Weight Loss Mastery with Dr. Jessica Hehmeyer: Rational Wellness Podcast 340
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Dr. Jessica Hehmeyer discusses Weight Loss Mastery with Dr. Ben Weitz.
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Podcast Highlights
1:37 Some of the biggest challenges that clients have when trying to lose weight include the fact that people were born into a psychological force field that doesn’t serve them. By force field, Dr. Hehmeyer is referring to a series of conversations and perspectives that are not a good match for the outcomes that people want to happen. The first problematic conversation that people have is that what you eat or not is a moral decision–that food is good or bad or that if you cheated on your diet, you did something bad, and this can lock people into a cycle of shame. It would be better to see what we eat or not and whether we exercise or not will simply produce certain outcomes and this is not a moral situation. If we want different outcomes, we need to make the necessary changes.
3:50 People have different motivations for eating and for what they eat. Losing weight is not easy and that is why these new weight loss drugs like Ozempic are being used by so many patients that can afford them.
4:50 As we dig into the science of these GLP-1 agonist drugs like Ozempic and Wegovy, we can find many natural alternatives that can produce the same effects as these drugs have, such as fiber and berberine and eating healthy fats, without the potentially horrible side effects of these drugs, such as intestinal paralysis or obstruction, which can lead to death, or gall stones or pancreatitis.
8:11 Obstacles to weight loss. One of the barriers that many people are hopeful that they have is a slow thyroid, though a sluggish thyroid is rarely the only barrier that they have to weight loss. For sure, we want to test and make sure that their thyroid is functioning optimally and we want to support the thyroid so that is the case. But Dr. Hehmeyer finds that thyroid alone is not often the main barrier for her clients to achieve the weight that they feel the best. A more common barrier that she finds is impaired insulin sensitivity, which is a fasting insulin level above 7. Insulin is a hormone that signals your body to store fuel as fat.
19:24 Dietary approach to weight loss. Dr. Hehmeyer usually recommends a vegetable forward diet, though not vegetarian. She also wants clients to follow an approach that they feel they can maintain for the long term. For example, unless the clients feels that they can maintain intermittent fasting for the long term, then she will recommend against it. Dr. Hehmeyer does recommend eating for blood sugar stability, which means that you’re getting protein, fats that anti-inflammatory, nutrient dense vegetables, and for most people it does involve a mixture of either a whole grain or something like lentils. She feels that calories do matter and the law of thermodynamics is real, but hormones and inflammation also matter.
Dr. Jessica Hehmeyer is the founder of Well Empowered, where she practices data-driven, outcome oriented Functional Medicine. She is a Doctor of Chiropractic, an IFM certified practitioner, a Licensed Dietician Nutritionist and a Certified Nutrition Specialist. She is also an expert in the fitness industry. Her website is Wellempowered.com.
Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure. Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.
Podcast Transcript
Dr. Weitz: Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field, to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates, and to learn more, check out my website, drweitz.com. Thanks for joining me, and let’s jump into the podcast.
Hello, Rational Wellness Podcasters, today we’ll be talking about how to lose weight and improve your health, with Dr. Jessica Hehmeyer. Dr. Jessica Hehmeyer, or Dr. H, is the founder of Well Empowered, where she practices data-driven outcome-oriented functional medicine. She’s a doctor of chiropractic, an Institute of Functional Medicine Certified Practitioner, a licensed dietician nutritionist, and a certified nutrition specialist. She’s also an expert in the fitness industry, and she also has a bachelor’s from UCLA. Very interesting, Dr. H, because we have a lot in common. I have a BA in Philosophy from UCLA, I’m a doctor of chiropractic, IFM certified, and also an expert in exercise with a background in bodybuilding and power lifting and fitness training, so welcome Dr. Hehmeyer to Rational Wellness.
Dr. Hehmeyer: It’s a pleasure to be here with you, Dr. Weitz. It’s funny, we’ve been living parallel lives, I love it.
Dr. Weitz: So, what are some of the biggest challenges that clients have when trying to lose weight these days?
Dr. Hehmeyer: Oh my goodness. Well, where do we start, right? But I would say challenges and barriers, there are a number of different things we could say about challenges and barriers.
Dr. Weitz: Okay.
Dr. Hehmeyer: And fundamentally speaking, my experience is perhaps the biggest challenge is that people were born into a force field, I like to call it, a force field in this area, that really doesn’t serve them. And by force field I mean a variety of inherited conversations and perspectives that are not a good match for the outcomes people are devoted to. And the number one, there are quite a few, but the number one conversation that is really a big barrier for people triumphing in this area of their life, is a conversation that collapses morality with what people are doing or not. And by that I mean, “Food is good, food is bad. Oh, I cheated over the weekend. Oh, I shouldn’t have that or I should have that.” All of that is the language of morality and that perspective is one that keeps people locked in a cycle of shame. It interferes with people’s ability to actually get clear that what we’re doing or not doing produces certain outcomes.
How we’re eating or not eating, how we’re moving or not moving, how we’re sleeping or not sleeping produces certain outcomes, and that’s not good, bad, right, wrong, it’s just true. And so, if we want different outcomes, we need to get clear on what effective new actions would be. And there’s the whole world of physiological barriers that I’m sure we’ll talk about together, but really, in the way of challenges people encounter is that they inherited a really crummy perspective in this area of their life. They didn’t even invent it, they just inherited it.
Dr. Weitz: So, really what you’re getting at is the different motivations people have for eating and what they eat?
Dr. Hehmeyer: Eating and what they eat and how they even relate to food and their body and themselves, which is really a big deal. It’s a big deal for people. The diet industry isn’t the size it is for no reason, and these new weight loss drugs aren’t going gangbusters for no reason, right? It’s because people are really struggling.
Dr. Weitz: Right, right, absolutely. But, of course, the reality is, the main reason why people aren’t losing weight is not because they have an Ozempic deficiency.
Dr. Hehmeyer: Right, nor Wegovy or Mounjaro, right? Yeah.
Dr. Weitz: Right, we’re out here in LA where Hollywood is, and it seems like these drugs are everywhere.
Dr. Hehmeyer: Yeah, yeah. Yeah, absolutely, absolutely. And listen, it’s interesting, and I’m sure you’ve done the same thing, it’s kind of fun digging into the science behind these drugs because as I read through their mechanisms of action, I go down the list of, “Oh, you know what else does that? This does.” Fiber does that, and fat does that, and movement does that, and we actually have all of the tools we need to support the physiology in such a way that the side effect is weight loss. We really do.
Dr. Weitz: Not to mention that if you increase your fiber intake or take some berberine or take some other herbs, you’re not going to risk the possibility that your entire digestive system is going to stop working properly and that you’ll end up with intestinal obstruction, your intestines will stop contracting, and risk dying or having pancreatitis or gallstones or so many other side effects that are starting to pile up now that all these people are taking these medications, which are really designed for other purposes like to control diabetes.
Dr. Hehmeyer: Yeah, yeah, absolutely, absolutely. And I’ve been scratching my head, and I’m sure you have too, Dr. Weitz, these last months going, “Wow, it’s amazing that people forget that so far, we haven’t come across a medication that doesn’t have unknowable unknowns.” There are, in virtually every medication… Well, many of them are so necessary and do amazing things, so I’m not here to bash every medication under the sun by any stretch of the imagination, but there are unknowable side effects that just very predictably will emerge over time, like some of the ones that you’re mentioning are starting to become more common, and we’ll see how things play out over the next decade.
Dr. Weitz: Yeah, we should not actually be at all surprised that the way these GLP-1 agonists work, some of the side effects that have come out because one of the mechanisms by which they work is by slowing gastric emptying, slowing your digestive system from working properly, so it’s not a shock that people are saying, “Oh, my digestive system’s not contracting anymore, and by the way, that’s why I am not hungry, and by the way, that’s how it slows glucose uptake.” It’s a well-known mechanism how these drugs affect the GI track and side effects shouldn’t be a shock if we understand the mechanisms how which these work. And I’m not saying that everybody who takes these drugs gets these side effects, but you have to know that if you’re taking a drug that’s slowing gastric emptying, slowing it a little bit too much is a possibility.
Dr. Hehmeyer: Yeah, yeah, absolutely, and it’s happening.
Dr. Weitz: Anyway, so let’s get into weight loss apart from Ozempic. So what are some of the reasons why people can’t lose weight? What are some of the barriers?
Dr. Hehmeyer: Yeah, some of the barriers, I’m sure you get this all day long, Dr. Weitz, also, but we know the barrier everyone wants. I will say most people are kind of hopeful that it’s their thyroid. They actually feel like it would be a good thing if they found out something was going on with their thyroid, and in my experience, it’s so rarely the thyroid. And I should say that even when the thyroid is playing a role, it’s never just the thyroid. So, if I think about physiological barriers to weight loss, absolutely we want to make sure the thyroid is humming along and working well or supported appropriately if it needs a little support, but even when that is true, even if the thyroid does need some support, I’ve yet to encounter someone where that is the only thing that needs to happen for them to arrive at a weight that they feel their best. And that’s the bottom line, I want people arriving at a weight where they feel their best so they can be their best. And so, when I start to look at other recurring physiological barriers, there are three, and the number one is impaired insulin sensitivity, which is different than an abnormal value. Suboptimal insulin sensitivity is different than high insulin or lab abnormal, and for most labs, the upper end of normal for fasting insulin is going to be 18 or 19, and we really want to see it at about seven or less.
Dr. Weitz: For sure.
Dr. Hehmeyer: So, once that fasting insulin starts to creep up, that’s telling us that your body’s receiving a message to store fuel at a higher rate, and so it’s going to be real hard to lose weight, your metabolism essentially has its foot on the brake.
Dr. Weitz: Maybe you can talk a little more about this particular lab value, because those of us in the functional medicine world, we understand the importance of measuring insulin and what it means, but the average person who’s not gone to a functional medicine practitioner, they’ve never had their insulin level measured. It’s not part of a standard lab panel, and these days, lab panels are very limited based on what insurance wants to cover, so they’ll have their glucose measured, they may get their hemoglobin A1C measured, but rarely, if ever, will the insulin be measured and explain why, knowing not just what your blood sugar is, but why the insulin level matters?
Dr. Hehmeyer: Yeah, well, abnormal insulin sensitivity is really often the first step on the route to pre-diabetes or diabetes.
Dr. Weitz: Well, maybe you could even explain.
Dr. Hehmeyer: Yeah?
Dr. Weitz: What does insulin do? Why is it important to know what your insulin level is?
Dr. Hehmeyer: Yeah, so insulin is a hormone that’s produced by our pancreas, and I think a good way of thinking about insulin is like an escort. So, when we eat foods, carbohydrates in particular, and especially high sugar carbohydrates or high starch carbohydrates, high sugar being obviously sweet things, desserts, cakes, stuff like that, starchy being things like white rice or pasta or bread or white potatoes, all those starchy things have the same impact on our blood sugar as the sweet thing. So, our blood sugar goes up with these carbohydrates and insulin’s job is to take that sticky glucose molecule by its hand, walk it over to a cell door, knock on the cell door, the cell door opens up and absorbs the glucose. And so, fundamentally, what insulin is doing, is making sure your blood glucose is not too high, your blood sugar is not too high.
It does other things too, so when our blood sugar goes up quickly, we produce a lot of insulin because our body doesn’t like it. Insulin escorts that glucose over to a cell, knocks on the cell door, the cell absorbs that glucose, and now your blood sugar, if it’s gone too high, it’s probably now too low, so it goes from too high to too low. That’s a whole other story. Yeah, yeah, the blood sugar roller coaster, it’s very real. But how insulin sensitivity gets compromised over time or decreases over time is when our blood sugar is constantly spiking, when we’re constantly spiking our blood sugar, and therefore we are constantly producing insulin. And I liken it to, over time, the cells lose their ability to hear the message of insulin. And it’s a little bit like if I showed up at your front door, Dr. Weitz, and I started ringing your doorbell, and I kept ringing it for two days straight, at a certain point you’d stop hearing the doorbell. And that’s kind of like what happens with the cells. The insulin keeps knocking, insulin keeps knocking, insulin keeps knocking, and at a certain point, the cell just becomes a little bit less responsive.
Dr. Weitz: Yeah, yeah, I’d like to point out that you could have two patients and they could both have a fasting glucose, let’s say they have a fasting glucose of 90, which is slightly higher than optimal, which is maybe somewhere around 80, and one person could have an insulin of three or four or five or six, and another person could have an insulin of 25. And the person who’s producing a lot of insulin, what that means is, not only is their blood sugar maybe a little too high, but they’re having to work really hard just to keep it there, so that person’s in worse shape than the person who’s not using a lot of insulin because the reason why they have to use a lot of insulin is because the cells are no longer responsive to insulin. And we refer to this as either having decreased insulin sensitivity or increased insulin resistance, and so, that’s the process that eventually leads to diabetes.
Dr. Hehmeyer: Yeah, absolutely, absolutely. So, again, just like we were saying, there’s a big difference between seven and 25, and yet, lab normal is up towards that upper end of the range, so we want to see the creep. If we can catch that creep, we can start to do interventions that make a difference, not just on those numbers and on your physiology, but ultimately translate into weight loss over time.
Dr. Weitz: And that’s another concept that the average patient out there needs to understand. If you go to your conventional medical doctor, they’re getting the labs back, whatever limited labs they do get, and there’s either a red or a black, it’s either normal or it’s abnormal. And if it’s normal, they don’t pay any attention to it, and if it’s red, then they might say something to you about doing something about it. But when you see a functional medicine practitioner, we don’t just accept these lab values. Why don’t we accept these lab values? Well, one reason why is nobody’s actually sat down and said, “What’s the optimal level for overall health for this lab value?” They’re just saying, “What’s the range that the average American has?” And sometimes these ranges are huge. You’re talking about the range for insulin. You can get a hormone panel done for men, and the normal range for testosterone, depending upon the lab, is somewhere between 150 and 1000 or 1200, which is huge. So, when you see a functional medicine doctor, we’re not just looking at how do you compare to the average American, because that’s not a good comparison. You don’t want to be like the average American, you do not want to be normal.
Dr. Hehmeyer: Truly.
Dr. Weitz: You want to be optimal, so we’re looking at the optimal range. We’re figuring out what part of that range is going to give you the optimal level of health.
Dr. Hehmeyer: Yeah, absolutely, absolutely. Yeah, and in that average, just to your point, you don’t want to be average, we’re looking at everything from 18-year- olds to 90-year-olds, people who are on no medication to people who are on tons of medication, probably favored towards people who are on tons of medication because those are the people who typically get their labs done more often, and so they’re going to be disproportionately weighted in that average that’s come up with to formulate that value.
Dr. Weitz: Right, and we’re talking about the average American, and we already know that 70 to 75% of Americans are overweight, so you’re already comparing yourself to a very unhealthy group of people. And one thing people might not realize is that these lab values, what’s considered normal actually changes. And during COVID, because so many people were not exercising, were staying home, were stressed out, were eating more high calorie foods, and because they were drinking a lot more, the normal lab values for a number of the labs, like for example, UCLA where we both went, I had a patient come in and I looked at her liver enzymes based on her UCLA lab panel and her AST, it said it was 65, and they said that was normal because…
Dr. Hehmeyer: No.
Dr. Weitz: Yes, it used to be 40 was normal, but now it’s 70 because so many people got higher liver enzymes that we just changed the normal.
Dr. Hehmeyer: Oh my gosh.
Dr. Weitz: Does that mean 70 is now okay? No, you’re just comparing yourself to the average American, so this is why looking at normal lab values is not a good way to try to focus on improving your health.
Dr. Hehmeyer: Yeah, truly. That makes me think of, my aunt used to joke that when her check engine light went on on her car, she’d just put a piece of black tape over it. Problem solved, just change the range, it’s fine.
Dr. Weitz: There you go, exactly. So, let’s get back to weight loss, so what kind of dietary approach do you like or do you recommend? Does it depend on the person, do you recommend low-carb, low calorie, paleo, keto, vegetarian? What’s your way of handling the optimal dietary approach?
Dr. Hehmeyer: Yeah. Well, I would say, it does depend on the people. I can tell you things that I don’t vote for, so I don’t vote for vegetarianism. I would love to, for the planet’s health, I just find that it’s typically not the right fit for people’s health. And so, I am definitely vegetable forward, and another way I would say that is nutrient density being a focus, but definitely, I look at the person in front of me, and when I work with people, I actually have them track their nutrition and I have them track for a couple of weeks so that I can get a realistic perspective of what life looks like for them according to how social they are, their life commitments, work, all the stuff, and then based on that, we start to talk about and create together their path forward. I’m a big believer that people need to be a part of their health journey as opposed to, “I’m the doctor, I know best.” We’re here to guide people. And yes, we have a lot of information, but it’s only going to be useful for people if the people are able to understand why it’s useful and also start to take new actions. So in this partnership, basically it’s kind of like I’m consulting, “Okay, here are the actions that I see as useful, let’s talk about your next step.”
So, a few other things that I don’t advocate for, I advocate for changes that can only be maintained short term, unless we’re specifically, let’s just say we’re doing almost like a microbiome remodel. Let’s say part of their work is we need to remodel their microbiome because inflammation is super high, and we find out for that person that their microbiome is playing a major role in the inflammatory process, which by the way, if insulin’s number one in the way of barriers to weight loss, inflammation’s right up there with it. I don’t know that it’s necessarily number two, it might be number one in some person and number two on the other, but it’s just to say addressing inflammation is really important and we can measure it. We can measure it in blood labs, we can measure it in the microbiome, so if we find out that inflammation is coming from the microbiome and we want to make some short-term dietary changes as we address that, that would be appropriate.
But otherwise, specifically as it pertains to weight loss, when someone says to me, “What do you think about intermittent fasting?” I have a few questions for them. One question I have is, “Is it something you think you can do forever?” And if the answer’s no, then it’s not a solution in my eyes. If it’s not a sustainable action, it’s not going to sustain outcome, so it’s not a sustainable solution. And another question I ask people is, “Does it feel like punishment to you?” And a lot of people who I work with are coming to this with a history of a complicated relationship with food and their body. Maybe they’ve never been formally diagnosed with an eating disorder, but a lot of people have at least engaged in disordered eating, eating that’s born of self aggression, we could say. So, with that, if that feels like punishment, if intermittent fasting feels like punishment, it’s also something that I’m not going to vote for.
So, two things, unfortunately vegetarianism is not something I typically vote for and nor is anything that can’t be maintained long term. But eating for blood sugar stability, you and I know this really means eating whole foods, making sure you’re getting protein, making sure you’re getting fats that actually are anti-inflammatory, making sure you’re getting nutrient dense vegetables, and for most people it does involve getting a little mixture of something like a whole grain or lentils. And that last category is the one that I might decide is not the best fit for the person, so in other words, things like beans or grains, they can be, well, they do affect our fasting glucose a little bit more than the non-starchy vegetables and the like, so if someone is at a metabolic disadvantage coming into our work, meaning their insulin’s very high, their inflammation is very high, we might, at least initially, really start with a low to no grain approach so that we can help their physiological resilience, rebalance them, and then we might bring some in, in a more moderate way.
Dr. Weitz: Right, okay, how much do calories matter?
Dr. Hehmeyer: They matter, but they’re not the whole story.
Dr. Weitz: Okay.
Dr. Hehmeyer: So, I like to say the law of thermodynamics is real, so you can have your food be very nutrient dense, and if you’re eating 3000 calories and you only need 1600, you will gain weight, but all calories are not created equal. So yes, calories are part of the weight equation, but how our food affects our hormones, so insulin being one, also our satiety hormones, also our hunger hormones, related to insulin, I would think about cortisol, our stress hormone, so how food affects our hormones is going to affect our weight. And then also, whether a food is contributing to inflammation, promoting inflammation, that’s the third way it can affect our weight, so we have calories, hormones and inflammation, those are the three ways that our food affects our weight.
Dr. Weitz: So, how do we manage the hormone part of it, especially as related to hormones that affect appetite and satiety and things like that?
Dr. Hehmeyer: Yeah, well, I can tell you one of the things we definitely don’t want to do is a thing that was the thing to do when I was at UCLA, which was no fat. Fat-free eating, oh my gosh, I just want to close my eyes and burn it, right? It was the worst thing we could have done. Well, maybe not the worst, but it was bad. So, we definitely do want to eat fat, because fat promotes the production of cholecystokinin, which is a satiety hormone, so we do want to eat fat when we eat. We don’t want to eat carbohydrates alone because eating carbohydrates alone lead to that blood sugar rollercoaster you and I were talking about, blood sugar up, blood sugar down, when blood sugar’s down, we’re super hungry, so we don’t want to do that. We want to eat fiber. Fiber promotes satiety, it stretches our stomach actually because it expands and that causes us to feel satiated. Okay, yeah, we want to make sure we’re chewing our food sufficiently, but guess what? If you’re eating whole foods, it’s really hard not to chew your food, so it kind of becomes a side effect of eating whole foods, is making sure you’re chewing enough. And there are things that can be said about digestive enzymes, making sure you have sufficient HCL or stomach acid does play a role in satiety as well, but those are some of the things we can do nutritionally on making sure we’re having protein, protein promotes satiety, helps keep our blood sugar levels stable.
Dr. Weitz: What are the most important satiety hormones?
Dr. Hehmeyer: Most important satiety hormones, so leptin and cholecystokinin are the most important satiety hormones and ghrelin is really kind of our only hunger hormone, so we’ve got more on our satiety side than we do on the hunger side, which is good news.
Dr. Weitz: Oh, okay. What makes ghrelin go up?
Dr. Hehmeyer: Well, I mean, the blood sugar roller coaster will, right?
Dr. Weitz: Right.
Dr. Hehmeyer: So, eating any kind of carbohydrate dense meal, blood sugar goes up, blood sugar goes down, the ghrelin would go up then. Not having fat, which also is, even if you had protein and carb, you’d be better off than just carb alone, but even without that fat, you’re going to have more readily produced the ghrelin there also.
Dr. Weitz: Are there ways to specifically modulate ghrelin and leptin to balance things off? Are there supplements, are there other strategies that can help us with that?
Dr. Hehmeyer: Well, definitely. I mean, anything that affects our hormone receptors would be useful, so our omega fatty acids, I think about that with helping our hormone receptors. That just means for the people listening for any hormone to be effective, we need to produce the hormone and we need to receive the message of the hormone. It’s like a ball in a mitt, and so those omega fatty acids work on the mitt side, it’s like they make that mitt really sticky, so that’s useful. Magnesium would be something that would be useful to that end. I mean, berberine does such an amazing job with insulin, and honestly, I haven’t studied its impact on leptin, but I have to believe there’s something there. Do you know anything about that? Have you looked at that at all?
Dr. Weitz: Berberine has a lot of positive benefits, and I’m not sure exactly how it affects leptin, but I do think it can play a role in appetite to some extent. There’s even been some data showing that it may have some benefits similar to the way these drugs like Ozempic work. I don’t think it’s really anywhere near as effective, but I know one of the manufacturers told me at some point, “Hey, I’m sorry, we’re totally out of berberine right now because somebody started putting some articles on social media claiming that berberine is a natural Ozempic and we’re totally sold out.”
Dr. Hehmeyer: Yeah.
Dr. Weitz: But it definitely does not have the same effect from my experience or everything I know about it, I don’t see that drastic slowing of gastric emptying and things like that.
Dr. Hehmeyer: Definitely not, but it does really play a big role in improving insulin.
Dr. Weitz: Yes, definitely, and it’s been shown to work similar to the way Metformin works, and Metformin, as we know, is the number one selling diabetic drug, and I also take berberine as a longevity supplement because of its benefits, and some people take Metformin off-label as a longevity drug because we know that modulating insulin resistance, keeping your blood glucose in optimal range is going to decrease your risk of so many chronic diseases including cancer.
Dr. Hehmeyer: Yeah, absolutely.
Dr. Weitz: So, what are some of the other top nutritional supplements that can help in a weight loss program?
Dr. Hehmeyer: Well, I definitely take a specific to the individual approach, so when I work with anyone, I am going to be, first of all, gathering information through conversation and then gathering data through labs. You were saying, Dr. Weitz, so many labs are pretty rudimentary and insufficient, and I’m sure like you, when I send people to go complete their labs, I let them know, “You’re going to feel like you’re donating blood. We’re getting a lot of information, not because it’s cute, because it’s actionable. And we’re not throwing darts here, we’re going to test, we’re not guessing.”
Dr. Weitz: By the way, I’d just like to say, this is something I’ve said many times in many podcasts is, so many people go to their primary care doctor and they get this very limited set of labs essentially to get a CBC, they get a chem screen, or it’s sometimes called the metabolic panel, very limited set of labs. Maybe they’ll throw on a basic lipid panel, and that’s about it. And of the range of different labs, it’s about this much, and yet, they think they had every test done that could possibly be done.
Dr. Hehmeyer: Right, right, right.
Dr. Weitz: And so, if you see a functional medicine practitioner like you or me, there are so many other important things that need to be tested in the body, like your vitamin D level and your omega-3 level and your red blood cell magnesium level, and your advanced lipids and your advanced metabolic panel and your full thyroid panel and your hormone panel. And if you’re not getting those done, you really have very little understanding of what’s going on with your physiology and metabolism.
Dr. Hehmeyer: Definitely. Absolutely, absolutely. And to think about what are some recurring themes? We talked about insulin, we talked about inflammation as barriers to weight loss, and the third thing that I’d say is, a very technical term, detox pathways gunked up, detox pathways that aren’t working well. And those, I look at that in a few different ways, but one of the things that has me think about that is when there are certain nutrient insufficiency or deficiencies when B12 and folate are on the low end, or when homocysteine is high.
Dr. Weitz: Or when glutathione is low.
Dr. Hehmeyer: Yeah, exactly, exactly.
Dr. Weitz: How many patients have gone to their primary doctor and had their glutathione level measured? Never.
Dr. Hehmeyer: Right, yeah, exactly, exactly. I actually, you’ll appreciate this, at one of our IFM conferences, there was a woman who was, and yay for her, she was transitioning from mainstream medicine to functional medicine and so she was in the learning process and she was learning a lot of terms she hadn’t encountered before. And she said something and she’s like, “Glutathione shouldn’t be taken if someone’s had cancer, it can be a problem.” And I was like, “What? What?” And I’m in my head trying to figure out what she’s talking about, and then later I’m like, “Oh, she’s thinking about glutamine.” Yeah, there are some concerns that glutamine could be contraindicated, but glutamine is very different than glutathione.
Dr. Weitz: Absolutely.
Dr. Hehmeyer: It’s just to say that, yeah, there are a lot of wonderful things that mainstream medicine does, but this area, it’s just not part of their toolkit.
Dr. Weitz: No, absolutely, especially when it comes to things like cancer.
Dr. Hehmeyer: Yeah.
Dr. Weitz: Very likely to hear, “Don’t take anything under any circumstances because vitamin C could kill you, but don’t worry about this chemotherapeutic drug that’s going to put you at the edge of door’s death.” Death’s door, I should say. Anyway, so intermittent fasting is an interesting one. You mentioned that and how you’re not necessarily a fan of that, especially if people don’t do it. It’s just so interesting that I’ve been involved with health and nutrition counseling for a long time, like 35 years, and I remember when I first got into it, the absolute bible was the reason why everybody’s gained so much weight and can’t lose weight is because they don’t eat breakfast and then they eat too much for dinner and they’re overeating and their blood sugar is erratic. And the bible is, you have to eat within an hour of waking up, you have to eat breakfast, that’s the key to weight loss, and it’s just so interesting how now the key to weight loss is skipping breakfast again.
Dr. Hehmeyer: It is funny. That I think is, one of the problems is, people are not getting curious about the details for the individual, the person in front of you, instead, it’s the one size fits all approach.
Dr. Weitz: So, let’s see, are there any other important things that you would like to talk about in your weight loss approach?
Dr. Hehmeyer: One thing I would say is, for your listeners out there, anyone who’s struggling with this area of life, I really invite you to do two things. First of all, I invite you to get very clear on why mastering this area of your life is so important to you. In other words, imagine a future where this area of your life is handled, you have the outcomes you care most about, and you actually are able to produce them and sustain them reliably with ease. Ease doesn’t mean you’re not thinking about it, it just means you’re not struggling. You’re just doing what needs to be done to get the outcomes. So, one is, imagine that future and imagine what would become available for you in your life because I really find when people get clear on their why, things start to open up. Doorways start to open up, new actions become available that were previously challenging, so that’s one thing.
And then the next thing is really, I invite those very same people to start engaging in an inquiry of what’s the best choice I can make right now? Right now, what’s the best choice I can make right now? And if people are playing that game, if you’re playing that game in earnest, you’ll start to make better choices, one at a time, one at a time, one at a time. Better’s not perfect, but better’s better. Having two pieces of pizza instead of five is a better choice. Having two glasses of wine instead of a bottle is a better choice, so we’ll vote for a better choice all day long over the inherited all or nothing perspective.
Dr. Weitz: Something else that strikes me is, some of us in the functional medicine world have seen quite a number of patients with the aftermath of COVID, what we call long COVID, and I wonder about the aftermath of Ozempic and all these patients who’ve been taking Ozempic for the last six months or year, and now they finally have to get off, and now their weight is going to skyrocket because they no longer have this artificial appetite suppressant, and we’re going to have a huge number of patients post Ozempic who are now going to have to actually learn how to eat properly and exercise and figure out how to manage all these factors that control their weight.
Dr. Hehmeyer: Yeah, and I think you’re onto something there, Dr. Weitz, too, because it’ll be interesting to see what their microbiomes look like, because they’re [inaudible 00:40:14].
Dr. Weitz: Maybe we should term it post Ozempic syndrome, POS.
Dr. Hehmeyer: Oh my gosh, truly. I think that’s a good one. That has legs.
Dr. Weitz: I think we got to do a paper on post Ozempic syndrome.
Dr. Hehmeyer: Yes, and we can create a study of 30 volunteers.
Dr. Weitz: All right, so final thoughts for our listeners, Dr. H.
Dr. Hehmeyer: So, final thoughts are this area of life is masterable, and any area of life that you’ve mastered, it’s going to require a few things. It’s going to require information, knowing where your body is and where your physiological barriers are to weight loss, as well as what actions are required to remove those physiological barriers, right? It’s going to require information. It’s also going to require inspiration, which is different than motivation. Motivation is momentary, motivation is the Whole 30, yay, yay, let’s do this, but inspiration is, this is something you can cultivate and practice, and to me that’s really why getting clear on your why is so important. That’s where inspiration lies. And then the third thing to master anything any of us need is really being strategic. How am I going to take this information and turn it into actions in my life in a way that works for me? So, information, inspiration, strategy. Fundamentally, these are the three elements that we are required to master anything and this area of life is masterable.
Dr. Weitz: Great, so how can listeners and viewers get ahold of you, find out how they can work with you or sign up for some of your… You have some courses available as well?
Dr. Hehmeyer: Exactly, exactly. I have both courses and one-on-one, and you can find me at wellempowered.com. Feel free to schedule a complimentary 30-minute Zoom consult to explore working together, and then if you’re on social media, you can find me at Well Empowered on Instagram.
Dr. Weitz: That’s great. Thank you so much, Dr. Hehmeyer.
Dr. Hehmeyer: Thank you so much, Dr. Weitz. I wonder, this parallel life we’re living, we’ll have to talk about where we’re going to go next. POS, POS, post Ozempic syndrome.
Dr. Weitz: I think that could be something. Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would certainly appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review. That way, more people will discover the Rational Wellness Podcast. And I wanted to let everybody know that I do have some openings for new patients so I can see you for a functional medicine consultation for specific health issues like gut problems, autoimmune diseases, cardio metabolic conditions, or for an executive health screen and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way. That usually means we’re going to do some more detailed lab work, stool testing, sometimes urine testing, and we’re going to look at a lot more details to get a better picture of your overall health from a preventative functional medicine perspective. So, if you’re interested, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at (310) 395-3111, and we can set you up for a new consultation for functional medicine. I’ll talk to everybody next week.
