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The Neuro Experience
Obesity Isn’t About Willpower—It’s In Your DNA | ft. Dr. Rocio Salas-Whalen
00:15:36
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- [00:00]
A
I'm Louise Nicola and this is the Neuro Experience. I've heard people also saying that they're taking a certain probiotic or a prebiotic that actually has GLP1 in it. Is that a thing?
- [00:12]
B
If it was working, there will be shortage of that probiotic and not of semaglutide or tirzepatide.
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A
So let's talk about that because we have this huge ozempic wave and I know that's just the GLP one, but then we've got tirzepatide, which is GLP one and gip and I'm guessing there's going to be a triple threat coming up next year.
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B
Oh my God.
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A
You actually described this life cycle of GLP1s like the iPhone.
- [00:39]
B
Yes.
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A
At the seat of it, they all call people, they all do the same thing, but every year they're getting updated, they're getting better.
- [00:47]
B
Better, safer, less side effects, more potent, more efficacious.
- [00:52]
A
Right, okay, so let's talk about what's the difference between GLP1 ozempic and then the GLP1 and GIP? Tirzepatide.
- [01:00]
B
So GLP1, which is hemaglutide, it's a single hormone, tirzepatide, it's a combination of two gut hormones, GLP1 and GIP. And the retatrutide is the triple agonist. And this is going to be GLP1, GIP and glucagon. So together. And they're in phase 3B. So they're almost there. Almost there. And the results are beyond anything that we've seen. Patients losing up to 40% per body weight compared to what we see in tirzepatite, which the max is 24, 25% of weight loss.
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A
But what is glucagon doing extra.
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B
So glucagon itself, it produces or increases the production of glucose in the liver. Right. It's really interesting that they added this hormone and they're seeing even more significant weight loss. So really the mechanism of action in regards to more weight loss is not really known in your book.
- [01:57]
A
So you, you've a doctor's guide to GLP1 medication, sustainable weight loss and health. You deserve. You also have a strong love for midlife women and you also are prescribing perimenopause menopause. So you're doing a lot of hormone replacement therapy, which I think right now that is being spotlighted. The word estrogen and menopause. Right now we're hearing a lot about it, which is a great thing. No Longer are we. We're hoping that women are no longer scared to, you know, get on this in fear of breast cancer. Let's talk about midlife and let's talk about estrogen's role in, in fat. And that mid area in that midsection where a lot of women are reporting to start gaining weight and they've got stubborn fat. What's happening there?
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B
So after the age of 40, women gain 1 to 2 pounds per year on average. And we attribute that to the changes in estrogen. Right. So we need estrogen. Estrogen is an anti inflammatory horm hormone number one. But also estrogen helps to maintain our body composition with lean muscle mass and maintain our body fat in our hips, in our breast that is more protective for our fertile years. And what happens in perimenopause and menopause is that fat gets transported more centrally. We start accumulating excess fat intra abdominally and that's the visceral fat which is the pro inflammatory fat. Right. That's what we call the bad fat that can lead to metabolic disease. Increases your risk for cancer. Cancer. It's pro inflammatory. So all of those changes while the estrogen starts to fluctuate during perimenopause, can affect the body composition of women. So many times women come to my office and say this is not the way that I used to gain weight.
- [03:42]
A
Yeah.
- [03:43]
B
Now everything in the center. Right. So they know their bodies and they recognize that this is not their normal pattern or wake of waking.
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A
If a female is taking hormone replacement therapy, whether it's estrogen, progesterone and they also want to take a GLP1, can they? They're not contraindicated against each other, they.
- [04:02]
B
Don'T replace each other. Right. They have different function in our body, but they are options. And I always say that both HRT menopause hormone treatment and GLP1 should not be the last resource. Right. They should be first line treatment.
- [04:21]
A
That's interesting. But if someone's prescribed a GLP one, are they going to be on it for the rest of their lives?
- [04:26]
B
It's always what's the story of the individual patient that brought them to use or need a GLP1? Right. Every patient has a different story. So for patients that always struggle with their weight, since childhood they've had child obesity or overweight, they've been on diet most of their life, they've been in training programs, they go to camps to lose weight weight. Most likely those patients will require long term treatment. Let's say a woman that never struggled with weight Pregnancy hits midlife, they have 30, 40 pounds that they cannot lose. They'll go on a GLP1. Maybe there's a possibility that they will be able to maintain on their own once they lose the weight, if they never struggle with weight. But maybe the same woman has a very strong family history of obesity and while she was working out in her 20s and her 30s, not with the kids, not with age, starts gaining weight, has obesity, most likely that she will require also long term. But I always like to flip the coin. Using a GLP1 long term is not a failure. It's not bad. It's actually, we have to see it in a positive way. And this is the beauty of these medications and this is the difference of using a medical treatment and going into a crazy diet that is going to make you lose 30 pounds in four months. Right. Is that we actually, for the first time, have a medication that will help you maintain the weight loss.
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A
Maintain is the key.
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B
Right? Maintain the weight loss because many things can take you there, but it's not maintainable, it's not sustainable. But for the first time, we can offer you something that is also going to help you stay at your goal.
- [06:18]
A
How do you feel when people come to you and say, and this is talking like a social media perspective when they say you shouldn't get GLP1s? You can just, you know, what about willpower?
- [06:30]
B
Yeah. I think it's very, very easy to assume when you see somebody with obesity that they have not tried to lose weight, that they have not done the legwork, that they've not seen. Doctors, nutritionists, trainers, they probably can give this person a cathedra in weight loss and diet and nutrition. Right. I haven't met a single patient, and I have thousands of patients through the years that came to me and said, I do nothing about my weight, I have obesity, but I'm sitting in my couch all day, I don't think about it, I'm not trying. And this is one of the reasons that I wrote my book, because it was so, so eye opening, hearing story after story of my patients doing everything that we were recommending them. They were eating less, they were counting carbs, they were counting grams of fat, they were working out cardio, spinning, you name it, they were doing everything, but it was just not working. So we know now that weight gain, obesity is not a willpower. So having more willpower is not going to make the person lose weight. It's a multifactorial disease. We have hereditary genetics. Right. And that accounts to 50 to 70% of the reason somebody's going to have obesity or be overweight. Right. We know the parents weight preconception, both mother and father is going to impact their offspring's weight in the future.
- [07:58]
A
Hold on.
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B
Yeah.
- [07:59]
A
The weight you are when you are pregnant can directly affect your unborn child and how they're going to live their life.
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B
You're already increasing the risk for obesity even before conception. If you start with obesity. And this is for both partners of always my counseling for my fertile age patients that are thinking pregnancy, I always explain to them, look, this is the best for the future of your baby. The best for less complications during pregnancy and even to improve your chances of fertility. Right. Is starting conception at a healthy weight. Now we have obesity that can be transgenerational. Right. So and I always do a very thorough family history on my patients. I go two, three generations above the patient and you always see a pattern of obesity. So I put to my patients in the table, I said, you have the possibility your grandparents, your great grandparents didn't know, your grandparents didn't know, your parents didn't know that their weight affected your future weight. But you know, so you can break that transgenerational hereditary of obesity.
- [09:08]
A
Oh my goodness, that is huge. Because then they stop passing it on.
- [09:12]
B
Exactly.
- [09:13]
A
I mean, to me it sounds like a miracle drug. Right. But what type of scientist would I be if I didn't look at both sides of the coin? Now when I put this out on social media, I get so many comments and we're going to go through them and maybe we can myth bust. Now, I've been told that taking a GLP one can increase your risk of getting certain types of thyroid cancer. Is this true?
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B
That is not true.
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A
Why is this a thing?
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B
So in the studies in the laboratory, it was found that some mice there was a higher occurrence of medullary thyroid carcinoma, which is a very specific, very aggressive and aggressive thyroid cancer. Right. It was never reproduced in humans. It has not been reported in humans. Other types of cancer have not been reported in mice, less in humans. Right. And somebody having a history of thyroid cancer does not disqualify them to use a GLP one. And I think that's a big misconception and a miss. Except medullary thyroid carcinoma, that's pretty much our only absolute contraindication on a GLP1 is if the patient or a first degree relative has history of medullary thyroid carcinoma.
- [10:32]
A
But why would that be? What's the pathway there?
- [10:35]
B
So we don't know, but we don't want to increase the risk of the patient to develop it. Right.
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A
Keeping in mind that study was done on mice and not replicated in humans.
- [10:44]
B
And again, we have 20 plus year data, clinical data of GLP1 medications.
- [10:50]
A
Now we have, I don't know if it was done in humans, but maybe you can talk to me about that. That GLP1s actually show a reduced risk of getting breast cancer, which I think is phenomenal. I'm going to read it here. A cutting edge new study showed that tirzepatide, which is the GLP1 and GIP the dual drug already held for impressive weight loss, slashes breast cancer tumors by 20%.
- [11:14]
B
And you know, it's not a surprise, that's huge.
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A
20%.
- [11:18]
B
And I'm gonna tell you why. What's one of the highest risk for breast cancer? It's not family history, it's obesity. Colon cancer, prostate cancer, thyroid cancer, stomach cancer. The highest risk is obesity. So if you, you are decreasing obesity, you're going to decrease the risk of cancer. Remember, you're going to have some anti inflammatory benefits from this drug. Right. So what drives cancer? Inflammation. Right. So if your immune system is concentrated in inflammation, you cannot have the proper response for viruses, for cancer cells. But if the inflammation is reduced, then your immune system can work and protect you.
- [12:06]
A
Actually, when we talk about inflammation, this is probably where we see all of the GLP1s and Alzheimer's related dementia right at the seat of all of this. This is the research that I have thrown myself into over the last 10 years. We do see if you go deep and deep and deep, you see at the root of it really is inflammation as a cascade to all the other different risk factors. And what you're saying here is if we can downregulate inflammation, which is what we're all trying to do, we're all trying to do that, Right. We can minimize the risk of getting breast cancer by 20%.
- [12:39]
B
Yes. So GLP1s are neuroprotective.
- [12:43]
A
They are neuroprotective.
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B
They are neuroprotective. Also it improves insulin sensitivity in the brain, which we know, hyperinsulinemia and insulin resistant. It also drives cancer you mentioned earlier.
- [12:56]
A
And I just want to go back to and know if this is the same effect you said you're seeing in a lot of your fertile females that you see that are not really in midlife, that you're getting better conception rates because of GLP1s. Is that also because obesity and insulin resistance is causing maybe infertility pcos, Polycystic.
- [13:18]
B
Ovarian syndrome is the number one cause of infertility in women. Right. So by improving that with a GLP1, you improve the chances of conception. Right. So that you hear of sempect babies is because many women that thought that conception was not an option for them, that they've tried, now they go on a GLP1, they start losing weight, no inflammation, they start having a regular cycle.
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A
And they're happier and they end up pregnant.
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B
Exactly.
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A
They've probably got more muscle mass, they.
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B
Want to have more intercourse. You know, they feel confident mental health, and that's what happens.
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A
So, Dr. Sayloswell, and I'm going to read something to you, very dear to my heart, that I posted on Instagram that went quite viral. GLP1 meds dementia risk by 30 and this was a study published in JAMA Neurology in 2025. They analyzed nearly 100,000 people aged 50 years and older with type 2 diabetes who were on GLP1 medications and saw a 30% reduction in Alzheimer's disease. That really caught my attention. It really caught my attention and made me so, so happy.
- [14:29]
B
Yeah. I mean, again, if you know the. But the physiology of a GLP1, how they work, it leads to improvement, not just in dementia and Alzheimer's, chronic disease. I predict that in the next few generations, there will be less type 2 diabetes, if any chronic diseases, less cancer. Right. So this is going to be a snowball effect in health.