Non GLP-1 Medications for Weight Loss Help

In this episode, Rick and Greg explore effective weight loss options outside of GLP-1 medications, offering a practical and medically grounded look at alternatives for patients who cannot tolerate or access these newer therapies.

They begin with a discussion of weight loss physiology, emphasizing the roles of hormones, appetite regulation, and metabolic signaling—highlighting why willpower alone is often insufficient for long-term success.

The episode then reviews several evidence-based options, including:

• Phentermine, a long-standing and cost-effective stimulant that reduces appetite and increases energy
• Topiramate, a medication that targets cravings and reward pathways in the brain
• Combination therapy (phentermine + topiramate) for enhanced outcomes
• Orlistat, which reduces fat absorption but carries notable gastrointestinal side effects

They also discuss off-label use of metformin, particularly for improving insulin sensitivity and stabilizing metabolic function, as well as berberine, a supplement with similar mechanisms.

As part of a comprehensive approach to weight loss, Rick and Greg also highlight the role of targeted nutritional supplementation. Their supplement line, available at GetWeightWise.com, is designed to support individuals navigating medically guided weight loss—helping address common challenges such as energy levels, metabolic support, and medication-related side effects.

A key focus of the episode is the importance of working with a medical provider, as studies and clinical experience consistently show improved outcomes with supervision, accountability, and individualized treatment plans.

The episode concludes with insights into emerging evidence that personalized dosing strategies—especially with weight loss medications—can significantly improve results compared to standardized protocols.

Disclaimer:

This podcast is for informational and educational purposes only and does not constitute medical advice. Listeners should consult their healthcare provider before making any medical decisions.

Transcript

SPEAKER_01 0:24

All right, here we are, Greg. Hey, how you doing, Rick? Good. Welcome back. Here we are at Healthier After. We want to talk about some uh great info today. Yeah. Uh and it emphasizes, you know, we usually start an episode with essentially a medical disclaimer. We are medical providers. We are not your medical provider. What we provide here is information and education. Uh and and we really just uh want good information out there for people to use, uh, but it is not meant to replace your uh relationship and advice of your uh professional medical provider. Uh so please consult with them before starting any medical weight loss program, any supplements, any medications. Uh and that's that's super important today because what we really want to talk about is um some options. We've talked a lot about um different you know, lifestyle changes and things. We talked uh last week's about GLP1 medications and what a what a like life-changing um whole whole paradigm shift they are in in the weight loss thing. And there's they're they're really are shifting what weight loss means. Yeah.

SPEAKER_00 1:23

And even other things, right? We talked about other benefits of GLP1s, like yeah, it's the weight loss stuff, but it's so many other things. And so we we expect that that'll continue. We'll talk about GLP1s ongoing here, probably forevermore. Yeah. So yeah.

SPEAKER_01 1:37

But but then again, they're they're they may not be for everybody. They're expensive, there's some downsides, and and we want to be honest about that as well. And there are some other options. So, what we really want to talk about today, I think, is some some different options, review a little physiology and talk about maybe some other options that aren't GLP ones. Um but but the important thing is a lot of what we're gonna talk about, there are prescription medications that require your provider, your medical provider, to prescribe medication. And and inherent in that is a responsibility to oversee uh your use of those things and how you're responding to those and and make any dose adjustments. And so we'll talk about that, but it's it's just I can't emphasize more the importance of doing this with your medical provider uh because that's really what we're gonna talk about is things that require that.

SPEAKER_00 2:19

Absolutely. Yeah, and we can always talk about support and things you can do on your own. Um, you know, we're gonna we're gonna uh kind of dive into this more, but just having the support of a medical provider is as shown study after study. Every time they've studied and looked at this, having that accountability as well as the support uh from a medical team, it really does and can enhance uh the benefit, um, namely really just the um overall, the overall outcome. Like your outcomes are better when you have a medical provider that you can do this with, that you can seek medical attention from. Um, if needs be, you can discuss the good, the bad, uh, and they can guide you through this process. So we're gonna talk about a lot of that today.

SPEAKER_01 3:00

Awesome. So let's get into it a little bit. Um, so GLP ones, I mentioned they may not be for everybody. There are some downsides, there are some things. You know, some people have side effects that they just cannot manage, they just can't tolerate the side effects. That usually that's nausea. Um, and and and there are people I know people that that really cannot tolerate more than like the tiniest little dose, and and it just it messes them up.

SPEAKER_00 3:22

Yeah, it's like a dose that is is gonna be not probably effective for them in terms of weight loss, maybe a really low dose, um, but um gives them all the side effects. Unfortunately, there are a few patients that Rick and myself have seen that you know, a lot of people tolerate them fine, and uh and the worry of a lot of patients I see is the side effects. Most people really do tolerate them fine, but there are some patients that for one reason or another, whether it be uh, you know, the side effects or whether it be even the cost of the medication, yeah, is that uh they just for whatever reason they can't be on them. So we want to we want to discuss some of that today, some alternative options that uh are you know you can discuss with your medical provider.

SPEAKER_01 4:02

Yeah, and and and there are a few people there, you know, there are uh certain medical conditions that are contraindications to taking it. I mean, if you have you know, if you're one of those people that has a family history of uh multiple endocrine neoplasia type two men's two, I call it men's two because I can't say that big word. You know, I mean I mean that's a real thing, and and and you should not take GLP1s if if that's you. Uh so there are other options. Uh and then there are people who just cannot get over an injection. Yeah. It's just, you know, and that's that's okay. It's true.

SPEAKER_00 4:33

And there are oral forms, and we talked a little bit with Cliff about that. If you guys ever tuned into that episode about um oral uh peptides, GLP1 specifically, and we know that the absorption is significantly lower, but can be effective for those that don't um that don't essentially uh or can't tolerate injections. The the problem being there once again is sometimes there's some barriers with uh oftentimes the oral medications that have the side effects that are undesired. Uh the absorption is is not as good as the injections. And then once again, uh cost. Like cost is sometimes uh one of the biggest barriers.

SPEAKER_01 5:08

Yeah. So so the big picture on weight loss physiology, just do a little refresher. We've talked about this a little bit more in detail in some episodes about what we're talking about with weight loss. We we we're looking at regulating appetite, and that involves some things in the brain and some things that are hormonal. Um, we talked about insulin a lot uh and how that how that um guides your body to to store fat. Um we talked about energy balance and hormonal drivers. Uh we talked about just the willpower and how often you know willpower just isn't a thing on its own. Like it like it you wish it was, but willpower alone doesn't seem to be as effective as willpower with assistance.

SPEAKER_00 5:48

Yeah, and a lot of times a lot of times on that willpower, boy, it's uh it can short term. It's short term.

SPEAKER_01 5:54

Yeah, it works short term, but it but it it is rarely um sustainable for long-term uh lifestyle changes. Right.

SPEAKER_00 6:04

Yeah. Well, just I mean, that's what the science and the evidence shows. That's what it, I mean, over and over again. And it's because you're constantly fighting uh the system, the system that is meant to keep you alive. It it wants your body wants your appetite to be high, high because it thinks that you're hunting and gathering for food. Your body doesn't realize it's 2026 and you're not you're not in a position where you have to go and do that. Right. And so we there's a reason why our body does that. It's frustrating at times when you're in a position where you're like, hey, why does my body feel why do I feel hungry all the time? And then of course, the way that we live and our lifestyle sometimes just even feeds that more, right? We talked about we've talked about the insulin, which we really dove into uh recently about how once that gets going in the wrong direction, it just feeds the cycle of constantly feeling like you can't um ever scratch that itch. Yeah. And you constantly feel hungry because we know it increases other hormones, including the hunger hormone, and you just it's this vicious cycle.

unknown 7:00

Yeah.

SPEAKER_00 7:01

Okay.

SPEAKER_01 7:01

So, so um, what we're gonna talk about is several medications at this point. Um, all of them target uh some uh of the pathways that we talked about, like how your body handles the hormones, the energy levels. So let's dive in with uh number one, pentermine. Fentomine is a medication, it's a stimulant.

SPEAKER_00 7:20

Yeah, stimulant medication. So it is a controlled substance. By a controlled substance, we just mean that it does require a prescription. And when it's controlled, it does mean that there can be a dependency or uh uh inclination for like you can basically be build up uh um how do I say uh um uh physical dependence on that medication. And so it's controlled for a reason, right? You need to have this monitored by a medical provider. Uh, this requires a prescription. Phenomine, besides the GLP ones, by far and away. I mean, before the GLP ones, even there were um there was phenomine. I mean, phenomine was by far and away the number one uh weight loss medication that was prescribed. And so it's uh it's important to know that uh kind of what it does. Uh the good news about phenomine is it's inexpensive. It's not it's not costly. It's maybe 20 bucks uh for a month supply at the pharmacy. And so it's uh it's a really effective medication. It's a stimulant medication, so it hits on some pathways that suppress appetite, uh, that uh suppress cravings and hunger, uh, oftentimes gives you energy. A lot of people really love uh the little boost that they get from phenomene, you know. Um boy, I you know, and I'm not trying to, you know, target any one specific group here, but moms, like moms that are, you know, maybe just like that kind of post pregnancy, post-breastfeeding, trying to get off the baby weight, uh, but also feel like your energy's that because you're just taking care of babies and and doing all the things that that moms do. Uh like I said, I don't want to, I know dads do some of that stuff too, but uh I'm just saying like that's one where phenomine I find is so effective. They get that nice boost of energy, they get a nice help with appetite, uh, you know, appetite and cravings. You usually take it in the morning because it's a stimulant, right? You you don't want to mess with your sleep, uh, as we've talked about before. And so they take it in the morning, the AM hours last eight to 12 hours, and you just get some good energy with some uh with some appetite and craving suppression, and and usually is meant for more short-term use. Recent studies have come out, and they actually um the American Obesity Association as well as the American Entercronology Association released, and I don't want to don't quote me on this exactly. I mean, I'm I don't I'm not reading off of anything uh to be able to say this, but essentially released a uh a joint article, a shared article where they really found that like the use of phenomene um is really per patient. There it used to be a set, like three months, no longer. Now they're finding that like, hey, look, if these people are reducing their risk factors, their weight's dropping, they're tolerating it well, there's a very low risk for dependency. And if they're doing well on it and losing weight, they're actually uh risk versus benefit ratio goes up. If they need to be on it longer, it's totally appropriate. Now that's of course where the medical provider then comes in.

SPEAKER_01 10:17

And you make a decision based on that as a provider. Super popular medication. So by short term, usually it has meant three months, but now it looks like evidence suggests that could even go longer than that.

SPEAKER_00 10:27

Yeah. And they didn't do a whole new study on this. The I mean that those are very costly, millions of dollars to these studies. Fenomin's been fenomine's been generic for quite a while. They more so were looking at it from a these uh the endocrinology, you know, association as well as the obesity association, like these are these are professional bodies of of medical providers that are trying to just give you the latest, greatest information. And so they're not like you know, they don't have stock in phenomine or anything like that.

SPEAKER_01 10:55

They they are really just looking to to update and provide quality information, and and and good usage um data for for providers. Yeah, guidelines. Okay, so what are the downsides uh on phenomine? Uh why would I not take it?

SPEAKER_00 11:11

So it's a it's a good question. So uh obviously, if you have a uh uh concern with taking anything that's a stimulant, if someone's ever had uh an addiction in the past to stimulants, uh whether it be legal or illegal drugs, uh definitely don't want to go down that road. You don't want to you don't want to start that pathway again. Um, you know, if you are very sensitive to stimulant medications, you could sometimes just do a lower dose. Phenomine has a pretty broad range where it works within. So I have some people that are just sensitive to stimulants. They tried phenomine and did really well with it just at a lower dose. Um, but in some of those people, insomnia can be one of the side effects that I'll see. Now, most people typically three to five days of maybe feeling like they didn't get as good a sleep and then they get kind of used to the medication, they start sleeping fine. But I've had a few patients that just really couldn't tolerate that um, they would be able to get to sleep and then they'd wake up for no apparent reason and just couldn't get back to sleep. And that's just, of course, we know we've talked about it a bunch here, how important that is. So we don't want to have, you know, who cares if you have uh some decent energy during the day and some appetite suppression if you're not sleeping, because eventually that just will just wear you down. And we know that that can have a counter effect to your weight loss.

SPEAKER_01 12:19

And and and then additionally, um, as a stimulant, it affects your heart rate and your blood pressure. Absolutely.

SPEAKER_00 12:23

So you can have palpitations, you can have, I mean, so uh this is age-dependent. I mean, there's not a necessarily a definite cutoff in age, but I mean, I'm typically not putting grandma on this. Um, it's no offense. I know that grandmas are now younger now. It seems like younger nowadays, 40-year-old grandmas. Great grandmas, great great grandma and great grandmas. Uh really anyone over the age of 60, extreme caution with this, right? We don't need to be working that ticker necessarily harder than you would with normal activity and exercise. Number one side effect I actually see on this medication is uh dry mouth. It's and it has a little bit of an anti-conolinergic effect. Um, and it'll dry your mouth out a little bit. So we do have to be cautious of that. I love that side effect for patients because it gets them drinking water. And so I I mean, personally, when they tell me they have a dry mouth, I'm like, perfect. Drink more water and constipation. Yeah, with that dry mouth, you can get some, of course, it further down the GI tract, you can get some constipation. Not something that I hear a lot.

SPEAKER_01 13:21

If people are drinking water and they're moving more, if your mouth is too dry for too long, the other end will be too dry soon enough.

SPEAKER_00 13:30

Yep, it'll it'll it's all connected, right? It's all connected. So it's uh phenomine's a great one. It actually, besides the GLP ones, has been found to be the most effective percentage-wise when they did the studies. And I want to say it's right around eight to ten percent, is on average what people lose. Yeah, I think that's about right. Um, and so eight to ten percent, which is really good. It's respectable. And it was really the most effective one until the GLP ones came out, really the most effective way. And once again, it's pretty cheap, it's generic.

SPEAKER_01 13:59

It's this is old school weight loss, yep. 15, 20 bucks, um, but still widely used. Yep. Yeah. Okay. So I'm still stuck on the GI tract. Like, like, what's our little catchy phrase we have to say? Like, like when it comes to your GI tract, you need to stay wet the whole way through.

SPEAKER_00 14:15

Yep. I don't yeah, I don't know what might be.

SPEAKER_01 14:18

Constipation is not a side effect. We might do a whole constipation starts at the I uh Yeah, we're gonna have to work on that. We're gonna do an entire episode on constipation. It actually is one of the biggest side effects uh some of these medications as well. All right, so pentermine, that's awesome. So now now uh let's just stay on that for a second. There's actually a combination um product, right? With pentamine and topiramate.

SPEAKER_00 14:41

You can do a combo, which is called QCima or QCima. I mean, that one's the pronunciation might be a little bit off, but it's uh uh QCMA is a combination of phenomine and topiramate. So topiramate known uh drug used for actually um seizures. It's actually for for the brain. And some people use it for uh migraine headaches, actually. You got it. So headache medication, seizure medication. Um, and so we it actually works really great at low doses for appetite suppression. So this is working on that part we talked about, part of the brain, the dopamine section. Okay, go ahead. Yeah, and so it's no, it's just really nice. We uh oftentimes, if I have patients, so I use this in a couple different ways in clinic. Um, oftentimes it's it's in addition to so the phenomine's not quite getting you there, you want the combination, or you are sensitive to stimulants and you like the phenomine at a lower dose, but then you combine it with uh with the topiramate, really effective that way. The other thing that topiramate works really well for uh when I'm seeing patients in clinic, if they are like the phenomine's wearing off around six or seven o'clock in the evening, and I need something to bridge me because I get really snacky between that seven and bedtime. And we always talk about not eating late. And so sometimes if I do it separately, uh not the phenomine, topiramate together, I'll do phenomene for the AM hours. It wears off in around late afternoon to early evening. Um do a topyramate just on a low dose, and it'll it'll bridge you in without that stimulant effect. Topiramate, unlike phenomene, still helps with appetite and cravings without the stimulant effect. Um, the the it sounds counterproductive. Some of the side effects of topiramate are you know making you tired. Uh-huh. I don't see that as much. Every once in a while I'll have patients that get a little bit uh dizzy. And uh, but once again, at these lower doses, I just don't see the side effects all that often. Most people tolerate it fine. If I take a patient off topiramate, it's generally speaking because they just don't feel like it's working well enough to get them where they need to be. And we sometimes have to go a different route. But for the patients that works for, it's it's a great combination with or without phenomine.

SPEAKER_01 16:44

Okay, awesome. So, so so the topiramate, what it adds to the fentermine as a stimulant, works on an energy level, is uh is the topiramate would be kind of working the brain on your cravings on that on that reward pathway that that leads you to emotional eating. Sure. Uh you know, the the person who's like, I don't feel physically hungry, but I keep eating anyway.

unknown 17:04

Yeah.

SPEAKER_01 17:04

So that that it that that's what we're targeting with this.

SPEAKER_00 17:08

And it and it really does target different pathways, as Rick was saying. So I I like it because sometimes we need a little bit of a combination approach there. I find that it's very effective. I'll typically prescribe it separately. I don't usually do the name brand because it's a little more expensive. Um, so I'll typically prescribe it phenomene and topermate separately and just figure out what combo works for the patient. It's generally, once again, the real reason we why you want to go to a medical provider that uh deals with specifically with this is because they can usually find um what's gonna work best for you.

SPEAKER_01 17:39

Well, and it makes sense when we talk about like how that works and on the brain, um, because it's actually used sometimes in helping with smoking cessation, right?

SPEAKER_02 17:47

Yeah.

SPEAKER_01 17:48

And so so it's it's just that whole kind of reward pathway in your brain that that we try to interrupt. Um so that's good.

SPEAKER_00 17:55

That's good. And and if you're smoking and it stops you from uh craving cigarettes, I mean I think it helps you quit smoking, it's all the better same.

SPEAKER_01 18:03

Like smoking still 2026, here we are, we will say right now, smoking is still bad.

SPEAKER_00 18:09

Yeah, we that hasn't changed. There's no new data in that. In fact, there's more data against it than than ever before.

SPEAKER_01 18:16

Yeah, I mean, this is okay, side note, but in in the like practice in the emergency department. That that that to me, it's it's one of the most the most heartbreaking things is is to see people who who, you know, we see people at the end of years of of smoking, and and they all know, you know, everybody knows they can also smoke it, but but when that day comes that like I can't really help you breathe anymore, uh you're never gonna get better. Like it to me, to me, that's a that's a sad day. Um and and I think all these things that are that are addictive, that are healthy, it's really what we're trying to do is get people to be able to make these these changes, improve your lifestyle, because improving your lifestyle improves your life. And and it's not just about extending how long, but it makes your life better.

SPEAKER_00 18:58

Yeah, I've heard uh kind of the argument with smoking is that like, oh, well, it really helps like suppress my appetite.

SPEAKER_01 19:03

And I'm like, boy.

SPEAKER_00 19:05

We've got to find something else.

SPEAKER_01 19:07

I mean, not not at all a healthy way to suppress your appetite. No, I mean the the side effects are ultimately way way worse. Way, way worse. Uh yeah. Uh anyway. All right, uh, so so now let's talk about um uh should we talk about oralostat? Orlostat. So so this is oral stat is a medicine. It's a it's a fat absorption blocker. Like, like you you eat it, you're it doesn't it doesn't get absorbed in your body.

SPEAKER_02 19:35

Yeah, right.

SPEAKER_01 19:36

You take it and it stays in your intestinal tract, and in the intestinal tract, it grabs on to any fat you eat and keeps it there. That's kind of how it works.

SPEAKER_00 19:45

You just don't you don't personally absorb fat. Now, this uh orlostat got popular, especially during the um 80s, 90s, when fat was looked at as like the big enemy. Which which we look, too much fat, we can argue like that that's not gonna be good for you. But we also know fat's not the enemy, uh like the biggest enemy at the time it was really and still is uh more like sugar, simple carbohydrates. Um, but that this came along when uh it was like, hey, fat's the enemy, so if we just stop you from absorbing fat, then make your body so you cannot use it. You can't get it in you. If you're not like a sweets person, but like you overdo it on all the fatty stuff, then this might be a good option for you. The only side effect, which I mean kind of is intentional, is that if you overdo it on the fats, you will know it. You will know, um, because it does not absorb, so it has to leave the body, and uh you will have some bowel movements that will be like you will have to put in your diary because it'll be something for the record books. Dire.

SPEAKER_01 20:45

I never realized that diary sounds like the very start of diarrhea. It'll be I didn't no pun intended there. Yeah, but that's what you're gonna get. Like, like, like straight up, um, you you you eat orderless fat, it keeps you from absorbing fat, and and that's good because it fat is very concentrated calories that your body can store as more fat. Yeah, I mean so so it's it's a reasonable thing, but the fat stays in the pipe. And yeah, you don't absorb it. It keeps going through until it leaves the pipe.

SPEAKER_00 21:19

Yeah. So if you overdo it on fats on this, this is kind of just more almost like, hey, we're not gonna absorb as much fats. And you need some fats, right? So it's not doesn't stop. Instead of going into your body and being used, it goes into the toilet. Yes. It goes into it stays over.

SPEAKER_01 21:32

Or in your pants.

SPEAKER_00 21:33

Yes. Or wherever like wherever you are, and then it has to come out. It's not gonna absorb.

SPEAKER_01 21:38

It doesn't go anywhere else but out.

SPEAKER_00 21:40

So this has been really popular. It is prescription um at the higher doses. It's a low dose over the counter. Yes, or low dose over the counter. So it's not a it's not a bad option if you feel like the fatty stuff, like even like I would say the ice cream is probably dual, right? It's like the high fat, the high um high high uh sugar. So I really think that it comes. Down to this is an over-the-counter and/or work with your medical provider. We're going to tell you why we believe working with your medical provider is a better option here soon. But either way, this one is about three to four percent drop in body weight. So it's about half or a little less than half of as effective as like say something like a comparable phenomine. And so not crazy effective. But if it discourages you from overeating on the fats, that's really where I think the biggest benefit is that sometimes we'll put your you in check and be like, I know if I overdo it on the fried foods or the or the too much ice cream, I know I'm gonna pay for it.

SPEAKER_01 22:37

Yeah, it provides it, it literally provides a motivation for you to be cautious about your fat ethics. Yeah.

SPEAKER_00 22:45

And all the side effects are related to GI. I mean, there's almost yeah, I could get that's all it stays in there. Yeah.

SPEAKER_01 22:51

Yeah. Awesome. Okay. So so those are those are some things to talk about. Um, we got a few minutes. Let's talk about um some off-label uses of some medications. Uh and by off label, we've talked about this before. There, that's just using a provider prescribing a medication that that hasn't really been studied for this, uh, but it's kind of known that it helps with something, right?

SPEAKER_00 23:14

You're kind of banking on the side effects of a medication. You're you're knowing that, like in our case, uh, usually hitting on either you know something that helps with metabolic support or control or or something that really helps with what we know is like as a side effect, hey, everyone that was put on this medication reported 80% of these people reported that it decreased appetite and cravings. Well, yeah, so we didn't they didn't study it for that, but they had a significant amount of side effects of hey, these people are tend to lose weight because their appetite uh decreases, which is when we talked to Cliff, if you guys remember, I mean, which is kind of how GLP1s were found to be more of a weight loss as opposed to just for diabetes. So yeah, it's uh I think uh one of the biggest ones uh that I use in clinics still to this day is metformin. Yeah, which is again, it's a diet, it's a diabetes drug.

SPEAKER_01 24:03

Yep. Um, but it supports uh weight loss biology.

SPEAKER_00 24:07

Yes, right. Yeah, so improving insulin sensitivity is the biggest thing. And we've talked, we talked uh in at length. Was it last episode that we talked about insulin a lot? I sometimes get them. One of the episodes recently, so you'll have to go, you know, see that, is is we talked about um the importance of insulin, insulin in your body, how insulin uses everything. We we ended up um it was last one. The um your insulin, uh improving your insulin sensitivity just means that your body is more sensitive, uh, your body responds quicker, more timely insulin release. So when we have that with something like metformin, which is an oral medication, so that's why a lot of people like it, uh, a lot of times it just helps your body really just utilize the metabolic system a little more, a little better and uses utilize insulin a little bit better. So keeping blood sugars in check. Um, so insulin resistance or insulin, you know, increase in insulin sensitivity, uh, it can really help with that. Now, there's been a couple studies that have shown there is no direct effect on appetite or cravings with metformin. There's there's never been anything shown with that in terms of when they study this medication. However, there's been some studies that have they have found later on that when you get your metabolic system in check, you're not doing this big yo-yo up and down with your insulin and sugars, is that there's an indirect effect of better management of cravings. So not necessarily appetite, but cravings, right? Because what drives cravings in a lot of cases, we had a bunch of sugar earlier in the day. Now we've tanked our blood sugars and now we're looking for anything sweet. If you can get that under better control and you're on get less of that yo-yo, metformin essentially can uh help with some of those cravings. So I do like it. I've had patients that reported back uh after putting them on it, kind of unexpectedly, that they're like, hey, yeah, it's helping me lose weight, helping support my metabolic system. I feel like it helps me be the word I hear all the time is more steady, just more steady in my blood sugars. And then an indirect effect of like, oh, and yeah, and it just helps me with those little uh afternoon snacky, I want a sweet cravings. It just helps kind of calm that down.

SPEAKER_01 26:16

Awesome. Okay, so so those are I think that's a good list of some options that people have uh outside the GLP1 realm. Uh, but but again, these things that we've been talking about require medical provider. Now, um, let's talk about a supplement of the week. Yeah, supplement that you could actually get without your medical provider, right? So anything in in this realm.

SPEAKER_00 26:35

Yeah, supplement of the week we want to talk about is berberine, and it's because it it's a supplement, you don't need a prescription for it. It's and it acts very similar to metformin. And in several studies, it shows that the effects are similar to metformin, maybe not quite as strong, not quite as direct, but really uh a good supplement overall, um, but really, really hits on on really those pathways similar to metformin that helps with insulin sensitivity. And uh so berberine is the supplement of the week. You can kind of just uh really look it up and you know can take it as as uh indicated on the bottle, depending on which route you go. We have a great berberine supplement with uh you know with with what you know that we provide provide on our website so you guys can look at that. Um uh so that's support, well, that's not the support. Getweightwise.com. Yeah, so we have the channel. Getweightwise.com. Yeah, getweightwise uh.com has a link if we figure that out in the description. But it's uh we have a good berberine one on there. I have several patients that have taken that one that really, really liked it, uh or are still liking it as just like, hey, kind of a more uh I think that word natural gets used maybe a little too frequently in medicine. But yes, a kind of a more natural approach to doing similar to what Metformin does without the prescription.

SPEAKER_01 27:52

Yeah, awesome. Okay. Uh and finally, uh last couple minutes, let's talk about uh the skinny on science. Yeah. So I'm I'm gonna pull up. I've got I was looking at uh there was an article. This is just an article written by a provider who did they kind of did their own little in-house study on multiple patients. They do um telehealth visits, and and what they wanted to compare is you know, the the studies that were done on GLP1s on semaglutide were done um in a way that that uh it was called the step trial. So so they they have well-defined dosing regimens. Okay. So I'm gonna close that for a second. Um, so you follow that. And most prescribers, most uh providers will will follow these dosing regimens. You you know, you it's it's very set. And and and most of the time this is like, okay, your provider gives you a prescription, you're gonna follow this schedule, uh, you're gonna take this dose for four weeks, you're gonna up the dose to this for four weeks, you know, up the dose, and uh you follow a very regimented plan, and your provider will see you in six months or a year. And that's that's fairly common practice, and that's kind of what how those trials were done. Uh, what what this guy did is they they kind of personalized this a lot more, and they did follow up uh a little more than monthly. Like it was, I think in in one year they averaged 12.7 visits, and they they adjusted the dosing of the medication much more individually and frequently. And so so uh the results of this are that uh compared to I think 14.9% body weight loss in the in the actual STEP trials, uh in their clinic, they resulted the average weight loss was I think 21.8 percent. So, so like half again as much of your body weight lost by specifically adjusting the dosing of your GLP1 medications uh with regular kind of monthly follow-up. Um and you talked about you know the importance of of um accountability. Yeah, but but but just just the dosing, making it more individualized, more specific. And they went slower with some people, faster with some people, and and achieved remarkably more weight loss uh by by doing that. So so again, I to me that just emphasizes the the importance of of close contact, frequent contact, follow up with your medical provider who's providing these medications. Um it's just it's not as much it is not as effective to just get it on the internet and inject it according to the the standard dosing standards because everybody's individual.

SPEAKER_00 30:27

I agree. And the thing I'm hearing there is just that is that is that if you're gonna go get these medications and you're just gonna like more is not always better. I think the idea that it like as much as I can get, as much as as high as I can go and tolerate and lose weight is not always better. We've seen this with our patients, but it's it's uh so it's something we already knew, but it's nice to see that someone actually put it into a like into a trial and essentially a study. And it's it's just really nice to see that the thing that we already knew that not everyone requires a really high dose of GLP1. Some people, the combination of a low dose GLP1 and lifestyle changes is exactly what they need. And increasing their dose would only potentially increase their side effects with really no benefit.

SPEAKER_01 31:11

No, the the counter to that is actually I have another study I was looking at today that that they they went uh, or some people they went as high as three times the the recommended maximum dose of celloglutide. Um, and some people tolerated that well and did much better on on that. So so I mean, it's just it it it emphasizes again the the wide variety of effective dosing there is with these medications.

SPEAKER_00 31:36

And I I couldn't agree with that more. I see in clinic where I have had to move someone all the way up to these max doses and they're still not responding, and you're scratching your head. You're like, so I have someone on the same medication, yeah, same medication as as another patient, uh, similar size, similar build, similar age, similar medical history, and they're responding at the lowest dose. And then I have another patient that's at the max dose, and they're like, Can we go up? And like, usually the answer is no. They're their reason they're doing these trials is because they've just found there's a certain amount of the population, and we don't know if it's receptor sites. We're not really sure if it's that they just don't have as much GLP1, but they really don't respond to even the max dose of, let's say, Ozempic or semaglutide or you know, even Manjaro. So they are looking at those trials now as a legitimate for some people that need to go up. But once again, if you're utilizing a medical provider to be able to walk you through this, you're gonna be able to determine when when it's best to maybe start looking at um exceeding even the max dose as these trials give us more information. Because we're finding that these patients that uh end up getting put on these higher doses, at least everything that I've read so far, is that we're not increasing their side effect profile. They're doing great. Yeah.

SPEAKER_01 32:48

Yeah. Awesome. Okay. Well, get some berberine, uh, talk to your medical provider. Um, and we will see you next week. That that's a I think it's a good wrap-up on some other options for people. Uh, get some information out there uh in case that's gonna be helpful. And uh we hope that makes you healthier ever after.

SPEAKER_00 33:08

Thank you.