3 Keys to Sustainable Weight Loss: Strength, Protein, and Smart Habits

What's the best and healthiest way for a woman to lose weight? >> Lift weights. >> Lift weights >> and eat. >> And eat. Yes, absolutely. And you could have a very slight calorie deficit towards the end of the evening. >> Running >> as a way of burning calories. The

problem is people think that they can out exercise a bad diet and you can't.

>> Composition of your diet matters immensely. >> And I hate calling it lose weight. I I

now call it recomposition, >> but let me put it in context. Yeah, go

run. You're going to burn 100 calories a mile. Three Girl Scout cookies, three thin mints, US favorites, >> is 180 calories, >> so you have to run two miles to eat

three cookies. Most of us, if you're going to eat cookies, don't eat three

three cookies. Most of us, if you're going to eat cookies, don't eat three Thin Mints. You eat the whole sleeve. Right. To your point, it is impossible

Thin Mints. You eat the whole sleeve. Right. To your point, it is impossible to out exercise food unless you're a high level athlete and even thousand calories.

>> Even then, no. Because we look at diet composition. >> And we see that um endurance athletes who use a lot of high sugary type carbohydrate like the gels and the sports stuff, they've interrupted their gut microbiome so much that they have >> sugar alcohols.

>> Yeah. Well, it's not even that. It's the fillet change. We're seeing a decrease in the diversity. Even though they're exercising and we see that exercise increases the diversity of the gut microbiome, it's what they're eating

during the training with the heat and hypoxic stress that is creating the growth of the firmis fil that's associated with o obese outcomes. >> So that's it changes the gut the gut

bacteria. Yeah. if they are. >> So, we have this mis Yeah, we have this

bacteria. Yeah. if they are. >> So, we have this mis Yeah, we have this misconception that if you're an elite athlete and you're burning all these calories, then you're just eating to fuel, right? But it's not. It's the

quality of the diet. If we want to perform well, whatever performance means. If you're Olympic athlete down to recreational person who just wants to

means. If you're Olympic athlete down to recreational person who just wants to accomplish a 5K, the composition of your diet is immensely important.

>> What about a Zen? Everybody seems to be on a Zen GLP1s. I prescribe it and our clinic is all pmenopause and menopause and so we always start with let's see how you do with lifestyle changes first. So we give that 3 to 6 months. When they

come back, every time they come back, we're doing another body composition ch for probably 50% of the patients lifestyle plus or minus HRT. They're

their body composition changes. They're happy. They're health, you know, they're much healthier. Everything's moving in the right direction. So now we're left

much healthier. Everything's moving in the right direction. So now we're left with the people who are doing all the things. >> This isn't the typical story of people that start a Zen, though. They see it on Instagram and then a week after I'll be at their house and I'll be like wait and they'll tell me yeah I'm on a Zen and

it's really it's usually just someone sees it online they hear it on a podcast and they're on it within a couple of days >> that access is getting easier the price is coming down and there is for any medication there are risks there are benefits and there's

ways that will promote health and with any medication you can not promote health if you give >> I mean GLP-1s can be revolutionary for certain people, a lot of people are not training for a 5K, let alone anything else. And we know if we go very simply,

>> fat cells, right? They make a different type of estrogen. They're inflammatory.

You have insulin resistance. And all of this sets you up at a deficit to say, "I want to get healthier." It for women, we'll say who have PCOS who already have a predisposition for insulin resistance. Gio, they have a harder time losing

weight because now they're also storing visceral fat. We know they get on this cycle with hormonal change. you know, being on ozimic allows them to lose weight and combat insulin resistance in a faster way than they've ever been able

to do before. And especially when it comes to fertility and you're on a timeline, that can be really revolutionary when you lose weight because that estone decreases. Many women with PCOS, if they were overweight, will start ovulating again because that suppression from the

additional estrogen is gone and their inflam inflammation markers go down, their insulin resistance decreases. So there's a subset of people who have found their life changed by them and we never want to discredit that. Many

people have had difficulty losing weight, chronic medical conditions have been able to reverse them and this has been a tool in the tool box >> because about 70% of Americans would fit in that category of chronic health

conditions, difficulty losing weight. >> So 73% right now are overweight or obese.

>> So should 73% of Americans be on GLP once >> and was higher in women.

>> Well, we always one common thing is having tools in the toolbox and being able to know when to use them, when to offer them. Just like when we have the HRT discussion, we don't want to see people, we'll say women for this

discussion, not being offered a therapeutic option or not choosing it out of fear.

>> Well, when I hear that it's going to help me lose weight >> and I've got two options. I can go out and lift all these weights, Stacy, and I can which you know, Vonda, I don't Yeah, it's hard, isn't it? Go to the gym, I have to put my shoes on or all these all these things. or I can take this injection

>> and lose all your muscle and lose your bone and end up like the little floating figure in Wall-E movie that I've talked about before, right? And that's that's my fear of just blanket people using >> you're also whether you mean to or not

giving the illusion that you know willpower is all you need to lose weight by what you said, right? I can either do these hard things or I can choose this medication which appears to be the easier way out. And two things can be true at once. People can work extremely hard. Maybe they don't understand

exactly what they should be doing and that's part of what we're trying to change the discussion on. But reversing some metabolic change even initially can make a big difference in their game plan. But you will lose body weight on

these medications. And so you have to have somebody you know guiding the ship.

these medications. And so you have to have somebody you know guiding the ship.

I think what we all don't love is the access without oversight. Meaning

nobody's helping you say how are you not losing muscle? How are you doing this in a safe fashion? You can just text somebody on an app and suddenly have the medication shipped to your house. You know in our clinic it is an hourong. Now

they're coming in to discuss the GLP1 option. It is an hourong visit >> of risks, benefits, side effects, protein intake, resistance training mandatory. We will follow your bone density. We will follow your bone mass.

mandatory. We will follow your bone density. We will follow your bone mass.

I mean, your muscle mass. You know, we have these scanners.

>> These are great available. And we're not going to get to a number on the scale and sacrifice your long-term health. And my patients are drinking the Kool-Aid.

They're coming in. They they've found, you know, they >> they're coming to you for a reason.

>> Yeah. And so, I'm a little bit unique in my clinic in that I have a social media following and people kind of watch a few things before they come see me. So, they

know my they're not shocked by me giving this advice because I give it all day on social media. So if you give them the ismpeek but they still don't go to the

social media. So if you give them the ismpeek but they still don't go to the gym, they still don't do anything else. >> Then we'll stop giving it to they won't be healthy and they know that. We've talked to them about that. We've

explained it on the front end that this is a tool in your toolkit because we can see their muscle mass. We won't renew the prescription if they've lost the muscle mass. So if you are losing weight and not lifting and eating enough

muscle mass. So if you are losing weight and not lifting and eating enough protein on ompic or any way else and you do a body composition, you may see total

weight lost. You will see pounds of muscle loss. You may see body fat

weight lost. You will see pounds of muscle loss. You may see body fat percentage loss. But if you do this correctly with enough protein in your

percentage loss. But if you do this correctly with enough protein in your diet and lifting weights, the amount of muscle loss will be very small versus

amount of fat loss. So you we know >> we are going to lose a little muscle, but you can't lose eight pounds of muscle. >> Right. >> Right. So we can tell >> and I give them the hard numbers like 10% is acceptable. We're going over

that. We're getting into the danger zone. We're going to cut back on your

that. We're getting into the danger zone. We're going to cut back on your dose. We're going to, you know, but they commit to the the work on the front end.

dose. We're going to, you know, but they commit to the the work on the front end.

>> I think that's the important point is that these GLP1 antagonists don't burn your fat. They burn they stop you eating as much. >> They stop there, say,

your fat. They burn they stop you eating as much. >> They stop there, say, >> which is going to mess which is going to reduce everything. Because I was thinking about myself. I was thinking, well, I I go to the gym every day. I'm

going to keep going. So maybe if I had a a little bit of a zanek or whatever it's called, >> then my it would burn my fat. But actually that's not it's just going to stop me eating which is going to reduce my muscle, my bone, >> right? Goodbye biceps.

>> Yeah, that's the that's the thing. It's like >> I'll lose my subscribers and help you.

>> Exactly. Exactly. >> Yeah. >> Okay, that makes sense. So to this person asking what's the best and healthiest way to lose weight, the response is stop eating the cookies and start lifting some weights. Oh, the 8020

rule, right? So 80% of the time you're on it, right? You're paying attention to

rule, right? So 80% of the time you're on it, right? You're paying attention to a high quality diet. You are eating according circadian rhythm. You are

doing the strength training. You're getting the good sleep. And then 20% is life where I'm going to stay up late. I'm going to have some wine or whiskey.

I'm going to go out. I'm going to be on vacation. So you're not excluding all the fun things in life. If it comes to a point where you're like, I'm still not budging the needle, then maybe it's a 9010 rule where 90% of the time you're

on it and 10% is the life factor. There's these hard and fast rules I've been accused of giving. I don't give rules. I give optimization ideas. So,

it's not following strict 8020 or 9010. It's what fits in your life. And if

you're really motivated on losing weight, the first thing I tell people to do is ditch alcohol.

>> Mhm. Everyone wants to lose the the part on the belly. >> Yeah, >> sure.

>> Is there not like an exercise I can do just to burn the part on the belly?

>> So visceral fat's a little bit different. It's like a whole different organ. So you know when we talk about visceral fat, it has different drivers.

organ. So you know when we talk about visceral fat, it has different drivers.

You know, we drive fat to the intraabdominal cavity. It has it creates different cytoines. Subcutaneous fat is a storage facility. It is when we

different cytoines. Subcutaneous fat is a storage facility. It is when we overeat calories, we will drive fat under the skin. And it's kind of genetically determined. Females tend to gain about their hips and thighs. Okay.

genetically determined. Females tend to gain about their hips and thighs. Okay.

And actually that hip and thigh fat is protective for cardiovascular disease in a premenopausal woman. Not in men but in women. >> And so it is the so but when that fat shifts to the intraabdominal cavity, it starts that fat is metabolically

active than the fat under our skin and it creates these pro-inflammatory cytoines. And then you end up in this negative feedback cycle of you know your

cytoines. And then you end up in this negative feedback cycle of you know your liver starts becoming dysfunctional, insulin resistance increases, that drives more fat to the visceral cavity, increases inflammation, and it just goes on and on and on.

>> So get liposuction. >> No, no, no. >> You can't lipo the viscra >> inside that fat that's really inside the abdominal cavity is what we're talking about. That visceral fat, which is the worst kind. >> Well, what about liposuction? Can't I

about. That visceral fat, which is the worst kind. >> Well, what about liposuction? Can't I

just suck it out? People are doing all kinds with their >> under the skin.

>> Under the skin, you can. That's an aesthetic decision. What was the stuff under the skin? >> Oh,

>> lipo suction it out. Is that a good idea or a bad idea? >> No, it'll come back.

>> All these things we're talking about, it sounds like a lot of instructions, and it is actually, but when you layer them on, it becomes your lifestyle. It's not

a diet. It's not an exercise program. It's just how I live, right?