Weight Loss Drugs: Side Effects, Risks, Alternatives with Dr. Neal Barnard | Exam Room Live Q&A

[Music] thank you by The Physicians committee hi I am the weight loss Champion Chuck Carol We Appreciate You raising your health IQ with us coast to coast and around the world more than 150 countries all joining together to make the world a healthier place and today we are talking about weight loss drugs you know new projections show that the weight loss drug Market is going to be worth an eye-popping 60 billion dollars within the next decade people are willing to pay already thousands of dollars every single month just for the opportunity to lose those unwanted pounds but that weight loss comes with a whole host of potential side effects so today we are talking about wagofi we are talking about ozepik those pricey monthly injections that have been seeing this massive surge in popularity has surge so great that manufacturers are even struggling to keep up with demand but is the risk really worth it we're going to find out here today as we welcome Dr Neil Barnard back to the exam room live and if there's a question that you would like to ask Dr Barner go ahead post that in the comments or in the chat and we're going to get to as many as we can here on the show today when we open up the doctor's mailbag and with that let's go ahead and open up the show Welcome Dr Neil Barnard back to the exam room live I feel like it's been far too long my friend it has been too long but it's great to see you Chuck great to see you as well let's go ahead and Dive Right In 60 billion dollar industry for weight loss drugs business is truly booming and I thought about you last night this is when I shot you the email I saw a report that these these weight loss drugs they're they're just booming everywhere and as a matter of fact there are 273 million videos about them alone on Tick Tock that have been viewed more than 1.2 billion million viewed 1.2 billion times 1.2 billion times just about weight loss drugs which if you think about it Dr Barnard not exactly the sexiest topic but fair to say that these things have kind of gone mainstream haven't they they've gone mainstream and that's for a reason it's because of commercial promotion it's if you want to make a a record sell if you want to make a movie Cell you promote it like crazy and Novo Nordisk which is the manufacturer of agovi endocentric is promoting them like crazy they spend about 25 million dollars on direct payments to Physicians to have them talking about these drugs they're lobbying Congress like crazy and they are lobbying the Press enormously and there's a reason for that we have 93 million Americans who are in the Obesity range regarding body weight and if you were to get all of them theoretically on the Govi you know how much that would cost that would cost about a trillion and a half dollars can you imagine says you don't have to tell me we want to line up to stick our hand out and get a trillion and a half dollars a year now then that's not going to happen but what if you've got one in ten obese people on wagobi that's 150 billion dollars you would get every single year so the figure you gave Chuck I think is conservative I think that they are aiming even higher hmm well let's uh talk to me a little bit about how these drugs are supposed to work uh give us the reminder there because if memory serves these were not originally created for weight loss were they they were really marketed initially for diabetes and and they do reduce blood sugar uh to a degree and they also cause some weight loss and that got people excited what if I don't have diabetes I just want to lose weight let me take this drug and what the drugs do is that they interact with the brain to turn down your appetite and so the effect is not enormous if you're 100 pounds overweight you're not going to lose 100 pounds on mcgovian the vast majority of cases but you might lose 30 35 pounds and so that feels pretty good to people and they've been ready to line up at the cash register comes along with the cost apart from the money there is also heck to pay in the bathroom I mean people are nauseated and vomiting and they get diarrhea and that's those are very common side effects they sometimes go away with time they sometimes don't and then the more serious issues are gallbladder problems pancreatitis a French study suggested that thyroid cancer was about 58 more likely in people using these drugs and those are all the risks over relatively short-term studies the longer term risks are really anybody's guess how alarm should we be that we're seeing a potentially positive correlation with cancer when we're talking about such a short-term study most studies that I'm aware of that deal with the chronic illness such as cancer they're a little bit more long-term than this right and and I think your concern Chuck is exactly on point because these are not drugs that are intended for short-term use they will freely tell you that if you stop paying you're going to get all that weight back so the drug is really given to you for a ransom so to speak or a membership if you want to put it more nicely as long as you pay the weight stays off but when you stop paying the weight comes back on in the vast majority of cases so it's a it's it's only a temporary effect so let's say after 10 years you get tired of paying it's the cost is about 1300 a month after manufacturer coupons that's about fifteen thousand dollars a year and if after 10 years or so you don't want to pay or your insurance will not pay um then you're just gonna go back to where you started do we know why there is such gastrointestinal upset with these drugs in a lot of patients and it also reminds me of another popular uh weight loss can't miss solution back in the day it was something that was uh I think it was like an alternative to oil or something oh lestera was marketed as Olean like potato chips were fried in it I do believe back in the day but people stopped eating that stuff because it upset their stomach so badly and I'm just curious what is it about these particular weight loss drugs and others that make us so prone to having you know an upset stomach well these drugs are an analog for what we call glp-1 this is a natural compound your intestinal tract makes it so when you eat food especially carbohydrates healthy foods your body makes some glp-1 goes to the brain and it turns off your appetite this is part of your natural uh mechanism to say I'm eating now you could stop eating pretty soon it's your appetite control and so all the the is it packs into an injection more glp-1 than your body would naturally make or or that's the net effect it's an analog of it to take a patent um and so the fact is they're pushing your body in a direction it would never have gone in and so that's where the side effects come in a couple of other side effects of note that I know that we recently by the way petitioned the FDA if I'm not mistaken to put a warning label on the side of these uh drugs but a couple of others that were mentioned were constipation and hair loss constipation not exactly like spending a whole lot of time in the bathroom matter of fact it's the exact opposite that's not fun but I would think for a lot of people hair loss is also going to be a big deal yes I think so um many people have talked about what seems like premature aging and that could just be when people lose weight there as the fat stores go away their their face tends to Sag so these are things that are getting people upset but um I have to say Chuck what I think matters the most is they're creating really a false narrative and you see this from the 60 Minutes show that aired on January 1st of this year you see this in many of the programs the spokespersons that are on the programs are typically being paid by Novo Nordisk and so they want to suggest well your problem with obesity has nothing to do with with what you're eating it has all to do with your genetics you've got something wrong with your brain that your parents had and your grandparents had and it's an inability to control your appetite and so you need this medication to get your appetite back under control or there's something wrong with your metabolism or you try to diet and it just wouldn't work for you so no diet could work I call that a false narrative because if you take that very person who was told that they had a genetic defect in appetite control and you bring them in and give them a modest amount of support in education in a plant-based diet the kinds of things we're using in research where you have vegetables and fruits and beans and Grains as much as you'd like to eat but people discover is those high fiber High complex carbohydrate foods trigger the appetite control really effectively and over the long run people who follow that way of eating lose about the same amount of weight or more than people would lose with Govi so from my standpoint I think of it as informed consent that's that's the foundation of Medical Practice patient comes in they need information from you the doctor about what will work and what are my risks and doctors should not let the patient leave the exam room without talking about what a healthy diet can do that makes these injections unnecessary absolutely uh I'm gonna put a pin on that just temporarily because I want to Circle back to that because there's something very interesting that's happening with a particular subgroup of people who are trying to lose weight state that are now seeing these drugs heavily marketed to them very interesting but I actually was able to pull up a copy of the the warning label or the copy for the warning label that you sent to the FDA in this petition I'll read it verbatim for the exam roomies here uh this is what uh we propose goes on the side of these weight loss drugs it says quote a low-fat plant-based diet one that is free of animal products has been shown to be as effective or more effective at lowering weight compared with weight loss medication appropriately planned plant-based diets avoid the increased risks of nausea vomiting diarrhea gallbladder disease and pancreatitis along with thyroid cancer and Fetal harm associated with glp-1 receptor agonists so that's a pretty all-encompassing petition there what are we expecting with this particular petition well I should say also that all the side effects of a plant-based diet are good ones it's not just that you lose weight your diabetes gets better your blood pressure gets better your cholesterol better uh cholesterol gets better what are we expecting um this morning at coordinate I got a call from the FDA actually um I was at home and they called and they were busily posting uh our petition to them and they wanted to know we had submitted 27 references to them scientific references and they wanted to ask about which ones we felt should the public should see and which ones not so Mark Kennedy our vice president for legal Affairs and I consulted and we've we've been working with the FDA right now so they are this is on their desk today that's amazing um that they they responded already um that's fantastic I also want to underscore the fact that you said that there were 27 citations in this petition of irrefutable research I would imagine that that carries a lot of weight when you're sending it to an organization such as the FDA it does it carries lots of weight I mean we are in this to win it and we bring the science to them that said keep in mind they are under huge pressure Novo Nordisk not only has a lot of clout with the fdas as does every enormous pharmaceutical manufacturer but as I mentioned earlier they pay into the campaign funds of members of Congress um they pay they max out on their campaign contributions particularly for those who are going to be able to opine on whether Medicare should pay for agovi for example and so in turn those members of Congress are more than happy to call up the FDA and say you don't want to be too unfriendly to these pharmaceutical manufacturers and that is unfortunately why you see a lot of positive press and not too many people raising the red flag that we're raising all right reminder if you have a question for Dr Barnard you can drop it in the comments or in the chat we're going to open up the doctor's mailbag here in just a little bit but Dr Barnard a couple of times already you have mentioned that a lot of these doctors and these experts that go out and they talk about these weight loss medications are actually being paid by the drug manufacturer that happened to also be the case for a study that crossed my desk that was of particular interest that showed that there are now um or there is I should say a push to Market these drugs to bariatric surgery patients who have regained a significant portion of their weight now I make no secret about the fact that I had weight loss surgery over 13 years ago and I credit that as a jump start for getting me to where I am today however without making major lifestyle and diet modifications there's zero chance that I would be sitting here today so this study Dr Barnard what it did it went in and it looked at Patients about eight years or so after they had weight loss surgery and by and large they had regained about 40 percent of the weight that they lost and what this study showed was that the weight loss drugs helped them lose about 10 percent of their body weight for a second time or probably a third or fourth because you got to figure the surgery was not the first attempt to lose weight nonetheless the drugs helped them lose 10 percent of their body weight but in fact this study was led by people who were being paid by as you said Nova Nordisk which makes what Govi and there was a quote in the press release that was sent out along with the study that really kind of spoke to me and I was hoping that you could comment on this and then I'll give my thoughts as well and the quote from this particular Doctor Who led the research said there was very little published data on how to treat post-bariatric surgery weight gain very little data when you hear that what are your initial thoughts as far as jumping right into the medication Waters I think it's really unfortunate that people think of it that way because what got us heavy in the first place if you think about what's on the average American's plate I mean it's not lots of fruits and lots of healthy vegetables and things those Foods don't have a lot of calories in them they've got a lot of appetite taming fiber in them but if the average American eats cheese for example it doesn't have fiber it's got a lot of fat it's about 70 percent fat and so you're getting a huge amount of calories and so you think gee there's something wrong with my appetite I'm gaining weight even though I'm eating what seems like a normal amount wait a minute there's nothing wrong with your appetite what you're eating is foods that are so dense in calories that by the time your appetite control is triggered you've taken in a huge number of calories it's not your fault it's the fault of the food the average American was eating less than four pounds of cheese back when the US government started tracking back in 1909 well today the average American eats about 27 pounds of cheese 37 pounds of cheese huge amounts it's about 70 000 calories per year just from that one food so let's say instead of taking the medication I decide I'm not going to eat cheese I'm not going to eat bacon sausage I'm going to eat healthier things they're not so calorie dense your appetite is triggered after you've had fewer calories and the weight regain just doesn't happen yep I agree with uh a hundred percent of what it is that you said and I can tell you from personal experience very well that it comes down to education education that is very much lacking in the majority of instances after a person has a bariatric surgery I mean you you have to understand that when a person opts to have bariatric surgery oftentimes they're looking at it like a life and death proposition either they genuinely are on the fast track to an early grave or they've just basically concluded that life is not worth living in the particular body that they have at that moment they're tired of waking up they're tired of hurting they're tired of what they see in the mirror and so that leads them to make this decision what I will say however is that where a lot a lot a lot of people get steered wrong is with this lack of education and I always think back to the support groups that I had to attend immediately after for a couple of years even after my procedure where we would sit down with a dietitian and even a trainer from the doctor a psychologist and we would as a group talk about our feelings what our successes were for the week what we struggled with but over time what I saw was a lot of people going right back to their old eating habits and it got to a point where people were eating candy and drinking soda and eating like ham and cheese sandwiches during these Roundtable discussions and I wasn't vegan at the time but I was just kind of like why in the world would you go back to eating this stuff and then secondly why is the messaging that you you're going to be okay if you can eat these things in moderation a lot of people can eat those things in moderation but the candidate who was there having bariatric surgery I would say is not among the population that can handle those types of things in moderation if they were they wouldn't be sitting in that particular room so why is the messaging moderation instead of making these changes that would enable them to have long-term success that to me is the most frustrating thing absolutely right Chuck and and to say to a person let's face it you're addicted to certain foods but to be on this diet that's going to help you to maintain the weight loss you've now achieved you can have your addictive food but only 30 as much as you really want or 40 as much as you really want that's like taking a person who's addicted to cigarettes as all smokers are and say you can only have the first quarter of the cigarette and then you've got to put it out um addiction doesn't work that way once you're triggered that addictive behavior um you know the floodgates are open and it as hard as it is to have things in moderation um and so forth the the thing that is really easy to do or easier to do is just get these Foods out of your life you know you say this this food does not love me back this is a love affair gone bad let me just get these Foods out of my life and that's meat and cheese and dairy products in general and really greasy oily Foods when those foods are gone and the forgetting process helps you to say you know that was my past I'm eating healthier foods now you discover that the food you're eating now are not just healthier but they're they're tastier for you they work with your biology so that your appetite control comes back to where Mother Nature wanted it to be well let me ask you this I think that this is kind of a fair question to ask is do you think that these drugs would work in conjunction with a plant-based diet just as a Kickstart to get people really going down that healthier path a little bit quicker than they ordinarily would I think some people use them for that reason I think there are weight loss experts who use them for that reason I'm not sure that that's Justified though I have to say I understand the idea but the problem is that when you stop that artificial control that comes from the pharmaceutical then you know then the weight you're likely to see some weight gain at that point so what I'd rather to do is is teach you a healthy diet right now that you feel the power of that healthy diet right now so that you don't have to deal with these pharmaceutical pharmaceutical complications or the risks that they entail absolutely absolutely and you know what I can't wait to talk more about this with you and a whole panel of experts um including Dr Garth Davis from Houston Methodist a wonderful bariatric surgeon he's going to be joining us at the International Conference on nutrition of medicine we're all going to be sitting down and talking about weight loss drugs and bariatric surgery both from the clinician and the patient perspective um I I first of all I'm humbled to be included in that um but second of all let's talk about this panel because I really think you know biasedly I will say this is kind of like the keynote of the entire conference for me but let's talk about this panel what are we what are we talking about specifically here yeah well you actually you you said it Chuck one person that I should also highlight is in addition to Garth Davis who does surgery he does bariatric surgery and we'll talk about the role of surgery and the role of diet changes both to get people ready for the surgery and to keep them some afterwards and the fact that sometimes it makes makes the surgery unnecessary but we're also going to have Dr Jamie Kane with us from New York who uh has he heads um the uh an obesity treatment program at one of the major medical centers in New York and is going to talk about what is the role for drugs and I think he will say that there is a role for them in certain circumstances so we're going to bat that around Dr Hana kaliova is going to come in and talk about the role of diet not just in appetite control but in actually trigging your body to release the very glp-1 that these drugs are designed to stimulate in other words as I mentioned earlier your body makes it can certain foods augment that effect in a natural way and uh spoiler alert the answer is yeah so Hannah's going to show you how oh yeah I love Dr kaliova she is uh literally one of the smartest people I know I mean I tell her that every time she comes on the show she is so steeped in that research and just lives and breathes it as does everybody else on this panel here's the full rundown but uh in addition to you and myself Dr Jamie Kane as uh and Dr Garth Davis as you mentioned Dr Jim Loomis our colleague over at the Barnard Medical Center Dr kaliova Dr Steve floam and Dr Vanita Rahman so we're really going to have a really slick well thought out thorough conversation that's going to be Friday afternoon ironically right after lunch so I think that that's the perfect time I think it is um the International Conference on nutrition and medicine is August 10th through the 12th I think it's going to be our best one yet um obviously people adore the conference food but the uh the intellectual aspects and the the learning that people take away with it plus the personal connections they take away with them are just really available nowhere else it's it's a top-notch comp difference really really is Washington DC as you said Dr Barnard August 10th through 12th some other names who are going to be speaking at the conference because it is three days it's not just that particular panel uh Senator Cory Booker is actually going to be helping to kick everything off for us this year I'm really looking forward to hearing him speak and then we're going to close with Dr Michael Greger always a fan favorite Dr Dean ornish this is another presentation that I am just elevating to see I cannot wait to see his research on Alzheimer's Dr Christy Funk is going to be there Dr Andrew Freeman he's going to be reviewing the entire year in nutrition research I love it when he does that he's done that here on the show it is fascinating Dr Gemma Newman uh my co-host for one healthy World she's going to be there as will Brenda Davis phenomenal dietitian so great Dr David Katz so many others so you can join us right now pcrm.org icnm to secure your tickets today pcrm.org slash icnm we're actually going to be recording episodes of the exam room while we're there as well so really a great time and it is kind of the highlight of the nutrition summer wouldn't she say it yeah it is and it really all comes together not just in the scientific sessions but Friday night we get together and we have our special dinner um and this year we're gonna we're gonna concentrate in the dinner um with a presentation by Dr Adrian Foo Berman from Georgetown who is going to talk about the sneaky things that pharmaceutical industry Representatives do to push drugs on patients and on the public it's really eye-opening and we have a special award that we're going to give to Marty Wasserman who last year Dr Martin Wasserman was at icnm and Marty Wasserman used to be the Secretary of Health for for the state of Maryland and has been a good friend for a long time but he gained a little bit more weight than he wanted but Marty is a real athlete he has swung the Chesapeake Bay swim it's 4.4 miles he's done it 24 times well last year he was 80 years old he said I've got I got to do it at 25th time but I want to do it in my wetsuit that I wore the very first time so uh Marty about a week ago jumped into his wetsuit having lost 25 or more pounds thanks to uh Consulting with Dr caliova and changing his diet and he jumped in swam across the Potomac came out at age 81 having conquer really feeling like he'd conquered the world so anyway Marty is going to be there we're going to recognize his achievement 81 man yep yeah and an incredible athlete and he will credit uh Frank legal credit you check for all the information that you give and Dr Kelly over and others because he he embraced the dietary change that you've been talking about all this time he used he used it to slim down you have never seen a healthier looking person and to get in the water and to I mean this is an athletic achievement um just really fantastic anyway so that's just one part of of uh ICM it's people get together yes it's science but it's also these personal connections and and and everybody's on their own trajectory and and they learn a lot and take it home with them and you know I'd be remiss if I didn't also mention that the food is outstanding the food the food is amazing it's gonna be yeah it's always great but I think this year it's going to be really special because um not only do we do we work with the Grand Hyatt Caterers on on great food but um Dustin harder who you know very well um our culinary expert here has been working with them to serve Universal meals uh which are the coolest Foods ever because they work for any kind of diet and New York health and hospitals they are bringing their chef down here to show the foods that they are now serving as part of Eric Adams new initiative so the patient goes in the hospital and The dietitian says here's our featured food today you know it's plant-based it's vegan and if the patient says no I don't think I want that what else do you have they'll offer an alternative which is also vegan and So eventually you could probably get a hunk of chicken out of them but you got to work at it the New York health and hospitals system has healthy foods they've really brought it forward like nobody else they're going to be there they're going to serve the exact foods that they provide and so everyone can taste it and see how they can bring this back to Peoria to serve in their hospitals all right let's do an exam roomy roll call real quick we haven't done one of those today I want to say hi to Sonya who's joining us from Arizona uh ante from Berlin Germany very cool Evelyn so happy to be catching the show live she says very cool and I also want to say hi to Greg who's here as well so thank you guys so very much for checking in around the world and let's go ahead and open up the doctor's mailbag and take some of these questions that you all have been sending in today um we have a couple of people who are wondering we've we've talked about uh what Govi and ozempic but they're wondering if the side effects are the same for a similar type of medications yeah yeah so far as we know they are these are all ones that deal with the glp access it was the way we would put it there are a number of different brands some made by Nova Nordic some made by competitors but the risks We Believe are pretty much the same so far as We Know and Lori at 1209 is wondering whether we know if these side effects are permanent or not you know all bets are off um with most of the um the really severe nausea and vomiting eventually is going to go away for most people it doesn't go away for everybody um but for for many they they're the GI tract does settle down and they do a little bit better but then others probably get worse with time if we're talking about the thyroid cancer risk that came up in a French study one would only guess that the longer you're on at the risk the the higher the risk same with pancreatitis same with gallbladder disease we have a couple of people wondering when would these drugs necessarily be appropriate is it for their original intent which I believe was diabetes uh you can make that in case but keep in mind what does the plant-based diet do for diabetes uh plant-based diet gets the fat particles out of your muscle and liver cells that allows your natural insulin to work again so if we make the same diet change the need for medications goes way way down and let's see shout out to Laurie says that uh been vegan 16 weeks blood pressure is down as well as nine pounds down she says she's also sleeping better and then throwing a bunch of emojis including some heart and uh or a heart and a bunch of fruit so that's cool Lori congratulations 16 weeks that's pretty big what what do you think is a realistic expectation for somebody that goes this route after 16 weeks which is about four months what results could somebody expect to see here well first of all you're going to start seeing results way before that point um people start seeing let's say a person has diabetes they got extra weight their blood pressure is up and so forth and they decide are right I'm gonna try I'll try this this diet then this diet that I would suggest is only plants uh throw out the animal products completely so top your spaghetti with tomato sauce instead of ground beef sauce fine keep the oils really low too what happens is your your blood sugar starts dropping on day one your blood pressure will drop a little more gradually in your cholesterol a little more gradually too your weight is going to start dropping on day one two but take it slow if you lose a pound a week that's fine that's 52 pounds a year if it was a half a pound per week that's fine it cup weight comes on gradually let it come off gradually keep in mind you're not starving you're not limiting your portion size you're not counting carbohydrate grams you're eating as much as you want and the weight will come off on its own all right I want to say hi to another uh over 60 star athlete here Charles strohner says uh hi from Diamond Bar California says keep up the great work Dr Barnard I'm the guy who wrote up Crystal Lake at 62 years old 62 riding up a lake I'm not too familiar with Crystal Lake but it sounds like it's a pretty good feat sounds cool give me a call all right with you next time I love it uh here we go let's take a question um from Ashley Madden kind of change topics here just a little bit Ashley Madden was just on the show she sent me a DM she's got this new cookbook out called plant-based delicious just amazing amazing food in there um just as a total curveball here Ashley's wondering whether there is a maximum amount of antioxidants that can be absorbed in a single meal you know that's an interesting good question um when we're thinking about antioxidants we're thinking about say the orange pigment in Keras that's beta-carotene or the red pigment in tomatoes that's lycopene or the purple pigment in blueberries and grapes that's anthocyanins and the goal is not to get a huge amount in any given meal but to make sure that you're eating for color on every meal and so if you have colorful Foods you'll be getting those antioxidants that your body needs now I don't know the answer to the question as to whether if you max out a huge amount of antioxidants in one meal will your body be unable to absorb them after a certain period of time I doubt that we're getting to that point but I don't know and we can look it up all right let's get back to the topic at hand today Maryland 1210 what about weight loss pills that are supposed to be all natural and safe that also offer fat burners and pills too she says clean the colon okay um let your body respond naturally to Foods there are certain foods that will ramp up your metabolism a little bit there are certain foods that will actually help trap calories and help you get rid of them and we could talk more about that but the foods that do that naturally are high fiber foods and certain specific kinds of foods give me a couple of examples researchers at tuft University some a couple of years ago brought in individuals and they gave them either high fiber grains like brown rice or low fiber grains like white rice and what they showed is that not only is fiber filling it triggers appetite control that kind of thing but more than that the fiber as it goes down your intestinal tract traps calories some little bits of fat or protein you haven't absorbed yet and it carries them out so you flush them down the toilet so in other words that those were calories you never had a chance to absorb so these foods cause weight loss naturally so rather than go to the store and get a fat burning supplement in a capsule and pay 30 bucks at the cash register don't do that go to the grocery store and get the foods that they have that allow you to really tackle your appetite trap some calories increase your after meal burn and and a plant-based diet does all of those things at the same time interesting question from Peter came in at 12 28 Dr Barnard wondering whether diabetes drugs they mentioned uh glyphoside for example wondering whether they can hamper recovery from the Disease by overstimulating uh the hunger drive and thus causing a person to overeat have you heard about that doing kind of the opposite of curbing the appetite yeah um well well first of all it should be said that all these drugs have a wide range of side effects they're trying to do what foods would do naturally and and frankly one of the biggest risks we see with them is that they can cause your blood sugar they're trying to control your blood sugar they can cause it to drop too low and so that hypoglycemia then leaves the brain starving for glucose and if you have that effect too many times we worry about the long-term effects on the brain so that for me is the bigger concern the the beauty of it is that if we use the diet on its own it effectively does what the Glipizide and the other medications do in a safer way without the dips into hypoglycemia all right let's say hi to Greg uh who was with us today says you want to know how well a diet can work check this out seven and a half months in and down 70 pounds says listening to the exam room has been a huge help Greg that is awesome 70 pounds in seven months I can only imagine how great Greg must be feeling right now Dr Barnard yeah I am sure and and take it slowly so many pounds um that fast that's quick um and I'm sure all your friends are commenting on on your incredible success but take it slow um uh you can lose weight in a nice gradual way and you're gonna be fine so anyway congratulations on that I'm sure you are inspiring plenty of other people to follow your lead oh no doubt he also has a question for you he wants to know what you might suggest when eating healthy doesn't necessarily suppress his appetite especially at night okay um well I guess a couple things I would say one is we have to look at which foods have which kinds of effects on appetite let's say it's something like uh say green leafy vegetables really healthy high in fiber but you might discover that after eating them you still have a little appetite left often that's because they didn't have much complex carbohydrate in them unlike say something like brown rice or whole grain bread there you're getting fiber but you're also getting a lot of complex carbohydrate which will tend to tackle the appetite a little bit more effectively and make you decide okay let me stop eating so uh bring back into your diet if you haven't already grains beans those kinds of foods that bring that healthy complex carbs or starch that helps calm the appetite one other thing if you look at kids at the dinner table or if you remember back when we were kids you know kids didn't sit at the dinner table for hours wanting more and more and more food they got bored and the reason is they had other things to do they wanted to go and play they wanted to do a game they wanted to watch TV they wanted to put on a play or play their guitar or whatever sometimes when we're older food is sort of the only entertainment we have in our lives okay note to self if we're if we're if food is the only thing that gives us pleasure and we're focusing on it all the time we need to read a good book we need to dig into a documentary we need to have a walk in the park with a friend we need to fill our lives with other things that are nourishing in their own way man I love that reading is almost a bit of a lost art that's not exactly the topic of the show but pick up a book everybody it can change your life man that is no doubt let's grab two more uh before we wrap things up today uh RBM all right RBM is going through a bit of a rough spell here Dr Barnard hopefully we can help get them back on track a question came in at 12 33. RBM says that they went vegan two years ago but fell off of the wagon wondering what type of support group there might be to help get them back on track and stay accountable so if somebody slipped up what might you recommend uh thank you you know they're really three elements to adopting a diet or to staying on a diet the first is some kind of medical evaluation see where you are now that doesn't take long but it's good to know your current status secondly a one-time visit with a good dietitian someone who's an expert in vegan diet somebody who follows it herself or himself they can sit down with you and say let's really think about what our options might be for breakfast lunch and dinner that can help you even if it's just one visit even if it's not covered by your insurance it's it's well worth it and then the next step is kind of what you're asking about who can I hook up with for that long-term support frankly that's why the exam room is here because when you join into the exam room you know that you're getting information but you're also among friends and so it's inspiring to do this and any kind of plant-based class that you can be part of on a regular basis you'll see them uh on our website at PCR pcrm.org events you'll see the classes that you can join many of them are free and as long as you've got that Weekly support or Whatever frequency it can be you'll discover that you have a chance to get your questions answered feel like you're part of something that's that's bigger than ourselves and that often is all it takes to stay on track love that answer makes me feel good and so does our final question of the day which really just I mean it makes me laugh to be honest with you I'm not even sure how this is possible it's a question from Liz and Liz wrote in I'm a oh boy hold on to your hats for this one I get 70 to 80 percent of my calories from different types of beans and the rest of my calories from starch fruits and vegetables my question is is more than 160 grams of fiber per day unhealthy Liz says they are 119 pounds and about 5 feet 7 inches tall holy cow 160 grams uh I guess my question is where are you putting it um if if you if if you look up the numbers a half cup of beans is a typical serving that's about seven grams of fiber so let's say a cup of beans that's 14 grams if you want to get to 160 grams of fiber per day you would have to have a little over a half a gallon of beans a day um pretty heroic I guess as theoretically possible okay here are the numbers a half a half cup serving of beans seven grams of fiber typical vegetable like broccoli or cauliflower about four uh typical fruit like an apple or an orange about three whole grain bread maybe two grams a day so that's going to give you fiber and in a normal plant-based diet with no animal products at all it'll add up to maybe 40 grams uh something like a 45 50. it depends on what you're choosing 160 sounds like a lot but I'm well it's frankly Beyond heroic um don't aim for that but here's our rule of thumb if you're eating plant Foods As Natural as possible you don't need to count you're going to get the fiber that you need and it'll be healthy for you now if you are new to beans they're going to cause a little gassiness because your intestinal tract hasn't encountered them before so start really small just a little small serving and over time you can build up and make sure they are well cooked there are no Al Dente beans make sure they are really soft and that'll make them more digestible you know you were talking about books just a minute ago and I would think that eating 160 grams of fiber per day would be the perfect opportunity to get some reading done because at that point you would have to have a full-blown library in the bathroom with all the time you're going to be spending there that is just that's a Whopper of a number right there my friend 160. oh my goodness gracious don't try that at home or anywhere else for that matter oh man I don't know if we're going to be talking about that on July 12th when we do this show The Big Show live in New York City but I am fired up for this one my friend let me tell you what at the Museum of the city of New York you're gonna be there I'm gonna be there we're gonna be doing the big exam room live and we've got a panel of guests that will knock your socks off rip esselstyn from plant strong will be joining us Dr Robert osfeld an exam room favorite phenomenal cardiologist he's gonna be in the house that night and breaking news Dr Michelle mcmackin will also be on stage with us that night in New York on July 12th man this is going to be the most heart healthy night ever Dr Barnard it really is I have to say I can't wait we I thought we had such a blast doing this in Los Angeles and if anything the New York one is even going to be bigger and better so I can't wait I think it's going to be so exciting oh I'm super so July 12th New York City pcrm.org events and there's also a link for you to get your tickets right now in the episode notes so go ahead and join us would love to see you there and you know today's episode of the exam room podcast has been powered by the Gregory J Ryder memorial fund the Gregory J Ryder memorial fund supports organizations like the Physicians committee that carry on Greg's love for Animals by promoting plant-based health and working to end animal abuse while emphasizing programs that promote systemic change and also benefit people you can visit them online right now at gregoryriderfund.org that's Gregory Ryder spelled REI terfund.org such a great cause I love getting those email updates from Allison Mahoney letting me know all the great things that they're up to it's so true you know Greg had such a marvelous heart for animals and it was such a sweet person Allison has carried this forward so wonderfully and and is is really thinking what can we do to bring compassion and kindness and good health back into this world thank you Allison she is truly the best absolutely truly the best and you Dr Barnard are also simply the best thank you so very much for being here today and raising our health IQ it's kind of a delicate topic for a lot of people but hopefully we were able to open some eyes present some facts they really aren't being talked about nearly enough you bet thank you Jack all right and to the crew behind the scenes for making the magic happen thank you guys and to the exam roomies thank you guys for joining us and asking such wonderful wonderful questions as always and for everyone here at the Physicians committee I am the weight loss Champion Chuck Carroll we'll talk to you again very soon but until then keep it plant-based

Channel: Physicians Committee

Views: 8,073

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Id: SuZf3QBLs9Y

Length: 44min 17sec (2657 seconds)

Published: Wed Jun 21 2023