GLP-1s are Changing Addiction Treatment w/ Dr. Stephen Klein

If your GLP-1 has quieted more than food noise, this episode will help you understand why. Ana sits down with Dr. Steven Klein, addiction medicine physician at Caron Treatment Centers, PhD in human genetics, person in long-term recovery, and long-term GLP-1 user, to unpack how GLP-1 medications may reduce cravings beyond food.

In this episode, you'll learn:

• Why food noise and addiction cravings can come from the same brain circuitry
• How GLP-1s may reduce alcohol, opioid, and other compulsive urges
• Whether these medications blunt pleasure or simply reduce obsession
• Why low-dose treatment may still help with cravings
• What habits, support, and recovery tools still matter on or off medication
• How genetics, epigenetics, and chronic stress may influence addiction risk
• Where someone can start if they need help for addiction

About our Guest Dr. Steven Klein:
Dr. Steven Klein is a physician-scientist specializing in addiction medicine with expertise in pediatrics, medical genetics, and the neurobiology of substance use. 
At Caron, he plays a leading role in advancing biologically informed therapies for recovery, including the integration of GLP-1 receptor agonists to reduce cravings and support long-term outcomes. Dr. Klein earned both his MD and PhD in Human Genetics through UCLA’s Medical Scientist Training Program and completed residency and postdoctoral research at the Children’s Hospital of Philadelphia. He is board-certified in pediatrics and addiction medicine and board-eligible in medical genetics.

You can connect with Dr. Klein and Caron here. 

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*The content of this show is for informational purposes only and does not constitute medical advice. The goal of this show is to provide various points of view about GLP-1 Medications. The personal and professional opinion of the guests and their content does not necessarily reflect the opinion of Ana Reisdorf or GLP-1 Hub.

Transcript

SPEAKER_01 0:00

And now GLP1s that tend to be removing all types of cravings: alcohol cravings, opioid cravings, compulsive sex cravings, gambling cravings. I mean, I think what's so interesting is that up to this point, we've had to pick what medication we use based on the substance patients are coming in on. What's amazing about GLP1s is they seem to be treating compulsive addictive behaviors across the board.

SPEAKER_00 0:23

Did you know GLP1s are cutting cravings not just for food, but also for alcohol, opioids, and even gambling? Welcome to the GLP1 Hub Podcast. I'm Anna Reisdorf, registered dietitian and GLP1 user of over three years. Today, Dr. Stephen Klein, addiction medicine physician at Karen Treatment Centers, and someone in long-term recovery himself, explains the brain science behind why these medications work across addictions, what it means for his patients and other GLP1 users, and what the future holds for this off-label use. Also, we have a new segment this week. Every Thursday, I will be answering listener questions. I get a ton of them every week, and everyone could benefit from some of these answers. And I'm starting with the questions from my members first. But as always, if you are enjoying this podcast, please leave a quick review on Apple Podcasts and Spotify. Make sure that you share your thoughts if you are watching over on YouTube in the comments. Now let's get on to the show. One snack I've been recommending a lot lately is Harvest Snap's lightly salted baked veggie snacks. They're made with green peas as the first ingredient and deliver five grams of whole food protein and four grams of gut-friendly fiber per serving, a satiating combo that delivers essential nutrients between meals. These real veggie crisps are savory, crunchy, and made with simple ingredients. Plus, they contain no added sugar and are free from common allergens. Head to harvestsnaps.com and use the code SNAP15 for 15% off your order through June 30th. Welcome to the GLP1 Hub Podcast. I want to welcome today Dr. Stephen Klein of Karen. He is an addiction medicine doctor, and he's going to talk to us today about GLP1s and how they're changing addiction medicine. I don't even know where to start with that, but why don't you tell us a little bit about your professional background and what you do, Dr. Klein?

SPEAKER_01 2:30

Absolutely. Thank you so much for having me, Anna. So as Anna said, I am an addiction medicine doctor full-time at Care and Treatment Centers. I haven't always practiced addiction medicine. I came in through somewhat of a circuitous route. I started my career in a medical school at UCLA, where I did medical school and also graduate school. I have a PhD in human genetics. So I studied genetics for about five years in between medical school and then went to residency at the Children's Hospital of Philadelphia, where I studied pediatrics and medical genetics as well as some metabolism. Besides being a doctor, I'm a person in long-term recovery. So through that whole kind of training path, I was also developing my own relationship to recovery from a drug and alcohol abuse. And I'm also a person who's now been on a GLP1 for a long time. So it's something that shaped my personal practice, my conception of hunger and cravings. And now I kind of wrap that around to provide addiction medicine care at care and treatment centers and in a few other venues we can talk about.

SPEAKER_00 3:32

Wow. So you've done you've been through it all in addition to being a doctor to help the other people.

SPEAKER_01 3:38

Yeah, doctors are people too. So we had a life outside of my medical training. That life has definitely been shaped by some of my medical training. You know, my drug and alcohol use really crescendoed until my uh my graduate school career, where some personal issues really brought it more to the surface. Maybe it was bubbling underneath for the majority of my life. But yeah, I've been through, you know, a lot of different trials and tribulations. And I think I look at the world through the lens of a molecular biologist and also a physician and also a person with lived experience. And that really helps me bring that experience to my patients and help them on their journeys.

SPEAKER_00 4:17

Cool. That's that's really nice to have somebody with a personal experience. I think that's why my audience connects with me because I'm a GLP1 user too. So it's not just the expertise, but also the personal experience. So, in terms of GLP1, for those of us who are using it, we've experienced the reduction in the food noise. But how does that translate to the addiction part of it?

SPEAKER_01 4:36

Yeah, I'm so glad you started with that question. As human beings in an evolutionary capacity, we have to do two things seek pleasure and stay alive. Those are our two tenets as people who inhabit this earth. And that's really what all of our brain chemistry has evolved around. And really why food noise is so related to substance noise is because they're both located in the same pleasure center. So there's really great studies that when you eat sugar or when you do cocaine, the same areas of the brain light up. So the noise that drives someone to say eat, that may be something they want to or don't want to or keep eating is can be the same noise as the signal in the brain that's signaling people to drink alcohol, seek cocaine, seek opioids, things like that. So it's all really the sh the same exact brain machinery, what we call neurocircuitry. In general, that area and that circuit is called the mesolimbic system. Some people, including myself, refer to it colloquially as the hedonistic system.

SPEAKER_00 5:35

Okay. And so how does the GLP1 affect that system? Like what is it doing to us?

SPEAKER_01 5:41

Yeah. So it really affects every part of the brain in that circuit. So all the regions of the brain that make up the mesolimbic circuit, which include, there won't be a quiz after this, I don't think, but it includes things like the ventral tegmental area, the nucleus accumbens, the prefrontal cortex, and the hippocampus all have GLP1 receptors. And when the GLP1 receptor agonist binds that receptor, it changes the circuit in a certain way. But largely what it does is it allows the reward pathway. It allows the presence of the feeling of reward or satiation, or the feeling of fullness, or the feeling of serenity without stimuli. So either without food, without alcohol, without drugs. It allows people to feel kind of like at baseline, a general feeling of ease and contentedness that they wouldn't feel without it. And as a person in long-term recovery, you know, I've heard a lot of different language. Some people feel like they have a kind of void, a hole that can't be filled, that they're trying to fill that hole with alcohol, with drugs, with food. I mean, I think people who have experienced ravenous hunger can relate to that. That's the feeling of eating beyond the intended purpose of caloric intake, eating for emotional satisfaction, eating for a feeling of security. I think that's what my patients are using drugs and alcohol for and what these medications really help with.

SPEAKER_00 7:08

Sure. So some of the hedonistic pleasures, right? Eating good food, maybe having a glass of wine, that kind of thing, some of that is like enjoyment in life. Do you think the GLP one numbs that or like takes it away? I've heard people saying they just feel kind of flat on it.

SPEAKER_01 7:24

I think that's interesting. I don't, I've not had that personal experience. I haven't had that kind of resounding noise or signal from my patients. I also think we're entering an era where 10 to 12% of Americans will be on a GLP one in the coming years. So if it was like overall like blunting people, I think that would be a pretty loud signal that we would hear, not minimizing anyone's experience. But you know, I think it's one of those things that, at least for me in my life, I mean, I'm an Italian Jew from New York. Like food is a huge part of my life. And as a person on a GLP one, I still love food. It's just not my obsession. I'm not thinking about what I'm eating for dessert when I'm still on an appetizer. I can really enjoy food. I love to cook. I love to cook for my my husband. I love to cook for my family. And GLP1s for me haven't taken that away. But I think I started a little bit higher, and that food was likely problematic for me for a long time before I started a GLP one.

SPEAKER_00 8:22

Sure. So with your patients, like how are you incorporating the GLP1 into their addiction recovery? Like, is that what you start with, or is that like a secondhand treatment? Like, how does how does it all work?

SPEAKER_01 8:33

I think about it as really like an adjunct therapy. So, really, the the core of what we do at care and treatment centers is the treatment of addiction. I think the treatment of addiction is really understanding the why behind drug use. My favorite expression is that alcohol and drugs are not the answer, but they make us forget the question. And patients are here so they remember the question. What are they running from? What are they hiding from? What is driving their emotions to not be able to cope and then turn to drugs and alcohol? So I think about that as kind of the mainstay of addiction treatment. Within that, we offer a few different medications. Most of them are so that patients can more successfully engage with those therapies. So those are things like naltrexone that remove alcohol cravings, suboxone or bupenorphine that removes opioid cravings, and now GLP1s that tend to be removing all types of cravings: alcohol cravings, opioid cravings, compulsive sex cravings, gambling cravings. I mean, I think what's so interesting is that up to this point, we've had to pick what medication we use based on the substance patients are coming in on. What's amazing about GLP1s is they seem to be treating compulsive addictive behaviors across the board. And that's really a difference of approach and a difference in in the medication class. And I think about them as really alleviation, alleviating craving so that patients can focus on the deeper work.

SPEAKER_00 9:56

Okay. And so it has to be paired with some other lifestyle. Some patients are or some of my audience is saying it's really helping me eat less, but I still have these sugar cravings at night. I still have so there has to be a habit piece to this addictive thing, correct?

SPEAKER_01 10:13

Yeah, you know, I think uh that's in the best case scenario. I think the analogy that I use all the time is that drug addiction is like there's a record playing in your mind. And that record always ends in drug or alcohol use. And what these medications do is they pick the needle off that record long enough for me to teach you a different song. And I think that's the part of it that's really important is that yes, you are eating less, but then really the the nuance and the diligence of understanding what your eating patterns were before, what your using patterns were before. I think about these medications as really buying time and time with the kind of pressure off the system so that meaningful change can be made.

SPEAKER_00 10:55

Right, right. So, because I used to work in bariatrics when people were preparing for a gastric bypass and they would just transfer their addiction to something else when they couldn't have the food anymore because of the surgeries, right? So it'd be, you name it, other things. So with this medication, are you thinking of it as like a long-term thing to continue to manage that craving? Or do you think that these people using it for addiction could possibly get off of it once they learn the habits?

SPEAKER_01 11:21

I think both, yes, and I think you know, I meet my patients where they are. I start a medication when they're in residential treatment, largely after major life events that have probably not been the most enjoyable, that have brought consequences, where they're kind of at a point where they're ready to ask for help and they meet me. I'm happy if they want to be on the medication long term. I also foresee a world where, you know, investing in the work and coming off, similar to coming off of SSRIs, similar to coming off the box owner bupenorphine therapy, is available to some patients. It's a very delicate dance, a nuanced dance between provider and patient. But I think meeting them where they're at and making sure that, you know, if the medication has brought you up to this point of recovery, that the clinical supports and new lifestyle meets you there. So then the medications can come down. I think that's a balancing act that needs to be done. And it requires a lot of patient-facing time and really understanding where your patients are and being honest with them and them being honest with you. And I think that's why like I think about these as incredibly personalized medications that are in part of incredibly personalized treatment plans.

SPEAKER_00 12:31

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SPEAKER_01 13:55

Yeah, luckily, I actually think there's three dosing ranges. Again, luckily, think that the reduction in cravings actually happens first. The glycemic control for diabetes is in the middle, and then obesity is really the upper, the upper range. Okay. So a lot of the data that's come out on alcohol use disorder, actually, the biggest study to date was really only 0.5 milligrams of semaglutide. So, you know, I think there's a signal there that this can start decreasing cravings soon at low doses. And the protocol that I use, I am prescribing to people who are not BMI above 30 or even above 27. So normal BMI. So un uh non-expected or not like pathologic weight loss is something that I think a lot about. And I I like the idea of being able to keep patients on low dose where we've been able to show that there's not weight loss at the 0.25 and 0.5 milligram amounts when patients are of those BMIs.

SPEAKER_00 14:49

Mm-hmm. Okay. And are if you do see that they're losing weight, do you like taper them down?

SPEAKER_01 14:53

They don't really need to, or yeah, so it's it's honestly not a conversation that I have that much. There's a few times when patients will say, you know, I'm down a few pounds and I'm okay with it. So they maybe came from BMI 26 to 25 and they're okay. It's a conversation, again, that requires a lot of check-in and a lot of kind of patient-facing hours in general. I do think about coming down in dose. So if we're at 0.5, I'll come down from there. But it's really that back and forth. I wouldn't say I have like a standard protocol. It's really up to the patient. We have standard dosing protocols for kind of where we stop. But as far as where they want to stop or where they want to titrate down, I leave it up to them. And it's, you know, it's a balance. Uh, these medications may suppress appetites. So does cocaine, so does methamphetamines. So, you know, that balance of malnutrition in in certain patient populations, you know, I don't addiction is a high morbidity, high mortality disease. If I think about dropping a few BMI points versus kind of the chance of of recovering from a high morbidity, high mortality disease, sometimes that factors into my risk stratification.

SPEAKER_00 15:59

Right. So talk a lot about long-term life on this medication, whether it's on or off or maintenance and that kind of thing. And something that's been coming up a lot is dealing with like your emotional triggers and stressors and things like that that have gotten you to where you were. So if like you're you lose insurance coverage, you don't like just gain all the weight back or whatever it is. So, what are some of the pieces that you help your patients put in place to either to like maintain recovery, the addiction? Like what are some of the habits that they have to focus on?

SPEAKER_01 16:29

Yeah, it's a big question. The entire field of 12-step mutual help recovery is kind of aimed at that. But sure, how do you treat addiction? I think for me personally, the things that have been really helpful that I try to convey in my patients is the idea that, you know, I'm not in it alone. So I identify as a drug addict and an alcoholic. And therefore, I know that the alcoholism and drug addiction centers in my mind. And therefore, the solution to those things can't be of my own. I'm constantly engaging in community, asking for help. For me personally, that looks like a participation in 12-step support groups like AA, having a sponsor, having close friends, that like when my emotional triggers come up, my response is not to reach for a drug or for a drink, but to reach for the phone and discuss those things so that I'm kind of thinking about that process. I think equally important is, you know, participation in other aspects of my mental health. I see a therapist regularly. I talk about my mental health. I try not to, you know, measure up to the bravado of masculinity where I can't talk about depression and anxiety. I tend to talk about those things openly. I have a high pressure and high stakes job. I talk to my therapist about that and just kind of keeping my mental health in check so that those emotional triggers don't overwhelm me to go back into old coping skills. I think, you know, for me, recovery has been a long-term game of teaching myself to reach for my tools instead of my weapons. And I think that can apply to drug and alcohol use. I think that can apply to diet and exercise. I think, you know, I was someone who really perseverated over my weight for a long time. And, you know, all of these things I was trying to come up with myself. I was trying to have, you know, the Monday. Well, I ate like terribly on Sunday. So Monday, diet's for everyone, everything will be great. But the minute that I'm off my diet, it's back to, you know, the Sunday feeling. And what's really been helpful for me is I have a team now. I'm lucky enough that I can, you know, engage a nutritionist, I can talk to a dietitian, I can talk to someone about exercise. And I try to follow someone else's plan instead of my own.

SPEAKER_00 18:38

Yeah. I think it's always easier when somebody else tells you what to do. You know, at the gym, it's easier when you got a trainer just being like, just do this. You don't have to think about it. Feels very heavy, like a heavy list, even if you know, even if you've been to the gym a thousand times. So we had talked briefly before we got on the call about how genetics plays a role. And you've done some research in methylation. Can you explain a little bit about genetics and addiction?

SPEAKER_01 19:00

Sure. So, in general, like first blanket statement is addiction genetic? You can talk about the very binary yes, no. There's definitely a genetic component of addiction. Addiction tends to cluster in families. There's been lots of studies that establish, yes, that in fact there is a genetic component to addiction. So to go a little bit deeper than that, I think it's important to start understanding kind of the way that the brain adapts. So again, I'm I kind of think about the lens of evolution. We are exquisitely beautiful at adapting to our environment. So we, better than any other species on the planet, can adapt to what's going on around us. That means we're constantly adapting to levels of stress, levels of wakedness, levels of dopamine stimulation in our lives. So I think it's really interesting as a kind of molecular biologist who studies addiction and thinks about addiction to think about the ways that our brains are adapting, about methylation is the way that we adapt our genetic code to what's happening in real time. The evidence from that actually comes from a really fascinating study, which is that if you look at the methylation pattern or the epigenetic signal of grandchildren of people who have survived the Holocaust, there's a signal there. So there you can distinguish them from grandchildren of people who didn't survive the Holocaust. So that just means that when we're navigating the world and we're exposed to things, hopefully not the type of stress that's elicited by a genocide, but stress in our lives, our epigenetic code is evolving and adapting. And I think about, you know, the idea that stress is really toxic and that stress can be really damaging. And I think about the ways that we're stressed out now, the constant bombardment of our dopamine pathways, of our reward signals, constant screen time, being more connected yet feeling more alone than ever before. And I think about how that sets up kind of like an intergenerational pass down of what's happening with addiction and why, you know, addiction seems to affect Americans more than other developed countries. So I think about the genetics of that and really how are we protecting ourselves from these stressors, and then how are we potentially passing on those stressors and those stress signals. At the end of the day, for me, addiction is maladaptive stress response. So I think about that stress response is what you're born with, what you develop through life experience, and then what manifests kind of in adulthood. And I think about all those as being contributors.

SPEAKER_00 21:28

So with this world that we're living in with all of this stress, you've already mentioned like going to therapy and having a support group. Is there anything that we can do that's doesn't cost money, maybe, that uh would help us manage the stress better?

SPEAKER_01 21:41

Yeah, a big thing that I think about a lot that's free, that you know, is part of my practice as a as a human being is how am I seeking community? How do I build community with people around me to feel really connected and supported? And and how do I uh help people around me? I think the you know the The helping each other and building community. It's a little, I would say it's a little entitled for me to say, you know, I'm a educated doctor. I have the opportunity to be paid to help people every day. But, you know, I think it can be less than that. I think it can be just making the decision to connect instead of disconnect from each other. I think that's a really low activity that can really help us reconnect and start to protect ourselves and protect our minds. I think also openness, so sharing the experience that we're going through and not trying to compare and compete as much, but just relate and comfort each other is something that it in my mind is also kind of like free of charge. And um, I I think those types of interpersonal supports actually have a lot of bang for their buck. If I had to say, like the number one thing in my personal recovery story, it hasn't been GLP1s or therapy, it's been community.

SPEAKER_00 22:54

Interesting. So what if for somebody who feels alone, I think there's a lot of people like that, where would you start with a community? Yeah, I think one or not.

SPEAKER_01 23:03

Yeah, I think if you're like listening to a podcast like this and you're already kind of seeking people with similar experience, that's a great place to start. I think beside what we're all trying to project, we're all starving for community and sometimes starting that conversation at work. I actually love that about GLP ones. I love that they are treating obesity and potentially drug addiction because these are things that we've been told are our fault. These are things we've been told, it's your fault that you're overweight, you don't eat right, and you don't exercise enough, and it's your fault that you're a drug addict because your moral fortitude to just say no isn't good enough. And I think these medications, just being open with people that you're on them or that you're thinking about it or eliciting their experience can be the start of a community. And I think, you know, community doesn't have to be formalized like Alcoholics Anonymous or NA. It can really just be someone that you're working with or someone who reaches out for help and wants to know your experience.

SPEAKER_00 24:00

Sure, definitely. I think that the GLP one, there's like a big GLP one community online. Some of them are better than others. You know, I think that it has given people a lot of support to where they, you know, can get that feeling that somebody understands what they're going through finally.

SPEAKER_01 24:14

Yeah, I think we all need a little bit of help. And the GLP1 communities are people who are ready to accept help. I think that's a stage of change that's incredibly exciting. And also people who are on that same stage together obviously feel camaraderie. And I think that's really beautiful as someone who, you know, I think about my role as an addiction medicine doctor is restoring agency, which is the ability for people to make decisions that align with their value system. And I really love that these GLP ones are helping large portions of the population. Of course, there are accessibility issues, of course, there are healthcare disparity issues, but they really are helping people, and they're helping people not only identify, but then name and take action against the things that are causing them strife.

SPEAKER_00 24:59

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SPEAKER_01 26:25

Yeah. So what I'm most excited for, I would say, is that the National Institute of Drug Addiction, uh kind of shorter called NIDA, is currently sponsoring lots of randomized control trials using semaglutide. I don't think trisepatide yet, but large trials that will demonstrate really what we need, which is enough clinical evidence for the FDA to list alcohol use disorder or opioid use disorder as an FDA-approved indication. I think that opens the doors for widespread use. That also opens the door for insurance to be reimbursing these for patients who have that as their primary diagnosis. I think what's interesting when you talk about evidence is, you know, the idea, and we just looked at care and treatment centers. We've treated about 440 patients under our care with GLP1s. If I look at their average BMI, it's actually 30. So those people would have qualified. That's the FDA-approved indication is BMI above 30. So, you know, having data that 100% GLP1s decrease alcohol cravings and randomized controlled trials is great. I think the other part of this is that these medications are helping people. And even if they're just helping people to lose weight in early recovery, I think that's great. But I my experience is that they're actually doing much more than that. We're using them in patients who have cocaine use disorder and methamphetamine use disorder. Those disorders do not have FDA-approved treatments. So this is really a field where anything that we do is off-label. So I think the idea that, you know, giving someone who doesn't have any other opportunity at medically assisted treatment an opportunity to try a medication like this is transformative.

SPEAKER_00 28:04

And do you think that that research will maybe help the costs come down a little bit?

SPEAKER_01 28:08

That's my hope. I think, you know, to the second part of your question, I think the more tools we have in the toolbox, I think there's undoubtedly going to be biotech companies that bring GLP ones that are solely indicated and solely uh marketed to substance use disorder is forthcoming. And then I think, you know, the more uh players in the field, you know, if we have something that's great that comes out that shows 25% weight reduction uh for obesity, if that becomes the go-to agent for that, and then Nova Nordis wants to repurpose Wagovy, Ozempic, or another medication, or expand the indications to allow people to use those for substance use disorder. I think the more that we're moving in this field, the better. I mean, I think for me, this is why I became a doctor. I I want people to experience health and I want people to be empowered to make decisions that they feel good about that are supporting their value system and their value structure. And for me, with my personal experience, I mean, my personal experience with GLP ones is just that. At the beginning of the day, we only have a certain number of tokens. I get to decide what I do with those tokens now. They're not automatically going to controlling my food and exercise.

SPEAKER_00 29:17

Right, right. I feel that it's for me, it's giving me a sense of freedom, like my life. I don't have to think about it anymore. It's got all this brain space. Filling that brain space up is a different story.

SPEAKER_01 29:28

That's a different story. There's things that can help with that too, but there's also community and activities and you know, just what you're doing, like having a passion for something and then getting the getting people in the room to start the conversation. I think, you know, having time for your passions and not for the things that pain you is is really what I hope most medicine moves towards, which is really helping people build sustainable, fulfilling lives. And again, that's why I treat addiction. I think, you know, you watch people transform and build lives and recover. And if these medications can help with that, I want to be part of that movement.

SPEAKER_00 30:02

Sure. So if somebody that's listening is struggling with addiction, what is the first step to take?

SPEAKER_01 30:08

Yeah. So I think um, first, just if you're listening and it's you, just hear me and saying that you're not alone. There's help available and there's help for for you. That help can look like a few things, depending on what your resources are and what your availability is. Starting the conversation with a medical professional is definitely a place to start, whether you're resourced enough to have a primary care physician, or there's lots of places like care and treatment centers that will always help kind of get you into the place that might be able to best serve you. One of my things that I tell people is there's no wrong door to enter addiction medicine, addiction care. I think starting that conversation either with a doctor who's well-versed or with a treatment center that can point you towards a doctor is that, you know, there's nothing that you're doing wrong. There are things that we as a medical society can do to help you. And if you're struggling with addiction, you're definitely not alone.

SPEAKER_00 31:00

Awesome. Well, thank you so much. And tell people where they can find out about the programs that you're offering at Karen or if they want to reach out for your support.

SPEAKER_01 31:09

Yeah, absolutely. So um, I can be found um on Karen's website. So Karen will help triage you to any number of resources that are at our disposal. And we they can help you get plugged in with our GLP1 program or at least refer you to me. And I can help refer you to providers who are actively prescribing in this space.

SPEAKER_00 31:28

Awesome. Thank you so much, Dr. Klein, for being here. Such an important conversation. It's like an exciting piece of this GLP one uh story, I think.

SPEAKER_01 31:36

Yeah, you know, I I'm really it's really my honor to be here and just to be talking to someone also with lived experience who's like made this part of their passion. Like it's really great. I mean, I think this is uh on a grand scale, you know, us helping each other and us building community and us also fortifying the medical community with that power, which is reaching out to people and letting them know that we're here to help.

SPEAKER_00 31:56

Awesome. Thank you so much. Thank you for your expertise. I appreciate it.

SPEAKER_01 32:00

My pleasure.

SPEAKER_00 32:01

Hope you enjoyed this episode. And now it's time to get into listener questions. And this week's question comes from Jen, who is a member of the GLP1 Hub membership. And Jen says, What is the best way to figure out your goal weight? It has been so long since I have been at any weight that would be considered a goal, I am unsure, other than using BMI charts for how to figure that number out. And actually, I don't recommend setting a goal weight because this could set you up for disappointment. It is possible that whatever number you might have in your head, even if it is a BMI of 25, let's say, which is a normal BMI, that may not be a sustainable number or a realistic number for where you are in your life right now. I think that a lot of people see really large weight losses on this medication, 70, 100, 150 pounds. I mean, I've interviewed people on this podcast who've lost who have lost hundreds of pounds, but that is not actually the typical result for this medication. The medication is supposed to help you lose around 15, 20% of your starting body weight. So that's like the average result, and that is considered a good result. So what that means is if you weigh 250 pounds, you can expect to lose about 50 pounds. That is an average sort of weight loss for what they saw in the studies for the medication. Now, those studies were only for a certain period of time, so it could be possible that the people continue to lose after that. But that is what the data says. That is the expectation for this medication. So if you set a goal weight that you want to weigh 150 pounds and your weight stops at 200 pounds, you're gonna be pretty disappointed. And the goal is not necessarily to be at a normal BMI. The goal is to reduce your risk. Just losing 5% of your body weight can have a significant impact on your health. So rather than focusing on the number on the scale, I want you to kind of reframe it and think about how are your lab values? How do you feel? Are you sleeping well? Are you feeling full of energy? Are you able to eat enough? Are you eating the protein that you need and getting your micronutrients, all of that kind of stuff that is a picture of like real health and not so much the number on the scale? So that's kind of how I want you to think about it rather than setting a specific goal weight. So I hope that that helps. And if you want more information like this and advice from me every week, I have a newsletter called the Steady State Newsletter, and I send that out every Tuesday. And I'll see you in the next episode.