Today I’m talking with Dr. Emily Passic about semaglutide, also know as Ozempic of Wegovy. I had a ton of questions and concerns about it and I’m sure you do too, so I wanted to bring on an expert who really understands how this drug should and shouldn’t be used, who it is and is not for, and can answer all our burning questions.

Dr. Emily Passic, ND, MsAy. Dr. Passic is board certified in Naturopathic Medicine and holds a Masters in Ayurvedic Science from Bastyr University and has been practicing since 2016. She works at an integrative pediatric and family practice in Kirkland, WA. She has spent time in India learning from some of the top Ayurvedic doctors and incorporates multiple modalities for treating chronic conditions. Her passions include cardiometabolic health, longevity medicine, mold and mycotoxin illness, full body detoxification, chronic infections, chronic pain and female hormones. She utilizes dietary intervention, supplement management, lifestyle modifications and peptide therapy. Please note her medical license is only in Washington state and she cannot prescribe outside the state. 

Dr. Passic owns and operates a nonprofit organization called Allow Healing Nonprofit. These consultations are virtual visits only (no in-person option). www.emilypassic.weebly.com

She also sees patients in person at Centered in Wellness, a concierge practice in Kirkland, WA. www.centeredinwellness.com

Some important notes on semaglutide: Semaglutide can be a very safe and effective tool in weight loss if done correctly. Patients should be doing appropriate detoxification as losing fat can cause toxins to circulate which can be very damaging to the body and brain. If managed properly, the benefits of semaglutide go beyond weight loss and include improved cardiac health, neuroprotection and decreased GI inflammation.  Semaglutide is not for those with low body weight, children and those with current or history of thyroid cancer or an endocrine condition called MEN(2).   

Disclaimer:

This podcast and website represents the opinions of Jeannie Oliver and her guests to the show and website. The content here should not be taken as medical advice. The content here is for informational and entertainment purposes only, and because you are unique, please consult your healthcare professional with any medical questions.

This website or podcast should not be used in any legal capacity whatsoever, including but not limited to establishing “standard of care” in a legal sense or as a basis for expert witness testimony.  No guarantee is given regarding the accuracy of any statements or opinions made on the podcast or website.

In no way does listening, reading, emailing or interacting on social media with our content establish a doctor-patient relationship.

Privacy is of utmost importance to us. All people, places, and scenarios mentioned in the podcast have been changed to protect patient/client confidentiality.

Views and opinions expressed in this podcast are our own and do not represent that of our employers. While we make every effort to ensure that the information we are sharing is accurate, we welcome any comments, suggestions, or correction of errors.

Interested in working with Jeannie? Schedule a 30-minute Coffee Talk here.

Connect with me on Instagram @joliverwellness and check out the options for my more affordable self-study programs here: https://www.joliverwellness.com/diy-programs

Music credit: Funk’d Up by Reaktor Productions

A Podcast Launch Bestie production

Hey there.

Welcome to the Nutrition Edit podcast.

I'm your host, Jeanie Oliver, and today we're gonna be talking about semaglutide,

otherwise known as Ozempic or wavy.

This is a really buzzy drug out there right now, and I had a ton

of questions and concerns about it, and I'm sure you probably do too.

So I wanted to bring on an expert, somebody who really understands

how this should and shouldn't be used, who it is and is not for.

And can really answer all of these questions for us.

So today my guest is the brilliant Dr.

Emily Paek.

Dr.

Paek is board certified in naturopathic medicine and holds a master's in

Ayurvedic science from Basi University.

She has been practicing since 2016 and she works at an integrative pediatric and

family practice in Kirkland, Washington.

Dr.

Pasek incorporates multiple modalities for treating chronic conditions, and she

has spent time in India learning from some of the top Ayurvedic doctors there.

Her passions and focuses include cardiometabolic health, longevity

medicine, mold and mycotoxin illness, full body detoxification, chronic infections,

chronic pain, and female hormones.

She also utilizes dietary intervention, supplement management, lifestyle

modifications, and peptide therapy, which is where Semaglutide falls.

So I am really excited for you to hear this interview with Dr.

Pasek.

Just keep in mind that you should never take medical advice from

this podcast or any other, and always refer to your own licensed

practitioner with any health concerns.

All right.

On that note, without further ado, let's jump into the episode with Dr.

Emily Paek.

Hey, so welcome back to the Nutrition Edit everybody.

I'm your host, Jeannie Oliver, and my guest today is Dr.

Emily Paek.

Emily, welcome to the show.

Thanks, Jeannie.

I'm so happy to have you here.

Yeah, I'm excited to be here.

Yeah.

So, full disclosure, Emily is a close friend of mine, has been for years and

is just an amazing, brilliant woman.

I may be slightly biased, but it's just, it's true, it's true.

Bias aside, tell us a little bit about your background, because you have,

gosh, background nutrition, you've got fitness, you've been a doctor for how

many years now have you been practicing?

Um, I graduated in 2016.

Okay.

Yeah.

and have always, Been in health and wellness.

I mean, aside from my bachelor's in business, I quickly realized

the business world was not for me.

I was losing years off my life in business.

so about 20 years ago I went to nutrition school and I was

also a fitness instructor.

So I was doing fitness, you know, 20 years ago or whatever, and, got my clinical

nutrition certificate and then, went to teach on cruise ships and do all that.

So, you know, that's what got me really fueled in, the way that people look at

the body from all over the world really, because the people that work on ships and

come on ships are from all over the world.

And so I, I was outta my bubble, right?

Mm-hmm.

So we all, we're all kind of in our bubble and I was living in San Diego

before that, which is a true bubble.

Yes.

And so, on ships, it was interesting because I was a fitness instructor,

but I was giving classes on health and detox, and that's what kind of got me

interested in environmental medicine.

Yeah.

And I, there was a naturopathic physician on my ship too.

Uh, she was a body worker.

so after ships I went to massage school.

And so what I found was, was that I was trying to come at healing and

wellness from every angle I could.

It was like fitness and massage and nutrition.

And that's when I realized like, I really need to go to medical

school and fill in a lot of gaps here and, and take biochemistry

and learn anatomy at, to its core.

so that's kind of my background and how it all came together and my focus was,

has really always been environmental medicine and, um, just overall health.

Yeah.

And I always mentioned that I've had my own health adventures and

you only, you don't have to share about that if you don't want to.

Um, but I know that you have as well, so, yeah.

You know.

Absolutely.

And I think that that has made me a better doctor.

and for all the doctors I know that have gone really deep into certain

areas, even big doctors that, run the longevity world have their own story.

And so for me, mine was, was just some serious chronic illness with no diagnosis.

Mm-hmm.

And it's a really lonely place to be when you are very ill and you don't

have a diagnosis that fits in a box, it doesn't have a, a code that the

insurance company likes, and there's no specialist that knows what you

have there was a point where I had.

10 or 11 or 12 doctors, and nobody knew what was wrong with me.

And so that's where I started just searching and digging and treating myself.

and that's how I got interested in all this because I had to do every diet

known to man it seems like, and take out every food and add every nutrient

and do all these different supplements.

And I did all the weirdest things that you can imagine.

And I finally got better.

But, I did look into what seemed like every corner of health trying

to figure out what was wrong with me.

And so, that has helped me a lot because I have patients come in who

are in that same boat and, and they feel alone because nobody really knows

what's wrong and their doctors are not spending enough time with them.

naturopathic doctors.

Yes.

Functional medicine doctors, yes.

But, these are the people that, You know, Western medicine fails them.

Yeah.

And I've had so many, I mean, myself included, I've had so many clients who

have been told it's all in their head.

Mm-hmm.

It's all psychosomatic, um, at worse.

Mm-hmm.

Where they've been just dismissed.

Mm-hmm.

Oh yeah, I got that diagnosis too.

I was given antidepressant and, you know, a lot of people get put in

the fibromyalgia box or whatever it is, and it's really unfair.

And, and no one's really listening to them until they find a doctor who will sit down

and take a, a really complete history.

And the history is generally gonna give you the answer.

You know, there's a lot of tests out there too.

But, but honestly, you go back to the beginning of medicine, when, when they

started learning the review of systems and the physical exam, the answer was,

was in what the patient's telling you.

Right.

And that can take some time.

Right.

And I think most doctors in mainstream medical, they're, you

know, I, I mention this often that I feel their hands are tied.

They can have the best of intentions, but when you have 15 minutes or eight

minutes to see a patient, what can you do?

You know, it's, they're so limited.

and it, system fills them as well.

Mm-hmm.

So, yeah, that's one of the cool aspects that I wanna get into when we talk today.

And I'm so excited to talk to you about this because obviously it's

a really hot topic right now and, everyone is touting ozempic as this

miracle drug, and so people are getting it in, possibly dubious ways.

And I think that this is really gonna be an interesting talk because things

can be helpful, harmful, or neutral, I think, depending on how they are used.

Who is managing your care, if anyone.

how things are prescribed, what you're doing in your lifestyles, you

know, outside of just popping a pill or taking an injection every day.

So I'm looking forward to getting into that with you.

And I know people have a lot of questions and misconceptions about

this, as did I, and it was really enlightening to talk to you some more.

So let's dive into this and talk about Semaglutide or

what is also known as Ozempic.

and you can go ahead and, and take the reins on this.

I think there are a couple other names for it as well, is that correct?

There is also Wego V and Resus and, okay.

And then Semaglutide is part of TIR Peptide.

So for, for all intensive podcast purposes, we can just.

Reel it all in and say Ozempic.

Okay.

Or semaglutide, although I will say the difference in how I'm using it.

Yeah.

I'm really curious to hear about that.

So tell us a little bit about what it is and you know, what it was designed

for and why it's the hot new thing now.

Yeah, so it's a GLP one agonist and basically what this does in a nutshell

is it improves your insulin sensitivity.

And the thing that we focus on a lot is in, in our type of medicine, in

naturopathic medicine, functional medicine is insulin resistance.

Because insulin resistance is the precursor to diabetes.

So even if someone doesn't have diabetes or even pre-diabetes,

but they have insulin resistance, that is a pretty bad marker.

And you can run this in a basic blood panel.

Yeah.

Insulin resistance is going to increase aging and most all chronic disease.

And so that's why this is, this is a preventative medicine step.

And so as this GLP one agonist, it sensitizes your cell to glucose basically.

So the way that we, the way that we talk to patients about this is, over

the course of your life, you will be exposed to more toxins, have more

inflammation, take lots of antibiotics, create a lot of this, inflammation,

and that will cause this insulin insensitivity or insulin resistance.

And so basically what that looks like is your body constantly

pumping out more insulin.

And so you have this glucose in your blood and the glucose

wants to get into the cells.

And so we think about this cell and you've got the insulin, which

is allowing the glucose to go into the cell to be used for energy.

If, Those insulin receptors become resistant, that sugar

and that glucose cannot get into the cell and be used for energy.

And that's what creates elevated blood glucose, which we all

know is just circulating around.

So they're just knocking on the door and then your body's

pumping out more and more insulin.

And so now you've got elevated insulin.

Elevated blood glucose, and no energy.

Yep.

So this sensitizes your insulin receptors so that that glucose

can get into the cell and be used.

And so it decreases.

That insulin resistance, and this is what I'm measuring on a lab.

I say, how much insulin re resistance do you have?

And it's like a number, is it 29?

Is it 50 or is it way up there?

And it's 60 or 70.

okay, when you say the labs to, um, are you looking at fasting insulin, C-peptide?

No.

No.

What do you look at?

It's actually called insulin resistance.

It's an, it's an IR score.

Okay.

And so it's on, it's on an extended lipid panel.

Okay.

So lipid panel's, like a cholesterol panel.

But the last thing on this, this N M R panel it's called, is an, IR score,

which is insulin resistance score.

So it's just one number.

I of course also draw, a fasting blood glucose, a fasting insulin, and an a1c.

And if I am afraid they have diabetes, I draw a C peptide.

Okay.

makes sense.

Thanks for clarifying that.

Yeah, it does.

Absolutely.

So this insulin resistance, and just to clarify for people too, when you say,

Hey, you have no energy, you know, we need to get this glucose actually into the

cells so that we can use it for energy.

We're talking about mitochondrial function there, correct?

Yeah.

Right?

Mm-hmm.

Yeah.

Speaking to that, just a little more, the mitochondrial dysfunction.

Well, yeah.

I mean just, just their job for, you know, in the cell of converting

that, that glucose into a tp.

Right.

Which is our energy for everything.

We do it.

It goes into a t p and, and actually what I wanna highlight is that the place that

uses a lot of that glucose is your brain.

Yes.

And so, kind of important, this, this is really important, but also,

one of the things about semaglutide, which, you know, we can, we can sort

of get into, is neurologic function.

And the thing that I, that I see with Semaglutide, in the future of

Semaglutide, which, you know, if you kind of wanna talk about where it came

from, my understanding was that it was originally studied as an Alzheimer's drug.

And it's not, it's not an Alzheimer's drug now, but it is in clinical

trials in phase three clinical trials.

which is really easy to look up on clinical trials.gov.

So it's, it is absolutely being used because we know that Alzheimer's

is called type three DI diabetes.

Yep.

So we have this insulin resistance specifically in the brain.

The brain uses a ton of glucose for energy and there's no access to it

because we're insulin resistant.

Yeah.

So that will be a conversation for 2026 when those trials are done,

because this is years of, trials with semaglutide for Alzheimer's.

but that's currently where it's being tested.

So what I think is interesting is that, you know, everyone's using ozempic

semaglutide for weight loss, but they're actually doing this dramatic benefit to

the rest of their body, cardiovascular system, their brain, um, even just

utilizing glucose in their muscles, their liver, because it's used everywhere.

so the fact that, um, fatigue is one of the most common complaints

in every single doctor's office.

Office.

We have to have my office too.

Insulin resistance.

Yeah.

It's one of the top three complaints.

So, this is imperative that we're checking for insulin resistance when,

when anyone complains of fatigue.

Yeah.

And I'd love to point out too that.

as we talk through this obviously semaglutide, Ozempic

is not right for everybody.

We'll get into who it's right for, who it is not.

But assuming you're someone who it is not right for, or maybe you don't have a,

you know, a lot of excess fat you wanna lose, you don't wanna spend money on

something like this, whatever it may be.

You can address insulin resistance with diet and movement alone.

You do not need a drug to do it.

You know, that's something that I am constantly focusing on with people is

one of the first things that I address is, let's get your blood sugar regulated.

Let's help you move away from any insulin resistance, gets your

cells more insulin sensitive.

We can do that through moving our muscles.

Yeah.

Moving our muscles and eating all leg glycemic diet so that our blood glucose

isn't spiking all over the place and constantly elevating that, insulin.

So, tell us about that.

Tell us who.

At least in the setting of where you're using this in, in your practice, who are

the people who are the best candidates for this, and who are people who maybe

this would not be appropriate for?

it's a broad question because people come to me wanting to

lose weight sometimes, right?

Sure.

So there are some people that actually want it, that ask for it,

because now everybody knows about it.

If you've watched the news for five seconds.

and there's people that I actually recommend it to because I'm looking

at their labs and what I say in my office is you're looking in the

mirror and I'm looking at your labs.

So we have maybe two different agendas, but, we meet in this place

where I wanna do what's most safe for the patient, which means, you know,

people who are underweight, it's not really, they're not a candidate, right?

if they're clinically underweight, but if they wanna lose weight, I

will draw all the labs before I even consider semaglutide, just to make

sure that those markers are all good.

Like it's healthy for them to actually lose more fat.

there are people who have cardiovascular disease, this would be appropriate

for them because it is so healthy for your cardiovascular system.

insulin resistance affects your heart and your vessels.

And so even if that's the main consideration for that person, I'm

going to recommend it for them.

Provided it's safe for them to lose weight, right?

Sure.

So every single person's situation is different.

in the wake of a global pandemic, It is shocking how much anxiety, depression,

and suicidality are out there.

And yeah, maybe they just wanna lose 15 pounds because it is just

another level of depression for them.

Mm-hmm.

And I support that.

I fully support that because maybe they've been trying to lose weight.

I mean, Jeanie, I'm sure that you've seen people where they're doing

all the right things and they just are at a standstill with weight.

Yes.

And I wanna help them get over that hump.

And if it means one year on semaglutide and they've finally broken that

barrier and lost that 10 or 15 pounds or whatever it is, I will teach

them in that year, okay, this is how we're gonna change your lifestyle.

But maybe they were just too depressed to even get there before.

Sure.

I understand that.

So we do a lot of education when it comes to.

Starting it and being on it because their dietary habits are gonna change.

their emotional patterns around eating is gonna change because Yeah.

I wanna dive into that a little deeper too, so, yeah.

Right.

Keep that in your back pocket.

Yeah.

Yeah.

Yeah.

So, one of the things that I really want to highlight in terms of who's a

candidate is, people with a lot of toxins.

Mm-hmm.

And we can save the whole detox conversation, like the

in-depth one for another day.

But I never talk about semaglutide without talking about detox, because Yeah.

Of the extraordinary, uh, damage it could do if you start bursting a bunch

of fat cells and your toxins run rampant.

And I'm so glad that you are bringing this up because even if somebody is

like, Hey, I wanna go on a ke ketogenic diet, I always encourage or support them

through detoxification prior to that.

So tell us why that's so important.

That is amazing.

And thank you for that, because not enough people are doing it.

it's easy to do certain things with weight loss, and that's the

thing about semaglutide in Ozempic is it's, it's relatively easy.

You have to give yourself a shot once a week.

So maybe that's hard for some people, but that's relatively easy.

A detox is hard.

Yeah.

Um, if you're doing it right.

And so the thing is, our body's really smart and it stores toxins

in fat cells to protect our brain.

So a lot of toxins can cross the blood brain barrier, including heavy metals.

In metals or we're talking mercury, cadmium lead.

Yeah, mercury lead, cadmium.

Aluminum.

Yeah.

Aluminum.

Yep.

and so your body stores these toxins in fat cells and so it, it, it's, your body's

doing the best thing it can at that time.

And so before we embark on a weight loss program, and we know

that semaglutide can be really effective for losing a lot of weight.

Uh, if you do it right, it's not excessive weight loss.

So we can talk about dosing, but, what's happening is that your body's

gonna start, you know, bursting fat cells, toxins are gonna come out.

So what I do for everyone is I make sure that they are a good candidate.

Meaning when's the last time they did a detox with me?

Mm-hmm.

Because, a lot of patients, because I have, I have two practices, but

one of them is a concierge practice.

We are in person.

I see patients four days a week in a clinic.

I have a telemedicine practice where I see patients remotely.

So the people I see in person, most of them I've done a detox with, especially

if they came to me wanting to lose weight.

I said the first thing we're gonna do is detox.

And it's still what I say.

The first thing we're gonna do is detox.

Yeah.

And, and now that semaglutide is, is, uh, we can then add that on,

but not until the detox is done.

And so I first draw labs, extensive labs, and then we do, the toxin solution.

So it's a really specific detox.

It does the gut, the liver, the kidneys, and then if you

want an extra like ninth week.

So it's essentially an eight week detox.

so we wanna make sure everything is moving because the last thing you

want is for someone to start, bursting fat cells and exploding toxins out

through their body when their liver isn't functioning appropriately.

Right?

Uh, or they have the wrong mix of bacteria in their gut.

Mm, because endotoxins are a really big thing.

Endotoxins are basically when you've got, a bunch of toxins in your body

from a lifetime of toxic exposure or just living on the planet really.

Yeah.

You're living on the planet.

Just life on earth.

Yeah.

Let's be real.

So, um, especially in America.

Right?

Exactly.

So, so we do this detox and usually people lose 10 to 20 pounds on the detox.

And I've done this for years.

I mean, I dunno, the whole time I've been in practice.

So, the toxin solution was written by Joe pno, he's the founder of BA Year.

So like left pno, I find no other.

Detox that compares to this.

And so, so I walk them through that and I meet with them every week that

they're on it to make sure that they are feeling good, or if they're feeling

bad, it's the right kind of symptoms.

It's like, Hey, your liver is working really hard on detox right now.

And, um, yes, I know that detox is a very heavy word and there are

people that say like, detox doesn't exist, but I, I am not on that.

page detox does exist and we have Yeah.

So many toxins we need to actually help your detox organs function better.

and so this is why the detox aspect is important.

We've seen people have some pretty bad symptoms of rapid weight loss, not

through semaglutide, but other things.

and they've had some pretty bad neurologic symptoms.

Oh, I've seen that so often.

Especially when I was working in a clinical setting.

And I do have a, a client who recently, Did a trial, I think it was before we

were working together of the ozempic without doing any of that beforehand.

and I had a really bad experience with it just felt rotten immediately.

And so, you know, I think that this is another really important piece

that, look, this is not something that you just take on a whim.

This is something that you need to prepare your body for.

It needs to be administered in an appropriate, you know, caregiving

setting with the right practitioner who really knows what's going on.

And.

How to prepare your body for it.

And I think that detox has become such a dirty word because people

don't really understand it.

They think of, oh, just a master cleanse, or, you know, something that's just some

ridiculous calorie restricted crash diet.

It's not actually detoxification at all.

Right.

And so it's given it a bad name.

Right.

And people will be so much more successful on semaglutide once they've actually

detoxed because now their body will feel safe to let go of those toxins.

Yes.

And move through the appropriate channels.

Right.

Move through the gut, the liver, the kidneys, I mean,

let's not forget the skin.

Right.

The largest detox organ.

Yes.

Yeah.

It's one thing to mobilize toxins out of our fat cells.

It's Right.

A completely different thing to get them out of the body.

Right.

I talk about this all the time.

Like, you gotta pull 'em out and you gotta get them out.

Then that's step one, step two, That is absolutely so important

so that people don't feel bad.

And I think that that is the reason people are feeling.

So there's a couple pe a couple reasons people are feeling so bad.

And when I say people, I'm, I'm not talking my people like mm-hmm.

People who go and get ozempic from a group home.

Did you know that you can get it on a group and you can never see a doctor

and, buy it, and no one's following you.

And, and no one's looking at any labs Blows my mind.

And, and certainly not talking about any of this.

So, that is why I think it's out there that the side effects can

be so bad because for one, people are just, they're titrating up too

quickly and nobody's following them.

Meaning increasing the dose.

Right.

Actually, you shouldn't be nauseous every single day for weeks.

Right.

Or you shouldn't be constipated, not even for one day.

Yeah.

Yeah.

And that is, you know, then you're just re recirculating these toxics.

Oh God.

I know.

Constipation is the last thing that you want when you're releasing toxins.

Right, exactly.

And so you need to have the right tools.

And I say to my patients, like, tell me right away if you're constipated.

I mean, text me on the weekend and tell me, because I wanna get on this.

And so I give them the tools to make sure that doesn't happen.

And to make sure that their bowels are moving appropriately before we even start.

Like, I will not start them on semaglutide if they're constipated from the beginning.

Yeah.

Cause that's not, they're gonna feel terrible.

Yeah.

It's not gonna be good for them.

They're also gonna feel bad.

And so I think with the right dietary counseling people won't feel as

bad, including not eating too much.

so this is where this part of this, emotional eating

happened, you know, like this.

Yeah.

Do you wanna talk about that?

Well, you know, one of the questions that I had for you before we started

this, and we were talking about doing the episode together, was because what

I had heard from multiple sources, And you mentioned you've been using

this in your clinic for three years.

For most people this is this brand new thing that's only been, you know, a matter

of months on our radar on the market.

But one thing that I had heard was, well, it only works while

you're taking it not beyond.

And when you stop taking it, you'll gain all the weight back and then some,

you're losing muscle mass during it.

And the only mechanism by which it works is basically appetite suppression,

which obviously that's not the case as you're explaining, like, no,

there's all these other benefits with insulin sensitivity and cardiovascular

benefits and things like this.

and then my other question about that was, So this is kind of a two-parter

and, and we'll come back to that as far as, you know, long-term management

of this, how people can move off of it if they don't wanna take it forever.

All of those things.

But another one of my main concerns, first of all, it, it's the loss

of lean muscle mass, right?

Anytime that we go on a severely calorie restricted diet, your body

wants to metabolize or burn muscle because it's an easier thing to burn

often than fat is, especially if you are insulin resistant and you

don't have that flexible metabolism where your body can easily burn fat.

And when we lose lean muscle mass, we're very effectively slowing

down our metabolism, right?

And it's just terrible for us in, in a multitude of ways, and especially for,

you know, women, we lose muscle mass as we get older at a much more rapid rate.

It's harder to build back.

We don't want that.

So that was one of my main concerns.

So I want you to speak into that.

And then the emotional eating piece is huge too, because from

my perspective, I never want to see people go for the bandaid.

You know, often the people that I work with, they have been using the

bandaid approach their whole lives for decades, treating essentially

the symptoms of excess weight.

Those are symptoms of trauma response, emotional eating, addiction as a result

of trauma and emotional eating, right?

So, you know, in my mind I'm thinking, well, this isn't

addressing any of those root causes.

If we're gonna go upstream and really look at the root causes of

why is this person carrying excess weight, or eating emotionally, et

cetera, where is that coming from?

People don't just sit down and, and bingey because it's, you know, they

feel like it one day out of nowhere.

Like there's always something deeper going on there that's driving that mechanism.

And so yeah, in whatever order you wanna address those things, go for it.

So, so it actually does stop cravings because it works on the

dopamine system of the brain.

And so this is the reward system.

And food is absolutely a really common addiction.

And pick, pick your food.

You know, like for some it's, you know, fried food and some it's alcohol and

some it's sugar and some it's chocolate.

And you know, because I've been using Semaglutide for three years

and it was, we used Liraglutide before there was Semaglutide.

So even before Semaglutide we were using a different peptide

similar to it did the same things.

I have seen so many different things and no two people are the same.

That's what I'm Right.

Of course, I can tell you for sure that no two people are the

same that do semaglutide, saga yesterday and, I said, you know,

how about how's your alcohol intake?

Because I also, I saw his liver enzymes go down, which I will say

in, um, maybe a hundred percent of people liver enzymes go down.

And so that's great.

improved.

Liver function is always good.

That's, that's incredible.

because, yeah, their liver's just not having to work as hard.

Mm-hmm.

And, and I'm counseling them on what to eat and we're, you know, of course like

you were always talking about organic and, and you know, grass fed and everything.

And so they've improved their diet.

as a baseline, but, I ask about cravings and everyone tells me their

cravings are, they're like, I just don't feel like drinking anymore.

Like, in the beginning it didn't make me feel good.

And I'm like, well, it's cuz I told you not to drink in the beginning.

Like, you're really not supposed to have alcohol when you're titrating up because

it is such a quick source of sugar.

And so it makes people feel really bad.

Mm.

And they don't wanna do that again.

You know, like, it's like a, it's like a bad night of drinking in college,

and you're like, oh, shame on you.

Right?

And so you just, you, you kind of learn that it doesn't make you feel good.

And so this is the same thing.

So whether it's sugar, whether it's fried foods or chocolate, they realize

it actually doesn't make me feel good.

And that if that was their coping mechanism, they need to

find another coping mechanism.

Yeah.

And now it, it frees them up to do that because they're not hitting that

dopamine button anymore, at least while they're, where they're on it.

And people are generally gonna be on it for long enough to learn

other coping mechanisms and learn.

That they don't need those foods and for some it's, binge eating.

And so you can't binge eat on semaglutide.

You just can't.

Right.

You're, you're not hungry.

So it does slow your gastric emptying.

which is why for some people, if they're prone to constipation, that's

the first thing that we talk about.

So it's slows your gastric emptying, you feel full longer.

This is part of why people get reflux.

They eat too much, so I counsel them too.

Mm.

Mm-hmm.

Start with half, like, eat half of what you normally eat.

Wait 20 minutes and see if you're still hungry, because you will

feel bad if you eat too much.

Yeah.

Not indication that came in and said, you know, for three weeks in a row,

I just had to finish that last bite.

And I threw up.

Oh, wow.

And the next week it happened again.

I just had to finish the last bite and I told myself I probably shouldn't, and I'm

not hungry, but I'm so conditioned Yes.

To clean the plate or, yeah.

God, that's so common.

Well, she did it for three weeks in a row, and then she said, I, I'm finally

ready to tell myself I don't need to eat the last bite, because Yeah.

That's not fun to eat too much.

So for her, this is a lifetime of clean your plates, you know, and, and,

and hearing that so damaging voice.

Mm-hmm.

And I think that this is a really interesting aspect to me because one

thing that I've always encouraged my clients to do is to, what I call,

create new rituals, create new sources of self-soothing, comfort, pleasure

in your life that don't have to do with food or alcohol because mm-hmm.

Look, our brains are hardwired to find pleasure in food so that we

will keep eating and stay alive.

There's, you know, we, we talk about food addiction, I think.

I wanna clarify that a little bit because, you know, if I refer to food

addiction, I'm talking about using food in a way that is detrimental.

As humans, we are like, of course we have to eat, we are eaters,

like this is part of being a human.

We are naturally drawn to food.

It is emotional, it should be pleasurable, it should be

social, and all of these things.

I mean, there's so many aspects to it, right?

And so there's nothing wrong with that.

But when it becomes something that we are using in a way that is harmful

to our health or to us emotionally, that's when, we're tipping the skills

into like, okay, this, this isn't as healthy relationship, it could be.

And I think that this is really interesting because it can be really

hard for people to voluntarily remove that source of pleasure and

self-soothing, but because this, in this situation, They're not getting

the effect of it, like you say.

Mm-hmm.

it almost forces them to be like, oh, here are these emotions, you

know, here's what's going on.

Because I know for me, I used to just not want to experience

the unpleasant emotions.

So what do we do?

We anesthetize with whatever it's Yeah.

And if we can't do that, we have to face that on some level and find out a

another way, hopefully a healthier way.

Right.

And there is deal with it.

This now global pandemic of loneliness.

Yes.

and this has just like, this research was published last

week or something like mm-hmm.

After the pandemic.

And, and this is where it's like people's alcohol consumption just

went through the roof and then Yeah.

And then all of this, anxiety and depression and now the loneliness factor.

And so feeding that with.

Food, alcohol, what have you, is, is just a downward spiral.

And I think that this helps people come out of that a little bit,

whether it's semaglutide or some, some other kind of whatever you

are doing in your practice, right?

Like with counseling on the whole people are, are all one being, you know, yeah.

This mind body, this, this one person.

And so, that has to be part of the conversation, which is why

buying some glut tide on Groupon is not going to help you, right.

Address the root cause.

It's just not Right.

Right.

Yeah.

And so let's talk a little bit about the food piece of this, because you know, I

always encourage people, and I know you do too, because we have such a holistic

approach in, in our practices, it's not just about food, it's not just about

getting treatment or a prescription, like we should be addressing mental health.

and seeing the appropriate.

Professionals are getting the support where we need it.

so, you know, I would definitely encourage you if you're listening

and you're someone that struggles with depression or anxiety, get that

support for your mental health as well.

Whether you are or not taking something like this, like I think that that's

an important layer to include.

so that said, moving on from there, let's talk about the nutrition piece a little

bit because again, like one of my concerns with this was loss of, lean muscle mass.

So how can people prevent that and, what are ways that they can

make sure that they're eating an appropriate amount of not just

calories, but getting that nutrient density that they need in their food.

How do you address that?

Yeah.

So my example back to, if you're gonna eat some chips on the way home from work,

you're gonna be too full for dinner.

Like have a half an avocado.

That's, you know, if, if, if I had to choose, pick your nutrient dense food

because you actually might be surprised in how not hungry you are for the next meal.

So nutrient density is something that, you know, because I'm a naturopathic doctor,

I've already talked about nutrition with all the patients, and so this is,

it's not news to them that we're talking about nutrition and like you and like

most nds we're, we are focusing on, you know, organics, non gmo, grass fed,

things like that and not eating foods that you're allergic to or sensitive to.

So, right.

Um, so that's, that's kind of a base, that's sort of the, the

low-hanging fruit in terms of health.

And so that, Is, I'm generally just reminding most of my patients about that.

But if a patient is new to me that I have to start from the beginning, right?

With, here's what to eat, what not to eat for you if you wanna feel good.

And so that, that takes some digging sometimes in terms of how they

feel in terms, what they're eating.

So, sometimes I send people to you for that.

So, I do think that not losing muscle, that's a really tough question because

it depends on how much semaglutide someone's gonna take and for how long

and how much weight they have to lose.

And I have to, I, I have to, I have to be the doctor in the room.

So if this person is on the brink of a heart attack, yeah.

I will choose losing weight first and building the muscle later if

I had to choose one or the other.

Sure.

Yeah.

Like, and, and there, there are patients where their cardiovascular.

Risk factors are very high and they're not gonna lose weight rapidly in

a dangerous way because if I have them on the right dose, they're

gonna lose one to two pounds a week.

Yeah.

That's a really healthy range.

Monitor that.

Mm-hmm.

We're always monitoring that we're taking their weight every time or when they call

in or they need another prescription.

We we're always getting the weight and we have a body fat scale

that tells us our lean muscle.

Nice.

what I think I'm gonna start doing, and I'm not doing right now because I

just saw this patient yesterday, who has one of those scales at home that

measures, you know, the biometrics.

Yeah.

And if you have a recommendation on that, Jeanie, I'd love to hear it.

I just, because I can look at this guy's, his metrics from, from every day and

like trends, it'll show me the trends.

Whereas if, if I take it in the office every so often, it's not as good as if I

have all of his data on his phone from, you know, where his muscle mass is at

his, Visceral fat, things like that.

and to answer that really quick before we keep going, I don't have a

particular device that I recommend.

What I typically do with my clients is I have them go and ac get an actual DEXA

scan or body spec, some sort of scan that's gonna give them a really detailed,

accurate body composition assessment.

And then they can invest in one of the at-home product scales to kind

of monitor it from there on out.

And then maybe they go back for the more expensive, full-blown scan, you

know, every six months or once a year, or, you know, possibly even quarterly,

depending on what their goals are.

But when they can get that really accurate baseline, they're able to

kind of determine what's the percentage of, Error here, or what's the accuracy

difference between this and my home scale?

Cause if they can do that within a matter of days, they kind of know, oh, hey, if

this told me I'm, you know, 35% body fat, and I get home and it says I'm 32, I know

that there's about a 3% margin of error.

And then they can go from there and kind of track that daily.

So that's typically what I do on that.

But I do think that those scales can be a really helpful ongoing tool.

Yeah.

that's great.

and I'm actually curious, so what kind of scan do you send

them for, aside from a dexa.

Oh, there's another, it's still a dexascan, but it's called Body Spec.

So it kind of just depends the area that you're in and which, you

know, which company is doing it.

Um, okay.

Yeah, I've heard of that.

Um, shout out to Dexa Fit Seattle cuz I love those guys.

They do a great job, but yeah.

Okay.

No, that's great because I have a coworker who, who sends people for

that, and I only just heard about it this week, so actually I'm new to that.

we are just using a tanita scale in the office.

Yeah.

And I don't know how accurate it is.

I mean, I, I would like to find the most accessible, you know, accurate

device that people can use on their own.

not all my patients are in the state of Washington, so I can't

always send them to a place.

So that's, you know, one thing I'm curious about, many gyms

will offer that service as well.

there's one that's commonly used.

I, I'll try to look it up and put it in the show notes.

because I do think that that's a really important part is the muscle.

and so counseling people on eating enough protein, of course, you know, solid,

healthy protein sources and because they're gonna get full quick, I mean,

I just, I wanna prioritize amino acids and, calories that are gonna be used

to benefit their body, not just wasted.

Which of course, again, is back to naturopathic medicine, natural medicine,

like don't waste your calories.

So, yeah.

Um, people figure it out pretty quickly too, I think, when

they're actually on semaglutide.

so does that answer that question?

It does.

And I think the important difference to point out there is, in our

typical sort of dieting world, we're told to just eat less.

Oh, you can still eat all the foods you love, meaning

processed, typically nutrient.

devoid or empty calorie foods, so to speak, just eat less of it.

Right.

Okay.

Well, the problem with that is that you're already not eating a particularly

nutritious diet, and now you're just reducing the calories overall.

So now you're getting even less nutrition because it there wasn't

enough nutrition in the first place.

So, I don't care what you're doing anytime that you're trying to lose

body fat, gain lean muscle, you need to increase your protein.

You need to make sure that what you're eating is actually feeding your body and

giving you the nutrients that you need.

But if you're gonna have a reduced calorie intake, it's even more crucial that

you're not eating empty calorie foods.

Right, exactly.

And luckily, they're not gonna crave it as much because it's not

gonna hit the dopamine button.

Right.

And so what I find is it's, it's sort of built in that people

don't feel as good on those foods.

the chocolate example, did you hear that one?

There was a recent person, no, that was eats chocolate every day and

was nauseous every day for the first maybe two weeks on semaglutide.

And, you know, I thought this is weird because my patients never

stay nauseous for every single day.

Like, what is she doing?

Stop eating the chocolate.

And literally that day the nausea went away.

I mean, your body is telling you, I don't, this doesn't make me feel good.

That's so interesting.

And is it because, I mean, we all know that that chocolate like cacao

can be a, you know, it's definitely stimulates that dopamine production

and or, you know, most people think, oh, it stimulates endorphins.

That's what we hear.

You know, it's an endorphin thing.

And so is it that your body's getting kind of an overload of that so it doesn't want

more or what's causing the nausea piece?

I'm not sure I can answer that, but that is what I thought was so interesting

about this particular person is that her go-to thing is chocolate.

Yeah.

And the body just said, I actually don't want that.

And I have not had any patients in the last three, four years that have

said I couldn't eat any chocolate.

it's like there was some internal mechanism that knew

that this is the thing Mm.

That she has every single day.

And all of a sudden that reward system of the brain just didn't want it anymore.

Yeah.

And I, I can't even explain the mechanism, but what I can say is that

for each person, their vice, that is what becomes something they don't crave.

Yeah.

That's fascinating.

Feel good.

So that, that I found was interesting because.

We all have a vice.

Yes, yes, that's true.

Definitely.

And I would, I would count chocolate as, although I don't know, chocolate for

me is what I call a preemptive cheat.

I can have really high cacao dark chocolate, which is

relatively low sugar, you know?

Yeah.

Comparatively to milk chocolate or something like that.

and have a few pieces of it.

And that just does the trick for me and it actually prevents

me from wanting to go Yeah.

Eat something that I might be tempted to go overboard with.

You know, it's definitely not something where I'm like, oh my God, I can't, I

can't wait to have my chocolate right now and I have to have lots of it.

Right.

That might be very different.

Yeah.

So, yeah.

But that's a really interesting aspect of that's fascinating.

so, you know, you mentioned like nausea.

If people are eating these things that aren't necessarily ideal, are there any

other limitations or side effects to semaglutide that we should know about?

So when we're talking about the limitations, let's talk about the

difference between semaglutide, which I'm talking about compounded semaglutide.

So I use a compounded medicine and I can adjust the dose however I want.

And I talk to my patients in terms of units, not in milligrams,

because it's too confusing because they're, it's too similar.

Once you look at an insulin syringe mm-hmm.

They're like, am I talking milligrams?

And, and it's, it's too confusing.

So I speak to them in units, but they're dosing themselves at home.

and I can start with the tiniest dose.

Like it's literally like the tiniest amount of medicine.

If they get nauseous on that first tiny dose, I might pull it back a little bit.

And when you're dosing with one of these dosing pens, something that's, you know,

covered by insurance or not covered by insurance, but you're getting ozempic,

it's set as a certain milligram, right?

So you get a, 0.25 milligram pen or a 0.5 milligram pen.

The limitation is that that's where we're running into

shortages, like drug shortages.

And so for people who still want their ozempic, but they're out of

a certain, like the manufacturers out for that time being mm-hmm.

They'll just skip to the next highest dose.

Oh boy.

Okay.

So there's no personalization with that, right?

Right.

That is, that's a huge limitation because some people will say, well, I'm not

losing weight on 0.25 milligrams anymore.

Yeah.

So they'll, they'll maybe the 0.5 isn't available.

They'll, they'll jump up to, oh my one milligram, or, and

that could be a huge increase.

That's huge.

And I would never do that to a patient.

I had a patient do it on accident once and it was not pretty.

Mm-hmm.

I mean, we need to make sure that the, dosing is very accurate and that's

why we're checking it all the time.

My patients on semaglutide generally have my cell phone number.

Yeah.

and I wanna make sure that they're successful on it.

Meaning what I tell them is, successful semaglutide management is weight

loss at one to two pounds a week.

If you're using it for weight management.

Again, I'm not always using it for that.

Sometimes I'm using it for brain protection, for cardiovascular

disease, you know, insulin resistance outside of weight loss.

And so, right.

I say if you're using it for weight loss, effective dosing is one to two

pounds per week and no side effects.

Yeah.

And yeah, you might have a little bit of nausea.

I will prescribe them a Zofran for nausea, which they usually take one

little tablet and the nausea's gone.

So, you know, maybe when they dose again next week, it might come back for a half a

day and it takes Zofran and it goes away.

So I feel like that's pretty benign.

I, I certainly don't wanna be, you know, a naturopath who prescribes a drug

and then gives another drug for that.

But when, what I do see is that the overall benefit to decreasing your

insulin resistance, like for a better, cause we're doing something so healthy

for your body that we're only using that sort of, take a drug for another

drug only while we're titrating up.

Mm-hmm.

Until they get to their therapeutic dose and they're not gonna need that anymore.

that's what I've seen.

And so that titration is a really important, like three months or so.

because those side effects can occur.

so limitations for me.

it, it's really about if something is not available, if they have

ozempic and it's not available.

So it's part of why I don't even prescribe ozempic, well, most of my

patients would not get it covered.

Let me just say that I don't even know if I have a single person in my practice with

actual type two diabetes because I turn them around when they have pre-diabetes.

Yes.

Yeah.

You're preventing that in the first place.

Right.

And for people who don't know, just to clarify, um, what compounding

means, so they're what we call compounding pharmacies, and they

can actually put together the, you know, drug or whatever it is that

you're using in a customized dose.

Is that correct?

that is accurate.

So I can get whatever dose I want in, whatever, you know, milliliters I want.

So how much of that drug do I wanna get and I can decide what the patient

gets, not the insurance company and not the Walgreens pharmacy.

Right.

So you're paying out of pocket for it, but you're actually able to

increase or decrease at a very specific personalized amount versus just

jumping up to the next whatever, twice the dose or, or whatever it may be.

Right.

And they're paying out of pocket and it's, not even close to

being the price Ozempic is.

So I, wow.

I mean, if I had to guess, I think Ozempic is 1100 a month.

Oh my God, that's wild.

Um, it used to be 1600, depending.

Okay.

Depends on which of them you're talking, you know, between Mago, bels,

Ozempic, they're somewhere around there, you know, maybe 1100, maybe 1600.

1300.

semaglutide compounded is more like 200.

So it's not, you're still paying less.

Yeah.

And you're getting everything that comes with that.

If someone, like a naturopathic or functional medicine doctor is prescribing

it, which is all the things that, that we're talking about, which is the,

watching for side effects, appropriate dosing, detox, all of these things.

Yeah.

And it's just another reminder that how something is used and the context

and the care that you're getting around it makes all the difference.

Right, right.

That's fascinating.

when we talk about people that may need to use this, first of all, if someone starts

using it, do they have to use it forever?

And if not, like how do people navigate this when you're talking about long-term

use or transitioning off of it?

Mm-hmm.

That's a, that's a really good question, and that is one of the most popular,

bashes I see on Ozempic and Semaglutide in the, in the news and Google.

so I've had only a couple patients come off of it because they lost the weight

they wanted to lose and they actually didn't wanna lose any more weight.

Mm-hmm.

And, well I guess probably more than that half, but this is, I'm talking in the

last like two months, I mean, recently.

So the people that I've worked with, we have access to a peptide,

which is called cjc Epi Morelin.

So we can, you know, talk that in another podcast.

But it's a peptide that also helps weight loss by stimulating

growth hormone, basically.

So it helps you build muscle, muscle.

So in the two patients most recently that have said, okay, I actually don't

wanna lose any more weight, but what I'm really focused on is building more muscle.

And I take cjc at Erlin, I really like it for it's an anti-aging peptide.

Um, because I'm focused more on building more muscle.

I don't actually wanna lose any weight.

so then I've switched them to C J C because they want the anti-aging effect

of peptides and, and they kind of maxed out on their semaglutide, I guess.

So, so for me, switching, not that everybody has to switch to another

peptide, but we need to do something to stimulate, and these are people

that are exercising, I mean personal trainers, what have you, like exercising

well, like really, on a very healthy level and have a great diet and mm-hmm.

And a good supplement routine, like everything.

Um, but they just want a little bit of like oomph on, on anti-aging

and, and really we do a lot of anti-aging in the clinic.

and so yeah, increasing muscle is anti-aging an absolutely, or

I should say pro, Healthy aging.

Right.

And, like you and I were saying, and when we were talking in the beginning is

that, muscle is the currency of health.

Yes, absolutely.

This is like the motto of the peptide company.

So where most of my education comes from is my boss, Dr.

Cynthia Keller, who is a triple board certified functional

medicine MD pediatrician.

and she works for Dr.

Seeds, who is sort of the head honcho of all peptides.

So if you look up Dr.

Seeds or you watch any of his videos, you'll, you'll find out that

anyone who's learned about peptides either learned directly from him

or someone who learned from him.

And the, the book he wrote is called Peptide Protocols.

So yeah, so everything that, that I know has come directly downstream from Dr.

Seeds to Dr.

Keller.

and then she teaches us in the clinic about really healthy.

Management of peptides, meaning it has to be utterly safe before

we're gonna give anybody a peptide.

Yeah.

Like that is number one.

Because as we are seeing with semaglutide, this is like unsafe

management of peptides and mm-hmm.

And drugs, frankly.

it's kind of abuse of, power.

well it's greed, right?

I mean, anytime that there's like potentially a miracle weight loss

drug, I mean, everyone's gonna be like, money, money, money.

They see the dollar signs and that's a huge driver for that, right?

Right.

Yeah, no, absolutely.

And, the way that we dose peptides is like, we do one peptide at a time.

We get really good at it.

We make sure the safety, Profile is of the utmost importance.

And, and then we see, okay, if, if we're using this on all of our patients

for, you know, whatever autoimmunity, like, let's see how it works.

And so we have in increased the number of peptides that we've used over time

by focusing on one at a time and, you know, spreading it out, all using it on

our patients and then coming back as a team and saying, here's what worked and

here's when it didn't work, and here's when it really worked and here's the

dosing that's best because mm mm-hmm.

You know, peptides are not new.

They've been around a hundred years.

I mean, insulin is a peptide.

It's been around for a hundred years.

Yeah.

So like, it's not new.

They're used in, in all over Europe.

I mean, if you have a stroke and you live in, Germany, you're gonna get

a peptide infusion in the hospital.

I mean, this is not new science at all, right?

It's we're just late to the game here in the us and.

Peptides are naturally occurring in the body.

Correct?

Absolutely.

So this is just using them therapeutically, right?

there's isolating them and using them, right?

Yeah, exactly.

There's strings of amino acids, not long enough to be a protein.

Got it.

Right.

So the Yeah, natural, I mean like made in your body.

So this is not, this is why as a naturopathic physician, I feel

like, I can still call myself a naturopath, even though this is

a description I might be writing.

There's a, you know, there's a lot of things I have to think about.

I, I want to do like nature cure medicine.

I also need to live in the current time, you know, in 2023 where

we have a lot of toxic exposure.

And you know what, 80,000 chemicals in circulation, only a couple hundred unreal

have actually been tested for safety.

Like, yep.

That's where the, the missing.

Pieces is this is the safety of all these chemicals that we're

inhaling and, you know, eating and absorbing our skin every day.

Yeah.

And I think when we bring that back to the concept of, of fat loss and

excess weight and obesity, you know, it, this is not about fat shaming.

This has to do with the fact that excess fat in itself can be inflammatory.

Absolutely.

Yeah.

Right.

So, you know, we don't want that, I mean, on the most baseline level, if

we can look at it as just adding extra stress to your joints, it's not healthy.

Like the body doesn't really want that.

Right, right.

So, doing what's healthiest for our bodies, this doesn't mean like, you're

gonna be unhealthy if you have an extra handful of pounds on, like we're talking

about, you know, more extreme cases.

so anyway, that's a whole other conversation, but I just think it's

important to point out that this is not about fat phobia at all.

No, no.

Not at all.

And like I said, I'm looking at the labs.

Exactly.

That person can decide if they want.

Yep.

If they're coming to me for weight loss, that's, that's really up to them.

I'm just trying to help them be more healthy in the most

healthy way that we can do it.

Yeah.

Which is why I don't just willy-nilly write a prescription for semaglutide.

And I have a patient I checked in with today who came to me for Semaglutide

and I said, you're not a candidate for Semaglutide until you do a detox and

I'm gonna walk you through the detox.

I'm gonna hold your hand.

I'm gonna talk to you every week about the symptoms you're having.

And, today she said, you know, I was having these really bad headaches when

I started the liver aspect of the detox.

Mm-hmm.

And I said, well, okay, we're gonna stay on the liver.

Yep.

Um, this is someone who was a former drug user and, We're staying on that

liver detox until you don't have any more symptoms, because that means

that your liver is really working hard right now to, to clean up shop.

Right.

And, um, so we're gonna go slower on the detox, but once we finish this detox,

which, you know, started at six weeks, but for her manned up being three months, then

that semaglutide is gonna go a lot better.

Yeah.

And, that's really what it's about.

Yeah.

I, I love that Emily.

I love that there's this whole different perspective on this, and I think it's

really, really crucial that people understand the differences there.

it's the same reason that if someone comes to me and I can see that they're a

totally healthy body fat percentage and they wanna lose 30 pounds or something,

like No, like if you wanna address body image issues and your relationship with

food and you know, your mindset, awesome.

You know, if you wanna really like dial in to eating healthfully and working

out in a way that, you know, promotes optimal health in your body, great.

We can talk about that.

But I'm not going to just jump in and do the weight loss piece

when, that's not necessarily where, where one needs to start.

That's not really the issue.

That's just Right, right.

A symptom of other things.

Yeah.

Yeah.

That's, that's amazing.

Yeah.

So, share any tips for people who may not have access to someone like you or care

like you, but maybe they have sort of tried everything and are really, I have

one client, for example, who has been, and obviously, you know, I am not a doctor.

I don't diagnose and treat.

I address things like lifestyle and nutrition and movement.

so I'm not in a place where I would be prescribing anything like this

or even recommending it to people.

But she definitely is someone who I would refer to you.

and she would be, I think, in the ideal candidate.

But for people who maybe don't have access to functional medicine,

naturopathic doctors, I'm using her as an example because she's seen

regular MDs, her doctors within the mainstream insurance system and they

keep trying to push this on her.

But they are not doing any of these detox protocols beforehand.

They are doing probably pretty high dosage, treatment straight out the gate.

So what would your tips be for people that are in that position?

if they don't have access to getting it and working with someone like you,

that's gonna take this more whole person, holistic approach to the treatment.

but maybe, you know, it is something that they could benefit from.

okay.

So I can't prescribe outside the state of Washington.

Right?

So I see patients in other states and I do detox, I do all kinds of things,

but I, I only have a medical license in the state of Washington, so I

can't prescribe outside of Washington.

but I see patients for detox, for weight loss, things like that.

so I'll, put them through the toxin solution detox.

So your question is a little bit opposite.

It's kind of, Well, let's just say that they can get semaglutide, but not a

functional medicine or, or a naturopathic doctor who's gonna do a detox protocol.

I would still say go out and buy the toxin solution and do it.

Yeah.

It's, it's meant for people.

It's not meant for doctors.

It is meant for the lay person, and it is a step-by-step detox.

Safe for everyone.

Yeah.

It means safe for everyone.

He wrote this book for everyone, and it's not like, take this supplement

with this brand name on it.

It is, here's the nutrients that you're gonna need for the liver

portion of this, and it is gonna be like n a c 600 milligrams,

vitamin C one gram twice a day.

So that doesn't have a name of a, a supplement company on it,

because he knows that that book, you know, in 50 years, that's gonna be

irrelevant because those supplements.

Might not be around.

So it's so that you can go and get those.

Because now we have access to, we can get anything on online now, right?

So you can, yeah.

Not that I ever want my patients to buy supplements on Amazon, but this is not it.

Right?

We're right.

But if we were talking to someone who really wanted to do a, a solid

job of like prepare for the weight loss and do the protocol, like I'm

recommending it, people can do that.

They can just buy this book and go.

Chapter by chapter, and he explains why, why are you taking

vitamin C during a liver by detox?

Why are you trying to eat more beets and sunflower seeds and leaky greens?

What do those do for the liver?

And he explains every single recommendation.

And Joe Pizzorno's focus is research-based, right?

Which is, you know, evidence-based, research-based medicine about

environmental detox, endotoxins.

You know, he talks about what is an endotoxin?

Why do people with the most insulin resistance have the most endotoxins?

Mm-hmm.

Right?

This is a huge correlation there.

So the book is written for people who know nothing about health.

I've never seen a naturopath, have never done functional medicine.

So that's my recommendation.

Yeah.

Cool.

Well, and I'll throw in a shameless self plug here too, that I do.

It's shorter.

It's only 21 days, but I do a 21 day.

My reboot, your about detox is, is following essentially

those same principles.

I would say it's even maybe a step before that.

Mm-hmm.

It's a good primer for that.

That just gets people to shift what they're eating in a way that

supports those organs of detox and helps to kind of open those, those

pathways and a really gentle way.

and, offer supplements through that as an option.

People don't have to do it, it's really just a food-based approach,

but I use pretty much his, I mean, that's kind of the protocol that I'm,

that I've built it on for the very reason that, you know, you're right.

It works, it's tried and true, it's evidence-based.

Um, so that's something that you could do too, whether it's with me or someone else

that's taking a really, nutrition-based or food-based approach from this, because

I think people may have a hard time doing some of those things if they're.

Eating a standard American diet out the gate.

So, you may approach something that's a little bit more of a

gentle shift in what you're eating.

and even just, you know, lifestyle shifts, like your stress, what

kind of exercise that you're doing.

Like, I don't let people do really heavy strenuous exercise when they're

detoxing because often it just kind of works against 'em and they can

feel really just depleted and awful.

so anyway, I just wanted throw that in there, but yeah.

being followed by someone is ideal.

Like not doing it on your own.

Yeah.

You know, so since everyone has access to you, that's amazing because you

addressed the exercise piece as well, which doesn't happen in the book.

That's mainly about supplements and food and other ways to detox, like

skin brushing and sauna hydrotherapy, massage, things like that.

So, yeah.

Yeah.

And hey, if we can do it, all of it, awesome.

Yeah.

Well that's fantastic.

So, God, you shared so much great information today.

Is there anything else?

So in addition to the detox piece before they start something like this, what about

when somebody wants to titrate down off of something or stop using it eventually?

Like let's say that they get to their goal weight and they're like,

okay, kind of done with this now.

And maybe they can't do another peptide option, but they're like,

okay, I just wanna get off of this.

I can't pay for it anymore.

Um, what would you recommend for them in that scenario?

Right.

So I usually have them titrate down, like let's say they got up to 20 units.

Mm-hmm.

I try to talking units to my patients cuz that's how we roll.

So they might go back down to 10 units.

And then they might go every other week until they're slowly off of it.

Mm-hmm.

It's really just a slow titration off.

Yeah.

Um, just gradually reducing the dose.

Yeah.

Yeah.

Right.

Because, if they do stop cold Turkey, that might not be good for them.

They might see, because we're talking brain chemistry in some of this, right.

With, with dopamine.

Like, I wanna make sure that they can maintain, their

healthy lifestyle and diet.

And so I'm gonna see them regularly during that weaning off phase.

So, um, so that's how I've recommended patients sort of come off of it.

you know, I've had patients stop cold Turkey and it wasn't, it wasn't

terrible, but, some of those people really, the people that didn't see the

benefit in semaglutide never used it.

Right.

You, you can make the best.

Treatment plan for your patient, but if they don't do it, it's not gonna work.

Right?

Yeah, exactly.

Yeah.

So, so there's people who have said, well, I have my semaglutide,

it's still in the fridge.

I haven't used it.

So yeah, those people have stopped cold Turkey, but they didn't

actually really regularly use it.

so I'm generally doing a weaning off approach.

And, I haven't not seen this big influx of weight come back mm-hmm.

On anyone.

So the, the fact that that is the big thing that they're going to

highlight on the news, you know, How long were those people on it?

And did anyone give them any dietary counseling or, you know, right.

Yeah.

Did anything actually change during the time that they were on it or are

they going back immediately to the lifestyle that they were living, the

diet they were eating previously.

one other quick thing, cause I know we're running out of time and I

wanna be respectful of your time, but one thing that we men or you

mentioned to me is the H C G diet.

And I would love for you to just tell us your opinion on that, because

that's something that I just, it just made my skin crawl when it was like

the big thing and a lot of doctors were pushing it, even naturopaths.

And I just, it never sat well with me.

And I'd love to hear your take on that kind of, in a comparison,

lens to what we're talking about now with the semaglutide.

Yeah.

And I wanna be clear, I definitely don't recommend H C G at all and, never have

and never really quite understood why my people were prescribing it anyways.

Yeah.

what I have seen a 100% is that people that have done H C G, and I'm not

saying this is for a hundred percent of people, but for the a hundred percent

of the people that I've seen do it Right, they've gained the weight back.

Yep.

I've seen the same.

Which to me, the the, the name for that is just yo-yo dieting.

Exactly.

That is not metabolism, caloric restriction and muscle loss.

Yep.

So it's a no for me.

a hundred percent, there's no comparison to me for, I mean, that the whole goal

is just caloric restriction, aside from changing your, your, your brain chemistry.

Yeah.

And that's coming at it from a true just appetite suppression period.

Nothing else, no other benefit that does not have these cardiometabolic

effects and the benefits that we see with some glut at all.

It's not improving your insulin resistance, it's not improving

your overall health, your heart function, your vessels, your

brain, your gut, your inflammation.

I mean, semaglutide does all of that.

So yeah.

Awesome.

Thanks for clarifying that.

Mm-hmm.

I think that's, that's an important thing.

so tell us more about where people can find you and I know you work in a

concierge practice, so who can see you assuming that they're in Washington state.

Mm-hmm.

Um, and if not, if there's anything else that you recommend they check out.

Um, Yeah, so I'm at a concierge clinic called Centered in

Wellness in Kirkland, Washington.

And, uh, this is concierge.

So you pay a monthly fee to join the clinic and be a member, and then you

have access to the services, if you don't want the pediatric services.

So that's a, that's another part of the practice.

So Dr.

Keller sees pediatric patients.

Uh, her concierge fee is more, and there's quite a long wait list.

Mm-hmm.

Um, but to be a member and to be not part of the pediatric practice,

you have access to everything else.

We do a lot of, like I said, longevity medicine, anti-aging.

I do a lot of detox, chronic infections like yeast,

parasites, uh, SIBO if you will.

I do a lot of body work.

I still, specialize in physical medicine injuries.

Things like that.

and, we have neurofeedback, we have bio sound, which is, treatment for, anxiety.

P T S D, insomnia.

and we have massage and we have acupuncture.

So, if you wanted to come to the clinic, that's what we do.

And, I do bill insurance here, but I also, it's also a concierge rate.

my own and operate a nonprofit called Allow Healing.

And this is my weekend job.

So I see patients in all your free time.

You're amazing woman.

Um, free time when I'm not with my kids.

Yeah.

and, uh, I see patients across the country.

On telemedicine only.

So I don't bill insurance.

I'm cash based, but I am a nonprofit, which means, uh, my

rates are pretty affordable.

And, so I, I function a little bit more as a, if I see you outside the state

of Washington, I'm not functioning as a doctor because I, I, again, I right

license, but I am more of a health coach.

but I do detoxes and, and supplements and I, I treat a lot of mold toxicity.

We didn't even talk about that cuz we don't have to.

But, one of my specialties is mold illness.

Yeah.

Mold toxicity, and everything that comes along with that.

So, it's another episode I'd love to do.

Those are, those are the, the, the two places you can find me.

Awesome.

Cool.

Well thank you so much for taking the time to talk with us today.

This has been so enlightening and interesting and hopefully

super helpful for all of you out there who are curious about this.

Um, I feel like it's on everybody's radar at this stage.

and now you are armed to come at it with.

The right mindset and tools and hopefully at the right team.

So thanks Dr.

Emily, and thanks for joining us today, everybody, and we'll see you next time.