Ozempic Secrets

But before we dive into that , maybe just tell us a little bit about your background and how you came to be interested in this fascinating area .

Even though I'm very active like I play basketball I go to the gym every day Just struggling with the extra bites here and there that make my weight is on the higher side .

So my BMI was on the 31 range and I have been trying to lose weight for a while , being a cardiologist and knowing the obesity and everything that comes with it , and knowing the obesity and everything that comes with it . You know the metabolic syndrome and hypertension , diabetes , hypercholesterol , and I'm treating that on a daily basis .

So when I heard about the GLP-1 , I studied it more and I saw a lot of people having great results on it . And when they approved it for purely weight loss almost a year ago , I was interested in using it myself . Unfortunately , I didn't have not , unfortunately I didn't have diabetes , so my insurance did not approve me .

So I bought it myself and I lost , maybe the first month , around 10 pounds and I was very , very interested in it . So I started prescribing it to my patients , and not surprisingly .

But I can see it very quickly that patients are getting off blood pressure medications , cholesterol numbers getting better and even A1C numbers getting better , and patients are breathing better . They're not using their CPAP anymore .

So there's a lot of benefit I found from just losing weight with those medications and I felt , you know , I'm not going to leave this to anybody else , I'm going to do it myself , because there's a lot of doctors have hesitance of prescribing it . They don't know much about it , they don't want to deal with it . I don't know what the exact reason .

That's not all the doctors able to prescribe it . And I feel uh comfortable , uh , doing it . So I felt , uh , let me do that . And I I saw great results with my patients and uh , then , um , it starts to be my standard practice to uh check about on their all my patients , and try to decrease the BMI to the normal level as possible .

It's natural uh hormone or peptide in the body , natural hormone that decrease the gi motility and I think the researcher just tried to increase it and reproduce it and inject it in animal mode and then after that to make it like diabetes medication .

They found the effect of decrease in appetite by decrease in the GI motility and other ways of action , and that's how you lose weight . Basically , you decrease the GI motility and you feel full most of the time when you take the injection once a week .

Peptide , yeah , and it's naturally occurring , right , and glucagon , as we learn in medical schools , you know , it's like the counterpart to insulin sort of , in sort of a way of dealing with the way the body processes nutrients and senses nutrients and things . So is .

And then it has this effect on diet , right , and , excuse me , the effect on appetite , so that people lose their appetite . Is that the main effect ? You think that the weight loss is mediated through that , correct ? I ?

You know you feel nauseated when you eat , like or like feel like uncomfortable when you eat a big meal and also constipation is the main side effect of this medication . But it's also the effect and luckily those side effects are very mild and just , mostly when you start using the medications .

That's why we started and lowered those and increased and asked the patient to increase their salad and fibers in their diet to decrease those kinds of side effects . And in very rare occasion we give Zofran for those patients but it's not the mainstream of treatment .

But overall it does decrease the GI effect and it has some central effect on the appetite center in the brain , just indirectly . But the main effect is , as you said , the counterpart of the insulin and it works and decrease in the motility of the GI system .

And the newly they have this sublingual or oral one . It's not very full studies as the injections but some people are afraid of needles and they made this daily semaglutide pill or sublingual kind of drops they call them , but they're not well studied and I don't usually deal with them very much .

But the injections once a week and you take it as the doctor recommended and obviously you have to accommodate that with certain diet and the reason for the diet you will lose weight with diet or without diet because you're not going to have appetite , but the diet is to make sure you're not losing from your muscle mass .

So you know as a doctor you don't want we care about cosmetic weight loss , but I really what I'm really interested in and losing weight in a healthy way and keep it off . So that's why we accommodate some kind of exercise programs and certain diet high protein diet , high fiber diet , low carbs and low fatty diet diet .

High fiber diet , low carbs and low fatty diet . So the body or the person will adjust to a healthy diet . So when we wean them off the medication , they can keep the weight off and that's the whole purpose . Those medications are not forever and I know some patients ask me . You know like you always think about the easy solution for a problem .

You know this is a help and it's an excellent help . Luckily humanity have , I would say , in the last year and I think it will cause a great , great change in the environment of you know , the weight loss .

But we have to do it the right way , by making the effort on changing the diet habit and doing exercise in the right way so we lose weight and keep it off .

So if you want to lose 30 , 40 pounds , probably three , four months , uh injections and try to wean it off as possible in a month or so and obviously with the right diet , with the right exercise and the decrease in the dosage of the medication , gradually the weight will stay off the patient , the stomach will become a little smaller , the patient will enjoy , you

know , enjoy being an optimal weight and they will stay motivated . Most of the time I let the patients see nutritionists , dieticianists , trainers , mostly online or in person . Depends on their comfort level and so far success rate is more than 90% , which is excellent in medical field to have any approach to have 90% or more success rate .

Who can take this ? What are the contraindications for it ? Is it all ages or is it just adults ?

The semaglutide is the ozambic wugobi I'm going to talk about the active ingredient now . Zambigugovie I'm going to talk about the active ingredient now . So the semaglutide is working on GLB1 , one receptors , but the terzapatide works on two , so it's still more potent . So that's why 12 years old to 18 years old , we try to use the less potent one .

However , the doctor can decide . Now the contraindications you know . Try to avoid it in pregnancy and even breastfeeding , just because you know from the effect of it can cause nausea in pregnancy . If it has nausea , you don't want intractable nausea or vomiting for those patients and dehydration and all those things .

You don't want that to happen during the pregnancy or breastfeeding . Usually thyroid cancer , medullary thyroid cancer , either with the patient or a first degree relative . We try to avoid it because they found some association with increased risk of thyroid cancer . That's why it's part of my initial intake .

If you have thyroid cancer it's not probably the right medication for you unless you see your endocrinologist and try to approve it . Even with that I don't think I feel comfortable just because the studies showed increased risk . Pancreatitis is history of pancreatitis also probably relative contraindication .

Just because it acts on the insulin and contra insulin and all those things . You try to avoid that Severe constipation . You don't want to exacerbate that . The other things to consider with GLP-1 is if you have near-future surgeries and with all the anesthesia that you may have that decrease the GI mortality . You don't want to increase that .

So we usually stop it a couple of weeks prior and resume it maybe after , just to increase safety . Actually , anesthesia nowadays they cancel the uh , the elective surgeries . If you are on glp1 agonist medications , uh , that's very much it and you know you don't want to mix . It's eventually it's a diabetic medication .

You don't want to be on high dose insulin and multiple other oral uh medication for , so that should be very monitored very well with your physician .

So if you , if you have untreated depression , probably this is not the right medication for you . Again , you know , if you have treated stable conditions of of hypothyroidism not talking about cancer , hypothyroidism ph is stable , it's okay . If you have , uh , if you have depression , that's controlled in your medications . You know I I pay close attention to them .

I may not escalate the dosage . You know , like those medication you escalate dosage by the studies every two weeks , four weeks , monthly . So you try to maybe do it less and start low and just increase it slowly just to avoid . But usually the headache and the depression are the main big things that you may see .

But if it's a treated cancer , if it's slow growing cancer that we already talked with hematology , oncology , we don't think it . Prognosis okay , there's no potential chemo needed . We still give it under close monitoring . But the medication and the association between this medication and possible positive effect is medullary cancer and the depression issue you raised .

And the reason for that is like , I like to eat and I'm fine , you know I'm going to . You know I don't want to take it anymore . And the reason for that is like I like to eat and I'm fine , you know I'm gonna . You know I don't want to not eat .

So , uh , you know that's a personal choice and uh , but there is a joy in eating and what we are trying to do is not to take that off . We just decrease the weight in a healthy way and then then you can eat your normal calorie intake , whatever you spend . You want to eat a little more , exercise a little more .

But those medications I still encourage people to take care of their weight in a healthy way , but if they can't , this medication will be able to decrease . You know , because if you are 300 , 300 pounds , it's very hard for you to run to exercise , you know , with all the depression that may come with it , um , with the breathing problem , with other .

You know the medication you may be on , so those medications can help you for three months , six months . You don't have to be an optimal weight to get off them . Just get the large amount of weight off with three months , even with the little side effect that may have , and then take it over . That's my suggestions usually to my patients .

You know , you , you mentioned a few of them downstream and it and it speaks to you know , sort of the underlying metabolic root cause of any of these diseases in this , this , this drug , through its actions , is affecting , you know , metabolic health at a basic level , which which amplifies across to you know , potentially cardiovascular disease .

You know the whole stream cancer , alzheimer's , all the way down the road . Do you think the effect is primary ? The metabolic health benefit is primarily mediated through weight loss , or is it something more fundamental ? Weight loss or is it something more fundamental ? In other words , if a thin person takes this um , will they still see the metabolically ?

Not a thin but a kind of average weight person takes this , would they still see the metabolic benefits without necessarily the weight loss ?

Everybody should be on aspirin to decrease , uh , heart attacks . Remember that . Then they have to do a randomized controlled trial and spend tens of millions of dollars . And we saw that no , it does not decrease heart attacks for healthy people and you should not be on it automatically . You know that's against the normal .

You know what doctor would have said in the past . You know the same thing as beta blocker . You , it used to be contraindicated for heart failure . Now , if you have heart failure you have to give beta blocker , otherwise you will do malpractice to your patient , you know . So the same thing with statin .

We thought statin decreased the heart problems with just decreasing the cholesterol level , with just decrease in the cholesterol level . However , we saw independent kind of antioxidant effect of statin on the overall health and decrease in all kinds of risks and mortalities .

So to answer this question , I don't know , but I will not be surprised if after two , three years we see an independent effect of those medication on health overall . But most what I know for sure that decrease in diabetes , improvement diabetes and hypertension and cholesterol decrease in . That will make you live better and will make you live longer .

We have a complete weight loss clinic that we also send the actual medications that are zepatide and semaglutide , to the patient's door from just online encounter , video encounter usually .

And we are in 22 states now and we just wanted to make this medication and treatment available to the patients in the right way . You know , you know , like not just spending medication and good luck . We , we follow with them , we make sure they are losing weight in a healthy way and we are just a click away nowadays for weight loss .

They can schedule appointment with us . We talk like what we're talking right now see if they are the right medication . If it is , uh , it takes a few days .

The medication will be on , uh , on the doorsteps and they start injecting and we have we follow up with them , sometimes weekly , sometimes bi-weekly , monthly depends on the response , and we are available to them .

We have a lot of doctors involved in this and the dieticians and the life coach to make it more a team approach for weight loss , and I'm very pleased with the results we're having with the patients and the satisfaction that I have . It's really uh , very , uh , very promising and , uh , we're going to keep doing that .

So they basically just call you over Zoom , they can have the conversation and speak with your whole team and get it taken care of there , and most States in the United States are 19, . About half , I guess it's available . They can check on your website and see and see what those are . What are the ? What are the if people , if people stop using it ?

What are the main reasons in your experience ? Or is that not a problem ? It is a problem .

He reached Manjaro of 15 and it's like you know , literally took like nothing . For me , I take 2.5 , which is the lower dose , and my appetite is suppressed for a week , you know . So he's taken . So it's just people are different . That's why there's other ways to lose weight beside the GLP-1 . We also use it .

You know , we don don't just use the glp1 and tenuouscom , we have other other options . So that's one reason . The other reason is depression . You know , if they have underlying depression or they don't know they had depression and you started them , they don't feel good . Uh , and luckily it's also rare , uh , other reasons for that finance .

You know , if they don't have a couple of hundred dollars a month , they cannot . And those medications are . They are , you know , on the cheapest side because , especially for tenuouscom , we use the brand name and we use the compound Compound is FDA approved some pharmacies to compound the same active ingredient and it is lower price .

So for us , like the semaglutide is $1.79 a month , the terzibetide is $2.99 a month , it's still a significant amount of money . If you don't have the means , it will be a reason to stop . Those are basically the main two or three reasons .

You should have a really , really good insurance and good employer , because it's not only the insurance the employer sometimes have . Give you good insurance and tell the insurance the employer tells the insurance we're not gonna pay for weight loss period because it costs almost 1,100 a month for the brand name .

So some employers like we don't want to deal with that , uh , but cash pay . That's why the we're dealing with the compound heavily . Uh , because we want this treatment to be available and it's the same active ingredient as the brand name and that's what I personally use . To be honest , you know I used to pay to pay . I have a breed .

I used to have breed diabetes with BMI of 31 . Like I'm the perfect , you know , my A1C was 5.9 . And my insurance did decline me . I don't know if it was my employer or and I'm a physician , you know cardiologist , so I assumed I had a good but long story short , you know , like that's reality and I was declined , so I paid the first month , $1,100 .

But then , when I used the compound , the same exact effect . So you know what , why I'm going to do this and that's what I'm dealing heavily with , um and I do my due diligence . I don't use pharmacies that they're not fda approved . I use the pharmacies I'm using on myself and uh , you know , with all the thousands of patients , uh , we're dealing with .

You know , the compound just worked fine . It's the same active ingredient . You know , like using tylenol or using acetaminophen , you know it's the same medication .

But yeah , that's a possibility . And , by the way , the numbers I'm giving you 179 and 299 , it includes the shipment , the medication and the doctor consultation we have in this concierge kind of medical treatment . The reason for that is I know a lot of companies online .

They're kind of you know they take some intake , they see the patient once and they give them the medication and you know those medications are , you know , not candy . You know they need close follow up . They need , you know , because sometimes escalating those is not the right thing for the patient . Maybe they're good with the lowest dose Eventually .

The target is to lose weight . If it's working , just keep it . So we wanted to keep that touch . Even with everything , try to decrease the possible margin of benefit to make it available to the most patients and so far we're very happy with our results .

Doctors will give you the best treatment , the best options , even if you don't want to be a member with us . We'll be happy to help you for free . No hidden costs , nothing . Tenuouscom T-E-N-U-I-S-S . And . You can book your free consultation and you can follow our page on Instagram and Facebook and I'm Dr Amr Syed .

My co-founder and colleague , dr Muhammad Abdullah is also will be available for you .

We started this company like six months ago and we're helping a lot of patients and we'll be happy to help you as well .

I'm almost doing 5Ks every other day as time allows and all those things . So I highly encourage people . You know you're going to change your life , you're going to transform your life with weight loss and 10EOScom is always here for you and I really appreciate what you do , dr Lufkin . I'm a big fan .