Combining Internal and Functional Medicine for Lasting Wellness with the Popkin Method

Welcome to another episode of The Popkin Method, where Dr. Matthew C. Popkin dives deep into the science and practical application of living your healthiest life. In today’s episode, we move beyond medical jargon and buzzwords to show how foundational habits, like restorative sleep, purposeful nutrition, resistance training, and strategic supplementation, can transform real lives. Through powerful case studies, you'll see how The Popkin Method adapts to each individual, whether someone is looking to lose stubborn belly fat, struggling with advanced diabetes, or recovering from orthopedic injuries.

Dr. Matthew C. Popkin explains how cutting-edge medications like GLP-1 therapies and peptide stacks fit into his approach, but only as part of a much bigger picture because extraordinary health is created by ordinary habits repeated over time. Whether you’re curious about functional vs. traditional medicine, looking for hope after a setback, or searching for the tools to make lasting change, this episode unpacks the philosophy that puts the patient, not just the diagnosis, at the center of every decision. Get ready to rethink what it really takes to restore, protect, and optimize your health for decades to come.

Timestamps:

00:00 Diet and exercise assessment

04:42 Creating a personalized nutrition plan

09:38 Customizing patient treatment plan

10:45 Intensifying medical therapy for diabetes

15:25 Using tirzepatide and emerging therapies

18:55 Discussing Peptide Stacks for Healing

20:49 Optimizing recovery through nutrition

24:17 Diagnosing and managing insulin resistance

28:05 Why I practice personalized medicine

31:06 Addressing comprehensive diabetes care

37:05 The Popkin Method philosophy

37:54 Blending traditional and functional medicine

You can see Dr. Popkin through his online virtual functional medicine program anywhere in the country or the world for that matter.

You can visit Dr. Popkin in his Hollywood Florida office for an in person weight loss experience.

Visit thepopkinmethod.com to send a message to schedule an appointment with Dr. Popkin or email Dr. Popkin at mcpopkinmd@yahoo.com.

Podcast Website - https://thepopkinmethod.com/

Matthew C. Popkin, M.D. - https://thepopkinmethod.com/about

Podcast Partner - TopHealth - https://tophealth.care/

“Disclaimer: Informational only. Not medical advice. Consult your doctor for guidance.”

Transcript

SPEAKER_00 0:12

Welcome back to the Popkin Method, the podcast where we explore the science of longevity, metabolic health, functional medicine, hormone optimization, and living your healthiest life using evidence-based medicine combined with practical strategies that you can actually apply. I'm your host, Jamie, and as always, I'm joined by Dr. Matthew Popkin. That brings us to something that I know many of our listeners have been waiting for. So we've spent the first part of today's episode talking about principles. Now, I'd love to see those principles demonstrated in some social proof. Can you walk us through a real patient whose health improved simply by following the foundation of the Popkin method without jumping immediately to advanced medications or hormones or anything like that?

SPEAKER_01 0:57

Absolutely. Actually, one of my favorite examples, Jamie, is a 71-year-old gentleman who came to see me because he wanted to lose what he called his belly. He wasn't looking for a miracle, he wasn't asking for injections. He simply wanted to feel healthier and move better. So this guy, he was five foot ten, weighed approximately 240 pounds. And now here's what made him interesting, Jamie. He was already active. He played a competitive tennis two or three times a week. And if you saw him, you might assume he was doing everything right. But as we talked, a very different picture emerged. He drank several glasses of wine almost every evening with dinner, and considerably more on weekends and during social gatherings. His diet wasn't terrible, but it was heavily weighted towards the starchy carbohydrates. He ate a lot of bread, rice, potatoes, pasta. Interestingly, sweets really weren't his weakness. He rarely drank soda. He wasn't eating cookies and candies. His issue was that his meals simply contained far too many refined starchy carbs and not nearly enough protein. And the second thing I noticed was that despite being active, he wasn't actually exercising in a way that preserved his muscle. And while tennis is wonderful, it gets you in good shape, it's fantastic for coordination, agility, cardiovascular fitness. He wasn't performing any of the resistance training that I've talked about. Nothing at all. No dumbbells, no resistance bands, no weight machines, nothing that would really send a signal to his muscles to grow stronger. And without having adequate protein intake, his muscles really were just not, you know, were not getting the benefit of growing. So he was really losing lead muscle mass. And finally, he wasn't taking a single supplement. So although he looked like a relatively healthy 71-year-old gentleman, a bit overweight, when we examine the entire picture, there was tremendous room for optimization.

SPEAKER_00 2:49

Well, I think that's fascinating because I imagine a lot of people listening are thinking, wait a minute, that sounds like me. I'm active, I play golf, I play tennis, I walk, I do all the things, but that's very different from deliberately preserving lean muscle mass, even though you're active.

SPEAKER_01 3:07

Yeah, exactly. I mean, being active is wonderful. Although, you know, my friends that tell me they act, you know, they exercise and they golf, you know, they're not walking the course, Jamie. They're they're taking the carp. So I don't know exactly how much exercise this is. A couple of beers and some cigars as well. I don't really know if I'd call that exercise, but you know, being active, Jamie, just like you said, it isn't always enough. So rather than prescribing medication or giving him a peptide, I simply applied the popkin method. And first, I normalized his sleep schedule. He began waking up at the same time every morning, going outside for early morning sunlight, delaying his caffeine by an hour or two. And by the way, he loved his caffeine. He would have three or four cups of coffee and espresso. Literally, he told me the first thing he does is make a bee line for his coffee maker. And I told him, put that on hold and make a beeline for early morning sunlight. I had to improve his evening routine on not bringing the phone into bed, but having a digital sundown, getting the body ready for sleep, reducing alcohol to two drinks on Sundays, on Saturdays and Sundays instead of drinking nearly every evening. Um, that was a bit of a challenge because socially he drank wine with his wife and during social gatherings and so forth. So we changed his nutrition around and some of these habits around. And he followed my intermittent fasting schedule, which he was pretty close to that 12-hour window anyway, but would ruin it with evening snacks and early morning coffee with cream and sugar. So I had him follow my intermittent fasting schedule, four days at 12 hours, two days at 16 hours, and one day at approximately 18 to 24 hours. And most importantly, again, every eating window had a purpose, right? I wanted him to consume about 150 grams of protein each day based on his ideal body weight. And I wanted him to maintain a calorie target of about 1,800 to 2200 calories, which with his height and weight created a modest caloric deficit without making him feel deprived. So I shifted his meals towards lean proteins, fiber-rich vegetables, healthy fats such as avocado, extra virgin olive oil, and I dramatically reduced his starchy carbs, the bread, the pasta, the rice, and the potatoes. I started him on the Core 5 supplements and finally gave him something incredibly simple: a home resistance training program using dumbbells, nothing fancy, just a structured routine with some instructional videos that I sent him so he could perform these exercises safely and consistently. Now, 30 days later, Jamie, just by doing these things, he lost 10 pounds, he dropped two belt notches, his joints felt better, he moved better on the tennis court, he had more energy, he slept better, and perhaps most importantly, he realized that his body was capable of changing without relying on medications, even over the age of 70. So this is really a success story.

SPEAKER_00 5:57

Yeah, that's incredible because it demonstrates that sometimes the biggest improvements come from consistently doing the fundamentals. But I have to imagine that not every patient has the luxury of beginning slowly, right? There must be times when someone walks into your office and you immediately recognize that lifestyle changes alone aren't enough, that the medical situation is too advanced to delay prescription therapy. Can you tell us about one of those examples?

SPEAKER_01 6:25

Yeah, absolutely. I think this is where my background in internal medicine from the Cleveland Clinic Foundation and over 25 years of incorporating functional medicine really come together. And one of the biggest misconceptions people have about functional medicine is that they believe that we're, you know, somehow against prescription medications, and that couldn't be further from the truth. Prescription medications, they save lives every single day. The question isn't whether medications are good or bad, the question is whether they're being used at the right time for the right patients while simultaneously addressing the underlying causes of disease. So let me give you an example. Here's a 48-year-old gentleman who came to see me after several years of neglecting his health. I mean, really neglecting his health. His medical history immediately caught my attention. He had type 2 diabetes, used to take insulin, stopped taking the insulin for some reason, had high blood pressure, was on two or three medicines, cut he cut that back to one. High cholesterol, he stopped his cholesterol medication. And approximately 15 years earlier, he actually required three coronary artery stents because he had premature heart disease. So this is really a guy who has some significant medical issues. And over the previous, let's say five years, however, life had really gotten in the way. He had gradually gained nearly 80 pounds. He stopped exercising, his diet had really deteriorated significantly. He was no longer following any type of structured nutrition plan. He admitted that convenience had really replaced uh intentional eating. As I mentioned, he also stopped taking most of his medications that were originally prescribed for him and really only continued one blood pressure medication, one oral diabetes medication, his anti-platelet medication, he continued because he had the stents, and he had stopped taking insulin altogether. So this was really not a good situation, Jamie. And he told me I just gave up. I didn't care anymore. So before recommending any treatment, I really wanted to understand exactly where he stood metabolically. So I did some labs, and unfortunately, the results really confirmed my concerns. His LDL or bad cholesterol was shockingly elevated, his good cholesterol was pretty much non existent. Uh triglycerides were through the roof, inflammatory markers were off the charts, and most concerning, however, was a test called hemoglobin A1C, which measures your average glucose over previous 90 days. So it measured 11.7%, which indicated that his diabetes was severely uncontrolled. I hadn't seen a level that high in probably 10, 15 years. So to give you an example, a level of seven is considered bad. So 11.7 is really, really bad. So when we looked at his daily glucose readings, which he rarely would take, but when we started looking at them, most of them were over 300 milligrams per deciliter, with normal being in the 90 to 120 range. So he was out of control in his diabetes. So at this point, we weren't talking about prevention. We weren't talking about, you know, doing some lifestyle modification. We were talking about reducing his immediate risk of some very serious complications like a heart attack or a stroke.

SPEAKER_00 9:36

Yes, very different than your previous patient.

SPEAKER_01 9:38

Yeah, completely different. And, you know, this gentleman absolutely needed the foundation of the popkin method, which we actually, you know, put in place, but he also needed very aggressive medical treatment from day one. And that's exactly why medicine should never really be practiced in a one-size-fits-all philosophy, right? I mean, for him, I immediately began rebuilding that foundation. So I addressed his sleep, circadian rhythm, eliminated processed foods. He really began the same structured intermittent fasting program that I teach many of my patients, but under really close supervision because of his diabetes medications. And I emphasized, again, lean protein, fiber-rich vegetables, healthy fats, and dramatically reduced refined starches and added sugars. The story doesn't really change for the most part when we're talking about the basics. I introduced a progressive walking program with his long-term goal of adding resistance training as his energy and his glucose control improved. And also after he completed a cardiac workup to assess the condition of his stents. So, as with many of my other patients, I incorporated the core five supplements as well. But Jamie, I also recognized that lifestyle changes alone were not going to bring a hemoglobin A1C of 11.7 into a safe range quickly enough. So I had to intensify his medical therapy. And given his history of diabetes, established heart disease, I restarted evidence-based cholesterol-lowing therapy with a statin medication. I optimized his blood pressure regimen by adding what's called an ACE inhibitor, which we give to diabetics to help protect the kidneys because his sugars were just dangerously elevated. I initiated both a long-acting and a meal-time insulin with very careful monitoring using what's called the CGM, which is a continuous glucose monitor instead of just doing the finger sticks, uh, and very frequent follow-up. And the purpose, Jamie, wasn't to keep him on these high doses of insulin forever. The purpose was to quickly reduce glucose toxicity, improve his symptoms, and create a safer metabolic environment while we addressed the underlying lifestyle factors, which was driving his disease process. So I also arranged a very comprehensive cardiovascular evaluation, including stress testing, a coronary CT angiography to better understand the status of his coronary arteries and the patency of the stents that were put in 15 years ago. Because someone with long-standing diabetes, uncontrolled diabetes, hypertension, markedly elevated cholesterol, and inflammatory markers really deserves a very thorough cardiovascular assessment to make sure they're not going to have a heart attack or a stroke.

SPEAKER_00 12:12

Yeah, and that's a pretty important distinction. You didn't abandon the Popkin method because he was sicker, you actually applied it more aggressively while simultaneously treating the immediate medical risk too.

SPEAKER_01 12:23

Yeah, exactly. I mean, that's one of the defining principles of how I practice medicine. Lifestyle and prescription medicine are not competitors, they're teammates. You know, one treats the immediate danger, the other changes the long-term trajectory. You know, if you need medications, we'll use them. But many times, you know, medications are used because people don't want to change their lifestyle. But in particular cases, yeah, we need to jump right to prescription medications. And within about 30 days, this guy's average blood sugar had fallen dramatically from well above 300 down to about 150. His blood pressure normalized pretty quickly, his cholesterol began moving toward the recommended uh treatment targets. And most importantly, he started feeling hopeful again. His energy improved, he became more active, he was sleeping better. And for the first time in years, Jamie, he believed that his health could actually improve. And that's something we don't talk about enough in medicine. You know, hope is therapeutic. When patients begin seeing measurable progress, they become partners in their own recovery. And that's exactly what happened here.

SPEAKER_00 13:26

Yeah, I think these first two cases really illustrate something that listeners might not have expected. Uh, the popcorn method isn't really rigid, it's adaptable. The philosophy stays the same, but the intensity of treatment depends entirely on the patient's medical condition.

SPEAKER_01 13:42

That's exactly right. I mean, medicine shouldn't force every patient into the same treatment plan. You know, the treatment plan should be built around the patient. Some people need lifestyle modifications, some need medications, some need both. Our responsibility as physicians is to recognize where someone is today while helping them move towards where they want to be tomorrow.

SPEAKER_00 14:03

Well, speaking of individualized care, one of the most common questions you receive involves GLP1 medications. They are everywhere right now. People hear about semaglutide, trisepatide, and now retitrutide, but there is still a ton of confusion about when these medications should be considered and how you decide which one is right. So can you walk us through your approach?

SPEAKER_01 14:25

Yeah, I'd be happy to because I think there's far more nuance here than many people realize. And you're right, these GLP1 medications, they are everywhere. At first, it's important to understand that these medications, they're tools, they're not magic. You know, they're incredibly valuable when they're used thoughtfully, but they work best when they're built upon the same foundation we've been discussing throughout today's episode and every episode of my podcast: lifestyle, nutrition, movement, sleep, muscle preservation. Those don't become less important because someone starts a GLP1 medication. If anything, they become more important. You know, when I evaluate a patient for one of these medications, I'm looking at several factors. How significant is their insulin resistance? How much visceral fat are they carrying? Do they have fatty liver disease? How well do they control their appetite? Do they eat emotionally? Do they have diabetes or prediabetes? What other medical conditions are present? Do they have high blood pressure, high cholesterol, heart disease? You know, those answers they help guide the conversation. So in my own practice, Jamie, I most commonly use terzipatide because I found it to be an excellent option for many of my patients with obesity and insulin resistance. It provides very, very meaningful appetite reduction while supporting weight loss when it's combined with the comprehensive lifestyle change. And for some patients with more advanced metabolic disease, particularly those with significant fatty liver disease, I will also discuss some of the emerging therapies that are still under investigation, such as Retta True Tide. And everybody wants REDA. Everyone's asking me for Retta. They see it at the gym, they see it on social media, their friends are on it, and everybody wants the newest shinest toy that's out there. And early clinical trial results have been really encouraging, but it's important to remember with Redatrutide that these, you know, these newer medications, as they continue to be studied, their role and routine in clinical practice is still evolving. So one principle, Jamie, that remains constant regardless of whether I'm using semaglutide, trzipatide, retotrutide, is that I always aim for the lowest effective dose. And you know, my goal is not to push someone to the highest possible dose simply because it exists. My goal is to find the dose that allows the patient to make sustainable lifestyle changes while minimizing side effects and preserving lean muscle mass. I try to explain to patients that the dosing schedule that most of these clinics are using, those are the same dosing schedules that were used in the clinical trials. So there's there's no reason to think that those clinical trials should be mimicked and those dosing schedules should be mimicked in real life. So that's jamming everybody into the same prescription, so to speak. And that doesn't necessarily need to be done. You can individualize the dosing schedule because ultimately I don't want patients becoming dependent on these medications forever. And if we can help them rebuild these healthy habits and support long-term health, the goal is to get them off of the medication. Importantly, Jamie, the medication creates an opportunity, the patient creates the transformation, and that's where the Popkin method makes all the difference.

SPEAKER_00 17:31

Yeah, I love that phrase. Medication creates the opportunity, the patient creates the transformation. It really captures everything that we have been talking about today. The medications don't replace healthy living, they create the space for healthy living to finally succeed. Um, Dr. Popkin, we've spent a lot of time today discussing metabolic health, obesity, diabetes, and cardiovascular disease. But another area of your practice that generates a tremendous amount of interest is orthopedic medicine and injury recovery. People hear terms like wolverine stack and glow stack are naturally becoming curious. So can you explain what those names mean, how you think about healing peptides, and more importantly, how they fit into the Bopkin method?

SPEAKER_01 18:16

Absolutely. And before I ever talk about a peptide, I go right back to something we've repeated throughout today's episode. Healing doesn't begin with a syringe, healing begins by creating the right environment for the body to repair itself. So whether someone has diabetes, a hormone imbalance, or a rotator cuff injury, the first prescription is still the same: better sleep, better nutrition, better movement, lower inflammation, support recovery. The story doesn't change. The body has an incredible capacity to heal when we remove the obstacles that are standing in its way. Now, with that foundation in place, there are situations where I may consider peptide-based therapies as part of a broader treatment plan. So, as you mentioned, one combination that many people have heard me discuss and what is referred to as the wolverine stack is the combination of BPC157 and TB500. Now, another version, which is called the GlowStack, that happens when you add a copper peptide to the wolverine stack. And pretty much every day, probably four or five times a day, I'm getting people interested in going on one of these two peptides. And while the copper peptides have traditionally been discussed in the setting of skin and hair health, I sometimes incorporate them into a broader treatment strategy because of their potential role in tissue health and repair. And research in this area, Jamie, is still evolving. And these therapies should always be considered within the context of a comprehensive treatment plan. In my practice, I'm getting a lot of very good results with both the Wolverine stack and the GLOS stack in patients that have orthopedic issues. Now, the important point is this none of these therapies replace rehab and physical therapy. None of them replace proper nutrition, they don't replace proper sleep. They're intended to support an overall recovery strategy, not substitute for it.

SPEAKER_00 20:02

Can you give us an example?

SPEAKER_01 20:03

I got a couple actually. So one patient that immediately comes to mind is an athlete who developed persistent shoulder pain after training. This is very common, especially as we get older. The shoulder tends to develop issues with the rotator cuff. And this particular patient, MRI testing, it demonstrated a partial thickness tear of his rotator cuff. Naturally, the first question he asked me was, Do I need surgery? And that's a question that I hear quite often. And the answer is not necessarily. Every rotator cuff injury is different, and some of them require surgical intervention, whereas others respond very well to conservative management, which we always try to do. The key is making an accurate diagnosis and developing an individualized treatment plan. And for this gentleman, surgery wasn't the first step. The first step was improving the biology surrounding the injury. So I optimized his sleep because tissue repair largely occurs when we're sleeping. I cleaned up his nutrition by eliminating ultra-processed foods and emphasizing adequate protein intake, colorful vegetables, and healthy fats to support recovery. I made sure he was meeting his protein target every day because muscle preservation becomes incredibly important whenever an injury limits activity. I discussed the core five supplements to make sure he wasn't missing basic nutritional support. He was already on creatine, vitamin D, magnesium, and a probiotic, but he wasn't taking omega-3 fish oils, which I added for its anti-inflammatory effect. Then I started a structured physical therapy program instead of his modified shoulder exercises that he was doing to maintain shoulder mass. And I want to emphasize that point, Jamie. The goal wasn't simply to strengthen the large shoulder muscles. It was to strengthen the rotator cuff complex, improve scapular stability, restore range of motion, and improve the mechanics of the entire shoulder. Because if you don't correct the underlying movement pattern, you haven't really solved the problem. And as part of that overall recovery plan, I also started him on the glow stack. Again, not instead of therapy, alongside of Therapy. And the combination allowed him to continue progressing through rehab while I closely monitored his symptoms and his function. Over time, he regained his strength, he improved his range of motion, he actually returned to athletic activity. And most importantly, he avoided surgery. So I want to be very clear though, that doesn't mean everyone with a rotator cuff tear can avoid surgery. Some tears absolutely require operative repair, but it does demonstrate that conservative management deserves very thoughtful consideration before assuming surgery is the only option.

SPEAKER_00 22:31

Yeah, I really like the way that you presented that because you didn't present the peptides as the hero of the story. The hero was actually restoring the body's ability to heal.

SPEAKER_01 22:42

Exactly. The peptide wasn't the treatment, the patient was. Everything we did was just designed to improve the patient's own healing environment.

SPEAKER_00 22:48

Well, can you give us another example where the popkin method helps someone with a completely different orthopedic problem?

SPEAKER_01 22:55

Sure. Another patient is a 48-year-old gentleman who had struggled with his weight for years. And to his credit, he'd already lost approximately 60 pounds before he ever even walked into my office. And that's an incredible accomplishment. But despite that success, Jamie, he was still about 50 to 60 pounds above his goal weight, and he'd reached a plateau and was getting frustrated. Fortunately, at the same time, he had developed significant low back pain, and his MRI demonstrated that he had an L4, L5 disc bulge and an L5-S1 disc herniation. Fortunately, though, there wasn't any significant compression on the exiting nerve route. So he wasn't experiencing progressive neurologic deficits or sciatic pain, but he was having significant back pain. So once again, the immediate question became do I need surgery? And once again, my answer was not necessarily. There were several modifiable factors contributing to his pain. First is, you know, excess body weight, which increases the mechanical load across his lumbar spine. Every pound lost reduces stress on those joints and discs. So I really re-emphasize to him the importance of losing weight. Secondly, he had significant weakness of his core musculature. So improving the strength and endurance of those core muscles would help stabilize the spine and improve movement mechanics and really help him to fix this problem naturally. Third, his metabolic health still required attention. Labs showed a normal blood glucose and a normal hemoglobin A1C, but his fasting insulin was quite elevated, which indicated that he had insulin resistance. And this is one of the tests that I recommend patients do. Everyone looks at blood glucose, fasting, and hemoglobin A1C. And if that's normal, they assume that the patient doesn't have insulin resistance or because they don't have diabetes. The elevated insulin levels or the elevated fasting insulin levels really tells you that the patient has insulin resistance. So you treat that patient the same, put them on a diet that is low in starchy carbs, and basically do all the elements of the popkin method to help reduce insulin resistance. And in this particular patient, I had a sneaking suspicion that there may be some fatty liver involved. So I did an ultrasound, which unfortunately demonstrated significant fatty liver disease, suggesting ongoing insulin resistance despite the weight he had already lost. So I stepped back and I treated the whole person, right? I optimized his sleep, I reinforced an anti-inflammatory eating pattern. He started doing intermittent fasting, assured that he reached his protein goals while maintaining a modest caloric deficit. His exercise program focused on core stabilization, flexibility, and progressive strengthening under appropriate supervision and physical therapy. Now, because of his ongoing obesity and his metabolic dysfunction, we discussed adding a GLP1 GIP glucagon-based therapy to support continued weight loss. And given the degree of his fatty liver disease, I started him on RETA truetide. So here's a really good example, Jamie, of where RETA would really help this patient in a bunch of different ways. So at the same time, we discussed the potential role of peptide therapy as one of the components of his comprehensive rehab plan. So I started him on the glow peptide stack as well. And the objective, Jamie, wasn't simply pain relief. The objective was restoring function, reducing inflammation, improving movement, allowing him to feel better while he was going through physical therapy, decreasing the mechanical stress on his lumbar spine, helping him become stronger than he was even before the injury occurred. And that's a completely different mindset than simply asking, you know, how do we make the pain go away? Instead, I was asking, how do we build a healthier version of this gentleman?

SPEAKER_00 26:34

That's such an important distinction. Pain relief is certainly valuable, but your goals seem much bigger than simply making someone feel better just today. You're really trying to reduce the likelihood that they'd end up back in the same situation like a year or two later.

SPEAKER_01 26:49

Exactly. I mean, the symptoms matter, Jamie. Of course they do. But if all we do is chase symptoms without correcting the underlying physiology, movement patterns, body composition, and lifestyle habits that contributed to those symptoms, we're simply treating chapters instead of rewriting the story. And that's exactly the physiology of the Popkin method. Every recommendation has purpose, every layer builds upon the previous one. Every patient teaches us that lasting recovery is rarely the result of one intervention. It's almost always the result of many good decisions repeated consistently over time.

SPEAKER_00 27:22

And I think that is the perfect lead-in to our next discussion. Listening to all of these case studies, it's become very clear that your approach is unique because it combines traditional internal medicine with functional medicine. So we've spent today's episode discussing obesity, diabetes, cardiovascular disease, orthopedic injuries, hormone optimization, nutrition, supplements, peptides, lifestyle medicine. But what strikes me is that all of these patient stories have one thing in common. You're never practicing only internal medicine, you're never practicing only functional medicine, you're blending both together. So can you explain why that's become such an important part of who you are as a physician?

SPEAKER_01 28:05

Yeah, I'd love to because this question really gets to the heart of why I practice medicine the way I do. As many of our listeners know, my initial training was in general and orthopedic surgery at the Mount Sinai Medical Center in New York City. Then the desire to treat the entire patient in a preventative fashion led me to do a separate residency in internal medicine. And it was my internal medicine residency at the Cleveland Clinic Foundation that really taught me to think systematically about what causes disease in the first place. Every patient is like a puzzle. You don't simply look at one lab value, you don't treat one symptom. You ask, how do all of these systems interact? How does the diabetes affect the kidneys? How does obesity affect the heart? How does sleep affect blood pressure? How does chronic inflammation influence cardiovascular disease? How does fatty liver disease contribute to insulin resistance? Internal medicine teaches you to connect these dots, but functional medicine really addresses the root cause of the disease. Popkin method creates the environment to address most of what causes disease in the first place and prevents it from occurring or treats it if it's already present. Internal medicine teaches you to recognize dangerous diseases, it teaches you when medications are necessary, teaches you how to keep people alive. And that's an incredible foundation. But early in my career, Jamie, I began noticing something different. You know, many of the diseases I was treating were diseases that, in at least in part, they developed over years or even decades. You know, people weren't waking up one morning with diabetes or fatty liver disease or metabolic syndrome or severe obesity. These conditions were quietly developing beneath the surface. And I found myself asking a very different question. So instead of asking, you know, how do I treat the disease? I started asking, why did this disease develop in the first place? And that single question changed the direction of my career.

SPEAKER_00 29:51

Well, that's a fascinating distinction. You were talking about moving from disease management to disease investigation almost.

SPEAKER_01 30:00

Exactly. I mean, functional medicine gave me another lens through which to view my patients. It encouraged me to ask questions like, how is this person sleeping? Or what are they eating? How much muscle have they lost? How much visceral fat are they carrying? What's their stress level? What's happening inside their gut? Are they deficient in important nutrients? And could improving these factors meaningfully improve their overall health? Now, here's where I think functional medicine sometimes gets misunderstood. Some people believe functional medicine replaces traditional medicine. As a classically trained Cleveland Clinic internal medicine physician, I don't agree with that at all. And on the other side, some people in conventional medicine dismiss functional medicine interventions because they're focused on medications. And as a functional medicine expert, I don't agree with that either. To me, they're partners that treats long-term trajectory. One stabilizes the patient, the other transforms the patient. And when you combine the strength of both, you have something incredibly powerful. And that's what the popkin method is all about.

SPEAKER_00 31:00

So you're not really choosing one philosophy over another, you're combining the best of both worlds.

SPEAKER_01 31:06

Exactly. Think about the gentleman we discussed earlier, whose diabetes was out of control, his hemoglobin A1C was 11.7. Um, imagine if I said, well, we're only going to work on nutrition. That would have been incredibly irresponsible. He needed insulin, he needed cardiovascular risk reduction, he needed blood pressure treatment, cholesterol treatments. Now imagine the opposite approach, right? Suppose I simply prescribe medications without addressing his diet, his sleep, his lack of exercise, his obesity, his visceral fat, his muscle loss, his alcohol use, his stress, the fact that he simply gave up on taking care of himself. Eventually, I'd probably need more medications to address each issue and more medications and even more medications. And he certainly would not have felt any better having doing this. And neither approach would have been complete. So the real answer is combining both disciplines, Jamie. Eventually, we probably need more medications to address each issue than more medications and even more medications. Neither approach is complete. The real answer, Jamie, is combining both disciplines. That's what the Popkin method is. It's not alternative medicine, it's not conventional medicine, it's comprehensive medicine, it's personalized medicine. It's medicine that asks not only what disease does this patient have, but also what can I do to address as many issues as possible without over-prescribing medications that don't get to the root cause? And most importantly, what kind of life does this patient want to live?

SPEAKER_00 32:36

Yeah, that's a really great way of looking at it because throughout today's episode, I've been noticing that your treatment plans aren't centered around medications, they're centered around people.

SPEAKER_01 32:46

Exactly. Medicine has always been about people for me, Jamie. And don't get me wrong, the lab values matter, the MRI matters, the CT scan matters, you know, whatever tests they're doing matters. But before any of those, there's a human being sitting in front of me. And if we forget that, we've missed the most important diagnosis of all.

SPEAKER_00 33:05

Dr. Popkin, we have covered an incredible amount of ground today. We've talked about sleep, we've talked about nutrition, exercise, supplements, peptides, hormone optimization, internal medicine, functional medicine. And we've walked through a few different patients, and yet I keep coming back to one thought that none of these patients were really looking for a medication. They were just looking to get their lives back. And as you've watched thousands of patients over the course of your career, what do you think separates the people who truly transform their health from those who continue to struggle?

SPEAKER_01 33:40

That's a wonderful question. And after more than 25 years of care for patients, I don't think the answer is any one thing. It's not genetics, I don't think it's age, I don't think it's finding the newest medication. The patients who transform their lives all have one thing in common. At some point, they stop asking what's the quickest way to lose weight, or what's the best supplement, or what's the newest peptide. Instead, they begin asking a very different question. Who do I need to become to be healthy? And that's a completely different mindset because lasting health isn't built around a prescription, it's built around identity. Healthy people don't simply make healthy choices, they begin seeing themselves as healthy people. They protect their sleep because they value recovery. They prioritize protein because they value muscle. They exercise because they value independence, they walk after dinner because they value metabolic health. And those decisions stop feeling like chores. They become part of who they are. And that's when transformation becomes sustainable.

SPEAKER_00 34:40

So you're really saying that the popkin method isn't about chasing perfection. It's about changing identity one habit at a time.

SPEAKER_01 34:48

Exactly. People often think success happens overnight. It doesn't. Success happens quietly. It's the decision to go to bed 30 minutes earlier or to take a walk after dinner, to prepare tomorrow's lunch instead of ordering fast food, to lift weights when you don't really feel like doing it, uh, to choose water instead of soda, to continue the program even when the scale weight hasn't moved. Uh, those decisions they seem insignificant in the moment, but over weeks, months, and years, they completely change the trajectory of a person's life. And one of the greatest privileges I have as a physician isn't watching someone lose 50 pounds using a GLP 1 medication. It's watching someone regain confidence, watching them walk into my office standing a little taller, listening to them tell me stories like they played on the floor with their grandchildren without pain, listening to them say, Doctor, I finally feel myself again. Those are the moments that remind me why I became a physician in the first place, because medicine isn't simply about extending life, it's about restoring life.

SPEAKER_00 35:48

Before we wrap up today's episode, I think we have to introduce something new. Throughout today's conversation, you shared so many practical lessons. And if listeners remember only one takeaway from today's discussion, what would today's popkin pearl be?

SPEAKER_01 36:04

The popkin pearl, I like that, Jamie. I guess today's popkin pearl would have to be modern medicine should never replace healthy living. It should encourage it. Whether we're talking about prescription medications, GLP1 therapies for weight loss, hormone replacement, peptides, or regenerative medicine, every advanced treatment works best when it's built upon a foundation of restorative sleep, purposeful nutrition, resistance training, and consistent daily habits. Remember, the goal isn't simply to lose weight or fix a lab result. The goal is to restore health. It's to reduce inflammation, improve metabolic function, preserve lean muscle, protect your brain, strengthen your heart, rejuvenate your soul, and build a body that's capable of carrying you through decades of healthy living. So never underestimate the power of mastering the fundamentals because extraordinary health is rarely created by extraordinary interventions. It's created by ordinary habits repeated consistently over time. That is today's Popkin Pearl.

SPEAKER_00 37:05

Very profound statement, Dr. Popkin. What I love about today's conversation is that everything we discussed was different, but the philosophy really never changed. Whether it was a healthy 71-year-old who simply wanted to lose abdominal fat, a patient with diabetes and heart disease, someone recovering from orthopedic injuries, or a patient considering a GLP1 therapy for weight loss, Dr. Popkin always started with the same foundation. The Popkin method isn't about chasing symptoms or searching for shortcuts. It's about restoring the body's physiology from the ground up. First, improve the environment your body lives in through better sleep, healthier habits, and reduce exposure to things that work against your health. Then, fuel your body with nutrient-dense foods that prioritize protein, fiber-rich vegetables, and healthy fats. Build strength throughout purposeful movement and resistance training, then support that foundation with thoughtful supplementation. And only then, when clinically appropriate, layer advanced therapies like GLP1 treatments, peptides, hormone optimization, advanced regenerative treatments, or prescription medications. Today's episode reminds us that you don't have to choose between traditional medicine and functional medicine. The best care often comes from thoughtfully combining the strengths of both while keeping the patient, not the diagnosis, at the center of every decision. So if today's conversation helped you think differently about your own health, we'll hope you'll subscribe, leave a review, and share this episode with someone you care about.