Mounjaro One Year Later: The Risks and Rewards - Ep 63

This episode is for entertainment purposes only.  We are not medical professional and we strongly suggest that you reach out to your physician for any medical advice.
 
Join Tish and Ellen this week as they shoot down the taboo surrounding weight loss medication and pull back the curtain on the weight loss industry, challenge the stereotypes and changing the conversation. From the latest medications like mounjaro that are revolutionizing the weight loss landscape, to the new drugs promising a weight loss boost of over 24%, we tackle it all in a frank and enlightening discussion.

We're diving into the murky waters of weight loss shaming and the culture of guilt, comparison, and judgment that society often attaches to losing weight. But there's more – we’re recounting co-host Tish's personal journey, including her transformative experience with weight loss medications. We also don’t shy away from the darker side of weight loss – botchedt bariatric surgery and the psychological perils of yo-yo dieting.

To wrap things up, we navigate the potential risks of medical interventions for weight loss. Weighing the benefits against the side-effects, Tish offers an unbiased perspective to help you make informed decisions.  Join us as we confront weight loss myths, shatter stereotypes, and champion a healthier approach to shedding pounds.

Obsessions:
Tish: calming Himalayan salt LED light bulbs
Ellen:  iced coffee glasses 

Tish and Ellen want to give a BIG thank you to everyone who helped support the show.  And, please support us with a monthly PATREON subscription and get a quarterly live  Q&A with Ellen and Tish.

Transcript

Speaker 1: 0:22

Tish, our most popular episode to date is episode 39. It's the one about your weight loss journey on Manjaro, and in this episode, you called it a game changer for you and for many other midlife women.

Speaker 2: 0:37

You know, alan, you're so right. We have gotten, so, I think, the most listeners by far on that episode. So it really is touching something right. And I've been on Manjaro now for about a year and it is just not a game changer. It has been a life changer for me.

Speaker 1: 1:00

I hear you and I know we've both been surprised about how many downloads we've had on this episode since it aired, and since that time the popularity of drugs sold under brands like Ozempic and Manjaro and Wacovi have even exploded more, and there's new innovations coming out quickly, like an Eli Lilly drug that could boost weight loss to more than 24%, which is more than anything on the market right now.

Speaker 2: 1:28

You know, so for us, I think it is so important to us that we wanted to keep up to date on things that are happening in this whole weight loss market right Especially now in the wake of the report that linked Lisa Marie Presley's death to a bowel obstruction that was believed to have been caused after a prior bariatric surgery that she had underwent, and I thought we needed to continue this conversation about how much are we dying to be thin, and I'm ready to share my health care story as well. That has happened in the meantime.

Speaker 1: 2:13

Yes, I know we've alluded to it on several other episodes Tish, but I think this story is really interesting and I thank you in advance for sharing it. I also think this is a great topic for us to circle back on Now. We know obesity. According to the EASO, which is the European Association for the Study of Obesity, that it's the fifth leading cause globally of deaths, and that's 2.8 million people. That's startling.

Speaker 2: 2:44

You know, I think we think that this overweight is an American issue, right, but those statistics tell us that it's definitely not. So the question now becomes how far are we willing to go to lose weight and when do the risks outweigh the benefits? Right, and who gets to decide on how much medical intervention we should be allowed to exercise? And I know this has been a decision I have had to face personally.

Speaker 1: 3:20

As well as many other midlife women, and the answers are not always so cut and dry. They're not so clear. But before we get into this update on you, tish, and what's happening in the market and media, let's get to our weekly obsessions. I know you must have something good for me this week.

Speaker 2: 3:40

I have a kind of what I think is kind of a fun one. So I have discovered these Himalayan salt LED light bulbs and they are so cute. So you know those big salt crystals and they have. They tell you about all the health benefits and calming benefits of using those. You have all the tiny crystals inside of a light bulb and when you plug it in, you plug it into a regular light socket. It could be a string of lights outside or it could be a lamp, doesn't matter. You have this beautiful glow that it has and it's supposed to be giving you a calming effect, and the crystals like dissolve and dissipate into the air around you as you use them. But I want to exchange all my outside lights with these just to get that little ambiance of the glow through that pink yellowy.

Speaker 2: 4:38

You know so that is my obsession for the week Himalayan salt. Led light bulbs.

Speaker 1: 4:48

I really need to see a picture of these, because I'm not really sure how they work. So when you get them up, please share with us with our listeners. We'll share a photo. So that's so interesting and I love how you always zhuzh up your patio tish.

Speaker 2: 5:07

I got small real estate out there, but I need to have it as an impact upon a little sanctuary. What about you, Alan? What is your obsession for this week?

Speaker 1: 5:19

Well, my obsession also is kind of like summery and backyardy. It is a set of four iced tea or iced coffee glasses and they all come with a bamboo top and a glass straw, so it's very sustainable and nothing's better than a really great iced coffee at two or three in the afternoon, or even a chai or an iced tea. So I think this set of these glasses are really timely.

Speaker 2: 5:52

I love those. I saw the picture of the glasses and they're so adorable. And what I love is that the straw is glass too. So I'm not a fan of straws. I really am not. You know, you'll always see me out and I will pick up my cup and stuff like that. There's just something about the plastic straws. I don't really like them, especially the silicon ones either. But the glass ones, you're going to know when you use them if they're clean too right.

Speaker 1: 6:21

I have to tell you that one of my boys uses the metal straws and I'm always thinking what is in?

Speaker 2: 6:30

there, exactly, totally gross, exactly, yeah, yeah, yeah, exactly. So, yeah, those are cute. But again, everyone keep in mind that both of these will have links. Go ahead and use our links. It helps support our podcast when you do that, and we love bringing our obsessions to you all, absolutely All right.

Speaker 1: 6:53

So let's pivot back to the sobering facts about Obesity. Tish, that same organization, ea, so reports that obesity has increased 100% since 1980.

Speaker 2: 7:06

Wow, I mean, I don't say that again. I think people are going to hit 100% 100% Since 1980.

Speaker 1: 7:16

So this is a growing issue, even despite all the options out there. I remember all the sugar free, everything we've gone through fat free, sugar free, this free. So on one hand we have increasing obesity rates, but on the other hand we have even more options dietary options, medical options for weight loss and I know you've told me that one of the hardest things for you if I could say this, around your weight loss and when you were heavy and now when you are thin, has been the shaming aspect of obesity.

Speaker 2: 7:51

Oh yeah, yeah, you know. Yes, there is so much that shaming and there's now this new phenomenon of weight loss shaming, right? So, Ellen, I just feel so strongly that we need to discuss this point yet again. And you know there's a lot of fat shaming. That's nothing new. You've heard a lot of people talk about that and we've discussed it on here before. But now that there's this weight loss shaming, I don't even understand where this is coming from, to be honest, to the point that we're seeing a lot of people lying about the fact that they are getting medical intervention to help them lose weight.

Speaker 1: 8:38

Right, whether it's surgery or medication. I hear you, tish, and we've all heard the stories of celebrities getting outed for their use of medications, these new medications on the market. So there definitely is an issue in our society around weight loss medications, as if it's like a too easy solution or they want us to think they just toughed it out with willpower and exercise. Why can't we celebrate getting healthy and losing weight here?

Speaker 2: 9:09

You know, that's what I really want to know, Because you know and I have faced this right People acting like I was cheating in some way to get dinner. You know, medication, while it's part of the solution, it is not the whole solution. I know plenty of people that have taken the medication and have not lost the weight. Right, you still have to make life changes, and I know plenty of people who took the medication and they felt like I said they lost little to no weight at all. So does it make it easier? For me? It made it extremely easier. It made it obtainable and doable, but I still had to work out and I still had to make better choices and I still had to do all the other things. Right, yeah, but it made it possible and sustainable for the first time in really my life.

Speaker 1: 10:16

Those are all great points, tish, really, and I know you've worked hard. I've watched you through this journey, which has taken over 24 months for you. Your diet changes, the no candy in your house whatsoever, the exercise, the treadmill, the pickleball, counseling and more. You have done so much work but still the shaming's happening and it's like. It's like people don't realize what they say and what they do and how they react is really something that people take in and they act like. Chronic obesity isn't dangerous, right.

Speaker 2: 10:57

You know, I have to think that it's about the competition, and some people just need to feel superior and they want something that they can hold others down with. I don't know. That is, if they're thinner, it elevates them in some way. I'm not sure what it is, and it happens with weight, with beauty, with wealth, careers, and the idea is that there is something that is as effective as manjaro, and people need to stop this shaming so that people can feel that there isn't something wrong with taking it.

Speaker 1: 11:45

Absolutely I agree, and I think that it started with celebrities not admitting it and then it just kind of, I think, trickled down from their tish, and I do feel like we're turning a corner. We're turning a corner on this, though.

Speaker 2: 12:02

Yeah, it's funny. I heard one celebrity say oh, I didn't know that injection was for weight loss. You injected yourself with something. You didn't know what it was for, what it's so untrue and that the fact that people have to hunt them down to out them but they're leading to the reason that more people do this because they're trying to put themselves forward is I've done it on my own.

Speaker 1: 12:37

That's the only true blue way to do it Right, right, get a medal for doing it on your own.

Speaker 2: 12:47

You've gotten help, but you're going to shame other people not to get help. That one just blows my mind. We all saw the pictures of Elon Musk overweight in a bathing suit, right, and they criticized this guy. They just bashed him so bad, right? So then I guess he saw the pictures and thought I don't think I like the way I look. So he did something about it and he went on Osempic and don't they bash him for that. Yeah, like he did something about it. You told him he was chubby. He went and did something about it. You know, as if we shouldn't be using these successful tools, like I just again, it's this whole campaign of shaming and it's got to stop.

Speaker 2: 13:36

You know, I personally felt shamed many, many times for being heavy Right, and now I feel that there's a lot of people that are out there trying to shame me for using these new weight loss medications. You know how I am, Elon. I'm very transparent with stuff. I'm going to say what I'm doing and you know, if somebody doesn't like it, they're entitled to that opinion. But I try to encourage at every turn. When someone says, hey, how did you get there? What are you doing? I'm telling them the tools that worked for me. I don't necessarily know it's going to be the tools that work for them, but I'm going to tell them the tools that work for me.

Speaker 1: 14:21

And I love that Tish, your transparency, and that's kind of feel like a little bit of a no win situation for you and many other folks. Let me ask you this have you ever watched that show botched?

Speaker 2: 14:34

Oh, I love botched. I love me some botched. I love Dr.

Speaker 1: 14:39

DeBrow and Dr Nathiff.

Speaker 2: 14:43

Yes, yes, I love those two. They're so funny together.

Speaker 1: 14:47

They're so funny together and I just love that show and I, you know, I asked this because they both just came out last week and asked people to stop shaming users of these new diet drugs, weight loss drugs, and they said one of the reasons they were talking about it is that they said it was important for people who use them to not feel shame and to openly be able to share with their doctors about what's been working, what's not working, what's been hard, some of these side effects we're going to get into later and that people were reluctant and this was part of kind of the process that they were going to miss out as doctors, and it's an important part of any drug on the market.

Speaker 1: 15:33

You know, he also said I'm just going to quote him these ozempic type drugs aren't the new Botox, they're better, they're Botox. Liposuction, breast augmentation, facelifts put it all together and you got a drug that's not only making people look better and feel better, it's treating the number one risk factor for heart disease, diabetes and cancer. So this is an incredibly powerful, positive thing. That is truly the most significant medical breakthrough in history. Now, maybe he got a little crazy there at the end, right Tish, but I mean I don't know.

Speaker 2: 16:13

I'm not sure that he's far off, because it has so many other implications. And I think that the one part two where they talk about I think there are and I've heard this from other patients they're so afraid to talk about side effects because they're afraid for their doctors to take them off of it. If I complain, will the manufacturer remove me from the patient assistance program. If I complain that I'm having a side effect, will my doctor take me off of this. But here's the thing that's so important about those side effects is we need to know them. We need to know what the signs are. We need to be open. Nobody's going to take you off of anything. You know if you tell them what's happening with you. You have to be transparent about your health issues with this stuff, absolutely. So this is all a great way to look at it, and how I've been looking at it as well is did I need to get diabetes and hypertension or do I get proactive and start taking these medications before I get there?

Speaker 2: 17:30

You know, in the beginning, when the medication had first come out, there was all this uproar that the weight loss patients were stealing the medication from diabetics and I just kept saying to people because I heard some of that are you taking someone's diabetic medication? And I said, well, first of all, there's lots of successful diabetic medication. It's not like this is the only option on the market. And I said, but why do I have to get that sick before I do something? You know, why aren't we being more proactive about weight loss before we get into these more serious medical issues? And you know, here's the thing people have such strong opinions about these medications. It's unreal.

Speaker 1: 18:23

Yes, they do. And to me, you know, treating chronic disease, heart disease, diabetes, cancer, all of these things in advance and giving people a chance to get their lives back right, to remove that barrier how can that be seen as a bad thing? So I think that doctors Dubrov and Nassif, they really hit on something here, that they are not only making people look better, but they are treating the number one risk factor, which is obesity for so many other chronic conditions that really take people's lives away and cost our country so much money.

Speaker 2: 19:10

So yes, very much so.

Speaker 1: 19:13

Yeah, so All right. Well, let's turn to the news again, because this topic's everywhere Tish, and I know we're going to quickly get to your story. But just a few weeks ago, weight Watchers and I've done Weight Watchers in the past. Have you done Weight?

Speaker 2: 19:27

Watchers? Yo, of course, of course.

Speaker 1: 19:30

I mean, there's probably very few women have it.

Speaker 2: 19:33

Weight Watchers is considered and correct me if I'm wrong the most sensible sustaining weight loss. Like it teaches it doesn't go into extremes. It teaches you to live a life that is health-driven and controls your food right.

Speaker 1: 19:56

Yes, and to make good choices, to be able to have cake at a party or a slice of pizza. And then I remember this day on the program. But I was shocked when Weight Watchers announced their own branded ozempic called Sequence. It was out in the news a couple weeks ago and it really made me feel like Weight Watchers is now on the bandwagon with this. That's a major step, I think. Tish.

Speaker 2: 20:23

You know, that should speak volumes to people because and that's why I kind of mentioned that that Weight Watchers is considered that lose a little bit over a long period of time for sustained weight loss. They're the sensible weight loss right, and so if they're embracing these medications, that should really speak volumes to people, right.

Speaker 1: 20:50

Yes, I think it should, Of course. And then there was the story on what really was the medical reason for Lisa Marie Presley's death.

Speaker 2: 21:00

Yeah. So, as I was saying, the reports of Lisa Marie really hit home with me. I've been very open and I shared my weight loss journey, and I've mentioned in the podcast recently that I have personally had a lot of medical issues that I've been dealing with, and I, too was hospitalized for a bowel obstruction that I am still sorting the aftermath with my doctors.

Speaker 1: 21:28

Well, tish, let me first say I'm so happy that you got treatment immediately and have recovered, but tell us a little bit more about what happened and how you feel about it.

Speaker 2: 21:41

So what? And it doesn't cause every bowel obstruction, but a lot of bowel obstructions are caused from scar tissue that is present from past surgeries. And in the case of Lisa Marie Presley, she had had a bariatric surgery and the scar tissue from that particular surgery they have determined was the catalyst that started this bowel obstruction. And then it's a cascade effect that can happen in the body where it goes from a serious condition to a fatal one, and it can do that quite if it's not treated quickly. So for me, I've had quite a few abdominal surgeries and what surgery created the scar tissue that led to this bowel obstruction? And it's not a you just had a surgery and it's gonna happen in the next month or two. This is something that can happen years later.

Speaker 2: 22:49

So, and I've had quite a few surgeries from different things. So from one or several of the surgeries it created a condition where it stopped the movement of anything through my bowels and it is excruciatingly painful experience. Because I'm kind of a high-risk candidate, they opted not to do surgery immediately. I think if I had been someone else they may have gone in and resected powder my bowels like immediately. It's that serious. Instead they decided to try to force fluids down to move it and luckily though, it was not a pleasant experience at all. Luckily it was able to move things along enough that I didn't need surgery after all, but I'm needing to be very cautious and I'm still doing a lot of follow-up with that, so it's a serious thing. So, whether the condition is from a hernia surgery or whether it's from a bariatric surgery, all surgeries have inherent risks, and it can have risk later, such as with Lisa Marie and myself.

Speaker 1: 24:15

Now, tish, I know when you first started taking Manjaro it was bumpy. There's like stomach issues, there's some nausea, constipation, indigestion these are things I read about on the internet, right. But you had kind of moved past a lot of that by the time you had this serious medical issue, right?

Speaker 2: 24:37

Yes, I think one of the very initially there's some nausea, there's achiness, you almost feel like you have the flu sometimes, again, every person is different. Every person reacts differently. There's a lot of thought behind different. If you put it in your thigh, it's not as upsetting to your stomach. So there's all kinds of theories around this, but it's a new medication and we're still learning so much about it. So, yeah, you've really got to look at and start weighing it. It's like a balancing act between these minor discomforts and the benefits you get from it, and so that's what you start looking at.

Speaker 2: 25:26

For me, like I said, it was initial the nausea. I got through that pretty fast. Any type of weight loss typically leads to constipation, and so you have to be very active in your water intake. You have to be very active in supplements and things that you take to make sure that things are still moving. That's pretty common with any type of weight loss, though, to have that kind of things happen, so I think you have to be very careful. That is why it is so important to be you know that these medications are under the guidance of doctors.

Speaker 1: 26:05

Well, I think that's very true. Let me just circle back, though, to this bowel obstruction. Are you afraid of this happening again?

Speaker 2: 26:16

Yes, absolutely. So I am very diligent about my routine on a daily basis to make sure that I minimize my risks to this. Would the risks have been there if I wasn't on menjarra? Yes, I to be honest, my personal opinions. I am not a medical professional right. But if I were overweight to the point that I was before I started my weight loss journey, I think, you know, maybe the outcome might have not have been as positive. I'm in as good physical shape that I have been in for the majority of my adult life.

Speaker 1: 27:09

Since college, since college.

Speaker 2: 27:11

Since college. Yeah, I'm actually lighter than I was, than I was in college. I'm lighter than I was when I was in high school. So these and for me, one of the biggest benefits that I have received from the menjarra has been what I refer to, and a lot of people refer to, as a quiet brain when it comes to food. And anybody yeah, anybody who has had a serious issue with food, they know that we describe it as a noise and it's this constant nagging thoughts of food. When is my next meal? When do I get to eat again?

Speaker 2: 27:59

Eating, eating, eating like your majority of your day is, with thoughts of eating, snacking. You could be eating a meal and planning your next meal and what one of the biggest things that I noticed being on these medications is. Those thoughts have calmed and I'm not thinking about it all the time. Again. That's another thing. That kind of also helps with the weight loss because you're not constantly thinking about oh, what can I eat? What can I eat, what can I eat? And if you've never experienced it, it's so hard to understand. But when you talk to somebody who's been through it, the only way I can explain it is it quiets your brain.

Speaker 1: 28:52

I know we talked about that before Tish too, and I know that I've read that people feel like it's quieted their brain around smoking and other kind of addictive behaviors as well.

Speaker 2: 29:05

Yeah.

Speaker 1: 29:05

Let me just ask you one more question here. So you've weighed the risk rewards then of continuing treatment. Can you share a little bit about that?

Speaker 2: 29:17

Yeah, and that is really up for still a lot of discussion, because there is no clear path at this time for maintenance dosing and I had really hoped that the manufacturers would come out with some better guidelines to what this is going to look like. Again, the doctor that I used I was actually the one a year ago that introduced him to what this medication was. He had to look into it and research it before he would even prescribe it to me, and on our last appointment I had asked him had he heard anything else and he said he had not. Now it's very clear out there that without the medication, weight can come back on. So I have been on a program of just weaning myself off.

Speaker 2: 30:16

But again we're in a new area here because there is no clear cut path of how do you do you come off? Or is this kind of like a diabetic medication that you may be on for the rest of your life? And someone was like well, would you want to do that If it meant that I could keep myself at a healthy weight and keep my co morbidity factors down, risk of cancer, risk of heart disease, risk of hernias. There's all knee replacements, hip replacements, I mean the list goes on and on right. When you are obese, the co morbidities are just endless. So if I had to stay on something for the rest of my life to lower all those risk factors, me personally I'd say yes.

Speaker 1: 31:15

I hear you loud and clear on this and I think that it is an individual journey for each person and I am really understanding from this discussion how much obesity contributes to other diseases. And I think we can safely say, though, like you did, you are in uncharted territory, and so are thousands, if not hundreds of thousands, of people in the US and the world that are taking these new weight loss drugs, or these drugs now off market labeled for weight loss.

Speaker 2: 31:58

So I was going to say here's the thing a lot of people ask me well, because this is a thing about decisions, decisions about your weight loss strategy and what is best for some people, and it's really going to depend on how much weight you want or need to lose, right? So I thought it would be a great thing if we could go through the different types of options that are out there and what is the expected weight loss from them. It gives people an idea.

Speaker 1: 32:31

I love this. Okay, so, decisions, decisions, decisions, right, Exactly Okay. Hcg I know many people have taken the HCG jobs. Average weight loss is one to two pounds a day for the 21 day cycle. I know you did this and lost quite a bit.

Speaker 2: 32:51

I lost 21% of my body weight, and that was after several cycles. Okay, they have you go off of it for a little bit, go back on it. And I maintained the weight loss for about eight months. I started to gain some weight back, and that's when I picked up with different options.

Speaker 1: 33:13

Okay, Ozympic is five to 14. Menjaro is 15 to 22. How much of your body weight did you lose on Menjaro?

Speaker 2: 33:24

I lost 28% of my body weight Again. That was after a 21% loss of my body weight on a previous thing. So again I mean you're talking to somebody who has lost 100 pounds, so but for me it was significant yeah.

Speaker 1: 33:43

Then we have you know surgery gastric sleeve 25 to 35, and bypass 38. So very different approaches, very different results, average results.

Speaker 2: 33:58

So I think you can see why. Because somebody may say well, why would anyone with all these new medications out? Why would anyone elect to do surgery? And you can see the percentages why they do right. And I think that's where the confusion comes in with Lisa Marie Presley. Lisa Marie Presley, why she wasn't in the needing to lose 30, 40% of her weight. You know they're seen out of character for where she was, where her size was. So I think that's the question that comes in.

Speaker 1: 34:41

I agree, and I think, though, when new procedures come out, you know, as we say, sometimes they could be the wild, wild west, and we just don't know. But let's pivot to just regular diet and exercise, something I've said. I've gained and lost the same 18 pounds for the last years.

Speaker 2: 35:02

Okay, isn't that so true for all of us? Right, and here's the thing when we're younger, that's easier to do, but as we get older it gets harder and harder. Right? But according to the National Institute of Health, numerous studies show that diet and exercise and behavioral counseling right, in the best cases will only lead to 5 to 10 percent average weight loss, and very few patients with significantly elevated weights will achieve and maintain that weight loss. Now, my personal doctor, when we had discussion about this, he his thesis, he said, I think feedback was. He felt that only 2 percent of his patients and this is kind of looking over, you know, years and years of being a doctor had been able to lose and keep off the weight for more than a year.

Speaker 1: 36:04

Well, don't we know the yo-yo? That's why they call it yo-yo dieting. I mean, I think almost every woman I know goes up and down and, at any given time, tish. More than a third of Americans are on diets right, and the leading reason is everybody wants to lose weight. So most, according to these stats, are going to be disappointed because even stressful weight loss is usually regained within a few months and this repeat failure makes people feel desperate and sad. I mean, I feel sad that I've yo-yod up and down for the last 20 years.

Speaker 2: 36:44

Yeah, I mean, you know it's, it's that you get down on yourself. You know it's like how did I let that happen again? Yeah, Trust me. I have been on this my entire life, this little roller coaster.

Speaker 1: 36:57

I'm right back there. You have your skinny clothes, your medium clothes, your heavy clothes. Right, it's like which ones are. Am I getting out from under the bed or the other closet?

Speaker 2: 37:08

Right. So, as we have said a couple of times, obesity has its own mortality risks and according to, like the American Cancer Society right, they say that being overweight or being obese is clearly linked to an increased risk of cancer and according to this their research, excess body weight is thought to be responsible for about 11% of cancers in women and about 5% of cancers in men in the United States, as well as 7% of all cancer deaths.

Speaker 1: 37:52

I am blown away by that.

Speaker 1: 37:55

I had no idea until right, this second between the link between obesity and cancer. I mean, that is powerful If we think about just that one change right Obesity to cancer. I'm going to add to this statement because you know we love our facts here. The American Heart Association made this scientific statement obesity contributes directly to the incident of cardiovascular risk factors, including a word, I don't know how to say eclipthymia, type 2 diabetes, hypertension and sleep disorders. So obesity also leads to the development of cardiovascular disease and cardiovascular disease mortality, independently of other cardiovascular risk factors. Now, I know that was a mouthful.

Speaker 2: 38:54

What they're saying is obesity and heart disease are just so closely linked Absolutely, and so it brings us back to this question when do the risks of obesity outweigh the inherent risks of these medications and surgeries?

Speaker 1: 39:16

Yeah, where is the line? I mean, I think we've danced around this the whole episode Tish. And who gets to decide what options are available and how much risk each person can take? It's a personal decision.

Speaker 2: 39:32

You know, here's the rub, alan. Unlike other medical decisions, other people feel is, if they have a right to help make these decisions for you, it's crazy, right. So why do people feel that they have a right to comment on, say, my personal medical decisions? When it comes to weight loss, I would never tell somebody how they're going to treat themselves with cancer or how they're going to treat themselves with cardiovascular disease. I mean, it is incredible that they think this is on the table and I personally, like I said, I personally heard a lot of negative feedback about my weight loss decisions, to the point when I remember I had to tell people in my life look, this is not up for discussion.

Speaker 2: 40:29

I've made my decisions and I've weighed the risks. I'm aware of where the risks are, but I also know the great risks that come with obesity. And at this point I need you to either support me or just stay silent, because I need the focus and the drive and the support to get to where my goals are. You know, I had some friends and again, it was definitely out of a place of love and caring, yes, but they had to pull back and not say anything and we even discussed it later and they were like well, I was just, you know, concerned that such, what they perceived as such drastic measures were going to lead to even more health issues. And I said I understand that, but I was living. The health issues today basis with the obesity.

Speaker 1: 41:33

You know, tish, I had to hold back when you first started and just be supportive Again. It was, I think, like what you were saying. I was worried for you. I felt like, have they really done this long enough? I'm hearing all these things on the news and you know, you and I lived through the fen-fen craze of was that the national genius? I mean, right, people with having heart problems after that. But what I quickly saw was how confident you became, how strong you were becoming, how much this changed your life. I mean, it was just so apparent and that you were really taking this seriously and cautiously. And so I think that you're right. Why do people, even if it's from a place of love, they feel again like they know better and they, I think, really have a hard time? Again, it goes back to me with the shaming. But when I saw how much this changed your life and it is not a surgery, right, so we're lower in the risk there I think it was something that people jumped on with, on board with I think they did.

Speaker 2: 42:58

You know and again, I'm not a medical professional I think everyone needs to do their own research. They need to work with their doctors to develop whatever their plan is. But for me, the medication Manjaro has been a life changer and medications like this you know they're going to be coming out without new medications. They're working on all kinds of things and I think for me, I like the idea that there's a lot of research and development going into medications so people don't have to opt for surgery that don't absolutely need that or they can intervene before they get to the point where surgery is a better option. But I'm going to just put this message out there.

Speaker 2: 43:50

If you've been one of these people that has shamed someone else or felt like this was an easy road for somebody to take and trust me, it took me a very long time to get down this road and I had to make a lot of changes to get down this road and just step back, do some research, but don't put people in a position where you're shaming them for either being heavy or you're shaming them for not doing something about it. People just have to let this go. You know what I mean. They just have to let it go, that we don't put people in a position where they feel they have to lie and hide and that we just support each other and what decisions they make.

Speaker 2: 44:42

I think the next huge hurdle to come with these medications has to do with affordability. These initially, eli Lilly had a great patient assistance program that was open for everybody. That made it an affordable option. It is now not as affordable of option, especially for a lot of people. I hope that changes before too long because and I hope a lot of the insurance companies come on board to say I would rather pay for this medication than the all the comorbidity things are going to have to pay for all the medications that come with that, because I think it comes down to a better quality of life.

Speaker 1: 45:34

You know what Tish well said and I just want to thank you for your vulnerability today, for sharing your health scare and for sharing your point of view and your experience. I think what I'm taking away, and I hope other people take away from this, is that it is a miracle. It's affecting a lot of people. We have a lot of options. This is one of the options, but do not shame people for making those health choices. To be healthier and I know you were delighted with the lack of medical issues that you had while taking this drug. Yeah, I know you have great friends who came through for you. You had great doctors, you really taking care of yourself, and I just want to hold you up as a role model for other people.

Speaker 2: 46:33

Thank you, I try to be as supportive to others that are going through this, because I know how hard this road is, and I want us to continue to kind of keep our eye on all these developments, these new medications coming out and new concerns. I think this needs to be a continued conversation. We need to be open about what is happening new developments, just everything. I think this is something that we will continue to delve into.

Speaker 1: 47:09

That's right. So thanks for joining us tonight. We want to just give a plug for our Patreon. Join us as a patron and support our podcast. We'll have a link to that in our show notes and until next time, midlife first.

Speaker 2: 47:26

Have a great week.