Transcript of Episode 523: Ashley Koff, RD: GLP-1, Weight Loss and the Mistakes That Create Rebound

Hi, guys. It's Tony Robbins. You're listening to Habits and Hustle. Crush it.

In this episode of Habits and Hustle, I sit down with dietitian, author, and friend of mine, Ashley Koff, to unpack why weight loss has quietly become the wrong goal for so many people, and how chasing thinner without addressing health is leading to burnout and a rebound weight gain. This conversation cuts through the hype and focuses on what actually holds up once the shortcut stops working. We break down why GLP-1s don't automatically make you healthy, how the real problem isn't the medication, but how people are using it, and why not eating on these medications is a major mistake. Okay, guys, we have my friend is back. My friend's back in town. Her name is Ashley Koff. She is a dietitian, but she's not just any dietitian. She's probably one of the Smartest Dietitians I've ever met. And anybody who knows you, her, would agree, seriously, because she's just very knowledgeable, and she has a new book coming. Actually, her new book is out now, and it's called Your Best shot, and it's called The Personalized System for Optimal Weight Health. And it's all about the GLP-1 epidemic, you guys, which, by the way, can I just say one comment, and then we're going to take these magic mind shots?

If you walk around LA or anywhere at this point, everyone is thin now. I feel like, is it just the fact that we're living in a pseudo-reality? But everybody, I feel, is on one form or another of a GLP-1. Have you not noticed this?

It was really interesting. The person I had coffee with this morning said the same thing, and she's in a different... She's 70, and she was like, Oh, my 60-year-old and seven-year-old friends. She looks skinny. But it's funny because some of them are so happy because they are actually healthy, and some of them are skinny and unhealthy or unhealthy-er. And nobody's acknowledging the difference. Because she was like, a lot of people do not look good. I said one thing, I'm 52. I do not want to lose weight in my face. And it's like, we don't get to choose where we lose weight from.

No, I agree. That's what she That's a very good point because that is very true. Just because you're skinny doesn't mean you look better. A lot of the people I see wandering around is that, yeah, they're thinner or skinnier, but they just look exactly the same of how they looked before, just a smaller version of themselves. They don't look toned. They don't look healthier. Their face looks more gaunt. So I want to talk to you about the major craze of what's happening. I don't know about you, but I've had a really hectic, crazy couple of weeks. And so my focus is all over the place, which is why I love these little shots. This is caffeine-free.

So it's going to help us. Thank goodness it's caffeine-free because you know I'm such a slow metabolizer of caffeine. I know. Oh, my gosh.

Well, this is actually a mental performance shot with zero caffeine, you guys. I love it. And it actually does a trick. It keeps you on point.

It's a rare day that I'll just take anything, but you happen to have introduced me to these. Really? Yes.

They're delicious. I take them every day. And that's not because they're a sponsor. It's because they are delicious, and that's why they are a sponsor, actually. But okay, now we're going to be locked in. Are you ready? Got to be delicious. Got to be delicious. All right. Oh, are you okay?

I'm super focused. I'm like, I just felt like form of. It's like a superpower.

Exactly. Okay, good. Okay, so let me first by ask Let me ask this question. Everything in the world, things become super trendy, and there's a fad, and the pendulum swings one direction. That's my concern with these GLP ones. I think that people are using it more as a crutch, not as a tool. What is your perspective on this. Yeah.

Well, first, let's unpack that these GLP-1s are doing something super important. They are teaching doctors, dietitians, and hopefully, and this is why I wrote this book, individuals about our actual human anatomy. So the body is designed with weight health hormones. Glp-1 is one of them, GIP, PYY, CCK, we can go on. These hormones are the first domino in a line of things that need to happen in our body for us to be weight healthy, and we'll get into that. What the medications are is they are this version of the medication, not new ones that are coming out, but this version of the medication, they are a biosimilar hormone replacement. What do I mean by that? You hear bioidentical when it comes to estrogen or testosterone, insulin. If it was bioidentical, it would be the exact same made in a lab, but your body uses it in the same way. They're biosimilar in that the body uses it in the same way. So when these hormones come to the receptor sites, the body says, I know what to do with GLP The difference is our own body hormones stay on for 2 to 5 minutes. These stay on for 24 hours.

The first version was for 24 hours. Now it's 24 hours for seven days. So what you want to think of is they are like an amped version of our own hormone. Basically, when our body gets the hormone from the shot, they get it in a way that keeps us in this metabolically active, telling our hormones to go to work state. That has a lot of advantage. It may in our brain calm us down from thinking about appetite. It might calm us from thinking about food. It might make us break up with daily alcohol or other things because it shifts how we're thinking about things. But it also does things in our gut as an example, where if we're delaying gastric emptying for 2-5 minutes, now think about we're delaying gastric emptying to some extent for 24 hours for seven days. That's going to have consequences. If we're stuck in a metabolically active phase, if we're telling insulin to go to work, then our body is going to turn around and not be in the recovery mode. What I see people is they're fatigued or their heart rate variability, which will measure and is a measure of the body's ability to be in a relaxed state, that is tanking.

That's going down. What we have to look at is the medications are working exactly as they're intended to, but we have to understand the considerations. I don't necessarily think it's cons, but I think it's considerations. Now, anyone taking a medication to lose weight or a doctor prescribing it to lose weight, is actually in an old system and creating problems for people. We do not want to lose weight. We want to address why the body is creating excess fat, why it might be putting fat around or in our organs, why our bone is breaking down instead of being reformed, why we're struggling with muscle mass, why we're struggling with cravings. We want to get to the root causes of those. If you think of the medication as a solution alone, that's a big problem. But if you use it as a tool, so I love what you picked up on, that's exactly it. If you use it as a tool and you understand how it's working in that person's body and you optimize around it, it can be a very effective tool.

Okay, but that still doesn't take away from the fact that people who should not be doing it are doing it. So that's the first part, right? And wasn't this medication for diabetics?

Okay, so let's unpack a couple of things. It's really interesting to me. I grew up with a lot of weight challenges, and I was always told, you're healthy. But from the time I stopped being cute and chubby at around 10 and became a fat girl and teased, and the doctors were like, okay, there's nothing wrong with you. You're just like, just eat less, Ashley. I was actually really active. Some would tell me to... So they didn't tell me I needed to be active, but they would say, You just need to eat less. And some would say, Why don't you stop eating when you're full? And I'm like, Cool. I can just keep eating because I never felt full. I'm like, All right. Me too. Nobody was unpacking the fact that I was on antibiotics from basically the time that I was born, almost monthly because of ear infections and throat infections. Even when they ultimately looked at that, like at 19, and they're like, Okay, you need to stop having these ear and throat infections, they took out my tonsils. The answer is that there's a problem with your tonsils. Nobody was ever looking at the root cause in there.

The root cause of my fat was that my digestive system did not work better. It took me doing a horrible goat's milk cleanse and being in a bar and meeting a weird gastroenterologist who suddenly said to me, It's not what you're eating or what you're not eating. Your digestive system doesn't have what it needs to run better. Why am I saying this to you right now? When you said people are using that medication that shouldn't, I totally take issue with that. I take issue with a society that... There are so many people taking statins or proton pump inhibitor medications that I feel as a clinician who does this, I probably could be helping them on or off those medications. But nobody is judging someone for taking a proton pump inhibitor and saying, You shouldn't be suppressing acid. You should just be eating and exercising differently. And so the acid production in your body is different. And we have so much bias around weight. And we turn around and we say, I could look at you. The woman that I was with this morning has no extra fat on her body. And she said to me, My doctors are telling me that I should go on this medication.

I'm thinking, are they trying to tell me I'm fat? I said, no, what they're trying to tell you is there's applications for these medications that your appearance doesn't tell me anything. The same thing that people say you could be healthy at every size. Why are we judging somebody who's obese or who has excess fat or whatever? I don't care what your size is. I look inside of you. I want to know, are you healthy inside of you? I'm not going to judge someone and say, is it inappropriate for you to be using the medication? Because I have people who have eating disorders and disordered eating. I have people who have blood sugar dysregulation. I have people who have cognitive impairment, other reasons where I'm like, oh, this might be a part, a tool that could be useful for us for a time period or maybe ongoing. The second part of your point, though, is really valid. If somebody uses this medication and they just think that all I need to do is use this medication, they're not fixing anything. That part of it is going to mean that that's why you, A, would have to stay on it, and B, in using it, you actually may be missing that you could be making other things worse.

I think that's what you're picking up on, too.

What can you make worse?

Well, you can make your sleep worse, and your sleep could already not be better. You could make your heart rate variability, which is a measure of your body not being in the relaxed state. We have this Yin-Yang in our body. We have our sympathetic and our parasympathetic. If we aren't careful and we keep our body in a stressed-out state too much, then that can cause us to just burn through things. If we keep pushing our body to be producing insulin and sending insulin out, that could be an issue for our insulin production. There are other factors. Certainly, if we create a space where we're not hungry all day and so we don't eat all day long, we could take somebody who is already nutrient insufficient and we could make us more nutrient insufficient. The one that I think you would spark to is if somebody's too tired to exercise or their muscle, they're not building muscle or they're not able to actually make muscle because they're not taking in enough of the nutrition that could help the body build muscle, then, yeah, you might lose weight, but you're actually more metabolically disadvantaged by being fat with lower muscle mass on that part.

Right.

But we've been doing this a long time, this business. We met, by the way, everyone. We did a weight loss show together eons ago called Shedding for the Wedding. I was the fitness trainer, and Ashley was the dietitian. That's how we became friends. And so this goes back a long, long time. A long time. And there is something to be said for behavior modification. Totally. And I mean, you can say whatever you'd like, but I think a lot of people are not modifying their behavior, and they're relying on this medication And what's happening, what I've seen in real-time, is people acclimate to the medication, and then their appetites come back. And then when they get... They either have to stay on this medication forever, and then keep on adjusting it to go up or they start gaining weight back. And when they get off of it, and I've seen this probably six to eight times in the last year, they gain all their weight back and more because they actually lost muscle mass and they didn't lose the actual... They didn't lose fat because you're losing both muscle mass and fat, and their appetite comes back with a vengeance, which is not great.

Okay, so let's say this. So why blame a medication for somebody who isn't using it right?

Okay, let me say something. The second part of it is I hear a lot of people talk about microdosing it for inflammation, cognition, all these things. But yet there's not really any hard research to prove that it helps with inflammation, it helps with your cognitive abilities. I find that when people want to do something, they can think of a hundred reasons to do it. If they don't want to do something, they can think of a hundred reasons not to. That's how our brains work. There's not enough feedback on it. There has to be something to the fact that calling a spade a spade, which is people, this bullshit of body positivity, where, where, where. That left because people now could be thin. They're like, Body positivity, what? That's not even in the conversation anymore because everybody's taking it because they want to be thin.

If you can afford it. So I heard recently people who get if you can afford it. So let's go back to behavior modification.

Let me say this. One more thing. So what they're doing is compounding it, and that's a little bit cheaper. Anyway, that's my rant for the minute.

Okay, so let's unpack a couple of different things. You love that word, unpack. Well, I think it's important because it's probably the best word to use here, which is there is an argument for everything you say on either side, right? And at the end of the day, I just say, and it's probably my ego at this point, I'm 52 years old, I've helped thousands of people. If you're coming to me as a patient and you want to get better, I am going to help you. I do not have a crystal ball about how your life is going to go. I also I don't even have a crystal ball for the recommendations that I'm going to make. I can't say, Hey, Jen, if you take this supplement, this is what's going to happen to you. I can say, I strongly think this is what we should do. And then we do an experiment and then we have you do that, and we get the data from it, and did it work, and did your body show us that it likes it, and then we move on from there. So the one thing that I would say to anyone listening is, if you're not taking that approach, you're doing it wrong.

If you are listening to anyone, I don't care how brilliant or how they look or like any of that, I don't care who the biohacker is, any of that piece. If you're following what somebody else did for themselves and you're expecting the same outcome, you are to blame. It's just bad on that part. Now, the other part about behavior modification. For the first 20, 25 years of my life, life. And then I would say also as perimenopause reared maybe around 45 to 50, I have tried every behavior modification under the sun. I have free-based fiber. I definitely have had 30 grams of fiber before a meal in these nasty crackers so that I would feel full because I didn't feel full. I've slammed 120 ounces of water. I've given up drinking. I was a macrobiotic vegan who was hanging upside down in yoga. I didn't drink. You name it. This is not for not trying. So I want to be really clear there. And when you look at my genetics, I used to think that I was designed to be obese. That was the messages that my genetics showed me when I was able to sit down with somebody who said, there's another way of looking at this.

Your body is like, you are designed to survive. Like, your body hangs on to everything because you are an endurance athlete who is designed to hit it hard and not survive if resources were not available. I'm like, Well, that's really cool. Not great for modern day, but it's cool outside of that. So I had to reframe everything. And for me, what I would say is what we're not doing enough of is we're not understanding where the rubber meets the road. This is why I think as a dietitian, I am uniquely positioned to have this conversation rather than a physician, because I think there is a myth of a non-compliant patient. Sure, we can have somebody that's just like, I'm not going to get out of bed and exercise. But when I start to unpack, why are you not getting out of bed and exercising? You slept crappy, your digestive system was off, your blood sugar is impaired. So when we start to work on those things, can we get you to a place where you can get out of bed and exercise? It isn't about just telling someone to exercise, and then they're not exercising, and now we just deem them a failure.

Because I've been deemed a failure across the board. You know what I mean? I was the one that ate three containers of a Jenny Craig meal because I was like, Okay, well, one just didn't fill me up. And I'm like, Why am I not losing weight? I was like, here is this. As a dietitian. Yeah. This was before I became a dietitian. So let's be clear. Yeah.

But it was funny. We all go into the career that we think we struggle with, right?

That we struggle with, yeah. It's Totally on that part. It's so funny.

It's always the way it is. Are you on a GLP-1 now?

No. For me, and I love that I get asked that question, too, because I had gained weight as perimenopause. What I will say is, as a kid that struggled with my belly, it was always my belly. I was like, how do I lose my belly? And it really led me down dark paths. Really a lot of just negative. I was such a happy in every other aspect of my life, successful, fun, et cetera. And then I was this diet failure, and I just tried to hide it. I tried to drink and be the fun one. I tried to dye my hair blonde. It turned orange with sun in. I tried everything to not be me, right? Because I thought my belly was this failure. So when at 45, I started to gain my belly back again, and it was incremental, it was slow. And then there were some things to point to. I'd been through breakups. For me, it was like pandemic time. For all of us, it was the pandemic It was other stuff. But I'm like, okay, let me go to my toolkit and try to figure out how I can heal myself.

I knew I needed to focus a little bit more on tuning up my digestion. And it was the world of fasting. I'm like, fast like a girl. I love Mindy's work and stuff. I started fasting. I just like fasting, aka not eating. I was just like, I got down to where I wasn't eating for four hours in a day, and then I decided to train for an endurance event.

Hold on, you weren't eating for four hours?

I was only eating for four hours in a day. I created such a small window. I mean, yeah, I know. And also really not fun to be around. It took me longer to break up with alcohol, too. But then I started endurance athlete training. And so I would do these long zone twos instead of intense weight, like what works better for my body, hit and strength training. So I tell all this stuff because I had a great toolkit. I did Prolon, I did all these other things. I'm like, I'm still gaining weight. I'm still gaining weight. And so at that point, the GLP ones weren't popular/ accessible at space. And so I slowly, I gave up alcohol. I leaned into my digestive health. After my endurance event, I went back to strength training. I went back to increasing my protein. But then at that point, I was like, okay, I'm in trouble because all those things, I'm still just breaking even. And I was carrying 20 pounds in my belly. And I just was like, I can keep getting stronger, but I've got 20 extra pounds in my belly. So that was a very dark moment for me.

And at that point, I met a doctor who said to me, I've been working with GLP-1s for ages at this point. She had worked with the originally or Glutide. She said to me, I want you to know this is an option for you. Here's this, don't feel badly about yourself. I was like, Okay, I'm excited about that. I was like, All right, I'm going to try this. Your point of low dose. I met Tina Moore, and she's like, There's a difference between microdosing and low dose. I was like, Okay, I'm going to start on a low dose. I try a low dose, and what happened to me on a low dose? I stopped pooping. And let me be really clear, as somebody who's entire life was about constipation, if you make me not poop, I can't handle it. And I tried everything. I tried magnesium, I tried this other stuff. So I would say it was maybe about two months, like Somewhere in the range of two to two and a half months. This is what I will tell you. From the moment that I gave myself my first injection, and this was 10, I guess it's 10 units, the smallest amount from a compounding, we'll talk about that in a second, I had a different brain chemistry than I had ever had.

I was like, Oh, my gosh, I might not be thinking about food. I didn't realize how much... I wasn't eating a lot. I just didn't realize how much I was always thinking about food. And all of these other things. Anyway, after about two, two and a half months in, I'm like, My digestion, I can't handle this. I'm not going to use it. And I had also, at the time, randomly, because of the work that I do, met the folks from New Zealand who make amerisate, which is a compound from hops, and it's what one might call like a natural or a GLP-1 activator. I started using that and I was like, Okay, I actually like this, and it's not turning off my system in the same way because it only works for four hours. It's not working at thousands % higher. It's modestly. But I found that I really liked it for my appetite and my cravings. In the midst of all of this, I saw a doctor and she's like, You have a massive fibroid. Like, your uterus is four or five times the size. This is what's going on. This is why you're cramping, why you're bleeding, all this other stuff.

So I ended up having a hysterectomy. Nobody here needs to know my whole personal medical story.

But you're selling it, so go on.

Well, I'm going to stop. But here's the story. You asked me a question of the agonist. Would I use the agonist? And I still have it at my house. I'm like, if I have no idea how actual menopause is going to hit me, especially now that I have had a hysterectomy. If I need it, I would have no problem using it because I would know how to use it for my body. But the issue that I have in here is everybody, because I took off 20 pounds, the only question everybody wants to know is, are you using an agonist? And I was like, I just told you a whole story here. I climb mountains now. I fixed my digestion. I started eating again. By the way, I eat within an hour and a half of waking or game off. I have to have food. So you don't fast anymore? No, I don't fast anymore.

That's why you just... You said, Oh, I love this. I love Mindy, Fast Like A Girl, blah, blah, blah.

I loved her book at the time, and then it didn't work for me.

I love Mindy, too. Hello, Mindy. However, you know, Mindy has been on this show many times. First of all, I can't fast to save my life. No, you shouldn't. The only fast I can do, and that was even very difficult, was that prolon. The prolon, yes. The five-day fast mimicking. Because at least you're eating something.

And it works beautiful for me, but I lose muscle on it, so I get pissed. Oh, really?

Yeah, totally. In five days? In five days. But like the- Okay, so think about that. If you're losing muscle in five days, how can you talk about... If people are not eating for months on end, how can you say a GLP-1 could be good for somebody? Because they're going to be losing an copious amount of muscle.

I don't want them to use it. If somebody's using a GLP-1 and they're not eating, they're using too much of it, and they're using it wrong.

Okay, but the microdosing... Yes. Okay. Now I understand your story. Yeah. Do you think that microdosing is good or bad. Great.

If we apply Dr. Tina Moors and what I believe in as the true term of microdosing, so we have totally lost the marketing conversation, but a true microdose is a microscopic amount. You don't use that for weight health. Do I think using a low dose and a lower dose and using it and all the other tools is better in most instances, absolutely. I think people are, and doctors in particular, are just saying, Start at this low dose and go higher and higher because that's the research that pharma did, and they want us to go higher. I think using a lower dose is oftentimes smarter on that part.

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The compounding has changed. I'm concerned about compounding now. So what happened was the compounding that was available when that was what I had gotten, it was a different compounding pharmacy. There's A and B. At that time, it was because there was a shortage of the ingredient, and the compounding pharmacy, it was held towards the regulations of the FDA and saying that we are only using that ingredient. The compounding pharmacy, the ones that are regulated now, are regulated at the state level and through a pharmaceutical association, and they may not be the exact same ingredient. And so the real question is, I don't know. I don't know what somebody is using. If somebody is getting semi-glutide or they're getting tersepatide, I like that. There are some now that they've added B12, too, because everybody's like, Well, because more B12.

That's what they're doing now. They add B12. But I'm Especially in California. That's not good?

Well, it depends. So first of all, it depends. Is your B12 low? And also I have some people that are doing that and they're going into these longevity centers and they're getting a B12 injection on top of it. And they're also taking a methylcobalimen in their supplement. What's that? That's B12. Nobody's looking at it, right? And I was like, Hey, you're just getting too much B12. More B12 is not the answer on that part. Now, could they have a benefit of getting B12 in with the GLP-1 because they weren't getting B12 in before. And is that helpful to them? Yes. But B12 works in the body with B6 and with folate. And that helps you when you have the right amount, it helps to reduce homocysteine. So if I just give you B12 and I don't optimize your B6 and your folate, I could also be creating a cardiovascular problem, not solving one. So it's important for us to pay attention to.

This is what I'm saying. This is why I don't love is that people are not taking into account. Once you do one thing, it will offset something There's a lot of this happening. So people think just like more is more. Like, oh, I need to lose weight, so I'll do this. Or they're ordering it from China. No one knows where they're getting their stuff from. Now, I'm curious about something with GLP ones. I've always I'm curious. Like trisepitide, semiglutide, there's a new one now. Retro-trutide. Retro-trutide. They're all GLP-1s, but they're some that work on more receptors to make it more effective.

Great question. So semiglutide is a single agonist. It is an agonist. So agonist versus antagonist. A statin and a PPI are antagonist. They work against the way that the body is working. An agonist, by definition, means that it's doing what your body would normally do. Semiglutide is a single agonist. It is an agonist for GLP-1. That's one of your weight health hormones. Then tersepatide, even though it sounds like it's a three one, tersepatide is a dual agonist. It is GLP GLP-1 and GIP. Retrochutide, I don't even think I can pronounce it, is a triple agonist. It is for GLP-1 and GIP, and then it's going in and it's working on a different glucose hormone. Then there's this whole new class of medications coming out called small molecule non-peptide. That's important because they are not bioidentical. Oh my gosh, you're going to kill me with these names, but I think it's O4 glipron or Something like that that's going to come on the market this next year, everybody's really excited about that one because it's oral and it's called a GLP-1 agonist. But when you have the receptor site in the body, there are two pockets to the receptor, as we know.

When you have a GLP-1 agonist, it comes in, it hits that first pocket. It's like pool or pinball. When it hits that first pocket, it opens up the next pocket and it lands into the second pocket. This one, the non-peptide one, is just a chemistry lab project, and it jumps over that first pocket and it lands in the second pocket. I don't know how that is going to work in your body. That has me very concerned about if you skip over something. I've seen plenty of medications, COX2 inhibitors and others, that are doing something that is like what the body does, but also different. I don't know what that means. So that is very different to me. But that explains to you how liraglutide, semiglutide, trizepitide, retrotrutide, how they work.

So more receptors, I would imagine.

Different receptors.

Or dual receptors.

Different receptors.

Well, because semiglutide, I feel like Ozempic is old school.

Yeah, it is. It was the Ogie.

Ogie. But people get way better benefits on trizepitide or There's appetite.

You know what's interesting? This is where the data is really interesting. The better benefits are number one, in some of the research, it was shown that they lost weight faster or they lost more weight. Okay, you and I have a strong agreement. I don't want you lose weight faster, and I don't want to just mark whether or not you've lost weight. I want to know fat loss. Okay, let's take away the weight problem.

You're not getting as nauseous. You're not getting as tired.

Yeah, has not been my patient experience. I have had so many people that I've taken off is a part of working with their practitioner, taken off of terepotide and we're using Semaglutide. I think at the end of the day, the side effects, they're not even side effects. If you have pre-existing digestive issues, they are going to get worse on this medication. If nobody assessed and helped you optimize or resolve those digestive issues, and then they put you on this medication, it is going to exacerbate those. If you have those, you're also going to see the higher and the quicker that you go, the more dose and the higher amounts, et cetera, it's just going to keep getting worse on that part. To me, the consideration for the medication choice is likely number one, what's your insurance going to pay for? Or number two, what do you have access to? But what we really want to understand is in any medication, how do we keep it from being too difficult on your body, which is where the side effects become pronounced.

Okay, so are you for or against? Because I'm still confused.

Don't put me there. I'm agnostic. That's my point.

I like to use it in patients. I'm talking to you I'm reading your book. I still don't know. Do you like them? Do you not like them? Because you were on it and you said it changed your brain chemistry and it was great. But then you're not on it because you did fiber and you do endurance. I'm confused. Do you like it? Why are you on it if you still have this great effects.

Yeah, because I don't need it. At the end of the day- You just told me you lost 20 pounds. Yeah, I did because I had 20 pounds. Oh, the fibroid? No, but not even the fibroid. My whole system. So psychologically, I was in a bad place. Physiologically, I needed to do work. I love that we're trying to put people, you can't put me in a box. People want to know, are you pro or con? I am a health care practitioner. You were in front of me.

You were in a book on this. I did.

You know what the book is?

Is your book pro or con?

Okay, so the book is, and it says there, GLP-1 shot or not? I don't care. At the end of the day, the answer to the book is, I can help you get weight healthy, whether you're using the shot or not. There are people who are going to benefit from using the shot. I have no issue with that. There are people who are going to benefit from using it for a short period of time. There are people who are going to benefit from using it ongoing. There are people who are going to benefit from using a higher amount of it. There are people that are going to benefit from a lower amount.

And you don't have an opinion if people- Here's my opinion.

Don't use the medication unless you do what you do in this book. And what you do in this book is you optimize your own weight health and your own weight health hormones. No one gets to go on this medication, and it is not a pass for doing all the other work.

That's the key piece. Okay, so let's move on from a GLPM for one second. Perfect. All right. So what are the other ways, in your opinion, because you have to have one. If you're on this podcast, crying out loud, give me an opinion. Yeah, I'll give you the opinion. My God, it's like talking to Donald Trump on both sides of his phone.

No, no, no. But I think you're wrong there, Jen, and I'm going to hold you to this. Okay, go hold me to it. Which is you are trying to get me to create a one-size-fits-all an opinion that somebody wants me to have. And the opinion is it has to be personalized.

Okay, so let's talk about this. Because I think things are real, that people... I think the psychological effects are big. Food noise, you That's a big one. Curbing the cravings, curbing those.

Psychologically, I think- Optimizing blood sugar where it was designed for.

Optimizing blood sugar, all the things. Let's say if you're on it- Or not on it. Not on it. Not on it. Not on it. Not on it. Not be on it, not be on it, whatever. What are some other key- Perfect. Ways we can optimize our health that will take us to our goal? Great.

I use the analogy of making a pizza. Everybody gets a pizza. There's a crust, there's sauce, there's cheese, and there's toppings. Have you ever had a really crappy pizza, but there were a couple of great toppings? Like the topping was delicious, but the rest of the pizza was crappy. The cheese, the sauce, the crust, not great, but the topping was delicious on that part. Or have you ever chosen a pizza? Okay, I won't even ask you. Anyway, the reality is the crust is digestion and hydration. You cannot have any health outcome, any health outcome. You can't stop hair loss, you can't make muscle, you can't optimize your cholesterol, you can't prevent Alzheimer's, you can't do anything that you want to do if your digestion is suboptimal. I include hydration in digestion because hydration is not about drinking water. Hydration is about your body's ability for to do all the things it's supposed to do in the body. One of those is to help it absorb nutrients in that part. Fun fact, one of your weight health hormones, PYY, helps to regulate hydration in the colon. When I talk about repairing your weight health hormones as not optional.

You want the opinion from me? Optimizing your weight health hormones is not optional. Glp-1 shot is optional. Supplements are optional, but we have to optimize our digestion and hydration. Okay, the sauce is better nutrition. It's pillars: quantity, quality, timing, and balance. You know how I told you that I can't fast in the morning? I don't want people choosing a caloric window 12: 00 to 08: 00 PM, meaning where they start eating at 12: 00 and they finish at 08: 00 PM, and saying, I'm doing an eight-hour window. For most of us, that eight-hour window works much better if we start at 10: 00 AM or if we start at 08: 00 AM and we finish at 05: 00 or we finish at 06: 00 PM. I also want you pit stopping regularly throughout the day. I was just on a panel with one of your favorites with Mark, and we were having a whole conversation about Mark's Daily Apple. Why am I forgetting? Oh, Mark's just on. Yes, isn't it? And he's like, Well, I just don't eat if I'm not hungry. And I said, so hunger, that there's a hunger piece to this, but Actually, your body is designed like a race car.

We actually need to pit stop pretty regularly to fuel it, to give it what it needs, whether that's water, whether that's nutrition, on that part. The cheese are your lifestyle choices. Stress, breathing, joy. We We want to make sure that we're moving our body. What's some of the dumbest? Chapter 4 is shit to unlear. One of the things we have to unlear is how dumb our recommendations are. One of our recommendations is to exercise for 30 minutes in a day. When I say that to someone, you know what they think? Great. I can sit on my butt for 23 and a half hours. No, your body needs to be moving probably about every three hours. It matters what type of exercise you do. Sometimes you need to be hitting it hard. Sometimes you need to relax. You need to move your fascia. You need to open up your fascia. When we come over to the lifestyle choices, those are your cheese. So your crust, digestion, and hydration, the pillars of better nutrition is your sauce, and then the cheese are the pillars of the lifestyle choices on that part. That's good.

I like that.

No shot or not.

No shot or not. Okay, I'm going to say a couple of things. I think one of the best things you can do for your digestion is actually exercise. Is exercise, yes. Is moving more. Yes. However, here's the however, when you move more or when you hit it really hard, because I've seen you work out before, when you I hit it really hard.

I've tried keeping up to work out. Sometimes I cut them. You're good. As we're in that part, we have to recognize that the act of exercising at that pace is stressful on the body. It turns attention away from digestion in the moment. With my pro athletes, with anyone who's hitting it hard, once you finish exercising, we then have to get you to relax. We have to turn off that stress response. If we don't do that, and this is one of the reasons I like to use continuous glucose monitors is because I also will call someone out. They'll tell me, I had a guy who ran five miles every day, and he's like, Ashley, I run hills and I run hard. And he's like, I just don't know why I'm not seeing body composition changes and this other stuff. And I looked at his continuous glucose monitor. You know what his body thought of his run? What? His body was like, meh. You could do that in your sleep, dude. I'm actually doing it in my sleep. I went back to him and his trainer and I said, you need to do HIIT workouts. You need to do things that are like, this is not my skill set.

This is your skill set. But I am telling you, your continuous glucose monitor is telling me your body isn't stressed enough when you're exercising. And so for him, we actually use that information to help pivot, and that's what changed his weight health. He did not need a GLP on agonist, but he was really struggling to make muscle and to see body composition changes.

Especially with endurance. I find that a lot of people who are high endurance athletes, your body acclimates to that, too. And so like, okay, now you're running 5, 6, 10 hours. Now what? That becomes a walk around the block, like anything else. Like, your body does acclimate. But I'm talking from a place of just digestive because I think that is a big one. It is.

I agree with you. It is. Midsection movement. I mean, we've been at hotels. We've stayed near each other. I've stayed here. I will roll over. If my midsection after a flight is not working, I'm going to roll over on whatever ball you have. I literally am going to lay on it and roll it around, or I'm going to do chair twists on the airplane. I'm going to move. Just to move around. And to move the midsection, right? Our body, the muscles in there, we have to move. That football field, we have to move it on that part.

Yeah, that's interesting because I feel like... I never thought about that part. What I think about is that's why I don't like spin class or cycling because we sit all day anyway. So I believe it should be vertical and upright as much as possible. I'm a big believer that movement, I don't even like the word exercise. Yeah, Same. I think if it's between movement or exercise, move. Move.

Because that- A hundred %.

Will help with your digestion, your brain, your cognitive abilities.

If you're running around after... Put me with my five and seven-year-old niece and nephew, and I'm exhausted after three hours because we are moving, most of the time, we are moving the entire time. So don't turn around and tell a mom or a caregiver, an aunt or somebody else, on top of that, you now have to exercise. No. For that person, they may need to actually go stretch. They may need an Epsom salt bath. They may need to turn off their stress as a reaction to that. So I think inappropriately, we've given these mantras of making things really simple. You know what I mean? And it's just we've so screwed up. When people say, eat five servings of fruits and vegetables, everyone hears fruits and not vegetables because first of all, fruit's delicious and it's sugar. It's like, okay. That's true. I love fruit. You know on that part?

You know my thing in fruit. Right.

And then we can't stop in that part. So I think that so much of this also with our weight health hormones is eating what's delicious to us and using our body the way that it was meant to be used, to your point of we've got to move more.

Yeah. So a couple of other things. Are we eating too much protein?

So there's no we. So the question mark is, are you, Jen, are you eating too much protein?

Am I eating enough?

So there are two different sides of too much.

Hold on. Because I want to ask about if we're eating too much protein because we're talking about digestive issues. Yes, exactly. And that can be a problem.

Bing, bing, bing. You're so smart.

I didn't just fall off the truck yesterday.

No, you didn't. I love that. I saw your recent podcast a couple of months ago about that. I'm so glad we're paying attention to it. First of all, one of the things that does not help us is when we give an amount of protein in the day and we base it off of our weight. Especially if your weight is above 150 pounds, this whole idea of one gram per pound, when you get to 200 and 300 pounds, somebody should not be eating that much protein. The question often that I'm faced with is, are you giving your body enough protein in a moment that it helps to resource the body with what it needs protein for, but also that it's stabilizing blood sugar. That's usually for most people, you don't want to go lower than 15 grams at an eating occasion. That's really important because remember all those bars that were eight? They'd come out and they'd be like, I'm a high protein bar, and it was like eight grams because things used to be four grams. As you know before. So we do have to have a baseline minimum. The question of at any time do you go above 30 or 40 grams at a sitting?

You have to have optimal digestion. I will also look at your blood sugar because excess protein can negatively impact your blood sugar. The other piece of it is, is your digestion able to break down the protein that you're currently getting in? So sometimes, as an example, after a really intense workout, the reason that I might use liquid nutrition that is higher in protein there is somebody may not be able to break down and absorb the... The digestion has been turned off. So eating a steak at that moment might not be a better idea. But having something in the liquid form or having cottage cheese or something else that's a little bit easier might be easier for them at that. But when we look at too much, the signs of too much are, do I have bad gas? Do I have acne? Do I have bloating? Are things going the wrong way? Do I have reflux? Do I have constipation? So digestive issues. Then we really have to look at from an amino acid standpoint, maybe you're having the same, maybe you're having eggs and chicken and eggs and chicken and eggs and chicken, and we need to get some other amino acids in there to help you.

It's not always about more protein, but we should be assessing somebody's protein rather than just coming in and then saying, eat more protein. But here's the final one that I find the kicker. What food in nature is protein?

I mean, salmon?

I'm going to say it differently. No, I'm going to say it Because I set you up there. What food in nature is only protein?

Well, you have fish that has a lot of- Only protein.

Oh, jeez. Nothing. The answer, nothing. Nothing. Okay. Nature did not- That's a trick question. Nature did not... There's a total trick question. So salmon has fats. No, they have fats in there. Their fats are actually some carbohydrates. There are some antioxidants, et cetera. The dumb advice is start your meal with protein. No, start your meal with a food that contains protein. But I need to know there's a difference between maybe having lentils, which contain protein, versus having steak at the start of your meal. Or there might be a difference for you between having hemp seeds and having wild salmon, even though they have a very similar essential fatty acid profile.

Okay. So are most people, you said we don't like the we. That's right. But in general, now that proteins become so popular and trendy in terms of people are, I think, a little bit over protein themselves. You think that that is happening?

I definitely think it's It's happening because the advice is to eat protein. I think what's happening is, number one, people are making choices that they don't realize maybe how much fat they're also getting in, or they're getting rid of all carbohydrate and just feeling like, I'm only going to choose protein and fat and not have the others. As a result, they're not getting the right balance of nutrients on that part, and they are bandating their digestive issues. I mean, you see people who are freebasing magnesium, you have people who are like- What do you freebase?

You said it twice now.

What does that mean? I I like that term. Free-basing magnesium. It's a drug term, so this is why you don't know it. Free-basing cocaine, I hear all the time, but magnesium. So literally, we've gone from a society that free-bases cocaine to a society that free-bases magnesium. I have people who have literally told me that they are taking magnesium with every single meal because otherwise they're constipated. That's an important thing to recognize that maybe we need digestive enzymes. Maybe we just need to eat less at a particular meal on that part.

So people actually They free-based magnesium because they're constipated?

Yes. Yeah.

Okay. And so I was actually going to add- Instead of moving their belly. Instead of moving their belly. So like going on a Swiss ball or just moving around. But what about digestive enzymes? If we took a couple of those supplements, do we take it before we eat or after we eat?

Yeah. So digestive enzymes are different than proteolytic than other enzymes. They do have to be taken. They should be taken typically right before or right with the start of your meal because the body produces digestive enzymes, and it produces them in response, along with their weight health hormones, in response to signals that we are getting in food. It's a personal assistant for your digestive tract. So number one, When you optimize your digestion, you might not need digestive enzymes because in that optimization, you may help your own body produce enough digestive enzymes. During that process of optimization, we may use digestive enzymes as a supplement to help you. Then the other side of it is there are times where you might just benefit from using a digestive enzyme. As an example, maybe you're eating different food from what you normally eat. Or for me, I travel so much. Traveling, especially on a long flight or a long car ride, because I'm not used to being sedentary, and the air pressure, it will negatively impact my digestion. I use digestive enzymes to help me. It's like a personal assistant that I use for my digestion in those moments, too.

So do the digestive enzymes do the same thing for your digestion that magnesium would?

No, different. Okay. So magnesium is a mineral, is designed to, and it works in opposition to calcium, and it's one of our electrolytes, and it is designed to relax. It exists in our cells to kick out calcium, to turn It's not the stress response, so it is allowing relaxation. So why it's helpful for things like constipation is if your constipation is motility-related, and I do a whole deep dive on magnesium and how to choose the right magnesium from food and from supplements in the book, when We're looking at that and you come in and you say, Okay, so if your motility is slowing down, if you follow classic recommendations for constipation and you eat more fiber, you're just going to have a slowed down system with a snowball of fiber in there, and it's going to be more painful. We need to do is we need to encourage the motility, and that's where an optimal amount of magnesium can be helpful. Digestive enzymes are different. Digestive enzymes are in your body, and they're like forks and knives. Maybe we didn't chew our food optimally, but just think about, instead of cutting your food into one or two pieces.

Now think about cutting it into 30 pieces. And what we're trying to do is have it be absorbed better. So that's the job that it does. So it breaks down the food. It breaks it down the food. So it's in breakdown. One of the chapters of the book, I talk about how we're not having breakdowns often enough. We are not breaking down our food. So we're giving people... Society gives people a lot of credit for what we're eating, like kale and salmon. We're like, Oh, those are healthy foods. Your body doesn't give you credit until it is broken down into nutrients and in the cells and able to be used by the cells, and then it high fives you. And then it's like, I'm going to grow hair. I'm going to give you energy. I'm going to do whatever.

That's a really good point. I think that's important because I think what I found out was I'm not even absorbing the nutrients that I'm even eating. So here I am eating all these healthy foods that are not great when I'm not even absorbing them. So how do people even find out if they are absorbing?

If they're absorbing. Yeah. So one of the things, because I always want us to be able to do this personally. I've created the first ever weight health hormone assessment, and included in there is an assessment of absorption. We also can use better quality tests. There are a variety of different digestive poop tests, and we can test from that part. However, your body is going to tell you, if you are If you are having any of the digestive issues, then we have to work on absorption, and we have to remember that hydration is a part of absorption. Hydration brings water and nutrients into the cells. If you are dehydrated, if you're peeing all the time and you're drinking water, then it's going to tell me that you're not absorbing nutrients into the cells. So absorption, and if you drink alcohol, if you are on non-steroidal anti-inflammatories, like an Ibuprofen, a Tylenol, if you've used hormones, if you are on certain medications, if you experience stress, ever. If you eat things that your body is intoler to. So if you find out you're gluten intoler, or you find out... And by the way, if you have any exposure to any environmental toxins, all of those things are affecting the lining of the digestive tract, and that's where our absorption is occurring.

The majority of people that I see a tune up of your absorption is warranted on a regular basis. It is not something we do once in our lives. I didn't do it at age 20, and boom, I've had weight health the rest of my life. It's something we have to do. I recommend on a quarterly basis.

Wow. Yeah. Those poop tests are super popular.

They're different kinds now. There was a poop in tubes and take those tubes and we'd look at those. Those provided us with a lot of information. But now with the introduction of a more full spectrum genetic test. We can also poop, wipe ourselves and swipe. I know, I love your face, but all you have to do is swipe that, like we would do a COVID test in our nose. You send it in and you get all of this information.

And what I like about that- You're wiping yourself and what are you doing?

You take the Q-tip or whatever on your poop. So it's a lot better than having to stuff your poop into tubes and do that. But it's great. It can give us great insights. However, if you do one of those tests and you buy one of those tests online and you get the AI report and it says you're You're low in this and you're high in this and you just start to go take whatever you're low in, I'm going to start taking, whatever I'm high in, I'm going to avoid. No, that's not the way that it works. You need a clinician who's trained in the test. You still need somebody to interpret it and say, But why is this happening? In most of my patients' case, it's insufficient intake of glutamine, which is an important amino acid, and it's also lifestyle behaviors and nutrition choices that are not optimizing absorption.

What?

As an example, every time we need an antibiotic, it's going to negatively affect the lining of our digestive tract. And one of the reasons I broke up with alcohol was because, just one of the reasons, was because I was tired of what I call washing my floor with dirty shoes. I'm working so hard on my weight health and on my belly. And then you're sitting there and you're like, okay, every time I have a drink, it's eroding my digestive lining and my liver's ability to work better at it. And I was just like, honestly, it's not that worth it to me on that part. You were well ahead of the game on that part. Yeah.

I think drinking is the absolute worst thing you can do. For any type of weight loss program or any health program. Or just being healthy, period. You feel bloated. It keeps weight on. You feel gross, sluggish. I never understood it. Thank God I don't like the taste of it because that- I love the taste.

What I found for me, too, it was a social coping mechanism. And so I would find that I would drink because I either didn't want to be there, very blunt. And so then I was like, well, if I drink, maybe I'll enjoy myself. And Did you? No. And I also stayed longer. And then I also... Your budget or whatever. But I also found that it negatively... It would help me lean into other behaviors that I don't like. It made it harder for me to feel present or honestly, to choose who I wanted to have in my life versus the people I don't need to have in my life. You know what I mean?

It's like a lubricant for like, so you get an epic being with whoever. That's right. Around you because I get that totally. Yeah. Let me share my daily routine game changer with you. It's the Momentous 3. I've been using their protein, their creatine and omega-3 combo for months now, and the results are undeniable. These nutrients are key for long-term health and performance, but hard to get enough of through diet alone. The CriaPure creatine boost both physical and your mental performance. The grass-fed way tastes great with no weird aftertaste, and their omega-3 is a must for recovery. Since adding these, my energy, my recovery, and my overall well has really improved. So if you want better performance, this is the way to go. Visit live momentous. Com and use my code, Jenn, for 35% off your first subscription. That's live momentous. Com code, Jenn, for 35% off your first subscription. Trust me, you'll be happy you did. I want to take a quick break from this episode to thank our sponsor, Therasage. Their trilight panel has become my favorite biohacking thing for healing my body. It's a portable red light panel that I simply cannot live without.

I literally bring it with me everywhere I go, and I personally use their red light therapy to help reduce inflammations in places in my body where, honestly, I have pain. You can use it on a sore back, stomach cramps, shoulder, ankle. Red light therapy is my go-to. Plus, it also has amazing anti-aging benefits, including reducing signs of fine lines and wrinkles on your face, which I also use it for. I personally use use TheraSage Trialight everywhere and all the time. It's small, it's affordable, it's portable, and it's really effective. Head over to therassage. Com right now and use code Be Bold for 15% off. This code will work site-wide. Again, head over to theraesage, T-H-H-E-R-A-S-A-G-E. Com, and use code Be Bold for 15% off any of their products. I wanted to ask you about something that recently I've been playing around with because I had someone on the podcast, and he It was actually the medical medium who's very, very polarizing, super polarizing. But I will tell you one thing about that guy. As polarizing and as kookey, as some people may think he is, when I him and put him on my stuff, the amount of people who are like, Oh, my God, he changed my life.

Oh, my God. If he was right or accurate about that. So listen, if it's working for someone, I think it was fascinating. And he did say something that I thought was interesting. He said that your immune system is in your blood system. Is it in your blood, not in your gut? What do you think about that?

I think he's right and wrong. Okay. You hate this. What's the position?

Remind us never to have a back on the podcast again.

Never going to have us again.

I mean, this is really like we want an opinion.

Okay, so I'm going to tell you, you can't ignore that your immune system is in the lining of your gut. So he is physiologically wrong on that. What you also can't ignore is that we... I don't actually think we have an immune system. All right, you want my full opinion on this? Yes. We don't have an immune system. We have a body. It is an ecosystem. It is so dumb for us to talk about a digestive system, an immune system, a nervous system, an endocrine system. That was a convenient way for us to teach to teach people about the body and to create a healthcare system that is not working well for us because it segments where we send people. You have a heart problem, you see a cardiologist when really, you should be working with me on your gut, or you should be working with you on your fitness, or whatever, in all of that. So what he's doing is, number one, being dramatic, which always gets you likes and shares, but number two is saying, how could the blood not be part of the immune system? But why does he have to say that your digestive system isn't?

Let me tell you what- That's key.

Okay. Yeah.

You made a good point. He said that people are getting way too much blood draws. They're getting a lot of blood. And when people are sick and then they go to the doctor and they're like, okay, let's take your blood again. And the more and more blood that you're getting taken, the sicker you're becoming because they're stripping your immune system. So why I'm bringing this up is because people say... Everyone says, you need to... A lot of people, not everyone, that you need to get your biomarkers check, let's say, quarterly.

Let's talk about that. Okay. I didn't say you need to get your biomarkers. I said assess your digestion. I'm not saying you. Okay, carry on.

I'm not saying you are talking about other people. I've had more than one person on this show. Okay.

Thank you for making me your second guess..

What I was going to say is that more and more, I'm noticing that people started with 80 biomarkers you're getting checked, 100 biomarkers you're getting checked for. Now someone's coming to my house for this really elaborate program, and they're doing five A hundred biomarker testing. When it is enough is enough. And when I go see my doctor, he's like, Listen, there's always so many things we can check. You can test for a thousand things. I think functional health now is going to do a thousand or someone else is going to do a thousand biomarkers because they need a point of differentiation to market themselves. For marketing purposes. But isn't that just becoming too excessive?

Okay, so two different things to think about. The first thing, because then we also have You can go get total plasma exchange where people are giving their entire blood and bringing whole new plasma in there. I was going to ask.

I was going to talk about that, too.

When we talk about being sick, is there such a thing as too much? Yes. Also, I want to acknowledge, I don't think doctors are the best suited to help people optimize their nutrient levels. Because the way that doctors are taught, and we're in a doctor's society that I'm trying to break open, doctors are taught to look at biomarkers almost exclusively and diagnose you. They might look at a CBC, the one that your insurance, that old one, remember, 10 markers, right? They might say your iron is low. You know what they'll then tell you to do is to go take an iron supplement. I can tell you I'm not I'm not going to do it right now, but I can tell you 15 reasons your iron could be low. One of them could be your testosterone. They haven't even tested your testosterone in that part. When we look at blood markers and we use those, so this society of, I need more blood markers and I need more blood markers, and I'm going to tell you something funny about this one that you're about to have done, I'm going to get more and more and more tested.

At the end of the day, if you're not absorbing your nutrients, nothing is going to improve in any of those markers. I don't need I don't need you to do that. I don't need you to do a poop test. If you come in and you tell me that you're farting and it smells really badly or that you feel like you're five months... You look like you're five months pregnant or you're putting on weight and you don't know why. I ask you questions. My entire book is, these are the whole chunk of, this is a playbook. These are the questions you need to be asking. And only one part of the assessment, only one part in there are 10 labs to look at. Now, that doesn't mean that there aren't really valuable labs. It doesn't mean that if I'm curious about your testosterone, I might want five labs drawn. And that could be an important thing to do. But when we go in and we do all of these labs, and then we give you an AI report that tells you, that doesn't know what you're doing or any of this other stuff and tells you, Here's what I would do based on your labs.

Honestly, you're the fool for following it. At the end of the day, and so when he's saying, I think you're wasting your time, your money, and your blood if you're doing it inappropriately. That said, I also think what we have is a reaction to a society where we have had for too long, too few blood markers and the wrong markers, and we've been making decisions about that. Are there some blood markers that I would look at on a quarterly basis? Yes. Are there some that I would look at every six months? Absolutely. Do I use Function Health myself? Yes, because without having a physician that I could turn to immediately when I was moving, that could look at all of that. But you know what pissed me off? I went back for my... They're like, We include two blood draws in a year. Yeah, but they didn't include any other one. In the second lab draw, it didn't include any of the ones that I needed to look at. It only included their second set on that part. That wasn't helpful to me. Then I ended up paying... If I had gone with them, I would have ended up paying another $1,000 to get the ones that I actually wanted to get drawn.

The models of health care that are out there that are creating access and the ones that are telling us to do all of these things aren't better. Anyone that's coming over to your house, I love that they're coming to you, and that's wonderful. But I just really have to question, why do you need more blood drawn? We know you need to work on getting yourself to absorb more nutrients. So unless it's a follow-up to that to see if you're now absorbing nutrients better, I think you're wasting your blood and your money and your time.

Okay, so then what are the 10 biomarkers that everyone should be looking at. Yeah.

In the book, I look at the ones that are going to give me information about your weight health hormones. I had to make a decision to include hemoglobin A1c, and it really bothered me. Hemoglobin A1c is a 90-day average of our blood sugar. It is better than just having a fasting glucose. We prick our finger in the moment and we find out our blood sugar from a trend standpoint. But because it's an average, it doesn't give me really good information. But when I use that, it can give me a little bit of insight. Then I also like to use a continuous glucose monitor. I did include A1c. I included vitamin D because I want to know about that one. I included LDL. I included your triglycerides. I also included in their Fasting insulin, if you have access to it, that one could be helpful. Hscrp, so a marker of inflammation, noting that it might not be the best marker of inflammation, but it gives me a little bit of information on that part. I forget what numbers I'm at at this point, but there might be one or two. Oh, your ALT and your AST because they're going to help me see if I should be looking at your liver as it relates to fatty liver.

We haven't even talked about that. Why are we creating? What happens when the body... You could be a healthy weight, but I see so many people where their AST and their ALT are elevated above where they should be, and that tells me that their liver is really struggling, and we need to optimize our liver on that part. That's one part of weight health hormone assessment. Those labs can give me good directional information In addition to you answering questions about your lived experience, in addition to us measuring your breathing, your heart rate variability, in addition to us looking at your weight composition, not your total weight, I could care less what the total number is, and in addition to us asking about questions and assessing your digestion and hydration.

Got it.

Yeah.

All right. So what are some ways that we can improve the way we absorb our nutrients? Great.

So first of all, not giving our body too much at one time. So recognizing that when we give our body a good amount, that is actually better than giving it more because if it has too much work, it can't absorb it. The second one is optimizing hydration. So instead of pounding, say, 60 ounces of water at one time, maybe it's 8, 10, 12 ounces. Maybe your food is rich in electrolytes. Maybe you're not also having alcohol or caffeine at the same time, and we're not eliminating it. Maybe we need an electrolyte supplement. What's in that electrolyte supplement depends, et cetera. Then the third one that I think is really interesting is you were talking about movement and being active. Actually, the body is not going to want to absorb nutrients when we are inactive because the body is going to be like, I just may as well store it as fat because I don't need to use it in that part. So part of absorption is getting that balance right between not What do I give my body when I have been really active? And then also, what do I give my body when I'm not active?

Got it. I like that. I think that a lot of women struggle with this whole thing, right?

Yes, big time. Also because so many women we've been on, one of the ones that I think for me was inappropriately was I was told to be on birth control for heavy periods. So birth control is one of the ones that's challenging to our body's absorption, the lining of our digestive tract, et cetera. Really? Yeah.

So if you're on birth control pills, it can make you constipated?

Not so much about them making it. It could contribute to constipation, but it can also deplete nutrients that our body needs to be able to absorb nutrients. Oh, yeah, right.

We talked about that. So you see how tired I am. I need more magic. I know.

Has your magic... I didn't mean constipation.

Magic hour. I meant It's more like nutrient absorption. Yes.

And another one that we both like is one of the reasons I like acromancia as a microbe, acromancia clostridium bifidobacteria. But acromancia by name is acromancia mucinophilia. It's a probiotic. The mucinophilia means I like mucin, and it means that it goes in and it chews up the mucus in the lining of your digestive tract. When it chews it up, it's getting rid of the old and forcing the body to create new. That's part of the repair work for the lining of the digestive tract.

But you told me off camera that glutamine is really good for- Glutamine is great.

Yeah. When we were taught nutrients, but whenever we were learning about that, we were taught that glutamine, because the body can make it, is something that's called conditionally essential. What I communicate to all of my patients and publicly is that existence in 20, 25, 26, 27 and beyond is making glutamine more of an essential nutrient. Yes, the body can make it, but we have increased our needs for it because of all of these other things that challenge muscle and challenge the lining of our digestive tract. It both helps us with building muscle and it also helps us with the repairing. It's the glue, if you will, for the lining of the digestive tract.

That's one that I feel like people don't talk about enough, right? You hear a lot about vitamin D, you hear a lot about omega-3, you hear a lot about the creatine, of course, is really popular. The same supplements keep on- Glutamine is one of my...

I don't actually put people on other nutrients until Until typically it's either glutamine plus the others or I use glutamine for a time period, then I add in other nutrients. Because if you're not going to be able to be able to absorb it, why do I care if I'm putting it into your body? It's just going to be gone on that part.

So I should start taking my glutamine again. Yeah, remember that? I remember. I used to be on that a long time ago.

Yeah, it's a good one. And I think also, too, it's another one as we've encouraged more, and I love plant-based eating. And if you're plant monogamous, I I love that part, too. But you can get glutamine from different food sources. But if you're not eating animal protein, you're probably going to be getting a lot less glutamine.

I think Momentous has one. That's good.

How would you know that one's good?

Well, because you told me it was good. That's how I know. So momentous. There's quite a few.

So momentous, there's a shout out. There's one... And there are some people that have concerns. I think it's right. Dr. Russell Jaffe, who is the founder of Perc Supplements. I use their glutamine with a lot of patients. I take myself. It's called Endura-P-A-K. I like that one because if your body recycles glutamine, there can be some downsides to it. I have people who are just so insufficient in it that I'm not concerned about that. But if you are somebody where it's come up that you have that concern that a DuraPack is going to be an excellent one. I just wish they made it in a powder because I try to not take as many capsules. But those are some of the capsules that I'll take more off.

I remember that. Ashley gave me a really good tip. She says not to have as many capsules and have most things in liquid form because- Or powder. Or powder because of what the capsules are made from, right? People will think about that. What are the actual capsules made from?

It depends. There are some now that they call it Pullin, P-U-L-L-A-N I think, or pullane. That had a big issue because it's naturally made from seaweed. People were like, That's got carrageenan, but they didn't understand natural versus not natural. You'll see in... I mean, one of the things that I use when I've evaluated thousands and thousands of supplements is I'll actually look at what is the lining made. Maybe it's made from gelatin, maybe it's made from... A lot of them will just say, Vegey capsule. But that's like vegetable oil, buyer beware. What is your capsule actually made of is something you want to know.

Yeah, that's a good point. Is there any other interesting little things like that you can share with us?

Yeah, like when you're trying to pick something you mean?

Well, no, I like that one about the capsules. That stuck in my head. The couple of things that you've told me before, the sponge versus the host.

Oh, the hose versus the sponge. The hose.

Because I think people do. They chug water and then- And they put it and they basically they're not absorbing it because you're supposed to drink slow.

You drink slow or fast. But what's interesting is there are three phases, and I go through this. Once you figure out, are you a hose or a sponge? With sponge being optimal, I go through looking at your water intake, how much, how often, what type of water. Then the second thing I look at is your exposure to dehydrators, especially right around the time you're taking water, including stress, because stress is a dehydrator. Too much added sugar is elevated sugar. Blood sugar is a dehydrator. Stress is a dehydrator? Yes. Hi, Jen. I know. Hi, Jen. I know. Oh, my God.

I didn't know stress is a dehydrator.

Yes. When we look at these things, and of course, things like alcohol and caffeine. By the way, and sugar, I'm not saying we can't have any of these. We just have to recognize that they may be why we're not absorbing water. Then the third one that everyone's giving so much attention to is what are those hydrators? Those minerals that can help us to... So magnesium, sodium, calcium, potassium. Most of us do not get in enough potassium. We do not want to supplement high amounts of potassium, but we want to make sure we get it. But I have a lot of people who... One doctor called me, she's a friend of ours, and she was like, All my patients heard the Heberman podcast, and they're all taking two elementies a day, and they're getting in two grams of sodium. I said, I know. I'm like, First of all, again, the listener who is doing this, you're the problem. I'm just going to call you out on this. But you are not his size. You might not even be male. He went through his diet and figured out, okay for him, he sweats a ton, he exercises a ton, and he realized, I'm not getting salt in other places, and this one works for me.

You have to do that same thing. And I talk I love that in the book. It's really important.

I tease you because the whole one size does not fit all. So true. People look at somebody on Instagram and they're like, okay, if I do exactly what that person is going to do, I'm going to look like them or I'm going to be like them. No, you're not. That's right. That's right. First of all, na-a, that doesn't work like that.

That time that I tried spraying my hair to get your color, I ended up with orange. I literally looked like Ronald McDonald. I had orange curly hair. My mom made me cut it off. I was at a buzz cut for my sixth grade pictures because she was like, This is so embarrassing. I think that's good. Buy or beware on that part.

The other thing, though, is- That's this day on that sun in for one thing because I totally did the same thing.

Oh my God.

I wanted to look at this blonde girl named Jennifer Feldman. I did the same thing. I put the blonde, the sun in my hair. It was orange and gross. And I was like, Why don't I have blonde hair like her?

Yes. So true. And I could sit there and try to eat what you eat and just be like, I'm going to eat what you eat so that I can look the way that you look. And you want to see the fastest way to me putting on 10 pounds, right? And even if I ate what you ate and exercised the way that you did, it's not going to work for me. But the one thing I think that is the reason that I wrote this book, and the book has online resources, including access to health coaches. The reason I wrote the book is it also sounds like it's so complicated. It sounds like it's not doable. It sounds like I wake up and for every one of my patients, we're assessing all of these different things. You know, literally that your your sole day job has to be your health on that part. I don't want people to feel that way. I think that there are things like you can bite into an apple, and if an apple does not taste sweet enough to you, we know that we need to look at your sweet taste buds and we need to work on that part.

Giving you the tools to be able to do that, that's the only thing that I then want you to focus on. I don't want you to do all these other things. Now, it might illuminate for us that you actually have a digestive issue and we need to work on the digestive issue, but it also might just tell me that you're getting in... I'm going to use my free-basing. You're free-basing monk fruit or stevia, and instead you should just be eating wholefoods and reducing your amount of non-nutritive sweeteners, or for God's sakes, having a little bit of sugar if you wanted to have something that was sweet on that part.

I think what's making us all crazy and sick is the fact that we're all hyper-focused on health and living until 150. And this whole longevity trend is It's overkill at this point. The stress that people are- In obesity. In obesity, right.

A hundred %. We are fat on information.

We're too much information. I can't take it anymore with all the different... People are wearing the glucose monitors and the sleep trackers and the beds that are cooling or not cooling, and they're tracking- Or they feel like they can't be healthy because they can't afford that, and their health care premiums just doubled between that and paying for their kids to have shoes.

And they're sitting there feeling like, I can't be healthy. And that's totally inappropriate. So we have to intervene on that part and recognize, look, if you to be entertained by nutrition and health, great. But if you are obsessive compulsive about it, it is not better for you than anything else on that part. And too often with all the different wearables and everything else that we're tracking, we're doing a great job of data collection, but we're actually not doing a great job of healing and actually taking some data and being like, Hey, can I... I can do as much with an apple as somebody can do with 2700 labs and all of these other things on that part. I think that's where the rubber needs to meet the road. We really come back to this is why a quality dietitian, nutrition of somebody to work with who can help you put your plan together is going to be, in my opinion, better on that part.

Agreed. I think everything has just become overkill at this point. It has been. If people just do a little bit, it's better than doing nothing. Progress is better than perfect.

Could you agree to take glutamine for six weeks?

Yeah, I can try.

Before you get any labs done.

I know. That's more because I was so curious, and they're like, this program is super stealth. I was very... They're like the people that are doing it- Some things belong to be stealth. Yeah, I know. Very dialed in. I know. It sounds very excessive. I haven't actually gotten my blood done for a while. But I'm actually concerned and like, well, I'm 500.

Okay, but also, let me say this. For anyone who is thinking about getting their blood work done and spending the money and thinking about whether you're spending the money or not, if you know know that you have just been through a period of a big health issue, a big stress issue, a big life change, like maybe you were just traveling a ton or anything else like that. Give your body a month or two, at minimum a month, of good recovery and taking your nutrition and doing those things. Otherwise, we know right now that your body does not have what it needs to run better because of everything one has been through. And all your lab tests, it's going to be expensive. As my medical medium said, you're going to give away your immune system with that blood work, and you're going to come back, and the recommendations are going to be to do all of these things. It's because we haven't healed your body to a certain extent. My advice always before you invest in the lab test, whether it's the gut test, whether it's the blood test, it's anything else, do that. That's why I put a 30-day tune up in here.

Do the 30 days in some degree. You don't have to do it perfect, better not perfect, and then get your labs done after that. So maybe take your glutamine for four weeks and then do the blood work.

Oh, no, I'm actually...

Momentous. Let's get it. They should send it to you.

Okay, I'm going to call Momentous. They should send it to both of us.

I will. I'm going to call them. Momentous. Get on it.

It's the best brand. It's my favorite.

And by the way, I love them. It does not have to be a Momentous. And please don't buy things on Amazon, but that's a whole other story.

That's a whole other story. But I will say I like Momentous for many reasons, but they're third-party tested. I know the guys there. Their quality is, I think, bar none.

I use from orthomolecular, I use from metagenics, I use from pure encapsulations. I mentioned Perc. It does not have to be one brand, and I like Momentous. What I would say about glutamine is wherever possible, I think you should use the powdered form rather than trying to do capsules on that part.

I'm going to try to get that.

Could you do four weeks before you get your blood work done?

Well, I better start four weeks ago. Yeah, exactly. Because it's coming in the next couple of days.

It's worth calling up and being like, Hey, quick reschedule.

I think that might have to happen. Okay. Ashley Koff, my dear. I love her. She's great. She's a friend.

She's- Has no opinion.

She has got zero opinion. She's on the fence on everything. That's right. Her book is called Your Best Shot.

I'm on your fence.

Yeah, exactly. You're on my fence. The book is called Your Best Shot. Ashley is very wise, very smart. And like I said, I've spoken to a million dietitians. You are by far one of the most well-informed I've ever met. Also, you explain things very well. Thank you. Sometimes. Although you explain things very well, but at length. At length.

I mean, maybe we couldn't just make it a little bit shorter. I wanted to take you through the whole pathway on that. I appreciate it. I always appreciate it. The oversimplification can be... I get it. I'm not probably not designed for the modern age of 30 second clips.

No, no, no. What are you talking about? They're a minute now. Minutes 30, sometimes.

I probably need a few more magic mics for that. Magic mics.

Where's your mind in the gutter? I wish Tateam or Chani, whatever his name, would be hanging out here. That's right. All right, guys. Have a good one. Thank you. Thank you.