Episode 62

GLP-1 Guide to Healthy Habits and Success

Published on: 1st January, 2025

Navigating GLP-1 Medications and Building a Healthier You: A Fork U Guide

Introduction: The Revolution Starts Here

Welcome to Fork University, where science meets sarcasm, and healthy eating gets a reality check. Today, we’re diving into the world of GLP-1 medications, like Ozempic and Zepbound—those little injections making waves in the weight loss and metabolic health scene. Spoiler alert: Even if needles aren’t your thing, this advice is gold for anyone looking to improve their relationship with food (yes, even you, cereal-at-midnight enthusiasts). So, grab a cup of tea (ginger if you’re nauseous), and let’s get started.


Breaking Free from Diet Culture: Goodbye, Guilt

Ah, diet culture. That pesky little voice whispering, “Carbs are evil,” or “You’re only worthy if you can squeeze into those jeans from 2012.” Here’s the deal: Diet culture sucks, and it’s time to boot it out of your life. Here’s how:

  1. Focus on Health Over Appearance
  2. “Strong, not skinny” isn’t just a gym bro mantra. Celebrate wins like better blood sugar control or climbing stairs without feeling like you ran a marathon.
  3. Neutralize Food Labels
  4. No food is inherently “good” or “bad.” (Except maybe that mysterious gas station sushi. Proceed with caution.) All foods can fit into a balanced diet—just maybe not all at once.
  5. Ditch Unrealistic Media
  6. Swap those Instagram influencers with body-positive accounts. Life is too short for filter-fueled comparisons.

Taming Side Effects: Fiber, Hydration, and the Art of Not Overeating

GLP-1 medications are game-changers, but they come with their quirks. Here’s how to navigate the rocky road of side effects:

Constipation: The Fiber Fix

Fun fact: Only 10% of Americans eat enough fiber. No wonder our colons are grumpy. Fix that with:

  • Whole Grains: Brown rice, quinoa, oats—because white bread is so 1990.
  • Legumes: Beans, chickpeas, lentils—fiber heroes and fart-inducing legends.
  • Supplements: Citrucel or Metamucil work in a pinch, but food first!

Hydration: Sugar-Free Isn’t Always Your Friend

Not all hydration packets are created equal. Skip the sugar-free gimmicks and opt for options like Pedialyte. Bonus points if you grab the popsicles—because who doesn’t love reliving childhood?

Nausea: Avoid the Grease Trap

High-fat foods + GLP-1 = a stomach rebellion. Swap fried chicken for grilled and save yourself the bloat. Greek yogurt and peppermint tea are your new besties.


Building Healthy Habits: Small Steps, Big Wins

Forget the “eat less, move more” mantra. Here’s what actually works:

  1. Mindful Portions
  2. At restaurants, box up half your meal right away. Or embrace the kids’ menu—yes, you might even score a toy.
  3. Protein with Purpose
  4. Greek yogurt, beans, and protein shakes are your go-tos. But don’t let diet culture trick you into thinking protein is the only macronutrient that matters.
  5. Celebrate Non-Scale Victories
  6. Fitting into old jeans? Amazing. Cooking a new recipe? Even better. Toss the scale if it’s ruining your day—you’re more than a number.

Long-Term Success: Sustainable, Not Perfect

GLP-1 medications are tools, not magic wands. They’re here to help you build a healthier relationship with food, not to police your every bite. Remember:

  • Moderation Wins: That scoop of ice cream isn’t your downfall. Balance it out with nutrient-rich meals.
  • Be Patient: Rapid initial weight loss (thanks, glycogen, and water) will slow, but consistency pays off. A pound a week equals 52 pounds a year. Do the math and cheer yourself on.

Conclusion: Fork U’s Final Wisdom

GLP-1 medications are here to support you, not define you. Focus on health, ditch the guilt, and enjoy the journey. And don’t forget: Consult a real, western-trained physician and a dietitian. Chiropractors and green juice influencers don’t count. Ok, I sometimes drink some green juice.

Transcript
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>> Dr. Terry Simpson: Hey. Today's podcast is about navigating the

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GLP1 medications. But it turns

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out a lot of this advice is for anyone in the

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new year who wants to develop better eating and a

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better relationship with food. So even if you aren't

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on these medications but want to eat a little better,

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maybe give a listen. All right, on to the show.

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M

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Today we're digging into GLP1

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medications like Ozempic, Zepbound and

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others. They're revolutionary, but

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even the best tools need proper

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handling. As a weight loss surgeon,

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I've spent years teaching people how to eat better

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after surgery. Surprisingly,

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the common things we teach people after surgery who have a

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smaller stomach is the same thing

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we teach people after GLP1 medications

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begin. We also know things that

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don't work well. What we know doesn't work well

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is telling people to eat less and move more.

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Another bit of advice that doesn't work well is telling people

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to just eat less than what you've been doing.

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The most important advice enabled

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by surgery or weight loss GLP medications is

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the opportunity to repair the relationship

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with food and repair the trauma

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from years of diet culture. And

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while these drugs curb that relentless

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food noise in your brain that tells you to eat even when you're not

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hungry, these drugs do have common side

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effects. So on today's pod, we'll go through some

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of those side effects and teach you how to navigate this

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incredible journey.

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I'm Dr. Terry Simpson, your chief medical

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explanationist and this is Fork

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U Fork University, where we make sense of

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the madness, bust a few myths, and teach you a little bit

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about food and medicine.

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Let's start with diet culture.

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Diet culture refers to those societal norms and

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beliefs that value thinness, appearance and weight

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over health and well being. It often promotes

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restrictive eating, obsessive exercise and

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guilt around food choices, perpetuating

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harmful body image, weird

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ideals and disordered eating habits.

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For someone using GLP1 receptor agonists like

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Ozempic or Zeppbound for weight management and other health

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concerns, addressing diet culture

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is critical for fostering a healthy relationship with food

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and body. So here's how we want to remove some of those

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diet culture elements.

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First, shift the focus to health

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and functionality. Meaning we want you to emphasize

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overall health, energy levels, metabolic improvements rather

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than weight or appearance. Celebrate non scale

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victories such as better blood sugar control, improved

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mobility, reduce blood pressure, maybe make your

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goal this year doing the splits. Okay, maybe not the splits. I

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did them when I was 10 years old. I've never done them since. But maybe

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this year I'll do some better yoga moves. We want you to

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redefine the idea of good and bad foods, removing

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those moral labels from foods. Because all foods can fit into

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a balanced diet in moderation. Except death cap

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mushrooms. A uh, gram of them will kill you faster than almost

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anything. But encouraging mindful eating to recognize

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hunger and fullness cues without judgment. Let me give

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you an example. The power you have

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over food with the GLP1 medications

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is can eat a small amount of

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food, sense the feeling of fullness

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and walk away. You will

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notice you don't need to get it again.

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You now have power over the food. Where before

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you'd have that sense of fullness walk away, but you'd be

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back or you'd eat more later. Now you

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have a tool that will help you that, that

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encourages more mindful eating, slowing

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down, taking your time, sensing

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fullness so you don't get overstuffed.

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Setting individual goals beyond weight loss is important

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too. So we want you to focus on

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sustainable habits like eating nutrient

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dense meals, regular physical activity, stress

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management that doesn't involve alcohol or drugs,

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and personalized goals to align with those intrinsic

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measurements like feeling stronger or improving

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sleep quality. For God's sake, buy a new

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mattress. Maybe I'm talking to me.

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It's really hard to unlearn

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harmful messaging that has been placed by diet

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culture. Especially this time of year when you will

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see supermodels who are anorectic

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going on bikini clad or

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whatever clad as an ideal body image.

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They're not understanding that

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medication as a tool for health management rather than purely for

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weight loss is key and

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reinforcing that. Its purpose is to support overall

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metabolic health, meaning your body's metabolism, its

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health not confined to societal pressure.

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But as anyone who's been on any weight loss journey might have a

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bit of trauma from the absolutes of the diet. These

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new medications will help you get that better

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relationship with food. But we have to

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balance that with this caveat.

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There are some foods you may need to be careful about on these

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medications. You've probably all heard about the side

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effects of GLP1 medications. Nausea, vomiting,

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reflux, constipation. They're pretty common. So let's start

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from the bottom up.

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Constipation. Typically it's a lack

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of water and a lack of fiber.

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Fiber is a key ingredient. It's even considered

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an essential nutrient for your gut. It feeds the healthy

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bacteria in your gut or the microbiome and they produce a

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lot of incredible things to thank you. Everything from

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dopamine to your own endogenous

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GLP1. Yep, you make it in your gut. And

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some anti cancer agents that keep your colon happy and

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healthy and keeps things moving along.

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It's astonishing that only 10% of Americans get the fiber

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they need from their diet. And if you find yourself consuming

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less fiber because you're consuming less food, you

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might develop constipation. Now some

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of this can be helped with fiber supplements like citrusyl

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metamucil, etc. But those are a supplement, they

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are not a solution.

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Instead focus on finding and

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incorporating fiber rich foods and

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making them a part of your routine. You want some example

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fiber rich foods? Whole grains like

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whole grain bread and whole grain pasta.

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Another one are legumes, beans,

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lentils, chickpeas, tofu, etc. Most

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people when they think of fiber, think about fruits and vegetables. And while

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those should be a part of your diet,

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they're not a big source of fiber like the powerhouses of

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whole grains and legumes. Now

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there are plenty of you who've been indoctrinated into that low

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carb mantra of all grains are evil.

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Lets be clear, from a scientific point of view,

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grains are not evil. People

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who consume whole grains, not refined grains,

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have less obesity, less heart disease, less

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cancer, live longer. Not bad, huh?

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Uh, nothing like whole grains or brown rice,

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quinoa or even oats. Adding them to your diet

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to not only get fiber, but a lot of other benefits of whole

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grains. Legumes are another great source of

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fiber. Legumes are things like beans, chickpeas,

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lentils, even peanuts. Let me give you an

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example. Beans are great for

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breakfast. One of my favorite breakfasts when

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I go to breakfast houses is getting

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huevos rancheros. But I'm not such a huevo

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fan. But I like the beans and having those

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beans with a little bit of hot sauce is great.

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Soups you can add beans to, you can add chickpeas

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to, you can have hummus as a dip. You can add

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beans to salads, they're delicious.

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And lentils the same way. I have a great recipe for

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dal in my website. Beans are not

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only fiber rich, but a great source of

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protein and low in fat.

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Fiber is just one half of the equation for constipation. The

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other half is hydration. And hydration is something if you're

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on a GLP1 or if you've had weight loss surgery you hear a

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lot about. Let me help you to avoid a

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scam. There are lots of

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hydration packs or IV hydration packs

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for sale and most of them aren't

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terribly useful. Why? Because Many of them

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advertise themselves as sugar free, part of diet

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culture. You want to be sugar free, but here's the

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need glucose in those hydration packs, otherwise you don't get

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the full benefits of the hydration of the salts in

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that pack, including magnesium, potassium and sodium.

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Without glucose, you lose the best

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way to get electrolytes in your

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body. How do I know? Did you know

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there are 92 million kids today who are

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alive because of a simple hydration formula

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involving a 6 to 1 ratio of glucose to salt in

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a liter of water? 92

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million kids. They didn't just give them salt and

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water, they didn't just give them water. But

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true dehydration from diarrheal viruses,

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cholera, rotaviruses, et cetera. You

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need true hydration uses that formula. So what

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do I recommend? In almost any pharmacy, you can get

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what's called Pedialyte packages. These are the things we give to kids

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who are dehydrated, but they're fine for adults.

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They're available in every pharmacy. They're easy to carry with you.

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And the Pedialyte even has popsicles, so you can make them up.

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So if you're feeling nauseous, licking

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a popsicle is one of the great things you can do to get some good

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rehydration. And here's a tip.

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If you are taking a GLP1 medication and you

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notice that after you get the shot,

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you have some nausea, we think

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you should take a full packet of hydration

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about an hour before you take your GLP1

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medication. Why? Because that way we know you're

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going to be pretty well hydrated before going in it. So if

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you have any adverse reactions, at least you've got that

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down. And finally, let's talk about this.

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If you're eating less, you're going to have fewer trips to

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the bathroom. That's normal. That

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is not constipation. Let's talk about

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nausea and reflux. High

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fat foods delay digestion

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in normal people, in everybody, and

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they worsen nausea. And if you're on a

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GLP1 medication, like Ozempic or

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Mounjaro, your stomach is not going to

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empty as fast as it normally does. Things will

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sit in there. So that means that,

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I mean, I love Popeye's chicken. Who doesn't?

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But if you have too much of that delicious crust that

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will sit in your stomach, delay emptying. Your stomach

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will get more and more gastric juices become more and more

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bloated, and you won't like the result. Greasy

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and fatty Foods delay stomach emptying. The technical reasons,

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fat in food stimulates the release of a hormone called

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cholecystokinin, which releases in the duodenum

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and that inhibits distal stomach motility.

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That's our way of saying the food stays in your stomach longer. And that,

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combined with the medications GLP1s means the food's gonna

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sit there for a while. It also stimulates

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pyloric tone. Alright, what is that? At the end of your stomach is a

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sphincter called the pylorus that opens to empty

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the stomach. But

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greasy foods and GLP1s

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cause that sphincter, uh, to be

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tight. If food sits in the

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stomach longer, you get bloating,

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distension, reflux, nausea,

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and even vomiting. Have you ever had food poisoning?

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Food poisoning is when your body keeps food in your stomach

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longer until you get bloated, nausea and you vomit. It's trying to keep

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the bacteria from entering into your gut.

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That's why it's not a bad thing to vomit if you have food

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poisoning. Well, GLP1

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medicines are sort of like that. They keep food in your stomach

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longer. Now, if you eat too much or if you

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eat on top of being full, you're going to have more

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nausea. But grease isn't the only

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thing that causes food to sit in your stomach

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longer. Here's a few other things. Foods with a lot of

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added sugar, sugar sits in your stomach, breaks

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down, causing more acid to hit the stomach, leading to more bloating,

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more discomfort. Typically, these are high

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sugary drinks like fruit juice, southern

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sweet tea, soda. So instead those are

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things to be minimized. Alcohol with

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GLP1 drugs presents its own unique

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set of issues. Now, in general,

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we are working hard to tell America and the

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world that there isn't a safe level of

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alcohol. And if you can stop consuming it, you will have better

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health for it. This is in contrast to what we

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believe for many years, science advances. Sorry to take

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away your favorite afternoon drink, but alcohol

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is not good. And a combination of dehydration and

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increased alcohol can lead to pancreatitis in some

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people. So if you're dehydrated and are drinking alcohol, which

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leads to more dehydration, you can develop

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pancreatitis. So best to avoid alcohol on

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GLP1 medications or limit it to one

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glass. Many people actually find when they

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start GLP1 medications, they lose their taste for alcohol

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altogether. It might be a social thing. They're used to grabbing a beer or

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glass of wine, but. But otherwise, when they start tasting it, it just

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doesn't taste the same. It's

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okay. Remember the other thing. Because you're not eating

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that much, you don't have food quantity which absorbs some of the

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alcohol. So you're going to get a little bit tipsy a little

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bit faster. Here's a tip for restaurant

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use. When you go to a restaurant,

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if you're like the rest of us, you want to finish what's on your

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plate. Get a To go box immediately.

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We use this tip all the time for our weight loss surgery patients who have

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smaller stomachs. But think take

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that immediately. Get the to go box. Put the food in

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there. And if you don't want your friends to know that you're eating less

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quizzes of GLP1. They don't care. Really, they

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don't care. You can tell them you had a late lunch. You can tell them

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you want to save some for your friends. You can tell them you want some for

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tomorrow for breakfast. Doesn't matter. Make whatever excuse you

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want. But it's a great tip for eating less, even for your

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friends who are going out and want to lose a little weight, which most

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of America does. How about fast

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food? Well, aside from avoiding greasy things, the kid's

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menu is going to be your best friend. And

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hey, you might even get a toy with your meal.

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I mean, who doesn't want a toy? So, like, if you go to Chick Fil a, get

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the grilled chicken, please. Your stomach will thank you for it.

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But most nausea happens when people overeat,

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right? Overeating feels like

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overstuffing a suitcase. Just because you can zip it closed

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doesn't mean it won't burst open later. So for nausea,

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take a walk, take some ginger or peppermint

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tea, and if it's overdone, you start feeling the

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reflux but have to go to bed. A wedge pillow will help

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a lot. Here's another one. You're going to hear a

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lot of people who've had GLP1 say, oh, you got to have a lot of

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protein. Well, protein is a key, but don't overdo

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it. Beans, Greek yogurt, simple shakes

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can keep you balanced. There's no need to overthink it.

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We want habits that last a lifetime. And

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eating more protein can lead to people eating more

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greasy things like steaks or sausages, which we

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don't think are great overall nutrient

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balances in a healthy diet. More

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importantly, adding too much protein at the expense of

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other parts of your diet can lead to more constipation and other

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issues. Finally, be patient with

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yourself okay. Initial weight loss

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is often due to water and glycogen. So what's that? It's

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dramatic but temporary weight loss. Glycogen is how

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your body stores extra glucose. It's stored in your muscle.

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You need it for times when you're exercising, sleeping, fasting,

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just in everyday life. Many people who are overweight have a

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lot of excess glycogen stored in their muscles and they lose

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the glycogen as they burn through it when they go through eating

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less. And for every pound of glycogen you

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burn, you will lose 2 pounds of water.

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Hence, early weight loss is often rapid.

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Sometimes people even think they're losing muscle because they'll see muscle go down

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on some of these fancy scales. But you're actually losing glycogen from

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muscle. You are going to lose fat in the

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background and you will see fat loss

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come, but in a far more stepwise fashion. But here's

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the other thing. You need to liberate your scale.

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If your day is going to be ruined by a number on a scale, it's time

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to let it go. You don't need it. The

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medication allows you to listen to your body, to eat smaller

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portions. That will take care of the weight loss.

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And isn't it a great feeling to know that you can have a smaller

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portion? Feel satisfied. Walk away

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knowing you're not going to be starving later. Knowing you're not going to be called back to the

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refrigerator. Taking time

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to learn about good things to eat, learning

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new recipes for the new year, that should be your

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goal. So you can forget the scale.

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You can celebrate wins, like fitting into old

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clothes that were too tight or treating yourself to new ones.

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You deserve it. But there are plenty of you

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out there who really like to track your weight. And that's great. Just

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don't let those few pounds here or there ruin your

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day.

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And trust in in the process,

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you are going to need a daily vitamin. And there are a lot

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of choices out there. Oh my gosh. So before you buy

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the fancy AG1 for 80 to 100 bucks a

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month, try a few different vitamins. See how they settle on your

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stomach. You might find that children's chewable

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a couple a day work just as well. And they're pretty

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inexpensive. But if you want to be a little

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bourgeois and like the expensive vitamins,

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that's fine. I have a simple key for

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you. Your body doesn't care how much the vitamin

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costs. Your vitamin comes from whether

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it's a rose hip or a synthesized in a lab. Your body doesn't care.

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It will utilize them. And when you see

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all this extra stuff on the label, like I take

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a little AG1 and it has all this extra stuff.

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But the key on the label is the

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little disclaimer where it says, the FDA has not verified

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these claims. Meaning,

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don't listen to what we're saying. Prenatal

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vitamins are great too, by the way. If you want to buy the expensive

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juices, go ahead and buy it. So I want you to think

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about this. GLP1s are a lifelong medication to treat

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the disease of obesity. They give you

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the tool, you'll be able to use it. Your

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goal is to eat better and not get trapped

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into absolutisms. The ice cream you

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ate won't ruin you. You can enjoy

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it. You can enjoy a little bit of everything.

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You truly can moderate and eat

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almost anything and enjoy it. So listen to your

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stomach, mostly eat well, mostly

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plants. And yep, new medicines are coming.

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You may be transitioning to one of the new medications that are in pill

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form later on, but until then,

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your goal is great food, delicious food,

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healthy and enjoyable food.

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Well, that's a wrap. Remember, GLP1

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medications are tools, not magic. But

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I would always recommend that you go with an obesity

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specialist who are trained in GLP1s and know how

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to help and walk you through and guide the process.

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Not a, uh, coach, not a life

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coach, not a gym bro. This

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podcast was written and researched by me, Dr. Terry Simpson. And while I

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am a doctor, I am not you your doctor.

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I do want you to consult a real western trained

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physician and a good registered

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dietitian. Not some alternative medicine practitioner,

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eastern thing, chiropractor. They don't know about GLP1

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medications. Do check out the blog associated with the

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podcast at YourDoctorsOrders.com and 4Q.com

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4Q is distributed by our friends at Simpler

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Media who also help with the editing of the

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sound and make me sound better than I am.

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Special thanks to the pod God, Mr. Evotera.

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And until next time, keep your fork

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on the road to health.

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Hey EVO, these new GLP1

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medications are frigging amazing.

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They have actually flattened the obesity curve in the United

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States for the first time in 30 years.

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I am thinking that there are going to be a large population

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of America that's going to be using them. Maybe they'll even listen to

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this podcast.

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>> Speaker B: You totally missed a great opportunity for a

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much less large population.

Speaker:

Choke. But no.

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Still good tips. I could use

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them. Cheers. Oh, and uh, happy New Year.

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About the Podcast

Fork U with Dr. Terry Simpson
Learn more about what you put in your mouth.
Fork U(niversity)
Not everything you put in your mouth is good for you.

There’s a lot of medical information thrown around out there. How are you to know what information you can trust, and what’s just plain old quackery? You can’t rely on your own “google fu”. You can’t count on quality medical advice from Facebook. You need a doctor in your corner.

On each episode of Your Doctor’s Orders, Dr. Terry Simpson will cut through the clutter and noise that always seems to follow the latest medical news. He has the unique perspective of a surgeon who has spent years doing molecular virology research and as a skeptic with academic credentials. He’ll help you develop the critical thinking skills so you can recognize evidence-based medicine, busting myths along the way.

The most common medical myths are often disguised as seemingly harmless “food as medicine”. By offering their own brand of medicine via foods, These hucksters are trying to practice medicine without a license. And though they’ll claim “nutrition is not taught in medical schools”, it turns out that’s a myth too. In fact, there’s an entire medical subspecialty called Culinary Medicine, and Dr. Simpson is certified as a Culinary Medicine Specialist.

Where today's nutritional advice is the realm of hucksters, Dr. Simpson is taking it back to the realm of science.

About your host

Profile picture for Terry Simpson

Terry Simpson

Dr. Terry Simpson received his undergraduate, graduate, and medical degrees from the University of Chicago where he spent several years in the Kovler Viral Oncology laboratories doing genetic engineering. Until he found he liked people more than petri dishes. Dr. Simpson, a weight loss surgeon is an advocate of culinary medicine, he believes teaching people to improve their health through their food and in their kitchen. On the other side of the world, he has been a leading advocate of changing health care to make it more "relationship based," and his efforts awarded his team the Malcolm Baldrige award for healthcare in 2018 and 2011 for the NUKA system of care in Alaska and in 2013 Dr Simpson won the National Indian Health Board Area Impact Award. A frequent contributor to media outlets discussing health related topics and advances in medicine, he is also a proud dad, husband, author, cook, and surgeon “in that order.”