In Episode 53 of the Pound of Cure Weight Loss Podcast, Dr. Weiner and Zoe dive into meaningful topics, from celebrating non-scale victories to understanding the limits of BMI and exposing the troubling influence of pharmacy benefit managers (PBMs) on healthcare costs. This engaging episode not only informs listeners about these issues but also empowers them to advocate for a better, patient-centered healthcare system.

Celebrating Non-Scale Victories on Your Weight Loss Journey

Weight loss is about more than numbers on the scale, and non-scale victories (NSVs) are a powerful reminder of the progress often missed. Dr. Weiner and Zoe discuss these achievements, which include everything from improvements in flexibility to walking up stairs without fatigue. Zoe suggests keeping a running list of NSVs to stay motivated, especially during weight loss stalls. This practice can give you a balanced perspective on success, showing that even small victories matter. Tracking NSVs is a great way to remember that you’re moving forward, even when the scale doesn’t reflect it​​.

The Limits of BMI as a Health Measure

The Body Mass Index (BMI) has been widely used to assess health, but it’s far from perfect. Dr. Weiner and Zoe critique the BMI’s shortcomings, explaining how this 200-year-old formula, which simply compares weight to height, fails to account for muscle mass, body composition, and other essential factors. Dr. Weiner points out that BMI often mislabels individuals, especially those with high muscle mass, as “overweight.” They discuss alternatives, like the Body Roundness Index (BRI), that consider waist and hip measurements, offering a more nuanced health picture. Dr. Weiner underscores the importance of moving beyond BMI and adopting more accurate, holistic measures​​.

Pharmacy Benefit Managers: Putting Profits Over Patients

In their discussion on pharmacy benefit managers (PBMs), Dr. Weiner and Zoe reveal how these intermediaries have shifted from helping lower drug prices to prioritizing profits. PBMs now control nearly 80% of pharmacy claims, often inflating prices to serve their bottom line. For example, PBMs have been known to hike up the cost of drugs like Zytiga from a wholesale price of $229 to as high as $6,000, placing a heavy burden on patients and taxpayers. Dr. Weiner argues that PBMs’ monopolistic practices highlight the urgent need for more transparency and regulation in healthcare. By better understanding the role PBMs play, patients can advocate for policies to lower drug costs and improve access to care​​​.

How to Advocate for a Patient-Centered Healthcare System

In the final segment, Dr. Weiner and Zoe encourage listeners to take an active role in changing healthcare. They urge you to research healthcare legislation, support representatives pushing for lower drug prices, and vote for candidates focused on putting patients over profits. Advocacy, they emphasize, is essential for reforming healthcare to make it more accessible and affordable for everyone​​.

Episode Takeaways

This episode tackles the critical issues of weight loss success, BMI’s limitations, and the role of PBMs, leaving listeners with actionable steps to navigate the healthcare system and celebrate their own achievements. Episode 53 of the Pound of Cure Weight Loss Podcast is a must-listen for those interested in health reform, practical weight loss advice, and a more compassionate approach to healthcare.

In Episode 52 of the Pound of Cure Weight Loss Podcast, we delve into Vanessa Ruiz’s (@myvanety) personal and transformative journey with sleeve gastrectomy, her experiences with body dysmorphia, and her decision to include compounded semaglutide in her weight management plan. Her story provides insight into the challenges many face with obesity treatment and the importance of the “Choose Your Hard” mindset.

Vanessa’s Journey to Sleeve Gastrectomy

Vanessa grew up struggling with weight, influenced by family dynamics and cultural pressures around food. In her 20s, life changes, depression, and a PCOS diagnosis caused further weight gain, prompting her to pursue a sleeve gastrectomy in Mexico. Despite undergoing the surgery during the pandemic and navigating limited post-op care, she took her recovery into her own hands by researching and preparing herself, leading to successful early results.

The Role of Compounded Semaglutide in Long-Term Success

Three years post-op, Vanessa began to experience weight regain—a common hurdle for many sleeve gastrectomy patients. Compounded semaglutide, a variation of GLP-1 medication, became essential in helping her control food noise and support her appetite regulation, enhancing the long-term success of her sleeve gastrectomy. This medication, while not a replacement for lifestyle changes, provided Vanessa with the support to maintain her achievements, highlighting its importance in post-surgical weight management.

Navigating Body Dysmorphia After Weight Loss

A surprising challenge for Vanessa was body dysmorphia, a disconnect between her physical transformation and her self-perception. Despite her progress, Vanessa struggled to see herself as others did, facing persistent negative perceptions about her appearance. Therapy and mindfulness practices proved valuable in helping her manage these emotional hurdles, emphasizing the importance of psychological preparation for those undergoing significant weight loss.

Advice from Vanessa: “Choose Your Hard”

Vanessa’s motto, “Choose Your Hard,” speaks to the importance of making difficult but rewarding choices. She shares how the challenges of surgery, weight regain, and mental health management all contribute to a healthier life—a difficult but preferable alternative to the hardships of obesity. Her message encourages listeners to face the tough journey with resilience, as the outcome is worth the struggle.

Building Community and Support

Vanessa’s story also highlights the critical role of community support. By connecting with others facing similar experiences, she found encouragement to push through both the successes and setbacks.

Final Thoughts: Empowering Yourself for Sustainable Health

Vanessa’s journey offers a realistic look at the emotional and physical dedication needed to achieve weight loss success after a sleeve gastrectomy. For those managing body dysmorphia, considering GLP-1 medications like compounded semaglutide, or simply seeking encouragement, her story is a testament to the power of determination and the strength that comes from “Choosing Your Hard.”

In Episode 51 of the Pound of Cure Weight Loss Podcast, Dr. Matthew Weiner and dietitian Zoe Schroeder tackle listener questions on NAION vision, mocktail ideas, limited weight loss after a sleeve gastrectomy, and managing the “murky middle” phase after surgery. Here’s a quick recap of the insightful advice and tips offered in this Q&A episode.

Understanding NAION Vision Risks with GLP-1 Medications

The episode kicks off with a question about the connection between GLP-1 medications (like Ozempic and Wegovy) and NAION vision, a rare eye condition that can cause sudden vision loss. Dr. Weiner explains that NAION is often linked to low blood pressure, a risk that can increase with weight loss. He advises patients on GLP-1 medications to monitor for symptoms like dizziness upon standing, as these may indicate hypotension and increased NAION risk. Adjusting blood pressure medications may be necessary as weight drops.

Key Takeaway: If you’re taking GLP-1 medications and blood pressure medicine, monitor your blood pressure closely. Weight loss may require medication adjustments to lower the risk of hypotension and NAION.

Mocktails: A Fun, Alcohol-Free Way to Celebrate After Surgery

The next question dives into mocktails, a perfect option for those who want to celebrate without alcohol after gastric bypass surgery. Zoe shares ideas for tasty, sugar-free mocktails, like mixing sparkling water with hibiscus tea and adding frozen watermelon cubes for flavor. She also encourages listeners to use fancy glasses and creative garnishes to make the drink feel special.

Mocktail Idea: Hibiscus tea with sparkling water and frozen watermelon cubes makes a refreshing, celebratory drink that’s low in sugar and calories.

Key Takeaway: Mocktails can help you enjoy social occasions without alcohol. Use sugar-free ingredients and fun presentation to keep them bariatric-friendly and festive.

Limited Weight Loss After A Sleeve Gastrectomy

A listener who had a sleeve gastrectomy but lost less weight than expected wonders why their experience differs from others. Dr. Weiner explains that weight loss results vary widely, with some patients experiencing more dramatic changes than others. He emphasizes the importance of combining surgery with lifestyle changes and, if necessary, GLP-1 medications to amplify weight loss.

Key Takeaway: Every weight loss journey is unique, and surgery alone may not guarantee specific results. Combining surgery with lifestyle changes and, if needed, GLP-1 medications can enhance weight loss success.

Navigating the Murky Middle Phase of Weight Loss After Surgery

The episode concludes with advice on navigating the “murky middle” phase around six months after surgery. This stage involves adjusting to a slower weight loss rate and a returning appetite. Zoe suggests shifting from a protein-focused diet to one rich in vegetables, fruits, and nutrient-dense foods to avoid the “portion control trap,” where patients eat small portions of high-calorie foods, risking long-term regain.

Key Takeaway: Use the murky middle to build healthy habits with nutrient-dense foods, setting up a foundation for sustainable weight loss and maintenance.

Conclusion: Small Changes for Long-Term Success

In Episode 51, Dr. Weiner and Zoe underscore that bariatric surgery and GLP-1 medications are tools, not quick fixes. By making mindful adjustments and focusing on healthy eating, patients can set themselves up for long-term success.