Dr. Fatima Cody Stanford: Weight loss, GLP-1s and Can You Ever Stop

Summary

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Let's Talk Off Camera with Kelly Ripa

Episode: Dr. Fatima Cody Stanford: Weight loss, GLP-1s and Can You Ever Stop

Date: September 24, 2025
Host: Kelly Ripa
Guest: Dr. Fatima Cody Stanford (Obesity Medicine Physician & Scientist)

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Episode Overview

In this highly anticipated episode, Kelly Ripa dives deep into the rising phenomenon of GLP-1 medications (like Ozempic, Wegovy, and Zepbound) for weight loss. Joined by Dr. Fatima Cody Stanford—a leading expert in obesity medicine—the conversation covers the science behind GLP-1s, who they help, alternatives for those for whom they don’t work, real-world patient experiences, common misconceptions, costs, international access, and pressing listener questions about efficacy, side effects, and long-term use.

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Key Discussion Points & Insights

1. What Are GLP-1s? Understanding the Basics

• GLP-1s (Glucagon-Like Peptide-1 receptor agonists) are hormones already present in the human body that regulate hunger and satiety. (03:07)
• Medications like Ozempic and Wegovy are synthetic versions designed to help those with a GLP-1 pathway deficiency.
• Having more GLP-1 naturally means you’re likely to have an easier time feeling full and regulating weight; less means you’re predisposed to carrying more fat.

“GLP1s... is a hormone, a peptide that’s actually in our bodies. It helps regulate our hunger and satiety signals.” — Dr. Stanford (03:18)

• Hunger and satiety cues are biologically regulated, not simply about willpower.

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2. Medication Efficacy: No “One Size Fits All” Solution

• GLP-1 drugs don't work for everyone; weight regulation is complex, and multiple neural pathways can be responsible for excess weight.

"Do these work for every single person? Is this miracle? Absolutely not." — Dr. Stanford (06:31)

• Alternatives include medications like phentermine (norepinephrine pathway), topiramate (GABA pathway), and bupropion/naltrexone (Contrave), all working differently for different individuals. (07:47)

“Different people need different combinations, right? Because our pathophysiology is different. It’s what makes us unique, is what makes us human.” — Dr. Stanford (08:22)

• Treatment requires individualized approaches; continuous adjustments are usually necessary.

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3. Patient Experiences: Food “Noise,” Plateaus, and Individualized Responses

• Some patients find GLP-1s "quieten" food noise, others do not experience this as strongly.

“It’s not muted, it’s quieter.” — Albert (06:08)

• For some, the medication enables them to stop eating when full or share meals for the first time (10:20).

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4. Self-Medication and Online Access: Risks and Monitoring

• Dr. Stanford warns against purchasing GLP-1s online or outside medical supervision due to:
  • Risk of unknown formulations/doses
  • Lack of monitoring for side effects

"...if we're looking for something that's potentially online, I don't know what to expect from those things...I need to know what to anticipate.” — Dr. Stanford (13:07)

• Proper medical oversight is essential for both safety and optimizing outcomes.

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5. Long-Term Use: Do You Have to Take GLP-1s Forever?

• Key theme: For >85% of patients, stopping GLP-1 medications leads to regaining most or all lost weight (17:32).
  • These drugs address the biological underpinnings; if withdrawn, the body tends to revert to its pre-treatment baseline.

“About 85% of the patients will regain all of their weight.” — Dr. Stanford (15:32)
“These are meant for chronic use.” (16:02)

• Only about 10–15% successfully maintain weight loss after stopping, and there's no way to predict who they’ll be.

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6. The Cost & Access Dilemma

• Major barrier: Most insurance still doesn’t cover GLP-1s for obesity, due to continued stigma and the high prevalence of obesity.
  • Cost can be ~$500+/month out-of-pocket (17:39).
• Oral versions and international options (e.g., Canada, Israel) might eventually lower costs, but access/legality is complex (24:13, 36:49).

“Companies still don't believe obesity is a disease, or if they believe it's a disease, it's one that's too expensive for them to cover.” — Dr. Stanford (18:05)

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7. Side Effects: Beneficial and Adverse

Positive “Side Effects”

• Decrease in alcohol consumption, reduced impulsive behaviors (gambling, shopping)
• Potential benefit for neurodegenerative and inflammatory conditions (27:09)

Negative Side Effects

• Most common: Nausea (40% of users), constipation, diarrhea, fatigue (29:09)
• Rarer but serious: Gallbladder issues, bowel obstruction (34:34)
• Unfounded rumors (social media-blamed sudden “blindness” not substantiated by studies) (29:24)

Other Concerns

• “Ozempic face” (saggy/aged facial appearance) and hair loss are simply byproducts of any rapid weight loss, not unique to these drugs (45:22, 49:57)

“Whenever we lose weight...we lose fat mass. We carry fat stores in our face...This idea of Ozempic face comes from the fact that when we lose weight, we can lose it from anywhere.” — Dr. Stanford (45:22)

• Hair loss solutions: Topical/pill minoxidil (Rogaine ingredient), biotin supplements/shampoos (49:57)

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8. Caller Questions: Real-World Issues

Caller 1: Jennifer (Daytona, ~15:07)

• Lost 125 lbs on Zepbound; wants to wean off due to cost.
  • Dr. Stanford reiterates high risk of regain if stopping.
• On healthy habits: Most patients already have strong routines; meds are not a shortcut but a necessary adjunct (19:44).
• Dr. Stanford hopes oral options may lower cost barriers soon.

Caller 2: Ann (San Diego, ~24:27)

• On Ozempic; concerned about a neck lump after seeing ad warnings.
• Dr. Stanford: Lump concern is mostly for those with medullary thyroid cancer risk; quick reassurance and reiteration—chronic use is necessary for maintenance (25:24).
• Ann’s doctor said it’s not related; Dr. Stanford emphasizes proper monitoring.

Caller 3: Samantha (Minnesota, ~32:38)

• Rapid weight loss; liver enzymes elevated; bowel obstruction after switching to Manjaro.
  • Dr. Stanford: Mild, temporary liver changes are rare but possible; bowel obstruction relates to slowed gut motility.
  • Recommends hepatologist follow-up and more time for normalization (34:34).

Caller 4: Sue (Michigan, ~36:10)

• Traveling to Mexico; wonders about buying cheaper meds abroad.
  • Dr. Stanford: Cheaper in many countries but require prescription by doctor licensed in the country; warns against over-the-counter or unregulated purchases (36:49)

Caller 5: Tracy (Allentown, ~44:20)

• New diabetes diagnosis; worried about “Ozempic face” and aging.
  • Dr. Stanford reassures: Lose weight, any method, lose fat everywhere including face. Focus is on heart health first (45:22).
  • Tracy on metformin + Ozempic: Dr. Stanford explains they’re commonly used synergistically in diabetes management.

Caller 6: Monica (Palm Desert, ~51:04)

• In perimenopause, asked about “GLP-1 booster” fiber supplements for modest weight loss.
  • Dr. Stanford: Total gimmick; fiber can help satiety, but supplements labeled as GLP-1 boosters are marketing ploys (51:58). For perimenopausal gain, considers endocrinology and HRT evaluation.

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9. Upcoming/Alternative Treatments

• Oral GLP-1s: Eli Lilly’s Orforglipron (oral, non-peptide); about 13% weight loss in trials, expected lower cost, but still pending FDA approval (40:09)
• “Peptides”: Friends sometimes use code language to describe their regimens (41:28)

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Notable Quotes & Moments

• On Individualization:

  “I realize that this person needs a little sprinkle of this, and this person needs a little sprinkle of that…and guess what? Some people need a little sprinkle of all of it. I need to put it all in a big stew, right?”
  — Dr. Stanford (08:22)

• On Weight Regain after Stopping GLP-1s:

  “When you pull back on those medications, just like if we were to take away a cholesterol medicine…your body will go back to wherever the state was before you were taking the medication.”
  — Dr. Stanford (16:02)

• On Social Media “Ozempic Face”:

  “That’s not really a thing. I understand that it’s been popularized by social media, but it’s not really specific to Ozempic.”
  — Dr. Stanford (45:28)

• On Stigma and Insurers:

  “Companies still don't believe obesity is a disease, or if they believe it’s a disease, it’s one that's too expensive for them to cover…”
  — Dr. Stanford (18:05)

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Timestamps for Key Segments

• Main topic intro/GLP-1 explanation: 03:03–05:40
• Are GLP-1s a miracle drug? Alternatives: 06:31–09:51
• Personal stories on food noise/response: 09:56–10:41
• Individualized treatment, not “one size fits all”: 11:37–12:54
• Risks of buying online/off-label: 13:06–14:47
• Long-term use and weight regain: 15:32–18:05/25:39/48:54
• Costs, coverage, and access: 17:39–19:17/36:49
• Positive/negative side effects: 27:09–29:24
• Oral GLP1s future: 40:09
• Social/marketing gimmicks ("boosters"/"peptides"): 41:25/51:58
• Perimenopause/Hormone therapy and weight: 54:33

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Final Thoughts

Dr. Stanford’s parting message:

• Obesity is a chronic disease requiring individualized, often chronic treatment.
• GLP-1s (and other agents) are tools— not magic bullets — best used with medical guidance, alongside lifestyle measures.
• There's no shame or “failure” in needing pharmacological or surgical help.
• Stigma, cost, and access barriers remain high.
• Stay skeptical of online “quick fixes” or supplement claims.

“I was surprised, as I think the callers were, and surprised their doctors didn’t sort of inform them of this: that they are going to be on these medications for the rest of their lives.” — Kelly Ripa (55:28)

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This episode offers a deeply informative, honest, and approachable look at the current state (and limitations) of GLP-1 therapy for weight management—busting myths, setting realistic expectations, and empowering listeners to make their own best choice.

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Transcript

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[C]

Hi doctors. I have read of course again, like you said, don't believe everything you read online but that you can get the medications so much cheaper in other countries like Mexico. Well, we're going on a Mexican cruise soon.

[D]

Can I venmo you?

[A]

Somebody gotta cue me or do I cue myself?

[B]

Cue yourself.

[A]

Okay. Hey everybody. We are back with a new live episode. Welcome to this episode of let's talk off camera. Before we get started today, we need to give a shout out to our daddy, Andy Cohen. It's his 10 year anniversary of Radio Andy. We love you daddy.

[D]

It's very exciting.

[A]

And Lisa, who is in charge of Radio Andy is here with us in congratulations. Thank you, Lisa. We owe it all to you and to Andy. Now listen everyone listen up and listen up good because this is going to be besides our plastic surgery episode. I think this will be the most listened to episode. Okay, we're going to give you the skinny. See what I did there, Jan? If you've tried every diet, every fad, even every workout craze, are GLP1s the miracle drug everyone's talking about? Are they for you or are they just a fleeting trend in the weight loss world? Today we are cutting the noise and diving deep into science with a true powerhouse. Dr. Fatima Cody Stanford is a leading specialist in obesity medicine, a leading expert on GLP1s and she's here to guide us through all of the latest breakthroughs, the potential side effects and answers. Your yes, you dear listener, your toughest questions. Dr. Stanford, how are you? Thank you for making time for us. We really appreciate it.

[E]

Thanks so much for having me. It is great to be here today.

[A]

Okay, so tell us exactly what are GLP1s, and I did not know this until Jan explained it to me that GLP1s are already in our body.

[E]

Yes, they are. And I think that's a really important point to start off with, Kelly, because a lot of people think it's just something that we are administering via a shot, via tablets, and we can come back to that a little bit later. But GLP1s, which stands for glucagon, like peptide 1 receptor agonists, say that 20 times fast, actually exists in our bodies. It's a hormone, a peptide that actually is in our bodies. It helps actually regulate our hunger and satiety signals. Okay. So it actually sees. Stimulates our anorexigenic pathway in our brain that tells us to eat less and store less, and it down regulates our orexigenic pathway in our brain. I know that's. Those are fancy words. I'm sorry, that's just how I work. I'm a physician scientist. But our anorexigenic. When we hear anorexia, we think, you know, eat less, right? So for those of us that have more of this in our brain and our bodies and our GI tract, right, where it's also located, you can imagine that those of us that have that on board, we just have an 8 innately more of this ability to regulate our hunger signals.

[A]

Hunger.

[E]

When we think about hunger, and this is how I ask my patients, is kind of how hungry feel between meals? Are we constantly thinking about what's the next meal? Are we thinking about not only the meal today, are we thinking about the meal next week? There's some of my patients that are already thinking about not only what are we eating today, but gosh, what am I thinking eating at the end of the week and then what am I thinking about next week? They're already way ahead of me and I'm like, not even thinking about today, right? So they're very far ahead. And the satiety is like how much you eat actually at a meal. Like, are you eating a small, a medium or a large portion to feel full? So that's how I think about those two concepts. And so GLP1 that exists within us that regulates that hunger and satiety signal within our brain and within our gut is on board for those of us that have more of us, more of it, that are born with more of it. You can imagine, like I said, we. We regulate a much leaner Phenotype mean a leaner body type. And those of us that maybe have less of it, we can. We unfortunately, carry more adipose or fat mass. Okay, so that's the easiest way to explain it.

[A]

Jan, go.

[F]

Okay, so Albert, who is with us, obviously has talked about, openly and honestly about being on this drug for how long now?

[D]

God, since the pandemic. So, what, three, four years?

[E]

Yeah.

[A]

Okay.

[D]

Yeah.

[F]

And you have said, like, my understanding of the drug is it quiets the food noise. Right. That's a simple way of saying it, but for Albert, I've never gotten the sense, and this is. No, shame on Albert, but, like, I've never gotten the sense that the noise has been quieted at all.

[A]

To us, it seems like the noise is constantly.

[D]

It's not muted, it's quieter.

[A]

No, but it seems like it's very loud.

[F]

You talk about food all.

[D]

No, but I also think, as you were saying, that I think my whole childhood.

[E]

See you, everybody.

[A]

You understand this fantasizing about what you're telling Americans.

[D]

When you're at lunch, you're talking about dinner. When you're at dinner, you're talking about breakfast. You're always talking about the next meal. That is a learned behavior. That is.

[A]

That is very much.

[E]

Let me interject here. I want to think about. This is really, really important because these medications. And this is really important because, Kelly, you said this at the outset of the show. Do these work for every single person? Is this miracle? Absolutely not. That's really important for me to say at the outset. So this pathway may not be dysfunctional in persons that try it. And so when we're wondering why. Why is someone not responding? It may be that. That may not be the pathway of dysfunction. So there are other medicines that are around that have been approved. Approved by the fda. Let's go back to an oldie, but a goodie like phentermine. Phentermine was first approved by the FDA for weight regulation in 1959. Okay. Phentermine stimulates something called norepinephrine within our brain. So maybe that's the dysregulation. That pathway is dysregulated. What about another medication called topiramate? Topiramate, Topamax. Some people call it dopamax. It can be used to treat migraine headaches, things of that sort of. That stimulates gaba, which is gamma aminobutyric acid. I like to say fancy words. It makes me sound smart.

[A]

But you know what? It's. We're writing them down so we can sound smart later.

[E]

No, But. But that stimulates GABA within the brain. Maybe that's the pathway of dysregulation for this individual. But so different pathways may be the cause of dysfunction. So some people respond to phentermine topiramate combination. That's a medication approved by the fda. It's called qc. Okay, so maybe that would be a better agent. Maybe there's another drug called bupropion. A lot of people may be like, wait a minute. Is that my antidepressant? Yes, it is approved as an antidepressant. It's approved in combination with another agent called naltrexone. It is called contrave. That combination of medications is another pathway that may be a pathway that causes weight regulation completely different from the GOP ones. That may be a pathway that may be more useful to an individual. And so the whole point is, is that as we're thinking about weight and weight regulation, all of these are mostly working on the central nervous system, which is in the brain. You can understand that not everyone needs the same recipe. Think about it. You're going into a restaurant, right? And. And someone likes this recipe over here, and another person likes this recipe. Different people need different combinations, right? Because our. Our pathophysiology is different. And it's what makes us unique, is what makes us human. And as I'm treating my patients, I realize that this person needs a little sprinkle of this, and this person needs a little sprinkle of that. And this person needs a little sprinkle of this. And guess what? Some people need a little sprinkle of all of it. You know, I need to put it all in a big stew, right? So that's, I think, what's really important. And so as I'm thinking about kind of what you mentioned, Jan, about Albert. Do you go by Albert or Al? What do you like?

[D]

Either one. Whatever you prefer.

[E]

I was thinking about a little Al Green situation.

[D]

Oh, I love it. Go with. That's great.

[E]

But if we think about it, maybe Albert needs a little. Maybe. Maybe that. That. That pathway alone is not adequate for him. Maybe he needs a little touch of this or a little touch of that or a little touch of this. Or what? Or some.

[A]

He heard you say the words. He heard you say the word stew. I.

[D]

No, the drugs. The drugs have worked. I mean, the. I started on Ozempic, lost 10 pounds, switched over to Manjaro, and lost another 20. So 30 pounds altogether. It clearly works. It's quieter. It. What. What it does mostly, I find is it really in the middle of a meal which I never used to stop eating before, I would clean the plate. Now I'm stopping sometimes halfway through a meal and thinking, oh, I'm full. Or like the other day.

[A]

Yes. You and I actually share.

[D]

We shared a meal.

[A]

Everybody was a astounded by that.

[D]

Yeah. And I never seen Albert share before and I didn't. And I didn't even finish it like the hat when we split it.

[A]

Well, that was a lot of food.

[D]

It was a lot of.

[A]

I mean that was food for seven people.

[D]

But it's, it, it definitely has worked. I just don't know that it's done. It's not like the miracle where it's muting the, the noise in the brain.

[A]

But for our listeners who may have tried Ozempic and either it didn't work for them or they didn't feel well taking it or what have you, whatever the list of, you know, it's non efficacy for them. There are other pathways in. To me it sounds like because I just went through menopause not too long ago and I remember when I excited Kelly, I was thrilled. But when I started doing hrt it was experimental at first. It was like it's not a one size fits all. You know, it's like you've got to figure out how much estrogen is you need, how much progesterone you need. You've got to figure out the right combination. And it's very individualized. And it sounds like what you're saying is that if you are looking to lose weight via medication, it's also very individualized.

[E]

Everything is very individualized. I mean I saw patients today. I saw about 20 patients. I before the show, for those of you don't know, I was running over to get on air literally from my patients. And there is not one patient that I saw today that had the exact same need or combination or response to therapy. Whether they were on these GLP1 medications, whether they had undergone bariatric surgery, whatever it was, there was no person that came in that was exactly alike. And I think it's really important for us to recognize that when I'm seeing patients that I don't expect that anyone that comes through the door is going to be exactly like any other person. And so I have to tailor therapies to fit the person in front of me and recognize that there's going to be heterogeneity between person from person to person. And I also have to let them know that when we start any therapy that I don't know exactly how they're going to respond, and they have to be willing to recognize that we may have to modify therapies along the way. And most of my patients have been with me for a long time, most of them for a decade or more, which speaks to the chronicity of this chronic disease, that is obesity.

[A]

But so speaking.

[F]

It's Jan, just speaking of that. What about. Because people can buy this now online. You see it all over Instagram. Like people are just buying it and taking it. So is that scary to you?

[A]

Is that safe?

[E]

I would say no. So when I'm caring for these patients, I'm monitoring them very closely. I'm checking for side effects. You know, every potential drug has its potential adverse effects, and I want to know what's going on with my patients. Patients, obviously, once they get titrated up on medications that are stable, I'm expecting them to be fine. But let's say they're titrating up and they have something that happens if they end up needing some acute medical care and attention. I'm privy to what potentially could be the side effects we know from the trials. So semaglutide trial. Semaglutide is the trade name for Ozempic, which is the trade name for patients with diabetes with govi. Right. That's that drug. Or a Manjaro Zepbound, which is Tirzepatide. I know what to anticipate. I know what are the. The most common side effects to what are the most rare side effects. But if we're looking for something that's potentially online, I don't know know what to expect from those things. Is it something that I wouldn't anticipate? What are the doses? Patients will come in and say something like, I'm on whatever dose I'm like, I don't. That's not even a dose of something. I don't even know what that is. Well, so that's really important for us to consider because I need to know what to anticipate. What if I'm called from the emergency room? What if I'm paged? What do I need? What is my guidance that I'm going to give them? I have over 2500 patients on these medications, so I should be able to anticipate what to expect. I'm a principal investigator on trials that are upcoming for medications that are. That have yet to be approved. So I should be privy to what's going on. If I'm not able to give you that guidance, then who can?

[A]

So we just, as expected, the phone Lines are blazing. So we're going to take a caller before we have to take a commercial break. So let's get to Jennifer in Daytona. Hi, Jennifer, you're on with Dr. Stanford. She's standing by and ready to answer your question.

[C]

Hi. Thank you for taking my call. I've been on Zepbound now for about a little bit over a year and a half, and I'm just about at my goal weight. I've lost about 125 pounds.

[A]

Wow.

[C]

And my question is, and it's worked wonderful for, for me, my question is, do you have any recommendations for titrating down or hopefully coming off of it at some point?

[E]

Thanks so much for your question, Jennifer. So one of the key things about these medications, and we've actually done trials, actually, Louis Aroney, who's at Cornell, ran this trial specifically on Zepbound, which is Tirzepatide. And the studies indicate that when you titrate off of the medication, about 85% of the patients will regain all of their weight. So I just want to make sure that you're aware of that, because these medications, you're on what's called a dual agonist. It's a combination of a GLP1 and a GIP. And for those that are listening, we haven't talked about gip. GIP stands for glucose insulinotropic polypeptide. So it's a more potent medication than just semaglutide, which is your Ozempic wegovy. And when we pull you off of that drug, we're no longer acting on those brain pathways or those gut peptides that you are now giving yourself. And unfortunately, when we pull back on those medications, just like if we were to take away a cholesterol medicine or just if we were to take away a blood pressure medicine or anything else, your body will go back to wherever the state was before you were taking the medication. So these are meant for chronic use. And when you pull them off now there are about 10 to 15% of patients that will not regain all of their weight. Who are those 10 to 15%? We don't know. So you might be in that 10 to 15% that's able to maintain, but that's a gamble that you will be taking. And so I just want to let you know that that's what the studies show and it's what we see in real life for patients that do try to titrate off. Someone like yourself that's lost 125 pounds, that's a tremendous amount. That's equivalent to what we see with, like, a bariatric surgery response. And so I just want to make sure that you're aware of that.

[A]

I have a question, Jennifer. Is there. Is there a reason that you want to titrate off? Does your doctor want you to titrate off? I'm just curious.

[C]

Money aspect of it.

[E]

Okay.

[C]

Because I do have to pay monthly because the insurance doesn't cover it.

[E]

So it is pricey. So you're probably saying, Jennifer, 500amonth if you're going through Lily Direct, Is that correct?

[C]

I do 550 because I've, I've been using their discount cards so far, but I may switch over to the Lily Direct soon.

[E]

Yeah. So it'll. It'll drop it just by 50amonth. So it is. It is.

[A]

Insurance companies cover this. Why? Why isn't there an affordable way to have this covered for people that really are struggling with obesity?

[E]

Oh, you're gonna get me on a soapbox, Kelly. I'm sorry. You know, I think that, you know, companies still don't believe obesity is a disease, or if they believe it's a disease, is one that's too expensive for them to cover because too many Americans have this disease. Right. We're Talking about over 200 million with this disease, and they don't want to have to pay for it because they see it as pricey and the price tag is high. So, Jennifer, I don't like the price tag. I wish it were lower. What I will say is that, and like, hopefully we'll get to this during the show, is that there are some oral options or for Glipron Semaglutide at high dose that will likely be coming onto the market at some point in the near future that will likely help bridge patients that are unfortunately having to, you know, bear the brunt of this high cost for the medications. And hopefully that will help you to maintain some of the weight at a much lower price point. But I'm very pleased with what you've been able to achieve and hope that you'll be able to stay on therapy. Thanks so much for sharing your story.

[A]

Yeah, Jennifer, also, just one more quick question. I'm just curious. Were you able to develop, like, any habits like, like exercise, hab. Walking habits, meditation habits, anything, you know, anything along that line that may. And Dr. Stanford, correct me if I'm wrong, but that may aid in, you know, the assistance of coming off a medication like that?

[C]

Yeah, I typically work out about 45 minutes a day, and then I know exactly what I eat. Every meal for the most part. So even if I, you know, spread a shot out maybe for two weeks instead of one, I know what I'm supposed to be eating, so I tend to not eat over that or at least try to.

[A]

Those sounds like good habits, right, Dr. Stanford?

[E]

Yeah. And actually, you know, a lot of my patients that come in actually already have these habits, but their body has just not responded to these lifestyle modifications, which is why we needed to put them on therapy to begin with. I had a patient today that I saw who I started on therapy, who has a workout regimen that would run laps, no pun intended, around almost anyone that I can name and has had these habits for 12 years, but their body has been unresponsive to these habits. And so I think, you know, we need to recognize that many of the people that are venturing, particularly patients that have had, you know, excess weight for quite some time, have really tried to implement these lifestyle measures and have had them, but their body has been unresponsive to those lifestyle habits alone and have really needed additional assistance, like Jennifer here, for example, who needed pharmacotherapy to help complement that. So, Jennifer, I really applaud the lifestyle modifications that you're doing. And like I said, I really hope that you're able to remain on therapy and hope that Lily's listening to really, the struggles that you're having in terms of. Of. Of really, you know, maintaining this therapy.

[A]

Jennifer, thanks so much for the call, and best of luck to you. We're all pulling for you. Dr. Stanford, will you stick around? We have to take a commercial break. And we'll be back. How absurd is it when footwear barely survives a season? Nothing annoys me more than when I invest in a pair of boots that fall apart immediately. Well, some things are. Are actually built to last. And that's what L.L. bean has been doing for over a century. Making boots with a level of craftsmanship that proves not everything has to wear out. Bean boots carry that tradition forward. Handcrafted in Maine with the same care since 1912. Made with full grain leather, durable rubber bottoms, and triple needle stitching. Built to last. These aren't shoes made for a single season. They're boots designed to take on years of rain, sleet, mud and snow, and come out stronger. They're perfect for commutes, weekend hikes, cheering from the sidelines. And when it comes to style, Bean boots prove that timeless design always wins. They've looked the same for more than a century, because real style doesn't chase trends. With every season, each pair becomes more personal, more distinctive and a reflection of the life lived in them. L.L. bean boots are simply best worn. Find your [e-mail] crafted to last, ready for the outdoors and timeless in style. Summer is all about looking and feeling your best without piling it on, looking refreshed, without going full glam. Thrive Cosmetics is your go to for simple, clean and radiant summer looks. Minimal effort, maximum impact. Every product is 100% vegan, cruelty free and made with clean skin loving ingredients that work with your skin, not against it. Their Infinity Waterproof Eyeliner comes in eight beautiful shades and is smudge proof for all day hot weather wear with high pigment definition. And you must try their brilliant eye brightener. It's fantastic. It gives me an instant eye lift and here's the part I love most. For every product purchased, Thrive Cosmetics donates products and funds to help communities thrive maximize your look with minimal effort. Go to thrivecosmetics.comoffcamera for an exclusive offer of 20% off your first order. That's Thrive Cosmetics. C-A U S E M E T I C S.com offer camera.

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[A]

Okay, we're back with Dr. Fatima Cody Stanford. She is telling us all about GLP1s and other weight loss medications. Let's get to another caller. We have Ann in San Diego. Hi Ann, you're on with Dr. Stanford.

[C]

Hi Dr. Stanford. Hi Kelly. I watch you every morning.

[A]

Oh thanks.

[C]

You're welcome. I have been on ozempic for about 1 and a half years and it's done well for me. I do notice that I only finish half of my meals. I have lost weight and my doctor does check my blood work like every three months. But at one point I found a lump in my neck and I was sitting there watching the Ozempic commercial and it says if you find a lump or swelling in your neck, call your doctor. So of course I did that right away and he said oh, oh, that has nothing to do with those embits, blah blah blah. It's gone away since. But I'm just Worried about all these side effects that people might be getting. And, you know, I'm glad I've lost weight and I'm still on it. I wonder if I will ever be able to get off of it, though.

[E]

Okay, so Ann, your question is, is it about the lump? Is it about side effects?

[C]

It's about. I'm concerned, I guess I was concerned about the side effects. But will a person ever be able to get off of the Ozempic and maintain.

[E]

No.

[C]

Oh, man. So it's a lifetime.

[E]

Yes. So this is a. So this is a chronic use therapy for a chronic issue, which is the treatment of obesity. And when you get on the medication. Right. It is upregulating GLP1 that you would normally have in your body. If you were listening a little bit earlier, I talked about, some people have more GLP1 on board in their body, and so they defend a much leaner set point for their weight. And for those that don't, they need for us to administer it. Meaning you take a shot on a weekly basis. When you pull yourself off of the therapy, what you'll notice is you'll start to regain weight. And it's not at any fault of your own. It's not that you're doing something wrong. It's just that you no longer have that additional GLP1 being administered. And so you'll start noticing more hunger, decreased satiety over time, and you'll start gradually regaining the weight just because you no longer have that additional GLP1 on board. And so it's not your fault. It's just a issue with the GLP one that seems to be working for you. You've been on it for a year and a half is what you just told me. And in the outset, and that's just unfortunately what happens with the use of these medications.

[F]

Jan. Yeah, but talking about those side effects, I've been reading, like good side effects and bad side effects.

[A]

Okay, take us through the side effects.

[F]

What are some of the good things you've seen besides the weight loss?

[E]

Yeah, so let's go through the good things. I can take you through both. Let's. Let's do that pretty quickly. So some of the things that we've noticed is that we've seen decreased alcoholism. So a lot of people have noticed that, hey, I just don't want to drink alcohol. People that may have had a really tremendous taste for alcohol, they may just decide, hey, I don't want to do that. Other behaviors that seem to have been affected, maybe they've had a Gambling side effect, or maybe they've wanted to gamble, they don't want to do that. Decreased shopping, things of this sort. But we've also been noticing some potential positive benefit from for neurodegenerative diseases like Parkinson's, Alzheimer's disease, things of this sort. So they're starting to investigate for these types of conditions. So we're starting to see some really positive benefits in domains we had never considered. Also inflammatory conditions like gout, rheumatoid arthritis, we're seeing major positive benefits for reducing inflammatory conditions along those domains. So those are some positive benefits. Now, there still needs to be tremendous amounts of research for us to really see all of the potential effects and for us to see those medications being used exclusively for those conditions. But those are some positive benefits. I'm not going to just rattle off all the positive benefits. Let's look at the side effects. The number one side effects associated with the use of these medications is nausea. Nausea. Nausea. I said that three times because about 40% of patients going on these medications will experience nausea. Behind that, the next thing would be constipation. These, these medications through. Do slow movement through the GI tract. Okay. Delayed gastric emptying is what is associated with the use of these medications. So that's something to note. Now, you would think that if I say constipation, I wouldn't come behind that and say diarrhea. But there are some patients that will say, hey, I have some diarrhea. So that's something. What about fatigue? Some people will notice that they have some tiredness. So fatigue is something that patients might notice. So that's something that we might pay attention to. These are some of the things that you might think about when you're using these medications. And so I just want to kind of put these at the outset. There are other things that you might get into, but some. These are some of the things that I will immediately mention with patients.

[A]

I just read, I read, I read on Instagram. So take it. Take this. What I'm about to say. How you will. I read on Instagram that people are experiencing blindness just waking up blind.

[E]

Oh, no, no, no, no. So that's not. And so, interestingly enough, out of Mass Eye and ear, which is part of the Mass General Brigham, which is where I work, there were some studies looking at some eye or eye changes associated with patients that actually have a history of type 2 diabetes. Not necessarily just blindness, but changes within seeing and conditions associated with, I guess, ophthalmologic changes. But it's important to note that patients that have type 2 diabetes have end organ damage, it affects eyes, it affects kidneys, it affects legs, et cetera. And so I would be very, very careful in what you read on social media and look at the studies that are coming out from Mass eye and earnings that actually were a retrospective chart review, which is also, you know, we need to be a little bit suspicious because it wasn't like what we call a study that's looking forward, like taking patients that are on the medication and then those that were not on medication and looking at what do we see in terms of ophthalmologic or eye changes associated with the medication. So just be very cautious about what you're reading with regards to. To that.

[A]

What percentage of your patients, just quickly, because we didn't cover this, are diabetic and what percentage are you prescribing it?

[E]

Yeah, yeah. So I. In terms of my practice, I would say about a third of my patients have type 2 diabetes. And then that means about 66% have just obesity without having type 2 diabetes. Those patients would be on Ozempic. So Ozempic is the semaglutide labeling, or Manjaro. Okay. Those. So that's the single agonist, which is. Which is just a GLP one versus the dual agonist Manjaro. And then, of course, the labeling is wegovy for patients with obesity or Zepp bound for patients that have obesity. So it's just the wording in terms of. And the dosing does differ. For example, for Semaglutide, so Ozempic goes up to a 2 milligram dose. And then for Wegovia, it goes up to a 2.2.4 milligram dose. The dosing for Manjaro and Zeppbound is exactly the same. So Those doses are 2.5 milligrams, 5 milligrams, 7.5 milligrams, 10 milligrams, 12.5 milligrams and 15 milligrams.

[A]

Albert, what are you on the highest.

[D]

You start on the lowest.

[A]

You start on the lowest.

[D]

And then three months, I would go back and get tested, and then I would go up.

[E]

And technically we can titrate up every month. So the quickest you can move up those doses.

[D]

I'm sorry.

[A]

Yeah.

[D]

The testing of every three months was for the A1C, right?

[A]

I'm pretty sure Ann hung up on us. I wanted to thank Ann from San Diego.

[C]

And let's get the information.

[A]

Oh, you're still there. Okay, great. Thanks. Good luck to you. We have Samantha From Minnesota. Who's on now? Samantha, Hi. You're on with Dr. Stanford. What's your question?

[C]

Hi. So I was on Wingovy for a little over a year, and I had lost a lot of weight, like, at least, like, £40. And then. But during. During that time when they were taking my blood, my, like, liver enzymes were really high and stuff, and they said, well, that, you know, that can happen. Not a big deal. Well, then they stuck me on Manjaro, and I got a bowel obstruction, so now I'm not allowed on any of it. But my liver. Like, my liver labs are still crazy, out of whack. Is that normal?

[E]

So that's a very good question. Oh, I'm sorry. You were still talking. I apologize. I could have you off. Go on, go on.

[C]

Oh, no, I was just. I was just wondering, like, is that normal? Is that abnormal? You know, so.

[E]

So very, very good question. So I have seen some patients that have had transient increases in liver enzymes. For those that are listening, your liver enzymes would be your astro alt and your alkaline phosphatase. If you guys go back and look at your labs, you may not be sitting around thinking about these numbers, but I do have to think about them. And so we typically see these resolve over time. I don't see this very frequently with patients, but I have seen some elevations that may sometimes occur, and they should normalize if you're off of the therapy. I don't know how long you've been off of the medication, but we should see this improve the bowel obstruction that you may have developed. Like I said, we talked about that slowness of gastric emptying that occurs with these medications. And so you may have developed that bowel obstruction as secondary to that issue. And so it sounds like you're no longer permitted on the medications because of that issue that happened. That's a separate issue from the liver enzymes. How long have you been off the medication?

[C]

Well, I've been off for, like, the last three months, and the liver is. It's still wacky. So they said that, like, Maybe, like, the GLP1s induced it, and now we're having a. Just trouble bringing it back down. Like, sometimes, like, the enzymes will, like, come down, but, like, the bilirubin will be up really high. You know what I mean? Like, it's just, like, it's not figuring itself out.

[E]

Yeah. So I would give it a little bit more time. Three months is a pretty short duration for it to resolve. I would actually give it, believe it or not, at least a year for it to see significant resolution. And make sure you're working with the hepatologist in the middle of all of this. So that's a liver doctor specifically to make sure that they're following your liver enzymes closely during all of this. But that's a doctor that's specifically works with the liver and not like someone that is not a specialist in that domain. And I don't know if you're working with a doctor in that domain specifically.

[C]

I'm not. Well, I've been working with GI and.

[E]

Yeah, get a GI hepatologist. Like there's GI and then there you want a specific liver doctor in like a special GI doctor that works which is a hepatologist in the GI domain. Does that make sense?

[C]

Yep, absolutely. Thank you. I appreciate that. Yeah.

[A]

Samantha, thanks so much for your call. Good luck to you.

[C]

Thank you.

[A]

We've got sue from Michigan. Sue, you're on with Dr. Stanford.

[C]

Hi doctor, thank you so much for taking my call. And Kelly as well. I have read of course again like you said, don't believe everything you read online but that you can get the medications so much cheaper in other countries like Mexico. Well, we're going on a Mexican cruise soon.

[D]

Can I Venmo you.

[C]

Heck with the souvenirs I'm going to give to a Gobi. But are they regulated there? Are they cheaper? Can I just go over and get something otc? How do you know anything about that?

[E]

So that is first of all you are right that the medications are priced considerably lower in several countries, including Canada, the uk. I haven't had any of my patients go to Mexico to get the medications. Typically what's needed and like I said, I don't know specifically about Mexico, but typically what's needed is you need a doctor in that country to prescribe the medication. So you would need someone with a license to prescribe in Mexico or typical. So I can tell you with Canada, in order to get the Mexico the medicine in Canada, you need to have a doctor that's licensed to practice in Canada to get the medication. Because for example, the price point in Canada is about 1/5 the cost here in the United States. But you would need a doctor that has a Canadian license. For example. I'm only practice, I only practice the United States. I don't practice in Canada. So I wouldn't be able to prescribe, you know, the medication to for you to go to Canada, for example. I presume the rules are the same for Mexico, but like I said, I don't Know, specifically, I hear what you're saying and I, I like what you're thinking in terms of access. But be, be thoughtful in terms of whatever their rule structure are. Rule structure is. I will tell you that there is some, there are some pharmacies that will ship directly with your doctor. For example, I do use a pharmacy in Israel for my patients that ships directly to my patients here in the US the price point is slightly cheaper than the pharmacies here in the United States. It does allow a US Doctor to prescribe to Israel and to ship here to the US not significantly. Like I said, it's somewhat cheaper, but not significantly cheaper. So I would just check what the rules and regulations are for Mexico specifically.

[A]

Sue, just thinking outside the box here and spitballing, have you considered taking a Mexican doctor as your plus one on the cruise?

[C]

Hey, that is a great idea.

[A]

I, Is that a great idea?

[E]

I'm going to meet somebody soon and.

[D]

Me is your plus two.

[A]

All right, Sue. Well I, you know, good luck, good luck with everything. And listen, if you are, if you pull this off, will you let us know at Radio Andy, we would love to find out how you make out on this cruise.

[C]

Yeah, I'm going to go the first pharmacia. I'm going to head right there and check it out and see what's going on.

[A]

I mean, what's the worst that could happen? You just ask, right? Dr. Stanford? I mean just ask.

[E]

But I think that you could probably find out before you go. Like I said, like I know the rules for Canada. I know the rules for like France. France is similar. France. You need to have a doctor that's licensed in France to get the medication. So just find out before you go and don't be caught off guard. Right.

[A]

Good luck to you. Thanks. Thanks for calling.

[C]

All right, bye. Bye.

[F]

I have a quick question before we get to our next caller because I read today in the news that they're about to or Eli Lilly is making a pill version of GLP1s.

[E]

Yeah. So let's talk about that. So that medication is Orphaglipron. It's a non peptide oral GLP1. The results for that trial came out, the attained study came out about four or five weeks ago and it has not yet been approved by the FDA, but it's showing about 13% total body weight loss with the use of that medication. Medication. We do think the price point for that pill will be significantly less than the injectable agents. And I do think that it will be a great addition to the armor materian for GLP1s. And I'm excited about the potential to be able to prescribe that for my patients. It will obviously be a pill, so it will be. Need to be taken daily, unlike the injectables, which are given on a weekly basis.

[A]

I have a few girlfriends that have always been thin but have in recent, recent years gotten noticeably, like, I would call them, like very thin. Like, you know, like super thin. And I'm like, what, you know, what are you. What are you doing? Like, are you on an. Are you on some. What's the routine? And they told me, oh, it's nothing. I've just been taking peptides. Is peptide like, are they code talking me? Is that code?

[E]

They are, right. I think they are, Kelly.

[A]

Right.

[E]

I will. I'm just gonna say I think they are, but I won't. I won't go further.

[A]

Okay. No, I got it. Got it.

[E]

I think they're using language.

[A]

Do we have to take a break now?

[F]

We're gonna take a break.

[E]

Okay.

[A]

You know what? We've got. We've got so many more callers to get to. All right, stick around, everybody. We are going to get to you. We're gonna be back with Dr. Stanford when we return. Stick around.

[C]

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[A]

We are back with a leading voice in obesity medicine, Dr. Fatima Cody Stanford. She's ready to answer your questions. We've got Tracy from Allentown on the line. Tracy, you are on with Dr. Stanford. What's your question?

[C]

Hi, Kelly. And hi, Dr. Stanford. Just want to tell you, Kelly, you're a favorite in our household.

[A]

Oh, thanks, Tracy.

[C]

My son, my son was a dancer on your show the one day.

[A]

Oh my gosh. Amazing. Royalty in the house.

[C]

Yeah. And then he did it this safari act during your break.

[A]

Incredible.

[D]

Wow.

[A]

Sounds like my cup of tea.

[C]

Yeah, we watch you all the time. But I'm really glad you're doing this. Just in June, I was diagnosed with diabetes 2. And my doctor put me on the ozempic for not only the diabetes, but for being slightly overweight. And I keep hearing all this about ozempic face and by already being older in my 50s, that concerns me with everything always drooping down. So how do you prevent getting ozempic face?

[E]

All right, my love, that's my southern roots coming out for a second here. First of all, I don't want you to be worried about that. We got to take care of this type 2 diabetes, which you know is a coronary equivalent. By that, when you develop type 2 diabetes, we call it a coronary equivalent because it's the, the amount of damage that's been done on your body once you get that diagnosis as it is, as if you've had a heart attack. So I just want you to recognize that that's going to be number one to acknowledge. Okay, so number one, number two, when we look at this idea of Ozempic phase. First of all, that's just something that was coined by social media. Whenever we lose weight, whether it's from lifestyle, whether it's from medications, whether it's from surgical interventions, we lose fat mass. We carry fat stores in our face. You can't see me. I'm pinching my cheeks. I kind of have the same cheeks I had when I was three. I'm much older than three. As you might know, we lose fat a lot of times in our face. And so this idea of Ozempic face comes from the fact that when we lose weight, we can lose it from anywhere, but we can lose it in our face. Okay, We. And so we lose it in our face. And so people may say, oh, gosh, you have this idea of Ozempic phase, but that can come from anything. It doesn't come from Ozempic specifically. It comes from any time you lose weight. And if you lose a large amount of weight, whether it be from medication or, like I said, lifestyle modifications or surgery, you lose a lot in your face. So don't be discouraged from using medication for that reason. I want your heart to be healthy, and I want you to go on the right therapy to treat that first. So don't be concerned. And first, and another thing, you said 50 is old, and I'm way too close to that for this to be old. I tell my patients they can't tell me they're old until they're 80. So I want to correct that also. So that's a really important note to. To. To. To think about. So I want us to to kind of rectify that as an issue. So that. That's not really a thing. I understand that it's been popularized by social media, but it's not really specific to Ozempic. Does that make sense?

[C]

Yes. Yes. And my doctor has me also on Metformin because, okay, one does for the kidneys and one is for the liver, correct?

[E]

Not necessarily so. Metformin is in a class of medicines called Obiquanide. You probably haven't heard that because metformin is an oldie but a goodie. Metformin is complementary. It's usually first line for patients with type 2 diabetes. And believe it or not, metformin augments your own body's GOP one. So it kind of is complementary. We can't use metformin if your kidney numbers are too low. So if your creatinine was below, you know, a certain number, or gfr. I'm sorry, is below a certain number. We can't prescribe metformin. But these two medications, if you're on a GLP1 and A and metformin together can work really synergistically. They work well together. And so often you'll see those two medications prescribed together very nicely.

[C]

Okay. Yeah. And they. And they had me with a diabetic dietitian. And yeah. So, you know, I have a whole field of doctors.

[E]

I love that.

[C]

My whole. My whole thought process was it runs in my family. I don't want to get to where my parents were with insulin and chronic kidney disease. So I'm trying to like, nip this in the butt right away.

[E]

I love that.

[C]

My husband wants to know if I will ever be able to stop Ozempic.

[E]

So, no. That's been a kind of a chronic theme for us today. If this medication is being used to treat type 2 diabetes, it's a chronic use therapy. You don't come off of the therapy. And you would use that chronically along with that metformin in conjunction with that long term to treat your diabetes and also the excess weight. So no.

[A]

Trace. Are you still there?

[C]

Yes. Hello.

[A]

Listen, don't worry about anything except getting your health. Right. Don't worry about anything else. And there are so many cosmetic procedures that are available if you. I am your girl. All I'm your go to.

[D]

It's like three episodes above this.

[A]

Yeah. Go back three episodes and you can listen to all the ways you can combat any sort of weight loss. Okay.

[C]

Okay.

[A]

What about hair loss?

[F]

Because I hear.

[A]

Oh, yeah. What about hair loss? Yeah.

[E]

Yes, hair loss. So hair loss is very common with these medications. A lot of times you're losing so much weight that the hair follicle itself is affected. So for many of my patients that this. This happens, I will often prescribe Minoxidil. You guys want to know what Minoxidil? You remember those Rogaine commercials from back in the day? It's the same ingredient that's in Rogaine. Okay. But I can prescribe it in a pill format, usually starting at 2.5 milligrams. It goes as high as 10 milligrams, but you will become a hairy girl. So we start at 2.5 milligrams, and usually that's enough to get things going. We can also use a topical meaning something like a topical Rogaine or a topical biotin. We can take it with biotin. Also, biotin is actually vitamin H, as in happy. So we can use that along with the minoxidil. Minoxidil is Prescribed if we do use it in a pill format. And we can use a biotin infused shampoo. Shampoo, whatever your favorite brand is to help with, with the issues with, with regards to the hair loss. Okay.

[A]

Okay, let's get to Monica in Palm Desert. Lucky Monica. Monica, you're on with Dr. Stanford.

[C]

Hi, Kelly. Hi, doctor. Thank you so much for taking my call. Kelly, you are my Oprah and I love you to death.

[A]

Oh my gosh. That is the nicest thing anyone's ever said to me. Oh my gosh. That's our new tagline. Thank you. Monica. What's Your question for Dr. Stanford?

[C]

My question for the doctor is I'm in full blown perimenopause and I have some stubborn £10, £15 that I've been wanting to lose. So I know I can't get on the official GLP1, but I've seen there's a nutrition supplement that I buy, but I haven't bought this. It's a Fiber 1 GLP1 booster. I don't know, does it work? Is that real or is it just a gimmick?

[E]

Okay, let's talk about these things that are labeled as GLP1 boosters. It is a gimmick situation because they just want to put GLP1 on the label to entice you because it's like, ooh, that sounds fun and exciting. It, you know, anything that's labeled as that is if it's not an actual GOP one is the not that. However, let's talk about fiber. Fiber improves satiety, which means that it's going to work in a way that mimics what they're trying to say is this GLP one like booster. Right? We want to improve satiety and fiber works on that perimenopause. However, what happens with perimenopause is we see a decline in estrogen and we see an accumulation of adipose or fat mass around the midsection, which is what you're probably dealing with, which is very common as we go through that menopausal transition. And so you're like a little bit upset about that situation, as all women are. As we go through that, no matter how lean we are, we can go through that transition. You can increase your fiber intake by not necessarily using this gimmick. You can just increase or boost fiber. One of the key things that I think is a really great strategy. It's one of the things that dietitians, one of the dietitians from back in the day, Tammy Flynn, put out that three Apple plan. Eating an apple prior to each meal, if that's one of the things that you want to use, you don't necessarily have to use this fiber one plan. So a GLP1 booster, like I said, is a gimmick.

[A]

You know, Monica, also, I would go to an endocrinologist or a hormone specialist and have your hormone levels checked and get your thyroid checked. Because I know, like, we were talking about this before this podcast started, but I. I went through menopause during the pandemic, so imagine. So imagine you're me and you're going through menopause. And also every gym is closed and everybody's just sitting around eating cereal. And very quickly, I gained 12 pounds, which doesn't sound like a lot, but I'm a really small person. So for me, that was a lot. And it took me almost three and a half years to take it off, you know, and it was like a lot of diet and exercise, like a lot of really sensible eating and devotion to exercising. But none of that would have made a difference, I don't think, if I didn't start doing hormone replacement therapy.

[C]

Okay, well, thank you very much. This has been very helpful, really.

[A]

Oh, I'm glad. Yeah. Good luck to you, Monica. And at the end of the day, you live in Palm Desert.

[D]

I mean, come on, Monica, have you been to Eddie V's Seafood place?

[C]

Of course.

[A]

Dr. Sanford, you say that the.

[D]

It's always famous.

[A]

The food noise. Some. Some ear. Some medical earplugs aren't big enough.

[D]

Seafood gym.

[F]

You need a new pathway.

[A]

What do you eat when you go to Eddie V Seafood?

[D]

Oh, I think I had a lobster tail. It was delicious.

[A]

Did you dip it in the butter?

[D]

And I had a martini. I may have. I don't know, actually, I think I did it with drawn butter. Listen, Monica understands. She knows.

[A]

Monica, thanks for your call. We really appreciate it.

[C]

Thank you.

[A]

So, you know, I really feel like, Dr. Stanford, you gave people really important, honest information. I was surprised, as I think the callers were, and surprised their doctors didn't like, sort of inform them of this, that they are going to be on these medications for the rest of their lives. I think that was a big surprise to a lot of people that you gave everyone a lot to digest, pardon the pun.

[D]

And that could change, right? I mean, that's just what we know as of now, correct?

[E]

No, that's not going to change.

[D]

It's not going to change. Okay.

[E]

No.

[A]

Well, I really appreciate you answering so many great questions, giving us all the answers that we needed. Everybody give it up for Dr. Fatima Stanford and we'll talk to y' all off camera next week. Bye Bye. Let's Talk Off Camera with Kelly Ripa is a production of Malojo Productions. From Malojo, our team is Kelly Ripa, Marc Consuelos, Albert Bianchini, Jan Chile, Seth Bronqvist, Roz Therian, Devin Schneider, Michael Halperin, Juliet Desch and Team Radio Andy Lisa Mantineo, Scott Marlowe, Jake Getz.

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