Epidose 65: The Real Reason You're Gaining Weight Back After Surgery

In this episode of the Pound of Cure weight loss podcast, Zoë and Dr. Matthew Weiner address various listener questions regarding weight loss strategies, particularly focusing on post-surgery weight regain, the importance of fiber, the role of protein shakes, and the challenges faced by non-responders to weight loss treatments. They also discuss the broader issues within the healthcare system, including the impact of pharmaceutical companies and the need for reform.

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Chapters:

00:00 Introduction to Weight Loss Q&A

01:02 Post-Surgery Weight Regain and Lifestyle Changes

07:13 Protein Shakes and Weight Loss Stalling

12:16 Understanding Non-Responders to Weight Loss Medications

20:09 Addressing Healthcare System Issues

29:34 Future of Weight Loss Care and Community Support

Transcript

Zoë (00:21)
Welcome back friends to the Pound of Cure weight loss podcast. We are so excited to welcome you to another Q &A episode. So you guys have been vocal on social media. We love it. There have been lots of really great questions coming in. And so if you've submitted a question recently, and we've gotten back to you like, hold on,

Matthew Weiner, MD (00:29)
Yeah.

Thank

Zoë (00:41)
We're gonna talk about it on the podcast. Here's the moment. So keep them coming. We're really excited for today's conversation and digging into your questions.

Matthew Weiner, MD (00:50)
Yeah, I love it too. You know, a lot of the questions we get are just way too much for social media. You know, it's just like, I'm like, well, you want to answer? I got an answer. It's a 10 minute answer. I mean, let's be honest though, how many of my answers aren't 10 minutes though, Zoe, right? Let's, but, but you know, there's so much there. Yes. There's so much nuance to it. So I think this is a great opportunity for us to really dig into these questions and get people the answers that they deserve.

Zoë (01:07)
Right? And there's so much nuance. Yeah.

Matthew Weiner, MD (01:18)
So, alright, well why don't you start us off? What's our first question?

Zoë (01:22)
Yes, absolutely. So our first question comes to us from YouTube. Is it possible to lose post surgery regain weight without GLP one medications only with diet and exercise as your lifestyle choices?

yes, absolutely. Guess what? Is it going to be harder? Yes. But is it impossible? No. You know, it really also depends on how long ago you experienced that weight regain and how long it's been sitting with you.

Matthew Weiner, MD (01:41)
Good.

Zoë (01:51)
So if it was five years ago, let's say you regained 20 pounds and then you've just been kind of steady there, then yeah, now five years later trying to lose those 20 pounds, it's gonna be challenging. But can you do hard things? Yes. But what it's going to take is more effort, right? With the GLP ones, you kind of have this tool, you have that push to make it.

easier to maybe stay away from trigger foods because you have decreased food noise. But thinking about how can we decrease food noise through food and your nutrition choices, there's absolutely plenty we can do with that. And in fact, the metabolic reset diet is beautiful for that because guess what? It's all about pushing, of course, whole foods. But the piece that I love is the volume and fiber because guess

Matthew Weiner, MD (02:30)
Thank you.

Zoë (02:45)
fiber takes a while to break down and digest, right? So that slows down your digestion. It keeps you full for longer as your body's working to break all that down. Meaning that pound of vegetables minimum that you're working to eat, it's gonna keep you full all day long. And something I love to harp on is when you are,

feeling hungry, what's happening? You are thinking about food more and you're probably not thinking about food that you are not trying to avoid, right? It's like, man, I wish I could have more vegetables. No, it's not, it doesn't work like that. When you're depriving yourself and you're feeling hungry, you're thinking more about those foods you're trying to avoid, which increases food noise, right? Which makes you feel more restricted, which ultimately for many people leads to a binge later on. So instead we want to work with

Matthew Weiner, MD (03:05)
Yeah.

Zoë (03:34)
your body work with your hunger and satiety signals, add more vegetables, add more volume, add more fiber so that when you're feeling full and satisfied, you're not thinking about food as much. That is your food hack for decreasing food noise so that you're not having as hard of a time staying away from some of those trigger foods that we see people struggle with.

Matthew Weiner, MD (03:36)
you

Yeah, I mean I think hitting on fiber like what's the answer to this question is fiber. ⁓ What can you do if you want to lose the weight?

without GLP-1s or additional surgery, the answer is eat a lot more fiber. Our metabolic reset diet is really essentially a high fiber diet. Why don't you talk a little bit about what fiber does to your blood sugar? Because I think that's the magic piece. And then when you're done, I'll talk about how fiber's different after surgery.

Zoë (04:26)
Okay, great. I love

that because yes, fiber, it slows down that spike in your blood sugar, right? If you were to eat, let's say a bagel, right? Or no, here, let me have a better example. Let's say you're running late for work, you stop at the gas station, you grab yourself a donut, and then you head off to work. What happens? Your blood sugar spikes up, and then it only stays up there for a little bit.

crashes down

Matthew Weiner, MD (04:53)
Yeah.

Zoë (04:53)
and then what happens you feel hungry a little bit later you're you're feeling kind of crappy with your energy levels right because of that drop if we were to instead swap that out for something that has Fiber and ideally a little bit of protein along with it, but that fiber specifically slows down the rate with which your blood sugars increase

And then the cool part is it stays stable for longer and slows and drops down more slowly, keeping your energy levels and your hunger more aligned with that stable blood sugar so you're not on that roller coaster, which will make you feel much better and of course, less cravings.

Matthew Weiner, MD (05:35)
Yeah, and the roller coaster goes higher and drops lower after bariatric surgery. We've answered tons of questions on this podcast about hypoglycemia, particularly after a gastric bypass. And that's triggered by those palatable foods that you absorb rapidly. It causes this rapid blood spike and then your body over releases insulin and you drop low. And then when you have low blood sugar, you've lost.

it's almost impossible to make good food choices with low blood sugar. So I think because of that rapid cycling that we see much more so after bariatric surgery than in patients who have normal anatomy, it's even more critical that you're packaging fiber with the food and that, you know, that kind of fiber plus protein recipe that you talk about so often. Like for me, the perfect breakfast is celery and peanut butter. Like that's just

man, that just dials it in. It's got a little bit of healthy fat to keep you full. The celery is the fiber. There's fiber in the peanut butter. There's protein in that. And kind of coming up with foods like that. And I'll tell you, it is amazing. That meal will keep you full for a long time. And so putting that together to prevent those blood sugar spikes is what's going to quiet that food noise, which is the magic that people are looking for in the GLP-1s. And so I think your point about, you

it is absolutely possible to lose that weight again, particularly if it's recent weight gain and also if it was induced by something we can identify. You were put on a medication, you gained some weight, you've said stop that medication. As soon as you can, you gotta get that weight off. And nutrition is always the first line. So yeah, it's fiber and protein. That is really the magic formula for that. so, all right, let's move

Zoë (07:23)
Anyway.

Matthew Weiner, MD (07:30)
on to the next question.

Zoë (07:32)
Okay, great. So the next

question is also from YouTube and it says, I've seen some information about protein shakes stalling weight loss. Does that apply to people who are using them almost exclusively or is it across the board? Does one protein shake a day make a difference? What if someone is lactose intolerant to the shake? Just create your thoughts on this. So really great question. We, time, want to really decrease that reliance on those protein shakes, especially for thinking about

post-bariatric surgery or folks who are on GLP-1 meds because of our whole philosophy of working towards whole, real, unprocessed foods. Now, protein shakes are kind of that insurance policy that a lot of people utilize to make sure they're getting their protein goals when it is important that they are, meaning in that honeymoon period. But here's the thing.

Protein shakes are ultra processed foods, right? There are a ton of ingredients in there. And if we can try to shift, even if it is taking one away and replacing it with a shake that you're making yourself, a smoothie that has maybe Greek yogurt as the protein source, and you're getting some fiber in there so it's filling you up more. So do I think that you have to completely take away the protein shakes? It depends on where you're at in the journey, but could it stall weight loss?

Matthew Weiner, MD (08:40)
you

Yeah

Zoë (08:55)
Sure, because

you're not feeling as satisfied. So my challenge to you would be try replacing one with something that is more Whole Foods rich with that fiber plus the protein and see what a difference it makes in terms of your satiety levels, your energy levels, how hard your body's working, your metabolism to break that food down. I think you'll see a big difference.

Matthew Weiner, MD (09:16)
Yeah.

Quiz question, back to your biochemistry classes in college. What happens to excess protein that you do not need or use?

Zoë (09:20)
boy. ⁓

Well, that gets converted to carbohydrates, which excess carbohydrates can get stored as body fat.

Matthew Weiner, MD (09:34)
Exactly. So if you're taking in more protein than you need or use, then your body is going to metabolize that into carbohydrates stored as glycogen. Eventually that can end up as stored body fat.

And so it's important, you know, for all of those low carb high protein, it's not quite so simple. You know, your body doesn't have these silos. There's an incredible amount of cross conversion of these products, these foods, these macros. And that's why just strictly counting macros is generally gonna result in failure and kind of gets back to my hot dog versus an almond.

Zoë (09:59)
Mm-hmm.

Matthew Weiner, MD (10:08)
Hot dogs and almond have almost the exact same macro breakdown, but very different effects on your food. ⁓ So I think another point of confusion too is that a lot of people associate protein shakes with the VLCD diet. And the VLCD diet is an awesome way to lose weight for a short period of time.

Zoë (10:24)
Mm-hmm.

Matthew Weiner, MD (10:32)
It is a terrible way to achieve sustainable weight loss. And so a lot of people look at using just drinking, just shakes, 800 calories a day. Look at this, it works great. The HCG diet was kind of based on this. It wasn't the HCG, it was the VLCD. It was the low calorie component that works so well. ⁓ so that's all, I always throw a wrench in the plan. We use that diet for our preop patients, but otherwise we really don't.

use that diet.

Zoë (11:04)
Yeah. And it actually makes me

think about something I wanted to mention with one of the other questions, which is trying to go back and reset your pouch by going back to only drinking protein shakes or only drinking liquids. Sure, you might lose that weight fast, just like you said, but then what happens after you stop doing that? Right? You need to eat real foods. We want to shift how you're eating in the long term. And that's ultimately what we keep harping on.

Matthew Weiner, MD (11:28)
Yeah.

Yep, mean our program philosophy is about sustainable weight loss. I always tell patients, I don't care what you weigh in six months, I care what you weigh in six years. And that's really what I think is necessary. You have to take that long view. It takes more discipline, it often takes a little bit more treatment than people would like, but it does work and it works in the long run and it gets to people to the space they want, which is that they feel in control of their weight.

And that's, know, when you're, when you've had surgery and you're regaining weight, I mean, what an awful feeling that must be. What an awful feeling. Like you had it, it was there and now, ⁓

It's drifting away and you're out of control. And that's where you gotta get back to that kind of step by step by step, nutrition, meds, surgery, looking at that triangle that we talk so much about and really looking at each layer and making sure you're optimizing it.

Zoë (12:32)
Mm-hmm, absolutely. All right, are ready for the next question? Okay, we're gonna kind of combine a couple questions that we got regarding non-responders. So one's from Instagram, one's from TikTok, but the question reads, get appetite suppression. It's taken nine months to lose 30 pounds. I've not lost any weight despite that suppression and appetite in months. Does that make me a non-responder? And then the follow-up question to that is,

Matthew Weiner, MD (12:35)
Let's go.

Zoë (13:01)
What can non-responders do?

Matthew Weiner, MD (13:03)
Yeah, so, you know, non-responders are really a ⁓ very, very challenging problem.

And I think with everything that's out there, everyone's on all their social media channels, showing their before and afters, talking about food noise. Oh my God, this is so great. And for many, many people, these medications are amazing. They are a true godsend. They quiet the food noise. They let people feel in control of their weight. They lose lots of weight. They tolerate them beautifully. I mean, that's what we see often, very often, but not every single time.

time. And so, you know, I think for the first question, they lost 30 pounds in nine months.

In order to determine if someone, first of all, would say that person is probably not a non-responder, right? I mean, that actually sounds pretty reasonable. ⁓ You need to know what medication they're on, what dose they're on, and what their starting weight was. So two important numbers that you should know for weight loss. The first is 20%, and in some studies 25. That's how much weight loss we see from terzapotide.

most commonly known as Monjaro or Zep-Bound, and 15 % for semaglutide, we go via Ozempic. And those are max dose numbers. So if you're at the highest dose. Another little important kind of conversion factor that we use quite frequently in our practice is that five milligrams of Terzepatide, which is the second from the lowest dose, is equivalent to full dose Ozempic, we go via semaglutide at 15 % total.

body weight loss. we, know, between with all that information, you can kind of look at what was your starting weight, how much weight did you lose, what dose of medication you're on, and did you get close to the expected weight loss? You know, if this person was 300 pounds and they were maxed out on ZetBound at this point, we would have expected 60, even 75 pounds.

And so 30 pounds at nine months where we've seen most of the weight loss, that person, I wouldn't describe them as a non-responder, I'd describe them as a poor responder. Another important point is that if you're a diabetic, like a real deal diabetic, A1C 6.5 or higher, and the higher the A1C, the truer the statement is, cut the weight loss in half.

Like whatever the numbers I gave you, you're going to lose half as much weight. So if you're 300 pounds and we predicted 60 to 75 pounds and you started with an A1C of eight, this is appropriate weight loss. ⁓ Yeah.

Zoë (15:46)
And

I think I think something important to note in this conversation too is managing expectations. I'm so glad you gave those percentages and those numbers because it can be so easy to get caught up in comparison online and you see these stories of these, you know, like you said, the before and afters and comparing yourself to the research backed predictions and those numbers you just gave.

and what's actually realistic in managing that expectation compared to what we see on what's not even potentially, you we can't even vet what's real and what's not on social media.

Matthew Weiner, MD (16:20)
Right, right, yeah. mean, for bariatric surgery, I've been giving patients at their first visit predictions of how much weight they'll lose for over 10 years.

⁓ And I found that that like, that just opens up the conversation and is so enlightening for patients to really get a sense of expectations and help some with procedure choice. And we do that with our GLP-1 med patients as well. ⁓ And especially with GLP-1 meds, there's always a cost conversation. So now it becomes cost per pound, dollar per pound, which is kind of the...

Zoë (16:57)
Interesting.

Matthew Weiner, MD (16:57)
formula we're trying to optimize. yeah, so the question is, so what if you are a non-responder? ⁓ I think, you know, I would kind of get back to Zoe and say like metabolic reset, really everything is dialed in as close as you can. In our new app, we brought Cali Ratio back and, you know, we're currently beta testing. This thing is gonna be in the app store, hopefully in a month or two. And so,

You can log your food in the Caloratio app and if you're scoring 40%, I wouldn't necessarily say you're a non-responder. I'd say maybe we can push the nutrition a little further and see what happens there. ⁓ I think another little side note about diabetics, there's more than one way to improve your blood sugar and...

besides GLP-1s and that's an incredibly good diet. You know, a metabolic reset diet, even moving a little bit more toward veganism, can get almost anybody's blood sugar under control and then your blood sugar starts to normalize and you respond to the meds from a weight loss perspective more like a non-diabetic and that's another really powerful tool that you can pull. But in all honesty,

The answer for non-responders, in my opinion, is bariatric surgery. ⁓

You know, yeah, if your BMI is in that category and you're not responding to GOP1 medications and you've maxed out the nutrition, then the top of our triangle is bariatric surgery. And, you know, we've been doing these surgeries for a long time. Our complication rate in a later episode, we're going to talk about an article that talked about a 4 % complex serious complication rate. Ours is one. We have a 1 % serious complication rate and even our serious complications.

Zoë (18:18)
That's all I was going to say.

Matthew Weiner, MD (18:48)
aren't that serious. My last leak on a primary non-revision bariatric surgery was 2017. know, Zoe, you were probably still in school then. That was the year you graduated.

Zoë (18:59)
That was the year I graduated college. Yes, yes. ⁓

Matthew Weiner, MD (19:03)
So, you know, we can do these surgeries really safely. They really are a continuum of the GLP-1 medications. They're an alternate treatment. And that, I think if you're really a non-responder in the BMI category where bariatric surgery is reasonable, that's what you should be considering.

Zoë (19:26)
Just one other thought I wanted to add on that is we also piggybacking on a comment that you made is we have to remember that the GLP ones are not, it's not a magic pill. It's not the end all be all. It's the tool to combine with the lifestyle modifications, the diet changes, and you're not going to get the best results if you're trying to rely on the tool alone. Just like for a lot of people, you don't get the best results doing the lifestyle modification alone in a certain.

you know, situation. So combining them, the two together. So I love the calorie ratio ⁓ part of the app for that and being able to really have that extra accountability of trying to beat your score and trying to hit those, that pound of vegetables in every day. There are so many really cool little resources and tools within the app to help you stay accountable to your goals.

Matthew Weiner, MD (19:58)
Yeah.

Yeah, the prescription is not the plan,

Zoë (20:22)
That's right.

Last question here. Ready, Dr. Weiner? It's one that I think you're going to enjoy to talk about.

Matthew Weiner, MD (20:27)
I'm ready.

Zoë (20:32)
is Congress and Senate going to stop taking kickbacks and fix the PBM and big pharma problem coming from TikTok?

Matthew Weiner, MD (20:38)
All right.

I mean, that, I feel like I need to do like a little joke. You're too old for this, but Johnny Carson used to do this thing where he wore like a headband of some sort and he was like a psychic and he would open an envelope and tell a joke. And my joke would be like, whenever our political system is fixed, which, you know, this is the underlying problem. But there's some good.

Zoë (20:43)
You don't know the answer?

I

Matthew Weiner, MD (21:07)
There's some good things happening here. ⁓ First of all, anybody watching UnitedHealthcare stock price? That just brings me such happiness. It's so terrible. What's the word in German like Freud and Schweiden where you take happiness in other people's pain and suffering? am getting a little bit of that with UnitedHealthcare and their stock is literally, they've lost half the value. They've been through three CEOs in the last six months.

Zoë (21:21)
Yes!

Right.

Matthew Weiner, MD (21:36)
They're under investigation for Medicare Advantage. mean, here's the scam. It's out. They own the doctors. Medicare Advantage plans are paid based on how sick a patient is. When you come to the doctor and the doctor says, you got diabetes and you got high blood pressure and you have this and all the diagnosis. We all see it in our charts, right? You see 42 different diagnoses. You're like, holy crap, I didn't realize I had that much going on. ⁓

the Optum physicians were incentivized to add as many diagnoses as they can to their Medicare Advantage patients to make them as sick as possible so that they would get paid more money from the government for the Medicare Advantage plan. And it ended up being billions of dollars that they were getting from this. And they just owned the whole pipeline and they just juiced the system.

to suck every dime they could out of the Medicare system. And now they're under indictment for that, which they should be because that's wrong and illegal. ⁓ The PBMs are also, ⁓ people are now understanding what's happening with PBMs. There's this guy, I think it's College Park Pharmacy, is anyone there, Forest Park Pharmacy? He just, went through and talked about all of the ways that Medicare is misspending money by using PBMs. And it ended up being like,

billions of dollars of waste when you look at the actual ⁓ prices of these medications ⁓ compared to what Medicare is paying for them. So we're starting to see this, people are understanding it, and we have this like early signs of recession.

And so, you there's just, you can't get blood from a stone and there's just no more money that we can continue to direct into our healthcare system. And so we have to start cutting costs. And man, our PBM's an easy place to cut cost.

because you can actually give people better access to medicines for less money just with some reasonable common sense reforms. And so all of this, we're getting some attention. We're working on our practice and if there's anybody out there listening who is somehow involved in HR and says, hey, I wish my company could cover these weight loss medications.

and they could probably do it affordably, we have figured out a way that we can get employers these medications for literally a third of the cost of when you get it through a PBM. Of course, we don't use a PBM, we don't use the traditional PBMs, but it is absolutely possible to get people access, have your employer cover these meds for 50, 100 bucks a month and have it be affordable.

this can be done and we have a way of doing that. So if you're out there, please reach out to us. We'd love to talk to you about how this can be done. But we're going to see more and more programs popping up because you can make money and provide better care. It's just there's so much opportunity in this space. because we're stuck, because there's just this zeitgeist of, hey, we've got to, we've got to act on this. All of the laws and all of the

the rules that have been paid for, that the government has been paid for, they're going to come under question. We're gonna see that there's really no appetite to prosecute them, right? Laws are only worth anything if there's a willingness to prosecute them. And I think that the likelihood that if there's some obscure law that could be interpreted in one way ⁓ that favors a pharma company, I don't think a lot of judges are gonna be leaning in that direction. Law is still governed by humans. ⁓

The answer is, the answer is as soon as we have systems in place that make sense and we have alternate opportunities. So right now if you're an employer and you want to offer healthcare, you really don't have a lot of choice besides using the big PBMs.

but you're starting to see these startups pop up. They're getting attention from venture capital. They're getting attention ⁓ from employers and these things are starting to catch wind and there is a motion afoot. Anybody interested in this stuff, check out the Free Market Medical Association. They're a really fantastic organization. I've been kind of following them for a decade or longer and they're doing some great things to really lower costs, improve quality.

Medicare, this is going to change. It really has to. And I don't know if Medicare for all is the way it's going to change. think with our current administration, it's not happening in the next three and a half years. ⁓ there's so many obstacles to that. It's not like Medicare is so cheap either. So I think that even Medicare for all doesn't fix the fundamental problems. So the answer is not this year, but

Zoë (26:44)
Mm-hmm.

Matthew Weiner, MD (26:48)
There's things happening. Pay attention. If you watch closely, you'll start seeing some things happening. We participate in a program where we directly contract with employers for bariatric surgery. This is a great program. Our patients are treated like VIPs.

It works for us financially, it works for the employer, the employers are paying half as much. Everybody's winning except the insurance company in these arrangements. ⁓ so, we're starting to see some movement. So I'm not as fatalistic as I have been. There's still a lot of crap going on, that's for sure. But ⁓ there's more and more people who are seeing it. that's, you gotta see it and you gotta label it.

And so I think this person who made this comment, see it and they labeled it. So we're there with you. Keep the faith. We're going to get there.

Zoë (27:39)
Yeah, absolutely. I just want I think that the conversation getting louder and more people talking about it. I mean, it's not like you said, it's not just going to not change.

Matthew Weiner, MD (27:52)
Yeah, think the thing that you can do is reach out to your HR company. Let them know that you know that they're misspending your funds. So when they buy health insurance, they're not buying it for you. They're buying it with your money. There's something called a RISA. And it basically means that the employer has an obligation to spend your money on your benefits, your retirement package, on all those things.

in your best interest. have to be fiscally responsible. And so when they're using PBMs, they're getting screwed, they're overpaying for insurance, they're not looking at plans, and you start complaining, they can get nervous. mean, the law is very much on your side that your employer has to spend this money in the most fiscally appropriate way for you. And so when you label it, when you put complaints into HR, and do it in a collaborative way, because they're doing it for the most part.

to lot of HR people. They're doing their best. ⁓

reaching out to them in a collaborative way, asking them about other opportunities and, you know, mentioning ERISA, it never hurts to mention ERISA because they're gonna be really sensitive to that. But, you the law favors this to some degree and we need to just bring attention so that people are getting some pressure to look at things outside the box. You know, most HR programs are very conservative.

but that's not working. We need to kind of get outside the box and come up with new ideas and partner with your employer. They want what's best for you too for the most part.

Zoë (29:36)
⁓ Well, we'll definitely keep ⁓ updating as we get updates and hopefully the conversation continues to evolve as time goes on and we'll see what happens next.

Matthew Weiner, MD (29:51)
Yep,

it's going to be interesting, that's for sure.

Zoë (29:53)
That is very, true. Well, we are excited to, you know, we've been talking about the app. Definitely keep your eyes peeled for that. You know, we'll be making announcements, but it's really, it's been really fun to be able to show our patients, use it together, you know, leverage the communities. There are just so much that we're so excited to bring this to the public about. What's your favorite part of the app, Dr. Weiner?

Matthew Weiner, MD (30:20)
I mean, there's two parts that I really, really like. I love the AI piece and I won't kind of drag this into this podcast, but in a later podcast, I kind of have a vision for how weight loss care will happen. And I think AI is a huge component of it. And I think this is kind of that first layer of like...

you can get a lot of really useful information. so even though the AI is good and honestly, keep I ask a question. I'm like, huh, that's pretty good. ⁓ But it's going to get so much better quickly.

⁓ The things that we have planned for this app, I think are really, really exciting. So that just the techie in me and just the optimal healthcare delivery. How can I deliver the most good for the most number of people in the least expensive way that just kind of, you know, that you, know me, Zoe, I kind of, I'm always making sure we're as optimal as possible. ⁓ I love that component, but the other piece I really like, and I'm really excited about is the communities because people feel like they're the only one.

Zoë (31:23)
Yeah.

Matthew Weiner, MD (31:25)
Every time I talk to somebody it's like, it's like in everybody else they got it going on and I can't do this and it's so, there's something wrong with me and our communities bring people together who have the same problems who are facing the same challenges and man is that

Zoë (31:46)
Good stuff on the horizon here, Dr. Weiner. Pound of Cure, we're doing it. Yeah.

Matthew Weiner, MD (31:50)
We're doing it. Yeah, follow us on social

media. That's where most of the announcements for the app will come. Yeah.

Zoë (31:56)
Absolutely.

All right. Well, we'll see you on social media and we'll catch you in the next episode.

Matthew Weiner, MD (32:02)
Absolutely. Bye. Bye