep into your apple
sauce at eighteen months true, Right, the fact that we
don't aren't set up in urban environments. We get to
walk a lot. I even live in an area where
my kids should be able to bike, but it's too
dangerous for them to bike, and I can't let them
do that into town because our town was not planned,
(14:08):
you know like that. And so there is a lot
of sedentary behavior. We sit at a computer, we are
just the world has exploded in technology. But then that's
made us just beings. That just sit still. You know.
Even this is so fascinating, even the fact that we're
temperature controlled now we have ac and heat and we
don't shiver and we don't sweat.
Speaker 1 (14:29):
Oh, that's interesting. I never thought of that.
Speaker 2 (14:31):
Has impacted our waking over the last fifty years.
Speaker 1 (14:35):
That makes total sense.
Speaker 2 (14:37):
And so there are the subset of people, that's the
majority of Americans now, whose bodies and environments and the
life that they were given and the life that then
they modeled for themselves has not allowed them to hold
on to where our bodies should be okay, And it
becomes very very hard to lose the weight once it's
come on. And I am not saying that environment and
(14:59):
food and nutrition and lifestyle aren't important, But the problem
is obesity is a disease that has a downstream effect
of so many other diseases. And we have an opportunity
right now with this medication to say, Okay, we can
treat this right now, and we can prevent all this
other stuff is going to come over the next forty years.
And while we do this, we should take the time
(15:21):
and the space and the money that we save from
preventing all these diseases to figure out how we can
undo what we've done over the past fifty years for
the world that we've created for ourselves. And so I
don't look as this medication as the magic wand that
solves everything. I see it as a tool for right
now to manage the disease that's in front of us
(15:43):
and allows us to kind of have this trickle down
effect in our families, our homes, our grocery stores, and
our urban centers and you know, just everything, and we
can start to unravel and get back to where we
were in the nineteen seventies. It's not that long ago.
We should be able to get.
Speaker 1 (15:58):
Back there completely. And I do think the conversation that's
encouraging to me, as well as seeing people who are
directly impacted by taking things like this, are that on
the bigger scale, we're starting to look at what's in
our food, what are we eating. All of those things
that you kind of touched on, I think are coming
into the conversation. They're entering the chat right now. So
(16:20):
it's perfect timing for both of these things to be
happening exactly.
Speaker 2 (16:24):
I do think we have to be careful that I
have seen a rising contingency that we can treat the
obesity by changing, by fixing our food source, our food ecosystem,
and our monment ecosystem. That's prevention. We need to put
all the energy there. Treatment is different than prevention, And
in no other disease do we look at prevention and
(16:46):
treatment as the same. But for some reason obesity I do.
And so if any listeners were like, yeah, yeah, and
we could just do, no, we have to do both
in order to stop the disease. We have to prevent.
That's changing, that's taking the chemicals out, that's improving our
food system, it's improving the quality of the air. It's
all the things that you were talking about. Yeah, treatment
(17:08):
is different, and that's why these medications are so revolutionary. Yeah,
and that's why it's so important for me to write
this book because we have an opportunity right now. Now,
then that's aren't a magic bond. You have to do
all the other work. And if you do all the
other work, change the habits, change your food, change your
mental the way you think about these things, exercise, well,
(17:29):
then you're really laying the groundwork to change to trickle
down for that prevention too. So like you're changing the
way you're doing it in your house, and your kids
are going to see a different modeling behavior. You are
changing the way you're exercising your community, and then it spreads.
So in the treatment, we can also prevent, but it's
important that we do all the work and we don't
(17:49):
just rely on the medication to have this magical effect
because it won't.
Speaker 1 (17:54):
Yeah, I mean, I love that that kind of two
different perspectives, I guess is the word I was looking
for those two different things, the prevention versus the treatment,
because in my head, I think I have wanted the
prevention to be the treatment for people. And that's I
mean in what you're saying in the book is like,
there's a lot more to it and the science behind
(18:16):
why that isn't just something that can be You can't
use the tools of prevention if you need to treat
the disease first. So this is medicine to treat the disease,
and then you go into prevention, which you talk about
in the book as well. You've actually created an entire
method and it's called this so Well method. It's talked
about a lot in the book. That was huge for
me too, because one of my biggest problems with our
(18:38):
society is I feel like we throw a pill at everything.
I'm just like, when nobody looks at the root causes.
We want the easy fix. I mean, I've been guilty
of it too, especially I suffer with sleep issues, and
so I'm always like trying not to take a pill,
but I need to sleep.
Speaker 2 (18:52):
You know.
Speaker 1 (18:53):
It's all of those things. And so I think it's
the same thing here where I just don't want to
see our society throw another pill at something. And so
seeing this method that you've created and that you're talking
about in the book was very reassuring to me that
there's more to this story. Can you tell the listeners
(19:18):
a little bit about the Sowell method and what your
point of it even is.
Speaker 2 (19:22):
Thank you? Yes. So. Over the past ten years in
my medical practice, I never felt great. I never felt
great about just treating the disease and Ei there's so
much more to it. And even though I found this
amazing specialty that allowed me to help prevent so many
other diseases, I never felt good about just writing a prescription.
I needed people to understand why I was having them
(19:46):
do certain things and why we were using the medication.
And I needed them to fully embrace the habit changes
and all of the lifestyle changes that needed to go along.
So I actually created a ten week curriculum in my
medical practice and actually everyone has to go through this,
and it worked so amazingly well that I put it
(20:07):
it was the whole reason I wanted to write this book.
I thought this, No other doctors are doing it this way.
It's really we're limited. Most medical practice are very limited
by this. And so I distilled down what we had
been teaching in our medical practice into this book and
it's just so well method. And there are three core tenants.
We have our habit foundations, our nutritional foundations, and then
(20:28):
our mental foundations habits. You've probably heard some of these
things before. They're very different when you do them through
the lens of a GLP one though, So things that
might have felt like just tearing down your will power,
you know, even stepping on the scale is one of
the core habits about how what I have people do
(20:50):
logging your food, not recording every calorie, but just thinking
about your food, thinking about your hunger scale, thinking about
what you're putting internal. Right, You're like, oh, I've heard this, doctor,
soa this is like this seems so basic. It's very
very different when you have this new found will power
for lack of a better word, with these medications, and
(21:11):
it helps you rewire what's become so disregulated in your
brain and your habits. We kind of have to go
back to the foundations. And one of the ways that
I approach this is really being emotionally neutral, and it's
something we talk about in the book a lot, is
that we're trying to take out beating oneself up, feeling
(21:33):
like we're not good enough, and just looking at this
as a process and being as emotionally neutral as possible
so that I always help people the habits. I want
them to become like brushing your teeth right, just something
you do, something you don't have to think too much about,
and if you skip it, you don't like not brush
your teeth the next day, you just get back to
it right right. And then we move into how to eat,
(21:54):
And this is always the thing that people right up top.
Everyone comes to my first visit with me or the
first class, tell me how to eat, and I'll say
not so fast, Like, you have to embrace the habits first.
It doesn't matter. I can tell anybody to go on
any particular diet and if they adhere to it, they
would lose weight. I mean, that's actually what the science shows.
So really it has to be about how can you
(22:15):
do this for the long term. So then we move
into nutrition. I have some very very clear tenants of
how to eat when you're on a gop one. It's
different than how our brain was programmed to kind of
be calorie reduced. We actually need to really hyper focus
on getting in the proper nutrition through macronutrients. So we'll
go through that in the book, and then we move
(22:39):
through what I think is the most important but potentially
the most overlooked component of significant weight loss, which is
the mental piece. Our brains will talk us out of success,
and we see this at all parts of our life.
Right we started to get imposter syndrome that this isn't work,
I can't do it, or you make all sorts of excuses.
Your brain will do these weird things sabotage you. We
(23:02):
really see it in weight loss, and I've worked with
so many patients over so many years on these medications.
I've realized that most people, everyone thinks that they're very unique,
but really we're all humans. And most people have the
same experiences. So we'll talk about things like the ten
pound panic, and practically every single one of my patients
on these medications will freak out at ten pounds and
(23:26):
I'll be why, Like, this isn't gonna work. I've done
this before, I know it's not going to work. This
was a bad idea. I don't know what to do.
Say trust the process, trust the foundations. Keep going. And
then we'll get to a place where a colleague or
a coworker says something and they'll say, did you see
that headline? You're going to die right, or they'll start
(23:47):
to think I'm taking the easy way out. Some belief
that they've held on to for a long period of
time will come up at some point in the future.
And so working on your brain is really really important,
and I actually ask people spend a lot of time
there because it's a thing that will derail people in
the six months, twelve months, two years out of their
initial weight loss. They'll think everything's great, and actually then
(24:09):
their brain starts to do some funny things. And I
give people cognitive new scripts, so like, yeah, they have
a belief and then we have to rewire it and
so I'll give you examples of what you can do
to kind of get past that. Anybody who's listening and
is like, I know exactly what you're talking about. I've
lost a lot of weight, and no one's ever put
it like that. But it's it's it's something that's universal
(24:31):
to this process. I think it's universal to the human
experience and one percent, but it just it rears its head.
And so that's fundamentally what we teach, and I've just
stilled it into this book and tried to make it
as easy as possible and really step wise, I'm a
big believer in like one, two, three, four, right, Like
that's how we learn, that's how we adapt, and so
(24:53):
that's how we put it in the book. And we
have lots of templates and worksheets and things that will
hap I help you and give you structure even if
you do just get the prescription at your doctor's office,
which honestly is the way the majority of Americans are
getting this right now, right, And you might need to
do more work than someone who comes through my clinic,
but it's all here now, and so if you just
(25:15):
follow along, you will have success.
Speaker 1 (25:19):
The thing that's so fascinating to me and hearing this,
and this was what I found in the book as well,
is when I start to look at obesity as a
disease or as a medicator, even as like a way
that someone has learned to survive in life, like as
a survival skill for treating with emotion I mean dealing
with emotions or stress or anything. It's not different from
(25:41):
anything else that we struggle with in mental health, like truly,
I mean everything you were just saying is exactly what
I think a good therapist does. In a way. It's like,
even if you need an antidepressant for a moment, a
good therapist is going to actually go. But let's look
at what's happening, Like, yes, let's take some of these
emotions down so we can process. And that's why you
(26:02):
need the medicine, maybe temporarily, but I don't want to look,
not check out what's going on, because our emotions are
talking to us. And that's the same thing here. It's
like those narratives are so deeply ingrained and programmed, like
you said, and so all of that rewiring. It's the
same thing that anyone trying to make any sort of
lasting change in their life actually has to do so
(26:23):
I just I just love that you're making those connections.
I think that's so beautiful. And I think from a
perspective like mine, where it's not something i've personally dealt with,
I'm easily able to relate that to many things that
I do deal with in my life. I love that
you pointed out the terminal uniqueness that we all feel.
I mean, I think we all are like, I'm so
much more fucked up than the other person. You know,
(26:45):
none of us are. It's just like we really just
have different ways of coping with life, and so what
is your way? And how do we get in touch
with that? And this is the deeper way to look
at weight loss. I'm such a big fan. I just
love that you're doing this work. I think it's so
amazing and wonderful. The book actually comes out January seventh,
so when this podcast airs, it will be out, so
(27:07):
I'll be able to put the link for all the listeners.
She's holding it a friend. It's a cue cover as well,
but it's just a good guide. I told you. My
co host on my Friday episodes has chip for any
of you listeners. He's been on a zembic for a while.
But the biggest thing that I've seen for him, even emotionally,
is that he's really leaned into like I'm going to
(27:29):
start taking care of myself through this though, Like he's
adopted a new diet, he's actually really cut back and
possibly quitting drinking like things that you know, he's really
taking pride in his health at this point. He's working
out a lot, and that to me, I've seen the
biggest shift in him that I've ever seen over the
course of our relationships. So I think it's a part
of this whole program like you're talking about.
Speaker 2 (27:50):
Yes, it's a powerful, powerful tool, and it really gives
people the bandwidth. Really yeah, why it's the brain in
many ways so that they can do the work. And
you know, just like you were sharing, this is about health.
I mean, all those things are telling me that's like
the most amazing health journey. I mean, I'm sure his
labs have improved and his future profiles, like everything he's
(28:14):
doing day to day that is just you're building this
up for longevity, and it's really important that we don't
confuse the use of this medication on the health side
and longevity. For Vanity and thinness because it has the
potential to do that, but that's not going to make
for a healthier human and a healthier experience. It's really
(28:35):
when we need this for very specific use case scenarios
and it's powerful and I love that example.
Speaker 1 (28:41):
Yeah. Well, if people want to keep up with you
anywhere else besides the book, where can they find you?
Speaker 2 (28:47):
So you can find me on social media at Alexandra
so at MD, and you can find more about me
and the company I've started at getsowell dot com. We
all right telehealth practice, but we also provide for for
oh my goodness, we provide support tools for TLP one users.
I've been talking all day, find interviews, I tripped. We
(29:10):
are the go to brand for GLP one users. We
have a whole support system to help people, everything from
the book to the toolkits to actually supplements to help
minimize side effects. So I'm on a mission to help
people feel their absolute best while they're on these medications
so they can achieve the most amount of health benefits.
So come over and connect with me on all those places.
Speaker 1 (29:32):
Amazing. I'm going to put all of that in the
description of this podcast, and also a link to where
you guys can find the book. Highly recommend it. It's
really easy to read, even like I just very quickly
read through it because it's such a fast read. But
it's full of information, diet plans, all of that stuff.
So you guys go get the book. Thank you so
much for being here.
Speaker 2 (29:50):
Thank you so much, Kelly
All right. If you guys haven't heard about g lp ones,
which are weight loss drugs like ozimpic, I would say
you're probably living under a rock. Many people have seen
these life changing weight loss from these drugs, but there's
also a lot of people who are skeptical, and I
can be included in that, as you know, what is
the longevity of this situation, what are the side effects?
(00:32):
And once again, are we just throwing a pill at
something that seems to be rooted in a deeper issue.
So I always love to do these deep dives so
we can set our intentions for the year. So doctor
Alexandra Soa is here. Hi, Doctor Soa, Hi.
Speaker 2 (00:45):
Thank you so much for having me.
Speaker 1 (00:47):
So I wanted to first and foremost just give listeners.
Like I said, if you haven't heard of ozimpic, I mean,
you even brought up to me earlier before we started
the podcast about the Golden Globes last night, and immediately
there's a joke made about, oh, look at all the
ozembic phases. It's a huge thing happening in our society.
So if you haven't heard of it, it would be crazy.
But if someone hasn't, can you just say tell the listeners.
(01:09):
What is a GLP one?
Speaker 2 (01:11):
Yes, So my book is called the ozembic Revolution because
we've kind of come to lump all these drugs under
the name ozempic, but really we're talking about GLP one drugs.
Glp One is a hormone that occurs in the body
and it has to do with hunger and satiety regulation
in fat storage. And we've now figured out a way
(01:34):
to make it and actually make it lasts longer than
it does in our body, and it's become a very
effective tool for blood sugar management, weight management, and now
we're getting even more indications about how it's helping. So
GLP one medications they mimic a hormone that's naturally occurs
in the body, and that hormone acts all over our body.
(01:57):
But really the three big ways that it works are brain, gut,
and pancreas at the level of blood sugar. So we've
had weight management tools before, and we were practicing this
field long before these weekly injectibles came to fruition, but
we've never had anything quite as effective. And that's why
we're all talking about it, because for the first time ever,
(02:19):
we have a weight management tool that's non surgical that's
helping people lose incredible amounts of weight, upwards of twenty
five percent or more of their total mindyweight. So that's
what it is.
Speaker 1 (02:30):
Well, you mentioned blood sugar. Weren't these drugs created initially
to help with diabetes.
Speaker 2 (02:36):
Yes, and they've actually been on the market since two
thousand and five this type of medication, first for type
two diabetes management, and then actually about ten eleven years
ago we had our first drug to market in this
class for weight management. So we've had them around for
a while. That's a misconception that people say, oh, they're
(02:57):
just brand new, they're not. The science was looking for
a better answer for blood sugar management other than insulin,
which has a whole host of complications, and we were
able to find that, and with new iterations of the drug,
they've gotten more effective and along the way we realize
actually there is an independent weight management effect. And then
(03:22):
now we've discovered other independent factors like management for sleep
apnea and cardiovascular and kidney protection. But yes, it did
start with blood sugar.
Speaker 1 (03:32):
We mentioned the book it's called the ozembic Revolution, and
we will get to that a little bit more. But
why do you think now, so if this drug has
been around forever, why are we seeing this massive uptick
in the use of things like o zimpic.
Speaker 2 (03:46):
So, as I mentioned, it's been out for a while,
but with every new iteration of it, it's gotten more effective.
And the first drug that we had to market for
weight management, sex Senda, was a daily injector and it's
weight loss percentages were okay, about ten percent. With the
(04:07):
advent of ozembic, which was a weekly injectible, which makes
it a lot easier for people to take a one
time a week shot versus a daily shot, that one
puts it in its new class. And secondly, it just
became a lot more effective at both blood sugar management
and weight management. So we're starting to see fifteen percent
total body weight and then the newest iterations of the drug,
(04:29):
which are two hormone agonists, so two types of hormones
are in it, Minjaro or zep bound, we see upwards
of twenty three to twenty five percent total body weight loss.
So that's what's happened is that kind of with every
new drug release, they've gotten better ways to give the
drug and just even more efficacious. So that's what we're
(04:51):
starting to see. Also, I will tell you I think
the creator economy, I think TikTok and Instagram over the
past few years have really shifted the way that people
are talking about weight management and obesity. I was screaming
from the rooftops for years that this is a disease,
we have tools to treat it. And people would be like,
(05:11):
look at me, like I was crazy, and I like,
I don't know, I don't know what you're talking about.
That sounds like quackery. And then when these drugs, I know,
something magical happen. Like with this availability of people to
share their story and people feeling empowered to share their story,
people went from being kind of very very private about
these journeys. I've even seen this in my practice. People
(05:33):
are like, I don't want anyone to know I'm on
these medications too. I'm going to share it, and i
want everyone to know, and I'm going to be so
proud that I'm on these injections and I'm going to
share the highs and the lows and create a whole
community out of it. So I really do think that
that's another big part of the cultural shift. It's people's
willingness to share and embrace that this is a disease
(05:56):
and I'm not to blame here and I'm not going
to take on the shame anymore. I'm using a tool
to treat my disease, and I want other people to
embrace that too.
Speaker 1 (06:05):
I want to get to that disease point because we
were talking a little bit about that before the podcast,
and your book was very helpful to me and understanding
a bigger aspect of obesity than I've ever actually even
considered personally. But you just kind of mentioned something that
I thought was so interesting about the sharing and all
of that stuff, and I was thinking, right, well, I've
seen a million fad diets and like the weight loss
(06:28):
surgeries like you mentioned throughout my lifetime. You remember the
days of like Atkins and all of those things. People
were seeing massive weight loss from those kind of things,
but they felt very temporary in a way, or something
that wasn't able to be maintained. So why is this different.
Speaker 2 (06:45):
Because this is getting to the bottom of the biology component,
and so you had spoken a little bit about it,
but my book it's a user guide to these medications,
so it's how can people be successful on them? But
before we get to that, I explain about the biology
of weight gain and why it is so hard to
often lose weight on your own, and why the mantra
(07:08):
of eat less exercise more it's a good way to
start your life and to prevent it doesn't really work
once we've gotten to a place of metabolic dysfunction, and
obesity really is a disease. Once excess weight comes on,
it is very very hard to get off and sometimes
(07:29):
we and I talk about this actually in the book,
about how low carbon kytosis can be an effective way
to get to kind of fix some of the hormones
that have become dysregulated when we put on weight. The
problem is is that we as a society and as
a species aren't really made to just eliminate whole elements
(07:51):
of our diet long long term. And I believe in
particular targeted diet interventions. I do, and I really do
think that whole foods is the absolute best way, and
sometimes I will put people on low carb and I
believe in it. The problem is, and I've seen this
over the course of my career, is that at year three,
(08:14):
maybe even sooner, people just get very tired of it,
and the hormones start to outweigh and like, talk to
you more. The hormones in your brain say I'm hungry.
I don't want to do this anymore. You can't do
this anymore. And what's so different about these medications is
that these medications are getting to the crux of the
(08:36):
metabolic dysfunction and helping fix them, and they are fixing
our behaviors and our brain too. They give people the
ability to take a pause and do the work that
they knew that they might have needed to do, but
we're just unable to. And we don't need as strict
(08:57):
a food dietary intervention, So we don't need to eliminate
whole food groups. Now, we need to eat very well,
and that's like the second tenet of my book. It's
a whole nutrition plan, but you're able to kind of
just live a little bit more normally and not as
strict on these medications because the medication is even more
powerful than our ability to restrict that we would be
able to achieve just through diet alone. And the evidence
(09:20):
on these medications is so strong for long term sustained
weight loss, far beyond what we can see with short
term fixes through diet and exercise. Now there are people
who are listening to this, or people say I know somebody. Yes,
as a population, we are on a big old bell
curve and their outliers on both sides, and so yes,
(09:41):
five ten percent of people will be able to keep
off weight through diet and exercise alone, but that leaves
about ninety plus percent who are unable to. And this
medication has become the tool to override all of the
hormones that have gone hey wire due to the environment
(10:02):
we are living in.
Speaker 1 (10:04):
Yeah, which is a whole nother conversation. Obviously, especially in
our country, it feels like we really aren't set up
to live a healthy lifestyle and at the affordable or
things like that, like you really have to make a
conscious effort. At the beginning of your book, you state
(10:26):
obesity is a fact of biology. And it kind of
hit me because, and I'm sure this may sound ignorant
to some, but I've always been thin, you know, like
that is how I've was born. I came into this
world very long and lean, and I've been very active,
and my parents both eat very healthy, so I grew
up just like living that way, and so I've never
(10:47):
personally struggled with obesity. So it is hard for me
to go, well, get off your couch or eat better,
you know, like that is a mentality that I've had before,
and I mean I hate thinking that now. It's hard
for me to sometimes have empathy for that because I've
never gone through it personally. But your book was stating
it so clearly to me, of like, no, there's way
(11:09):
more to it than just you have to go exercise
or you have to eat better for a lot of people.
So are you seeing that a lot where there's these
people who just cannot relate and so they're kind of
hating on these perspectives, and then the people who are
struggling with it really finding some finally finding a voice
(11:30):
for Hey, I've struggled and I've tried the diets and
I've tried the exercise. I need something more.
Speaker 2 (11:35):
Yes, thank you for sharing that, because I think it's
not something we want to admit, but all of us
are giving me. As an OBC medicine doctor, we all
carry some element of weight bias. It's inherent to how
we came to be in this world. Right, It's just
it's very, very hard and when we are lean and
(11:56):
I actually love the youc you say it came out
long and lean. Lean is actually the word we should
be after it's it's a leanness. It's not a skinniness, right,
it's a fit, it's a fitness. Yeah, and you have
done things in your life to hold on to that.
But also probably genetically you were set up for it,
and then environmentally and epigenetically you were set up for it.
(12:16):
So if your parents were fit, you know, actually a
mother passes on just even by proxy of in utero
children that are born to parents of obesity. If a
mother has bariatric surgery in between her first few children
and her second children, the children after bariatric surgery, after
weight loss, will have a lower incidence of obesity growing up,
(12:39):
even though they're raised the same household with the same genes.
Speaker 1 (12:42):
I believe it. I do.
Speaker 2 (12:43):
Yeah, So you know, some of us are fortunate. I
come from a family where you know, probably let's go back,
let's go back up just a little bit forget different
family Like whyman, But up until the nineteen forties, we
still had pole in this world who had obesity about
(13:03):
ten percent. And that's genetics. And I was to say
I come from one of those families, right, I just
come from a family that are hardier. They're not the
long and lean, they're the short and hardy. And that's genetics.
But what's happened is that something around nineteen eighty we
just started seeing this obesity rise, rise, rise, rise, And
(13:24):
that has to do with our environment and the world
around us, and some genetics could outsmart that. Right. And
now we're not saying that your genetics kept up in
one or two generations, but you were just kind of
primed and ready to be able to keep hold on
to the leanness. But so many others just could not
handle the insults that came at them, right, the high
(13:46):
fructose corn syrup that start to creep into your apple
sauce at eighteen months true, Right, the fact that we
don't aren't set up in urban environments. We get to
walk a lot. I even live in an area where
my kids should be able to bike, but it's too
dangerous for them to bike, and I can't let them
do that into town because our town was not planned,
(14:08):
you know like that. And so there is a lot
of sedentary behavior. We sit at a computer, we are
just the world has exploded in technology. But then that's
made us just beings. That just sit still. You know.
Even this is so fascinating, even the fact that we're
temperature controlled now we have ac and heat and we
don't shiver and we don't sweat.
Speaker 1 (14:29):
Oh, that's interesting. I never thought of that.
Speaker 2 (14:31):
Has impacted our waking over the last fifty years.
Speaker 1 (14:35):
That makes total sense.
Speaker 2 (14:37):
And so there are the subset of people, that's the
majority of Americans now, whose bodies and environments and the
life that they were given and the life that then
they modeled for themselves has not allowed them to hold
on to where our bodies should be okay, And it
becomes very very hard to lose the weight once it's
come on. And I am not saying that environment and
(14:59):
food and nutrition and lifestyle aren't important, But the problem
is obesity is a disease that has a downstream effect
of so many other diseases. And we have an opportunity
right now with this medication to say, Okay, we can
treat this right now, and we can prevent all this
other stuff is going to come over the next forty years.
And while we do this, we should take the time
(15:21):
and the space and the money that we save from
preventing all these diseases to figure out how we can
undo what we've done over the past fifty years for
the world that we've created for ourselves. And so I
don't look as this medication as the magic wand that
solves everything. I see it as a tool for right
now to manage the disease that's in front of us
(15:43):
and allows us to kind of have this trickle down
effect in our families, our homes, our grocery stores, and
our urban centers and you know, just everything, and we
can start to unravel and get back to where we
were in the nineteen seventies. It's not that long ago.
We should be able to get.
Speaker 1 (15:58):
Back there completely. And I do think the conversation that's
encouraging to me, as well as seeing people who are
directly impacted by taking things like this, are that on
the bigger scale, we're starting to look at what's in
our food, what are we eating. All of those things
that you kind of touched on, I think are coming
into the conversation. They're entering the chat right now. So
(16:20):
it's perfect timing for both of these things to be
happening exactly.
Speaker 2 (16:24):
I do think we have to be careful that I
have seen a rising contingency that we can treat the
obesity by changing, by fixing our food source, our food ecosystem,
and our monment ecosystem. That's prevention. We need to put
all the energy there. Treatment is different than prevention, And
in no other disease do we look at prevention and
(16:46):
treatment as the same. But for some reason obesity I do.
And so if any listeners were like, yeah, yeah, and
we could just do, no, we have to do both
in order to stop the disease. We have to prevent.
That's changing, that's taking the chemicals out, that's improving our
food system, it's improving the quality of the air. It's
all the things that you were talking about. Yeah, treatment
(17:08):
is different, and that's why these medications are so revolutionary. Yeah,
and that's why it's so important for me to write
this book because we have an opportunity right now. Now,
then that's aren't a magic bond. You have to do
all the other work. And if you do all the
other work, change the habits, change your food, change your
mental the way you think about these things, exercise, well,
(17:29):
then you're really laying the groundwork to change to trickle
down for that prevention too. So like you're changing the
way you're doing it in your house, and your kids
are going to see a different modeling behavior. You are
changing the way you're exercising your community, and then it spreads.
So in the treatment, we can also prevent, but it's
important that we do all the work and we don't
(17:49):
just rely on the medication to have this magical effect
because it won't.
Speaker 1 (17:54):
Yeah, I mean, I love that that kind of two
different perspectives, I guess is the word I was looking
for those two different things, the prevention versus the treatment,
because in my head, I think I have wanted the
prevention to be the treatment for people. And that's I
mean in what you're saying in the book is like,
there's a lot more to it and the science behind
(18:16):
why that isn't just something that can be You can't
use the tools of prevention if you need to treat
the disease first. So this is medicine to treat the disease,
and then you go into prevention, which you talk about
in the book as well. You've actually created an entire
method and it's called this so Well method. It's talked
about a lot in the book. That was huge for
me too, because one of my biggest problems with our
(18:38):
society is I feel like we throw a pill at everything.
I'm just like, when nobody looks at the root causes.
We want the easy fix. I mean, I've been guilty
of it too, especially I suffer with sleep issues, and
so I'm always like trying not to take a pill,
but I need to sleep.
Speaker 2 (18:52):
You know.
Speaker 1 (18:53):
It's all of those things. And so I think it's
the same thing here where I just don't want to
see our society throw another pill at something. And so
seeing this method that you've created and that you're talking
about in the book was very reassuring to me that
there's more to this story. Can you tell the listeners
(19:18):
a little bit about the Sowell method and what your
point of it even is.
Speaker 2 (19:22):
Thank you? Yes. So. Over the past ten years in
my medical practice, I never felt great. I never felt
great about just treating the disease and Ei there's so
much more to it. And even though I found this
amazing specialty that allowed me to help prevent so many
other diseases, I never felt good about just writing a prescription.
I needed people to understand why I was having them
(19:46):
do certain things and why we were using the medication.
And I needed them to fully embrace the habit changes
and all of the lifestyle changes that needed to go along.
So I actually created a ten week curriculum in my
medical practice and actually everyone has to go through this,
and it worked so amazingly well that I put it
(20:07):
it was the whole reason I wanted to write this book.
I thought this, No other doctors are doing it this way.
It's really we're limited. Most medical practice are very limited
by this. And so I distilled down what we had
been teaching in our medical practice into this book and
it's just so well method. And there are three core tenants.
We have our habit foundations, our nutritional foundations, and then
(20:28):
our mental foundations habits. You've probably heard some of these
things before. They're very different when you do them through
the lens of a GLP one though, So things that
might have felt like just tearing down your will power,
you know, even stepping on the scale is one of
the core habits about how what I have people do
(20:50):
logging your food, not recording every calorie, but just thinking
about your food, thinking about your hunger scale, thinking about
what you're putting internal. Right, You're like, oh, I've heard this, doctor,
soa this is like this seems so basic. It's very
very different when you have this new found will power
for lack of a better word, with these medications, and
(21:11):
it helps you rewire what's become so disregulated in your
brain and your habits. We kind of have to go
back to the foundations. And one of the ways that
I approach this is really being emotionally neutral, and it's
something we talk about in the book a lot, is
that we're trying to take out beating oneself up, feeling
(21:33):
like we're not good enough, and just looking at this
as a process and being as emotionally neutral as possible
so that I always help people the habits. I want
them to become like brushing your teeth right, just something
you do, something you don't have to think too much about,
and if you skip it, you don't like not brush
your teeth the next day, you just get back to
it right right. And then we move into how to eat,
(21:54):
And this is always the thing that people right up top.
Everyone comes to my first visit with me or the
first class, tell me how to eat, and I'll say
not so fast, Like, you have to embrace the habits first.
It doesn't matter. I can tell anybody to go on
any particular diet and if they adhere to it, they
would lose weight. I mean, that's actually what the science shows.
So really it has to be about how can you
(22:15):
do this for the long term. So then we move
into nutrition. I have some very very clear tenants of
how to eat when you're on a gop one. It's
different than how our brain was programmed to kind of
be calorie reduced. We actually need to really hyper focus
on getting in the proper nutrition through macronutrients. So we'll
go through that in the book, and then we move
(22:39):
through what I think is the most important but potentially
the most overlooked component of significant weight loss, which is
the mental piece. Our brains will talk us out of success,
and we see this at all parts of our life.
Right we started to get imposter syndrome that this isn't work,
I can't do it, or you make all sorts of excuses.
Your brain will do these weird things sabotage you. We
(23:02):
really see it in weight loss, and I've worked with
so many patients over so many years on these medications.
I've realized that most people, everyone thinks that they're very unique,
but really we're all humans. And most people have the
same experiences. So we'll talk about things like the ten
pound panic, and practically every single one of my patients
on these medications will freak out at ten pounds and
(23:26):
I'll be why, Like, this isn't gonna work. I've done
this before, I know it's not going to work. This
was a bad idea. I don't know what to do.
Say trust the process, trust the foundations. Keep going. And
then we'll get to a place where a colleague or
a coworker says something and they'll say, did you see
that headline? You're going to die right, or they'll start
(23:47):
to think I'm taking the easy way out. Some belief
that they've held on to for a long period of
time will come up at some point in the future.
And so working on your brain is really really important,
and I actually ask people spend a lot of time
there because it's a thing that will derail people in
the six months, twelve months, two years out of their
initial weight loss. They'll think everything's great, and actually then
(24:09):
their brain starts to do some funny things. And I
give people cognitive new scripts, so like, yeah, they have
a belief and then we have to rewire it and
so I'll give you examples of what you can do
to kind of get past that. Anybody who's listening and
is like, I know exactly what you're talking about. I've
lost a lot of weight, and no one's ever put
it like that. But it's it's it's something that's universal
(24:31):
to this process. I think it's universal to the human
experience and one percent, but it just it rears its head.
And so that's fundamentally what we teach, and I've just
stilled it into this book and tried to make it
as easy as possible and really step wise, I'm a
big believer in like one, two, three, four, right, Like
that's how we learn, that's how we adapt, and so
(24:53):
that's how we put it in the book. And we
have lots of templates and worksheets and things that will
hap I help you and give you structure even if
you do just get the prescription at your doctor's office,
which honestly is the way the majority of Americans are
getting this right now, right, And you might need to
do more work than someone who comes through my clinic,
but it's all here now, and so if you just
(25:15):
follow along, you will have success.
Speaker 1 (25:19):
The thing that's so fascinating to me and hearing this,
and this was what I found in the book as well,
is when I start to look at obesity as a
disease or as a medicator, even as like a way
that someone has learned to survive in life, like as
a survival skill for treating with emotion I mean dealing
with emotions or stress or anything. It's not different from
(25:41):
anything else that we struggle with in mental health, like truly,
I mean everything you were just saying is exactly what
I think a good therapist does. In a way. It's like,
even if you need an antidepressant for a moment, a
good therapist is going to actually go. But let's look
at what's happening, Like, yes, let's take some of these
emotions down so we can process. And that's why you
(26:02):
need the medicine, maybe temporarily, but I don't want to look,
not check out what's going on, because our emotions are
talking to us. And that's the same thing here. It's
like those narratives are so deeply ingrained and programmed, like
you said, and so all of that rewiring. It's the
same thing that anyone trying to make any sort of
lasting change in their life actually has to do so
(26:23):
I just I just love that you're making those connections.
I think that's so beautiful. And I think from a
perspective like mine, where it's not something i've personally dealt with,
I'm easily able to relate that to many things that
I do deal with in my life. I love that
you pointed out the terminal uniqueness that we all feel.
I mean, I think we all are like, I'm so
much more fucked up than the other person. You know,
(26:45):
none of us are. It's just like we really just
have different ways of coping with life, and so what
is your way? And how do we get in touch
with that? And this is the deeper way to look
at weight loss. I'm such a big fan. I just
love that you're doing this work. I think it's so
amazing and wonderful. The book actually comes out January seventh,
so when this podcast airs, it will be out, so
(27:07):
I'll be able to put the link for all the listeners.
She's holding it a friend. It's a cue cover as well,
but it's just a good guide. I told you. My
co host on my Friday episodes has chip for any
of you listeners. He's been on a zembic for a while.
But the biggest thing that I've seen for him, even emotionally,
is that he's really leaned into like I'm going to
(27:29):
start taking care of myself through this though, Like he's
adopted a new diet, he's actually really cut back and
possibly quitting drinking like things that you know, he's really
taking pride in his health at this point. He's working
out a lot, and that to me, I've seen the
biggest shift in him that I've ever seen over the
course of our relationships. So I think it's a part
of this whole program like you're talking about.
Speaker 2 (27:50):
Yes, it's a powerful, powerful tool, and it really gives
people the bandwidth. Really yeah, why it's the brain in
many ways so that they can do the work. And
you know, just like you were sharing, this is about health.
I mean, all those things are telling me that's like
the most amazing health journey. I mean, I'm sure his
labs have improved and his future profiles, like everything he's
(28:14):
doing day to day that is just you're building this
up for longevity, and it's really important that we don't
confuse the use of this medication on the health side
and longevity. For Vanity and thinness because it has the
potential to do that, but that's not going to make
for a healthier human and a healthier experience. It's really
(28:35):
when we need this for very specific use case scenarios
and it's powerful and I love that example.
Speaker 1 (28:41):
Yeah. Well, if people want to keep up with you
anywhere else besides the book, where can they find you?
Speaker 2 (28:47):
So you can find me on social media at Alexandra
so at MD, and you can find more about me
and the company I've started at getsowell dot com. We
all right telehealth practice, but we also provide for for
oh my goodness, we provide support tools for TLP one users.
I've been talking all day, find interviews, I tripped. We
(29:10):
are the go to brand for GLP one users. We
have a whole support system to help people, everything from
the book to the toolkits to actually supplements to help
minimize side effects. So I'm on a mission to help
people feel their absolute best while they're on these medications
so they can achieve the most amount of health benefits.
So come over and connect with me on all those places.
Speaker 1 (29:32):
Amazing. I'm going to put all of that in the
description of this podcast, and also a link to where
you guys can find the book. Highly recommend it. It's
really easy to read, even like I just very quickly
read through it because it's such a fast read. But
it's full of information, diet plans, all of that stuff.
So you guys go get the book. Thank you so
much for being here.
Speaker 2 (29:50):
Thank you so much, Kelly
Host
Kelly Henderson
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