The Truth About Ozempic and Co. with Dr. Omar Babar

do it with a clinic that knows what they're doing. Don't try and do it alone. You will run into trouble and if you do, run into trouble, you don't have anywhere to turn. Welcome to Barely Naked. I'm your host, Christina Byshel and together we will explore topics such as mental and physical health, healing and well-being. We'll meet inspiring individuals and hear their stories. I'm so excited to have you here. Let's dive in. Hi Omar, welcome to Barely Naked. How are you today? I'm Chris. Thank you for having me. I'm very well. Thank you. So you're the Medical Director of Healing Clinic in Leicester. You're a consultant and emergency medicine at the University Hospital of Leicester and you've been practicing medicine for 14 years in the NHS. Tell me a bit about how healing clinic came about, what your vision is and a bit about yourself, please. Okay, so I started training as a doctor since 2010 and I've been practicing medicine. I went into emergency medicine to finish my training and I became a consultant in 2019 and as I've worked as a consultant there and now in the NHS, in the emergency department, we do great things but some things that we can't do are provide other treatments like, for example, when someone comes to us with a problem, we can give them certain treatments, we can give them a parasite, we can give them a profen, we can't ever solve someone's pain problem or we can't solve the main issues, we can just help patch it along. So on the basis of that, and I came across a few different treatments that I tried on myself. I had this chronic pain in my neck that just wouldn't go away and I tried physio, tried massages, tried this, tried that, tried all these sort of things and it just wouldn't go away as I've carried on for about nine months. Then I came across a treatment called ozone. I was on therapy, I was on injections. I had that done on my neck and it went away, literally within a day. It went away and I had done an MRI before, I know I didn't have a disc problem and I knew that it was down to a muscle spasm and after dealing treatment, the pain went away and I was like, wow, this is very interesting to something here. So I'd learned about it, I had to travel to London for a course and I went to Germany for a conference on it as well, learned everything about it, that is to learn and then start practicing it and after start practicing it at Helent. So Helent came about as a place where you could go to try out, to test out all these innovative treatments that are out there that you can't get in this standard doctor practice. And from that we moved on from pain, we did hormone therapy, we did weight loss, so we did we do infusions, we do all sorts of anti-aging and longevity medicine practices. So we've got a whole range of treatments of the clinic and the idea was that it's a place where you can come to find out what's new and what's out there that does actually work, but you can't get it in your average medical clinic. So that's how Helent got founded and up and running for around two years now and it's and it's been great. It's been very popular, very and we've been making a bit progress with what we do. And so far it's been sharing it been quite fun. Amazing. The reason I reached out to your originally was because I saw some videos where you spoke about weight loss injectables and that's a topic that's come up on the podcast as well and in my circles, since it kind of started or became big with all the celebrities losing weight. And there's a lot of controversy, so I have a few doctors in my circle as well and there's been a lot of back and forth. So I thought I'll speak to someone who's an expert in the field and I'll get all the answers. I also put a post up on Instagram and got some questions from my followers. So I've got a few questions from them as well. But I want to start off just can you explain what weight loss injectables are and how they work? Okay. Yeah. So we do a whole bunch of weight loss treatments in the clinic. We've got literally hundreds of patients on these treatments at the moment. I'll talk you a bit about the history about these injections. So they came about quite early on actually when they first discovered something called the GLP1 agonist. And what that is basically is glucurone like peptide and it's it goes and latches on to a receptor that then tells your brain that you're full that you basically you don't need to eat or and that's how they discovered this peptide long ago maybe more than a couple of decades ago and then it was under under research and they they changed the formulation slowly bit by bit by bit and then came the very first iteration of it called succenda or lira gluteide. And that was basically a GLP1 agonist that needed to be taken once a day. So everyone had to take it once a day and people got the side effect profile from it and also the effect was not the not last for that long. So the same manufacturer came up with another medication called cemagluteide and this is the one that was a blockbuster drug also known as ozempic in one license and the other name for it is a week of e which is also the other license form of it. One is licensed for diabetes, one is licensed for weight loss, technically it's the same medication in a different dose. And this can be taken once a week rather than an everyday injection and again it turned out to be a great medication did really good for people with diabetes, did really well for people who wanted to lose weight and it's made by a company called Novanordisk. The other medication that's come about a couple of years ago which again has become very popular is a medication called ture's appetite. And the brand name for that is manjaro or zephone in the states. This is a medication that actually has a GLP1 agonist and something called a GIP agonist which is a gastric inhibitory peptide which has a few different, which are the few different things including improving your insulin sensitivity, improving insulin production. So again a medication that's great for diabetes and also great for people who are overweight and have problems processing their sugars because of genetic problems, because of being overweight, because of having the metabolic syndrome X as they call it. It's great for people like that. It just helps them process sugar better, helps them lose weight and helps their appetite and so on and so forth. So that's where that's where the medication, I mean that's the the newest version of it. Now there is one that is on the horizons is going to come out soon. It's by the company Eli Lilly, the same one who makes manjaro. It's called retitrutide. It's going to have three forms of receptor. So GLP, GIP and there's another receptor that works on account remember exactly yet. That's probably going to hit the markets, but probably later on this year or maybe even next year. I don't know when it's going to be licensed fully, but that's supposed to be far more stronger than manjaro. So it's an interesting time. Let's see what happens. It's super interesting, but you just said so weight the weight loss thing. We know we can use it for diabetes and I think there was this whole situation where people with diabetes couldn't get it for a while because there was that big craze about weight loss. I think that's even up now at least here it has, but who should it really be used for? Because just because someone comes to you and says, oh, I want to lose five pounds, are they the right candidate to use weight loss injectables? Well, the supply, as you said, did run into trouble early on last year. That has even doubt. So at the beginning, the demand was so high that the manufacturer couldn't keep up with the demand. And so there was supply issues and shortages across the world, but that seems to have improved. Now, who is it aimed for? Now, technically, if you look at the licensing guidelines for it, it's supposed to be used for people who are overweight or have a risk factor of diabetes, heart disease, high blood pressure. Even if they don't have it, if they have a family history of it, it's useful for them as well. There's more and more information coming out as to how some people actually are deficient in GLPs. As a genetic predisposition, predisposition, they don't actually, they are not producing enough of these peptides naturally. And so, again, it's geared for people. It's very useful for people who have the deficiency. Now, we're not. We haven't come far enough in science that everyone's been tested for it yet, but typically these people will be overweight. Whether it's useful for someone who wants to go for a short course, for five pounds to lose five pounds or so, not exactly. No. I mean, you can lose five pounds or so by by by improving your diet and improving your lifestyle and those sort of things. Where I say that with a caveat, the caveat being there is there is space for these medications in the microdose form. There's more and more information coming out of this and more and more research being done in this in this side of it where if you're using a small amount of this medication, maybe not even in the same frequency, sometimes it can be a bit infrequently, it can be in the same frequency or in some cases can be more frequently than the ones a week. It has certain other effects on the body that are proven to be quite useful. And I mean, it has an improvement in inflammation levels, it has improvement in pain levels, it has improvement in conditions which are autoimmune in nature. So people who are suffering with some autoimmune conditions, they're finding quite a lot of benefit of being on this medication. So, and that's why I have to caveat that yes, it's not ideally suited for someone who wants to lose five pounds. It's not that's not the goal of the of the medication, but there are other uses of this medications that are coming out that actually turning out to be more more interesting. And I think it's something that's going to become quite mainstream going forward. And then the use of this medication will become more popular for more variety of of conditions than we initially anticipated it for. Do we know what happens in the body that makes them useful for these other things? Yes, so there are the exact mechanism of which it works is not extremely clear yet, but we do know that it has a definitive impact on inflammation. So for example, a lot of the disease processes that we have are all rooted because of micro-inflammation going on in the body. So if you have high levels of fat, they produce inflammation and that inflammation then causes heart disease, can cause arteries to fur up, it can cause a whole bunch of things to happen. Similarly, a lot of autoimmune conditions happen because there's constant inflammation being produced. This medication and I don't I can't tell you exactly in which mechanism, but we know that it is helping this inflammation go down. And with that going down, we're finding a whole bunch of other other aspects of how things improve. For example, I've got patients who suffer with polycystic ovarian syndrome or PCOS. And basically, yeah. So the PCOS patients, they struggle with high levels of testosterone, they suffer with obviously ovarian issues in terms of hormone production. But in all boils down to the fact that these women are producing and generating more inflammation, then their counterparts who don't have it. And people on this medication, when I've started using it for them, they're improving. Their menstrual cycles are improving, they're getting periods more regularly. And they're finding that there and because people with PCOS have a tendency to be insulin resistant. And so one, the medication is helping that is helping their inflammation, it's helping regulate their periods. And as a consequence, they're they're becoming fertile. So if you micro dozing this drug and because you want to reduce inflammation or help with PCOS or similar, will you still be losing weight? Because there might be the incident that there's someone that wants help with those symptoms, but not necessarily lose weight. At the micro dozing level, it comes down to how sensitive you are. So if you are someone who's very sensitive to the medication, you might find that it is still affecting your appetite, even in small doses and you will, as a consequence, lose weight. And not because you take the medication or you lose weight, but more so, because when you take the medication, your cravings go down. The sugar level sugar cravings go down. Your savory cravings go down. Your alcohol cravings go down. And so as a consequence of cleaning out your diet, you do lose weight. And sometimes that's intentional. Sometimes it's a consequence of just eating more healthily. What does happen with being on the medication for a period of time is your body does get used to having that level of GLP in the system. And so if you want to carry on losing weight, then you do have to consequently go up and up and up on the dosage. And so someone who's doing this for not weight loss purposes, you take the low dose and you keep on the low dose. And so when you're not increasing the dose, you may not lose the weight anymore. So on the topic of side effects, I did do a bit of research and I found a few, but then they were all kind of contradicting. So I'm just going to ask you and you tell me what's true. So there was one that said ozempic was linked to thyroid cancer, but then other research showed that it actually reduces certain cancers, which one is true or they're both true. There's a known issue with a certain type of cancer, a certain type of thyroid cancer, which is called medullary thyroid carcinoma. And this is, it's a type of cancer cell or it's a type of thyroid cancer that's known to be affected by this medication. So if you have a past history of it, or if you actually have the active cancer diagnosis, then you're not supposed to be on the medication as a full stop. It's a clear contraindication to someone starting this medication. If you have a history of medullary thyroid carcinoma, or if you are actually fighting it, then just don't go on the medication. Now, the question whether it improves cancers, other type of cancers. Now, again, that's something that's not fully researched yet, but it works on the same phenomenon of it reducing inflammation. So when you are better regulating your inflammation, it can improve how you feel. It can improve your immune system. It can improve, although the other aspects of your body that do end-functioning properly will weed out and kill cancer cells. Because you on an everyday basis are killing potential cancer cells. That's what your immune system is trained to do. Every day we multiply millions of times. Our cells are multiplying all the time. And with every multiplication there's a chance of you developing an error in your genes. And those errors in your genes are constantly being weeded out by your own body. Your body recognizes, "Oh, this is not right. They kill it off." When your body is not functioning well, it will not kill those cells off. They allow to get grown and grow and grow and become the cancer. It becomes a tumor. And it starts to go somewhere. So if your body is functioning in its best form, you won't have cancer cells. Obviously, some people are genetically predisposed to certain things and so forth. But, yes, I guess the premise of it can't help without the cancers. I think the research is still being done. I think it's because your body is not able to function properly. What about pancreas? Because obviously it works with the pancreas as well because if you're diabetic, there's an issue with pancreas. So are there any effects on the pancreas? Is it good, but you know? So it obviously helps improve the pancreatic function. And so it's a better production of insulin from the pancreas when you're on dysmedication. One of the rare side effects is pancreatic. It's inflammation of the pancreas. Pancreatitis can happen with quite a few different medications and this is one of them. But again, it's something that happens in a rare capacity rather than a common side effect or a less common side effect. There's different categories that my drug can be listed in this. This happens in a rare circumstance. So how does it work when someone comes to you and wants to be put on a weight loss drug and say they're not incredibly obese? So it's a BMI, say maybe 28. I think that's still fairly normal. What's the first steps you take? What are the questions you ask? We go through a normal consultation process to check whether they, first of all, understand what the medication is, whether they're eligible for it, whether they're. what their goals are, what they want to reach from it, and obviously the side effect profile, expanding through all of that. Now, the reason for someone to be on the medication is quite wide. Now, it depends who you follow. So if you're following. I mean, we're in the UK and we have a committee of guidance called NICE guidance. So if you follow the NICE guidance, it says to use this medication for someone who is x weight, x BMI, x conditions that they have on background of et cetera, et cetera, et cetera. So if you go down that protocol, if you fit the criteria, it says straight forward, yes. If you need to be on this medication, it will help you reduce your risk factors for cardiovascular disease, for diabetes, for adlac pressure, et cetera. And so they will start. If someone is not in all of the criteria, for example, you'll get someone who is, instead of being. they say their cutoff is 80 kilos, but they're 75 kilos, and their ideal weight would be 60 kilos. But they're not clearly in that, in that mark. However, they do have a family history of diabetes. They do have a family history of heart disease, of high blood pressure, et cetera. They would be classified as someone who's eligible for the medication, as far as the manufacturer guidelines are concerned. Have you ever had the case where someone came who clearly wasn't part of that group, but who really insisted on wanting it? Maybe because they had an event coming up, but because they wanted to lose those five, eight pounds, what was their response there? I know we do. We do get these inquiries as such. It's not an easy conversation, but some people are just not eligible, because you do have people who have things like body dysmorphia, who have people, who just want to do it for that event. They don't understand that this is not a quick fix drug, that this is something that is used and should be used more so to help get you back into a good routine of food choices, of diet, of getting into a decent form of exercise routine, and all those things. It's used as a tool to improve your life, rather than I need to lose five pounds to fit into that crisis, not the best way to use a medication. Then there may be other ways to do that better, and this is not the right way to do that. You do have a psychotherapist on staff as well. Do you ever refer the patients over when you feel like, oh maybe it's body dysmorphia or an eating disorder or something else that's unhealthy? Yeah, so we do have a psychotherapist on the team, and we do have someone who actually was on an approach just initially for weight loss. After consultation, we decided actually there are some deeper issues here, so why don't we get you speaking to our psychotherapist first, and then let's take it from there, and she agreed, and she was open to the idea. Most people will say, thank you very much, and they'll like try somewhere else to communicate, but at least we have the facility to be able to get them on into other parts of the clinic. Right, so what are the long-term effects? This is a question that came from someone, one of my followers. What is the long-term effect of seosampic or one of the other drugs? Well, it's designed to be used as a medication for life, technically speaking, especially for diabetics and stuff, it's a medication that you get onto a dose. You don't incrementally go up on the dose, you reach a certain dose that's working well for you and you carry on being on it for life. As far as long-term effects are concerned, it's designed to be used longer term. Now, that comes again with a caveat that if you are using this longer term for weight loss purposes or for this side, then you do need to be able to make sure that it's done in a balanced fashion. For example, if you're not going to be eating, if you're going to carry on eating in a deficit, in a calorie deficit for a longer period of time, you will inadvertently miss out on micronutrients. You need to supplement with a micronutrient multivitamin tablet or mineral tablet, or you have to do things in a certain way that you're not going to miss out on what your body actually requires to carry on functioning well. So, if you're doing it for weight loss and doing it for longer term, the risk would be that you're not consuming enough vitamin B12, or you're not consuming enough collagen, you're not consuming enough protein, and that will eventually lead to issues down the line that your bones may become thin. You might develop osteoporosis, you might develop osteopenia, so there are things that are again coming out for people who are using this and not doing it in a balanced fashion, and so that can end up with some issues. But as far as the medication is concerned, it is designed for long term use, but if you've obviously done in a fashion that's controlled and done in a supervision of a clinician. You just touched on osteoporosis, and I had one follower ask me a question about that, and they said, "Can you combat bone density loss that happens when you're on the drug with heavy weight lifting?" So that's one of the things that we encourage all our patients to do. You do have to do some form of strength training when you're on the medication, because when you're in a calorie deficit and your calorie for a period of time, your body will send signals to everything to try and lose weight. So what I mean, everything, it'll send signals to your glycogen stores to burn into glucose to for energy. It'll send signals to your muscle to burn to release energy. It will also send signals to your fat to burn to lose energy. Now, next time you eat your glycogen stores will get replaced, because when you're whenever you consume food, they will have form a carbohydrate or protein in there which will break down to form a glycogen. It'll refill your stores. If you're eating an protein and you're doing some form of strength training, your muscle that you have lost as part of the energy production will get replaced as well. And obviously we want the fat to go down, and so the fat you don't want to gain excess of, and so that will carry on down. So over a period of time, if you're doing this properly, you will maintain your muscle mass as proportional to your body and do this in the right fashion. Now, if you have the right amount of protein and you're eating the right amount of calcium and vitamins and all these other things, you can reduce, the effect it can have an osteoporosis. Now, osteoporosis also happens because of lack of activity, lack of muscle activity, lack of strength training, lack of movement and all those things. So if you're doing this alongside that, of course, you will reduce the risk of developing those problems. Great. And now we've kind of cleared up the side effects and all the myths. Now I want to hear about a few success stories. Where do I start? So, I mean, let me put it this way. In our clinic at least, there's been zero patients who haven't lost weight on the medication. It's a brilliant drug for sure. It definitely has its uses and it's definitely here to stay. It is something that's going to be around for many years to come. It just helps people get into the routine of things. Over the over years, with stress, with poor lifestyle, with poor sleep, your cortisol levels are high, with your cortisol level high levels being high, you end up craving sugar, you end up craving fat, and so you make poorer decisions when it comes to nutrition. This medication helps take the noise away. You don't have a longer thinking about food that much and so you eat clean. It gives you the opportunity to clean. Let me rephrase that. It gives you the opportunity to make the right choices when it comes to eating food and making your food because it's not that little voice in the back of your head that says, "Oh, I want a biscuit." When you're passing by, a piece of cupcake lying around in the office that says, "Oh, yeah, let's just have that. I want that." That voice gets blunted significantly and as a consequence, you are able to now make better choices with your food. People who consume excessive alcohol or even if it's not excessive but are drinking quite regularly because they feel stressed because they want to relax with it. Suddenly on the medication, the cravings are gone. They don't want to drink or even if they're drinking, even if they use to drinking two glasses of wine or one glass of wine every day. Suddenly, after a few steps you like, you don't want it anymore and you put it aside. You are able, it does have an effect on cravings. People have reported that the want for gambling goes down. People have reported the effect of craving for smoking for nicotine that goes down. People's cravings for caffeine goes down. So there are many other things that happen as a consequence of being on it. So it sounds like it could support with certain addictions? And do. Obviously, it's not designed for addiction medicine. At the clinic, we have used it to help with alcohol and excess of alcohol consumption. We do paired up with some of our other medications which are used for this like NAD+ and additive less infusions. They have an effect on cravings. So yeah, alongside obviously a few different things that we offer, it definitely has a role in addiction management as well. That's not widely known at all though. I haven't heard about this anyway yet. And I think as time goes on, there'll be more and more and more things that come out how the medication is being used in different forms. In a microdose in capacity, I'm using on our patients with early onset Parkinson's. So this is an of license use of the medication, but it does help and he's feeling great. He's been able to reduce the dose of his actual Parkinson medication that he's on. So again, it's not something that's commonly known to help with that, but it does. And I have a patient who's on it for that reason. So what else do you use microdosing for? microdosing. I've used it for some autoimmune conditions. I've used it for this at the Parkinson's. I've used it for PCOS. I've used it for other metabolic conditions that have an effect. We've also used it for people who want to lose weight, who fit the criteria to be on it, but don't want the problems of side effects. They don't want because typically what can happen with the medication, it can cause nausea, it can cause constipation, diarrhea, all these sort of things. And sub for some people who are quite sensitive to the medication, even at the starting dose of say 2.5 milligrams, it's overwhelming. It's to the point that it causes too much disruption to their lives and people who have high functioning responsibilities, but also have fallen into bad habits. They want to get back into correcting that. Microdosing is a good solution because the side effect profile is quite low and a lot of people are actually quite sensitive. We went on the low doses and they benefit. You said before that it is designed for life, but would you microdose for life as well, or would you then come off it after a few months? I think the option is there to carry on for the long return and it comes down to what the goal is. So if your goal is to do it for a certain condition, you set the parameters and you say, okay, let's do it for six months, let's do it for three months, let's do it for a year to see how you feel on it. And then once you reach that goal, you have the option to review your options at the time. There's no, especially when it comes to uses like these, which are not your standard uses, the option is open. As long as it's being done by a physician who understands what they're doing, why they're doing it, how they're doing it, and you're keeping an eye on progress, you're keeping an eye on any side effects, you're keeping an eye on any long-term complications or effects that maybe may happen with the medication. I think it's a relatively safe job. What happens for people who do use it long-term, say not in a microdosing capacity, if they come off it, are the effects completely reversed within like say a year, or is the lifestyle change so big because you get so used to eating differently, behaving differently in terms of moving that there is a long-term effect? That's a very good question, so yeah, so that's the most of one of the commonest questions we get asked as to what happens when I reach my goal, am I going to put all my weight back, for example? Well, the idea of de-medication is to get you into a good habit. If you're going to use it primarily just to, yes, there's another diet fact, just like you've done a keto diet for a couple of months, then you've went and you tried the slimming fast diet for a couple of months, then you went and tried this style, whatever. If you're going to be that sort of person, then this medication you'll use in the same fashion. You'll use it for a short while, for a month or two months, you'll be might buy it online from a loads of places where you can buy it from. You get it from there, you'll do it in an unsupervised fashion because most of these places online, they don't offer you clinician appointments. You just fill out a form, you get them medication posted to you, and then you start. Whenever we've had quite a few patients who've come from those sort of settings and say, "I tried it, I didn't know what I was doing, it didn't make sense to me, I tried it for a couple of months, and I stopped, and I put all my weight back, and I want to do it properly now." Now, the reason you do it in a clinician with the clinician or with a proper program is so that you can make those changes that can last you a longer term. For the longer term. You're on the medication, with us, you want to be doing some form of exercise, you want to be doing strength training. Even if it's 10, 15 minutes a day, you need to be doing that, you need to get into the habit of making better choices. The idea is that when you're coming close to your goal, when you reach your goal, then we have a different protocol in which we sort of step you off the medication. We don't do a hard stop. When you do a hard stop, as in you've reached, say you were 90 kilos, now you were 65 kilos, and you say, "Don't, I'm done with my weight loss, I'm happy to stop." With us, you're not going to stop one fine day, all of a sudden, that's done. That way, when you do that, your hunger comes rushing back as soon as you stop the medication. The half-life of the medication is five days, so after five days, only half of the medication in your body, and after another few weeks or so, your body is completely flushed of the medication. Your hunger is going to come back, and so if you do it in the fashion that you're going to stop completely, you're going to come to a point where within a few weeks, your hunger is skyrocketed, and you're now gaining the weight back because you didn't do this properly. When the research showed, when you've reached your target weight, and you want to stop, you want to taper the dose down, so we stopped the medication over an eight to ten week period. You come down step-by-step, step-by-step, and then after eight week period, the research basically looked at, they followed people up for six months after they, after in that trial, and the people who tapered the dose down didn't gain any weight back. So you work really closely with your patients throughout the entire process to make sure that they're on the right track and they're supervised. You have to do it that way. Otherwise, you'll end up using it like any other diet. You're just going to put the weight back on. Because I've seen the ads on Instagram where you can fill in some forms and order them online, and I thought that was quite scary that that's even an option because I thought you needed, I mean, I don't know how it works because I haven't actually clicked on them, but I thought you did need a prescription. Yeah, the way they do it online is you just have to fill up some questions and make sure you're, you're taking the right boxes and the medication gets posted to you. That's it. It's pretty scary. I mean, because it is still a drug and it is a strong drug. Of course. There are some regulations that I've just come into play, at least in the UK, where the amateur has changed what they require for this medication to be dispensed online. So the online pharmacies and places which are selling this medication are under intense scrutiny as we speak, and they are having to make some changes to how they dispense it and what needs to be done prior to being able to dispense it. They have stipulated that they want a consultation with patients before they can be dispensed. I think that's obviously a move in the right direction, and I hope that people who need this drug will be able to get it safely. Yeah. I had someone ask what would be your opinion on intermittent fasting as an alternative to injections or pills? In a meta fasting is great. Lots of benefits. In trying intermittent fasting, you can do 14/8. You can do 14/10. You can do 16/8. You can do 18/4, 18/6. Different hours and different ways of doing it, but certainly it's quite useful. The one thing that I would say about intermittent fasting is do it in cycles. Don't make it a lifetime change. The reason for that being your body will adapt to that new way of eating, and the added benefits you get from intermittent fasting will soon be lost once you've done it for say three months. So, do it for three months. Start going to normal cycle of eating, and then restart it, and that way your body will remain in a fashion that actually you will get the benefits of it. The benefits of autophagy, the benefits of improved energy, the improved healing, all the things that come about it will wear off if you do it all the time. So, it needs to be done in cycles, and that way when your body goes back into normal mode, and then you do that for a few months, and then you go back into a cycle of fasting, you'll get the most benefits that way. Now, how does that compare with the weight loss injections? Well, let me put it this way. When you remain in a calorie deficit for long enough, your body starts to produce these hormones that then make you want to eat, that increase your hormone levels, increase your hunger levels, and so the food noise starts to get quite loud in the brain. Oh, I want my food, where my food, the hunger levels go up. And so, for most people who are on a diet of some form, and they're eating less than when they would normally do, they'll start to eat more with every meal. Even small amounts, 50, 100 calories extra with every meal, and the calorie deficit they were trying to maintain now gets equaled out. And so, you know, longer in a calorie deficit, and that happens on a very subconscious level. That's why most diets fail, because after a certain while, those hormones kick in, and they allow you, they don't allow you to remain in a deficit anymore. One year on these medications, that hormone, that noise, that hunger noise stays blunted, and so you're able to stay in a deficit for longer, and carry on coming down with the weight. And that's the beauty of the medication. Within the mid and fasting, you lose weight, you lose weight to a certain point, and then you will plateau. You will plateau because your your hunger hormones will get to a point where you will carry on now eating at your body requirements. Can you also, if you go on one of these injections, can you also potentially avoid having to get a gastric sleeve? Like, will the effects be so good that you might not need an operation? I would definitely recommend people who are considering getting a gastric sleeve, or a gastric bypass, or a gastric balloon to try the medications first, for sure. Now, when you, we have patients who come to the clinic now because they are post-bipass, or they're post-bastic gastric sleeve, who are now unable to absorb nutrients? Micro-nutrience deficiencies. They're low in B12, they're low in eye, and they're low in selenium, they're low in zinc, they're low in biotin, they're low in a lot of other B vitamins, and they can't absorb it. A lot of their stomach lining has been taken off as absorption becomes a problem, and now they come for three monthly infusions, or six monthly corrections, and so on and so forth, because they can no longer absorb, absorb their food. That's basically a permanent issue. When with things like this medication, it's like a non-permanent gastric sleeve, so you can switch it on and switch it off when you don't want it, and obviously, it has less risk factors. It's not surgery. It's so definitely a very good alternative to any form of bariatric surgery. I also saw that you offer fat dissolving. I'm sure that's not, you know, not an alternative for a gastric sleeve because obviously it's not probably, or maybe it is. The fat dissolving is something that's used for targeted weight loss. So, for example, if someone comes to us and says, okay, I need to get rid of my abdominal fat, but when you look at them, they're quite overweight, and they're just concentrating on this. In that instance, you have the options of gastric. Sorry, you have the options of fat freezing, you have the options of fat dissolving, but this person actually needs to lose weight overall. They're actually quite heavy. Weight loss injections are a better option. For fat dissolving, it's limited to a particular area, and you can only do it in one part of the body or the other, and it's not exactly a very straightforward procedure either. So, it does have to be done in sessions. It does have to be done with, again, a clinician, someone who knows what they're doing, because after the fat dissolving procedure, you have to wear these tight bands, you have to do this, you have to do this. There's a whole process. It's not as straightforward as, oh, I'll just get that dissolved, and I'll go away. It doesn't work like that. So, when we talk about dissolving, is that fat freezing, or are those two different things? Two different things. The fat freezing is literally, you freeze the fat. The fat freezes at a temperature lower than higher than your other muscles, and so at, say, minus six, minus seven degrees, your skin will stay alive, but your fat will freeze. And the idea is that when the fat freezes, it dies, and then slowly over the period of the next few weeks, that fat will get eaten away by your body and go away. So, that's the idea behind fat freezing. So, it's useful for targeted areas only. How permanent is that? Once you've lost it, you've lost it, but it can always be replenished if you eat enough. Sure. What are some other treatments that are really high in demand at the moment that you see? One of the treatments that is becoming more and more popular is NAD, NAD infusions, or NAD subcutaneously. NAD+ is a coin sign that's present in every cell of the body. The powerhouse of the cell is called the mitochondria. And the mitochondria is filled with things like NAD and other things as well, that help produce energy. Now, with aging, with every decade of life, you lose around 10% of your NAD stores. So, as you get older, the NAD levels start to drop. It's a natural pose of aging. Everything starts to slow down. Immunity slows down. Healing slows down. Recovery slows down. Energy slows down. Everything is going down. When you fill your body up with NAD again, you start to function like you did a few years ago. And so, energy is improved. Immunity is improved. Healing is improved in all those things. So, entities becoming more popular. Very popular in the states. And now getting more and more popular in the UK as well. So, we get quite a few requests for that. How is that administered? Is it a drip or? Both. I mean, there are many different forms of NAD. At the clinic, we do the infusions, the trip version. And we also do the subcutaneous injections, which are injected into the abdomen, just like the weight loss injections, for example. There are other forms of NAD. You can take it orally. You can take it intranasally. You can take it sublingually. New forms are patch as well. But they don't seem to work. We used to have access to those forms of NAD at the clinic, but we stopped doing them because we found the bioavailability was not that high. And so, subcutaneous versions definitely work. And the IV versions definitely work. But when you try and take NAD orally sublingual intranasally, you need very, very high doses for it to actually get absorbed into the bloodstream. And so, we just stop working with them, so we only keep the two versions at the moment. One thing I also wanted to talk to you about, because it's kind of, for me, seems kind of similar to the ozempic craze that happened with the celebrity. So, first of all, I wanted to know from you how you feel, because you're a dad of girls as well. So, I wanted to know how you feel about, you know, these celebrities getting small and small and small and potentially, we don't know if they're using them, but we're assuming they're using them some of admitted to it, using those injections. And then, on the same, how you feel about, say, lip injections and all these injectables for your face, that I feel like getting a bit out of hand now as well. And I feel like that kind of goes together. Having a positive body image is a topic for the entire society to have. Obviously, there have been lots of failed cases of botched Botox as a call it. And filler is going bad. And all these sort things and people actually getting into quite a lot of harm by overdoing their weight loss with these injections and so on and so forth. So, this is definitely a point of concern. But at the same time, there's been a lot of good work done by many different people on promoting a healthier body image. I mean, we can see that in advertisements. We can see that in in the fashion industry, where you have plus size models, where you have people of all different shapes and sizes, where now a lot to model for big brands and stuff. So, I think the general message of promoting a body, good body image is out there and many different charities, organizations and groups are actually putting all the good work out there for that. And so, it has to be a balance isn't it? And I think at the moment, there is a decent balance. Obviously, there will always be extremes that wrong. Yeah. It's just, I think it's tough, especially with social media, because young people, not just women, but young people, are confronted with all these ideals that in a lot of cases are not attainable. No, of course. I mean, you can see that by the number of people who are going abroad for facial surgery, for other forms of corrective work, work that may not be needed to be done, but they just wanted. It's a lot of ease of access to these things as well, things are getting cheaper as well. But at the same time, a lot of risk being taken by young people as well, older people as well, just to be able to look good and feel good. It is a problem for sure. And I think this still is a decent matter of work you have to be done. Do you ever get someone who comes in with, say, botched Botox or lips that are too big or whatever, and they want to get them dissolved and what you support? Yeah, of course. So, at the clinic, I mean, the aesthetics part of the clinic is dealt by my colleague. And we get work all the time for him. So, she does have to deal with people who've got one side higher than the other, lips have gone bad and like bloodblast. So, she does do a lot of corrective work and then restores it to, or to actually look better and even and actually more natural. And that's the sort of work that she does carry on in the clinic. It's basically very age-appropriate and very delicate work. That is very subtle of how it's done and how what the what is supposed to look like. And she does, she does, she does, she does, she's quite good with her injectables. So, it's similar to people coming to you who've ordered a weight loss drug online and then actually want to do it properly. Yeah. Giving, yeah. So, when we do our weight loss, for example, we get a monthly scan done. So, we have a body composition machine in the clinic and so when someone comes they get a scan done every month. And so, we know exactly where their weight is distributed, how their months gone on, how much muscle they've lost versus how much fat they've lost. And so, we keep a track of it. When, when you have that accountability and when you have that level of control, patients really like that. They write actually knowing what they're doing and what, how, how much did Ethan or what they gave up in the last month and what sort of effects they had that had on on their scan results, for example. And then on that basis, we guide them, okay, this month you've really need to improve your strength training. This month you really need to prove your protein intake. This month I think you've been snacking too much because you haven't shifted on your weight. So, there's a level of accountability and and they don't look forward to the scan. As in, they work hard knowing that oh, actually in my in a week's time, I've got a scan, I've got to face the doctor again, I've got to go stand on machine again. It's a competition and it's an accountability process and when you have that, people do perform better. This is exactly the case when you have a PT. You can go to the gym, you know exactly what you need to do. But when you have a PT on board, there's a level of accountability, there's a level of engagement, there's a level of encouragement in the process. And so, people who work with PT's do perform better than people who don't and will perform and do it for longer than and will get better results. So it's like that in the in the then. So, the message is really the drugs are safe as long as you do it with a responsible expert doctor and have that guidance. Do it with the clinic that knows what it what they're doing. You will want it to trouble. And if you do run a trouble, you don't have anywhere to turn. With us, especially with our micro dozing, especially with the way we do things, we we go above and beyond how we take tailored the doses so we can go well below the licensed doses, we can go in between the licensed doses. For example, someone who starts at 2.5, the next dose up is five milligrams. Well, that five milligrams can be a bit too much for some people. So we would go somewhere in the middle, 3.75 milligrams. And so we are able to cater two different doses and personalize it for you. And that's that's the level of detail you can expect from from working with a clinic like ours. And that is important. Those are all the questions I have, but is there anything you think is important to add? As far as the medication is concerned, it's definitely a good medication. And when you use properly, you can have some really positive effects. So a lot of some of our patients who have come to the end of their journey have completed their weightless program and everything, they're so happy, they're good, they're confident now, they're feeling better, they're eating well, they're in a good exercise routine. And you can see them when they walk in, they're just happy. They feel glad, they've done it, they feel proud of themselves, they're feeling more confident. And they're just able to say no to bad habits. And they say, no, I don't do that anymore. And no, I need to go to the gym now. And this, that whatever. So there is a lot of benefit if done properly. But the idea is that you do this to make a lifestyle change. It's a crutch, it's not the actual, it's not going to change your life. If you just take it or I'm going to change everything, no, it's something you use alongside other things to get into the right habit and right things. And when done in that fashion, it's great, it's a great job. Thank you. And thank you for taking the time to come on today and talk to me about this, because I've had this on my list for quite some time now. And I'm really excited that we got this episode together and did it. Thank you anytime. Thank you, Chris. Did you enjoy this episode? And feel free to share, like, follow, subscribe, just hit all of the buttons. For more info on today's topic, check out the show notes. You can also find me on Instagram @Christina_Simon linked in Christina Weishel and TikTok @Fairly_Naked_Pockast. See you next time!