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Summary
On episode 614 of 40+ Fitness, Coach Allan sits down with Sergio Padron, founder and CEO of MD Exam, a company that specializes in the newest medical weight loss approaches, including semaglutide (Ozempic, Wegovy, Rebelsus) and tirzepatide (Mounjaro).
Sergio argues these medications are not a shortcut. They work by triggering GLP-1, and with tirzepatide, GIP as well, so the brain registers “I'm full” earlier. But whether the weight comes off safely, and stays off, still depends on nutrition, hydration, and exercise.
The conversation covers the difference between the two drug classes, the most common side effects, how they compare to bariatric surgery, and why protecting muscle and bone matters most for people over 40 who use them.
Links
- https://mdexam.com
- https://start.mdexam.com
Key Takeaways
- Semaglutide curbs appetite by triggering GLP-1. That hormone signals your brain you are full, so you naturally eat less. Sergio says it works for roughly 7 to 8 out of 10 people, though the timeline to feel it varies from week one to week three or four.
- Tirzepatide is the stronger option for people who plateau on semaglutide. It triggers both GLP-1 and GIP (the gastric inhibitory peptide), which Sergio calls the screwdriver versus the hammer. His company typically moves patients to it around week five if they have not hit their expected weight change.
- Nausea and headaches are the most common side effects, and dehydration is usually the cause. Sergio says most people are not drinking enough water to begin with, and hydration has a direct effect on how the stomach and intestines tolerate the medication.
- Sergio believes these drugs will eventually replace bariatric surgery. His reasoning: surgery requires a painful recovery and a permanent adjustment to a smaller stomach, while peptide medications keep improving, are reversible, and in the next several years should become far more affordable.
- The medication only works long term if you change how you eat and move. Sergio insists people also exercise, even just 15 to 20 minutes a day, because he has seen patients regain most of the weight when they treat the shot as the whole plan instead of one part of it.
- Suppressed appetite still requires deliberate protein and nutrient intake. Because you are not hungry, Sergio recommends small, frequent bites, protein bars, and shakes so you keep getting essential amino acids and fats instead of simply eating less of everything.
- Coach Allan's caution: going too fast or too high a dose risks muscle and bone loss. He argues for the lowest effective dose rather than automatically climbing the standard escalation schedule, since people in their 40s, 50s, and 60s are already losing muscle and bone and can become frail faster if they under-eat while on the medication.
- Sergio's three strategies to get and stay well: commit to yourself and know your real reason for doing this, make a daily plan and write down your top three actions, and drink enough water because none of it works without it.
“You will become frail. You will lose muscle mass and you will lose bone density.”
Coach Allan
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Episode 678 – Are the weight loss drugs right for you with Alexandra Sowa
Episode Notes
Podcast: 40+ Fitness
Episode: 614
Published: 2023-10-31
Host: Allan Misner (aka Coach Allan), author of The Wellness Roadmap
Guest(s): Sergio Padron, the founder and CEO of MD Exam, a company that specializes in the latest weight loss approaches
Listen & Subscribe: Apple Podcasts · Spotify · YouTube (audio only)