Why Ozempic Is NOT The Only Way To LOSE WEIGHT! | Prof. Eric Westman

[Music] what would be your views on on the sort of the current invogue treatments such as you know the the woves and oics and things like that is that something that you use in your practice or is that is that something you don't you don't find that you need or is it still beneficial even on on in this context well um so I teach a diet approach we studied it published papers it's it's reliable it works you know have no doubt this will work so that's still what I like to lead with if someone's never tried uh a prescription strength diet or or medications even pills and shots and surgery I like to start with diet alone and just explain that if this clicks that's all you need most um doctors don't understand that most doctors now are are following the Pharma education and and the the um the effectiveness of these weight loss shots and the the marketing is just everywhere now and so I have people coming in um a story recently my my primary care doctor three months ago said you need to go see Dr Westman but you it's going to take three months so here want you get on this weight loss shot so had already lost 30 pounds of course the doctor didn't say watch your blood pressure so she came in with a blood systolic of you know 85 and was feeling dizzy and tired so you know you got to watch out the so these are powerful medicines that the doctor needs to understand how they affect the other medications uh I I well sometimes so the other curious thing that that's unusual is a third of people have significant non I or stomach pain or diarrhea even in the clinical trials so a third of the people dropped out most drugs won't be taken to the market if it has that messy profile you know but the the market is so big and that for those the two-thirds For Whom It Works without side effects it's having benefits so but some people will come to me now on a shot thinking that's the only way you can lose and have terrible nausea and just it's it so the doctors send out Zofran to treat the nausea of the medicine and and I try I try to explain well hey wait wait wait I can teach this with a with a diet and you don't even need these shots and but you know if someone gets on that and the other doctor didn't mention the diet they think that's the only way it's going to work so you know I am past president of a group of doctors that use these medicines um a lot and they use it safely with the teaching of diet with the medicine not all doctors are doing that and there is a concern of the muscle mass loss if you're not supporting the protein that you're not taking in and you're going to lose some muscle mass so the I guess the long story there are healthier ways to lose weight than to use one of the shots uh for some people it's a a godsend because it's simple that they've honed down the delivery system that you know any even I could do it any even a doctor could inject which I'm not a surgeon sorry so you wouldn't understand that one but um uh I think there there's going to be kind of unbalance in general that'll be more good than harm but I think you could do it even more elegantly by just changing the food and you know doing a carnivore diet and you're not subsequently getting the side effects and having to find we're in an awkward moment where the range of cost could be from $3 a month to $1,000 a month for an individual if the insurance isn't covering it and and some people are paying 500 out of pocket per month for these because they think there's no other alternative uh you know I I go to the weight loss meetings with other doctors who use this called obesity medicine Association and the uh concern or what I observe and it's just I guess an evolution of the field the medicines have now influenced the meetings so that you as you might expect that now the booths are big and the doctors get free meals at the dinners and and and it's like Midas has come through with the gold touch to make the doctor meetings nicer and better and of course that's going to make these doctors prescribe medicines more uh but uh I think there's going to be more good than harm although I I have concerns um and you I think you want to use one of these medicines with someone trained in obesity medicine not just the family doc saying here take it yeah yeah I would agree and and especially with the the dietary advice as well because I think that's that's such a big part that's missing from you know using these weight loss drugs or even weight loss surgeries I I know people who have gotten these surgeries done have had patients that have gotten these surgeries done or have been on the oics ETC no one no one talks to them about proper diet and lifestyle they you know in fact um I had um one person I know had this weight loss surgery and they they formed a stricture and so it was a very you know narrow opening from their their stomach to their small intestine and they um couldn't really eat much of anything and so the dietary advice was you just need to drink a lot of soda and ice cream and just get as many carbs and sugar as you can because you need at least 1,200 calories it's like where are the nutrients you know why and and so you're telling these people to it doesn't the calories are the only thing that matter nutrients you know can take a wash and they were getting they were getting quite serious uh nutritional deficiencies and getting hair loss and other sorts of serious issues and when you when when you do that you're you're forcing them to limit the amount that they're eating and then will go inmic and cause gastroparesis and force the same issue but you're not teaching them what to eat and so they have this um they they sort of get worse um habits as a result of that they're just forced to eat less but they're they're eating the same bad things or even worse things it's just they're they're forced to eat less of it and I think at the end of that when you come off the OIC of the wovi or you start stretching out your stomach again after a gastric sleeve you you have these very bad eating habits and then that's typically why people regain this weight and they lose muscle mass they lose lean body mass and then they regain all of this uh you know adapost tissue and this fat and I think that's likely why I think if you're going to do a surgery or an OIC that you you have have to do it in conjunction with a healthy lifestyle and diet otherwise you know what's the point well you know you're spot on and unfortunately that's not the the norm U so if you have weight loss surgery you know you like at the ruin y gastric bypass you you don't have to really say anything about food may people will lose 180 200 pounds over the next two years pretty reliably and so from the surgeon standpoint I could understand well you know it's you not a surgical problem anymore right but then when the weight loss stops generally the surgeons don't want to hear from the patient because you they want to operate and some will some won't and so we want people who have had weight loss surgery to come to obesity medicine doctors we will welcome you with open arms and teach you how to maintain and and even lose more weight I mean it's it's very unusual for someone with weight loss surgery to achieve their High School weight I mean they no one's taught them how to do that and and we see that not uncommonly teaching lifestyle because it'll continue to go down but yeah so that's the same concern with very low calorie diet programs the bar shake programs the the weight loss medicines that if no one teaches you how to sustain it it's just going to come back and and of course it plays into the drug company's hands where where well we'll just keep you on it forever and and they've already kind of anticipated this with clinical trials that show well if you randomize then people to Placebo or the real thing out here people regain the weight so we'll just keep them well but you didn't teach them how to eat so so why not teach people how to eat up here they'll lose the weight using the the food based diet program and then they'll also maintain it but you know it's kind of like the Wild West out there still you know cowboys and you know um you can uh say with without recourse that surgery is the only thing that works I see that and it's not true but if you're uh it's kind of like car salesman you know my car is the best well U there are a lot of cars that work a lot of programs that work in in my area there are you know half a dozen different programs that that work work and different styles but you want to be in one that that will help you not only lose the weight but also sustain the weight loss and I don't see the the Pharma companies stepping up to help uh educate about diet which you know is it their job uh you know yeah I think so but others don't yeah yeah well and it's yeah I mean I guess from their business perspective you know they they're more than happy with people being obese and eating garbage because then they get to to sell more of their of their products but of course that I mean that's and that and that can be their incentive and we can we just need to understand that you know that there it's not this um you know altruistic charity that they're they're just really hoping against hope to just better Humanity it's a business model and that's fine we just need to recognize it for what it is and if we want to if you want a cure if you want a long-term Sol solution and um and just a solution in general we're not we can't really rely on them uh to do that you know that reminds me of uh have you seen this new movie called first do no Farm PM no hav't seen it yet no Donald O'Neal who did serial killer serial killers 2 features aim mahra aim is a cardiologist in the UK who got in hot water question staton's use but in that uh movie which I highly recommend uh they interview Fiona Godley who's the past editor of the British medical journal and she kind of tells a story about the Staten drug companies and the industry and how they've asked the companies to open their data to be transparent about how good the the the drugs are and they they won't and so it makes me and she said you know they always did clinical trials to just show that their drug works better than Placebo right they didn't ever include a lifestyle arm or any other sort of thing and that's what we're going to see with Drug Company studies today they're just trying to prove that their drug Works Beyond Placebo without regard to let's say a different lifestyle approach or something and and yet what Fiona dardi said in that video or the film is they could have done that I mean how many how many gazillion dollars have been spent on these Placebo controlled studies when they could have added in something very simply to for the greater good of you know of the rest of us but that's not the the company agenda it's it's to get the approval of a drug now you know that's a great uh plug for doing post marketing studies where now that drugs are out there what we do is we compare it compare a carnivore keto is study to these other medicines and I've seen people do that um in figures with not in a prospective randomized way but the results we get from diet alone are are comparable even you know without the side effects and and the the expense yeah and and and and more beneficial side effects as well you know some other pleotropic effects that that that add further benefit as well and and certainly a lot of um these benefits have been already shown in ketogenic diets already it's just a matter of of getting it out to the clinicians to start actually putting it into practice you know we've come across this information but it was certainly not spoonfed to me in in medical school or elsewhere I came across this because I was investigating is is you know coming to the realization that I did a lot better on a carnivore diet humans biologically that's been our evolutionary past okay that makes sense to me but do we have any data on this what do we know what can we prove and I that's when I started really digging into the literature asking questions and trying to answer them by by looking into the literature and I came across a whole ketogenic body of of information which thousands and thousands and thousands of studies and and that made sense to me it's like well this is a ketogenic diet typically you get rid of carbohydrates you replace it with protein and fat that often comes from meat and so a lot of these studies are looking at a high fat meat-based ketogenic diet approach and and so that makes sense and so I found that and and that made a it made a lot of sense to me there's a lot of very good evidence showing and supporting the use of these um dietary interventions in in clinical practice and just in everyday life but what I come to realize is that there's there's because there's no product behind it it's not like there's a form pharmaceutical drug or big keto or something like that it's not going to it's not going to get uh lobbied at medical schools to be taught or in residency programs or they're not going to be sponsoring major conferences that are going to draw a lot of people and they're not going to have drug reps coming in every Tuesday and Catering a lunch you know ketogenic lunch buying everybody's steaks or anything like that because there's there's no marketing budget because there's no product line and that's the thing we have to go find this ourselves I I had um colleague of mine who I remember we were we were coming into Like A Tuesday meeting it was being catered by a by a drug rep and she's just really excited like oh I love Tuesdays and I was like oh free lunch and she said no it's like I just get to learn new research I always love it they presenting new research and new studies and I was like you know this isn't this isn't like the the research wing of the hospital coming in to tell us what they've discovered like this is this is this is a sales rep you know this is just they're telling us the the studies that you know fit their purpose to try to make us use their drug you know but but we think about it like that our continuing education it comes from these these reps that come to us and going to you know conferences and and we're just being spoonfed um but it's not going to happen with with this sort of intervention we have to go find it and so I I you know which is why I want to try to spread this out to as many clinicians as possible so they can start looking into this for themselves the information is there the evidence is is clearly there it just needs to be picked up and I'm still trying to figure out a way of like how do we how do we actually get this into those Tuesday meetings and and get this dispersed out to more people I don't know if you had thoughts on that hey guys just want to take a second to thank our sponsor at carnivore bar I don't promote many products because honestly all you need to be healthy is to just eat meat for those times that you're out hiking road tripping or stuck at work and you want a nutritious snack that is just meat fat and salt if you want it the carnivore bar is a great option so I like this product not because it's just pure meat but also because I want the carnivore Market to thrive as well and the more we support meet only products the more meat only products there will be available in the mainstream so if this sounds like something you'd like to get behind check it out using my discount code Anthony to get 10% off which also applies to subscriptions giving you 25% off total all right thanks guys well I have a couple thoughts um and on my way to that Direct a questioned in that movie first do no Farm aim Dr Mahal visits uh the he goes around the world and he visits Cape Town South Africa where Nelson Mandela and Gandhi have been and he talks to one of the leaders there and and he says well first you if you're going to make a revolution is you take over the education like this is a time honored way to do things right and and so basically Pharma has taken over the education of medical schools yeah it's per clear um the other thought though I had was I did meet a a very um driven individual in Indonesia and Tio protio is the father of someone with cble paly a child who he was told he would never walk and talk and and he sleuthed out well how how do you what do the children need in the brain and and they said well myin and and he said well how do they make myin too being engineer said well we can fix this and well you know it takes ketones and cholesterol and he said well let's give it to him so basically Tio has gone around Indonesia himself and Lobby doctors teaching them biochemistry so thinking the individuals can do this but I mean this is a heroic you know only the well one of the certain times when there's this heroic power or feeling of of energy is when your child is affected by something and you found something that fixes them so he's felt compelled to teach all through Indonesia put on a conference in Jakarta and I got to go to that meeting and the Facebook group they have is called ketofastosis Indonesia and the overlap there with the mainly Muslim country is they're very comfortable with fasting it's you know something they learn through their their culture and religion and so so one one person could so we could develop an army of volunteers of people they they've retired from their first career they they are now you know 70 and they they have all this energy now because they fix their medical issues well let's put them in an army to teach it doesn't have to be a Pharma company or or there doesn't have to be a lot of money involved to do this but that's a Tio's experience which it was pretty amazing to hear yeah that' be great if we could get get some people around to to go and and spread this around I I I would I would volunteer if we could get that going but but you have to bring food yeah yeah I mean the doctors are are accustomed fed unfor in my area it's you know the fancy Steakhouse so but if you have leave behinds at the office I I'd love to have that yellow book edited by nutrition Network and Prof noes that ketogenic textbook I'd love to have that sent to Department chairs or or doctors locally or certainly if if you want to influence your doctor um you'll give them a present at at the office have it be that yellow textbook although it is you know 100 bucks or something so but educating you know that I guess that's my uh still belief that this can be uh solved oh oh but solving something um is the answer for having things change so when we can fix things that medical the medical s establishment can't that's when people will gravitate toward this is that we just have to make the awareness be that you don't have to have type 2 diabetes you don't have to be on those medicines and I think the showing that we can do that and they can't is going to be how this area wins yeah absolutely so um just to wrap up I'm I'm conscious of your time but I did want to ask you one thing because it's something that comes up all the time people go on a ketogenic diet and um and all these things getting better their diabetes getting better the metabolic markers are getting better their blood pressure coming down they're coming off medications but then their doctor checks their LDL and goes oh my goodness you have hypercholesterolemia you're going to die this is going to kill you um and people get very worried about that um coming from you know professor of medicine ated Duke what what would be your response to that yeah so take a deep breath tell tell your doctor to take a deep breath and what you want to do is learn about a syndrome called metabolic syndrome so the old way to look at a cholesterol panel is to focus on the total and LDL cholesterol the new way is to look at the triglyceride and HDL cholesterol so I'll just pull up those four Labs over time and cover two of them the old old way oh it looks worse and then cover the other two the new way oh it all looks better so you have to have the ability to just insert the knowledge about the new way to look at the cholesterol panel and then most people will will follow although in my clinic if someone's doing a low carb keto carnivore approach for a decade or longer which they have I don't Focus so much on the cholesterol anymore and I'm going more directly to measuring the arteries themselves so in our area we can get ultrasounds of the arteries at low cost but people have to pay for it we can get coronary artery calcium scores and CT angiograms a little more expensive but the testing for these diseases is is the way to go because I've seen people with no arterial disease at all be put on a medicine for a cholesterol level so I teach my people in in in My Tribe to repeat after me cholesterol is not a disease cholesterol is not a disease AOS sclerosis is the disease that you don't want to get and that's what we're treating with with treating cholesterol so if you don't have atherosclerosis you know especially if you've lived to the age of 70 and you don't have atherosclerosis there there's no reason to be on a medicine to treat a condition that you don't have and and and yet it the medical mainstream won't it doesn't compute they'll they'll still well but you might later and and oh you wouldn't give chemotherapy to somebody for cancer on the odds that they have cancer that's basically what's happening with the cholesterol treatments now odds are you have it so we'll treat you well you know we can personalize things better than that and so it just takes a little education and and of course uh get a second opinion is the other way to say it or or say doctor thank you so much for your concern I I'm going to talk to my other doctor about it and and I'll be back and you know I've heard stories of doctors firing their patients well if you won't take it then get out well they must be on some kind of quota to have a percentage of their their folks on it I you know I just can't um see that as a uh rational way to to do things but most of the time people are not asked to look at the arterial system they they are just told to be on a drug because of a cholesterol level and we can do better than that yeah and so you you've been doing this for quite quite some time so like you said you'd have patients that upwards of a decade on these these diets that could have so-called high cholesterol I just think it's normal that's just what your body's trying to do if you fast for 5 days your LDL is going to go up too your body's trying to do that anyway um and is that what you're finding that people uh when you actually look at their vasculature are they free of disease with long-term ketogenic diets well you know that's a study I've never done and may be time now to kind of roll out the people in my my clinic panel you know I've been more following the lmhr study that Dave Feldman cholesterol code looking at say a 100 people in a controlled study like he has U but that I'm now finally getting the I don't know reputation or in a good way so that uh a medical student this last year reviewed the charts of our patients um that's the other thing we're trying to find money for research you can get un unpaid students to do this as part of their learning experience but he assembled all of the people we've been treating for heart failure and kind of an in a strange Twist of drugs working through ketosis now the Cardiology world is waking up to the idea that ketones might help heart failure so this so he said well this is you put together 150 people that we had had with some sort of heart failure and w you know no there weren't miraculous changes but you know uh the idea is that it was tolerable and and people lost weight and uh that whole story about the sglt2 Inhibitors which cause glucose and the urine and also ketosis I think it's pretty established now that it helps heart failure through ketosis and now it's a matter of percolating through to the cardiologist that you can actually achieve ketos without that medicine it's called keto it's called carnivore but no I mean that most of them are still in the this kind of barrier of you can't cross the high fat you know diet that they're still stuck in that old way of thinking it's just too bad yeah thankfully some are coming around in the in the low carb sort of groups there's there's one in Australia that I that I in in my area I just met him recently and he's all for ketogenic meat-based high fat approaches for his Cardiology patients and he made that same point about heart failure medication and ketones and he's he's very interested in in applying ketogenic diets to heart failure patients and so it may be that we we might be able to get a you know a small clinical trial going on that to see that and uh yeah I've seen I've seen the same thing anecdotally I've had um a several patients actually that have had actually quite severe uh heart failure congestive heart failure some es schic actually which is very interesting because if you have you if you have a heart attack you have this dead wall of your of your heart it's probably not going to come back to life but it seems that that the rest of the heart works better and there is some improvement you know going up from you know 15 20% uh injection fraction to 33% injection fraction in one case so that I mean that's that's going to make a big difference in that person's life and I've seen 20 to 50 20% 50% and of course there was a 140 pound weight loss along at the same time but that's okay too I mean that that's the other thing as I presented this years ago people were like well you're you're doing too much we don't know what the mechanism is and I well but but but so the diabetes is gone and the weight's down what's wrong with that but it in the weight loss be I never was so much a stickler on the mechanism I'm more of an outcomes kind of person and in a recent study of the heart function and and heart fuel utilization the muscle itself runs on fatty acids and ketones and but in that paper in the abstract they wrote we were surprised that very little glucose was used and you know don't write that in a paper shows shows your ignorance that you know the heart knew it all along the heart knows that it like so anyway um I think they were just trying to emphasize the shock that uh yeah the heart does great with um with that hey everyone really happy to announce a new sponsor for the show for everybody down in Australia Stockman Stakes who are delivering highquality grass-fed and finished pasture raised beef and other meats flash frozen and vacuum sealed tood door something that I've been enjoying a lot of myself recently as well they also have a great range of specialty items such as high fat keto mints and carnivore beef and organs mints with liver kidneys and beef art as well so use code chaffy today for free order of beef mints or another specialty gift along with your order at Stockman steaks.com DOA and I'll see you over there thanks guys yeah i' I've seen studies thing it's just being in ketosis and running on ketones can improve injection fraction by 30% or so just the ketones and um in that in that case case the lady went you know up 15 or so points 15 20 points that was with an es schemi case I mean she had had a massive heart attack and had heart failure as a result of that and then other non-ischemic cases I've seen even more dramatic improvements where they went one gentleman went from 14% ejection fraction to completely normal cardiac function in U I think it just less than six months very strict but it was it was massive massive Improvement you know there's kind of a strange irony or or deliciousness in the fact that the very diet that was thought to be the most harmful is the best is the best there's so many things that you know like the food pyramid needs to be turned totally upside down and then it's the best yeah yeah it is funny yeah it's it's AIT bit of sweet irony that's yeah unfortunately a lot of collateral damage along the way yeah yeah absolutely well uh Professor Westman thank you so much for your time I I I I could talk to you all day but I I don't want to monopolize your your time I really appreciate you taking the time to come out and speak with us um please let us know where we came follow you and find more of you and and support your work and and find your books well and thanks for having me I I really love what you're doing well I have an important announcement for those who have pre-diabetes or type 2 diabetes I have a free live webinar coming up on February 10th great and about the labs it's live I I go over the A1C the glucose but also triglyceride HDL and how low carb carnivore keto can reverse type 2 diabetes and so that's a free live seminar on labs for diabetes on February 10th and you can learn about that at my website adapt your life academ .c you just sign up for the the briy live seminar there and we'll get you in touch but it's exciting to teach this to to people and more and more people are interested which is fantastic perfect well I'll make sure all those links go up and I will try to get this up uh in the next week or so so we can get it before that conference so we can help publicize that great Professor we thank you so much for your time I really appreciate it take care take care the food very low in the carbs blood sugar is going to come down and it will help with diabetes for sure uh but so diabetes obesity uh heartburn Ural bowel syndrome um PCOS uh arthritis pains um all of these things uh reliably will improve yeah