Episode 173:
Show Notes 

In this episode, the passionate duo, Dr Mary Barson and Dr Lucy Burns take you on a deep dive into the intricate science of weight loss, unravelling the mysteries of hormones and internal chemistry. Their mission? To empower you with the knowledge that weight loss is not merely about counting calories but rather understanding the intricate hormonal dance within your body.

The Master Conductor: Insulin
At the heart of this discussion is insulin, which is often underestimated in its role. Described as the "conductor" of your bodily orchestra, insulin orchestrates the delicate balance between storing fat and burning it for energy. High insulin levels lock away fat stores, making weight loss a challenging endeavour. Insulin resistance, a common culprit, leads to the body hoarding fat and resisting weight loss efforts. The hosts demystify this phenomenon, making it relatable and easy to understand for every listener.

The Power of Real Food
Driven by their belief in the potency of real food, the hosts advocate for unprocessed, protein-rich meals. They emphasise that nourishing your body with the right foods can unlock the stubborn woodshed of fat stores, enabling sustainable weight loss.

Hormonal Imbalances and Their Impact
The hosts shed light on the impact of hormonal imbalances, including high insulin and leptin resistance, on hunger and satiety signals. Additionally, they delve into incretin hormones like GLP-1 and GIP and their pivotal role in weight loss medications such as Ozempic and Wegovy.

Exercise Beyond Calorie Burning
Exercise transcends the mere act of burning calories; it's about building muscle. The hosts passionately advocate for resistance training, likening it to tuning an instrument, as it elevates metabolism and sculpts a healthier physique.

The Role of Quality Sleep and Stress Management
Sleep isn’t just a necessity; it’s your body's rejuvenation palace. Quality sleep, stress management, and cortisol regulation form the harmonious background score of a healthy life, allowing your body to function optimally.

Navigating Weight Loss Medication Shortages
Due to the high demand for injectable weight loss medications, shortages have become a concern for users. The episode crescendos with excitement as Dr Barson and Dr Burns announce a free webinar to help individuals navigate these shortages and optimise the use of these medications. They emphasise the importance of empowering individuals with knowledge, enabling them to make informed decisions about their health.

Action Step: Register for Dr Lucy's Free Masterclass
If you or someone you know is on weight loss medication, don’t miss out on Dr Lucy's free Masterclass - "Three Things You Can Do in an Ozempic Shortage." This invaluable session is scheduled for October 23rd, 2023. Secure your spot by registering at www.rlmedicine.com/injection.

Empower yourself, understand your body, and embark on a transformative journey toward holistic health and sustainable weight loss. Dr Mary Barson and Dr Lucy Burns are your guides, leading the way to a healthier, happier you. Tune in, learn, and thrive!

Episode 173: 


Dr Mary Barson (0:11) Hello, my lovely listeners. I'm Dr Mary Barson.

Dr Lucy Barson (0:15) And I'm Dr Lucy Burns. Welcome to this episode of

Both (0:20) Real Health and Weight Loss!

Dr Mary Barson (0:23) Hello, lovely listeners. Dr Mary here with this episode of Real Health and Weight Loss, joined by my beautiful, lovely, fabulous colleague, Dr Lucyy Burns. Tell me Lucy, how are you going on this fine spring day?

Dr Lucy Burns  (0:39)  Well, I'm awesome. By the time this is coming to air, I'll actually be even awesomer, if that's a word, because I will have had a little holiday. And I think that rejuvenating, recharging, resetting and rebalancing is one of the most vital things that a human can do.

Dr Mary Barson  (0:55)  I love it. I'm about to go on my own little rejuvenating reset and rebalance soon as well. I'm going camping tomorrow with my friends and my kids’ friends. And I'm going to unplug, and I'm going to just de-stress. It's going to be amazing. The beautiful internal rebalancing that's about to occur is going to be extremely helpful.

Dr Lucy Burns  (1:19)  Absolutely. And honestly, you know, I think when we're in the thick of it, we often think we need months, months off to recalibrate. And, you know, in four days, we'll do it.

Dr Mary Barson  (1:31)  Easily, easily. Honestly, even just taking a few minutes here and there throughout your day can make an enormous difference. I still think on holiday, don't get me wrong, holidays are good. But if it's just a few little sort of peppered throughout the days, little moments to breathe are very good for your internal chemistry. And it's our internal chemistry that determines whether we are well or unwell, whether we are overweight, or whether we have a healthy weight, whether our bodies function well. Or if we've got pain, fatigue, problems. It's a great little segue, and I love it because today, we're talking about our internal chemistry and how we can get our bodies into a nice, healthy balance. And that weight loss is important for health. For many people, I'm far more interested in health than I am in weight loss. But I think for many people,  weight loss is part of the health puzzle. It is both a cause and an effect of, you know, being unwell, and I am having metabolic issues. And so it's totally okay to want weight loss. It's good to pursue weight loss as long as you do it in a healthy way. And calorie-counting, calorie-restriction is not a good way to lose weight.

Dr Lucy Burns  (3:00)  Absolutely. And my favourite saying of yours, Miss – weight loss is chemistry, not maths. And basically, that talks about the idea that it's a hormonal process, not a calorie-counting process. We are not buckets of calories. We are indeed a bucket of hormones. And when you understand that process, it just makes so much sense. And realising and you know, I'll just look and go – oh my god, I can't believe for decades, I mean, I knew the calorie amount of just about every food known to man, I could tell you, you know that a medium-sized apple had 80 calories. I knew a banana had 130 calories. Like, I haven't looked at that book for 20 years. I still know it because it ruled my life. And I'm sure many of you have for so long, and yet was just the wrong tool. I was basically trying to hoe my garden with a spade.

Dr Mary Barson  (4:05)  That's right. It can't get very far with that at all. I can rubber do the shakes. That overwhelming hunger with those processed shakes because, yes, they were low in calories, but they did nothing to actually address the hormonal problems that were going on inside my body as I have polycystic ovarian syndrome. I've been primed for severe insulin resistance. Pings are so hungry and suffering so much, but doing it because it was gonna get me thin and also doing it because I was told to by doctors and dietitians. I am so glad those days are behind me, that I have become enlightened and that I've met beautiful, enlightened people like you, Lucy. Now, we can help people lose weight the right way, which is by addressing their internal health.  

Dr Lucy Burns  (4:55)  Absolutely. And recognising that you know some of those tools, I mean, Optifast is still recommended today by doctors, particularly pre-weight loss surgery, as a good tool to reduce the fat in your liver. However, it's full of sugar. It's full of seed oils, and it's highly inflammatory. And honestly, just this morning, I was just doing a little scar of a Facebook group or library, my Facebook group that I'm in, and a lady mentioned that she's booked for weight loss surgery. She's been told to take these shakes, she's taking them, and her lipoedema pain is worse than ever, like she's so inflamed. And so really just comes back to this idea that yes, you know, weight loss is a thing that can be aspired to, but not at any cost.

Dr Mary Barson  (5:46)  And you said before, we're not buckets calories, but buckets of hormones, were actually like this incredibly intricate orchestra of hormones, where every single hormonal system in our body interacts with every other single hormonal system and in mind-bogglingly complex ways. And it is really complicated. But I love that we are really complicated, but we are also really simple. There is one master hormone and one master hormonal system that's like the conductor that can influence the balance and internal health of every other system. And that master hormone is insulin. Insulin has a major, major role in being overweight, in obesity, in type two diabetes, relevant for me, polycystic ovarian syndrome is incredibly important for menopausal women to know about Anybody with a weight loss goal needs to understand insulin and its role and what you can do to balance your insulin. 

Dr Lucy Burns  (6:52)  Indeed, indeed, and for those of you who haven't heard our woodshed analogy, I'm just going to quickly go through it because I think it just explained the whole way our fat storage works in a way that hopefully makes really clear sense. So, the way I like to describe it is that we have two forms of fuel that we can utilise in our body: carbohydrates or glucose. And we can utilise fat, and there are two forms. Carbohydrates and glucose are fast-acting energy, and they're like kindling. It burns quickly but dies down quickly. Whereas our fat is like logs, you put it on lasts all day, put another one on lasts all day, just the slow burn. In an ideal world, we should use both, just like in an ideal fireplace, and you would put some kindling on them. When the kindling is sort of getting ready, you put a log on. Like literally, it seems so simple, but that's pretty much how our bodies could work should work as well. But what's happened just with a combination of genetics, lifestyle, and external factors is our population has developed insulin resistance in a large proportion of it, so not every single person, but a very big proportion of our population is now insulin resistant, and what that means for the woodshed or the kindling log analogy is that you don't have access to those logs that should be just right next to your fireplace. In fact, they're out the back in a woodshed, and the woodshed is locked. So you put your kindling on total out to the woodshed, and you can see all of these logs, which is your stored fat. You can see it's all there ready to burn, but you got to open the door, and the door is locked. And the lock is essentially your insulin levels. So some people have, you know, one small lock, and some people have like six or seven or 8, 10 locks on their woodshed. It's locked tight, so they can't get their fat. To come back to their fireplace. It's starting to dwindle. The carbohydrates have sort of running out, i.e. the kindling is now down to a few ashes. And your brain is actually saying to you, you're running out of fuel, you're starving, you're hungry, you need to eat. And so you go — cow, oh my god, what am I going to have? And you grab a sandwich, and your brains really happy with that plan, because basically, you've grabbed a handful of kindling and popped it back into the fire. Everyone's happy. And this goes on and on. And basically, what ends up happening is that you're trying to heat your house with kindling. It's incredibly inefficient. And every single time you add more carbohydrates, you add another lock to the padlock of the woodshed. So, the solution makes the problem worse. And then you sort of end up in this little spiral.

Dr Mary Barson  (10:03)  It's like the literal explanation for something. We love literal explanations. I love an analogy, Lucy. Insulin is a hormone made by the pancreas. It has many roles in regulating blood sugar, but one crucial role is its role in regulating fat storage. And so, when insulin levels are high, it stimulates our fat cells to store sugar and glucose and turn it into fat. That's the process of making more fat. And when it's high, it also turns off our ability to burn fat. That is why, you know, the woodshed is locked, you can't get that. And if it's your metabolically healthy, then this is great, you know, the process works seamlessly. You can burn some sugar, and then you can burn some fat. So you're heating your house with both kindling and the woodshed. But the problem arises if you are not metabolically healthy, and this is incredibly common. Some researchers estimate that up to 88% of adults in the Western world are not metabolically healthy. So after 88% of people have got that, that metaphorical, you know, fat stores, their woodshed is locked, and then they probably don't even know. And there's traditional advice that really doesn't address what is actually locking away our fat stores. Not to mention also causing a host of chronic illnesses isn't going to work not for good health and not long term. Weight loss is not maths, it is chemistry.

Dr Lucy Burns  (11:34)  Absolutely. And the problem that then sort of the cascade event, as you mentioned, its hormones are like an orchestra. So, you know, that starts with insulin being high. Then, over time, there's another little hormone called leptin, which is our satiety hormone, or it's meant to tell our brain that we're full. And it rises when our fat stores are high, which is sensible because you know, you've got fat stores, so it tells the brain – listen, you don't need to eat that much, you've got plenty of stored fat, don't worry about it, except the brain becomes resistant. And so you then develop this leptin resistance, which actually then makes it very hard to feel full initially. So you'll constantly feel like you're hungry, and you eat, and you can eat huge amounts because the satiety signalling mechanism is also a little bit broken. And then, as part of all of that, we have the incretin hormones, which we have talked a little bit about in the past, but these little beauties have come to fame. They're like the star of the show at the moment because many of the injectable weight loss drugs have incretin analogs, and what that means is they mimic our natural incretin hormones, and these are called GLP-1 and GIP.

Dr Mary Barson  (12:53)  And these hormones have an absolutely key role as well. Hence, these weight loss medications, such as you know, Ozempic and Wegovy, they are absolute blockbuster drugs because they do actually help people lose weight at that metabolic level.

Dr Lucy Burns  (13:10)  Yes. And, in fact, I love the blockbuster word because you're absolutely right. They are the company that makes semaglutide, which is marketed as both Ozempic and Wegovy, is making so much money. And it's a Danish company, and they are now making more money than the entire GDP of Denmark to the point where it's completely kind of buggered up their economy, which again, I'm not an economist, but I'm thinking the economy is very much like an orchestra as well when you've got one player that takes over, it changes the whole tune. And this has had a profound effect on the Danish economy. But worldwide, because of the uptake by consumers, which are, you know, the general public and doctors prescribing them, there are massive shortages here, there and everywhere. 

Dr Mary Barson  (14:11) Which is obviously an enormous headache for people who are on these medications, you know, people who are, who are valuing their health and want to lose weight and are using this as a tool. And then, you know, the tool has an unstable supply. That's, you know, that's pretty rubbish for everybody out there. And I think that empowering yourself with knowledge and understanding, you know, how you can heal your metabolism, how you can actually address the underlying cause of being overweight, you know, without necessarily relying just on injectable medications, not saying that they're a terrible thing to use at all, but they aren't enough in themselves if you want permanent long term change, and there are things you could do that are actually pretty easy that you can have a fun wonderful, amazing, joyous, lovely, sparkly life, whilst healing your metabolism without necessarily needing the injectable medications, or at least using them a lot of date that I'd similarly I'd put people who have had weight loss surgery or bariatric surgery, it's just a tool, it's it is not bad at it by any stretch of the imagination. But it is only a tool. And you still need to get to that underlying cause, the underlying mechanism that's making everything out of balance. The beautiful thing is because of getting so interconnected that if you just start, you start getting things back into a more healthy, balanced diet to rebalance your body in a healthy way, and then everything else can come back into balance. And all of a sudden, this orchestra which was out of tune and all over the place, and the brass section was sleeping on the job, and you didn't even know where the strings were. All of a sudden, it's just playing beautifully, and you feel good. And you've got great energy, and you've got lovely mental clarity, and life becomes much more enjoyable. And you can live your absolute best life. But it can be quite simple. And it can be easy when you know how.

Dr Lucy Burns  (16:13)  Indeed, indeed. And I mean, it's interesting, I've certainly got plenty of patients who are on weight loss, injectable weight loss medications, you know, of course, every doctor does because, you know, they're extremely popular, and because they're extremely effective. Like, I'm not gonna say they're not effective. If they weren't effective, nobody would use them, this is the thing. But what the issue is is the supply and the supply. It's flattering, is the way I would describe it. So people get themselves into a rhythm, and then it conks out, and then they get into a rhythm, and then the supply conks out, and you don't know when the supply is coming and going. And this has been part of the concern, I think, for people is that the company's potentially, I don't know, again, I don't know if they're not honest, or they just have no idea what's going on. But they're, you know, they keep saying — Oh, are we back in August, and it's not in August, it'll be back in October, and it's not in October. And it's well, and so they're actually now saying that the supply can't be guaranteed for the whole of 2024. Which, you know, that's significant if, in particular, this is your only tool that you're using or that you know about. So, I mean, this is we're actually going to run a webinar on this because I think it's really important, I think it's really important that people are empowered with the knowledge of how these medications work, and what to do when their supplies running low or that it can't be guaranteed because it's creating panic, and it's it creates distress. And it's really interesting because I think for a lot of people, again, both bariatric surgery and people who are using injectable weight loss medications. There's a little bit of shame like people don't want to tell other people. They feel like I'm not going to say anything because I think I've taken the easy way out. And I mean, I would like to completely dispel that myth. I don't think anybody who has had bariatric surgery is taking the easy way out. And I certainly don't think anybody who is using weight loss medications is taking the easy way out. They have, you know, significant side effects. What I really hope, though, is that people who have been prescribed them have been given all the information they need to make an informed decision about that, which is one of the things, Miss, that you're going to go over in the webinar.

Dr Mary Barson  (18:41)  Yes, a webinar that we're giving on how to navigate a shortage in your injectable weight loss medications and how to get the most out of your injectable weight loss medications, how to get the most out of your Ozempic because I actually think that this is really crucially important information for all those beautiful people out there who value their health who want to lose weight as part of getting healthy. And you need to be empowered with the right information. So yes, we're doing a free webinar. And you can sign up in that the show notes in the link below is going to be great. It's going to be options to do a live Q&A as well as get all your questions answered. Just get empowered with the right information to help you navigate what is potentially going to be a really tricky time.

Dr Lucy Burns  (19:31)  Absolutely. And if people want to sign up, the link is going to be rlmedicine.com/injection. And you can share it with your friends. So even if you're not using weight loss meds again, if you've got somebody who is and they'd like to know a bit more, then just send them the link because, honestly, I just think that there's not enough knowledge out there for people and they don't know how the medication works and therefore how they can optimise as much and get the best use out of their medications.

Dr Mary Barson  (20:03)  You bet. Beautiful Lucy, going back to your gorgeous analogy of the woodshed and how the woodshed represents our fat stores all locked away there and possibly quite inflammatory as well. And we want to open it up. How do you, like, there's more than one way to open your woodshed and to be able to burn fat and boost your metabolism healthily? And you probably don't want to rely on one thing, but how do you do it? Well, how do beautiful people?

Dr Lucy Burns  (20:31)  Yeah, so look, there are multiple, multiple things levers that you can pull, things that you can do, of course, the basis for us is really real food, you know, the least processed food that you can eat for the majority of the time, that food should have a protein element to it and be, you know, reducing carbohydrates. Yeah. And it's funny because we, you know, we've pretty scathing of people that talk about diet and exercise. And part of the reason for that scathingness, is that the word? Is that when people use diet and exercise, what they're talking about is calorie restriction, and, you know, running or cardio or something to move more calories. So it's, you know, the whole calorie and calorie out. Whereas definitely, movement is very, very helpful. But in particular, building muscle. So, the more muscle you have, the better your metabolism. So yeah, so we are very big believers of that. And then, of course, there are other lifestyle factors that we talk about all the time, which is good quality sleep. We started this with rejuvenation and restoration. Well, every single person has a rejuvenation palace, which is called your bedroom. And you can just go there and rejuvenate your head off for eight hours. Awesome.

Dr Mary Barson  (21:54)  There are many babies you have in there. Just want to yeah.

Dr Lucy Burns  (21:56)  Yeah, I know. I know. And that's it. And in an ideal circumstance, you're absolutely right. There are seasons in life where that is harder than other times. But again, optimising, you can't change the cards you're dealt, but optimising the way you can play them is helpful. And you know, of course, we often talk about stress management. And that's a whole we've talked about that ad nauseam, it feels like, but cortisol plays a huge role in the orchestra.

Dr Mary Barson  (22:23)  It does, it does, at the beautiful thing is if you just start, you know, just real food, and I just start there, start making some delicious real food meals, educate yourself about that. And then things can really rebalance real quick, very quickly across your whole body. And you start to have that increased energy, less hunger, losing weight without feeling hungry, the cravings can go away. Small changes can really compound really quickly. And you can get your body into that beautiful balance.

Dr Lucy Burns  (22:54)  Absolutely. So lovelies, I would just like to finish with a reminder of Dr Lucy’s webinar, on October the 23rd. You need to sign up so that we can send you the recording if you can't come live, and we need to know where to send the link to so that you need to sign up, but you just go to our website, www.rlmedicine.com/injection. Send that to your friends. And we will give you an entire masterclass on really maximising the use of injectable weight loss medications.

Dr Mary Barson  (23:28) Yes, I can't wait to see all the interested people. There is going to be a wonderful informative evening and really empowering, like really empowering, practical information to help you on your health and weight loss journey and to get the most out of your medications and to just live your absolute best life.

Dr Lucy Burns  (23:45)  Indeed, indeed shortage or no shortage. All right, lovely one see you all next week.

Dr Lucy Burns  (23:58)  So my lovely listeners, that ends this episode of Real Health and Weight Loss. I'm Dr Lucy Burns…

Dr Mary Barson: (24:06)  and I'm Dr Mary Barson. We’re from Real Life Medicine. To contact us, please visit rlmedicine.com

Dr Lucy Burns: (24:16)  And until next time…

Both: (24:18) Thanks for listening!

Dr Lucy Burns: (24:20) The information shared on the Real Health and Weight Loss podcast, including show notes and links, provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.

DISCLAIMER: This Podcast and any information, advice, opinions or statements within it do not constitute medical, health care or other professional advice, and are provided for general information purposes only. All care is taken in the preparation of the information in this Podcast.  Real Life Medicine does not make any representations or give any warranties about its accuracy, reliability, completeness or suitability for any particular purpose. This Podcast and any information, advice, opinions or statements within it are not to be used as a substitute for professional medical, psychology, psychiatric or other mental health care. Real Life Medicine recommends you seek  the advice of your doctor or other qualified health providers with any questions you may have regarding a medical condition. Inform your doctor of any changes you may make to your lifestyle and discuss these with your doctor. Do not disregard medical advice or delay visiting a medical professional because of something you hear in this Podcast. To the extent permissible by law Real Life Medicine will not be liable for any expenses, losses, damages (including indirect or consequential damages) or costs which might be incurred as a result of the information being inaccurate or incomplete in any way and for any reason. No part of this Podcast can be reproduced, redistributed, published, copied or duplicated in any form without the prior permission of Real Life Medicine.