GLP-1 Medications Require Multidisciplinary Support for Holistic Health

Key Quotes

"I don’t think GLP-1 meds are the answer for everyone, but I also don’t think they’re the villain of the story. For many people they can be genuinely life-changing, when they’re used with the right support. So this episode is for anyone who’s made that decision (or is seriously considering it) and wants to do it safely, sustainably, and with as much information as possible."

Dr. Rupy explains that GLP-1 medications are not a universal solution but can be highly beneficial for many individuals when implemented with proper guidance. This sets the stage for the episode's focus on providing comprehensive information for safe and sustainable use of these medications.

"I can’t stop you from taking these medications, but I can help you be informed: what to ask, what to monitor, what to eat, and how to protect your muscle, gut, and long-term health along the way."

Dr. Rupy emphasizes his role as an educator, not a prohibitor, regarding GLP-1 medications. He outlines the episode's objective to empower listeners with knowledge about asking the right questions, monitoring their health, dietary considerations, and safeguarding their overall well-being while using these drugs.

"We break down GLP-1s, starting with what happens in an optimally functioning body: the roles of hormones like GLP-1, GIP, PYY and CCK, and how they influence hunger, fullness, blood sugar, and cravings. We also talk through what side effects might be telling you, what to monitor if you do choose medication, and whether supplements have a role -- including the so-called “GLP-1 boosters” you’ll see everywhere."

Ashley Koff, RD, details the episode's structure, beginning with the physiological processes in a healthy body, specifically the functions of key hormones. She indicates the discussion will extend to practical aspects like managing side effects, monitoring health, and evaluating the efficacy of supplements marketed as "GLP-1 boosters."

"So what we've identified is at the genetic level and then throughout the whole body's ecosystem, so brain, gut, vagus nerve, all these different things, there can be challenges. And there often are challenges. And for some of us, they're multifactorial. It's like all of them, you know, are working against us and our ability to feel full."

Ashley Koff, RD, explains that the inability to feel full is a complex issue stemming from multiple factors. She highlights that challenges can exist at the genetic level and within the interconnected systems of the brain, gut, and vagus nerve, often involving a combination of these elements working against an individual's satiety signals.

"So the fact that we're all, that you're only saying this about somebody who is losing weight, um, or where their objective right now is to actually deal with something and there's a medication that can be helpful, says to me that you have a bias."

Ashley Koff, RD, directly addresses skepticism towards weight loss medications, asserting that singling out these drugs for criticism reveals a bias. She argues that this judgment is not applied to other medications used for various health conditions, suggesting an unfair perception of individuals seeking to manage their weight.

"So food noise is a really important way for us to understand and food noise is just one part of unfortunately the noise of the experience of our lives, you know, that we're carrying. Um, and I think it's a really, I think, uh, Gabor Maté does a really good job of, of looking at this, you know, there's a lot of, um, and Amy Gappin, these are doctors who have really been focusing on trauma. Our trauma has our own noise and so sometimes our food noise is derived from our trauma."

Ashley Koff, RD, defines "food noise" as a significant component of life's overall "noise" or internal distractions. She connects this concept to the work of doctors like Gabor Maté and Amy Gappin, suggesting that food noise can sometimes originate from past trauma, influencing an individual's relationship with food.

"So the Gila monster is a prehistoric animal, um, that I think is, has provided us with a modern-day tool, uh, to our modern-day weight health problems. So it's kind of interesting on that part. By design, the Gila monster doesn't want to, it wants to be in a cold, dark place by itself. It doesn't want to go outside to, to look for food. It risks, you know, death, being in, you know, and it's in crazy heat, you know, in the deserts and these sorts of things. And so it was designed with what I wish they would find a way to mimic, which is the ability to, um, eat the fat from your tush so that you don't have to eat food and that's what gives the body, you know, what it needs."

Ashley Koff, RD, explains the origin of GLP-1 medications, tracing them back to the venom of the Gila monster. She highlights the animal's unique biological design for survival, particularly its ability to utilize stored fat for energy, which inspired the development of medications to address modern weight health challenges.

"So the way that I look at supplements is there's three roles for a supplement. A supplement can prevent or help to prevent, um, gaps that your nutrition is not, it is that your nutrition may create. So, um, when I am like, I travel a lot. When I am not able to be in control of my choices on a day-to-day basis, the role of maybe an, an omega-3 or a, um, some glutamine or like some of these other things may be able to fill a gap because I don't make the same choices every single day on that part, right?"

Ashley Koff, RD, categorizes the roles of supplements into three main functions. She explains that supplements can act as a preventative measure to fill nutritional gaps, particularly when dietary intake is inconsistent or compromised, such as during travel.

"The muscle loss is the most, the one that like I will jump up and down and build a lot of muscle, um, at how many times a day I'm screaming about this one because muscle loss occurs with weight loss. Um, so when we look at overall weight, the body is made up of bone, muscle and fat and some water, you know, in that part. So when we lose weight, we can lose some combination of any of those."

Ashley Koff, RD, expresses strong concern about muscle loss during weight loss, emphasizing that it is a common occurrence when weight is lost, regardless of the method. She clarifies that the body is composed of bone, muscle, and fat, and any weight reduction can involve a combination of these components.