More Than Medicine

MTM - Weight Loss Goals and GLP-1 Inhibitors

Dr. Robert E. Jackson Season 3 Episode 391

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Resolutions don’t work without a decision. We open with three unforgettable transformations—a highway worker shedding 220 pounds through daily walks and a simple menu, a granddad reclaiming the floor with a six-inch plate, and a construction pro who walked in rain, sleet, and blazing sun to lose 160 pounds on keto. Each story proves the turning point isn’t a trend or gadget; it’s the choice to change, followed by small, repeatable habits that outlast motivation.

From there we get practical and candid about GLP-1 medications like semaglutide and tirzepatide. We explain who typically qualifies, how insurers think about A1C thresholds and sleep apnea, and what real patients experience with appetite suppression, steady weight loss, and reduced reliance on other diabetes, blood pressure, and cholesterol meds. We talk costs, access hurdles, side effects that are common versus rare, and the monitoring that keeps therapy safe. You’ll hear how one retiree called six months of treatment the best money he ever spent on his health—and how others used these tools to unlock mobility, confidence, and longevity.

We also step back to look at how culture shapes metabolism. Stories from a South Pacific island and repeated trips to Haiti reveal how shifting from local foods and daily walking to a Westernized diet drove obesity, diabetes, and GI disease within a generation. The pattern is clear: when food quality drops and movement declines, chronic illness rises. Our closing playbook is straightforward—portion control, protein-forward meals, fewer refined carbs, daily movement, restorative sleep, and an accountability partner who helps you keep promises to yourself. Use GLP-1s wisely if you need them, build habits that last, and choose the path that lets you enjoy the years ahead.

If this conversation helped you think differently about weight loss, subscribe, share it with a friend who needs a nudge, and leave a review so others can find the show.

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SPEAKER_01:

More than that. Where Jesus is more than enough for the illness that culture is hosted by authoring physician Dr. Robert Jackson. And it's wife Carlotta and Dr. Annabella. So listen up because the doctor is dead.

SPEAKER_02:

Welcome to More Than Medicine. I'm your host, Dr. Robert Jackson, bringing to you biblical insights and stories from the country doctor's rusty, dusty scrapbook. Well, I know that it's New Year, and I know that many of you are making your New Year resolutions, and I know that weight loss is an important component of your New Year resolutions. So I thought that I would share a few ideas from the country doctor's rusty dusty scrapbook about weight loss. First of all, I want to start with three stories from my own medical practice. Now these are not recent stories in order to protect the reputation and the recognition of these patients. Oh, I don't know, probably 15 or 20 years ago, one of my patients came to see me. Two years prior, she had been a 400-pound, five foot four young lady. She worked for the highway department, and she was one of those employees that stood on the side of the road holding a sign that said stop or go. Unfortunately, people would drive by in their cars and they would roll down their window and hurl insults at her because she was wider than she was tall. Well, after a year or so of enduring the insults, this young lady made a decision and she started walking for exercise every day. Four miles she walked every day, and she changed her diet. She began to eat nothing but salad, cottage cheese, and a boiled egg twice a day. Over the course of two years she lost two hundred and twenty pounds on this exercise regimen and self imposed diet. I had no input in this plan whatsoever. At the end of two years she came to see me for an unrelated problem, and I had no idea who she was. I didn't recognize her at all, and she began to laugh and laugh and laugh, and she said, Dr. Jackson, you don't know who I am. And I said, No, ma'am, I don't recognize you. You're not the young lady that's listed on my chart. And so she told me the whole story and we began to laugh together. That's the first story. The next one is a story of a seventy year old man who had a really big abdomen and bad arthritis in his knees, and he complained to me that he couldn't get on the floor to play with his grandchildren. Well, he came to see me twice a year to check his arthritis and his blood pressure. Well, in between visits, he managed to lose 70 pounds. And when he came back to see me, I was shocked because his abdomen would had just disappeared. And I said to him, What in the world have you done? Are you sick? Do you have cancer? He said no. He said I got tired of not being able to get on the floor to play with my grandchildren. And he said, I put myself on a self-imposed diet, and basically what he did was he bought a little six-inch plate, and he said I ate whatever would fit on that plate one time, three times per day, nothing in between meals, and nothing after bed after supper time. And I I said, Well, well now did you do any exercise? And he said, Doc, I'm 70 years old. My knees are bad. I can't walk for exercise. So basically what he did was practice portion control for six months, and he lost seventy pounds. And he was so delighted because now he could get on the floor, play with his grandchildren, and the best part was he did not need assistance getting back up from on the floor. Now the third story is this. I was working at the psych ward at the hospital. They call it behavioral health, but you and I understand it's really the psych ward. And I met a young man at doing his intake physical, and the chart said that he weighed 320 pounds a year prior, and I looked at him, and today at his physical he weighed 160 pounds. So I asked him about it. And he said, Yes, sir, I did. I weighed 320 pounds a year ago. So I said, well now, have you been on drugs? He said, no, sir. I said, have you been sick? He said, no, sir. I said, well, what in the world did you do? He said, Doc, I got tired of being 320 pounds, and I made a decision. Key phrase, I made a decision. He said, I started walking for exercise twice a day, and I put myself on a keto diet. Now this guy worked a construction job, and he told me that he worked walked twice a day for a solid year, and he said I walked in the rain, the sleet, the snow, and the burning hot sun, regardless of the temperature or the weather, and he said I lost 160 pounds in nine months. I said, nine months? Did you get sick during that time? He said, Well, one time I my potassium was low, and I had to go to the ER for some IV fluids and potassium. But other than that, he said I was not sick. And I said, Have you gained any weight back? He said ten pounds, but I'm I'm holding steady. And I was amazed that he had done this without any medical assistance. Well, remember the phrase, I made a decision. And you see, I've learned over the years that weight loss is really between the ears. People make a decision, like this 400 pound girl, like this 320 pound young man, like this 70-year-old man. None of them had any medical assistance whatsoever. They all just made a decision. And I just want to plant that in your mind before we begin our discussion today because I want to talk today about the GLP1 inhibitors, which is the current craze in weight loss. The GLP1 inhibitors are Ozimpic, Munjaro, and Zeppound. And you see these advertised on television and your friends are talking about it. And currently if you have diabetes or obstructive sleep apnea, your insurance will pay for these. Now Margie, that's not her real name, came to see me recently, and she sat in exam room number two, and she told me that she had lost one hundred pounds using Ozimpic in the last year, and she was laughing because that very day two of her high school friends had seen her at a convenience store and didn't even recognize her any longer because she'd lost so much weight. Unfortunately, she still needed to lose another fifty pounds. She'd had no side effect whatsoever of the medication except for the appetite suppression. Now I have prescribed GLP1 inhibitors like Ozimpic and Moonjaro at least once per day for the last four years. When these medications first came on the market, I was very reluctant to use them. I waited till they had been on the market for over a year to a year and a half before I jumped on that bandwagon. Initially, it was too hard to obtain insurance approval and the medication was too expensive. But over time, insurance companies came on board. And now the insurance companies will pay for these medications for patients with an A1C greater than 6.5. Now, if you don't understand, an A1C is a test that measures your average blood sugar for the last 90 days. A normal A1C is about 5.5 to 6 in a non-diabetic. If someone's A1C is greater than 6.5, it indicates that they have a blood sugar issue. So an A1C of greater than 6.5 indicating diabetes, or if the patient has obstructive sleep apnea documented by a sleep lab analysis. Some insurance plans will pay for ZEP bound if your BMI is over 30 for weight loss purposes, but that's kind of rare to be honest. The medicines cost between$900 and$1,200 per month, and the patient's co-pay is often$250 to$400 per month, depending on their insurance company. Most patients tolerate the GLP1 inhibitors fairly well. In my experience, less than 5% have nausea or vomiting or diarrhea or maybe constipation, it can go either way. Sufficient to cause discontinuation of the medication. By the second month dose increase, most patients are already experiencing weight loss. It is not unusual for patients to lose six or eight pounds per month. Diabetics often are able to stop their other diabetic medications and rely solely upon the blood sugar controlling effect of the GLP1 inhibitor. Of course, blood pressure and cholesterol fall away, so these MIDS can often be discontinued as well if patients don't have cardiac risk factors. One of my patients was 79 years old. He was an active deer hunter, an active turkey hunter, but his arthritis in his knees was hindering his hunting and his yard work. He was 70 pounds overweight. His insurance would not pay for any GLP 1 inhibitor because he was not a diabetic. He was not someone with obstructive sleep apnea. So he took money out of his retirement plan and he paid for the GLP 1 inhibitor for six months. Cash pay. He lost 80 pounds and told me it was the best investment he had ever made in his health. He is now much more mobile, his knees aren't hurting nearly as much, and he's back to hunting and taking care of his farm. He's now maintaining his weight loss without the medication with old-fashioned self-discipline. He's no longer requiring his blood pressure medication, which I'd placed him on when he was 80 pounds overweight. When first introduced to the market, there were concerns that the GLP1 inhibitors could cause kidney issues, pancreatitis, and thyroid cancer. In my small patient population of three or four hundred patients, none of these pa none of my patients have had any kind of kidney or pancreatic issues, and I check their kidney function test every three months just to be safe. Only one of my patients has had pancreatitis, but she had a history of pancreatitis before starting on the GLP1 inhibitor. None of my patients have had any kind of thyroid issues. The most common complaint is hair loss in women due to rapid weight loss, but that's a common complaint on any kind of weight loss plan and it's a temporary condition. Let's talk about another patient. Flora is one of my patients who was on insulin, two other diabetic meds, two blood pressure meds, and two cholesterol medications one year ago. I started her on Munjaro to help with uncontrolled blood sugar, which in her case usually ran over 300, and I put her on it to help her with weight loss, which in her case she was over three hundred pounds. She's a school principal and is concerned that her diabetes will cause her to lose her job eventually. In one year she has lost eighty-five pounds. She has come off all of her meds except for ten units of insulin per day, one blood pressure med, and her statin drug for cholesterol. She's still steadily losing weight, and she's as happy as a clam. Another example is Jose. He's a self-employed gentleman. He's a brick mason. He's eighty pounds overweight, and he can't afford the three meds I've put him on for blood pressure, blood sugar, and cholesterol. Besides that, he hates taking medications. He has no insurance. I connected him with a telemed doctor group called Citizen Meds. Let me say that again. Citizen Meds. And that telemedicine doctor group provides him with Moonjaro for one hundred and eighty dollars a month. He received the medication in a vacuum sealed package. Each month he's now thirty pounds lighter and on his way to getting off of the medications that he hates to take. Time will tell if he will eventually be able to discipline himself enough to get off the Munjaro also. Now let me tell you a story. When I was a resident forty five years ago, a young missionary doctor came to well actually he was not young at the time. He was he was near retirement, but he told me the story of a young missionary doctor that he knew who had begun his ministry on an island in the South Pacific. When he started his ministry on that island in the South Pacific, the people there were mostly impoverished. Most of the people lived in grass huts with thatched roofs. They lived a subsistence living, fishing and farming until a seismologic crew came to the island and found shale oil, oil that could be extracted from the shale S H A L E shale on the island. Over the course of the next forty years, the people who lived on that island became affluent. Many of them became employed by the petroleum company that set up shop on that island. The people went from living in grass huts to living in brick houses. They went from being impoverished to being affluent. They began sending their children away to college. They began driving automobiles. And here's the key point. They went from eating fish and vegetables to eating a westernized diet. The missionary was a physician, and he said that when he arrived on the island there was no GI disease like he saw in the United States when he was in his medical training. Nobody had gallbladder disease, nobody had diverticulitis. For the first ten to fifteen years of his medical practice on that island, he never saw a case of colon cancer. And he said when he first arrived on the island there was no diabetes. But thirty to forty years later, while he was still working as a missionary doctor on that island, he said forty percent of the people on the island had diabetes. He said gallbladder disease was rampant, and he was beginning to see cases of diverticulitis and colon cancer. He said in one generation, because the people were now eating a westernized diet, they were experiencing the GI diseases that the people in the United States were experiencing. And he said forty percent of the people on the island were obese. When he arrived on the island, he said there was no such thing as obesity. Everyone on the island was thin, everybody walked everywhere they went, but now people were driving automobiles, forty percent of the people were obese, and everybody was experiencing the same kind of GI issues that people in the United States were experiencing who were eating a westernized diet. I think that should be instructive to you and me. And all of that occurred simply because of the westernized diet. Now I've been to Haiti probably five or six times on mission trips. And the first thing that I noticed on my first medical mission trip to Haiti was that everybody on the island is skinny. There's no obesity in Haiti. Why is that? Well number one, there's a scarcity of food on the island. And number two, ninety percent of the people walk or ride a bicycle everywhere they go. And one of the standard questions that I have to ask, especially of the women, is when did you last eat? And it's not unusual for women who are widows to say to me that they last ate two or even three days ago. And then I would say what did you last eat? And it wasn't unusual for them to say to me that they had eaten roots. And what they meant by that was they would dig in the ground and they would dig up roots and they would boil them and eat them because that was the only food they could find. Unfortunately, the roots had no nutritional value, it would only fill their stomach. The other thing I noticed is that I didn't treat adult onset diabetes at all in Haiti. Now there were some children who had juvenile onset diabetes, but as far as adult onset diabetes like we see in America in people who are overweight, there was none of that, not at all. Now there was also a missionary who worked there, and I worked closely with him. Now he had adult onset diabetes. And interestingly, I take care of him in the States. When he was in Haiti, his diabetes was perfectly well controlled without the Medication. Now why was that? Because he was eating the diet that most folks ate in Haiti. But when he came back to the States, his blood sugar would run high, over three hundred. Why was that? Because he was eating a westernized American diet. And I would have to put him on medication whenever he was in the States. And you see, blood sugar follows diet. And that missionary would always gain ten to fifteen pounds when he was in the States, and then he would lose it when he was in Haiti. And it goes to show you and me that diet affects our weight and our blood sugar and blood pressure control tremendously. I want to point you to a verse in Proverbs, chapter twenty three, and verse two, where Solomon the wise said, put a knife to your throat if you are a man of great appetite. You know there's an obesity epidemic in the United States. Forty to fifty percent of Americans are overweight, and many are grossly overweight, contributing to diabetes, hypertension, carniarter disease. Easily fifty to sixty percent of my patients could solve their health problems with a serious diet and aggress and an aggressive exercise program. However, they would rather take a a nine hundred dollar weekly injection than exercise self-discipline or put a knife to their throat. I tell my patients we need to go kicking and screaming into old age. And by that I mean we need to ins uh to resist the effects of age by proper diet and exercise so that we can enjoy the golden years. However thirty to fifty pounds of extra weight makes it hard on your back and your joints. Don't allow that to happen to yourself. Discipline yourself by eating properly and exercising regularly. I don't advocate taking a knife to your throat. If all else fails, I would suggest using the GLP inhibitors. They are a safe alternative. And no matter what weight loss option you choose, I would suggest that you have an accountability partner. Whether it's a family member or a friend or your physician. Accountability is key. It doesn't matter whether you're trying to get your finances in order or trying to lose weight or trying to discipline yourself to memorize scripture. Accountability is important for all of us. Accountability is nothing more than me and you helping each other keep our promises to God and to ourselves and to our family. All of us need accountability. And in the whole area of weight loss, well, we all need accountability in that area, don't we? And probably we need a lot of accountability in that area. So I know some of you are out there trying to set goals for the new year. The GLP1 inhibitors are a safe option, although very expensive if your insurance doesn't pay for it. Look up Citizen Meds online if your insurance is not going to help you out. Find you an accountability partner, and do not sneeze at a keto diet. That's a high protein, low carb diet, and an exercise plan. Portion control is very important. And lastly, find yourself an accountability partner. And may the Lord bless you in your weight loss plans for the new year. Alright, you're listening to More Than Medicine. I'm your host, Dr. Robert Jackson, and I pray that as the new year goes forward, the Lord will bless you real good.

SPEAKER_00:

Thank you for listening to this edition of More Than Medicine. For more information about the Jackson Family Ministry or to schedule a speaking engagement, go to their Facebook page, Instagram, or webpage at JacksonFamily Ministry.com. Also, don't forget to check out Dr. Jackson's books that are available on Amazon. The Family Doctor's Beach, the Truth About Life, and the first book, and the Family Doctor Speaker, the Truth About Speed, and Equipping Believers are evangelists.

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