Is Leptin Resistance The Reason You're Stuck?

Welcome to Your Life Reset, a Verta Health podcast where bold stories meet breakthrough ideas. From massive weight loss wins to exploring the latest research, discover what's possible when science meets real life. Hi everyone. We are live from Dallas and I'm very excited to get to chat with one of our medical providers here at Verta. Um her name is Joanne Parker. Joanne, why don't you just introduce yourself for our viewers? — Thanks, Teresa. I'm Joanne Parker, Dr. Joanne Parker. I am a family medicine physician and I've been with Verta less than a year, but I've been living the Verta lifestyle for over 10 years. — Oh, really? Yes. Okay. So, tell us a little bit about that. — Okay. So, back in 2011, a good friend of mine told me he was going to do this crazy low carb diet. — Crazy. And I thought he was insane and I thought it was dangerous. And I said, "Let me look into it first. make sure this is safe. And I started looking into it and I was just amazed at how much scientific sense it made compared to what I had been taught in medical school. — So I tried it myself. I started using it with my patients. And so I've been doing this ever since 2011. — Wow. — Yes. — What type of um how did your patients kind of react to this? Were they like, "What do you want me to do? " You know, if you approach it as I want you to follow this weird diet, people are very um hesitant. But I always started with, would you like to not have diabetes anymore? — And they're amazed like, I didn't know that was a thing. I didn't know I could get rid of my diabetes. I'm like, absolutely. And then they're on board. Tell me more. Tell me how I can do this. I don't want injections. I don't want insulin. I don't want pills. I don't want surgeries. I don't want shots. Tell me what to do. And so you kind of hook them in with that excitement of I don't have to have this disease anymore. — I think that's actually a great if you go if you flip the script or person to the patient, they might say, "Oh, um, hey doc, I don't want to have diabetes anymore. " — Yeah. — So help me out here. Or I have this idea I want to go with and it's going to help me not have diabetes anymore. — And most patients don't even know that's possible. — Yeah. So, so introducing it that way is fun and exciting and then people are on board and they're willing to make changes. — Yeah. — Well, Joanne, we're gonna talk about something I think is not terribly well understood. Um, we're going to be talking about the hormone leptin and we're also going to be talking about binge eating disorder, how they're related. I think that this is um I I'm definitely excited to hear about this and I think a lot of our members and people, you know, really everywhere are struggling with their relationship with food. They're struggling with this — with this both, you know, physically and psychologically. So, let's, you know, let's get into it. I'm really excited. Um so, you know, let's start simple here. Um what exactly is leptin? And I hear that it's the satiety hormone. So is that true? Tell us about it. — Almost. Okay. And this is my one of my favorite topics in this uh space because you know we talk a lot about insulin and glucagon — but we don't really talk a lot about leptin. Leptin's role. And people say oh leptin a satiety hormone. — If you think of satiety as feeling full after each meal. Leptin's not a big player there. — Okay. Um, there are lots of things going on when you eat a meal that tell you whether you're full, you've had enough to eat. Leptin has a role, but a very small role. The big thing that leptin does, and once you understand this, everything clicks. Leptin is a hormone that's made in your body, but it's sensed and signaled in your brain. Leptin tells your brain that you have enough body fat in storage. — Let's say that again. Okay. Leptin tells your brain that you have enough body fat in storage to survive any upcoming famines. — Okay? Which we're not really dealing with now. — We're not. But that's how we evolved, right? Right. But we did a long long time ago. Okay? — And here's the thing. When your insulin is high, and insulin is the hormone that manages your carb intake, right? So, when you're constantly having carb intake, and I don't just mean cookies and potato chips. I mean, you know, oatmeal, rice, and beans, all those carbs we were told were healthy and good for us. — Quinoa. — Quinoa, whole grains. Yes. Yes. — Your insulin is chronically high. And when insulin is high, your brain cannot hear the signals from leptin. — Okay? And so when your brain cannot hear the signal from leptin, your brain thinks you're starving to death. — That does not feel good. — No. Your brain thinks you don't have any body fat in storage. And so it will make you eat.

— Oh my. Okay. — It will drive you to go find food. And find carbs because carbs are the fastest form of energy. They're not the best healthiest. They're not the most nutritious form of energy, but they're the fastest form of energy. — Okay? And at that point, we want something. You feel like your brain thinks, no matter what you look in the mirror, see on the scale, no matter how your clothes fit, your brain thinks you have no body fat and storage because it hasn't heard from leptin for years. — Oh my. Okay. So when people talk about those midnight munchies or sitting down and eating an entire pizza and yet I still want an entire box of donuts, as far as your brain is concerned, even though you still have some of those fullness signals, the overriding signal is it hasn't heard from leptin and it thinks you have no body fat in storage and it will drive you to eat. — Okay, leptin's calling. We are not answering. — Leptin's calling but the phone is broken. You think your boyfriend tech ghost ghosted you when really your phone is broken. — Oh no. Nothing worse than when your phone is broken, — right? And you don't know it. And you're like, "Why is nobody calling me? Why is leptin not calling me? Leptin hasn't told me anything about body fat. I don't have any body fat in storage. I need to go find something right away. " — Your phone thinks that leptin is a spam. — Yes. — Yeah. So, you're just not answering. Leptin's like, "Hello, hello, hello, hello. " Yes. — Okay. — Yeah. — All right. So, we've heard about leptin. Yes. — Um, can you just give like a 30 secondond, you know, elevator speech about again what's leptin? If let's pretend I'm six. — Yes. — Um, — explain to me very simply. — Leptin is the hormone that tells your brain that you have enough body fat in storage to survive a famine. — Okay. And when leptin's a knocking or a call-in — and the phone's broken, — then we're gonna eat mostly carbs. — Okay. All right. I think I understand for the most part. — And when you when that light bulb goes off and you understand that, then all that behavior around binging starts to make a lot more sense. — Okay. All right. We're going to talk about binging in just a little bit. Um I want to go a little bit more into kind of uh the science of leptin. So is uh I I've heard about leptin deficiency and leptin resistance. Um are they the same thing? — No one is really leptin deficient. — Okay. — Leptin is made by your fat cells out in your body. — So even a person of normal weight is making leptin all day long. Okay. And people who are overweight have higher levels of leptin because they have more fat cells that are making more leptin. So there's plenty of leptin. Nobody's deficient. — Okay. — Leptin resistance refers to that fact that the leptin can't get across the bloodb brain barrier into the brain and tell your brain, "Hey, we got plenty down here. Stop eating. " That's leptin resistance and that's caused by high insulin. — Okay. All right. It's all making sense. — And another thing that's interesting about leptin is um high triglycerides, which are caused by a high carb diet. It's one of your cholesterol panels that your doctor gets also prevent leptin from getting into your brain. — Okay? — And poor sleep, stress, all these hormones interplay with each other in ways that your brain just can't hear the leptin. I'm noticing uh kind of a pattern here or some connections with the types of information that we tell folks — the same types of factors are impacting their ketones, their blood glucose, their overall insulin levels. It's the same. — All of our hormones do a very sophisticated dance all day long. levels are rising and falling in relation to sleep, stress, mood, sunlight, exercise, food that you're intaking, the types of food, the amount of food. It's all a very lovely dance, but when that dance gets broken, everything falls apart. — Yeah. So, obviously, there are things that we can really control like our food intake. There are some things that maybe in certain phases of life, you know, we're maybe illness, stress, lack of sleep, you know, so let's maybe not those all influence leptin. But if we focus on less on those factors and more on okay, what can we actually control, then we're going to be um on a better path. So, um we're going to move into um another tricky subject which is binge eating disorder. An area that you are quite an expert in. Not be well because you — Yeah.

— Not because you do it, but because you it sounds like something that you're very fascinated with and the relationship with leptin. So, tell us a little bit about that relationship. — It's complicated. Nothing I'm talking about is simple. We're going to simplify it today to make it easy to understand. But again, this is a complicated dance, right? — So, there is a clinical entity that's been described called binge eating disorder, — which is different, I want to say, than bulimia, which is binging and purging. Okay, — this is different. This is people who binge large amounts of food. The person who sits down, eats an entire pizza, and even though they feel full, still feels also hungry and will eat a box of donuts and is crying and wondering why they can't stop. M — um and feeling like there's something wrong with them. And in many cases that's been described as a binge eating disorder. There are multiple factors that go into that. Childhood trauma, childhood habits, stress, sleep, I mean all the things we just talked about. However, we also have noticed that people who've been described with this disorder or this situation have really high levels of leptin. Really high. which means their body is trying hard to signal that there's enough body fat in storage and their brain is not getting the message. — Okay? — So, I always like to say there's no psychology without biology, — right? It all goes together. We can't separate our mind from our body, our thoughts from our chemicals and hormones. So what I've noticed and what we have seen in the scientific literature is when patients switch to a very low carbohydrate diet which allows that insulin to drop and allows leptin to get through to the brain and go hey we got enough body fat in storage. Binging stops. It goes down. — The phone works. A message gets through. And when the brain understands, oh, we have enough body fat in storage, it stops driving that frantic eating behavior, does it stop completely? Not necessarily. Again, there's other factors that are involved and it's hard to tangle out or untangle what's psychology, biology. Again, they're interrelated, right? — But you can have a huge benefit in people who have this behavior. And my favorite thing about that is when someone says binge eating disorder. On the one hand, that can feel like a relief, right? I'm not weak. I'm not lazy. Um I have a disorder, right? There's a medical problem here. But what if there's not? What if it's not a disorder? What if it's just a situation? a situation where your hormones have gotten out of balance because you were trying to follow all the traditional dietary advice about whole grains and fruits and — those things and your insulin has been sky-high forever. And so a disorder feels like destiny. I have this thing that I have to control and manage and fight and willpower against. What if you don't? What if instead you had the ability to change your eating, change what's on your plate in a way that allows this dance to become coordinated again. And you're in control and it's not your destiny. And you have can have a significant impact on these behaviors that you find so frustrating and unhelpful. — I love being in control. — Do you love being in control? I love being in control. — Yes, I do. I do. — Yes. But it gives you power and agency and you're not helpless. You're not helpless in the face of, "Oh, I have a disorder. I'm always going to be this way. I'm stuck and the best I can do is try to, like I said, white knuckle and manage it. " We can make the white knuckle go away. — I just have to do this. I have to just be motivated. I have to have willpower. It takes the shame out of it. — Right. Willpower and motivation don't actually exist. — No, — they don't. No. — Nope. There there's hormones. There's habits. There's, like I said, there's a lot of biology involved. And I feel like it gives my patients back control of their lives. They don't feel like a helpless victim. They feel like, "Oh, I can make choices and I can make decisions and I'm not broken. " — Yeah. — Things are out of balance. They're out of whack and need to be realigned, but you're not broken. And that's powerful and it's positive. And I think it's a great call out too for so many people who are trying to repair this biology, right? Um where they are they're like, "Yeah, I want to — not have diabetes anymore. I want to not struggle with this disease of obesity for the rest of my life. " you know, and recognizing too that so many people we hear from are their

ketones are high, they're they've fixed things, they're hearing the leptin, their insulin levels are lower, and they still struggle with um I just want to eat a whole pizza. And it's I think recognizing that it's not going to go away. And again, setting ourselves up for success with that habit stacking with, you know, there's the behavioral changes and the support that you need in addition to just fixing the biological problem, which is a good I think — there's a very popular phrase right now in the common culture of food noise. — Yes. — People talk about food noise. We used to call it cravings or hunger. Now we call it food noise. Okay. But what the thing that we're describing, yes, may have some psychological basis, habit basis, but a lot of it is that leptin, right? Your brain hasn't heard from leptin probably in many years. Up some studies say that up to 80% of Americans are metabolically out of whack. — Yeah. So if 80% of people have high insulin, high leptin, but it can't get through, then that what we call food noise goes away when we get that back into balance. Your brain is not screaming, "We're not going to survive the next famine. Go eat something. " You know, it it's a — again recognizing like, "Oh, take a breath. This is my dumb brain that thinks I don't have any body fat in storage. What I call food noise is this biological thing going on and I have the power and control to change that. — Yeah, that actually makes a lot of sense too. why so many people we hear from, you know, my myself included, uh I used to be what I would call um a long time ago, I would be like low carb during the week and then I would go on an insulin fest in on the weekend. And I would always wonder why — it took me like the next four days to try to get rid of the cravings. And that makes perfect sense. The insulin levels were higher, the leptin, the leptin couldn't get through. And then by like Friday, — I was feeling pretty good. And then I just, you know, the whole cycle started again and over time I was like, — "Yeah, my body can't do that. That doesn't work. " — But again, you're not broken. — That's our biology. — We're going to talk about some practical insights now. So, we've done a lot of science, right? Um, we've talked about some habit stacking, behavioral changes. So, let's get practical here. Um, are there treatments or lifestyle changes that can improve limp leptin sensitivity? Teresa, you're not going to believe this, but if we follow a lower carbohydrate eating approach, insulin goes down. Leptin can get through. So, insulin comes first. Insulin is the primary hormone that we need to address in our carb heavy society. And again, I want to make clear, it's not just the cookies and chips. It's the whole grain pasta, the oatmeal, the fruit juice based smoothies that we've all been told to have for breakfast, right? — Yeah. — Um, — so and that takes work. That takes conscious decisions, habit changes, clean out the pantry, focus on nutrition, protein, and healthy fats that can work on that satiety in the short term while we make those changes. And that part is hard. that beginning part of getting it right. I like to think of this. I love analogies. And imagine a homeowner who's got three kids, right? And that homeowner is calling for pizza every night. Five, six, 10 pizzas a night, right? There's always going to be extra. — Well, — let's imagine there's extra. They order more than they can eat in a meal. Insulin, three kids, one of them is insulin. Insulin's job is to take the extra and put it in the chest freezer downstairs. We all have a chest freezer, right? In our basement, garage, somewhere where we put the extra, right? — Oh my gosh. Yeah. — Yes. So, that's insulin's job. Take the extra blood sugar, put it in storage, stuffs it into the cells. That's its only job. And it's really good at it and it will do it all day long until insulin resistance and diabetes farther down the road. But that's their job. Right now, imagine one of your other kids is down in the garage screaming upstairs, "Hey, we've got enough pizza in the chest freezer. " Right? But they can't hear it upstairs because insulin's running up and down the stairs getting in the way. — Making too much noise. noise, so it can't tell. So, you're stuffing all this extra pizza that you've ordered into this chest freezer, right? That's all the extra body fat we have in storage. Leptin is screaming from the basement upstairs. Can't hear it. It's like, "Oh, we don't have any food in the house. Let's order more. " — Okay. All right. — It feels kind of like pandemonium going on. — It is pandemonium and it's out of balance.

balance. — Let's talk about one meal. Let's say dinner. I feel like that's a tough one for a lot of people. — Sure. — How could we set up our plate to improve — Yes. — leptin sensitivity? So in the short term, what we like to talk about is prioritizing protein. Protein is a satiety hormone. Okay? — Protein makes you feel full in that meal as does fat. And typically it's protein with its fat. — Okay. — So your steak with the fat on it, your salmon that has fat in it, right? Um — your chicken with the skin. — Oh yeah. — Yes. Um, so having a meal that prioritizes protein, add some fat for flavor, leave the skin on your chicken, and then really controls those carbohydrates to limit them to like a green vegetable. You know, sauté your broccoli or your asparagus and some olive oil. — That meal is going to make you feel full in the short term, right? I always say to people, how much orange juice could you drink in one sitting? — The entire jug. Right. How much olive oil could you drink in one sitting? — Oh my gosh. — Like a sip. — I don't even Right. A sip. Right. Because fat — makes you feel full. We talk about foods that are rich. — We recognize that. Most people kind of cringe when I say that. They're like, "Oh, I couldn't glug a whole thing of olive oil. " You can do a shot, right? Because it makes you feel full. So in that meal, — set yourself up for success to feel full at that meal. And then what happens in that chaotic household? Insulin can go take a nap because insulin is not needed for protein or fat. — It's been running up and down the stairs. — It's arrested. Yes. — Now, caveat. Insulin is used for protein a little bit, but it's a short sharp spike, not a prolonged rise. — Okay. — Good clarification. — Don't come at me in the comments, you physiologists. Right. But for the most part, insulin can go take a nap because it's not needed. And it can go take a nap. And then you know what happened? Leptin can go upstairs and go, "Hey, we've got enough body fat in storage. " And then brain will be like, "Oh, I don't have to order 20 more pizzas. " — Plus, that gets expensive. — It does. Yeah, — it does. It's expensive to our health, right? Because carbohydrates are oxidants. They cause cell damage. all that excess glucose is leading toward diabetes when insulin just gets exhausted and quits. — So it's a good thing. So at each meal if you can set yourself up for success — and then it becomes a habit and that habit and then our bodies shift toward — so you can't eat as much protein and fat as you can carbs, right? So you're eating less calories. We don't talk much about calories. Calories count but we don't count them, right? You're not eating as much calories. And then if you need some extra energy, remember I said we had three kids. Do you know who the third kid is? — Um the crazy one. — No. — The same one. — Yeah. You know who our third one is? — No. — It's her friend glucagon. — Oh, — you've heard you may have heard of something called GLP1 drugs. — I may have. — You may have. Yes. — Yeah. — Glucagon like peptides. — Okay. — So, what does glucagon do? — Keep us full. — No. Glucagon's job is to go get energy out of storage. — Okay. Is it like the opposite of insulin? Kind of. — Kind of. Yes. — Kind of. — Glucagon's job is to go downstairs to that chest freezer, get some leftover pizza, thaw it out, heat it up, and go, — "Here we go. " — Okay. — So, when insulin goes and takes a nap, and leptin says, "Hey, we have enough body fat in storage. " brain says, "Oh, I don't need to order all that extra food. " And not only that, "Hey, Glucagon, go get some chest freezer. Go get some pizza out of the chest freezer. We have plenty. " And that's how we lose weight. — Oh, okay. — Right. — Okay. All right. — That's how a low carbohydrate diet can influence obesity. One, by you're let you're just intaking less, right? When you're eating protein and fat, you're going to intake less because you feel full at that meal. — Okay? And when you need extra energy, you can use ketones for energy, which we talk a lot about. And also, Glucagon, who's been sitting in the corner like, I guess nobody needs me. — Yeah, — right. Cuz you're glucagon. — I know. Glucagon's been sitting in the corner texting on his phone lonely. Nobody needs me. Because you keep incoming — with food can finally be helpful and be like, oh, I can go get some out of storage. And now we're all friends. — Oh, okay. — Right. One big happy family. — Big happy family. Insulin. — Crazy. Three kids. — Insulin's taking a nap. Pops up when he needs to, but is not just exhausted.

Glepin. Hey, we have enough body fat in storage. And glucagon. Like, I'll go get some. — It's all now working. — It's all working. It's all working. — Let's go back to dinner. — Let's do it. — What's your favorite? Let's say um Okay. Let's What's your favorite low carbohydrate dinner? — My husband makes the best filt on the grill. Salts it up in the afternoon so it gets that nice crust on it — and then goes out to the grill and he will grill up steaks, asparagus, and grilled onions. — That sounds amazing. — So good. With so much butter. — Oh my gosh. Okay, I'm going to tell you mine. — Every Monday, — we do this. Okay. Uh unless it's all 99% of the Mondays in our house, we have uh salmon and then I make cauliflower puree that I got to tell you, I have perfected it over the years. It's literally just — uh — cauliflower, — sour cream, — salt. — Oh, — if you want to get fancy, you can add some pepper, but I let people do that at the table. — Uh it is so good. The key though is you've got to get all that water out. Like you got to get so much of that water out and then it is literally just like mashed potatoes. So here's what you do. Then you serve it either if you're feeling fancy under the salmon or if you're like me, you get all the crispy skin first and you dip it in the cauliflower mash and then you Yeah. You take the salmon. Oh, it's so good. Um anytime we serve it to people that come over, they're like, "What is this? " And I'm like, it's cauliflower and it's amazing. So that's my favorite. You've got a pretty good one, too. Uh filt. I mean, you can't go wrong. Asparagus. I I've really gotten into asparagus lately. And the key is you got to figure out to cook how to cook it correctly. And — you don't want that mush in the can from childhood. — No, no. All right. You want it to still be a little crispy, a little charred on the grill. — Yeah. Mhm. Yeah. But you got to pay attention. I got a phone call one time while I was trying to do asparagus and it was like — I just ruined the asparagus. It's a little bit too charred. Yeah. But when you pay attention um we'll do a cooking show at the next one and then we can show how to like do asparagus and that ribeye and the salmon. Okay. So, we've um talked about some practical ways that you can make some changes. We've laid out uh your dinner. So, we're talking a nice protein with a good amount of fat. Now, if you have, let's say, you just you really like just a lean chicken breast, you can throw some butter on the top of that. No big deal. That that'll work. — Make a sauce, a little bit of heavy cream. — Oo, yeah. — I keep heavy cream in my fridge at all times just to splash in things. — Of course. Yeah. And then, uh, you know, your green vegetables or your non-starchy vegetables of any kind, right? And then, like, oh, the grilled onions. That sounds pretty amazing. Um, for me, we keep it pretty simple. Protein, non-starchy vegetables. Make sure there's plenty of fat. — So, everybody's favorite topic, GLP1s, — right? People are probably getting a little bit sick of hearing about it. But honestly, it's everybody wants to be okay. A lot of people want to be on one and the commercials are everywhere. It's going to fix everything, right? We all know that there's probably some caveats to that. We've talked about GLP1s a lot here. Um, so my question about GLP1s, you know, we're talking — OMIC, right? We've got Ompic, we've got um Wiggoi, which is really starting to come out. Yeah. Everybody's so excited in these commercials. They're dancing. They're like, I lost weight. Looks awesome. Okay, so let's talk about GLP1s. Um, how do they affect leptin or binge eating disorder or both? — Yeah, let's talk about that. Okay. Um, they don't. — Oh, so let's talk about GLP1 again. We said GLP, glucagon like peptide. Okay, our bodies normally make GLP1. It's one of the hormones we make. We make glucagon and we make GLP1. Less of it, but we make both. Um, but glucagon like peptide does a lot of what glucagon does. It goes and gets energy out of storage. So when you inject yourself once a week with that medication, imagine your household we talked about. Imagine if you know Glucagon was sitting in the corner lonely, sad, nobody was paying attention to him. No, he was not going and getting anything out of storage and then a bunch of big goons show up glucagon like peptide big dose. I mean, we're dosing people with higher than what our bodies make normally, right? So they come in, push everybody out of the way. We're getting it out of storage, right? And so you have these big goons who go

down to the chest freezer and they're getting that energy out of storage, right? — Okay. — And so that's why people lose weight and lose weight fairly rapidly on a GLP medication. Okay? It acts like glucagon and it goes and gets all that body fat out of storage. Unfortunately, because it's a big dumb goon, it also seems to take um energy from muscle. — Okay. — Possibly bone and possibly organs because all your cells have extra energy in storage. — Yes. — When you're overweight. And so it's pretty indiscriminate. And so we see people who not only lose body fat, which is what we want, they lose muscle mass, possibly some bone mass again, and some organ health. The organ health part is scary. — Very scary. — It's interesting. We need to know more about it. — Okay. — But so these GLP medications, they come in and they do the thing, right? And because they're pulling so much energy out of storage, there's a lot of more circulating blood sugar. Now you're getting it from the chest freezer. Brain is like, "Oh, okay. I guess I don't need to order any food. " And it will stop. That's why people have no appetite and that's why people feel nauseous because it actually slows your GI tract to the point where in some people it stops completely. So while glucagon while GLP is on board and these goons are in there pulling all that energy out of storage, you feel sick. You don't feel hungry. We have people who get sometimes malnourished and dehydrated because they just can't take enough in. So the goons are in the house. They're pulling it out of storage. But nothing changed with leptin and your own natural glucagon. In fact, your own natural glucagon is now hiding under the bed because these goons have showed up to do his job. — Oh man. — Right. — This household is getting crazier by the minute. — Sure. And so on the surface and on the scale it looks like things are moving in the right direction. And absolutely for some people getting that weight off especially people who are very overweight can be beneficial to health. Right. — Sure. fat cells do a lot of bad things and so there's getting that extra energy out of storage in itself is not awful but it doesn't solve the problems in the household it's still a dysfunctional family so when the GLP goes away when we stop taking it either we've hit a normal BMI insurance isn't covering it anymore the side effects are intolerable that nausea having our stomach stop moving entirely there are good medical reasons that some people can't tolerate a GLP long term. So when that stops and the goons leave, sure there's less pizza in the chest freezer, there's less body fat in storage, but nothing else has changed in that dysfunctional family and it goes right back to being dysfunctional. When people say, "I stopped my GLP and the food noise came roaring back," that's because the brain still can't hear leptin. Because insulin is still running up and down the stairs because you're still eating smoothies, oatmeal. A lot of people on GLPS have such low appetite that using protein shakes, which can be helpful if it's mostly protein, but a lot of those have a lot of sugar. — Yeah. — And so insulin still running up and down the stairs. — Oh, okay. So you could have the goons in the house and you could be having some — some benefit, — but then you're you still potentially unless you are following a low carbohydrate lifestyle, you you've still got this leptin issue going on and these high insulin levels going on in the background. — Yes. — Okay. And so that's why, you know, some patients at Verta who are using our program are on a GLP. But when they do our nutrition piece with it, when they follow that low carbohydrate approach, first of all, they have better success in their weight loss, higher percentages of weight loss, they don't lose as much muscle mass, and when the GLP stops, they have that foundation on board for that happy family. So that when the goons leave, leptin can still walk up the stairs and say, "Hey, we have enough body fat and storage. " Because even losing that much body fat, some people lose 15, 20, 30% of their body weight. Even a healthy individual at a normal BMI has plenty of body fat and storage. They have normal leptin that's telling their brain you don't need to eat a lot of extra. Right? So if our members, our patients can follow that low carbohydrate approach while using the GLP and once the GLP goes away and it really should always go away. I don't subscribe to the approach that these are lifelong medications. They don't have to. There's actually we did a survey um and — only

one out of five people on a GLP1 — imagined that they would take it in the long run, right? — Four out of five 80% of people didn't want wanted to get off it. — Well, you know, we started as a diabetes reversal company, right? People wanted to get off diabetes medications, off medication. The goal in life is not to be on more medication, right? And you know, there are some lifelong medications that people have to take when they're broken. There are some chronic conditions that require lifelong medication. Is obesity one of them? I think that's not a proven thing. And I know that the FDA and the drug companies are telling us that these are lifelong medications. And maybe for some people, a small percentage of people, they do need to be lifelong. I think for most people, if you can change what's on your plate, get your leptin and your glucagon and your insulin all to be friends again, you don't need it. Let it do its job. If it's a jump start for you, great. And for some people who can't tolerate the side effects, can't afford the medication. Coverage goes away. You can still be very successful. I mean, we've been doing this at Verta for 10 years. We're here at our 10 year anniversary. — Yes, we are. We've been doing this for 10 years without GLPS and our patients have lost significant amounts of weight. What was the lady last night that lost 141 pounds? — Yeah. — 141 pounds. And she didn't talk about using a GLP. — No, she didn't. — No. So, — she did it by eating eggs. — Eggs — and bacon — and salmon. — And salmon — and cauliflower — and hopefully that cauliflower mash. We'll see. — And um and filt and grilled asparagus. grilled onions. Yes. — And of course, we have lots and lots of vegetarian options as well. There are vegan options as well. In fact, at our dinner last night, we had a bunch of vegan options, too, that were — Yeah. Oh, delicious. But um so you can not only improve your leptin sensitivity, reverse your diabetes, reverse your obesity, — get all the kids happy again, — happy family, — and you get to eat all this delicious, delectable food, — wonderful. So yes, it's — Yes. And the food noise goes away. — Okay. And will there still be some days where we engage in some food behaviors that aren't as healthy as we'd like? Probably because we can't untangle psychology and biology. — Yes. — But we talk about harm reduction, right? The less the better. If those things mostly go away and there's a slip every once in a while, I don't like to talk about cheat. I don't think cheat's a nice word, right? We're not cheaters. We're human and humans have strengths and weaknesses. Joanne, this has been an incredibly insightful conversation. I have learned so much. I I hope our viewers have learned a lot too about all this and how it's so interconnected with metabolic health. Oh, yeah. Um and at the core, right, making those food choices that it can improve everything. We know it's multiffactorial, but at the base, that is what we can do. Okay. So, with that, we are going to move on to the hot seat. Okay, — rapid fire. Don't overthink it. Just whatever comes to your head. Okay, so what is your goto low carb comfort food after a long day? — Uh fa 5% whole fat yogurt with a couple of uh stevia chips. Chocolate chips. — Oo. — Yeah, — that's really good. Uh I like the Lily's chocolate chips. — Yes, the liies. Yes. I'm not paid to say that, by the way. I just really — And here's a secret I learned. The little um lemon and lime true lemon true lime packets. — You put a lemon in there, it's like lemon mering. — You put a little I still have yet to try that. — It's like a key lime pie. — Yeah. Okay. All right. — Question two. If you could keep one snack in your pantry for the rest of your life, what would it be? — I love a tinned fish. — A what? — Tinned fish. Sardines, muscles, tin salmon. Yeah. — Okay. — Pop open a can of that. — Oh, just eat it straight out of the can. — Okay. I got to say, I've never tried it. — Oh, you're missing out. — Um Okay. I always mix it with, you know, some mayonnaise. — Mayonnaise. Yeah. — All right. I'm going to do it. Um last one. — If you had to name a nutrient superpower for yourself, — what would it be? — It's steak. — Mhm. — Yeah. Okay. And steak. — That's a good one. So, is fillet your favorite cut? — I would say um filt or ribeye. — Okay. — My husband doesn't love a ribeye and so he really likes fillet. So, if he's cooking, it's fillet. But if we're at a restaurant, I'm going to order a ribeye. — All right. One more question. Uh it's

not on here. So, what's your favorite color? — I would say coral — cuz it looks good with my skin. Coral is great. Yeah, the coral jacket. I'm loving it. Coral looks great on you. All right. Well, Joanne, this has been so much fun. I'm so glad that we got to get together here at our 10y year anniversary. Um, okay. I'm going to ask you one more time for our viewers. What's the main takeaway from today? Let's pretend that we are all um all of us viewers are like 5 years old. What's the main takeaway? — Here's the main takeaway. You have to eat every day. You might as well put something on your plate that's gonna make future you better and not worse. — I love that. Thank you again. This has been so much fun and I can't wait to have you again on our We're going to do a live cooking show. Maybe asparagus. I don't know. That could be complicated, but I'm sure there's plenty of other uh topics that you would — Yeah. And we'll go shopping maybe for some tinfish. — Okay, — let's do that. — Yeah, that sounds great. Okay. — All right. Thanks, Joanne. — Yeah. If you enjoyed this episode, be sure to subscribe and leave us a review on Apple or Spotify. And if you'd like to regain control of your metabolic health and feel like yourself again, check us out at verda. com. That's vir. com. Your life reset is forformational purposes only and shouldn't be considered a substitute for professional medical advice, diagnosis, or treatment. Contact your provider if you suspect you have a medical problem. I'll chat with you all again soon. Until then, stay inspired, my friends.