Episode 8, Part 1 of The Living Life Well Show: Weight Loss: GLP-1s, Fasting, Diet, Exercise, Sleep and Hormones
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[00:00:00] Welcome to the Living Life Well Show, the intersection of God's Word, today's science, and healthy living with common sense application, all based on the truth of the Word of God. I'm your host, Dr. Jon Skelton. Now let's get straight to the truth.
Yeti Nano & FaceTime HD Camera-2: So today I wanted to come to you and talk about weight loss, all things, weight loss. I want to talk to you about the GLP-1s. The semaglutide
Yeti Nano & FaceTime HD Camera-2: a host of other, things that are, out there right now to help you. Potentially lose weight. And then I also wanted it to cover, fasting, as well as,[00:01:00] how diet and exercise are really gonna, play into that. And so with that being said, let's go ahead and, and jump straight in.
So as you know, the GLP-1s or. As we'll refer to them here, like, oh, Ozempic or semaglutide or Wegovy or a host of other, medications that are on the market right now. Have been around for actually quite a while. Um, I've been seeing patients, especially diabetic patients. On these medications for, several, several years now, but recently, obviously we know that they are being touted for weight loss and they are they're they're, allowing people to lose anywhere from 10 to 15 pounds.
Typically sometimes much more, sometimes a little less, depends on, the individual and what other factors, in lifestyle that they are choosing to add in to help facilitate that [00:02:00] or not. Let's get into this. so what is GLP one? What does it even stand for? Okay. So it's a glucagon like poly peptide. Well, What in the world is glucagon and, and why do we want to be like it?
So glucagon is a hormone that is released from the pancreas that acts to increase glucose levels, glucose or sugar is what your body uses to really, um, For energy. It's, it's the main substance that your brain uses. It's the first line energy that we use on a daily basis. No matter what task, we're typically involved.
in
how glucagon does this? Is it releases
glycogen. ~ ~ glycogen is [00:03:00] excess carbohydrates or sugar that we store in our skeletal muscles, but also our liver. And so we, we store those there for times in which a food supply is not abundant or say we have a lot of exertional demands. Think about, you going through a workout, things like that.
You're going to recruit those glycogen stores to help keep glucose levels high so you can continue to function and, work properly in all, the phases. Of health.
So as you can see, glucagon is very important. ~And so a glucagon like peptide. That helps to increase that process might be beneficial, but, but why are we increasing, blood sugar release and, and those things well, ~ the GLP ones ~also, what they do is they~ inhibit release of glucagon from the pancreas~ and they mimic glucagon in the system.~ In addition, they also help to increase. Levels of insulin.
The old tired, worn out cells that secrete insulin [00:04:00] are urged to stay around a little longer and keep producing more insulin. In addition, it also stimulates the production of new cells for insulin. When we have increased insulin that helps overcome the insulin resistance that's associated with, high levels of blood sugar and dietary indiscretion that occurs over. Over time. Insulin. Decreases blood sugar levels. It drives glucose into your cells. And so the excess glucose sitting around in the system. Causes issues with inflammation and causes. Insulin resistance.
And it's just a perpetual process that kind of continues on. So that is how the, the GLP ones, are working at least one way. Another way [00:05:00] is that they're really inhibiting the ability of your stomach to empty as it normally would. So, what does this do? This means that food and other stomach contents are sitting in there longer.
This means that they are undergoing, the first, few phases of digestion. A little bit longer and are sitting there and are more slowly released.
Then it also somehow seems to work at the level of our brain within the hypothalamus to decrease our hunger response. Well, we know that when we have a full stomach that feeds back to the brain,~ that's my hypothesis for how this is working.~ So they feed back, to the hypothalamus in the brain. Signaling, that you are not hungry.
And so that is how they tend to, to work and help decrease your appetite. So it has benefits of.[00:06:00] Appetite suppression. A slowing down of the emptying process. Of the stomach, which would help to not spike your blood sugar quite as much. Which would allow the increase insulin production that's occurring to then lower those blood sugars a more significantly. So. When we have increased insulin production.
And when we put patients on insulin, Many times they are seeing an increase in weight gain. Well, why is that? Because now that blood sugar that is circulating around the body is now entering the cell. You now have it available to use. It's getting then stored as glycogen when it's an excess. And then you are gaining weight because of this increased insulin load.
So this doesn't really make sense [00:07:00] as to how it would really be causing weight loss other than the fact that maybe you're not eating as much. Well, so let's, let's get into this a little bit more and a little bit more of where I think the, the weight loss is coming from. You see? So I've had diabetic patients that have been on these for years. And every single diabetic patient that I've had. Has had multiple gastrointestinal issues.
I've had diabetic patients that literally, were essentially caught in their homes because. They. Couldn't go out anywhere . They never knew when diarrhea was going to strike. And so it was debilitating and causing significant issues. And so what I would do is that was the first medication that I would take them off of . Any time I have a client on GLP ones, that's having any kind of gastrointestinal [00:08:00] issues.
Be it abdominal pain. Be it constipation. Be it something called gastro-paresis, which we'll get into in a minute. Be it, just diarrhea or been diagnosed with IBS or inflammatory bowel disease, all these things. I immediately take them off of the GLP-1s, but you would say, well, well, aren't you worried about their blood sugar?
Not really. There, the effect of the blood sugar is pretty minimal. It decreases your hemoglobin A1C by about one point. Which is good, but for the vast majority of my clients in the first 90 days, if they are already a diabetic and, and are, pretty significantly. Diabetic, meaning they've got. You know, hemoglobin A1C is a seven and a half or more.
They'll see a two to three point reduction, in those 90 days typically. So. Now. These GLP-1s cause weight loss. And the, the idea [00:09:00] is that it's possibly because of appetite suppression. But what I would also say is, very much a contributing factor is these gastrointestinal side effects particularly. Constant daily nausea, some with vomiting and then diarrhea. If you are having a chronic, diarrhea. You're going to be losing some. Some weight. So about 50% of the people that are on the GLP-1s have some sort of gastrointestinal issue.
And the vast majority of those are going to be either pain, nausea, vomiting, and, or the diarrhea. Now there are some serious consequences. If you don't consider those to be serious. That are associated, with this as well. Cancer of the thyroid, is a big one. But primarily what I'm going to focus on today is the gastrointestinal issues that, that we see.
So one is called [00:10:00] gastro-paresis. Gastro-paresis is something that we would see commonly with diabetics due to injury of the nerves within the stomach and telling the stomach when and how to empty. And so gastro-paresis what it does is essentially causes a paralyzed stomach so that when you eat everything just sits there like a rock.
It doesn't really move through. Gastro-paresis has increased exponentially over the years as diabetes has increased. And within the last five years of being an ER, doc, I have seen more people diagnosed with gastro-paresis in the last five years. Then I have over the previous 15 years. But the amount of gastro-paresis that is out there, which is, because of increased rates of diabetes. And because of [00:11:00] increased use of these GLP ones. And other drugs. We are seeing an astronomical increase in this debilitating disease.
Gastro-paresis causes constant pain nausea. Vomiting, as you might suspect, causes a lot of, um, just dehydration, and other issues and is quite honestly very miserable to deal with on a daily basis. So, how do we treat gastro-paresis? Well, you can try some dietary changes, which tend to help, but for traditional medicine, the, the vast majority of the ways that we, treat this is. with other drugs. There's a medication called metoclopramide. An old antibiotic erythromycin, these are known to stimulate a gastric emptying or emptying of the stomach. And so, those are employed, but those have been met with very limited [00:12:00] success.
And so, they've tend to, to turn to surgical options. Or I V feeds or nasal gastric tubes down into the small intestine to feed. Or a tube on the outside of your body to, to feed you. So essentially bypassing the stomach and going into, the small intestine directly. And getting tube feeds that way. Now there have been some other advances that still allow you to eat, as God intended. And that would be a gastric stimulator where we're really kind of stimulating those nerves that have been damaged. Either due to the, medications and or high blood sugar levels, to allow the stomach to then empty and process food in a more timely fashion.
So. Gastro-paresis is no joke and it is definitely not something that you want to get. Now again, with these GLP-1s, this is a small percentage, [00:13:00] but. Relative to the general population, it is. Occurring. Very, very high. So another thing that we'll also see is pancreatitis. So pancreatitis is inflammation of the pancreas.
Now, historically, when we see acute pancreatitis, it's most commonly associated with gallbladder disease, meaning that you have sludge. Or stones that are in the gallbladder. They escape the gallbladder and go into the duct that is shared by the, by the gallbladder, the liver and the pancreas called the common bile duct. When you get an obstruction there, just like you would, in a main pipe, in your house. As you can, think of this, all of the water within seat, back into every area, of your, of your house, if the, obstruction is in the main line.
So over time, this causes significant issues with the pancreas because the pancreas, every time you eat or drink something, it is secreting different enzymes, amylase lipase.[00:14:00] Insulin glucagon. All these things to help. Aid in the digestive process. Well, when it's obstructed, what happens is they start digesting themselves.
And so they start destroying the cells that are actually secreting these enzymes for digestion. This can, continue over time and cause big issues. Now we typically don't see chronic pancreatitis. With gallbladder disease, because we're able to either remove the obstruction and that helps to alleviate the pancreatitis. Now other causes of pancreatitis can be chronic. And we see this with alcoholism. We also see it with fatty liver disease. Which is typically going to be caused by, by diet and lifestyle issues, as well as obviously the alcoholism. Um, but then now we're seeing this associated with these GLP ones.
We've see it with [00:15:00] different antibiotics , but now we're seeing it quite a bit, with these GLP ones. So. Pancreatitis can be very debilitating cause severe pain. Vomiting, dehydration, all these things.
We've seen chronic pancreatitis on the rise as well, and especially in a chronic pancreatitis, because we are seeing so much more fatty liver disease now. And then of course, we're seeing these, these GLP ones. So. Pancreatitis when it's an acute episode,
you're gonna need a hospitalization. And what we do is we make you what we call NPO or nothing by mouth, meaning you aren't eating or drinking. We're just giving you IV fluids and pain medications so that you can stand the pain, allow the pancreas to rest. So that, that inflammatory process decreases.
And that now once you [00:16:00] do start eating or drinking, that inflammation has resolved so that those digestive enzymes go to where they're actually. We supposed to go through the common bile duct down into the small intestine. To promote digestion of whatever it is that you have eaten or drank.
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Now, when this becomes a chronic issue, because it's something that, that is an ongoing everyday basis, like fatty liver disease or. Someone that is, continuing in alcoholism, or if it is that you are having to take a drug that is causing this, that insult keeps coming and coming, and that inflammation never really resolves.
And so. Many times people are going to find different things that will flare them and, and cause it to be worse. So. They will do avoidance of those things. But sometimes when you've had an insult long enough, to the pancreas that inflammation just doesn't go away. When it doesn't go away, it turns into this [00:18:00] chronic pancreatitis and over time. That can result in you being unable to really secrete any of these digestive enzymes. And or insulin.
And so it can essentially result in you becoming a type one diabetic, so to speak. And can result in you needing to take a daily digestive enzymes to help. Process and, and digest your food normally. And so pancreatitis is a very, very miserable disease. And you want to do whatever you can to avoid having pancreatitis.
So. That is another, big side effect that's out of proportion. You know, with these GLP ones. And then the next thing that we're seeing a lot and is probably tied to the vomiting and diarrhea is bowel obstructions. So bowel obstructions historically have, occurred because of, abdominal surgeries, you saw this a lot, With [00:19:00] the, open abdominal surgeries.
Now we're seeing it still with laparoscopic surgeries. But what happens is, is, when we go into the belly and we have to do a surgery, that normally sterile undisturbed environment, the way God created us has now been disturbed. The reaction between the layers of the small intestine, the abdominal wall, the covering of everything. Reacts in such a way. That it kind of scars down or becomes sticky. What will happen is, some bowel may get stuck as peristalsis. Occurs or digestive process and, , contraction of the muscle within the bowel.
It can kink. And so if you think about it, like a, your water hose gets kinked in half like that, nothing really goes through, right? So you've clamped it off. Well, this is what we're seeing is, causing a bowel obstruction. Now, other things cause bowel obstructions to you can have inflammatory [00:20:00] bowel disease.
You can have. Chronic, severe constipation and, and these things get that can result in bowel obstruction. But typically it is a patient that has had previous abdominal surgery that is getting these bowel obstructions. I have diagnosed more bowel obstructions in patients that have never had an abdominal surgery before in these last four to five years, then at any time ever in the past, and also with these pseudo obstructions, with these into susception, which is a telescoping in of, The. Intestine on itself and, it gets stuck.
So we're seeing a proliferation of these bowel obstructions occurring and patients that really otherwise don't have risk factors. For that. So part of the idea behind this is, is that this is, occurring because there's inflammation of the colon. And that [00:21:00] is causing these kink points that had not previously been occurring because there wasn't either segmented or large areas of inflammation. And so. What, what we think is, is going on here is some studies have suggested and, in mice .
There's a migration of E. Coli bacteria. Now, this E. Coli may be also the underlying issue. That's going along with the vomiting and diarrhea. That's occurring in 50% of people. And so the bowel obstruction, when you get more inflammation, it can then again, as I said, cause that kinking process and, cause the obstruction along with diarrhea, along with nausea and vomiting and of course. Pain. So we've done all the bad and the ugly of the GLP-1s, but what is the benefit to them just besides weight loss?
[00:22:00] Well, we have seen that there's decreased. Decreased cholesterol, LDL levels, and we're seeing, decreased blood pressure, decreased risk of cardiovascular disease or stroke. And it is really. Uncertain as to whether it's actually the medication doing this, or is it just because of the weight loss?
I believe that it is most likely, due to just weight loss, because we do see all these benefits just with weight loss. So. Time will tell, as we go on and have more experience with these medications. Okay. So now that we've covered GLP ones, let's move on to fasting. So fasting would be considered time restricted eating. Or one to a multi-day fast. Okay. So we know that fasting has been around for thousands of [00:23:00] generations. We know it's the first thing that Christ did prior to starting his ministry.
Yeti Nano & FaceTime HD Camera-3: We know that. Most, religions have some sort of a fasting type period in it. Be it fasting, from a particular food, like in Lent, with Catholicism or going on a complete, fast doing. Water or in some cases, a juice fast. We've been able to really measure a lot of benefits, but what essentially is going on is that when you're doing time restricted eating and a multi-day fast. You are essentially clearing out. All those glycogen stores that glucagon is being released.
It's creating that. Glycogenolysis and gluconeogenesis to. Then stimulate glucose production that, then gives you energy. Well, after a period of time, then that starts to [00:24:00] burn fat. And so when you are fasting for a period of time, you're going to really just burn fat. And so that's why we see fasting being such a. Great benefit.
So a lot of people have myths around fasting. One of them being that you're going to burn muscle and what we're talking about hours to a few days, and a normal body weight person, or an overweight person. You've got plenty of fat stores to burn, and so you're going to be able to not really touch , your muscle. And really what we see with fasting is it really improves a lot of our hormone. Hormone levels. We get a lot of a surge in HGH or human growth, hormone and adrenaline.
And this allows us to continue to burn fat, lose weight and put. Put on muscle. And putting on [00:25:00] muscle is really important because that allows us to increase. Our metabolic rate allows us to continue to burn fuel burn calories. If you will, burn through glucose and fat stores. And really helps to clean out our bodies.
And so, the more that we're able to, effect and increase that muscle mass. The greater benefit that we're going to get, Even with fast. And then of course, with fasting, we are going to see changes to our glucose and insulin levels. We're going to see our insulin levels drop or our resistance to insulin is going to drop, especially as we continue to. Add on muscle the great thing about fasting is again, it's primarily fat loss that you are achieving, with this.
And so you're maintaining that lean muscle mass, which is so important for hormone production . And what's great about [00:26:00] this is we see changes to your total cholesterol levels coming down. We see inflammation levels decreasing, going. Through a fast. And for some people, we even see a decrease blood pressure levels.
And so all of these things are seen in general with weight loss. Now, if this sounds familiar is pretty similar to what the GLP-1s are touting. Right. And so the GLP-1s are essentially, in my opinion, causing you to fast or decrease your appetite. So that more likely you're doing time restricted eating to a certain degree because you're just not as hungry. And so for many, patients. That are on these GLP-1s.
That's what they find. They're just really not hungry. So they don't eat. Um, But they're keying all the negative side effects potentially, by taking these GLP ones. [00:27:00] That's why I think fasting is a tremendous alternative to GLP ones. Now fasting isn't for everybody. If you are on drugs associated. With diabetes, if you are on blood pressure, medications, or heart rhythm medications in those things, these are all things that you would need to consult a physician about. And quite honestly, before you do any kind of a fast, that's going to be more than 12 hours, you really ought to consult your, physician or healthcare provider. Prior to doing that, if you're on any kind of medications and then of course anybody who's underweight, or has had a problem with eating disorders, again, those are things that. Need to, um, be addressed prior to starting fast. Of course children, young children don't necessarily need to start on a fast. Pregnant mothers. Don't need to start on a fast either.
So, but those, people who can really benefit. From fasting is [00:28:00] quite large. And, really, shows a lot of the same benefits without the negative side effects that we see, with these, GLP.
Yeti Nano & FaceTime HD Camera-3: okay. So that's it for part one of episode eight, where we're addressing weight loss and the next episode, we're going to talk about diet. We're going to talk about exercise and we're going to talk about sleep as well as why you might not be able to lose that weight, even though you're doing all the right things. So until then, I hope you have a great day.
Thanks. And God bless.
That's it for this episode of the Living Life Well Show. If you like what you've heard and want to learn more, or want to know how to put this into practice for yourself, go to livelifewellclinic. com. Until next time, this is Dr. John Skelton saying, go out and live the truth so you can [00:29:00] live life well.
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