Dr. Ren-Fielding is my surgeon. She performed my VSG surgery on 11.11.2021.... this incredible surgeon saved my life. Not only did I lose the weight needed to (100 lbs down from my highest of 265, currently maintaining the loss) all of my medical issues have been reversed or put into remission. High BP and cholesterol, gone. Sleep apnea, heel spurs, gone. Fatty liver, reversed. Chronic asthma, controlled. Leukocytosis and thrombocytosis gone. T2 diabetes in remission. And my PCOS is so well controlled that I am actually considering having a baby because I am having healthy, normal ovulations for the first time in my life. Her expertise and guidance is something I fall back to every single day. THANK YOU DR REN-FIELDING. I'm finally living because of you . People... listen to this surgeon! She knows what she is talking about!
So nice to listen to an actual doctor interviewing other scientists/doctors and not just Joe Rogans of the world. Respect, Doctor Mike. I will show you to my little cousin instead Joe.
Rogan has some experts but a lot of charlatans too, and he doesn't have the expertise himself to push back on misinformation. Also, he's has a supplement company selling snake oil for 15+ years
@@jasongrundy1717 yeah, he does have great experts on... And sometimes even NOT so great "experts" on, and he just affirmatively says "mmm" to whatever is being shoved to his face, even if it contradicts the person that sat in front of him last week. Incapable of intelligent pushback most of the time. But my personal favorite occurrence on JRE is, when he invites a world class expert on, and then proceeds to cut him off 30 minutes into the conversation to go on an hour long tangent about "the trans", wokeness, women's sports and "the radical left", it doesn't really matter who the guest is, Joe manages to fit his favorite topic into any conversation 😇. Add on mandatory topics he has to touch regularly as well, such as chimps, bow hunting, DTM and aliens, and no egaggeration, I have seen him derail half or even more time that could've been an interesting discussion 😕. Crazy just how much that podcast fell off, used to be a regular listener 6-8 years ago, but it has been gradually declining, to the point where it is now, politically heavily biased embarrassment 🧐
yes! i thought the same. it's a bit frustrating when mike or others dismiss those of us who objectively do not react the same way to certain calories as "outliers" considering the percentage of people who are diagnosed with pcos worldwide and taking into account those that don't have the diagnosis. not to mention diabetes. PCOS is so common yet there is so little awareness about it and i've been misdiagnosed and prescribed hormones i shouldn't be which caused a lot of damage to my body because even doctors take it lightly, especially if it's not about treating infertility. But even after the diagnosis, most of my issues were dismissed as insignificant. anyway, hugs to all my fellow sufferers out there🫂🫂
@@xoBetsyhy12-y2y Dr Ren is brilliant. She is my actual bariatric surgeon and once she learned I have PCOS, she informed me of how my body processed carbs and sugars and how my diet post op needs to adjust for that more than the normal person. I am now having healthy ovulations and cycles that can be timed to the day. For the first time, I am considering having the baby I was told I could never have. Dr. Ren-Fielding is incredible.
Something I learned from you, Dr Mike, is to appreciate when a doctor can and is willing to say, "I don't know." And this episode re-emphasized the importance of that.
I love that Dr. Christine Ren-Fielding isn't tainted by social media and only provide scientific facts. Also kinda cute she's not aware of what's going on on social media. Glad she's not about the trend and just about science and experience. Thanks for this episode. Well done.
it's always funny to me when Mike has to explain to these esteemed experts how your average joe consumes information. it's actually really depressing 😭but i really appreciate his effort to bridge this gap and teach people how to express themselves in a more precise way given the current climate
Three years Post-Op RNY Gastric Bypass. I have zero regrets, even with an option today of medication, I wouldn't change my decision at all. 400lbs to 220lbs. I've ran 4 marathons since then. This has saved my life. No more apnea, my cholesterol is under control, my diabetes is gone. literally Best decision ever.
Congratulations! It's a life changing surgery with long term benefits, and people shouldn't be shamed for getting it. Do people get shamed for thyroid removal for hyperthyroidism? or a coronary bypass to treat blocked arteries? Absolutely not. They won't tell you to just "diet and exercise like a true person with effort," so why bariatric surgery getting all the flack? The conditions all these surgeries are treating are CHRONIC
Same for me. Got bariatric surgery in july. Have lost almost 80 pounds since then. My hyper tension is under control, cholesterol levels are way better and I sleep way better since I don't snore anymore. Best money I have spent
Set point theory is fascinating. I was 300 pounds around the age of 13. From maybe 11-15 years old I was around that weight. I dropped to 190 in a single year during my Junior year of high school. To this DAY, 20 years later, I still feel like it's so easy for me to gain weight and it's WHY I train every single day and track what I eat.
I do weight lifting 4x per week and try to increase my lifts 5-10% when I'm able. I also do 1-2 days a week of "free training". Yoga, hiking, martial arts etc@@theluschmasterinc
@@theluschmasterincI don't know about him, but I eat 1400 calories a day, train 30-60 minutes a day and weigh 330. If I have a new health problem like sleep apnea I gain a lot of weight. If I add any sugar to my diet like apples or bananas, or eat high carb foods like broccoli, carrots, or squash I gain weight. My exercise these days is body weight squats, stairs, walking, and some stretching. I used to do 100 pushups and situps and do bench and curls, but I got a hernia lifting an old water heater by myself, and I can't get it fixed because of my weight.
But ease of gaining weight could also be why you got to 300lbs in the first place, not that you created a set point when you gained the weight. Not too familiar with the theory though. If I were to guess I’d say you maybe just have high amount of Grelin or something making you more hungry. Personally I do get pretty hungry even after eating a lot, but specifically it takes a lot to make feel full.
I love how soothing Dr. Mike's voice is! The way Dr. Christine educates us about weight regulation without being judgmental is quite refreshing as well.
I’m a year and a half out from VSG (gastric sleeve) and I’ve lost 100 lbs. I didn’t want to get it done to start, needed it. I can now get a kidney transplant and I feel so much better. This weight loss surgery saved my life.
I had bariatric surgery 13 months ago - best decision I ever made! I have to work every day to make good choices to keep the weight off but so thankful science has allowed this for my health, family and future.
High protein and fiber keeps you full longer and prevents blood sugar spikes and then crashes that make you hungry again. Eating carbs with these things still does the same thing. I track calories and weight daily and have lost a lot this way.
My sleeve saved my life. It was the hardest experience I have ever lived. Not only for the physical and mental endurance you will go through years after your surgery but also for the stigma you carry. My mother was called a monster for supporting my decision. She was and is my rock.
AMEN! And according to that lipedema... Even my doctors say... well... your body just says ... no. I am able to lose some weight if I live on 1500kcal PLUS intermittent fasting... Who knew.. I am only able to keep that up a few months.. I will have surgery next year.. and I have major respect... it's a huge deal for me.. 🙈
Dr. Mike, thank you for always being so curious and inclusive. I truly enjoy listening to your podcasts. As a dietetic student and a future dietitian, I was wondering if it would be possible to have a Registered Dietitian on the podcast? Many people do not know what RDNs do, who they are, how they can help patients, how they differ from nutritionists, etc. A lot of pressure has been put on medical doctors and other healthcare providers to know everything about food and nutrition and to advise people on how and what to eat when a) they barely have time for a regular appointment and b) there are others (khm khm RDNs) whose educational background and experience are exactly that - food and nutrition. Thank you!
That's a really good idea . I've seen some shows where they were discussing foods with children who didn't even know basic fruits and vegetables - food knowledge is shockingly missing from a lot of people (through no fault of their own).
Doctor Mike, you make a really great podcast host. You remain patient and respectful, and you pick really great guests who are informed and willing to discuss. Cheers
I’m taking a GLP-1 and it’s working amazing. 205lbs and now I’m at 195 only 3 months later. Feel full after 3-6 bites of food. No snacking or cravings either. Amazing medicine and have had light symptoms from it.
Doctor Mike brings joy to everyone’s day. He is not only a phenomenal person, but also an understanding and overall kind human. He is open and teaches so much. Continue the great work Mike. We all love you and your content! ❤❤😊
what an amazing conversation! Thank you Dr. Mike. I had bariatric surgery in 2022 after being a food addict for YEARS. the surgery allowed me to be able to have control and ive lost 100 pounds. More importantly, i live a healthy lifestyle now. It seems so easy now... crazy this seemed impossible before. I fell in love with exercise, and i feel in control of my eating. no regrets, this surgery completely changed my life. I am forever grateful for this tool.
Bariatric surgery saved my life! I've had some regain I've been working on however, still the most impactful decision I've ever made next to managing my mental health.
I went from 350 to 170. I started my bariatric journey Nov 2018 and I only wish I did it sooner. I look at myself in the mirror or in pictures now and I still can’t believe what I see. I not only can do more physically and feel generally better but I am so much more confident in how I operate in the world.
God is good! I am in the process of having surgery due to the fact that I have a hard time maintaining weight loss. I have PCOS and I’m actually having surgery at this very same hospital. I appreciate Dr. Mike and Dr. Christine for bringing his topic to the forefront. Thank you for the information and for your medical professional information.
Hi Dr. Mike, I sincerely want to thank you for all the information that you have given me, a viewer over the years. Today I had my first midterm exam in medicine about a subject named PCM (professionalism, communication, and morality) and as the name suggests it teaches Ethics, the connection between a patient and his physician etc. , when I first started studying this subject, I was shocked to find that I already have a rudimentary understanding of the majority of its content, thanks to you. You are truly one of the most inspiring people on this planet and an amazing role model for myself, and for anyone with a dream to help people. I truly wish you happiness in life. Sincerely, a child you inspired.❤
This was a great interview! I don't think there's a great understanding of how much emotional and physical pain people are usually going through before they are turning to surgical or medical intervention. There's still a lot education to be put out there. It's great to see so many success stories in the comments section; that warms my heart. My mother was a prime example of a person who underwent gastric surgery, but because of a lack of food education, emotional eating/psychological factors and just plain old genetics, has returned back to her original weight within 10 years. As for Ozempic, my sister went on this for type 2 diabetes and was one of the unlucky people to have some truly terrible side effects in the few months she was on it. I think it's a great drug, for the right people, but there's always risks involved in every medication. The "celebrity" dieting fad to lose a few kilos seems truly baffling to me. It should be left for the people who actually need it for medical reasons, but maybe that's my general bias towards comedic extremes.
As a 4 ft 10 woman who is 174 lb (started at 187) and trying to lose 45 more lbs, this came at a perfect time. I won't be using ozempic or surgery personally but this is a fantastic talk!
I'm a Type 1 Diabetic, I have PCOS, I'm one of the most insulin resistant patients my doctors have ever seen. I'm five foot on a good day and as of September, I weighed 240lbs with very little success in losing weight by diet and exercise alone. My PCP was able to get my insurance to cover Ozempic in late September and since I've been on it, I've lost around 10lbs. This is the first time I've lost weight since I was a young adult. It has made me want to eat better, healthier, exercise more, and take better care of myself. I love how my body and my mind are changing for the better. All from a weekly shot.
I've had the lap sleeve and then I needed to have a bypass because of the acid reflux. I've lost over 100 pounds and found a new life. I have zero regrets.
When you are extracting clips for short reels, there are at least 2 or 3 just starting from 1:27:13. Great conversation. It looks like Doctor Mike didn’t use notes for this one; I was engaged the entire time because it seemed like a questions flowed directly from the topics covered.
I cried while watching this. I’ve struggled with weight gain for years. My body has plateaued around 250, and stayed there give or take 5 pounds over the last 15 years. Im 42. While not struggling to find a doctor that won’t tell me to simply loose 80 pounds, my weight has consistently been an issue. I can’t tell you how many times I’ve received the side comment of “loosing 10 pounds will make it easier.” While true, it doesn’t help battle the societal lessons I’ve learned over my life, coupled with ADHD and CPTSD. To hear two doctors not fat shame me or people like me, or resort to medicine first is quite refreshing and hopeful. Thank you.
I had SADI-S bariatric surgery three years ago and it was the best decision I've ever made! I'm glad my doctor at the time really encouraged me to do that and not all the weight loss meds. I loved this discussion!!
As someone who reached 1 year post op gastric bypass last week, I found this conversation amazing. She is right. My satisfaction is very high. My life is much bettter. lost over 120 pounds. Amazing video. Thanks.
I'm in a program right now scheduled to get agastric sleeve surgery. When I think about surgery compared to GLP1 meds, I think about a life without dependence on a particular medication. For me, that trade off just can't really be beaten.
It’s risk versus benefit. Bariatric surgery has been around longer and we’re more familiar with its long term risks/benefits. Ozempic has his own blessings and curses, though we have had less time compared to surgical options, to see it through.
As someone who is about 100lbs overweight at 5’2 I’ve been seriously considering bariatric surgery but so scared of the backlash from friends and family.ive failed multiple ways of losing weight and I just want control over my life again…this episode came at the perfect time and appreciate the insight ❤
unfortunately, the lack of understanding and the lack of will to understand the struggles obese people are facing is still so prevalent and while it's getting better, it's not going away any time soon. so i hope you can put what the people around you think to the side (easier said than done i know) and focus on yourself and what you want and need. there's nothing "easy" about choosing surgery nor is it your personal failure that it got to that point, even if the society has done a great job of making you feel that way. good luck with whatever you choose and all the best!
I gained 180lbs on prednisone over a year and a half period. I was 12 when it started and in total kidney failure. My skin stretched so much I have striae on 80% of my body because of it. I lost some weight after I got sick but continued to be overweight despite many years of trying to lose it. Medical trauma and chronic illness are never discussed in weight gain situations. I have high blood pressure from my kidneys being bad. I was forced to be overweight and then kind of left to figure it out on my own. My doctors always attribute to me being overweight to me eating and it was never that. I had a job last year where I walked 30,000 steps a day for 3-5 days per week (worked in trade shows.) I wasn’t eating anything and working 65-70 hours a week. I went from 221 to 170. Then when I had to quit because my kidneys were failing again and I started eating normal meals not even bad ones, I blew back up to 230 the heaviest I have ever been. I lost about 25lbs now and am in a research study which I work with a nutritionist and my nephrologist/rheumatologist and the materials they give me are actually dumb and unhelpful. I don’t understand where the disconnect is with doctors and my experiences medically. I am trying so hard every day and it’s like everything is against me. I really want to change this part of the medical industry and I’m hoping I can contribute to this study and help others with lupus and lupus nephritis who are struggling to lose weight.
I have been on prednisone for 6 years since my kidney transplant. I gained 100lbs in a year. I tried to lose weight for 5 years and only managed to lose 20lbs. I went on Ozempic in December 2023 and have lost over 100lbs. I eat around 1400 calories/day and lift weights 3 days/week. I’m not ever planning to go off this medication. Not ever.
I think the number 1 problem is processed foods. I really believe nobody whould be fat if everyone was eating only whole foods and getting exercise everyday.
This was so interesting to watch! My BMI is about 48 and considering glp1 meds myself. Surgery scares me so much, but this helps ease my mind a bit! I'm in my mid 30's and so far do not have any other health issues, so I need to get this tackled now. I was able to lose 50lbs on WW before covid but it was so hard, took over my life. Anything to help!
gastric bypass 6 yrs ago lost 150 lbs, doing well no need for meds. i am 150 pounds still, considered overwt. but dont care. i am 5'4". so happy that I did surgery. Have / had diabetes, hypertension, cholesterol issues gone or better. was overwt since i was 11 yrs old and now i am 59
This is such a brilliant conversation! I found it so informative. There were great explanations and analogies. Personally, GLPs have helped facilitate my journey to a healthier lifestyle in terms of eating and exercise. GLPs have definitely empowered me and positively motivated me in this regard.
I had roux n y gastric bypass august 2023. My life is SO changed for the better! One of the most difficult processes to go through and definitely not the easy way out! Hard work is necessary still. I have NO regrets!
Thanks, Doctor Mike and Dr. Ren-Fielding. This was a very interesting and informative discussion. And I think Dr. Ren-Fielding is correct in that patients with extremely high BMIs will continue to need bariatric surgery.
6 years postbariatric surgery and i have zero regrets. Going from 350 to 170 has changed my life. Unfortunately i gained 50 pounds back last year. However, the classes i took as a result of the surgery have helped me loose 30 of regain. I love that Dr. Chistine talked about treating obesity. I genuinely believe we should have a real convo about treating obesity. Getting the weight off and to Dr. Mikes point of eating exercising. There is a big missing point mental. Why are they obese. Why are we, i say we, overeating.
Really helpful for us this podcast....keep going.... I as a Science student I can learn so important term from your video....which is really important for me..
Calories in, calories out is physics, but how we store calories matters for driving the behavior that influences those inputs and outputs. When energy is locked into fat it isn't available to increase base metabolic rate or energy for non exercise activities. So the macronutrients and the speed of various metabolic pathways matters. Humans are not just buckets of calories, they are complex systems with multiple steps to store and retrieve calories in multiple ways.
So, are you suggesting bodies dont use fat for NEAT? That sounds absurb, i need to see a source on that. Maybe for people with metabolic disorders, but thats an exception not the rule. If you dont or limit carb intake, you will most certainly use fat stores.
I was so glad to see this. I'm a 200 lb. 67 year old formerly bulimic woman with one lung awaiting knee replacement surgery. I was able to get my weight down to 164 last year through healthy eating and walking 5 miles a day. I began gaining the weight back in January when my knee became bone on bone and I could no longer walk. Now I spend most days lying on the couch eating. My knee replacement is scheduled for March 2025. I need to lose weight and cannot find the motivation to do so. I'm on mood stablizers and antidepressants which makes it more difficult. I can't take nsaids for my knee pain due to bad kidneys. My PCP has offered a version of Ozempic but it scares me. I'm already taking a lot of medications that have messed with my metabolism. I need help to decide what to do to lose the weight.
I think it's worth talking through your fears with your PCP. Your history of Ed makes things like sleeve surgery tricky because it could trigger some stuff. I struggled with bulimia too but luckly I've been OK for the past 10 years, so I'm a less risky patient for surgery now. Time restricted eating and a low carb diet might help move a small amount of the weight to help with the knee.
My new knees have made a world of difference! I've lost weight for the first time in my life just because I can be more active again. My personal, non-medically trained opinion is to get your knee taken care of first, then think about your weight. I'm 5'6" and my weight peaked at 256lbs right before surgery. Less than a year out, I'm at 238lbs and still trending down. I'm just now working on adjusting what I eat. I've stopped taking ibuprofen. I went from struggling to walk my dog a half mile once a week to hiking 8 miles. I did find acupuncture helpful for pain relief until I could have surgery. Also, topical lidocaine.
I'm diabetic and have been on a few GLP1s, ozempic currently. I'm pretty sure ozempic is generally reported to be helpful for kidney problems if you stay hydrated. It has definitely affected my desire to eat and made it possible for the first time since I was a child to set my food down and say (and truly mean) that I was done before my plate was empty. If you start, just go very slow on dosage and don't let them bully you into higher doses if you are feeling any side effects (which is mostly nausea).
i feel like there are definitely cases for staying on ssris long term, i have ocd and it’s the only thing that keeps me sane - regular talk therapy exacerbates my symptoms. to be fair dr mike was probably referring to less complex scenarios.
Interesting interview. I just listened on iPhone - I'm sure he has no control over this but the BK commercial in the middle of the podcast was hilarious to me.
Doctor Mike, As a bariatric surgery patient who was on glp1 before surgery. You have no idea what it takes to lose weight and keep it off. You think it’s all will power and you’d be wrong. It’s about hormones and a broken metabolism caused by ultra processed foods. Once broken I’ve only found two things that help. Glp1 ‘s and bariatric surgery. Both of which change your hormones and cause you to crave healthy food not junk
I am a Duodenal Switch WLS patient, I am 5'10"... I went from 350lbs down to 150lbs today. This was the single best thing that has ever happened in my entire life, i would make this choice a million times over
They forgot to mention about dropping the weight before the surgery because the possible difficulties is doing anaesthesia in a too heavy person and decreasing the possibility of cardiac events
Did Fen Phen in the 90's. Lost over 100 lbs. Never had the heart valve issues thankfully. LOVED how it cut off the "food chatter." Found it impossible to lose or maintain for long once I came off it and I tried everything! I had gastric sleeve surgery because I didn't want my innards re-routed (but in hindsight, I wonder if it would have been better....) 7 years ago. Only lost around 70 or so pounds of the 125 goal. I have regained 55 pounds or so. Regardless of one's weight, my bariatric office has everyone on 1200 calories. Not so much low carb, but high protein. I'm now on Oz which also shuts off the chatter. That makes a huge difference and it's something someone who doesn't KNOW....just can't understand.
I've been on low-dose Wegovy for a week now, and the food "noise" in my head has almost completely gone. I have almost no cravings for carbs/sugars now. It's kinda freeing.
I found this very interesting! I've been morbidly obese for most of my adult life (I'm 73) After I had my third child, the gynaecologist told me that I needed surgery, because I had stress incontinence but, I needed to cut down on the amount of food I ate, I started to tell him that I really didn't eat much...I didn't get any further, he told me that nobody came out of Belsen looking like me, I still have stress incontinence!
i'm sorry to hear that, it's so upsetting how easily obese people are dismissed as just being fat cause they eat a lot instead of given the opportunity to find the underlying cause...
Very interesting discussion! I will have the Gastric bypass surgery in February next year and I have been very unsure if it is right for me, but I think it is. I have to give it a chance. 👍
I'm only at the first ten minutes of the discussion, but I'll still say this: The point indeed was made that the _type_ of food commonly consumed by people, especially in the west, is problematic as it's not satiating enough and is often too calorie dense with a bad nutritional profile - but this is all down to the consumer. I doubt most who are obese have anything innately wrong with their metabolism. Their bodies don't break the laws of thermodynamics, they simply eat too much and too bad. I'm not an American but I keep seeing online American people saying they eat unhealthy food (including pre-made fast food) because "it is cheaper", giving as an example how for breakfast they buy a McMuffin for $6 or so. What? How is that cheaper than making yourself a bowl of oats, 100% peanut butter, banana/apple and some milk? I actually checked - that would cost less than a dollar and would be more nutritious and satiating. The only "downsides" are that you need to put these in a bowl (which takes 30 seconds) and that it doesn't taste like greasy junk food, but it is still very tasty. It's all down to you to break your brain off of the habit of seeking overly greasy and sugary junk, and off of telling yourself that you can't afford anything healthy. If you order from restaurants or buy pre-packaged meals you are more than able to afford buying ingredients and making a healthy meal yourself.
i was thinking about the surgery, but honestly, what put me off the most was long term implications. Not only is the procedure permanent as far as my doctor told me, what he didnt tell me was that i would need to take suppliments for the rest of my live. I am thinking about trying Ozempic and I am aware that its not gonna fix me magically, but my appetite is my worst enemy and I cant focus on anything if it wents "beast mode". And as far as I know, thats the thing Ozempic is good at aside from being a diabetes medicin, to kill appetite. To clearify, i am not demonizing the surgery. Yes, my weight impacts my life, but I am still able to almost everything. This isnt true for some other patients and i am well aware of that, and for them the surgery might be the best choice. For anyone else fighting the good fight, wish you good luck. Just remember that there is no easy way to get thin, only to get worse. And obesity is never healthy.
Also, if you can, please tell your guest that I love her attitude -- especially the fact that she truly understands the impact of fat shaming, which I don't think the doctor in "My 600 pound life" does.
CORRECT ME IF I'M WRONG: I learned a long time ago that once you produce new adipose (fat) tissue, the cells in the mesh or net of adipose can fill or empty/expand or shrink as you fluctuate weight, but if the adipose is still there, it will always want to fill those holes with fat cells and that is the "set point" or tissue "memory". That's why liposuction can change this function.
I was curious about this too, and I'm in no way medically inclined, just been reading some studies of bodies after lipo and the physiological conditions of the subjects. It seems to me, from what most of the studies have stated, is that the body doesn't say to itself 'I have 10 empty fat cells, I must fill them' it says 'I need 10 fat cells and I need them to be full'. So whether you have 10 fat cells that are empty, or you get liposuction and remove all 10 fat cells completely, the body still sees a loss that it absolutely must replace for survival. Again, I want to say I'm no doctor so this was just my interpretation, but all of the studies I came across said that liposuction doesn't affect (or affects very slightly) the metabolic rate, hormonal balance etc etc and so it's very common for liposuction patients to have to return several times throughout their life, or also utilise other weight reduction options in conjunction with lipo (such as bariatric surgery or medications). However, the initial reduction of weight can very much make the subjects ability to exercise much more approachable, losing 10-15kg means less stress on joints, you won't fatigue as quickly, etc. But I don't think, from what materials I've come across, that the surgery actually affects the set point.
I've been on Zepbound for 10 months and I've lost 64 pounds and I feel absolutely terrific. The food chatter is gone, and I finally can stop eating mid dinner and feel full. it wasn't until I started taking the GLP1 was I ever able to feel satisfied or been able to quit eating. Will I bet on this for the rest of my life? Probably.
My late mother only ate food she cooked herself. No “convenience” crap, never too much fat (she didn’t like fatty food, it made her feel sick - just like me) and never snacked. She was much too busy. She didn’t like sweets. I never saw her eat candy/chocolate or crisps. She literally ate like a model preparing for a Viktoria’s secret show. No cereals, never alcohol, no soda/coke or any other sugary beverages. No artificial sweeteners either. She didn’t restrict her intake of calories - she just was not a great eater. She liked bread though and baked it herself. Delicious whole grain bread. The only food she craved were leafy greens. We still commemorate her by snacking on parsley 😌 She was always busy and always went for long walks. Almost every day. She was overweight (not severely, but still..) and it annoys me that the calorie-restriction-doctrine is still something society and even doctors consider an indisputable truth. “The body is not a machine” - so very true! If it were that easy, medical school would be easy and you’d get a degree in about a year. Of course calories matter. With her genetics… if she ate 2500-3000 calories daily and was sedentary, she would have been severely overweight and probably diabetic or would have had high blood pressure etc. She was overweight but not 200 or 300 (maybe 180 - she was not tall..) pounds. Very healthy, vibrant, fit woman.. until Glioblastoma took her at a young age. Guess what: when I eat more than 1200 calories I put on weight and I was never thin - although I was hungry and ate very little my entire youth. I was on a 500 calorie diet for 16 months once, worked out twice a week (not very much, I know..) as a young woman, lost maybe 20 pounds and still was slightly overweight. Nobody believed me how little I ate. Of course I couldn’t maintain that diet and I still struggle. I am not “fat” (slightly overweight) but still struggle with my weight and the “image” it represents. Very little visceral fat and quite healthy though. It took a very sensitive and competent endocrinologist (most are useless…) 2-3 years ago (“it is not your fault! It’s genetics”!) to stop hating and blaming myself. Thank you, Dr. Mike ❤
In high school, I had a friend in the same activities so we were about equally active. She easily ate more than I do. I was already obese. My friend was so underweight she had to take medicine to gain weight. That's enough to show me there are factors beyond what you eat and how much you exercise. And knowing that unexplained weight gain or loss is a sign of illness shows there are other factors at play.
@@BionicMilkaholic absolutely, there are so many things that influence what actually happens to those calories when they "go in" and how they are processed and used by the body, as well as what effect they have on the body (like glucose on insuline resistant people). it's such a simplistic view of such an important and complex system that i can't believe even people like dr mike still endorse it. all it does is lead to even more stigma towards overweight people and even more self doubt and guilt among the people who struggle.
I'm 5'10" and have gone from 329 to 287 as of yesterday via calorie restriction. I've done calorie restriction before and Gained back far more than I lost when I got off track. I don't have insurance just yet, and though I will be getting insurance soon through my employer, I fear it will not cover surgery, neither will it cover weight loss medications, neither can I afford either on my own. Not only does this not give me hope, but things like access to healthy foods, access to nutritionists and doctors who can help, and access to weight loss in general is truly for the wealthy, which most of us are not.
I am not sure I am comfortable with how absolute some of the language here is, saying it isn’t possible to lose large amounts of weight isn’t true, saying it isn’t probable is true, doctors should take care with language. Now later on it becomes clear with context that she doesn’t actually think it is impossible but improbable but still of people only listened to the first bit they would have the wrong conclusion due to the language used.
11:22 I think a good comparison to "calories in calories out" being incorrect, is how a heat pump can be over 100% efficient while still not violating the 2nd law of thermodynamics. Heat pumps move heat from the outside of a building to the inside, warming the inside and cooling the outside. Each calorie of energy you give a heat pump can move around 4 calories of heat from the outside to the inside. This means that from a human perspective, the heat pump is 400% efficient while from the universe's perspective the heat pump is only 100% efficient at converting electricity to heat. It's all about perspective. "Calories in calories out" is true from the universe's perspective, the human body cannot violate the 2nd law of thermodynamics or reverse entropy, but from the much more relevant human perspective, where basal metabolic rates and cravings dictates the flow of energy, "calories in calories out" ignores how the body actually interacts with energy.
I managed to quit drinking soda with artificial sweeteners thanks to a friend who initiated this project. Now I quite rarely allow myself to drink a soda, for special occasions. When I choose soda with artificial sweetener, I feel myself craving more soda for at least a week after. After one soda with regular sugar, I don’t experience this craving in the same way at all. I find it easier to go back to water, or sparkling water after a regular soda.
Hello Doctor Mike ☺️ Appreciate you, and the work you put into your videos🙏🏼 Would love to see a video on tips on good communication with patients. How to keep the time frame of a consultation, yet getting the most out of the little time you have as a doctor🙏🏼☺️
I was on Mounjaro for a year and lost some weight and my A1C came down. However I was still overweight. I had gastric sleeve last December. After a few months my A1C started to uptick and food noise came back. So now I am on Ozempic and the food noise is gone and my A1C is now down to 5.6. Losing the weight is still slow but it's going down slowly. I do exercise, prioritize protein and track my food.
One thing that I think is considered too little is surgical reduction of fat, for medical rather than cosmetic reasons. My own BMI was around 55, according to an NIH calculator (I'm well under 5 feet tall), and I had both ovarian and endometrial cancer. As part of my surgical treatment I had a pannectomy -- removal of the hanging abdomen, both skin and fat -- which resulted in about 35 pounds of weight loss. Most of that weight loss stayed off. As an aside, I didn't change my diet, except that for some time I needed to go on a LOW fibre diet due to the radiation I also had (which is known to cause diarrhea). I resisted that for a time, because it had cost me some effort to raise my fibre, but when I told the nutritionist I was thinking of it as "eating unhealthily" (because I didn't want to get used to it and have trouble eating high fibre again), she pointed out that eating very little fibre was healthy eating for me at that time. When I asked why pannectomies were not regularly done -- mine was an enormous boon -- I was told, "Oh, they generally grow back." The thing is that "growing back" is not a binary matter. In the years since 2007, when I had surgery, I have reacquired a little pooch at the bottom of my abdomen. So did my pannus grow back or not? The little pooch is maybe 5% of the size of the original pannus, so you could say it grew back -- but the benefits of that surgery remain, not far short of two decades since the operation. It was a bonus to me -- quite aside from curing the cancer, of course -- but I couldn't say the hanging fat and skin is ALL gone. If you put me in a database saying "grew back" or "didn't grow back," it might be said that I was in the "grew back" category -- and that would badly misstate the effectiveness of pannectomy for me. Equally, I wonder whether surgical removal of other large fat accumulations -- direct removal of fat cells, whether by liposuction or direct surgery -- might not be medically effective for many very fat people. I would suspect that little research has been done on that topic, due to the stigma of "taking the easy way out" of fat loss, and stigma against fat people in general.
Dr. Ren-Fielding is my surgeon. She performed my VSG surgery on 11.11.2021.... this incredible surgeon saved my life. Not only did I lose the weight needed to (100 lbs down from my highest of 265, currently maintaining the loss) all of my medical issues have been reversed or put into remission. High BP and cholesterol, gone. Sleep apnea, heel spurs, gone. Fatty liver, reversed. Chronic asthma, controlled. Leukocytosis and thrombocytosis gone. T2 diabetes in remission. And my PCOS is so well controlled that I am actually considering having a baby because I am having healthy, normal ovulations for the first time in my life. Her expertise and guidance is something I fall back to every single day. THANK YOU DR REN-FIELDING. I'm finally living because of you .
People... listen to this surgeon! She knows what she is talking about!
So nice to listen to an actual doctor interviewing other scientists/doctors and not just Joe Rogans of the world. Respect, Doctor Mike. I will show you to my little cousin instead Joe.
Unfortunately, those videos get more clicks
Joe Rogan has experts on. You have JRDS.
Rogan has some experts but a lot of charlatans too, and he doesn't have the expertise himself to push back on misinformation. Also, he's has a supplement company selling snake oil for 15+ years
@@Alton7771 challenge accepted!!
@@jasongrundy1717 yeah, he does have great experts on... And sometimes even NOT so great "experts" on, and he just affirmatively says "mmm" to whatever is being shoved to his face, even if it contradicts the person that sat in front of him last week. Incapable of intelligent pushback most of the time. But my personal favorite occurrence on JRE is, when he invites a world class expert on, and then proceeds to cut him off 30 minutes into the conversation to go on an hour long tangent about "the trans", wokeness, women's sports and "the radical left", it doesn't really matter who the guest is, Joe manages to fit his favorite topic into any conversation 😇. Add on mandatory topics he has to touch regularly as well, such as chimps, bow hunting, DTM and aliens, and no egaggeration, I have seen him derail half or even more time that could've been an interesting discussion 😕. Crazy just how much that podcast fell off, used to be a regular listener 6-8 years ago, but it has been gradually declining, to the point where it is now, politically heavily biased embarrassment 🧐
I'm glad Dr Christine is talking about PCOS and insulin resistance. Few people understand, and there needs to be increased awareness.
Stolen ass comment
What time do they talk about it so I can watch?
yes! i thought the same. it's a bit frustrating when mike or others dismiss those of us who objectively do not react the same way to certain calories as "outliers" considering the percentage of people who are diagnosed with pcos worldwide and taking into account those that don't have the diagnosis. not to mention diabetes.
PCOS is so common yet there is so little awareness about it and i've been misdiagnosed and prescribed hormones i shouldn't be which caused a lot of damage to my body because even doctors take it lightly, especially if it's not about treating infertility. But even after the diagnosis, most of my issues were dismissed as insignificant. anyway, hugs to all my fellow sufferers out there🫂🫂
@@xoBetsyhy12-y2y Dr Ren is brilliant. She is my actual bariatric surgeon and once she learned I have PCOS, she informed me of how my body processed carbs and sugars and how my diet post op needs to adjust for that more than the normal person. I am now having healthy ovulations and cycles that can be timed to the day. For the first time, I am considering having the baby I was told I could never have. Dr. Ren-Fielding is incredible.
Something I learned from you, Dr Mike, is to appreciate when a doctor can and is willing to say, "I don't know." And this episode re-emphasized the importance of that.
This needs to be said again! Saying you know everything is a red flag!
I love that Dr. Christine Ren-Fielding isn't tainted by social media and only provide scientific facts. Also kinda cute she's not aware of what's going on on social media. Glad she's not about the trend and just about science and experience. Thanks for this episode. Well done.
it's always funny to me when Mike has to explain to these esteemed experts how your average joe consumes information. it's actually really depressing 😭but i really appreciate his effort to bridge this gap and teach people how to express themselves in a more precise way given the current climate
Three years Post-Op RNY Gastric Bypass. I have zero regrets, even with an option today of medication, I wouldn't change my decision at all. 400lbs to 220lbs. I've ran 4 marathons since then. This has saved my life. No more apnea, my cholesterol is under control, my diabetes is gone. literally Best decision ever.
Congratulations! It's a life changing surgery with long term benefits, and people shouldn't be shamed for getting it. Do people get shamed for thyroid removal for hyperthyroidism? or a coronary bypass to treat blocked arteries? Absolutely not. They won't tell you to just "diet and exercise like a true person with effort," so why bariatric surgery getting all the flack? The conditions all these surgeries are treating are CHRONIC
That's amazing for you. Congratulations on getting your life back!
That's phenomenal. Congratulations on your success. I'm sure that wasn't easy to go through, recover from, and adapt to.
@@evilherbivore13 it was a couple months of adjustment but well worth it. I have anr entire new lease on life at 40 where I may not have made it to 50
Same for me. Got bariatric surgery in july. Have lost almost 80 pounds since then. My hyper tension is under control, cholesterol levels are way better and I sleep way better since I don't snore anymore. Best money I have spent
The concept of health in "The 23 Former Doctor Truths" book completely explains this. I wish I read it sooner.
Set point theory is fascinating. I was 300 pounds around the age of 13. From maybe 11-15 years old I was around that weight.
I dropped to 190 in a single year during my Junior year of high school.
To this DAY, 20 years later, I still feel like it's so easy for me to gain weight and it's WHY I train every single day and track what I eat.
you do heavy training everyday or like 30 minutes each day? what kind of stuff do you eat?
I do weight lifting 4x per week and try to increase my lifts 5-10% when I'm able. I also do 1-2 days a week of "free training".
Yoga, hiking, martial arts etc@@theluschmasterinc
@@theluschmasterincI don't know about him, but I eat 1400 calories a day, train 30-60 minutes a day and weigh 330. If I have a new health problem like sleep apnea I gain a lot of weight. If I add any sugar to my diet like apples or bananas, or eat high carb foods like broccoli, carrots, or squash I gain weight. My exercise these days is body weight squats, stairs, walking, and some stretching. I used to do 100 pushups and situps and do bench and curls, but I got a hernia lifting an old water heater by myself, and I can't get it fixed because of my weight.
I weight train 4x per week about an hour a day, then 1-2 days of yoga/martial arts/walking @@theluschmasterinc
But ease of gaining weight could also be why you got to 300lbs in the first place, not that you created a set point when you gained the weight. Not too familiar with the theory though. If I were to guess I’d say you maybe just have high amount of Grelin or something making you more hungry. Personally I do get pretty hungry even after eating a lot, but specifically it takes a lot to make feel full.
I love it when Dr Mike has other doctors on and talks medicine ! 😃, hope we get more of these kind of podcasts
I love how soothing Dr. Mike's voice is! The way Dr. Christine educates us about weight regulation without being judgmental is quite refreshing as well.
How many educators do you know that are judgemental
I’m a year and a half out from VSG (gastric sleeve) and I’ve lost 100 lbs. I didn’t want to get it done to start, needed it. I can now get a kidney transplant and I feel so much better. This weight loss surgery saved my life.
That's amazing 😊
I had bariatric surgery 13 months ago - best decision I ever made! I have to work every day to make good choices to keep the weight off but so thankful science has allowed this for my health, family and future.
❤ congrats! Same here!
After losing motivation about losing weight, perfect timing, thanks for this.
You can do it! I believe in you (and also get the struggle✌️)
High protein and fiber keeps you full longer and prevents blood sugar spikes and then crashes that make you hungry again. Eating carbs with these things still does the same thing. I track calories and weight daily and have lost a lot this way.
My sleeve saved my life. It was the hardest experience I have ever lived. Not only for the physical and mental endurance you will go through years after your surgery but also for the stigma you carry. My mother was called a monster for supporting my decision. She was and is my rock.
Im happy that Dr Christine is talking about PCOS and insulin resistance. Not many people understand and this needs to have more awareness
AMEN! And according to that lipedema... Even my doctors say... well... your body just says ... no. I am able to lose some weight if I live on 1500kcal PLUS intermittent fasting... Who knew.. I am only able to keep that up a few months.. I will have surgery next year.. and I have major respect... it's a huge deal for me.. 🙈
@nickib.8364 wishing you the best of luck and a speedy recovery. You got this!
@@nickib.8364 good luck with your surgery!
Dr. Mike, thank you for always being so curious and inclusive. I truly enjoy listening to your podcasts. As a dietetic student and a future dietitian, I was wondering if it would be possible to have a Registered Dietitian on the podcast? Many people do not know what RDNs do, who they are, how they can help patients, how they differ from nutritionists, etc. A lot of pressure has been put on medical doctors and other healthcare providers to know everything about food and nutrition and to advise people on how and what to eat when a) they barely have time for a regular appointment and b) there are others (khm khm RDNs) whose educational background and experience are exactly that - food and nutrition. Thank you!
That's a really good idea . I've seen some shows where they were discussing foods with children who didn't even know basic fruits and vegetables - food knowledge is shockingly missing from a lot of people (through no fault of their own).
Doctor Mike, you make a really great podcast host. You remain patient and respectful, and you pick really great guests who are informed and willing to discuss. Cheers
I’m taking a GLP-1 and it’s working amazing. 205lbs and now I’m at 195 only 3 months later. Feel full after 3-6 bites of food. No snacking or cravings either. Amazing medicine and have had light symptoms from it.
Doctor Mike brings joy to everyone’s day. He is not only a phenomenal person, but also an understanding and overall kind human. He is open and teaches so much. Continue the great work Mike. We all love you and your content! ❤❤😊
It was incredibly kind and thoughtful of you to take the time to write such a lovely message. I hope he sees it 🤠
what an amazing conversation! Thank you Dr. Mike. I had bariatric surgery in 2022 after being a food addict for YEARS. the surgery allowed me to be able to have control and ive lost 100 pounds. More importantly, i live a healthy lifestyle now. It seems so easy now... crazy this seemed impossible before. I fell in love with exercise, and i feel in control of my eating. no regrets, this surgery completely changed my life. I am forever grateful for this tool.
Bariatric surgery saved my life! I've had some regain I've been working on however, still the most impactful decision I've ever made next to managing my mental health.
I went from 350 to 170. I started my bariatric journey Nov 2018 and I only wish I did it sooner. I look at myself in the mirror or in pictures now and I still can’t believe what I see. I not only can do more physically and feel generally better but I am so much more confident in how I operate in the world.
I love hearing you both talk.
So professional, sympathetic and calm. ❤
God is good! I am in the process of having surgery due to the fact that I have a hard time maintaining weight loss. I have PCOS and I’m actually having surgery at this very same hospital. I appreciate Dr. Mike and Dr. Christine for bringing his topic to the forefront. Thank you for the information and for your medical professional information.
Best of luck to you!!
I also have PCOS and had the sleeve done in august. No regrets.
Hi Dr. Mike, I sincerely want to thank you for all the information that you have given me, a viewer over the years. Today I had my first midterm exam in medicine about a subject named PCM (professionalism, communication, and morality) and as the name suggests it teaches Ethics, the connection between a patient and his physician etc. , when I first started studying this subject, I was shocked to find that I already have a rudimentary understanding of the majority of its content, thanks to you. You are truly one of the most inspiring people on this planet and an amazing role model for myself, and for anyone with a dream to help people. I truly wish you happiness in life.
Sincerely, a child you inspired.❤
This was a great interview! I don't think there's a great understanding of how much emotional and physical pain people are usually going through before they are turning to surgical or medical intervention. There's still a lot education to be put out there. It's great to see so many success stories in the comments section; that warms my heart.
My mother was a prime example of a person who underwent gastric surgery, but because of a lack of food education, emotional eating/psychological factors and just plain old genetics, has returned back to her original weight within 10 years.
As for Ozempic, my sister went on this for type 2 diabetes and was one of the unlucky people to have some truly terrible side effects in the few months she was on it. I think it's a great drug, for the right people, but there's always risks involved in every medication. The "celebrity" dieting fad to lose a few kilos seems truly baffling to me. It should be left for the people who actually need it for medical reasons, but maybe that's my general bias towards comedic extremes.
As a 4 ft 10 woman who is 174 lb (started at 187) and trying to lose 45 more lbs, this came at a perfect time. I won't be using ozempic or surgery personally but this is a fantastic talk!
I wish you willpower.
Well done on the first 13 lbs. 🎉
Wish you luck and success for the rest.
Great Job!
good luck with your journey!
I'm a Type 1 Diabetic, I have PCOS, I'm one of the most insulin resistant patients my doctors have ever seen. I'm five foot on a good day and as of September, I weighed 240lbs with very little success in losing weight by diet and exercise alone. My PCP was able to get my insurance to cover Ozempic in late September and since I've been on it, I've lost around 10lbs. This is the first time I've lost weight since I was a young adult. It has made me want to eat better, healthier, exercise more, and take better care of myself. I love how my body and my mind are changing for the better. All from a weekly shot.
I've had the lap sleeve and then I needed to have a bypass because of the acid reflux. I've lost over 100 pounds and found a new life. I have zero regrets.
When you are extracting clips for short reels, there are at least 2 or 3 just starting from 1:27:13.
Great conversation. It looks like Doctor Mike didn’t use notes for this one; I was engaged the entire time because it seemed like a questions flowed directly from the topics covered.
Thank you for the compliment! For that reason, I actually never use notes for a podcast.
I cried while watching this. I’ve struggled with weight gain for years. My body has plateaued around 250, and stayed there give or take 5 pounds over the last 15 years. Im 42. While not struggling to find a doctor that won’t tell me to simply loose 80 pounds, my weight has consistently been an issue. I can’t tell you how many times I’ve received the side comment of “loosing 10 pounds will make it easier.” While true, it doesn’t help battle the societal lessons I’ve learned over my life, coupled with ADHD and CPTSD. To hear two doctors not fat shame me or people like me, or resort to medicine first is quite refreshing and hopeful. Thank you.
Just lose 80 pounds. If you can't do something that simple, you're not a person, you're an animal.
Loved this episode. It was such a fruitful discussion that has a lot of science, honesty of not knowing what's unkown, and nuance of what IS known.
I don’t understand why some people don’t like Dr. Mike so heavily, he’s just a cool doctor spreading good medical information
I had SADI-S bariatric surgery three years ago and it was the best decision I've ever made! I'm glad my doctor at the time really encouraged me to do that and not all the weight loss meds.
I loved this discussion!!
As someone who reached 1 year post op gastric bypass last week, I found this conversation amazing.
She is right. My satisfaction is very high. My life is much bettter.
lost over 120 pounds.
Amazing video. Thanks.
I love these episodes. More so than the fun ones. Thank you Dr Mike
I'm in a program right now scheduled to get agastric sleeve surgery. When I think about surgery compared to GLP1 meds, I think about a life without dependence on a particular medication. For me, that trade off just can't really be beaten.
Wow, what a great episode. Very insightful!
It’s risk versus benefit. Bariatric surgery has been around longer and we’re more familiar with its long term risks/benefits. Ozempic has his own blessings and curses, though we have had less time compared to surgical options, to see it through.
Great conversation. Thank you.
this was a fantastic episode. shout out to special guest mike's dancing bang.
As someone who is about 100lbs overweight at 5’2 I’ve been seriously considering bariatric surgery but so scared of the backlash from friends and family.ive failed multiple ways of losing weight and I just want control over my life again…this episode came at the perfect time and appreciate the insight ❤
unfortunately, the lack of understanding and the lack of will to understand the struggles obese people are facing is still so prevalent and while it's getting better, it's not going away any time soon. so i hope you can put what the people around you think to the side (easier said than done i know) and focus on yourself and what you want and need. there's nothing "easy" about choosing surgery nor is it your personal failure that it got to that point, even if the society has done a great job of making you feel that way. good luck with whatever you choose and all the best!
is the backlash more important that your health? do u need their support and validation to put yourself first?
This was so interesting and eye opening! Thank you both.
Thanks for the talk about the debates on calorie restriction!
This is such a great episode. Thank you for all you do Dr Mike!
Thanks for posting Dr. Mike❤
I gained 180lbs on prednisone over a year and a half period. I was 12 when it started and in total kidney failure. My skin stretched so much I have striae on 80% of my body because of it. I lost some weight after I got sick but continued to be overweight despite many years of trying to lose it. Medical trauma and chronic illness are never discussed in weight gain situations. I have high blood pressure from my kidneys being bad. I was forced to be overweight and then kind of left to figure it out on my own. My doctors always attribute to me being overweight to me eating and it was never that. I had a job last year where I walked 30,000 steps a day for 3-5 days per week (worked in trade shows.) I wasn’t eating anything and working 65-70 hours a week. I went from 221 to 170. Then when I had to quit because my kidneys were failing again and I started eating normal meals not even bad ones, I blew back up to 230 the heaviest I have ever been. I lost about 25lbs now and am in a research study which I work with a nutritionist and my nephrologist/rheumatologist and the materials they give me are actually dumb and unhelpful. I don’t understand where the disconnect is with doctors and my experiences medically. I am trying so hard every day and it’s like everything is against me. I really want to change this part of the medical industry and I’m hoping I can contribute to this study and help others with lupus and lupus nephritis who are struggling to lose weight.
I have been on prednisone for 6 years since my kidney transplant. I gained 100lbs in a year. I tried to lose weight for 5 years and only managed to lose 20lbs. I went on Ozempic in December 2023 and have lost over 100lbs. I eat around 1400 calories/day and lift weights 3 days/week. I’m not ever planning to go off this medication. Not ever.
I think the number 1 problem is processed foods. I really believe nobody whould be fat if everyone was eating only whole foods and getting exercise everyday.
This was so interesting to watch! My BMI is about 48 and considering glp1 meds myself. Surgery scares me so much, but this helps ease my mind a bit! I'm in my mid 30's and so far do not have any other health issues, so I need to get this tackled now. I was able to lose 50lbs on WW before covid but it was so hard, took over my life. Anything to help!
Unrelated, but Dr Mike please give us your take on DR OZ being appointed as administrator for Centers for Medicare and Medicaid Services!
More qualified than many previous appointees. The fact that Trump did it doesn't automatically make him bad.
@@jasongrundy1717Most health authorities consider him unqualified. The reverse is true also.
gastric bypass 6 yrs ago lost 150 lbs, doing well no need for meds. i am 150 pounds still, considered overwt. but dont care. i am 5'4". so happy that I did surgery. Have / had diabetes, hypertension, cholesterol issues gone or better. was overwt since i was 11 yrs old and now i am 59
i it done nov last year i was 301 now im 187 as of today
I've debated this surgery, I'm so excited to watch this. Thanks Doctor Mike!
This is such a brilliant conversation! I found it so informative. There were great explanations and analogies. Personally, GLPs have helped facilitate my journey to a healthier lifestyle in terms of eating and exercise. GLPs have definitely empowered me and positively motivated me in this regard.
I had roux n y gastric bypass august 2023. My life is SO changed for the better! One of the most difficult processes to go through and definitely not the easy way out! Hard work is necessary still. I have NO regrets!
hey doctor mike would it be ok to do a video about the crumble cookies situation when it comes to the calories and health with sugar
This Video is so fascinating! thanks for posting btw im one of ur BIGGEST fans❤
Thanks, Doctor Mike and Dr. Ren-Fielding. This was a very interesting and informative discussion. And I think Dr. Ren-Fielding is correct in that patients with extremely high BMIs will continue to need bariatric surgery.
6 years postbariatric surgery and i have zero regrets. Going from 350 to 170 has changed my life. Unfortunately i gained 50 pounds back last year. However, the classes i took as a result of the surgery have helped me loose 30 of regain. I love that Dr. Chistine talked about treating obesity. I genuinely believe we should have a real convo about treating obesity. Getting the weight off and to Dr. Mikes point of eating exercising. There is a big missing point mental. Why are they obese. Why are we, i say we, overeating.
Well...Dr.Mike im here to stop kids from saying first
🙇🙇🙇
😂😂😂
That’s just saying first with extra steps
First
Really helpful for us this podcast....keep going.... I as a Science student I can learn so important term from your video....which is really important for me..
Calories in, calories out is physics, but how we store calories matters for driving the behavior that influences those inputs and outputs. When energy is locked into fat it isn't available to increase base metabolic rate or energy for non exercise activities. So the macronutrients and the speed of various metabolic pathways matters. Humans are not just buckets of calories, they are complex systems with multiple steps to store and retrieve calories in multiple ways.
So, are you suggesting bodies dont use fat for NEAT? That sounds absurb, i need to see a source on that. Maybe for people with metabolic disorders, but thats an exception not the rule. If you dont or limit carb intake, you will most certainly use fat stores.
@@dang1099 first search yourself, then if you cannot find, ask for sources.
I’m so glad Dr. Mike doesn’t get out or buzz words and his videos to get clicks.
Excellent information! Thank you.
I was so glad to see this. I'm a 200 lb. 67 year old formerly bulimic woman with one lung awaiting knee replacement surgery. I was able to get my weight down to 164 last year through healthy eating and walking 5 miles a day. I began gaining the weight back in January when my knee became bone on bone and I could no longer walk. Now I spend most days lying on the couch eating. My knee replacement is scheduled for March 2025.
I need to lose weight and cannot find the motivation to do so. I'm on mood stablizers and antidepressants which makes it more difficult. I can't take nsaids for my knee pain due to bad kidneys. My PCP has offered a version of Ozempic but it scares me. I'm already taking a lot of medications that have messed with my metabolism.
I need help to decide what to do to lose the weight.
I think it's worth talking through your fears with your PCP. Your history of Ed makes things like sleeve surgery tricky because it could trigger some stuff.
I struggled with bulimia too but luckly I've been OK for the past 10 years, so I'm a less risky patient for surgery now.
Time restricted eating and a low carb diet might help move a small amount of the weight to help with the knee.
My new knees have made a world of difference! I've lost weight for the first time in my life just because I can be more active again. My personal, non-medically trained opinion is to get your knee taken care of first, then think about your weight. I'm 5'6" and my weight peaked at 256lbs right before surgery. Less than a year out, I'm at 238lbs and still trending down. I'm just now working on adjusting what I eat. I've stopped taking ibuprofen. I went from struggling to walk my dog a half mile once a week to hiking 8 miles.
I did find acupuncture helpful for pain relief until I could have surgery. Also, topical lidocaine.
I'm diabetic and have been on a few GLP1s, ozempic currently. I'm pretty sure ozempic is generally reported to be helpful for kidney problems if you stay hydrated. It has definitely affected my desire to eat and made it possible for the first time since I was a child to set my food down and say (and truly mean) that I was done before my plate was empty. If you start, just go very slow on dosage and don't let them bully you into higher doses if you are feeling any side effects (which is mostly nausea).
i feel like there are definitely cases for staying on ssris long term, i have ocd and it’s the only thing that keeps me sane - regular talk therapy exacerbates my symptoms. to be fair dr mike was probably referring to less complex scenarios.
Hello buddy looks like u posted this about 28 secs ago, great to see u again make such nice videos !!
I love these conversations, I take away a lot.
I would love to hear @AbbeysKitchen give commentary.
Interesting interview. I just listened on iPhone - I'm sure he has no control over this but the BK commercial in the middle of the podcast was hilarious to me.
Doctor Mike, As a bariatric surgery patient who was on glp1 before surgery. You have no idea what it takes to lose weight and keep it off. You think it’s all will power and you’d be wrong. It’s about hormones and a broken metabolism caused by ultra processed foods. Once broken I’ve only found two things that help. Glp1 ‘s and bariatric surgery. Both of which change your hormones and cause you to crave healthy food not junk
I am a Duodenal Switch WLS patient, I am 5'10"... I went from 350lbs down to 150lbs today. This was the single best thing that has ever happened in my entire life, i would make this choice a million times over
Top of the show. I'm sure this will be interesting and informative.
But he got that Superman hair today! 🎉❤
Howdy, thoughts on weight loss surgery for individuals with IBD issues like Crohn's disease? Worth it, too much risk, etc.?
Great episode Dr. Mike!
They forgot to mention about dropping the weight before the surgery because the possible difficulties is doing anaesthesia in a too heavy person and decreasing the possibility of cardiac events
Did Fen Phen in the 90's. Lost over 100 lbs. Never had the heart valve issues thankfully. LOVED how it cut off the "food chatter." Found it impossible to lose or maintain for long once I came off it and I tried everything! I had gastric sleeve surgery because I didn't want my innards re-routed (but in hindsight, I wonder if it would have been better....) 7 years ago. Only lost around 70 or so pounds of the 125 goal. I have regained 55 pounds or so. Regardless of one's weight, my bariatric office has everyone on 1200 calories. Not so much low carb, but high protein. I'm now on Oz which also shuts off the chatter. That makes a huge difference and it's something someone who doesn't KNOW....just can't understand.
I've been on low-dose Wegovy for a week now, and the food "noise" in my head has almost completely gone. I have almost no cravings for carbs/sugars now. It's kinda freeing.
I found this very interesting! I've been morbidly obese for most of my adult life (I'm 73) After I had my third child, the gynaecologist told me that I needed surgery, because I had stress incontinence but, I needed to cut down on the amount of food I ate, I started to tell him that I really didn't eat much...I didn't get any further, he told me that nobody came out of Belsen looking like me, I still have stress incontinence!
i'm sorry to hear that, it's so upsetting how easily obese people are dismissed as just being fat cause they eat a lot instead of given the opportunity to find the underlying cause...
I was always judgemental of fat people. This cleared my vision and I legit have more empathy thank you this video was amazing
Very interesting discussion! I will have the Gastric bypass surgery in February next year and I have been very unsure if it is right for me, but I think it is. I have to give it a chance. 👍
In the main, this was a great episode.
I find it interesting that this was posted during my fast
I'm only at the first ten minutes of the discussion, but I'll still say this:
The point indeed was made that the _type_ of food commonly consumed by people, especially in the west, is problematic as it's not satiating enough and is often too calorie dense with a bad nutritional profile - but this is all down to the consumer. I doubt most who are obese have anything innately wrong with their metabolism. Their bodies don't break the laws of thermodynamics, they simply eat too much and too bad.
I'm not an American but I keep seeing online American people saying they eat unhealthy food (including pre-made fast food) because "it is cheaper", giving as an example how for breakfast they buy a McMuffin for $6 or so. What? How is that cheaper than making yourself a bowl of oats, 100% peanut butter, banana/apple and some milk? I actually checked - that would cost less than a dollar and would be more nutritious and satiating. The only "downsides" are that you need to put these in a bowl (which takes 30 seconds) and that it doesn't taste like greasy junk food, but it is still very tasty.
It's all down to you to break your brain off of the habit of seeking overly greasy and sugary junk, and off of telling yourself that you can't afford anything healthy. If you order from restaurants or buy pre-packaged meals you are more than able to afford buying ingredients and making a healthy meal yourself.
Food choices is an oversimplification of a complex issue. You could also argue that anorexia is just food choices and we know it's much more than that
i was thinking about the surgery, but honestly, what put me off the most was long term implications. Not only is the procedure permanent as far as my doctor told me, what he didnt tell me was that i would need to take suppliments for the rest of my live. I am thinking about trying Ozempic and I am aware that its not gonna fix me magically, but my appetite is my worst enemy and I cant focus on anything if it wents "beast mode". And as far as I know, thats the thing Ozempic is good at aside from being a diabetes medicin, to kill appetite. To clearify, i am not demonizing the surgery. Yes, my weight impacts my life, but I am still able to almost everything. This isnt true for some other patients and i am well aware of that, and for them the surgery might be the best choice.
For anyone else fighting the good fight, wish you good luck. Just remember that there is no easy way to get thin, only to get worse. And obesity is never healthy.
Gut biome: would love to have heard about the impact of both surgery and the drugs on the gut biome.
Also, if you can, please tell your guest that I love her attitude -- especially the fact that she truly understands the impact of fat shaming, which I don't think the doctor in "My 600 pound life" does.
keep up the good work mike
CORRECT ME IF I'M WRONG: I learned a long time ago that once you produce new adipose (fat) tissue, the cells in the mesh or net of adipose can fill or empty/expand or shrink as you fluctuate weight, but if the adipose is still there, it will always want to fill those holes with fat cells and that is the "set point" or tissue "memory". That's why liposuction can change this function.
I was curious about this too, and I'm in no way medically inclined, just been reading some studies of bodies after lipo and the physiological conditions of the subjects. It seems to me, from what most of the studies have stated, is that the body doesn't say to itself 'I have 10 empty fat cells, I must fill them' it says 'I need 10 fat cells and I need them to be full'. So whether you have 10 fat cells that are empty, or you get liposuction and remove all 10 fat cells completely, the body still sees a loss that it absolutely must replace for survival. Again, I want to say I'm no doctor so this was just my interpretation, but all of the studies I came across said that liposuction doesn't affect (or affects very slightly) the metabolic rate, hormonal balance etc etc and so it's very common for liposuction patients to have to return several times throughout their life, or also utilise other weight reduction options in conjunction with lipo (such as bariatric surgery or medications). However, the initial reduction of weight can very much make the subjects ability to exercise much more approachable, losing 10-15kg means less stress on joints, you won't fatigue as quickly, etc. But I don't think, from what materials I've come across, that the surgery actually affects the set point.
Thank you both ❤
I've been on Zepbound for 10 months and I've lost 64 pounds and I feel absolutely terrific. The food chatter is gone, and I finally can stop eating mid dinner and feel full. it wasn't until I started taking the GLP1 was I ever able to feel satisfied or been able to quit eating. Will I bet on this for the rest of my life? Probably.
An IQ Test for a health insurance? The FUCK?
I've heard a lot about the US health care system before, but that probably takes the cake.
My late mother only ate food she cooked herself. No “convenience” crap, never too much fat (she didn’t like fatty food, it made her feel sick - just like me) and never snacked. She was much too busy. She didn’t like sweets. I never saw her eat candy/chocolate or crisps. She literally ate like a model preparing for a Viktoria’s secret show. No cereals, never alcohol, no soda/coke or any other sugary beverages. No artificial sweeteners either. She didn’t restrict her intake of calories - she just was not a great eater. She liked bread though and baked it herself. Delicious whole grain bread. The only food she craved were leafy greens. We still commemorate her by snacking on parsley 😌 She was always busy and always went for long walks. Almost every day. She was overweight (not severely, but still..) and it annoys me that the calorie-restriction-doctrine is still something society and even doctors consider an indisputable truth. “The body is not a machine” - so very true! If it were that easy, medical school would be easy and you’d get a degree in about a year. Of course calories matter. With her genetics… if she ate 2500-3000 calories daily and was sedentary, she would have been severely overweight and probably diabetic or would have had high blood pressure etc. She was overweight but not 200 or 300 (maybe 180 - she was not tall..) pounds. Very healthy, vibrant, fit woman.. until Glioblastoma took her at a young age. Guess what: when I eat more than 1200 calories I put on weight and I was never thin - although I was hungry and ate very little my entire youth. I was on a 500 calorie diet for 16 months once, worked out twice a week (not very much, I know..) as a young woman, lost maybe 20 pounds and still was slightly overweight. Nobody believed me how little I ate. Of course I couldn’t maintain that diet and I still struggle. I am not “fat” (slightly overweight) but still struggle with my weight and the “image” it represents. Very little visceral fat and quite healthy though. It took a very sensitive and competent endocrinologist (most are useless…) 2-3 years ago (“it is not your fault! It’s genetics”!) to stop hating and blaming myself.
Thank you, Dr. Mike ❤
In high school, I had a friend in the same activities so we were about equally active. She easily ate more than I do. I was already obese. My friend was so underweight she had to take medicine to gain weight. That's enough to show me there are factors beyond what you eat and how much you exercise.
And knowing that unexplained weight gain or loss is a sign of illness shows there are other factors at play.
@@BionicMilkaholic absolutely, there are so many things that influence what actually happens to those calories when they "go in" and how they are processed and used by the body, as well as what effect they have on the body (like glucose on insuline resistant people).
it's such a simplistic view of such an important and complex system that i can't believe even people like dr mike still endorse it. all it does is lead to even more stigma towards overweight people and even more self doubt and guilt among the people who struggle.
I'm 5'10" and have gone from 329 to 287 as of yesterday via calorie restriction. I've done calorie restriction before and Gained back far more than I lost when I got off track. I don't have insurance just yet, and though I will be getting insurance soon through my employer, I fear it will not cover surgery, neither will it cover weight loss medications, neither can I afford either on my own. Not only does this not give me hope, but things like access to healthy foods, access to nutritionists and doctors who can help, and access to weight loss in general is truly for the wealthy, which most of us are not.
I enjoyed this
I am not sure I am comfortable with how absolute some of the language here is, saying it isn’t possible to lose large amounts of weight isn’t true, saying it isn’t probable is true, doctors should take care with language.
Now later on it becomes clear with context that she doesn’t actually think it is impossible but improbable but still of people only listened to the first bit they would have the wrong conclusion due to the language used.
11:22 I think a good comparison to "calories in calories out" being incorrect, is how a heat pump can be over 100% efficient while still not violating the 2nd law of thermodynamics. Heat pumps move heat from the outside of a building to the inside, warming the inside and cooling the outside. Each calorie of energy you give a heat pump can move around 4 calories of heat from the outside to the inside. This means that from a human perspective, the heat pump is 400% efficient while from the universe's perspective the heat pump is only 100% efficient at converting electricity to heat. It's all about perspective. "Calories in calories out" is true from the universe's perspective, the human body cannot violate the 2nd law of thermodynamics or reverse entropy, but from the much more relevant human perspective, where basal metabolic rates and cravings dictates the flow of energy, "calories in calories out" ignores how the body actually interacts with energy.
Exactly what was I was thinking
I managed to quit drinking soda with artificial sweeteners thanks to a friend who initiated this project. Now I quite rarely allow myself to drink a soda, for special occasions. When I choose soda with artificial sweetener, I feel myself craving more soda for at least a week after. After one soda with regular sugar, I don’t experience this craving in the same way at all. I find it easier to go back to water, or sparkling water after a regular soda.
Hello Doctor Mike ☺️ Appreciate you, and the work you put into your videos🙏🏼 Would love to see a video on tips on good communication with patients. How to keep the time frame of a consultation, yet getting the most out of the little time you have as a doctor🙏🏼☺️
I was on Mounjaro for a year and lost some weight and my A1C came down. However I was still overweight. I had gastric sleeve last December. After a few months my A1C started to uptick and food noise came back. So now I am on Ozempic and the food noise is gone and my A1C is now down to 5.6. Losing the weight is still slow but it's going down slowly. I do exercise, prioritize protein and track my food.
One thing that I think is considered too little is surgical reduction of fat, for medical rather than cosmetic reasons. My own BMI was around 55, according to an NIH calculator (I'm well under 5 feet tall), and I had both ovarian and endometrial cancer. As part of my surgical treatment I had a pannectomy -- removal of the hanging abdomen, both skin and fat -- which resulted in about 35 pounds of weight loss. Most of that weight loss stayed off.
As an aside, I didn't change my diet, except that for some time I needed to go on a LOW fibre diet due to the radiation I also had (which is known to cause diarrhea). I resisted that for a time, because it had cost me some effort to raise my fibre, but when I told the nutritionist I was thinking of it as "eating unhealthily" (because I didn't want to get used to it and have trouble eating high fibre again), she pointed out that eating very little fibre was healthy eating for me at that time.
When I asked why pannectomies were not regularly done -- mine was an enormous boon -- I was told, "Oh, they generally grow back." The thing is that "growing back" is not a binary matter. In the years since 2007, when I had surgery, I have reacquired a little pooch at the bottom of my abdomen. So did my pannus grow back or not? The little pooch is maybe 5% of the size of the original pannus, so you could say it grew back -- but the benefits of that surgery remain, not far short of two decades since the operation.
It was a bonus to me -- quite aside from curing the cancer, of course -- but I couldn't say the hanging fat and skin is ALL gone. If you put me in a database saying "grew back" or "didn't grow back," it might be said that I was in the "grew back" category -- and that would badly misstate the effectiveness of pannectomy for me. Equally, I wonder whether surgical removal of other large fat accumulations -- direct removal of fat cells, whether by liposuction or direct surgery -- might not be medically effective for many very fat people. I would suspect that little research has been done on that topic, due to the stigma of "taking the easy way out" of fat loss, and stigma against fat people in general.