Good Neighbor Podcast North Atlanta
Bringing Together Local Businesses & Neighbors of North Atlanta
Good Neighbor Podcast North Atlanta
EP #110: Healthy Conditions - Weight Loss with Dr. Vahid Yeganeh
Discover the truth behind weight loss myths and misconceptions with the insightful Dr. Vahid Yeganeh from Healthy Conditions. With half of Americans striving to lose weight each year, Dr. Yeganeh shares his expertise on cutting through the clutter of misinformation, particularly on social media. Get ready to learn the significance of evidence-based strategies, the energy balance theory, and how oversimplified solutions can mislead those on their weight loss journey. Dr. Yeganeh provides a comprehensive look at the complexities of obesity and the importance of making informed choices for lasting health.
We also take a closer look at the fascinating world of weight loss medications like Ozempic, Wegovy, and Tirzepatide, which are making headlines for their effectiveness against type 2 diabetes and obesity. Dr. Yeganeh discusses their benefits, including potential cardiovascular advantages, while also addressing their high cost, limited availability, and the risk of misuse. Understand why resistance training is crucial to preserving lean muscle mass during weight loss, and why these medications shouldn't be a quick fix for those with minor weight concerns. Responsible use and personalized treatment plans are key.
Finally, we explore the seductive yet dangerous allure of fad diets such as the ketogenic, detox, and carnivore diets. Dr. Yeganeh sheds light on the potential pitfalls of these diets, including micronutrient deficiencies and cardiovascular risks. He advocates for sustainable and individualized dietary patterns, encouraging a healthy relationship with food by focusing on fiber, whole foods, and balanced lifestyle factors like sleep and stress management. Join us as we uncover the path to achieving lasting health benefits through thoughtful, evidence-based choices and sustainable lifestyle changes.
This is the Good Neighbor Podcast North Atlanta, where local businesses and neighbors come together. Here's your host, stacey Risley.
Speaker 2:Hello friends and neighbors, welcome to North Atlanta's Good Neighbor Podcast. Today we have Dr Vahid Yagana with Healthy Conditions, which is a concierge lifestyle medicine clinic in Buckhead. He is back with us today. He is our expert contributor for both Dunwoody Neighbors and North Buckhead Neighbors magazines and he's here today to discuss one of his most recent expert article, which is on surrounding the topic of weight loss and myths, medications and making informed choices. Welcome, dr Vahid, I'm so happy to have you back. Thank you, thank you for having me back. We're glad to have you. This is such a topic that so many people affect so many people that I think one of the stats that you had in the article was that 50% of Americans report, you know, trying to lose weight every year. So that's a huge number Most of us, really. So I'm glad that you're here to discuss this topic and really going to let you kind of take it away.
Speaker 3:Yeah, sure, Kind of like you said, it's definitely something that's on the front of most people's minds at some point in the year, at some point in their life. So you can imagine it comes up quite a bit in my day-to-day. Being an obesity physician, that's kind of part of what I do anyway. But even if that weren't the case, I feel that just in general primary care, that's kind of part of what I do anyway. But even if that weren't the case, I feel that in just in general primary care, it's probably one of the concerns that comes up quite a bit, and so that's why I chose that topic for the article.
Speaker 3:I feel like it's something that everybody can maybe glean a little bit of information from. These days we have a lot of misinformation out there, especially on social media, and so it gets difficult to separate fact from fiction. What, you know, what is actually going to benefit me and I think there is unfortunately probably not intentionally, but there's a lot of harmful information. So that was another goal of this article was to just briefly touch on a few things and make sure that folks are, you know, approaching this from an angle that keeps them safe and, you know, looks at things more comprehensively.
Speaker 2:Yeah, and that's really important. I like what you said in the article about you know everyone thinks they're an expert you know, and this is a subject that's it's dangerous to to pretend that you are more knowledgeable than you are or you know, you think that someone you know there's a TikTok video about this bad guy I mean, that's really dangerous with, especially with so many people you know looking for that quick fix and, you know, without really knowing how this affects your body and long-term health risks.
Speaker 3:You can imagine that, with it being such a popular topic and a very common pain point, if you're someone who's trying to sell a product or a service, that's an easy sell right. You just pick on a thing that is on most people's minds and you offer a very simple solution. That's an easy sell right. You just pick on a thing that is on most people's minds and you offer a very simple solution that's going to solve all their problems. And so, again, I don't think folks are intentionally trying to be harmful. You know, I want to be clear about that. I think the vast majority of people are trying to help, maybe sell their product or service, but what ends up happening is some of this information is way too reductionist and folks take it to heart and they apply it in their lives, you know, without even thinking twice about it. So, yeah, that's kind of where it gets dangerous. I don't think anybody's actually trying to harm anyone, but it does happen, yeah.
Speaker 2:Yeah, for sure. Well, and so you talked about in the article, you know, energy balance and weight loss in the context of overall health. You know, before we kind of get into some of the myths and pros and cons of medications and all of that, what? What do you mean that when you say in context of overall health?
Speaker 3:when you say in context of overall health, yeah, so the energy balance theory so some folks might know it as CICO or CICO, which is calories in calories out right, it is a very kind of simplified way of looking at it, because I can tell you that overweight, obesity, this whole field is very, very complex. Every case is a little bit different. You know you've seen 10 cases there. You've seen 10 different cases, right, but I think it's important to remember that if you're looking at the data and you know I always recommend, if you're going to get health advice or do anything with your health, make sure it's backed by robust, you know, scientific evidence. That's step one. And so, if we're looking at evidence-based medicine, this theory does hold true that calories being expended so the calories that we use and the calories that we're bringing into our body if there is a surplus or a deficit, we are going to see changes in weight.
Speaker 3:And really I think about it as a superpower. It's part of our ability to survive is the ability to store energy. I mean, if we weren't able to do that in our history as being humans, we wouldn't have survived because for the vast majority of our time on Earth, we were in a food scarce environment and so being able to store energy in the form of fat, I consider that a superpower. What's happening today is the food environment is different. You know, at least in our cultures here in developed countries, we have, you know, not just you know access to food, it's just the type, the quality. All of that impacts it.
Speaker 3:So the energy balance theory does hold true, I you know. The caveat with that is that the quality of things does matter. But overall, if you equated calories across different dietary patterns and you were just looking at weight loss, yeah, there wouldn't be any significant difference between them, as long as the calories were equated. Now those dietary patterns can be very different in how easy it is to adhere to them and how they impact your overall metabolic health, and then we can get into the weeds on that stuff. But yeah, overall, that's what I mean by the energy balance theory and that does still hold true.
Speaker 2:Yeah, and you mentioned in the article too, that taking in a certain amount of calories in the form of candy is going to be obviously very different than than if you're eating nutrient rich foods the vegetables and different things. So well, let's go ahead and debunk these outdated myths that people just need to to forget or ever ever thought to be true by anyone.
Speaker 3:Yeah, um, I I mentioned two in the article. There's a lot. There's not a lot of room for me to go on and on and on, as I tend to, as you well know, but I think these two because they come up often, and so I thought let's stick with the two that come up pretty frequently.
Speaker 3:The first one I mentioned is that losing weight is only about willpower.
Speaker 3:Honestly, if it was, more people would have success, right, and I would probably expand that, extrapolate to anything you're trying to do. If it was just about willpower, not just weight loss, then you'd be more likely to succeed, because at some point we all have quite a bit of willpower to do things. We have this energy, this enthusiasm, this motivation. It is not the case. There are so many factors at play. Everybody's physiology is a little bit different. You know the different hormones that are up or down in our bodies, the way we respond to food, how easily we are satiated by our food food, how easily we are satiated by our food. There's so many factors that go into what food environment are we in, what work do we conduct during the day, what our relationships are like. The list goes on and on.
Speaker 3:It is not just about willpower, and why I mentioned it here is because I feel like there's a lot of shaming that goes on still. There's still this sort of thought that, oh well, if you could only just eat less and move more. You know it's up to you. You are making this choice to be overweight or to be obese, right, and I think that's really, really harmful and it's, quite frankly, very inaccurate as well for most people, and that's why I mentioned I think, that that's something that everybody needs to get really clear that it is not just about willpower. The second myth is this one I could probably write a book on this one, Maybe I should Is that carbs are bad for you. So I, you know, okay, Throughout, you know throughout at least our lives, if you think as far back as you want. There's always been different diets, different things, and you know carbohydrates being bad for you is something that keeps popping up. You know, you think back to things like the Atkins diet and whatnot. That's exactly what popped into my mind.
Speaker 1:Is it yeah, when I think of that.
Speaker 3:yeah, Today you could think of maybe keto is like the new version of that stricter version of that and it's not true. Carbs are not all carbs are bad for you. The quality of the carbohydrates are what makes the difference. I mean if you think about how beneficial fiber is, and fiber is a component of carbohydrate foods right, or the carbohydrate macronutrient, and focusing on the quality makes all the difference.
Speaker 3:Whether we're talking about your metabolic health, you know so things like blood sugar, but even when we're thinking about things like, you know, surplus energy, and these processed foods do wreak havoc on our body. So processed, highly refined, processed carbohydrates are not the same thing as whole, unprocessed carbohydrates, things like whole grains, legumes, fruits, vegetables all these are wonderful for you. Those are the two myths that I would say it's important to distinguish. Yeah, yeah.
Speaker 2:Well, so now the next portion of the article really got into the pros and cons of using medications to help aid in weight loss. Do you want to touch on those? For sure, I think that that I think a lot of people want to turn to medication, I think, for before they try other things a lot you know, they um they want a quick fix, a pill that's going to fix everything.
Speaker 2:you know, so I can know that that can be dangerous and I would think, in a weight loss capacity to you know, that that could be something that we definitely want to caution folks about.
Speaker 3:but whatever, I'll say a few things about. You know again, very um. We can go into the weeds on this but you know, just on the surface, important things about um medications that are currently in the market that are getting a lot of media attention. So we're talking specifically about the glp-1 agonist, the git agonist. So these would be like um a zampic wegovi they're the same drug, just different fda approvals and um terzapatide, which is man Manjaro or Zepbound it's the sort of the weight loss FDA approved name. These are wonderful medications.
Speaker 3:Now I'll say I don't have any emotions around these things, right? So for me it's just the fact, and these medications can be life changing. They definitely have been game changing in the medical world when it comes to type two diabetes, when it comes to overweight and obesity. So they've definitely changed the game and, as far as what has been available, these tend to be the safest and quote-unquote cleanest options that we have, at least in the history of medications that have been used for overweight and obesity. Are they for everybody? No, there's definitely.
Speaker 3:You know cases where it's not going to be the right fit, and I think that's where we start getting into problems. So I guess the pros here would be that they're generally really well tolerated. The most common side effects tend to be gastrointestinal, you know might have some stomach upset, maybe a little bit of heartburn, so you can have that become severe too, right? Some folks have a bit more violent vomiting, typically if they already have a slow movement in their intestine. But anyhow, that's something that you know can be managed and individualized. Other pros of these medications is, as they study them, they're noticing that there might be cardiovascular benefits to using these. So there's interesting research going on about the use of these medications. In case you're wondering, we've been using that class of medication probably since the early 2000s for type 2 diabetes.
Speaker 2:I was about to ask that there was a big, I know, in the late 90s. You know there was a lot of people taking and I'm not going to remember the name of it. You may know.
Speaker 3:We've had quite a few medications and a lot of them no longer exist on the market because we still have things like Fenterman or combinations with Fenterman that are, you know, in the right case, are still used fairly widely. But, yeah, so these, this particular class, you know the Ozempic, wegovy class of medications we started those about around the early 2000s and then that's kind of evolved. I think Ozempic probably came a little bit later than that, maybe later in the 2010s, maybe a little, I don't know exactly when and we've used them, uh, you know, with pretty good uh safety profiles, uh, across the board, the cons, okay. So this is the part where I want to just touch base um, they are very expensive. Not all insurances cover them, so that's something to consider. Uh, we also don't have easy access to them, necessarily, because they are so popular they can't keep them stocked on the shelves, right?
Speaker 3:So, um, people need to be uh, running around shopping around. Okay, I need to make sure they don't I don't miss my next dose, because then everything kind of um goes backwards. So that there's that. I think that can be addressed. Um, the the concern I mostly have is there have been a lot of I guess I don't want to disparage anybody's work, but there have been a lot of opportunities. There are a lot of opportunities for you to just get these medications prescribed to you without a whole lot of evaluation. I mean, you can even get them online or a lot of places that have popped up.
Speaker 3:Yeah, they'll give you the compounded versions. They're happy to charge you for them and the compounded versions are cheaper than the FDA approved versions. They are not FDA approved. I personally don't recommend them. Again, it's science, it's data. I look at it, you know, as that position evolves. If the medical community changes their position on that, then I'll change mine if I'm presented with new data. But currently I don't. I don't send my patients to get the compounded version. I guess that would tell you kind of where I sit on that argument.
Speaker 3:And so there's been a lot of unscrupulous use. So folks that maybe weren't good candidates for these medications are getting to use them and unfortunately then they get into problems such as becoming malnourished or just losing a whole lot of muscle mass, because you're not just losing fat, you're also losing muscle if you don't do something to mitigate that right. And so, along with these medications, it's important to be doing things like resistance training to preserve as much muscle mass as you can while you the peripheral fat or the surplus fat that's on your body. But because it takes away hunger, so it will make you feel full faster. It will make you feel less hungry. If it's someone who said you know what. I just want to lose 10 pounds, these last 10 pounds, I'm going to go take this medication.
Speaker 3:I don't think that's necessarily the best scenario, because you can fall into this position of now being malnourished. So I say all of that. You know it is complex, it has to be individualized. I will end my kind of comments on these medications by saying that it is not an easy way out either. I think that's important to clarify. Some folks, this will change their life. This will give them a new lease on life and they have tried everything. They have done all those things that you think that they haven't tried and nothing was working, and this just changed their life. I don't think there's any shame in that. I don't think it's a quick fix for people and I think that they're very viable medications in the right context for the right patient.
Speaker 2:Well, and I love hearing you say that there are, you know, some cardiovascular, there's some, you know, data pointing that there are cardiovascular benefits, you know, to these medications, you know, helping with blood sugar levels and different things. So you know that they aren't just suppressing your appetite but they're also benefiting you in other ways, you know. So that shows a lot to how much these medications have evolved, you know, and that someone such as yourself would recommend them, so that you know, in certain situations, not everyone so I think that that does say a lot to our medical community that they've come a long way since they first were released for those purposes. But let's touch on the fad diets and I know that there are probably a ton more especially the really the short lived fads that you can, you can find on on any social media platform, probably super easily. But if they're, you know which, which are the ones that you want to kind of really steer people away from.
Speaker 3:Yeah, I mean I'll just say something about. I picked three for this article the ketogenic diet, detox diets and the carnivore diet. I just picked them because those are the ones that I get asked about most often. I don't know that I'm going to sit here and say everybody needs to steer clear. Again, I don't really have a lot of emotions around these things. It's my job to provide the facts and make my recommendations to my own patients. So, since we're just having a conversation, you know, if someone came and sat in my office it might be a different conversation, obviously. But I will say what I think about them and take that with a grain of salt. You know, do with that information what you will, right, so it is big.
Speaker 3:So earlier, you know, I mentioned the Atkins diet.
Speaker 3:So the keto diet really is kind of a evolved if you could use that term a more restricted version of an Atkins diet.
Speaker 3:Basically, what's going on is you are having a lot of fat and you're having very, very, very little carbohydrate and the idea is that you're going to keep your body in ketosis or using ketones for energy. The issue that we run into with the keto diet or at least anecdotally what I have run into with folks that I see in the office that have been on it or are currently on it is one there is a tendency to become deficient in certain micronutrients, vitamins, minerals, that sort of thing, because, if you think about it, it's a restrictive diet, so you're restricting a whole lot of stuff and you're restricting a lot of good stuff. You know, earlier I mentioned how carbs are not all bad for you, so you're really cutting out a whole bunch of fiber. Fiber only exists in plant foods, by the way. It doesn't exist in other foods that are not plant foods, so you are taking away things that are good for you from your diet. So that's one issue I have with the keto diet. Two, it is very strict.
Speaker 3:Therefore, it's not sustainable for the vast, vast majority of people, I have yet to meet someone that has been able to sustain a ketogenic diet. And then, thirdly and finally, on the keto diet, because you are having such a high ingestion of fats, it can affect your cholesterol levels, right? So you can run into trouble. As far as cardiovascular event risk right, your risk for heart attacks and strokes and that sort of thing I'll move off of the keto diet in case anyone that's listening is on it. I don't want to upset anybody too much, but I'll move to detox the detox diet. So here's the bottom line. On detoxing your body is amazing. Your liver detoxes your body, or everything that goes to your body. That's one of the functions. The liver does a lot of things, but one of the things is it detoxes, it deals with toxins, and so these dyes typically they are they tend to be just liquid. You know I'm going to go on this. You know, detox for a week or two weeks and whatnot. Again, we fall into this realm of now maybe we're we're not consuming enough calories, or we're not consuming enough variety of nutrients, and so I think that we can end up in a situation that can be harmful as well. So that's why I'm not a big fan. I don't think they're necessary. There's absolutely no robust scientific evidence to back up their use, no matter what your favorite TikTok influencer says. And I'm like you know, I'm a scientist. If tomorrow the data comes out, I will change my tune and I will prescribe them. So I have no issue, you know doing that.
Speaker 3:Next I'll talk about the carnivore diet. You know I'm, you know I'm a big sort of I promote a whole food, plant-based diet. So the carnivore diet, you would think, is sort of like the polar opposite. Honestly, even the folks that are promoting the carnivore diet, I think they're well-intentioned and I feel like they probably have sensed some benefit, because you are essentially eliminating a lot of things for your diet from your diet when you do the carnivore diet, and so by eliminating so many things, a lot of the things they eliminated might have been causing inflammatory issues and all kinds of issues. So you might actually feel a benefit to some of these.
Speaker 3:But, same thing, very restrictive. Now you're cutting out pretty much all fiber. So we run into issues in terms of risk for cancers like colorectal cancer. We also run into issues with heart attacks and strokes because now you're increasing your saturated fat intake, which there's robust evidence to link it to these events increased saturated fat in your diet. So that's my issue with that. And by decreasing fiber, not only are you increasing your risk for colorectal cancer, but your blood sugar gets impacted. All kinds of intestinal issues can pop up.
Speaker 3:So again, I'm not saying do or don't do, I'm just saying those are the facts as I know them. As the data evolves, you know, I'll reevaluate these things, but I will add to that I didn't put this in the article. I don't think there's a magical diet out there that works for everybody. I think there are things that generally should be consumed. You know, we should have a good amount of fiber in our diet, we should be careful around saturated fat, we should stay away from processed foods. But I don't think there's one magic pill out there. I think cases need to be individualized and we need to think about what dietary pattern is sustainable for you, you know, because a lot of these fad diets are not sustainable.
Speaker 2:And I think that that's the key, you know, finding something that is sustainable, that's something that you're able to implement and, you know, become something that you can live by, rather than it being a diet, so so to speak, you know. So speak to that for a minute, Dr Fahid.
Speaker 3:Yeah, absolutely so. My approach, and one that I recommend, is to look at weight loss from a wider angle. Right Is not to just look at it in a vacuum as all I'm interested in losing weight. No, we have to think about everything that goes into that how we're sleeping, how we're moving, the relationships we're in, do we have any level of chronic stress All of these things impact our weight, our health in general, but our weight, you know, or if we are of a weight of these or struggling with any of those conditions, this is impacted as well. So I would look at those things.
Speaker 3:I would think about nurturing my relationships and, speaking of relationships, nurturing your relationship with food forward into a healthier future for yourself. You need to really look at food as the nourishment that it is, and not this evil thing that, oh, you know, oh, I misbehaved, I ate such food or such and such food, or or oh, I was really good, I deserve X, y, z. I feel like those are very broken relationships with food where we need to just look at this is. This is nourishment, this is healing my body, this is I need to eat.
Speaker 3:You know you can't just restrict yourself from all food and focus on just one one parameter. So there's a lot that goes into it. You know, like I said, all these different pillars of health and sleep is a big one. You know, looking at how you're sleeping and when you look at it in that sort of comprehensive way, I feel like it becomes more and more real that this can be sustainable. Maybe I can actually do something different, because you know those of us that have tried to lose weight. You know it's not the first time. We've probably done this for years and years and years and kind of cycled and yo-yoed back and forth, and the idea is to break that cycle and move forward in a way that that is sustainable.
Speaker 2:Yeah, and I just want to in a way that is sustainable. Yeah, and I just want to reiterate one thing that you said that people have a broken relationship with food and to use food as a reward to yourself or to restrict yourself. Oh, I was so bad when I didn't eat that. That really does. We've had that all of our life. We've heard that you get rewarded with dessert as a kid.
Speaker 1:It's a part of our culture.
Speaker 2:Yeah, it really is. I guess when you said fixing relationships and you're working on the relationships in your life, it's a relationship with food. It's really at the root of it all, I guess. Well, thank you so much, and you talked about the importance of sleep and maybe that could be a future article, that we, that we do a sleep on our overall yeah.
Speaker 3:I would say that, of all the pillars of health, if I had to pick the most underrated sleep. It impacts more things than people realize it impacts. So yeah. I think that would be a really good.
Speaker 2:Yeah, I would love that and that would that would that would apply to 100% of people, right? I mean, seriously, it really definitely affects every aspect of your life, whether you realize it or not, and I would love some information about that. So well, Dr Fahid, thank you so much for coming back on with us today. It was a pleasure, as always. I look forward to the next time already. Thank you, Well, that's all for today's episode, Atlanta. I'm Stacey Risley with the Good Neighbor Podcast. Thanks for listening and for supporting the local businesses and nonprofits of our great community.
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