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Transcript11 lines
- [00:02]
A
Lemonade.
- [00:11]
B
Welcome to special premium episode with obesity medicine physician and scientist Dr. Fatima Cody Sanford. Here's some cutting root tape that didn't make it into the interview.
- [00:21]
A
First of all, there's been a lot of talk about lean mass and loss of muscle, you know, associated potentially with these medications. I think it's important for me to note that we, when we lose weight from lifestyle modification, we lose lean mass also.
- [00:35]
B
Can you define what lean mass is?
- [00:38]
A
So basically just muscle loss. I think it's important to, to note that we lose fat and muscle with lifestyle modification alone. That can be 15 to 20%, believe it or not, with just lifestyle. But we also can lose a considerable amount with the use of GOP1s. And so it's important to note that. So what we emphasize is, is strength training and protein. So about one and a half times what you presume would be the level of protein that you would need. We need to emphasize the, the utilization of protein intake. Now people like, do I just go eat steaks? No, you don't have to go and eat steaks. You, you know, for someone like myself who doesn't eat beef or pork or any of those things, you can have more of a plant based protein or if you're more of a pescatarian, you can eat sources from fish and things of that sort to make sure you're getting your protein contact or supp with protein shakes or things of this sort. You can do nut butters and Greek yogurts and things of the sort. The thing is, is that you just still need to be emphasizing protein intake. And a lot of patients really don't understand how important it is to be strength training on these medications. People like, oh, I did a walk or I did this or I did my jog or I did my bike. And I'm like, but where's the strength training? And this is really, really important as we age, because as we age, we start losing muscle. Whether we want to believe it or not, we really need to be encouraging strength training. They're like, well, how do I do that? And so I may, you know, as we get older, I may want you to even maybe increase your ratio of strength to cardio. Because the key thing that we really need to focus on is that quadricep hamstring strength, our core strength, which includes our abdomen and our back, all of these things are going to be really important for making sure the patient is not losing something that they really need to just navigate about space and time.
- [02:25]
B
You know, I also just have to note that Dr. Sanford, you know, when you're talking about like protein and strength training, not too different than some of what we hear from the Maha movement. And I think it is important to recognize when the parts of the Maha movement have real evidence and when there's agreement with the broad base of scientific consensus and when there's not.
- [02:54]
A
Right. I think that that's really important. I mean, I think that like I said, I want patients to be healthy. I want them to be engaging in healthy behaviors. This isn't, I'm going to make myself look better than you because I can do so many more pull ups than you. Right. Or I could do so many more push ups than you. I think a lot of the movement is like, haha, I can do this better than you. You know, it feels much like a competition on the playground. That's what a lot of it ends up feeling like. This is not what that is. I want to meet my patients where they are. And I always talk about getting them to the happiest, healthiest weight for them. When I saw patients yesterday, and I saw 18 patients yesterday, my goal wasn't to compare them to each other, it was to meet them where they were, at the place that they are at that moment in time and recognize that the patient that's coming after them may be in a very different place. And not to compare them and be like, you know what, the patient before you was here. I want you to be where they are. No, that's not the point. The point is to meet them where they are and make sure that they are where they are on their journey. Their journey is going to be different from the journey for the person in front of them. For the sixth person, the person that's six behind them, it's about their journey. And since they are going to be with me over the life course, because this is a chronic disease, I need to be with them and support them where they are to make sure that they're getting the best care that they need over the lifespan. And since they're, most of them are families also. Right. I'm taking care of the, sometimes the grandparent and the grandchild and people in between. I need to also be supporting them and making sure the family can support each other instead of making them feel that they're in a competition with each other because they are gonna need different tools and whatever the tools I can give them to compliment them and make them feel empowered. Regardless of their race, their ethnicity, their socioeconomic position, I need them to feel like they're the most important person in the room, and. And then I'm giving them the best tools to make them feel like they're their best selves.
- [05:00]
B
And hopefully that insurance will cover those tools.
- [05:02]
A
Oh, yes. Well, that's a different. That's. That's an entirely different podcast.
- [05:06]
B
Yes. A different podcast.
- [05:07]
A
Yeah.