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SPEAKER_00The Plus Sides podcast is a disruptor.
SPEAKER_03We're breaking down barriers, smashing stereotypes, and sharing inspiring stories that'll leave you feeling informed and empowered. Join us every week to learn from doctors who are specialists around GLP1 medications like Joseph, Bogovia Manjaro. We'll provide you with science and facts to validate these incredible stories. But that's not all. We'll also bring you the voices of the GLP1 Manjaro TikTok community. Real people who face the challenges of obesity-related diseases and disorders and discover the incredible plus sides of GLP1 medications. Our episodes are filled with heartwarming stories, laughter, and moments of triumph. You'll connect with our amazing community members who are reclaiming their health and experiencing their fullest lives. Are you ready to embark on a journey of discovery and empowerment? Tune in to the plus sides, cracking the obesity code, and together we'll change the narrative around obesity and end the stigma. Subscribe now on YouTube or your favorite podcast platform and join our incredible community. Let's celebrate the plus sides of life together, because every story deserves to be heard. Every life deserves to shine, and everyone deserves access to expert knowledge and medication. The Plus Sides Podcast, you're not alone. It's not your fault. If you're like most of us, you've been denied a JLP1 at least once. But did you know that less than 1% of denied claims are ever even appealed? Even though the data suggests that over 60% of appeals are often approved, that means that people who should be paying $25 a month are instead paying thousands of dollars a year out of pocket. Not necessarily because appeals don't work, but because the process is confusing and time consuming. But that's where Honest Care comes in. You go to their site and then you just start with a quick assessment. Okay. And then Honest Care will build your appeal with the clinical and medical arguments that your insurer needs to hear and then guide you through submitting it. If you've been denied, don't stop there because most appeals must be filed within 90 days. So don't wait. Go to findonestcare.com slash Kim to get your free assessment today. That's findhonestcare.com slash Kim.
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SPEAKER_03We're at episode 11. Holy smokes! 11!
SPEAKER_06I know. 11?
SPEAKER_03It has not been 11 episodes. I know. Like, you know, 11 of the Plus Sides podcast, cracking the obesity code. If you're new here, which like what are you doing? Like you we've been looking for glad you're here though. We're still glad you're here. We're so glad you're here. We can think we get about 100 to 200 new people every week. So we're stoked that you're here. But we're gonna tell you a little bit about what this is about, a little bit about ourselves, and then we'll get started. So uh this podcast was born out of the TikTok community for GLP1's like support with obesity, type two, insulin resistance, PCOS. We all met there, started taking these medications, which have completely changed our lives in many, many different ways and in different use cases, is kind of how I look at it. And then we thought, you know what, there's so much misinformation out there or lack thereof information or incomplete information. We should try to have a podcast where we all come together, where we tell our stories, where our testimonials matter and they're not being cut and positioned for someone else's agenda to further it. So that's what we're doing here. So we are gonna talk about a lot of different things, but we back it up with facts or diets or science or data, you know, to make sure you know what we're saying, or diance, yeah, to know that what we are saying is true. Anyway, so I'm Kim. I'm a nut. Um, we're glad to have you here. Um, I uh currently take Wagovi. I've been doing this for about a year. I've lost uh 60 pounds. This has completely changed my life, um, improved my mental health. Um, and all the things in all the ways, you know, got rid of food noise for me. I have a completely different lifestyle, I eat better, I exercise, and I actually enjoy it for the first time, which is huge. So for our new people, because we are learning now that we have so many episodes, right? That they are actually picking episodes that kind of resonate with them and then starting from the beginning. So for people that maybe have chosen this episode, um, especially since I think that this is one that resonates pretty well with you, Kat, tell me a little bit about who you are and why you're here.
SPEAKER_05Um so you can cat follow me on Kat Carter7 on uh TikTok. I do butt stuff, butt stuff with cat.
SPEAKER_03Lots of butt stuff.
SPEAKER_05We do. Um all above board. It's all above board. It's cat's butt stuff. So we're gonna talk about squats, leg lifts, um your, you know, stuff for your bum. Yeah, advanced to make you dance.
SPEAKER_03We make a new hashtag for your bum.
SPEAKER_05I love it. So um I do, I've always loved to work out and um I've always liked to uh well not like to, I always struggled with binge eating disorder. Um, always been on a crash diet, slim fast, puking, you know. It just it goes low carbon. All of it, all of it. Um but um I like to work out. I think it's a to for me, it's a pillar of uh of your for your mental health. Gonna do it every day, it's non-negotiable. So um that's a big part of it. But now it I feel like my physical fitness can also match with, I guess, my mental fitness. If that's um if you look at it like that with the Mondero, because it did reduce the food noise. I don't feel like I want to swallow or inhale an entire pizza every couple of days. Um and that's really freeing. It's very, very freeing. So um, but I I am a I call the slow loser. I like to incorporate um balance. And I'm all I'm a Libra, so I think it's all about balance. So I will have my vino, I will have a piece of chocolate, and if it um puts me down half a pound or stay the same for a week, um, so be it. I'm trying to learn how to live fully all the way with it. Um, but 60 pounds down, on and off, um, manjaro. And that's it in a nutshell because I'm a nut.
SPEAKER_03Sometimes you can't like it, like a nut.
SPEAKER_05Yeah, so Janine, what about you?
SPEAKER_03Who are you?
SPEAKER_05Yeah, she has a lock of princess hair. That's it.
SPEAKER_03Yeah, that's why that's the reason. We also drink water here. You're gonna see rando, like not cute things in the picture. Although you lock okay, because I I got me a Stanley.
SPEAKER_06He got it. I know. I'm cute. It's purple tie-dye. I'm like, that's like the plus sides, and but I can't decide if I should desecrate it with a paper with the case. It is tie-dye, it isn't just the solid Stanley, you got the tie-dye Stanley. You're just a little extra fancy, but everyone, because we're all on GLP1 medications, you will see us have at least two beverages. That that is our life right now. We are gonna double fist all the time. So um, I am Janine Trot. I'm on TikTok at the Janine. I'm a Virgo. Woohoo. Um and yes, just say that like that. Woohoo. Look, woohoo. Because being being a Virgo is a superpower. Beyonce is a Virgo.
SPEAKER_07That's why we say woo-hoo.
SPEAKER_06Steve Jobs was a Virgo, Michael Jackson was a Virgo. We make the world go round. So thus, here I am. But I um I am not just uh having an autoimmune disease, I suffer with obesity. Uh, I am a chogren's warrior, that's what we call ourselves now. So I just learned that. So I have Shogren's syndrome, but then also I'm a type two diabetic. But those don't define me, those are just some comorbidities that I deal with, but Maljaro has effectively dealt and is dealing with each of those. I was pretty much 200 pounds as of January 2023. I was in the obese category, I was well into the obese category. Um now I'm happy to be overweight. Yay! Party time, that's official. So, so um, so so you know what, just just from years of um now looking back, of seeing that I was probably insulin resistant. I we didn't talk about it, what like 10, 20 years ago. I I had never heard of it until recently, until I became a member of this community. And due to diabetes and hormonal changes, I started gaining weight really when I was about 30 years old. It just started creeping and creeping, and I couldn't understand. I started growing hair on my chin and on the side of my face. I just thought it was part of the aging process. Yeah, but that's why I'm here, and that's just the part of the story. Yeah, yeah.
SPEAKER_03And if you want to listen to more of your story, that's episode two, isn't it?
SPEAKER_06I think so. Yeah, I think it is. Is it episode two or episode three?
SPEAKER_03It's one. I think you're two, and then I think Kat is three because she was moving, and then I think I know I'm the first one. So if you want to listen to like more detailed, then you can go there. But that's like the gist. And you know, definitely this is your first one. We hope you stay and you start from the beginning. But here's how we roll here. Yeah. Um, so we are all friends, uh, we all live in Atlanta, yay. Um, and on the beginning of the episode, we kind of just talk, and then after that, we have on a community guest. So something that's really important to all of us is for people to be able to share their testimonials without being filtered, um, without being cut. Um, and so our guest today is Rebecca. So I'm gonna go ahead and invite her in. Hi, Rebecca. Hi, Rebecca. Hi, welcome.
SPEAKER_04So, how are you doing? We're so glad you're here. I'm doing all right. I'm glad to be here. It's pretty exciting. I'm not gonna lie, though, I'm really nervous.
SPEAKER_03Don't have to go this is not live, and okay, well, I'll just cut it out. You know what I mean? So you don't have to worry, you can pass gas in peace. And everything is cool. Just hit mute. Don't even lie. Oh, but yeah, so that's what this is gonna be for you. And I know we've kind of talked about it a little bit is I want you to just tell us your story. Like, and I know you've you've done that several ways on TikTok. You're documenting a lot of your journey. Um, but for some people that aren't on TikTok, we want them to know it too, because the chances of at least one person saying, That sounds like me, is very strong. And as I was listening to your story, something that could theme that just continued to come up for me was the fact that you were very athletic and that you have been dealing with being in sort of this obese box categories, stigma, like your whole life. And I thought that would just be the perfect thing for the episode is for us to talk about why it's not always about eat less, move more. And of course, we also have uh Dr. Mateo and Tia that will come on after and talk about a lot of the clinical sides of this and why these things make sense. Hey, have you remembered to comment, like, subscribe, share, click the reminder bell wherever you're watching or listening to this podcast? If not, please do it now so that you can help us grow and help more people. We love you. Hope you're enjoying the show.
SPEAKER_04Hi, I'm Rebecca. I have my own um TikTok. It is Rebecca on Monjaro, and I have lost 60 pounds, 63-ish pounds actually, since I started in September, uh, September 25th of 2022. Um, I started out on a Zempik for six weeks. I lost about 24 pounds. Um, I didn't do any exercise at that point. Um, then I had to get onto Manjaro because I couldn't get Ozempic. And um, when I started on Manjaro, I stayed on there for about two and a half months just so that um I could see how the medicine worked without working out. And then I started working out and things have been just moving along, progressed pretty fast up until recently where I've stalled. So going back into my history though, so I um have always done some sort of athletic activity. Um I danced for a long time, but I was always the heavy or the heavier ballet dancer. You know, all of the girls in the class were lanky and tall and slender and anyway. And I was just the short one. So I always not that anybody ever said you're the fat ballerina, but that's just how I felt. Um and you know, I didn't, I don't think I overate as a child, but and honestly didn't ever think about it. But then there were times, especially as I look back now, where I was like hiding my eating. So that sort of all started at that younger age. Um, when I got into high school, uh, we did a BMI test. And that's when a coach told me after doing like the whole pinch test thing, you know, that they do with the big plastic grippers. Um, and they have me stand on the scale. Uh, he told me that I was obese, even though I was about 135 pounds and I was still dancing. Um, I always considered myself relatively athletic build, you know, had like big thighs, relatively bigger ear, you know. So um, but when he said that, that also just kind of tanked and declined everything and how I felt. So that's kind of where it started. That he told me I needed to lose weight. Um, then as an adult, um, I was just never good enough. I was never, you know, pretty enough, skinny enough, whatever enough for men in particular. Um, so you know, I'd gain weight, would be like, hey, you know, you need to do this, that, and the other. It's embarrassing, it's whatever. Um I would work out all the time. I've done, I've done kickboxing, I've done um most recently CrossFit, I've done everything in between yoga, spin classes, swimming, aerobics and five o'clock in the morning. Um, you name it, I've done it. Um, I've been on every restrictive diet, Weight Watchers, Jenny Craig, uh, Noom. Um, I started doing like factor meals where I would only eat just like those specific meals and count my calories. I've always logged food to the point where it's become obsessive, like it just distracted from my everyday life, and I didn't want to live like that anymore. Um, I've had gallbladder surgery where I was told I wouldn't gain any weight, and then I did, and no one could give me any answers about that. Um, I had a hysterectomy in like 2020. I was also told I wouldn't gain weight, and then continued gain weight. That's when they started to do tests. But all my tests came back as relatively normal range, and the doctor wasn't willing to delve any deeper into that. Instead, it was just eat better or eat how you're you know, like eat well and exercise. Just keep doing that and you'll be fine. And then I think what really kicked it off at the very end was um in January 2020, my best friend and I were like, that's it. We're going to the gym, we're gonna uh do this, we're gonna knuckle down. And it in I don't know, eight months or something, we lost. I lost 21 pounds. Uh, we were just getting frustrated. My friend in particular, because she wasn't really losing anything at all. We were doing there four days a week. Um, we were eating relatively well. She was just eating salads, which is not necessarily the right thing to do when you're working out lifting weights and stuff, but that's what she thought she needed to do because that's what society has told her to do eat less, move more. And um, so we just kind of gave up, as one does after they've, you know, worked really hard at something. And um, and then that was it. I gained back all of that weight in the two months. I went back to my doctor yet again and said, Look, I've been here numerous times for the same thing. What's going on with me? Why can't I have answers? What can I do? What will make this better? And uh, we talked about bariatric surgery at that point because it had gotten, you know, to that degree. And um, I told her I looked into that and my insurance wouldn't cover it. So then she said, Hey, what about Manjaro? And that's how it led me to this. And this has been Manjaro has been the only thing that has allowed me to move my body and eat right, but not restrict myself or feel like I'm, you know, not living in the moment or being able to be happy or have a treat, you know, um, and still lose weight and still feel good and be healthy. My mental state is better. And um, and I think it's really important to get the word out about that. So that's kind of it in a condensed nutshell. Well, that was a great condensed nutshell. I tried not to make it 31 minutes again.
SPEAKER_03No, was that what it was? I don't know. I it was a long, yeah. Honestly, we were all texting about it and we were just enthralled. We thought it was and so relatable. And you know, I think it's it's really I remember that, but like you and I are pretty close to the same age. So um, I remember that in high school when they brought out that pension thing. I remember that. And I, of course, I was obese then. And I was also, I would say, I wouldn't say I would say I was active, but I wouldn't athletic. I was like always just average at kind of everything. Like, and my mom was like, you know, that means you're athletic, right? If you're average at everything, I'm like, I don't think so. I don't think that's what that means, you know, you know. Um, but I was like that too. But like I did things in school and I was very active, but I was obese too. Um now I have always been that way. It was more just like I wanted to be funny so that people like wouldn't notice, you know what I mean? Um, but it didn't matter. I never could lose more than 20 pounds at a time. Ever. Ever, ever. And then when I got older, my magic number was 30. And that is if I white knuckled it really, really good, you know. So I can totally relate why. And I again, like I was all over the place. I'm a social butterfly, like I was all doing everything. So it wasn't like it wasn't I wasn't moving, it wasn't like I was fat and lazy, but for sure that's what people thought. And the only way I could find a way around that is to be funny, you know what I mean? Right. And that's I think we all kind of find different things, but um, you also mentioned some stuff, and if you don't mind sharing, around kind of like and this is up to you, like I can cut it out, but if you know, around society and um, you know, kind of what the expectation was for you, especially like within relationships, um, or how you felt like I remember you specifically talking about like not feeling you were either too big or too small, like you know, and it was always like you were not enough or too much, you know. And I remember that in your story, and that really like hitting me. Um, and if you want to share about that, I can imagine others may feel that way.
SPEAKER_04Yeah, there's um one time in particular, and I I hate telling this story because I feel it my dad never meant it, I don't think, to be hurtful. But um, I had just had my second kiddo, I think, well, I say just had, I think he was about six months old. And um, I got all dulled up for dinner, and I went down to meet my dad and um and my stepmom, and they were and he turns to me and he says, Oh, wow, and okay, I was divorced at the time. I had had my kiddo, we got divorced, so I was single, and he goes, Rebecca, you could have any man you wanted if you just lost weight. Oh, and I was like, Dad, right, right, like he was trying to be encouraging, and he was trying to say, Hey, you know, you could meet a great guy. But it was like, oh my god, and the killer part about that now is I was 175 pounds, which yeah, wow. I like I would give my right arm to be back to 175 before. Although, right, and but yet my dad has been one of the first people to say, now that I'm at 185 pounds again, he has said, Wow, you look so skinny, you look great. So tell me how that is. And then when I was 170. 35 pounds, my gym teacher is telling me I'm obese, but yet at 185 pounds, people are telling me I look great. So it's like there's so much. I mean, and I don't know how you do swearing on here, but it's a mind fuck. I mean, oh no, we swear. Okay. Um, but yeah, we've all said it before. Right. Yeah. I mean, how how are you supposed to know what's right and what's wrong? I mean, you're never, you're never enough. You just aren't. Yeah.
SPEAKER_05And I mean, like, why why do you yeah, like why who who gave, I guess society, who gave exterior people permission to exactly either what is enough or is not enough?
SPEAKER_04Yeah. Yeah. Yeah. And I I recently had, you know, like a guy at work. I think he it was almost like he was trying to degrade my weight loss, like he was asking questions about it and he was excited. But then he was he said something degrading about it. It was like he didn't want me to have that that high in life or feeling more specific, you know.
SPEAKER_07Yeah.
SPEAKER_03So it does seem like when we do lose weight that people just don't always know what to say, especially if it was evident that we were quite large before, as opposed to like I think 10, 20 pound kind of weight loss comments, especially on these medications and all the controversy around them. Like, I I it drives me insane when someone will say to me, keep it up. Because all I hear when they say that is you are not enough and you haven't done enough yet. And it reminds me every single time I ever failed before. Absolutely. But they don't always know what to say, and that seems to be, you know, and like just like you said, your dad was probably saying, You are so freaking fabulous, and and men are what they are. And if you were to lose a little bit of weight, you could get whoever you wanted, but it came across like you know, just shit, you know. Right. Like my dad one time told me I was eating the I ate two pieces of bacon and two eggs and a piece of toast, and he told me I ate a lumberjack breakfast, and it was stuff like that. Those, and he probably didn't mean it. Like he's trying to give me, like, I would say, like a lens of what health should look like, right? But that did all I heard was you're eating, you're too much. You're eating too much, you're too much, you know, and that stuff just doesn't help. Now, I have a lot of grace for my parents, you know, too, because I don't think my dad meant to hurt my feelings, you know. But it did. And those kinds of people, I think too, that part of the conversation is it's not all, it's also not okay. Just tell people they look great, just tell people they're doing well. Like you don't have to go into this like really weird stuff, you know. And the fact that people even have to find out what it is you're doing, it speaks to the fact that we've been doing it wrong. Do you know what I'm saying? Like all of us have been doing it wrong. If we have to have a new conversation every time you lose weight about what you're doing, clearly eat less, move more was not the solution because you're having it again and you're feeling like you need to ask somebody else about it, you know. Anyway, sorry, tangent.
SPEAKER_06I just think Rebecca's story and almost all of our stories kind of go into if if this is the right word, the warp sense of beauty that society has and really had, but it's evolving and you know had has had for for women. And it's like, you know, no, you don't have to be stick thin, but for some reason that was the standard of beauty, yeah. And I think we, you know, we're all trying to, you know, be accepted in some way and be what we thought the best version of us was, and that was to be thin, but it's like, well, who was you know, us beauty magazines to tell us, well, this is how you should be looking. Okay, well, are you saying I should look emancipated? I mean, you know, right, yeah, right.
SPEAKER_04Well, it's just like with this whole, you know, Ozempek Manjaro butt thing. I mean, you know, you got Kadashi and booties, so now it's like, are we all insecure because our booties aren't big enough? So thank God for buttons. That's all I can say. Thank God for the buttons, sorry. But I mean, you know, that's that's what kills me. It's like we can't ever be quite right. So it's like, where does it stop? And I guess that's where I'm at right now.
SPEAKER_06I just stopped measuring myself, and I think, and I don't want to speak for Kat and Kim, but I think I can safely say that we're evolving into ourselves more, where it's like, whatever. Okay, so you might be 130 pounds. That may not work for me, but I but I think that through this podcast, we're learning to deal with things because you know the Kat and Kim have had, you know, childhood hurt. Mine came later on in life, but you know, hurt is hurt when people talk about your weight. That is personal. And it and and it makes you sometimes doubt yourself. And it's like now Mount Jaro has helped. I I know, at least for me, I'm like, yeah, stuff I used to let slide before. Yeah, I don't let it slide anymore. I'm like, oh no, I'm like, stop.
SPEAKER_03Yeah, it does sort of feel like you're your best, and and you know, this is that too good to be crude that you're gonna hear from us sometimes, guys. But you know, it does sort of feel like it helps you be your best self, like because your best self physically, not and not because you're thin, right? But because your body's feeling working fucking right, you know what I'm saying? Like you're feeling is absolutely and it's not just like I remember when I was talking to my therapist, not my therapist, but um my psychiatrist about it, and I was like, and I I'm not sure that I'm you know, I and y'all know I've talked about it pretty openly before. I'm not sure that I am that I have minute depression, I don't really have any of that at all. And she's like, Well, that's because you're losing weight and feeling better. And I went, no, no, no, it's because I'm feeling better. That's what it is. It's not, it's not the weight loss, it's the fact that my mind is clear, which has made everything fall in line. My mind is clear because my body's working right, right? And it wasn't before, you know, and it's hard to make people really understand like the power of that. Um, the power of like the gut on the mind, you know, like that is fascinating me like crazy. Like, you know, it really is. And I think that's why I'm so tired people talking about like this medication being this appetite suppressant. Like, come on, guys, we we have plenty of things we can take for appetite suppression, you know what I mean? We needed something to help our body work right, you know. And I think you're mentioning a lot of stuff about, you know, I think hormones, right? Where you were like, hey, like I had surgery, my body completely changed and started working differently. You know, I had you know, two different surgeries where that happened and and that people weren't necessarily looking deep enough. And I think that's something that we may also see too. I don't know about you guys, but until you go to specialists, that's when they're like, let me look a little deeper, let me look a little deeper. You know, because you know, general practitioners, they don't necessarily have the time to do any of that because they see so many patients, you know. But yeah, so I think I think it's just interesting to hear, like we hear these commonalities, like the fact that you were always, you know, very physical. And like Kat is like that too, which he was always very active. Like she really was, and like the fact that you were a dancer and all that stuff, it's like obesity doesn't care. Like it doesn't, it doesn't, it doesn't, it picks whoever, like you know what I mean. It's not, it's it doesn't matter what your background is, what your body was like originally, it doesn't matter what what race you are, what gender you are, like it will, it will come for everyone. Yeah, like that's the thing, but it is sort of universal, which in a way can help connect us, right? Um, so I really appreciate you know you telling your story. It means a lot to us. Um, and I know that there's somebody out there that feels feels very similar, and it'll be nice to hear somebody for them to know they're not alone, you know. And for the next part, we're gonna talk about why it's not their fault. So now we know, but you know who really knows? Dr. Mateo Renzia.
SPEAKER_05We're gonna call you a friend of the show. That's what we're gonna call it.
SPEAKER_02Oh, she's yes. I've listened to you guys, even though the episodes are not on. I love this show. Thank you for having me back.
SPEAKER_03Yes, we're so glad to be. Yes. So, um, so first of all, hello, welcome. Um, and second, um, I know you were able to hear Rebecca's story. You know, um, some of our friends I mentioned in the beginning may be new, and this may be their first episode where they were like, hmm, you know, and then it gets them to other episodes they may not have seen episode three, which Dr. Mataranty is on. And you can go back and listen to it. It's an excellent episode. It is, I mean if I just say something, but it's because we talk about it just sounded funny. Um, we talk about the death of diet culture and we specifically talk about telehealth obesity and why clinics and practices and why that has been a why there's been a rise in that and the need for it. So go back and listen to that episode. But going forward, we'll start talking a little bit about, you know, Rebecca, about eating less and moving more. And that's kind of how we'll get started. Um, but Dr. Rent, if people don't know about you, can you kind of just give us sort of an intro of who you are and what you're about? Hey, have you remembered to comment, like, subscribe, share, click the reminder bell wherever you're watching or listening to this podcast? If not, please do it now so that you can help us grow and help more people. We love you. Hope you're enjoying the show.
SPEAKER_02So thank you so much for having me on. I'm Dr. Matei Rinti. I'm board certified in internal medicine and obesity medicine. And I'm really passionate about this area. I'm someone that myself has been dealing with obesity my whole life, like literally since kindergarten. I can remember. So all of the stories, Rebecca, when you were just talking, I can relate to all of them. Everything from the comments from parents and school. I mean, it's sort of seared in there, you know? And I just became number one, I got more training. I started out as a primary care doctor, and then I realized we were never really getting to what was going on. We would kind of be like adjusting medications, but we never really got to what the problems were. And I found that when I did the obesity medicine board certification, I understood things so much more. So although I've been practicing for a long time, I felt like I finally got some of that stuff that I was really missing.
SPEAKER_03Yeah, yeah. Awesome. That's awesome. Yeah. Um, in terms of um these medications, um, I think that you've heard that they've changed like the lives of a lot of us, you know. And I know that you treat people that, you know, have obesity, right? Like, like all of us. Um, but I'm curious, you know, in terms of hormones, like Rebecca talked about that quite a bit, about with she has PCOS, um, and she talked about um, you know, um things with I think it was a hysterectomy, is that what you say, Rebecca? Yeah, yeah. And like, how does that affect? I would even say, like, we know it affects weight, but how does it affect obesity? And like, how is that sort of almost immovable? You know? Yeah. Because she's exercised her face off, you know, literally. But you know, like why is that?
SPEAKER_02So I feel like, you know, everybody like, you know, the the name of this podcast is, you know, basically uh eat less, move more. That's not accurate, right? And so what ends up happening when you've got met, I'm gonna use the word like metabolic derangements, when you have insulin resistance, which can go along with PCOS, when you have things like that happening, your body's physiology isn't working the same anymore. And so this concept of I just eat less and I move more, your body's not responding the same anymore. So we can't go about it in the same way. Your hunger cues don't work the same. You're actually deficient in some of the hormones that you need, you're not responding to other ones that you have a bunch of. That's the resistance part. So things just aren't working properly anymore. Literally, the system's broken, and then we're telling people, well, go do what other people at a lower weight do, and it's just not the same game.
SPEAKER_03Yeah, yeah, yeah. Makes a lot of sense. That's something Alex said on the last episode is he said, Why are we fixing the problem with the food with food? It doesn't make sense. Yeah, so let's fix the problem with the food with the food, you know, like you know, yeah. So I do think of yeah, because that's when I would say like the biggest, the biggest things that we get. And I don't know if I've so I've told the girls before. So my son, he's 10, and he's seeing me do this, and he has like ideas that he likes to share with me about like what we should what we should do and stuff like that. And he's like, I think that you should have a segment called crime and punishment, and you should bring up comments for haters and make them feel stupid. I'm like, well, that's not really mommy's jam, but I I still get your point because one of the biggest comments that I would say we get is you just need to eat less and move more. And I feel like that that comes from probably a place of people, you know, that definitely, that definitely were able to do that because maybe they only had 20 or 30 pounds to lose, right? Or maybe they weren't obese their whole lives, or maybe their body has continued to respond at its current state or always stay. So it's hard for them to even imagine, like even conceive that this is even possible. Like, what are you talking about, you fat lazy people? Do you know what I'm saying? Like, and I feel like that's where the hate comes from. So they just don't get it, you know? Um, and none of us got it either. And I think that's why we beat ourselves up for so many years, at least the girls on here that I know, you know. But yeah, so what um, so in terms of exercise, like what I mean, we're saying it's not responding the same, but now that we're on the medicine and we're taking it, right? Like our bodies are the physiology, like you said, is different. And we are able to exercise and like Kat has mentioned before, like she can see her areas like toning, like being tone, you know, and like her muscles, like, you know, showing more, even though she's always been very active. Like, what is it that's going on with that? What makes that change?
SPEAKER_02I I think honestly, the body composition's changing. So you're losing some of that adipose fat and you're holding on to muscle. And so fat takes up much more room than muscle. So you get this leaner look, you look, you know, you it's aesthetically what people are going for. But the thing I really want to stress is that exercise does not help significantly with weight loss, it's massive for weight maintenance. So I always say it's dose-dependent for weight maintenance. Like, I don't know people that are maintaining weight loss without um some form of movement, whether it's walking daily, whatever they like, right? But as far as if you use that as an approach only to lose weight, like I had multiple visits today, majority of them, super active women and men that are saying, look, I'm doing all this activity. Why is the weight not down? What the studies show us, there was a really great one that I love. They said five hours a day exercise, and people did not over the course of a year lose more than 3% of their body weight. That's not clinically significant. So they're busting ass in the gym and the weight's not going down. And you're you feel that, right? When you're doing like five, six hours a week, you're like, I'm putting in the work, right? I want you to extra exercise for a million reasons, but not weight loss. I want you to do it to maintain your muscle. I want you to do it for mental health or cardiovascular health, but not to lose weight. That's not going to be the thing that's going to help you.
SPEAKER_07Yeah.
SPEAKER_02Okay. Wow.
SPEAKER_07Makes a lot of sense.
unknownYeah.
SPEAKER_07I get it.
SPEAKER_03Yeah, I heard that a long time ago. Yeah. I feel like that so often in this community. Like, man, I wish I knew that 10 years ago. Like, I legitimately, even through the beginning of this, I was eating like a under a thousand calories a day because that's what I thought I was supposed to do. Because I come from diet culture, right? I come from eat under, eat as less as possible, eat cabbage soup, you know. Like I come from that world. And when I realized that my body wasn't losing weight, I was able to learn actually, if you fuel your body, your body will use that. And then you can lose weight. But if you starve it, it's not going to let you, you know? And those are all things that I never knew before until this medication. It really can help you learn things and have a whole new lifestyle, you know?
SPEAKER_02And it doesn't make intellectual sense, right? Like I really, before I would see the studies, I how did it make any sense that you doing more exercise does not move the needle, right? Like, is anyone else shocked by that? But it's like repeatedly the thing that's nice if you work with a doctor that's doing evidence-based medicine, we're looking at studies, we're looking at trials, we're not just seeing what one patient is doing, but what's the trend, right? Like, what is actually the reality? And that with more people than not, is that it's just not moving the needle.
SPEAKER_06Yeah, yeah, yeah. Yeah. I can, I can definitely attest to that. I know this time last year, I was working out like four to five times a week, and because I was on the road to 50. So I was, you know, trying to get myself together, and I think I maybe lost two pounds, and I was so defeated. Yeah. You know, but yeah.
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SPEAKER_05You know what I was gonna say actually with with working out too. Um I've I've learned in the last two, two or three years, I'll get a little bit personal. Um, I lost my dad. Um this is so I mean, I lost my my puppy. Uh lost my dog. Um, and my husband got sick. And so those last three years, um, working out was um the community, the people. Um, that that's that became the point of why I was going. Um, and then getting, it was almost like like say, for instance, during a spin class, it was meditative for me. I would just get quiet, maybe a little weepy in a run, in a ride, or just push really put really high numbers, um, and then just go to my car, maybe just fall into a puddle, maybe you know, boohoo a little bit sometimes. But that's when I really realized that the exercise is not about cosmetics or vanity. It was really about connecting with people and then getting into a meditative and zone out state for me to keep me from being a little puddle myself.
SPEAKER_02You know, one of the things I tell because I kind of work a little bit more holistically with people, and it's a way to process emotions. And a lot of the time, if you have food challenges, there's a there's a tendency to have a hard time connecting with yourself, and food kind of just like numbs it out a lot. You know, it tastes good, it just really does. Yeah, and exercise connects you with yourself again, just like the same way that listening to music, it's just we've it's beautiful what you just shared, what you got out of it. It wasn't the scale, right? But look how much it changed your life to have that as an outlet.
SPEAKER_05Yeah, I think people do for forget like the connection of like other humans, other people that you work out with. That's really important too.
unknownYeah.
SPEAKER_03Yeah. I um I think it's interesting. We've talked a good bit about mental health too, Kat, and you mentioned that too. Um, I think that something that I realized is that when I've gone through, y'all know I've gone through some trauma, right? With some things. And one thing that my doctor would always tell me is, you know, connect with your body because it's very easy to disassociate, especially if you've gone in like through trauma, right? Is to kind of leave. But if you are doing something physical, even if it's just yoga, she would say, like, even if it's yoga, even if you stretch, even if you go for a walk, like connect with your body. Or even like we know Rebecca likes to walk on outside because she makes these crushing noises and makes cool videos. But yeah, I think that that that's something that I again, and that's something else I wish I had known 10 years ago. You know what I mean? Um, it really does help. It really does. It kind of just it really does like make you be more present and more in the moment, you know, um, instead of going and trying to soothe other places with other things. Yeah.
SPEAKER_04I was gonna say that was a big thing that I've noticed this go around losing the weight in the past. Um, I worked out to punish myself. I worked out because I ate the wrong things and I was angry at myself. So I would work out. Now, when I'm working out, now that I'm on Manjaro, Manjaro is doing a lot of the work for me. I mean, as far as helping my body channel what I'm doing, I'm working out because I enjoy doing it and it makes me mentally happy, not because I ate a piece of cake and by God, I need to go for a walk. So I think that's been a huge difference for me to go around.
SPEAKER_03So for sure. Something that I've learned too about that, and what you're saying is it's like an uh this girl Catherine that I met in our community. I don't know if you know. But she's like, food does not have moral worth. You know, you if you eat a food and you call it a good food versus a bad food, like it's not that doesn't that that's not a thing. Like you're the one with the moral worth. That's just food. It's just few. Like it's either, you know, fuel that's great or it's kind of like lower grade fuel, but it's not good or bad. You know what I mean? Um, and that's been a big part of my healing too. Um, I think with the connection with the food, because I don't know about you guys, but I for sure had a complete sever of emotional tie to food, and it was like overnight. I woke up and I did not know what to do with myself. Like it was just, I it was just like someone just cut a cord, and I didn't know how to get dopamine or anything. So I had to relearn all of that. And honestly, I learned it through our community because other people were going through similar stuff, you know? So I mean, it's really fascinating what these medications can can do, you know? Yeah. Yeah. Yeah.
SPEAKER_05And speaking of like say mental health and how it correlates, I'm gonna kind of just build out onto the actually a question that I did have for you was uh for yeah, for Dr. Rentea is um would that be, is that part of the pillar um of all of the aspects of we don't want to call it weight loss, but obesity treatment, um, the mental health, the exercise. Um what do you what do you what kind of things, what what elements do you factor into the whole, the whole spectrum?
SPEAKER_02Yeah. There are a few really big pillars of, I always say weight management. That's the term I like to say, because I like to think we've got to manage this for life. You know, you're gonna have some periods that are great and other periods where you struggle, but there are so there's nutrition, what we're eating, there's exercise or movement, there's behavioral health, meaning how we're thinking and feeling and sort of how we're processing the world. There are medications, and then there's surgery. And I'm sure there's another one that I'm forgetting, but those are, you know, sort of big ones. And the challenge is like all of us don't have problems in all the areas. And that's like the thing that's tricky about it. So everyone assumes, let me tell you, when I see someone new, the story that they've always been told is that people always think that they're eating horrible food in massive amounts and sitting on the couch, and that's just not true for everyone. And so I think the main thing is when you're looking at this, it's like, what areas could I work on that can be beneficial to me that I'm willing and able to do? But not everything is gonna have to get overhauled. So some people I find maybe their nutrition is actually great, but they're stressed out 24-7. They hate their job, they're really just they're they're high cortisol 24-7 due to that. So that may be something more to work on, are like stress management techniques, even more so than what than what they're eating. I mean, you have to look at, or if they're not sleeping, that's massive. So it's like, where is it that life is not supporting you and it's showing up as weight that you don't want? There's usually a key there playing into it.
SPEAKER_03Yeah, that's a really good point. I wish someone had said that to me two years ago.
SPEAKER_05You know, it makes me think also, like, so um with like addiction counseling, um, giving yourself uh like maybe like personal goals versus like being focused on like say the addiction, which I would argue we probably all have a little bit of a food addiction, right?
SPEAKER_03Um a TikTok addiction.
SPEAKER_05Yeah, I'm getting help for it. But like actually giving you um like goals to work on for yourself or like maybe projects, things that you put off because you've been isolating or maybe numbing. Um would that, I guess, would that fall fall under mental health? That does.
SPEAKER_02So I want to give you an example because I just thought it said we were talking. So one of the ways that I first entered this space was through me getting weight loss coaching because I thought this was before I found obesity medicine, this was years ago. And I said there has to be another way because I'm having a hard time with my weight and I'm a doctor, and you know, I was looking at this. One of the things that we did in this program, so we looked at how to process emotions and how to do all that, but one of it was building out hobbies. Now, some of you might laugh. You're like, oh, don't you have hobbies? I had no hobbies. It's like there was nothing, and she had to say this was a doctor that was running it. She was like, a hobby is not something where you're making income. A hobby is not something where you are um where you're being productive. It's just fun. You're just being it does, you don't have to explain it to someone. And I I had to like rack my brain for what that would be. So that's building out the tools of what other aspects of life you like, because often like food just gets such a center stage and it's not your fault. Like it's very normalized, right? That we have a dessert after dinner or you go out to eat with friends, like a lot of things are food centric.
SPEAKER_07For sure, right?
SPEAKER_02Like, if you stop valuing that, okay, you don't have any of this other stuff built out. So I actually had to spend time, like, I enjoy taking a walk, I'm gonna make a scrapbook for my kid. I'm gonna just sit, sit in in silence. I really like sitting in silence. Like, I don't get enough of that. I consider that a hobby. Um's kind of test. Yeah. So like building out those kind of things, they matter because those are then you know other ways to relax. But for me to say don't use food, it's a very triggering thing.
SPEAKER_03Yeah. Right. Do you have to do that?
SPEAKER_05Yeah, absolutely.
SPEAKER_03And then I do remember like going through this journey, and I don't know if you guys have experienced this, but like the holiday piece, right, is when you're going to be with your family and there's going to be food and people are going to talk, they're all going to be eating the food with the food and talk about the food. And you don't want to eat the food because you just really don't want to eat the food. It's not like you're trying, like with your dieting, you're like just trying everything you can to stay away from the food, right? Or if you're like giving yourself some celebratory day, and then the next day you're going to, you know, abuse yourself in the gym to make up for your bad choice, you know? But I I always wondered like it was at the beginning of this, it was very much like a dread. I dreaded what that was going to be like, and it was incredibly uncomfortable, right? Because I knew people were gonna be like, try this, try this. I don't want to, you know, and I was still trying to figure out that whole emotional connection severing situation that I had going on with food, you know, and then now it's different. Now I'm able to be like, it's fine, but the food is not a big deal, it's just a piece of food, you know. But it took me a long time to get there. Have you guys experienced that with like family get togethers or the holidays? Yep, yeah.
SPEAKER_05Usually family, you would um drive me to eat.
SPEAKER_03Yeah, or I mean, I that's the way mom was always going, the thing, you know, and I'm like, but I don't want nothing. But before, but she would also kind of have the other side of her mouth when I was growing up, be like, eat, eat, eat. And then she'd be like, You're eating too much. Like it's just like mixed messages. Everybody's mom was like, That's still there, like regardless, like she's not like that anymore. It's still there, you know. Yeah, anyway, yeah. Anyway, um, but Janine, I think you had a question for Dr. Rentia.
SPEAKER_06Oh, yes, I do. Dr. Rentia, you were starting to see a lot of no right.
SPEAKER_03Ready? Five, three, five, four, three, two, one. Oh no, it's a bad one. There we go. Oh, we got moving though.
SPEAKER_05See, yeah, it was seven. It was close paper.
SPEAKER_06Okay, look, we're gonna try this again, but thank God for editing. So I'll make it quick. So, Dr. Mantia, we're we're starting to see a lot of cracking down on uh GLPs uh from like pharmacy benefit managers and insurance companies, like you know, with doctors prescribing them, um especially off label. We've recently heard that you know, some pharmacies are changing their policies and won't, you know, sell a GLP off label at all. Why do you think that is? And you know, when there's already such a huge issue with availability and affordability.
SPEAKER_02Yeah. So I think that the crackdowns from insurance, it's coming from, they want to save money, right? So they, for example, like unless someone has a type two diagnosis, they don't want to cover it off label for something else. To me, it's a hundred percent that I'm trying to do cost savings. I think we've talked about this before, that most people statistically are on an insurance plan for less than three years. So they know that you're gonna drop off the panel real quick. They don't care about your long-term health. So that's number one, they're they're, you know, they're wanting to save money. Um, the pharmacies are actually on the hook that if they don't get paid by the drug company, they then have to eat the cost. So they then want to make sure they're verifying the diagnosis, for example, like type two. But as far as I think they're still letting people, if they're doing cash pay purchase it, even even if it's um uh, you know, not um with that diagnosis code, like if it's off label for weight management. But really, what's just so disheartening is how much they're just trying to, it's almost like a witch hunt, how they're trying to go off, go after off-label use when one out of one out of four medications are written off label. And why are we targeting the weight management space, right? It's no different there. And so again, I just always find it's a way for no one wants to pay for the medicine, they're not thinking about his long-term health. Yeah, gotcha.
SPEAKER_06Yeah, which that's what we were talking about, is that we we thought it was pretty much a cost savings, you know, um, approach. But yeah, yeah, but um also and Dr. Rentio, uh, I have one more question. So uh I recently discovered an article that um discusses how insurance companies are sending letters to doctors saying if they find a doctor is prescribing off label, they may, you know, report them to the state board or even law enforcement. So this seems a little drastic. Um, is prescribing medications off-label illegal all of a sudden? Also, why is this so different from for these medications than other medications? And lastly, how do you feel about the validity of this letter? And is there, you know, anything that they can do to really enforce this?
SPEAKER_02Yeah, so first of all, I've seen the letter because I'm friends with a lot of colleagues, and you know, people share what's we stay connected as a community, OBC medicine physician. So I have seen these. Um, and it's it is not illegal to prescribe things off label, right? They might not like it, but again, one out of four meds. It's a very common practice in medicine. It's just that this area is very targeted. What it is not illegal in absolutely any capacity. What they're implying is that those doctors are lying because they'll look at the panel and they'll say, well, half your meds are off label. So you, they're implying that those doctors are making up like a type 2 diabetes diagnosis, right? Or that they're making up things that are not valid in the chart. But the reality is if you have an obesity medicine panel, more of your patients are gonna have different types of medications compared to like a traditional primary care setting, things like that. So there's nothing illegal about it. I think it's a scare tactic, and they're doing absolutely anything that they can to influence prescriber patterns. And I think it's really sad to be honest.
SPEAKER_03Yeah.
SPEAKER_02Yeah, yeah. Thank you.
SPEAKER_03I mean, what are the chances that they would even do something like that?
SPEAKER_02Like you can there's nothing illegal there.
SPEAKER_05There's nothing. I don't give that's great feedback. I'm just glad we were kind of yeah, okay. I'm glad you set the record straight.
SPEAKER_02Yeah. They might not want to cover it, but doesn't again they can deny it, things like that. But if the correct diagnosis codes are used and everybody's doing things ethically, writing for medications off label, it in no other area in medicine is it villainized like it is in obesity medicine. We really have this war going on of moralizing what medical conditions are are worthy of treatment and not. And I think it's quite sick, to be honest, that we don't value treating obesity when if we could do that, we could actually prevent diabetes and a lot of things. And we're saying, no, you it's an illness model, right? You have to be a million percent sick before we treat. Why is one worthy over another? Honestly, the drug manufacturers they should be making more if you know that, you know, three out of four people would qualify for the medicine. You know the demand's there. Why are we all turning on the doctor, the patient, the, you know, things like that? It's a supply issue, right? And like that's where a lot of the problems are coming from.
SPEAKER_03Yeah, and I I you know, you know, I run my mouth on TikTok a lot about the media and all the bullshittery that goes on there with these medications. And um, I have coined that term bullshittery. And um, but I really think it's because they're spending it to get any that they want to get as far away from being accountable for making those poor choices as possible. And so one of the easiest ways is to villainize obesity, villainize fat people is to, you know what I mean? It's one of the easiest things to do because people will latch on to it, because in America, especially, people want someone.
SPEAKER_02It's like everyone's trying to point the finger at someone else, right? So the insurance companies, a big thing I've seen as a clinician is that I will submit a prior authorization or do something, and then they'll deny it, but they keep telling the patient, no, all you need is for your doctor to fill out a form because they want to get them off the phone. It's like you've denied it. This is the reason you're giving, but the customer service is like, no, no, it's just a form, you know, and so they're lying to the patient, and maybe they don't, I don't know if it's intentional or not, but everyone is sort of misinformed and trying to point the finger at everyone else. And then no one is winning in the end.
SPEAKER_06Yeah, right.
SPEAKER_03Yeah, yeah, yeah. You know, um, speaking of type two, so something that Rebecca had shared with her story is that um she actually had a particular A1C and I can't remember the the number, and you can share that with Rebecca, but you know, kind of found out that later by going to a doctor that was a specialist in obesity as opposed to like her primary doc, you know, it turned out she was was type two. So she was like misdiagnosed. Um, Rebecca, feel free to like, you know, keep me honest here, make sure I'm saying things right. Like what if you want to add details, that'd be good because I'm oh yeah.
SPEAKER_04Um I I I had my blood work done and it was at 6.7. And my understanding now is that actually made me a type two diabetic. I think what my doctor did is because right after that, that's when she prescribed me Manjaro. I assume what she was trying to do was the hopes that Manjaro would lower my A1C and that I would not be a type 2, because I think she had mentioned to me that creates sometimes more issues with other insurance things that happen in the future. So I'm hoping she was trying to do that in hopes to not diagnose me as a type 2 diabetic. However, with the whole Manjaro situation, that could have potentially put me in the chances of not being approved with my PA, you know, now yeah. So um, and it wasn't until I talked to Dr. Mitchell per Kim that he was like, Well, I actually made you type two. So this whole time I could have had a PA approval. But my doctor even said that um when I went in to talk to her about it, that even with a type two diagnosis, she isn't able to get her other type two diabetes patients, the Manjaro PAs approved. So I don't know what she's maybe lacking in what she's doing, but yeah, I don't think she might not necessarily be lacking.
SPEAKER_02So a lot of the time, just because it's on the formulary doesn't mean that they can't still require step therapy. So what's tricky with type two, let's just talk type two for a second. Sometimes you need to have done the oral medications and then the other GLP ones. And then last is Manjaro, it's like a tier three. And so often it's not that they're doing it in a wrong way, it's that you have certain step therapy. And is that doctor willing to go through a year or two of walking through it with you until you get to Manjaro? Because they want to cover something cheaper, right? So if if Ozemphan can get it done, if some of the oral medications, we actually have lots of medication for type two diabetes, right? We do not for obesity treatment, but um, so a lot of the times what is required, all the doctors don't necessarily know. And it's a very time-intensive process, right? To know, listen, you have to fail XYZ. So we have to go try those. It's a lot of work to do that. Yeah, yeah, yeah.
SPEAKER_03Yeah. I think that's like also what it seems. And I I remember, I think it was a video of yours, Dr. Rantia, where you were like, you know, you know, GPs, they see like doctors every like 15 minutes. They don't have enough time, like with how they practice to be able to sit down with you and have these like in-depth conversation or be doing these really complicated PAs for complicated disease, you know. And and I think that that's an example, I think, too, of like, I mean, I have both now. Like it wasn't until I recognized through this process that I do have obesity, I do have many other related things because of it, that I want someone for the rest of my life to oversee the obesity piece. I still love my general and they have a place in my life and my healthcare. But for me, because I know this is complex and I know this is something I'll likely be dealing with forever, you know, um, that I I want that oversight. And I think I've seen a big difference in being able to have that in my like just in general, I just feel much more cared for, you know. Right.
SPEAKER_02Yeah. And it's just, you know, it's number one, it's like not only do they not have the time, but also the body of research to stay on top of is massive and obesity. Yeah. So they might be getting, I mean, I remember when I was doing mainly primary care, I was reading journals all the time. So you get these um think like magazines, and there's like little highlights of all the different topics, right? So you're staying on top of massive amounts of things, you're just not gonna know a little specific example for someone or how to this or how to that or how to pivot. You you just don't know because you know kind of like the basic stuff, and they they just don't have time to go through it. It's it's not that they're not meeting well, and some of them do great if they if they can't, right?
SPEAKER_06Yeah, yeah. And I I I just wanted to ask now, with especially primary cares and you know, with doctors just having so much on their plate, and with this with GLP ones now, more people are being prescribed them. What what do you all think? And especially Dr. Rentia, about is there a way to maybe have an advocate that could be like a go-between between the patient and the doctor that are for people that are on GLP ones?
SPEAKER_02Yeah, it's it's a it's a resource issue. So, for example, a lot of what I see getting done. First of all, I'm happy for anyone to get the medicine. And I'm so happy if a if a primary care doctor can get all their patients that needed that help, right? A lot of what I see though is they're doing some help, but maybe not super optimally. Like they'll be like, hey, here's a three-month prescription of the lowest dose. Come see me back in three months. And I really, you kind of lost time because you could have probably adjusted or done different things, but hey, something's better than nothing. Yeah. But the but what you're talking about, like, yeah, could there be someone that is not necessarily the physician, but sort of like a mid-level or someone else take it over a million percent, but who's gonna pay for it? So this is another thing. Obesity medicine is actually reimbursed super horribly. And so the reason that people end up going and doing like cash practices like me, it's because you cannot deliver the level of care that you want if you're sort of doing regular immersement, because it's not reimbursed at a specialist level. It's reimbursed uh regular, if if not even that, because you're spending even more time for the certain level of code that you're using.
SPEAKER_03Yeah.
SPEAKER_02I don't know if that answered the question.
SPEAKER_03Yeah. I don't know. It's worth it for me. And I think it is for a lot of people, like to have sort of that like subscription type of thing where you're I mean, I myself have that as well.
SPEAKER_02Like I myself, you know, BC Master physician, it's a monthly ser, you know, monthly service. It's it's that ability to just like like every other day, there's a shortage, there's a this, there's a that. Like, I just want to be able to have someone else help me, even as a physician. I need that help as well.
SPEAKER_03Yeah. And I also think too, when you get these things from insurance or when you come across these things taking these medications, you have questions and you need to be able to have a good relationship, you know, with your doctor to be able to ask them. And like that's one thing, yeah, because I've tried a couple, and the one that I have now, like I they will explain things to me. Do you want to mean? And they will listen to what I have to say. And I'll be like, I don't understand. And they will they will take the time to explain it, you know. And there's no way, like, I right now, my the the nurse practitioner as here for general health, she works two days a week because she's a busy mom and and she has young children, and so she's home most of the time. And I so if I send her a message, I'm not gonna hear after those two days, I'm not gonna hear from her for a week, you know? So it's it's very difficult when you're dealing with something as complex and kind of like a moving target, right? Which is yeah, which is trying to get in a healthy state, you know. Yeah, I so I I do think that that's been a big difference for me as well. You know, we've seen, um, and Janine kind of mentioned her experience with one particular pharmacy uh recently, uh, that basically called her doctor, she said show some kind of bust her, um, but called her doctor to verify that she was type two. Like they took it to that extent before they would fill her Manjaro. And then we were kind of hearing on TikTok, and you never know like what's 100% true or like what the caveats are, but that some of the pharmacies are saying they will not, they will not give you a GLP one at all. That if whether you have a PA or what what you're taking off label and it's approved, whether your insurance covers it, that they will big fat not give it to you. That was pun intended, only not. Um, you know, but not give it to you at all because they're making this policy around this because they're saying that it's because of um audits that they're getting from the PBM, that they're getting audits for. From manufacturers about paying paying out the coupon, you know, paying that difference out. Um, like what do you know about that? Because we're all just kind of speculating and we don't really know what you got.
SPEAKER_02So I personally have not experienced that. Again, I practice in Indiana, Illinois. I have not seen, so I have not seen them saying we're not going to give it out, period. I have patients that do cash pay that do not have a type two diagnosis that are on things off label, um, you know, people on regular insurance. So that I have not experienced, but again, I do hear a lot about how the pharmacies take the heat for it. And so if if the and and by the way, there's always a delay in things, right? So, like things that they did however many months ago, now it's coming home to roost. I will tell you a trend that I'm seeing, though, multiple of the big insurances are now as of um going into July, they're requiring everybody have new prior authorizations. So even if things were covered and maybe we got six months a year, they're like, nope, now you're gonna make everyone redo it because they changed. We're not gonna do any off label prescribing it, we're gonna make you prove the diagnoses, things like that.
SPEAKER_03Wow. Jeez, Louise. Yeah, mine is every six months right now. They changed it.
SPEAKER_02Yeah, yeah. That's another, I mean, like if we can talk about that too with with people getting care. Again, it limits down what physicians can handle that because I I have some people every dose that they go to, we have to redo a prior authorization. And I don't think that's always a joke. I'm like, is this for real? Because these new things pop up out of nowhere, right? Like they're not happening, and then suddenly everyone, you're like, Why are we suddenly reading? I thought we just handled this last month.
SPEAKER_03Yeah, right. Yeah, and they do continue to change things. And we kind of made a joke last episode. We were like, it's funny, like when you see terms and conditions for like these savings cards and stuff, it's basically like we reserve the right to change anything we want at any time, just deal with it.
SPEAKER_06Everything can change, but you're seeing more people that need a PA for every dose.
SPEAKER_03And I'm yeah, I've been hearing that some people need it every month. Some insurance saying every month you gotta do a new one. Yeah, which is bananas. Yeah, that's why and that's why PA requests are going up so high, you ding dongs, because you keep making all these people do this stuff, you know. It's like right.
SPEAKER_05Right? Like it's not gonna be really off label, right?
SPEAKER_02We know the the evidence is in, it's great, right? And now it was purely weight loss related that trial. So we know it'll get approved, but then again, then they might still say if your insurance covers it, if it's not a plan exclusion, you've got to do blah blah blah first. And they're always gonna start with like the old oral generic Orlastat, which is then a calm like we haven't written that in like 30 years. Orlastat, are they still really? Oh my god, that makes sense.
SPEAKER_06Yeah, yeah, yeah. And that's the thing is that uh yeah, yeah, and that's the thing is yeah, yeah.
SPEAKER_03I I think they will continue to make things as difficult as possible, and they will do, and I think that some people, because it's such a pain, will give up and that's what they want. Yeah, you know, I think they're definitely looking to try to make you do, and then you just give up. But like there's anything that I can say to our listening or viewing audience, especially if you're going through this, do not fucking give up. This is not that thing. This is not the thing you give up on. There are other things you give up on. Maybe you give up on the cake, you know, there are other things, but getting the medication that you need for your health is the thing you don't, you know, because it is not your fault. They have proven it with science. It is not your fault.
SPEAKER_05If we can get everybody, like if just just don't stop, uh just you have like a movement like that that they're usually like, yes, we're working on like get yourself a team where they keep doing these things for you, right?
SPEAKER_02Because you yourself cannot be appealing it and running after it all the time. But if a doctor has a team behind them, they will be able to just keep doing these things. That's just part of what is needed. And if you don't have that, it gets really hard.
SPEAKER_07Yeah.
SPEAKER_03And that's why I think we talked about on your episode originally when we started, is that the telehealth obesity specialty piece has been huge for people that especially people with areas. Yeah. Yeah. Yeah. Because they are like, well, I don't have obesity specialists, you know, or I don't this or I don't that. And even though you do pay a monthly fee, it's it's fairly affordable, like for what, especially for what you get, you know? Um, and I think that it's just really important that people are able to get people to understand this is a very complex disease. And these medications are also very complex. And I think that's why when I hear these trends right now, like people going to med spas where they get Botox and getting their GLP1 injection, I'm like, these medicines are made for you to do it yourself. I don't know what's going on. Why are they charging you for this? Like it I don't, you know, like I and why are you going to a med spa? Is there a doctor there? Do you have or anything that's not a doctor, like just a medical professional that is it doesn't just do Botox, like somebody, someone that actually understands. And I think that we're seeing a lot of that right now. And people doing even affiliate marketing for that kind of thing. And it's terrifying. Wow. Yes. Yeah. Yes. Not to mention we're seeing like all the trends of people being so frustrated by all these hurdles we're discussing that they are going and, you know, paying people like individuals, and not even like reputable compound pharmacies, but like just going and like paying people for some glutide. And and it's an individual and it's very, very scary, or mixing it up at home.
SPEAKER_02Like, oh my gosh, you highlighted that video, Kim. I was horrified when you showed me how she had a manual on how to do it. I mean, it was it was horrifying to me thinking of mixing something up randomly at home and inject it. Like it's just horrendous. Please do not do it if you're listening to this. Don't do that.
SPEAKER_07Yeah, no, yeah, don't. Yeah.
SPEAKER_03Yeah, don't. Yeah, don't do that. Just I like it's not worth it. The whole point is to get better, right? Not to put yourself at risk and get worse. And what it does bother me, and I rant about this quite a bit, and so you guys all know, but that the reason that we're in this position, right, to take these massive risks is because of the first time in our history of us, we have found something that has corrected our body and we are able to be our best selves in many different ways, right? Which is kind of talking about at the beginning around like mental health and everything. And so now, because of the system, we are being put in this position where we're having to take absolutely ridiculous risk, and because of the cost of these medications, also, frankly, and the availability and the scarcity, you know? And I hate that. Like if there's anything that I can't stand, and I wish that insurance would realize they're just so short-sighted. So, like when we had Dr. Meyer on, she mentioned actually insurance kind of sees you as like a patient for about four years, then they think you'll move on and get another company or get another plan or something like that. So when that happens, they don't necessarily care about the long-term health. What I don't get is if 40% of America is obese, it's just it's right the next guy or next girl or whatever comes right behind them, has the problem, and the other insurance kicked them down the road too. So it is everybody's problem. And I wish they would just realize that because when people go and they make these very scary decisions to do these things that we're talking about, and then they come back and they have now hurt themselves in other way. Insurance is gonna have to pay for that, you know? So, like it's just this massive cycle, and it's just vicious and it drives me insane. And I can imagine that as a provider, it drives you crazy too.
SPEAKER_02You're see you like me, you're having a very like for the greater good. What can we do and how can everybody be helped? And that's not how these people think.
SPEAKER_03No, no, no, that is not. They do not care.
SPEAKER_05No, could it be kind of like teetering on like say not conspiracies, but like just theories like, is there not enough money to be made in that? Is there more money to be made in diabetes medication for actual straightforward diabetics?
SPEAKER_02I don't I don't think like that. I think the main thing is that we still, despite years and years and years of this being an official diagnosis, people still think that it's you're not working hard enough, you don't have enough discipline. And I really think that the tide will turn in our lifetime where it's totally accepted, the medication's covered. A lot of this, number one, the bias and stigma need to be dropped. Number two, Medicare needs to cover it because then other insurance, um uh other people have for that. So we'll see it fall like dominoes eventually, but right now, okay, and maybe it'll require more generics, right? Like next year we'll get Lyra Glutide, which is successenda, um, Victosa for diabetes, that will go off patent. So I suspect that that's gonna happen. And one day we'll be like, remember when we were talking about, you know, yeah, Dr.
SPEAKER_05Alex Bavaro said that too. Yeah, exactly. Like we're in the middle of like an evolution. Yeah, yeah.
SPEAKER_03Yeah. And I think that's good. Like it at least gives me hope, you know, um, to think that, and Yana, um, I can be a little sunshine and those sometimes, but at least it makes me think that things, like you said, are moving in the right direction. The tide is turning. I don't know about the stigma. I think that that will stay with us quite a while. But at least with this podcast, we're trying to find more people to let them know they don't have to feel that way and that they can come in our community and that they are welcome here. So we're kind of removing the peace that we can and doing the things that we can.
SPEAKER_02Yeah, you know, one of the things is we have to help children that are suffering with this because one of the things with with stigma and bias, you're told it so many times you internalize it, that's the internalized oppression, and then you believe it, and that's the place you act from. And so if we can't help our kids to realize that size diversity is a fact and you're not broken, and you know, we so parents have to be diet culture themselves in order to help their children. And so this is like multi-generational how it's gonna go down.
SPEAKER_05I I feel like Kim and I are are you know, we're we're healing post that like now. I feel like I finally like because we're coming out of it in our 40s, but it's been internalized, I would say the majority of my life. Like you've I guess is it humility or humble? Like you just don't feel worthy enough to speak up because you were always kind of the butt of jokes, the you know, the the reason for you know, you know, you just you can't you can't be like other kids, like things like that. And yeah, just you just really, yeah, you're you're you just I just you broke my earring. But anyway, um, but you really touched on you, you're it's something that I I I know that maybe I I forgot because that's exactly what we went through. Like we're it we're it's a 40 year recovery from it. So yeah, it's true. It's it's it kids going through this now, it's it's it's crucial. Like yeah. Give them the self-esteem that we didn't, you know.
SPEAKER_03We just like, and then when we had that one episode where we talked about childhood obesity, and you know, Kat and I obviously can relate, um, but where we were talking about like there are actually pediatric specialists that specialize this, and like he explained to us like what use cases were around that. And he was saying, like, maybe we don't do a life, you know, threatening surgery on a child, maybe we treat them with the medication, you know. And we had never, I mean, before that conversation, I was like, mm-mm, mm-mm. But it was it's important to have the conversation, you know. Science has progressed so much now, and those are those are precious years, you know, and um so important. And I I don't know if again, like looking back, if it's something that I would have done. Um, my mom was really big on her brain, has not developed yet. She ain't taking anything. Uh, so I don't know, but I also think that's kind of maybe an old way of thinking in a way. So I'm for a 12-year-old, but I don't know. But yeah, I think I think it's time for us to, like you said, try to get ahead, maybe that our children don't have to deal with the same things that we did, even if it's society-based or medically based. You know, yeah. Well, this has been grand, despite said technical difficulties. So we've had a good conversation, I think. Um, but thank you so much for joining us again, Dr. Rentia. We really appreciate you being a friend of the plus side. Thanks, thank you and joining us to help us. Yes, we really want to be able to validate, you know, the experiences that we have so people don't just dismiss us. And so your uh knowledge really does help that. And it's we're we're gonna try to do everything we can to change things. So we really appreciate your time. Love that. You guys are I love your podcast so much. Oh, we love yours too. Kat and I would listen to it too. Yeah, we do. Yes. And I recommend it all the time in my lives. I'm like, and before we go, because I'm gonna ask you this because I'll forget. If anybody hasn't listened to uh Dr. Mateo Matilla's podcast, please do. And also, what are the two episodes on your podcast? Because I reference them all in my lives a lot that specifically talk about all of the medications used for weight. Yeah, um, there are two episodes and they're very, very good. And what what season and one or the other? Yeah. Do you remember?
SPEAKER_02So do you remember? So, first of all, the podcast. I would love if any of you guys want to listen to it. So if you're someone that you want to learn evidence-based things about medicine, I throw in there a little bit of some of the mindset things, but I try to keep it a little bit not boring medical, but just kind of help out with a little bit of just I know it's super helpful, right? Like what's happening. So it's called the Obesity Guide with Mateira and Tia MD. And the episodes that you're talking about, it's right in the beginning. It's like, I don't know, I would say like three, four, but it's part one and two. So it's right, like go all the way back to the beginning, past the little first intro. And I did that to begin with because I knew that people were just gonna want that. So part one, I go over all the medications, and then part two is kind of where can you find an obesity medicine doctor? What are some of the things that that logistically can you combine meds? Can you this? Can you do that? So those are really like the nuts and bolts. If you want an introduction to oral FDA-approved weight loss medications as well as injection, everyone's always talking about injection, but there are a lot of options, even if your insurance doesn't cover it that are generic, like just open your mind that there are options you might need to tell your doctor. So I have a lot of people that actually tell their doctor about it, and then their doctor listens and then they help them.
SPEAKER_07Wow. Yeah, because that's fantastic.
SPEAKER_03Unfortunately, in this area, and we know, like we've learned through this process that it's actually in terms of medicine and specialties, it's kind of new. Like it's not like you know, so because of that, there's not enough knowledge out there, and certainly not a lot of you know, medical professionals that are going and getting board certified. So I think if you're able to advocate for yourself, which is another reason we do this podcast, right, is for you to be able to understand that it is okay to respect and demand a certain level of care. And unfortunately, sometimes that's going to be educating yourself so you can educate others, you know. Um, what other places can we find you on social media?
SPEAKER_02Yeah, perfect. So I am most active on TikTok and Instagram. Those are the two where you can find me. So it's Matea Rentia MD. That's where I'm everywhere. I know I need to do YouTube and other things. I just there's only so much I can do. So we get it. We really get it. Ask me questions, you leave them on videos, things like that. I do a pretty good job on TikTok, like getting back to majority of those, just a really easy way between my day to kind of get back to stuff. And also Instagram is more um more like written stuff, if you like that. But otherwise, I'd only doing videos.
SPEAKER_03Yeah, I like the videos too. It's good stuff. Awesome. Well, thank you so much for joining us again. I will include uh Dr. Rentia's socials and a link to her podcast in the show notes so that you guys can watch it if you like. It's wonderful. And um, but thank you so much for coming. And um, Rebecca, thank you so much for joining us today and telling your story. Thank you guys for having me. I appreciate it. I get messages every episode from at least one person that says that sounds like me. And you will change their life. And they say, I will go talk to my doctor, and it's because they hurt you. So thank you for coming and sharing your story and being vulnerable.
SPEAKER_04You're welcome. Thank you guys so much. Thank you.
SPEAKER_03Thank you so much, everyone. Well, that was fabulous, right? Oh my gosh. Oh my gosh. Like despite technical difficulties. I know. Technical technical difficulties abound. I love you. You know, but I thought it was a really good conversation, and um, especially like even with Rebecca, and like I think it's important for us to talk about too, like when a doctor is looking at your blood work and they don't want to label you, but that label may be what you need to get the medication and the care that you need. And that was a perfect example, right? Because I think that not all doctors realize, especially we know about type two, which is it is chronic. And chances are once you've gotten to a certain A1C, you're always gonna have to manage it. It's not just gonna go away, it's not curable. You know, you'll manage it with food or you'll manage it with medicine or whatever. But even like we talked about that, right, when we had on um Dr. Tumor, you know, she's like, you can turn your blood sugar around with one meal, you know. But, you know, if it's at the point where they're tracking it monthly and they're giving the A1C, like that's very, very important, you know. So I think unfortunately, we're gonna have to do a lot, I think, as a community to be educated in our area so that we can advocate for ourselves. I really do, you know. Yeah, definitely.
SPEAKER_05Definitely never stops.
SPEAKER_03Yeah, it's true. Well, I think we've um spent quite a lot of time together tonight. So we can do some classic sign-offs if you guys have anything to share. Um, I am always just gonna say that you're not alone, it's not your fault. And I'll always say hosta la pasta.
SPEAKER_05What about you guys? I am going through this book of quotes by women, and um I found one that was awesome. And it's um by Georgia, it's Georgia O'Keefe. Um says, I've been absolutely terrified every moment, every moment of my life, and I've never let it keep me from doing a single thing I wanted to do.
SPEAKER_03Awesome. Wow. So true. You know, it's funny you say that. That's a really good quote. I actually say that on my lives a lot when people say, I'm scared to start. I'm scared to start. Yeah. Well, your doctor got you the medicine, it's in your hand. So you decided based on data and facts somewhere along the way to do it. So it's natural to feel afraid, but don't do it because don't not do it because you're afraid. Like if there's evidence to back it up, go for it, you know?
SPEAKER_06Yep, exactly. Exactly. I think the same thing, yeah, uh about fear, but yeah, you all know what I always say. It's a marathon, not a sprint. Yeah, yes, it is marathon. So we just have to keep going. We got to keep going.
SPEAKER_03Yeah, yeah. We're in it together though. So if you guys don't know about our community, there's not like some weird hashtag, just go to TikTok.
SPEAKER_05Unless you want to do butt stuff with cat.
SPEAKER_03I mean butt with cat is a hashtag, and of course the plus sides but quality hashtag and the plus sides.
SPEAKER_06Yes, hashtag butt stuff. Hashtag hashtag Meljaro, but hashtag I need to sit on a pillow.
SPEAKER_03My my handle on TikTok is weird. It's uh dinosaur monkey farts kim because my son made that up in 2020 when we were doing digital learning and I was like out of my mind. And I joined TikTok. And um that and I just haven't changed it. It's just it's just always gonna be dinosaur monkey farts. So if you want to follow me there, there you go. There's not a whole lot of dinosaur monkey farts out there, so I'm pretty sure you can fuse you. Anyway, well, it's been so great hanging with you guys. Um, thank you so much for all of your support. Oh, and we have to talk about the website, rock quick. So if you go to our website, um, which is the plus size, don't forget the c dot com. It's a play on plus size in case you don't know. You're new. Um, we have a merch store. So our podcast is completely driven by people donating their time. And we don't have sponsors or anything like that yet. And we're continuing to grow, which is grand. But if you would like to go and purchase something from the merch store to support our show, that would be excellent so that we can continue this obesity, advocacy, and educational effort that we are trying to do. We want to change things and we are trying to get as loud as possible. So if you want to go there and pick out some cute swag, because you know I'm marketing, I'd pick up some cute swag.
SPEAKER_05A great water bottle for the gym. Yes, that's that's what I'm looking forward to.
SPEAKER_03It is there, it's a good time. We've already had several people go in and get things, which is really nice because that'll cost all of our fees from the things.
SPEAKER_06Thank you. But you know that I love a good v-neck t-shirt.
SPEAKER_03So yeah, girl, I got you when it's on the way. I can't wait. Kat, there's a water bottle. It's got your name on it, but it's on the way. I can't wait.
SPEAKER_05I'll put I'll put my name on.
SPEAKER_03All right. All right. Thanks, everybody. Have a great night, and we will see you next week.
unknownSee you.
SPEAKER_06I'll see you next week. Asta pasta.
SPEAKER_03If you're like most of us, you've been denied a GLP1 at least once. But did you know that less than one percent of denied claims are ever even appealed? Even though the data suggests that over 60% of appeals are often approved, that means that people who should be paying $25 a month are instead paying thousands of dollars a year out of pocket. Not necessarily because appeals don't work, but because the process is confusing and time consuming. Okay. But that's where Honest Care comes in. You go to their site and then you just start with a quick assessment. Okay. And then Honest Care will build your appeal with the clinical and medical arguments that your insurer needs to hear and then guide you through submitting it. If you've been denied, don't stop there because the most appeals must be filed within 90 days. So don't wait. Go to findhonestcare.com slash Kim to get your free assessment today. That's findhonestcare.com slash Kim. Today's episode is brought to you by Roe, a telehealth platform that's changing the game of GLP1 access. What sets Roe apart? Roe understands the challenges of navigating insurance hurdles and the skyrocketing prices of GLP1 medications. That's why they specialize in getting insurance approvals for GLP1s. And if insurance is a barrier, they go a step further by prescribing brand name Zbound vials for prices close to those of compound GLP1s. With Roe, you're not just getting a prescription. You're getting a partner in your journey that's helping you access affordable treatment and guiding you every step of the way. Whether it's insurance approvals or cost-effective alternatives, Roe is here to make sure that you get the medication you need. Visit roe.co slash plus sides with a Z today to see how they can help you take control of your weight management journey with affordable, accessible care. That's roe.co slash plus sides with a Z, making healthcare work for you. Check out the link in our show notes for more details. Are you interested in understanding G O V1 medications like Osimpic, Wagovi, or Manjaro? Then join us on the Plus Side, cracking the Obesity Code, the groundbreaking podcast helping people change their lives one episode at a time. The Plus Sides podcast is a disruptor. We're breaking down barriers, smashing stereotypes, and sharing inspiring stories that'll leave you feeling informed and empowered. Join us every week to learn from doctors who are specialists around GLP1 medications, like Ozin Fit, Bogovia, and Manjaro. We'll provide you with science and facts to validate these incredible stories. But that's not all. We'll also bring you the voices of the GLP1 Manjaro TikTok community. Real people who face the challenges of obesity-related diseases and disorders and discover the incredible plus sides of GLP1 medications. Our episodes are filled with heartwarming stories, laughter, and moments of triumph. You'll connect with our amazing community members who are reclaiming their health and experiencing their fullest lives. Are you ready to embark on a journey of discovery and empowerment? Tune in to the plus sides, cracking the obesity code, and together we'll change the narrative around obesity and end the stigma. Subscribe now on YouTube or your favorite podcast platform and join our incredible community. Let's celebrate the plus sides of life together because every story deserves to be heard. Every life deserves to shine, and everyone deserves access to expert knowledge and medication. The Plus Sides Podcast. You're not alone. It's not your fault.