Episode Summary: Dr. Alexandra Soa on "The Ozempic Revolution"

Podcast: Totally Booked with Zibby
Host: Zibby Owens
Guest: Dr. Alexandra Soa
Episode Release Date: February 14, 2025
Book Discussed: THE OZEMPIC REVOLUTION: A Doctor's Proven Plan for Success to Help You Reverse Obesity, End Yo-Yo Dieting, and Protect Yourself from Disease by Dr. Alexandra Soa

1. Introduction to Dr. Alexandra Soa and Her Work

Zibby Owens welcomes Dr. Alexandra Soa, a dual board-certified physician specializing in internal medicine and obesity medicine. Dr. Soa is the founder of So Well, a platform offering telehealth services and metabolic support products. With over a decade of clinical experience, she has become a prominent voice in metabolic health, particularly regarding GLP1 medications. Dr. Soa's expertise extends to media appearances in outlets like The New York Times, CNN, and Women’s Health. She is also a Clinical Instructor at NYU School of Medicine.

Dr. Alexandra Soa [03:13]: "GLP1 medications have been around for a long time, but these new weekly iterations have really changed the game."

2. The Evolution and Impact of GLP1 Medications

Dr. Soa provides a comprehensive overview of GLP1 medications, highlighting their evolution from treatments for type 2 diabetes to powerful tools in combating obesity. She explains that the newer weekly versions, such as Ozempic, have significantly increased efficacy, enabling weight loss of 15-25% of total body weight compared to the earlier 7-10%.

Dr. Alexandra Soa [04:14]: "We have medications to help you in this. And that is my mission in life, to stand on my little soapbox and say that this is not about willpower."

These medications are not only effective for weight management but also show promise in treating a range of chronic conditions, including sleep apnea, cardiovascular diseases, and even certain cancers. Dr. Soa emphasizes the societal shift in understanding obesity as a biological disease rather than a result of willpower or lifestyle choices.

3. Addressing Mental Health and Lifestyle Changes

A significant portion of the discussion centers on the psychological effects of GLP1 medications. Dr. Soa introduces the concept of anhedonia, a reduced ability to experience pleasure, which some patients may encounter as their relationship with food changes.

Dr. Alexandra Soa [08:06]: "Most people find joy that they are freed from constant obsession about food. But for some, especially those whose social lives revolve around eating and drinking, there can be a sense of loss."

To mitigate these effects, Dr. Soa advises patients to proactively seek alternative sources of joy and fulfillment, such as hobbies or new social activities. This preparation helps in maintaining mental well-being during their weight loss journey.

4. Challenges with Medication Adherence and External Factors

Dr. Soa discusses the potential challenges patients might face when on GLP1 medications, especially during life changes or unexpected events that disrupt their routines.

Dr. Alexandra Soa [11:53]: "If you let go of the foundational tools, then you don't have your safeguards up. Everything can go crazy."

She advises patients to remain vigilant and return to foundational habits if they notice signs of regression, ensuring sustained success in their weight management efforts.

5. The Future of GLP1 Medications and Insurance Coverage

Addressing the accessibility of GLP1 medications, Dr. Soa highlights ongoing legislative efforts to include these treatments under Medicare and Medicaid, a significant shift from the longstanding exclusion dating back to the early 1990s.

Dr. Alexandra Soa [13:46]: "There is a proposed rule in Congress that would allow Medicare and Medicaid to cover GLP1 medications for weight loss."

She also mentions advancements towards pill forms of these medications, expected to enter the market around 2026, which may help reduce costs and improve accessibility.

6. Use of GLP1 Medications in Pediatric Care

While Dr. Soa primarily treats adults, she touches upon the approved use of GLP1 medications in specific pediatric scenarios. She emphasizes the importance of addressing the root causes of obesity, such as environmental factors and dietary changes since the 1980s, to prevent future generations from suffering similar health issues.

Dr. Alexandra Soa [17:46]: "For some children, the genetics are just not in their favor, and they're going to develop disease trajectories like type 2 diabetes."

7. Personal Motivation and Family Influence

Dr. Soa shares a poignant story about her grandmothers, whose lifelong struggles with weight and dieting fueled her passion for addressing obesity medically rather than through willpower-based approaches.

Dr. Alexandra Soa [19:24]: "My grandmothers were constantly thinking about weight. They went on diets from a young age, and it led to chronic diseases. This motivates everything I do."

Her personal narrative underscores the generational impact of obesity and the critical need for effective medical interventions.

8. Emphasizing Holistic Health Over Weight Loss

Contrary to labeling her book as a diet book, Dr. Soa clarifies that her focus is on restructuring the relationship with weight loss through simple food rules and prioritizing overall health metrics over mere thinness.

Dr. Alexandra Soa [26:49]: "Nutrition is a big part of health. If you're doing this journey just for vanity, it probably isn't right for you."

She advocates for a balanced approach that includes adequate protein intake, hydration, and fiber, which not only supports weight loss but also enhances overall well-being.

9. Conclusion and Final Thoughts

Zibby Owens commends Dr. Soa for her insightful and prescriptive approach to combating obesity, highlighting the book's utility in providing actionable guidance beyond just discussing the issues.

Zibby Owens [30:15]: "Congratulations on the book. It's so important, such an important topic. I found it absolutely fascinating and super useful."

Dr. Soa expresses her hope that her work will benefit future generations and contribute to ending the pervasive cycle of obesity and its associated health problems.

Dr. Alexandra Soa [29:32]: "Hopefully, it'll be different for the next generations. We can get ourselves out of this obesity pickle."

Key Takeaways

• GLP1 Medications: Transformative in treating obesity and related chronic diseases, with newer formulations offering greater efficacy.

• Mental Health: Addressing potential psychological changes, such as anhedonia, is crucial for sustained weight management.

• Accessibility: Legislative changes are underway to make GLP1 medications more affordable and widely available through insurance coverage.

• Holistic Approach: Emphasizing overall health and sustainable habits over restrictive dieting is fundamental to long-term success.

• Personal Motivation: Dr. Soa's personal and familial experiences drive her commitment to redefining obesity treatment.

This episode offers an in-depth exploration of the Ozempic revolution, providing listeners with valuable insights into the medical, psychological, and societal aspects of obesity treatment through GLP1 medications. Dr. Alexandra Soa's expertise and personal stories create a compelling narrative that underscores the importance of viewing obesity through a medical and holistic lens rather than a stigmatized one.