Weight Loss Drugs Work… But At What Cost?

Episode 114

1.6 million people in England are using GLP-1 weight loss injections, and most are paying privately. That single fact changes the whole conversation, because it raises the stakes around screening, fake supplies, side effects, and what happens when people take a powerful medication without the nutrition, exercise, and psychological support that should come with it.

We share what we learned at a healthy weight loss conference, including the NHS-style three-part approach to prescribing, common contraindications (from thyroid history to pregnancy planning and gallbladder or pancreatic issues), and the day-to-day reality of symptoms like nausea, fatigue and digestive upset. We also talk honestly about diet culture and the return of the “super skinny” ideal, and why that pressure can make people accept risks they would never take in any other area of health.

Then we get into the part that rarely makes headlines: muscle and bone. If a big chunk of weight loss is actually lean mass, and if people regain fat more easily than they rebuild strength, the scale can go down while long-term metabolic health goes backwards. We break down why protein (often at least 1.2 g per kg), whole foods, supplements when needed, and resistance training are non-negotiables, especially for women as we age. We also share Dr David Unwin’s take on hunger, why willpower-based dieting fails, and why sugar and refined carbs can behave like an addictive substance for some people, plus how trackers and CGMs can help or mislead.

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Transcript

Welcome Back And Life Updates

SPEAKER_02 0:24

Welcome to Far Too Fabulous. Julie and Catherine. Join us on a mission to embrace your fabulousness and reading find outness. Get ready for some crustiness, inspiration, candy chat, and humour as we journey together towards empowered wellbeing. Let's dive in. Hello, hello, and welcome to the Far Too Fabulous podcast.

SPEAKER_01 0:47

I feel a little bit rusty, because it's been a while. I was a little bit nervous. I was like, I don't know what to do. I can kind of remember how to talk. Oh, yes, look, it's a magic thing, I can do it.

SPEAKER_00 1:00

You can have a conversation with someone else rather than me talking to myself and you talking to yourself.

SPEAKER_01 1:05

Yeah, under a blanket.

SPEAKER_00 1:09

I've got one of those microphones. When I do the one on my own, it's different to the one we use, and it's one of those like with the mesh thing in front, so it all feels very professional, but I have to talk really close to it. So I feel like I literally don't move for the whole time I'm talking.

SPEAKER_01 1:24

Nose up against the mesh.

SPEAKER_00 1:26

Yeah, yeah, it's really weird. I love it. How have you been? You alright? We've just finally been back together. I know, I know, and it does seem a long time, even though it's not really that long, is it?

SPEAKER_02 1:37

It's not been that long, but no, I mean normally we get together every other week, don't we? So it's been it's probably been a month.

SPEAKER_00 1:44

Yeah, it probably has. I've seen you at choir though.

SPEAKER_02 1:47

Yes, yeah, yeah. Singing away, waving away, doing there's bits, isn't it? There's always bits where I know that you'll be enjoying it and I turn around and look at it. Yeah, you do, yeah, you do.

SPEAKER_00 1:58

Yeah, I like those moments. It's cute.

SPEAKER_02 2:00

I do, I do. I'm looking forward to. We've got um yeah, we've got concerts and all sorts coming up, and we get to sing with with the choir from Belgium as well. It's gonna be it's gonna be fun. More of us making noise.

SPEAKER_00 2:14

Yep, yep. And bringing the joy.

SPEAKER_02 2:16

Yes, oh, I can't wait.

A Conference On Healthy Weight Loss

SPEAKER_00 2:18

I can't wait.

SPEAKER_02 2:21

So, what have you been up to? Well, funny you should have.

SPEAKER_00 2:25

What is such a good lead in? Sahara while you were doing that Sahara Desert thing. Might you are. I was attending a conference for healthy weight loss. Well, stop living the dream. Living the dream.

SPEAKER_01 2:38

I mean, if I'd known, I'd have totally cancelled the Sahara.

SPEAKER_00 2:43

But it was really, really good. And I know that I've been talking to you about it, and I thought we should just talk about it on the microphone because I think it's got some really good information for people.

SPEAKER_02 2:55

Uh yeah, I think so. Tell so tell us what it was what it was about, and then we will we'll dig into it.

GLP-1 Boom And A Risky Market

SPEAKER_00 3:01

Yeah, so it was run by my governing body, which is called Bant, and they had different speakers, whether it was someone coming at it from a naturopathic nutrition perspective versus a doctor, there was quite a nice mix. There was a psychology side, so it was really interesting and very relevant. So the first speaker was talking about the weight loss medications, injections, the GLPs. Yeah, and she started off by saying that last year in May 2025, there were one million active users of the drug in England. Yeah, so not even in England, yeah, just in England, and then at the time of the conference, which was in March, there were 1.6 million people.

SPEAKER_02 3:51

Yeah, massive, massive uptake. Yeah. And didn't you you said that 95% of those were privately funded?

SPEAKER_00 4:02

Yeah, yeah. So only 5%. The the availability through the doctor apparently is that they haven't got loads of availability because especially because they have quite strict guidelines as to who can use it. Yeah. So 95% of those 1.6 million people had sourced the drug privately, and there's a big problem with fake versions of it as well. And she did say that people need to be really careful about where they obtain this from.

SPEAKER_02 4:31

It's really interesting, isn't it? And I think that we're gonna we can dig into this a little bit later, but that people want the results that these drugs promise so badly that they are willing to take an injection that's already been made up, that's in a you know, in an IKEA, a ziploc bag that's not got any labelling on it, they're willing to take that risk to get the results that they they've been promised. And it it's really it's really incredible. It it blows my mind. I don't and I mean and not in a like there is there is zero judgment about this because I d I you know I understand how kind of weight loss is sold and how it's so huge in our society and that it is so important to somebody that they would they would risk so much to get it.

SPEAKER_00 5:30

Exactly. And I was watching the not the Oscars, what's the other one? I think the Oscars is coming up, or is the Oscars been? Oscars may have just been. Yeah. I think it was what what the Grammys or the whatever it was, and I was looking at the red carpet where they come in and everything, and something I noticed was that the women are getting smaller. Yeah. Again, again, and the men are getting bigger, like the men are taking up all the space because they're big and they've got all the muscles and everything, yeah, and the women are expected to be these tiny, skinny, lollipop head situation again. What the hell is going on?

SPEAKER_02 6:14

And it's it seems I don't think I appreciated that it got better, it got more normal on the on the red carpet. They were they were looking a bit like the average population, and now it's gone the other way again. It's gone the other way again, and that the super skinny is suddenly very, very fashionable again.

SPEAKER_00 6:35

Yeah, and I know that these weight loss medications originally became popular in America because of the Hollywood scenario, wasn't it? Yeah, that they were using these drugs and getting the weight loss, and and that in terms of what we're what's being promoted to us all the time is that skinny is equals best. Is best.

SPEAKER_02 6:59

Yeah, and that's interesting, isn't it? Because I imagine in like Hollywood and movies and things where they've got enough money to be able to to take these things without thinking too much about it, and maybe for short bursts of time, they can just like use it. I'm not even sure what the what the word is, but they can just use it for those moments of time where they're gonna be seen or they're promoting a movie and things like that, and it's very unrealistic then for everybody else that's watching them.

SPEAKER_00 7:32

Yeah, but I mean, when when I was at this conference, they were talking about the that obesity in the Western world or in the modern world is is a massive, massive problem. Yeah, and in the UK, one in four children are classified as obese at the age of 10. That blows me away, and one in three adults now classified as obese, so that's a BMI of over 30.

SPEAKER_02 8:00

Yeah.

SPEAKER_00 8:00

Although they did also talk about the fact that the BMI is flawed, and we know that we don't like the BMI, but that's the category that they use or the classification.

SPEAKER_02 8:09

And I think probably for the general public, I think the BMI is as long as it's taken with a pinch of salt, is is okay. I think it's when you're talking about people that lift weights in general, it doesn't, it then it starts like people that are fit, it doesn't start to to work. Um, and I I do know, I have seen apparently that the since the introduction of the injections, the percentage of obesity is going down, and again, this is something we're gonna go into, it's not gonna be without its complications. Are we kind of like jumping from the fire pan into the fire? I d I don't know, but it's it's having an impact, and oh I mean, I don't know, but that's it's such a huge number. One in one in three, and and again, I'm gonna just I I'm not gonna apologise for keep saying this. We are not coming at this with any judgment because it's a lot of the time it's not our fault because of all of the like ultra-processed foods, all of the advertising, all of the way that society is set up. We're gonna kind of we're gonna dig into to lots of the way like that our days are set up that are not conducive to being fit and healthy.

How Doctors Prescribe Them Safely

SPEAKER_00 9:28

No, no. I mean, this this particular first speaker was a GP, yeah, and she said that she is only prescribing these medications with um three things in place. Yeah. So through the NHS, the doctors are supposed to follow this three-tier system, it's got a name, um, which I have written in my notes, but I can't read my own writing.

unknown 9:54

I love that.

SPEAKER_00 9:55

But it was medical management, so that was the drug, yeah, nutritional and physical activity and support was needed, and psychological support. If you didn't have those three in place, then that medication wasn't prescribed. And then the aim was to achieve 5% weight loss in 12 months. So if you if you achieve 5% weight loss over 12 months and you had those three things in place, then the outcome was much better. If you were one of the 95% that sourced it privately and didn't have that support, or maybe there are there are some places that private doctors or whatever that do offer that support, but the weight regain coming off the drug was wor it put you in a worse situation, you had less bone density, less muscle mass, worse metabolic health, and you regained all the weight and more.

SPEAKER_02 10:51

Yes, and it's and that you're then regaining the body fat, you're not regaining the muscle mass, you're not regaining the bone density, so that's why you've ended up in a worse state than than you were in the first place. And again, this is all driven by that top number, by as you so beautifully put it, your relationship to gravity.

SPEAKER_00 11:16

Yeah, your relationship to gravity. Yeah, yeah. The other thing that I thought was interesting was the contraindications. So there were out of the people sourcing it privately, there wasn't any check on whether they had a history of thyroid disease or thyroid issues because you can't, you have to be careful with these drugs with that. Yeah, if you were diabetic, if you were looking to get pregnant, there was quite a big discussion around the fact that before you get pregnant, you need to be in a really good nutritional way. You know, you need to be your body needs to be ready and taking these drugs before getting pregnant because when you lose weight, you increase your fertility, it also these drugs impact the efficacy of contraception and HRT that people were getting pregnant when they didn't mean to, and they were nutritionally deficient, yes, the impact on the pregnancy. So it was that that was talked about, and then if you had gallstones or no gallbladder, anything to do with the gallbladder, gastric issues and pancreatic issues, this was massive with red flag with um fast fat loss, yeah, is huge, isn't it?

SPEAKER_02 12:34

It kicks all sorts of complications off with pancreas and the and the gallbladder and things like that. Yeah, yeah. I think that that's really interesting. And do if you remember, I know you've listened to this podcast with Dr. Chatterjee and Dr. Unwendy. Yes, and he was talking about when doctors prescribe things that they don't give the full like ins and outs, the full contraindications, all of that. All the symptoms and things like that, yeah. They don't give them all of that, and what was he was talking about, these specifically, was saying that at the time of recording there'd been like 80 odd deaths directly related to these injections, and that nobody ever speaks about those. No, which initially I think is is interesting anyway, and what I also think is interesting is that if people did speak about those, I think that people would still choose to take them.

SPEAKER_00 13:33

Yeah, and that's pretty much what they said as well, that that would be the case, and even with the side effects being constant nausea, yeah, even being sick, actually sick, diarrhea, yeah, or swinging between diarrhea and constipation, yeah, headaches, abdominal pain, fatigue.

SPEAKER_02 13:53

And you get these straight after you've taken them, and then they gently wear off through the week, and then you have a injection, and then off you go again. Yeah.

SPEAKER_00 14:02

Yeah. So they did actually say that compliance to taking the drug was also a problem in those people that suffered the most severe symptoms, yeah, and they've got no help for that because of the mechanism of that drug. If you're somebody that's going to be symptomatic, there's not a lot that they can do about it.

SPEAKER_02 14:21

It's also the licensing, isn't it, with the with the drug, because it's licensed to continue to go up, and there isn't any like ver variation on that. You just have to, that's how it is prescribed, and you have to follow it. And so if you are on a a certain level of drug and you maybe you've not got used to it, or you don't need to go up, maybe it's working, like you're you're getting the right amount of fat loss, weight loss that you need to for it to be beneficial to you. But the prescription says, right, this week you've got to go, you've got to double it, for instance. I'm not sure exactly what the doses are, and you don't need to do that. That is where the all these symptoms come in, all these gastric symptoms, all this sickness, when you don't need to be taking that much, but that's just the way that the prescription is set up. And I don't know whether that's due to lack of research, I don't know if it's due to making money, I don't I don't know what it is about, but I know that that makes it really difficult for people to take.

SPEAKER_00 15:28

Yeah, yeah. One of the positive side of taking the drug was the fact that because it blunts the dopamine pathways, there was lower reward-seeking behaviour, which goes into that food noise cravings, but also there was a knock-on effect on alcohol, addiction, smoking, gambling, uh, shopping, uh, what even watching Netflix, that kind of thing. They'd noticed in the studies that that that had actually decreased.

SPEAKER_02 15:56

Yeah, which is which is incredible. I mean, that's fantastic that there is something like that. I think on the flip side, I know I've spoken to people who have um like not known, they've gone to dinner with a friend, and she'd not known that she'd been taking the injections, and she was like, you know, there's something really like different about her, something really off, and she was just like just level, just monotone, and and she'd found out later that that that's what it was, and so it doesn't just stick to food noise or cigarettes or Netflix, it's everything, it just sort of dampens everything down. So it's yeah, it's a real I think it's a it's a real balancing act with it. What I love, and I should have said this right at the beginning, is that the way that your governing body are so proactive with this, and I know that they've had to have been, but I think that the knee-jerk reaction from a group of nutritional therapists is just like no, like, yeah, no, don't do that. No, it's this is a ridiculous idea, no, and obviously that that answer's no good for anybody, no, so the fact that they have got themselves informed, they're making sure that everybody else is informed, and it's a very holistic approach, it's a very knowledgeable approach, it's a very non-judgmental approach. I just I just applaud them. I really I just I don't know, I just I love the response of it really, because I mean I know that that like obesity is such a huge, huge problem in society, in like financially in the NHS and all that sort of stuff, but right down on a deep, deep personal level for people, it is just a it's a lifelong battle for some people, and so this drug feels like the holy grail, yeah. And so, and so also to then find out that it comes with all sorts of all horrible side effects, and maybe it doesn't it isn't really this shining amazing thing, but there are ways that it could be, yeah, and that was definitely the message was that it's not an absolute no for some of these people, but it was you will not achieve the long-term weight loss if diet, lifestyle, psychological, physical habits have not been changed and and better habits formed.

Food Noise, Habits, And Regain

SPEAKER_00 18:19

Yeah, that was the message, and then putting in the support to counter the fact that calories are low, so you've gotta when you do eat, that's gotta be really high in nutrition. Yeah, you need to use supplements. In fact, even the doctor recognized that you couldn't do this without supplements, which I thought nearly fell off my chair. You had to have protein, yeah, it was really, really important, and whole foods, and then alongside that it was about the behaviour change, the relationship with food, the psychological factors, and it was all about the habits. You've got to change the habit, otherwise, you come off this drug, and you're gonna, if you've not done any of that, you're gonna be in a worse situation than you were before, yeah, and you will just bounce back.

SPEAKER_02 19:05

And I think you said 75% of people that come off it completely put all of the weight back on and more. I think that was the yeah, that is right.

SPEAKER_00 19:16

Yeah, so 95% of people within one to two years of stopping the medications.

SPEAKER_02 19:20

And I've actually heard that within five years it's almost a hundred if they don't take any medications and even some people that have that have adopted the lifestyle changes. Um, and so I don't know whether I don't know whether there's maintenance doses and things like that that that happen along with it. Um I wondered, did they speak about you know you're talking about that it shuts off the the food noise? And then so for somebody that is gonna get my bunny ears out doing it properly, that they've they've got the nutritional support, they've got the psychological support, they're doing the exercise and all of that sort of stuff. That when they um either reduce or come off it at at the end, whenever they've reached whatever their target is, does the food noise start again or have they created habits that it's that it's gone?

SPEAKER_00 20:19

That's a really good question, and it did come up. So the simple answer to that question is yes, the food noise does come back when you stop that drug, but because you've put these new habits and behaviours in place, you've got an awareness as to why that food noise is there, yeah, and then you use something else to the point that your your brain gets bored of the fact that it keeps going on about food and you're ignoring it.

SPEAKER_02 20:46

Yeah.

SPEAKER_00 20:46

So it's about those new neuro pathways, isn't it?

SPEAKER_02 20:49

Yeah, yeah, absolutely. Because I mean I know like uh when I'm due on and I just want to eat everything. Everything. I mean, to the point I could literally kill somebody. I'm just like, I'm I can't get enough food. I was like this the other day and I'm I'm an I'm annoying myself. I'm like I've and I've drunk loads of water and I'm trying not to be bored or you know, I've tried to exercise all of this stuff, but I'm a I'm aware of why it's happening, especially you know, and if I am bored, I know why I'm gonna go rummage through the through the cupboards. Um, but I also know that a day or so will pass and I won't feel like that again. And it must be really, I don't know, maybe the words frustrating, to come off it and then have that noise back again and think, oh my god, I've got to keep dealing with it. But like you say, I guess the more that you do it, the more it works, the less you'll have that that noise.

SPEAKER_00 21:46

Yeah, and don't forget that if somebody's had the psychological support, so they've found the underlying reasons why they've got all that food noise and the overeating or the comfort eating or whatever it is, yeah, you would have done some work on that anyway. Yeah, yeah.

SPEAKER_02 22:03

Really, I mean fantastic. And if it's part of that journey, if it's just another tool that you get to use, it's a it's an overall healing journey. If you've gone through the reasons that you're overeating and kind of really dug into that, it will just help the whole of your life.

SPEAKER_00 22:19

Yeah. The cost of these drugs, I don't know if you're aware of. Cost of these drugs, but I was not, and I was so shocked. So the average cost was five thousand pounds a year.

SPEAKER_02 22:31

No, that's that's crazy, and that's the average cost. I imagine that yeah, that it's a lot more for some people. Yeah, because I think they've also relatively recently gone up, which I find really harsh because I mean if somebody's on it and it's working, and that you know they might be stretched to financial capacity as it is, and then the company's just put the price up again. Like, what do you do?

SPEAKER_00 22:56

Yeah, you have to just find the money for it, won't you? Because you'll need to take them. So, but I think it was it was totally recognised that these drugs do not fix the root cause of obesity, and I thought that was a really important message. And the other thing that was uh interesting was that the actual amount of loss of of lean mass in these people was 46% of their weight loss was lean muscle mass. And if you lost over a pound a week, then you were into you're now losing muscle mass and bone density.

SPEAKER_02 23:31

Yeah. Yeah, which is interesting because I mean, like they're I imagine they'd hold up it as a success if you were losing more than a pound a week, and so actually it's not the body fat you're losing. And I'm and maybe I'm gonna grossly generalize here, but people that are using these drugs are going to be the women that are using these drugs, are going to be of a certain age where their muscle mass is already reducing, like anything from like sort of 30-35 upwards, your muscle mass is already reducing unless you are doing seriously active things about keeping it, and so when you're reducing your calorie intake, potentially your protein intake, easily the protein intake's gonna go down, and you're not actively working at keeping your muscle and then you're stripping it away, you're in you're in a you're just in a lot of danger there.

SPEAKER_01 24:29

I just turned into you, didn't I?

SPEAKER_00 24:32

I just lost my words.

SPEAKER_02 24:33

This is where we need to do video so that you can see the facial expressions that go on as I splutter over my words because I mean it's I and the more that I learn about sort of what our body is going through as we're getting older, just on a normal day-to-day basis, and if we do nothing about it, that we are literally we're not staying still, we are slipping backwards. So adding this this extra thing and it not being managed, it not being like you're not helped with it, is really yeah, it's dangerous and it's it's worrying.

SPEAKER_00 25:08

Yeah, it is. One of the other things that they mentioned was the amount of protein that you actually need to compensate for this loss of muscle mass. Think about we usually say between one and two grams per kilogram of body weight if you're active. Yeah, well, even if you weren't active, which most a lot of people weren't on these drugs, yeah, they needed a minimum of 1.2 grams per kilogram of body weight. Yeah, that's a bare minimum, yeah. And if you look how much of that, if you were to put that out on someone's table and say, this is what you need to eat, yeah, and then put that together with I feel sick, I am being sick, I'm nauseous, my tummy hurts. I don't want I don't want that amount of food. Yeah.

SPEAKER_02 25:53

Yeah, then you're gonna still like it.

SPEAKER_00 25:55

Yeah, then you're gonna struggle anyway. So there was a mismatch there of what you need to do to support yourself while you're on the drugs versus these symptoms coming in and and being problematic.

SPEAKER_02 26:06

Well, I imagine that the if your calories are that low, your energy is pretty low.

SPEAKER_00 26:12

Energy's really affected, yeah.

SPEAKER_02 26:14

You're not gonna feel like pumping iron, are you?

SPEAKER_00 26:17

No, no. So that was just the first speaker from us. What?

SPEAKER_02 26:23

Yeah, and then we had Well, it's only another 425 speakers to go settle in, people.

Dr Unwin On Hunger And Sugar

SPEAKER_00 26:31

We will not spend that much time on the other speakers. But the next speaker was Dr. Unwin. Oh, Dr. Unwin was there, and I I really, if you've not seen him speak or listened to him, he's so down to work, he's absolutely brilliant. And his wife is a psychologist as well, and so good team, yeah. Really, really good team. She's written um a really good book, but anyway, he was saying that I want to know why do the people overeat in the first place, and I think that's a question that you've got to ask of yourself as well, and and and be honest. And then he was saying diets will make you hungry, and then you will have to use your willpower, and then the only option is failure, yeah, and it is true. So, weight loss is about controlling hunger, is how we put it, and it's so true, isn't it? Yeah, the drugs take the hunger away, which is why they work, which is why they work, yeah. But obviously, you've got all these other things, which is hilarious, isn't it?

SPEAKER_02 27:28

Because the traditional diet, you reduce your calories, and then you're hungry, and it doesn't control your hunger, it it increases it, yeah. And then, yeah, and then you rely on willpower, which you all know my saying is it's bullshit. Um, yeah, and no, absolutely right, and you're just setting yourself up for failure. Oh, it's miserable, isn't it?

SPEAKER_00 27:48

Good god, it yeah, it it can be, but yeah, hungry plus stress. If you put I'm hungry and I'm stressed in there, yeah, that equals diet failure. Hell yeah. Yeah, so it was just interesting. His take on it. He works a lot with type 2 diabetes, yeah. So his focus was on that. But what was interesting was that he said that in his clinic he achieves um weight loss at three years, so he's looking at the longer term. So again, it's not drop a dress size in two weeks to go on holiday approach. Yeah, he's looking at, and he kept saying real world, real world is if you want to lose weight, he's looking at a three-year, yeah, three three years for these people, and you're looking at a 10% overall drop in in weight over three years, and that is drug-free. That's what he was like, that is drug free, whereas you could achieve five percent weight loss in a year on the drugs, but he said there are people that could lose 15% of their weight on the drugs in a year, and then he went through how dangerous that is as well.

SPEAKER_02 28:58

Yeah, no, that is and he is he because he's been through this as well, like his initial story was him as a GP having to nap halfway through his um like clinic time and having tea and biscuits and snacks and coffee and caffeine to keep him going through the day. And thinking, I think at 55, he was considering, oh my god, I'm gonna have to retire because I am so like low in energy and I feel so old and so decrepit that I can't possibly do my job, and then it wasn't until he was then diagnosed with a type 2 diabetes that it kind of shook him into action, and then that has changed everything for him, which is yeah, it's incredible. And I love that he's doing that over three years because I think that the the lots of the messaging around um like diabetes is that you do these short, sharp, maybe very intense diets for want of a better word, um, like treatment plans, shall we shall we say, with food. And so, and that might might not feel realistic for some people, whereas you know, you're thinking, okay, all right, this is a lifestyle change, I don't have to do it in the next six months or so. I'm gonna just keep kind of plodding along with this.

SPEAKER_00 30:21

Yeah, yeah, exactly. It is a lifestyle change, and I think that with the word diet, we we associate that with having an end date, yeah, but it is a lifestyle change, and then one of the other things he said that made me laugh, and it and it's so true, he said that if you want to lose weight, really it's about controlling sugar, your addiction to sugar. And you were talking to me before we come on the recording about bread, yeah, and we'd probably talk about that at some point, but he was saying that if I gave you protein to eat, you would not be able to keep eating protein, no, you'd have you'd need to stop fit at a reasonable time. Yeah, if I gave you fat, you'd have the same issue. If I gave you a block of butter, eat this butter, yeah, you would get to a point where pretty quickly you couldn't eat, you couldn't drink olive oil, could you all of those things? But he said, if I gave you a sugar, you could quite easily, if I gave you sweets or honey, even, or he's saying you could easily just keep eating that, and that's the problem. The sugar was the problem. So he said a loaf of bread, a massive bowl of of white pasta, yeah, you could keep going, you could keep going.

SPEAKER_02 31:36

It kind of fuels itself, doesn't it?

SPEAKER_00 31:38

Because the you get all that hit of like sugar and dopamine and you just keep going. Exactly. And some people really do not have an off switch for that. So he said, I don't have an off switch. It's not the fat. So it's not the fat and it's not the protein, it's the sugar. And he said, You need to treat sugar like an addictive substance. Yes, and you can't you wouldn't say to someone who wants to give up smoking, um, just have 10 or week or alcohol. If you've got an addiction, you have to go for total abstinence. Yeah, and he said, That is what you have to do on sugar, and your body will get really annoyed with you, it will try every trick it's got to get you to have that sugar, it will give you headaches, yeah, it will disrupt your sleep, it will make you moody, yeah, all of these things. But once you got past that, just like coming off a drug, yeah, like or alcohol, whatever it is, then once you got past that, then you can you can do it a lot easier.

SPEAKER_02 32:40

Yeah, that was my thoughts actually on the on the injections and the food noise. Like once you had got, so if you've used the injections to kind of almost get past that, those cravings of all of the all of the things that your body like would really, really like, but are absolutely no good for it. Once you got past that, yeah, those noises start to dampen down.

SPEAKER_00 33:03

Yeah, and that's where they were saying that that the drug could be used in a positive way if you're working on those other other things. Yeah, it was it was really interesting. So that was that was Dr. Anwin's kind of take on it, and obviously went into a lot more detail, and he's got a lot of case studies there, but I did like that that approach on the first doctor was this is how I'm using the weight loss medications, but you have to do this alongside it. He was I'm taking a drug-free approach, yeah.

SPEAKER_02 33:34

And he was really, he was really serious about that. And I think it was yeah, it was him that had advocated letting people really know everything about these drugs, like like metformin for the type 2 diabetes is just the the crappiest thing to have to take if you really have to take it. And so letting somebody know that there is a there is another way, and it's very rare for a GP, I have to say, really rare, and I appreciate that a lot of the time it's because they don't they don't have the time to support these people, it's much, much quicker to give them a prescription. The people coming into the office to see the doctor are expecting a prescription, yeah, and so the conversation around I could give a prescription or there's this that we could do and the support that it involves is much longer, it's a much lengthier process, and so I do understand why that's not the norm.

Trackers, CGMs, And Better Feedback

SPEAKER_00 34:33

Yeah, this doctor's approach was when you went in to see if you met the criteria, you had to have the appointment with the nutritionist, yeah, an appointment with the psycho psychologist, and before you got given your prescription. Amazing, yeah, and that should be the way. Yeah, I agree. Yeah. So the next speaker was all about teaching people how to eat for the rest of their lives. Wow. Which is what my job is. Yeah, yeah.

SPEAKER_02 35:04

But it's but nobody no that's not true. Not nobody, because I eat for my life and I'm constantly trying to tweak it and improve it for me. And I don't think anyone can specifically like you could do that for me, but lots of people you need to like really impact.

SPEAKER_00 35:22

I could tell you, but you've got to then actually do it, and that's half the problem, yeah, is I could tell people until I'm blue in the face, but at the end of the day, you have to do it within the constraints of your life, yeah, yeah, yeah, and to and tweak things and use what works and discard what what doesn't work.

SPEAKER_02 35:38

But I think generally people diet, and this is where my my kind of prickle happens with that word, is because they do it just for a holiday, just for a wedding, just for uh, I don't know, maybe maybe even if you are sort of fit and active, maybe you're doing it for an event or something like that. You're like eating well to train for the marathon or trek across the Sahara or something like that. Is that what you were doing? Yes, um, and then it stops, and then you go back to your default, and the default is much easier, but the ultra-processed food is part of that default because it's much easier, yeah.

SPEAKER_00 36:15

Yeah, it is, so it becomes you it's focusing on those habits and changing the behaviours again, isn't it? But one of the things that this particular lady said, so she was a nutritionist trained in the same way as me, this lady, and she was saying that what you must do is consider the long-term outcome of your short-term success. So if you in if you take these drugs and you have weight loss in the short term, you can't ignore the long-term outcomes, yeah, because that is actually the most important, yeah.

SPEAKER_02 36:51

And that's but the trouble is you're working with humans, and and we don't tend to think about the long-term things, we tend to think about the things that are right in front of our noses, don't we? Yeah, we and it's and more and more now we want the results yesterday, yeah, yeah.

SPEAKER_00 37:09

And there was again this theme about people not even caring about the side effects, they just want to see the weight coming off, and they didn't even care if the weight was coming off through the bones and the lean muscle mass, as long as the scale was going down, then then they were happy, yeah, which is really sad, but you can also understand it, yeah. 100% can understand that. Yeah, and there was a desperation around it, they there was a desperation, and they would do anything. One of the things that was also raised at this conference, which I hadn't really thought about, but is very relevant because I do use these with clients, is trackers. So trackers were interesting because they tend to underestimate and overestimate in the wrong areas, so they would overestimate the amount of calories that you would burn doing a workout. Okay, so when you're talking about trackers, you mean like my fitness pal or no or those sorts of things, yeah, or even like your the ones you wear on your wrist, any any tracker was pretty much had a 20% variation rate one way or another.

SPEAKER_02 38:20

Yeah. Okay.

SPEAKER_00 38:21

Yeah, so I found it interesting that on the food ones, for example, like my fitness pal, they would underestimate the calories by 20%, and then your wrist tracker would overestimate the amount of calories that you would burn doing a workout.

SPEAKER_03 38:39

Yeah.

SPEAKER_00 38:40

So there was a mismatch there again on what you think you're you're consuming versus what you are, yeah. Whether you think you're in calorie deficit and maybe you're not, if that's what you're aiming to do, although we don't necessarily advise that.

SPEAKER_03 38:54

Yeah.

SPEAKER_00 38:54

But it was interesting that those trackers do that, but then other trackers could be really beneficial, like the CGM had a definite positive relationship with food outcome because you could see in real time what is doing to you when you when you eat things, when you're stressed, if you haven't slept, you can see it directly. So I thought that was quite interesting.

SPEAKER_02 39:19

And I think but when you're talking about doing these things for life for longevity, I think perhaps taking the tracker's information with a pinch of salt and being able to see it happen like in your body, so you're doing something, whatever you've tweaked or whatever you're you're doing to progress your diet, as in you know what you're eating from day to day, and and then seeing if it works, like giving it a month and seeing it. So if you're and and again, we've we've talked about this, and I think we'll probably talk about this a lot more in in episodes coming up, is deciding what you're working towards. So is it is it fat loss that you're working towards? Is it muscle mass that you are looking to build? Hopefully, you know, that's that's the one you're yeah, that's the one you're kind of really focusing on. Um is it yeah, is it strength training? What is it your your training for? And then making those adjustments, using the track as as a as a rough guide, and then but then seeing if that's working in your body, seeing if your energy is picking up, seeing if you're not falling asleep after lunch, those sorts of things are really what you need to be looking out for, and so just using, I guess, yeah, just really using these loosely and not as the uh as the holy grail.

SPEAKER_00 40:49

Yeah, exactly. I think the the two main non-negotiables were exercise and protein, yeah. So those were the two absolute non-negotiables.

SPEAKER_02 41:03

Did you hear that vitality rooms, ladies? I didn't pay her, yeah.

SPEAKER_00 41:10

It was it was a massive focus on exercise and the type of exercise as well. So that um resistance type training where you are building muscle, but protein was really important, and we did look at foods that are the natural GLPs as well, yeah. Um, which protein is one of them. Yep. So protein, there's an amino acid in protein that directly impacts um the GLPs, but then looking at people's eating habits, what time are they eating? A lot of the they um showed us some stats that that 50% of people eat, or the average person eats 50% of their calories after five o'clock.

SPEAKER_02 41:54

Yeah.

SPEAKER_00 41:55

And it should be front loaded at breakfast and lunch.

SPEAKER_02 41:58

Yeah, yeah. And it's interesting because I mean I think I think we know this. Like, I think we know to eat like a eat like a king or eat breakfast like a king and and down to dinner like a pauper. But our society is just not set up for that, is it? Like we in the morning it's like bonkers when we're just grabbing anything, if anything at all, in the morning to just shove in our faces while you're doing school runs or getting out for work at nine o'clock in the morning, um, or getting through rush hour, all that sort of stuff, and the stress, and then yeah, then you're at lunch, and then maybe you don't take lunch if you're out. There's this whole, I don't know, this whole thing about working through and powering through, isn't there? And then you get home, yeah, like dinner time, starving, yeah, cram a load of stuff in your face, and then you're like, I haven't actually had anything decent to eat, so then you have a dinner as well, on top of that. Yeah, and it's it's oh the whole society is not actually set up for us to be well.

SPEAKER_00 43:01

Yeah, you are right. I think I spend a lot of time looking at people's food diaries, don't I? And a lot of people I see their evening meal is actually pretty good, yes, it's fairly healthy, and I bet they're going, but Julie, I'm eating really well. Yeah, look, and sometimes breakfast can be okay, it normally needs a bit of tweaking, yeah. But in between breakfast and dinner, it's all gone out the window. The lunch is often I didn't know what to have for lunch, I just relied on a sandwich, or I had a packet of crisps, oh, I was hungry in the afternoon I had some biscuits, and you see that snacking come in. Yeah, but actually, if we were looking, what are the main foundations for losing weight? It was make sure that those three meals are well constructed, you're not snacking in between, you're drinking plenty of water, you've got that overnight fast of 12 hours, maximum 14, because once we get past that as women, it starts to have other effects. Moving our bodies. Like if you're doing all of those things, the likelihood is that you will lose weight. Pulsion size was a big one. Yeah, you will lose weight, or you're or you're you've got healthy habits. But how many people look at those things before they go for the quick fix?

SPEAKER_02 44:20

Yeah. And then when you're doing those things, I mean they're just not glamorous, are they?

SPEAKER_01 44:25

There is no sex appeal to, you know, front loading your protein or making sure you drink all your water.

SPEAKER_02 44:36

And it's I I get it, it's boring doing it day in, day out, day in, day out. And I think that this is a barrier to long, again, quote unquote, diets, whereas people like the fact that there's there's almost like an end to it. Like I only have to give up all the foods I like just for this short amount of time. Do you know what I mean? Whereas I think probably somebody's thinking, oh my god, what I have to give up this sugary goodness forever. And I mean nobody is saying that. And once you have taken it out of your diet for a certain amount of time, it doesn't have that grip on you anymore. You don't have the same cravings for it as you do right at the beginning, it loses its appeal.

Metabolic Health Matters More Than Scales

SPEAKER_00 45:28

Yeah, yeah, it really does. So, I mean, I could go on and on, there was loads of speakers, it was an amazing conference, but the the message at the end was really for for us as being practitioners attending the the conference was if weight loss leaves our client metabolically weaker, yes, that is a failure regardless of the number on the scales. Amen. And that is what's happening with the weight loss drugs. A lot of the time you've achieved the weight loss at what cost if you haven't done those other things to support yourself, yeah, then you're worse off. Does the number on the scale at that point actually matter going forward in your life? That's really interesting, isn't it?

SPEAKER_02 46:13

And it's the it's the metabolic health and and all the things that go with that, whether you're obese or whether you've gone through this journey, yeah, will determine your risk of cardiovascular disease, uh, Alzheimer's, all of these things, even cancer.

SPEAKER_00 46:31

So, yeah, metabolically, you do not want to be weaker. So that was the the message to us as practitioners is if you're helping support your clients, you do not want to achieve the number on the scales, but leave that person metabolic metabolically weaker.

unknown 46:50

Yeah.

SPEAKER_00 46:50

But there is from the fur from the first speaker and going through the the day, there is a place for the weight loss medications, but you cannot achieve the outcome that you're really looking for unless you do it alongside the nutrition, the psychology, and the exercise. That was the main message.

SPEAKER_02 47:11

Yeah, that's that's totally I can literally feel that landed in my chest about these people being metabolically weaker when it is like health-wise, that is the main thing that you want to improve for somebody that's obese.

SPEAKER_00 47:26

Yeah.

SPEAKER_02 47:27

Wow. Yeah, fantastic.

SPEAKER_00 47:31

We should leave it there.

Subscribe, Share, And Join Us

SPEAKER_02 47:33

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SPEAKER_00 47:59

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SPEAKER_02 48:06

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SPEAKER_00 48:14

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SPEAKER_02 48:20

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