[00:00:00] JJ: I’m JJ Virgin, PhD dropout, sorry mom, turned four time New York Times bestselling author. Yes, I’m a certified nutrition specialist, fitness hall of famer, and I speak at health conferences and trainings around the globe, but I’m driven by my enthusiasm. [00:00:20] Insatiable curiosity and love of science to keep asking questions digging for answers and sharing the information, I uncover with as many people as I can.

[00:00:28] JJ: And that’s why I created the well beyond 40 podcast to synthesize and simplify the science of health into actionable strategies to help you thrive in each episode. We’ll talk about [00:00:40] what’s working in the world of wellness from personalized nutrition and healing your metabolism to healthy aging and prescriptive fitness.

[00:00:47] JJ: Join me on the journey to better health so you can love how you look and feel right now and have the energy to play full out. All right, well beyond [00:01:00] 40 years, I am super excited about this session today because this is one I’ve been wanting to do for a long time. We are going to be digging into GLP 1 today.

[00:01:10] JJ: We’re going to be talking about GLP 1, the hormone that you produce endogenously and why you might not be producing it well, how to know and how to [00:01:20] optimize it and how that should be like the big important thing that you do. We’ll also be talking about exogenous GLP 1 agonists. And so things like semaglutide, um, trizepatide, euphorbimazozimbic, injaro, we will be talking about when those are a good idea, what you should do if you’re considering going on one of those.

[00:01:39] JJ: Um, so we are [00:01:40] going deep into all of this. I have the perfect guest to be doing this. And it is Ashley Kopp. Ashley Kopp is a registered dietitian. She has been working in the world of personalized nutrition for 25 plus years. She’s the founder of the Better Nutrition Program. Where she leads a team developing [00:02:00] cutting edge personalized nutrition solutions.

[00:02:02] JJ: She’s also the fractional chief nutrition officer, um, where she does for several companies some strategic nutrition planning. She has literally worked all over the place with a lot of different big companies and also done a lot of different TV shows as well. She’s actually had a really fun, [00:02:20] fun career all over the country.

[00:02:23] JJ: And all over the world as a nutritionist. She’s done a bunch of reality TV shows. She was awarded by InStyle magazine as Hollywood’s leading nutritionist and CNN’s top 100 health makers and the top 10 social health makers in nutrition and the 50 top natural [00:02:40] influencers. So she is definitely one to follow.

[00:02:43] JJ: And she is literally a wealth of knowledge on this topic. I couldn’t have picked a better person to unpack all of this with. And it just so happened we were both speaking at Integrative Healthcare Symposium. I saw what she was talking about. It was going to be the same time as my talk. And I went, our talks are like almond butter and chocolate.

[00:02:59] JJ: [00:03:00] They need to go together. And, and I definitely want to, wanted to meet her in person. So this is a very informative, Amazing interview you are going to want to have pen and paper for. And also we have a guide that she’s put together. So if you’re curiously taking notes, you’ll also be able to get a guide with her recommendations and [00:03:20] her quiz to know if your gut fits GLP 1 optimized.

[00:03:23] JJ: So you’re going to be able to get that at jjvirgin. com forward slash KOFF. I will be right back with Ashley. Stay with me.[00:03:40]

[00:03:45] JJ: GLP 1s, we are going there, Ashley Koff. I am super excited about this interview. Yeah, I’ve been counting, literally counting days, then hours. And because there’s so much confusion around GLP 1, what it [00:04:00] does, what the drugs do. So we are going to unpack it. And I think before we even start there. You’ve been in the biz for a long time.

[00:04:07] JJ: We’ve been like circling around each other forever. What got you excited about GLP 1?

[00:04:14] Ashley Koff: Yeah. So, and reminding ourselves that GLP 1 is actually a hormone that is produced in our body, right? And [00:04:20] in the lining of our digestive tract. So my personal story probably should have gotten me excited about GLP 1. I was a kid with a lot of antibiotics.

[00:04:28] Ashley Koff: Um, I battled what I thought was weight and belly and just not eating well, but didn’t actually learn until. Much later that it was, it was digestive issues and certainly injury to the lining of my [00:04:40] digestive tract. So, as a result, I struggled with appetite, cravings, you know, I’m an athlete, so I would go and be like, I can, you know, act, train like a boy, I’ll eat like a boy, you know, and that kind of thing.

[00:04:49] Ashley Koff: I was like, didn’t work out physiologically so well, um, so, you know, I think some of those pieces, uh, in hindsight, this is so important to understand, so I definitely want to come back at some point to how we [00:05:00] think about kids as it relates to that and, and understanding even pregnancy and fertility, uh, because so much of this is, is being built at that point.

[00:05:07] Ashley Koff: I’m glad you said that, because

[00:05:08] JJ: I keep looking at this going. It must be that we’ve really messed this up, you know, that our natural state of being was to have been really good producers of GLP 1 and we’ve really messed it up.

[00:05:19] Ashley Koff: Yeah. [00:05:20] So we’ve really messed it up. I will also say, I think we’re going to continue to learn more that genetically there are people where they are just less good at producing.

[00:05:29] Ashley Koff: So we know people from a methylation standpoint where there are efficiencies and inefficiencies, you know, it’s detoxification, et cetera. When we, especially because, again, where it’s produced and how it’s deployed, uh, we [00:05:40] do understand that that is going to be something that has genetic implications, but like we always say, maybe like 20 30 percent genetics,

[00:05:47] JJ: definitely

[00:05:48] Ashley Koff: like 70 80 percent epigenetics.

[00:05:50] Ashley Koff: So we have screwed it up, um, we have, uh, when somebody has those injuries or insults to their digestive tract lining, that is going to be one of my, what I’ll call GLP [00:06:00] 1 personas. So when. We’re taking a quiz and we’re saying, should I optimize my GOP1? If I have those, or if I have a disease there, if I have Crohn’s, ulcerative colitis, celiac, you know, et cetera, I’m going to know I need to focus there.

[00:06:11] Ashley Koff: So what got me interested in it is I really started my career totally selfish because of my own experience helping people optimize their digestion. And this was the 2001, [00:06:20] 2002. Wow, no one was talking gut health. No, and we were like, you know, we were still convincing. So first of all, we only really had lactobacilli.

[00:06:27] Ashley Koff: We don’t even, didn’t even have bifidobacteria, you know, and it was at a time period where I had to convince practitioners that the gut health was actually related to somebody’s health goal, right? So in that space, we’re coming, I mean, it’s like, [00:06:40] seems like ridiculous.

[00:06:41] JJ: I literally had one doctor tell me there was no such thing as adrenal gland burnout, and then another one tell me that there’s no such thing as leaky gut.

[00:06:49] Ashley Koff: So, by the way, still today when the other, you know, and I’m like, okay. And I also had, um, you know, the IBD patients where people would say, oh, their nutrition has nothing, the nutrition has nothing to do with it. I mean, [00:07:00] come on on that part, right? So we had to learn that. And something very interesting happened to me.

[00:07:05] Ashley Koff: I was working on digestive health, but needed to make money, see some more patients. So I’m in Los Angeles and an opportunity came along to work in the minimally invasive surgery department, um, at, as an outpatient dietician at Cedars. Uh, and I, I thought [00:07:20] bariatric surgery was the worst thing ever. I had seen it in my residency.

[00:07:24] Ashley Koff: I’d seen a couple of people that had been, you know, they were non compliant theoretically, like the whole thing had not been done right for them. And I had this ego. I’m like, I can help anyone lose a hundred pounds and I can help them keep it on. Oh, the ego of youth in this space or to any practitioner who says like, you know, there’s a perfect [00:07:40] way of doing this.

[00:07:40] Ashley Koff: I’m like, we’re lucky we can get to the better way. So I started working in bariatrics and it was an over the night, what like literally overnight, the patient goes in, has gastric bypass. By day two, diabetes is gone. And they would say to me, Ashley. I don’t know if I can get my protein in. I literally don’t have any hunger.

[00:07:57] Ashley Koff: Like, I just, I forgot all day. And it was like, their, [00:08:00] their whole world was disrupted. Like, I’m forgetting to eat. I don’t, you know, I can’t get this amount in. So I didn’t actually even, it was probably like a year or two before we actually identified this is something called your incretin hormones. And we started to understand that, you know, Your GLP 1 hormone is actually the master regulator.

[00:08:17] Ashley Koff: It’s the switch that flips on insulin and [00:08:20] leptin. So leptin being our appetite satiety, right? And insulin being for blood sugar. So when we realized that that was there, to me, what always came about, whether it was the band, the lap band or, or the gastric bypasses, how do we make sure that we’re getting that result in people?

[00:08:34] Ashley Koff: And then also what happens if that result doesn’t stick around for people? And that was my, [00:08:40] like, it became this fascination with these hormones and how do we do it? And I certainly have explored all the things that, you know, that you talk about and that are so important for people. Protein first, the amount of protein, you know, are we getting in our fiber?

[00:08:53] Ashley Koff: Are we not getting in empty calories? Are we doing enough strength training? Because fitness impacts our, you know, [00:09:00] our fitness approach. All of those things, um, but it’s only been in about the last, I would say, four to five years with the explosion of the microbiome, the really intensified effort to understand how the microbiome works and sort of what are those triggers.

[00:09:13] Ashley Koff: And then additionally, some of the research that’s been done on key ingredients, uh, that has really helped us [00:09:20] understand how we can naturally optimize endogenous GLP 1 production. And the answer is who should be doing that? And we should say absolutely everyone, literally everyone. So that is the answer.

[00:09:32] Ashley Koff: It’s probably very similar to the conversation around detoxification. You don’t go on a detox because you’re eating crummy for a week or whatever. You have a [00:09:40] detoxification system. You want it working optimally. So we want our increment hormone system working optimally. So that has to be part of our approach.

[00:09:48] Ashley Koff: For everyone. The difference is who you are is going to depend on whether or not just doing it endogenously is an opportunity and is going to work for you, or are you [00:10:00] somebody who would also benefit from what we call exogenous. So for the people that don’t know that word, that would be what we’re doing outside of the body, i.

[00:10:07] Ashley Koff: e. a medication.

[00:10:08] JJ: And we’re going to go over to those two. There’s so many questions, but Can I just say it is bizarro to me the amount of misinformation and like flat out [00:10:20] hate on the internet about these medications. Like it is a hand scratcher to me. I was posting something about like, if you were doing these, here are the things you want to make sure you do to preserve your lead muscle mass, which by the way is the same thing you do if you’re going on any diet.

[00:10:34] JJ: Right. All diets, you lose lean muscle. It is not unique. And a [00:10:40] dietitian put in my little DMs, she’s like, disgusting. You know, smiling face, but I’m like, who does that? All these attacks around this is so interesting.

[00:10:51] Ashley Koff: Well, I think there are two things. The first, because I just went through this experience. I posted a delicious pizza in Arizona.

[00:10:59] Ashley Koff: I was [00:11:00] out on a date with my brother, going to a basketball game. Happened to go to. You know, this amazing pizza place that’s like so well renowned, and I posted the most beautiful looking pizza. And I had somebody post, out of the dietitian, aren’t you ashamed? There’s gluten and dairy, like these are inflammatory.

[00:11:13] Ashley Koff: If you’d say that, you know, and I was like, whoa. So I think we have to recognize that we’re in a culture of attacking people just, you know, [00:11:20] for whether it’s a hobby or because, yeah, we don’t have enough magnesium. I don’t know what the answer is, right? We’ll have some chocolate. Yeah, it’d be fine. And I think the other thing where, um, there is a perception, whether you yourself have battled either weight health or battled metabolic health and, or you haven’t, and so that hasn’t been your journey of judging [00:11:40] people for what we’ll call the cheating, like you’re not doing it the real way.

[00:11:43] Ashley Koff: And I think what, what we both share is the recognition that. We have a lot of tools in our toolkit and when somebody comes to us, whether it’s an individual or they’re reading your books or, you know, you’re reaching millions of people, what you’re saying is, hey, there are a lot of tools in the toolkit.

[00:11:58] Ashley Koff: And so we want to look at what are [00:12:00] all the tools and help you figure out today what’s going to help you be successful. And by the way, that might be different. You might need a different tool, you know, in four or five years, et cetera. Anyone that doesn’t approach it that way and sees that there is a right way or one path or what somebody should be doing.

[00:12:15] Ashley Koff: I hope that people just unfollow them. Like that’s the answer there.

[00:12:19] JJ: Right. Yeah. [00:12:20] Right. It like, there’s no one food that’s a villainous and all that. Yeah. That stuff drives me nuts. So, so then with that, GLP ones, how would someone know if they’re optimally producing them?

[00:12:33] Ashley Koff: Yeah. This is a really important question because I wish the answer was like, um, we’ve gone on this journey with [00:12:40] blood sugar where, you know, you could get your, You could get a regular fasting glucose, which is what your doctor would test.

[00:12:45] Ashley Koff: And we’re kind of, nobody’s like, that’s, I mean, that’s not that helpful in the moment to get that test. Um, then we moved over to hemoglobin A1c, which is a 90 day, um, but it’s an average. So, you know, if you’re looking at that, you’re not, it’s not telling me if like at three o’clock every day, you have a high [00:13:00] spike and a drop or, you know, some of these things.

[00:13:01] Ashley Koff: So it, it was better than the fasting glucose and now we have fasting insulin, right? And so fasting insulin is going to give us a better measure and things like maybe also looking at inflammation. So, We’ve been on that journey. We’re not on that journey yet with GLP 1 because GLP 1 is actually designed just to be produced and go [00:13:20] away.

[00:13:20] Ashley Koff: So it’s actually very interesting that the body designed something to literally be like a light switch. So it turns that on and then it goes away and then it turns that on and it goes away and it does that in the presence of food. So in order for us to test that, we can do it in a lab and we can certainly do it in a cell, meaning like a cell culture, you know, and looking at that.

[00:13:39] Ashley Koff: But to test it [00:13:40] in a human, um, it’s very difficult, and I actually wouldn’t put any stock in the blood work today where somebody says, oh, I tested your levels. So what we’ve done is, I will never tell you that you are high or low in GLP 1, and if anyone says they can tell you, they’re, they’re lying to you, like just flat out on that part.

[00:13:57] Ashley Koff: Today, like as of the date of us recording this, right? [00:14:00] Um, and if anyone wants, as figures out that test, please reach out to me because we want it. We want to get it out there, you know, to the population. So the other thing that we can do is then we can look for indications that your GLP 1 is suboptimal.

[00:14:12] Ashley Koff: And that would be things like, and we have a quiz where people can, you know, do this for free to just see, but it would be things like, I talked about all the different [00:14:20] digestive stuff. So If I, if I regularly use, um, uh, medications, if I’ve had, uh, you know, antibiotics, um, or high doses, or you’re like me as a kid, you know, you take them a lot.

[00:14:30] Ashley Koff: Um, if I am, I found out I was gluten intolerant, or I’m celiac, or, you know, there are many things that can attack that gut lining. If I’m somebody who, um, For certain [00:14:40] reasons, can’t consume fiber, or if I’m somebody who, um, maybe doesn’t consume any animal protein, or maybe I’m somebody who doesn’t consume these types of essential fatty acids, there can be things that can give me an indication on that front.

[00:14:53] Ashley Koff: And then if I have the opportunity to look at somebody’s labs, I can also, and wear a continuous, uh, glucose [00:15:00] monitor sensor, I can also get information on that part. Now here’s the kicker. Do we need to do any of that? Because we answered a moment ago and said everybody should be out. So why not be intentional about optimizing your GLP 1, which every dietary recommendation you’ve ever given literally is for optimizing GLP 1 on that part.

[00:15:18] JJ: Yeah. So funny [00:15:20] that the things that will optimize GLP 1 are also the things that will help you lose fat, put on muscle, will help, you know, with better blood pressure control, better blood sugar control. Like you look at the things and go, This thing does all these other things. You could do a talk on all sorts of different health benefits and [00:15:40] talk about it and every single one it would fix.

[00:15:42] Ashley Koff: That’s right. And that’s also where There too, we can turn around and say for those of us that are experts in this field, what we have been telling you for 20 years is still the information to be following on that perch. Where I think we’re a little bit more, like there’s, there are areas of opportunity because of the medications now being available, is that [00:16:00] we’re getting a little bit more Um, hyper focused on things that can actually really help with satiety or really move the needle with an insulin response, um, in terms of insulin resistance and, you know, some of these other pieces where people have maybe been investing in and really trying to do the work.

[00:16:18] Ashley Koff: They’ve been following your [00:16:20] advice. They’re, you know, going and they’re doing, and it hasn’t been working for them. So there are certain things like that. Like for me, I’ve found that for many, like a subset of my patients, I shouldn’t even say subset because It’s somewhere like 60 percent of Americans don’t actually experience feeling full.

[00:16:35] Ashley Koff: Um, now I’m not thinking about over full, but in that moment when you’re [00:16:40] eating and maybe you’re being mindful or not, you know, whatever, um, but you’re, you know, I love yaddy yaddy, but, um, but I’m eating my food and I have an amount and I feel like, okay, I, that’s the amount that I’m supposed to have. And when I eat that within an, like, you know, within 10 or 15, like, I feel good.

[00:16:56] Ashley Koff: So I’m not chasing for something else. Right. Um, and [00:17:00] we’ve tried all these different ways to help people maybe experience society, like have fiber first, or have something crunchy, or drink water, or make sure you, you know, take this, or like all of these other things, and that hasn’t been working. So in that instance, the fact that we now have tools that can actually target GLP 1 more effectively, those are starting to [00:17:20] show benefit for those, um, that significant body of patients of mine that don’t experience satiety.

[00:17:26] Ashley Koff: So some of those areas, I would say, are a little bit different, but at the foundation, it really is the same stuff.

[00:17:31] JJ: You know, I look at all of this, and so we’ve got Less than 7 percent of the population is metabolically healthy. I remember [00:17:40] hearing some stat years ago that by 2030, that we would be 100 percent diabetic.

[00:17:46] JJ: And I thought, that is the most outrageous statistic. No way. However, you know, so you look at the high degree of insulin resistance, and then you look at someone who says, okay, I’m ready to take this on. I’m going to start doing all the right [00:18:00] things and nothing happens. Because, and I had a great mentor early on who said, you do not lose weight to get healthy.

[00:18:07] JJ: You have to get healthy to lose weight. So you need to get metabolically healthy to be able to burn off fat and build muscle. And so they start, but they’ve got to improve that insulin sensitivity. And that, that, you know, [00:18:20] you look at me, go, okay, that means you better sleep better. Maybe you need a CPAP.

[00:18:25] JJ: You better start lifting weights, but you’re too inflamed and out of deep condition to lift weights. You know, you need to really shift your diet around, but you’re hungry, cravings. And I think that if there’s something out there that [00:18:40] can help people. Yeah. Yeah. We’ve got a crisis. Right. Why wouldn’t we use that?

[00:18:48] JJ: Yeah. The risk reward ratio is so clearly on the reward side.

[00:18:53] Ashley Koff: Yeah. Yeah. And sometimes, um, we need, like, it’s the same way of, you know, maybe why we use an elimination [00:19:00] diet or, I don’t tend to call them, like, straight out elimination, but I may take certain ingredients for somebody and say, let’s, let’s, let’s, let’s, let’s Or I do our digestive tune up all the time.

[00:19:08] Ashley Koff: So I’m like, okay, I want you for 30 days, I want you to do the things that support your digestion, because that’s going to then tell me how your body is responding and we can go. So for in this instance, we can turn around and say we have different [00:19:20] resources. Um, when I, when I think about GLP 1 and the body, I think this analogy will land.

[00:19:25] Ashley Koff: I’ve been trying it out in places, so we’ll see if it lands for you. But So, in the continuum of caffeine, something that we all love and we think about, um, when we think about a GLP 1 agonist, so a medication, and there are GLP 1 alone, there’s GLP 1 [00:19:40] GIP, by the time this is out there, there’ll be, you know, one that’s got three different points, etc.

[00:19:44] Ashley Koff: But let’s just call them these agonists as a, as a class. They are like having four shots of espresso in the moment. So the idea there is, you’re getting more caffeine, and you’re also going to get something that maybe sticks around for longer. Endogenous production, or what our [00:20:00] body produces of GLP 1 is like one shot of espresso.

[00:20:03] Ashley Koff: The issue is a lot of people are trying to get results on decaf or no caf. And that, in that space, does that work for you? Yeah. So in that space, there’s all these reasons to say for some people, they will experience benefit if we can get them from decaf or no caf to one shot of espresso. [00:20:20] For other people, their body and where they are, they can’t function and they need to be at that for shots.

[00:20:26] Ashley Koff: Now, I don’t want to keep you on four shots forever. Could it be that you need two and a half for the rest of your life? Potentially. Could it be that you go from four to one and then something happens in life and we need to go back to two, three, or four? You know, there are all of these [00:20:40] ways and that’s your relationship with your practitioner and understanding your body.

[00:20:43] Ashley Koff: But if I’ve got someone on four shots of espresso, I also need to understand that I am intervening with a hormone that is going right into their body that normally is not meant to stick around, and it is sticking around for at least 30 minutes, so it’s sticking around for a longer time. That [00:21:00] means, I’m going to use the words, Side effects.

[00:21:02] Ashley Koff: Side effects are not negative, they are just, here is what is happening as a result of going on the medication, so I think we just need to be doing a better job of saying, where are you on that continuum, and before I make a choice about, you know, what we’re, we’re going to use for you, let’s make sure that your body can handle four shots of espresso, [00:21:20] and let’s make sure we have a plan for what if tomorrow you need, that wasn’t available to you, you know, or that kind of thing.

[00:21:25] Ashley Koff: And so these are the things, the conversations we should be having instead of the, oh my gosh, I can’t believe they’re using a GLP 1, which is just, is somebody who is actually not solution oriented in my mind.

[00:21:35] JJ: Now, when someone takes a GLP 1 agonist, what’s the mechanism? [00:21:40] Because you said that when, you know, I know when we protein, we have fiber, I’ve been really playing around with allulose.

[00:21:47] JJ: For those of you that don’t know, allulose is a rare sugar that doesn’t raise blood sugar insulin. I heard about it years ago, and so I actually started converting my products over. Yeah. It’s the thing that, um, Quest was using. Right. And so I [00:22:00] was like, this is really interesting, but I was more interested.

[00:22:02] JJ: I’m like, oh, it doesn’t raise blood sugar insulin, you know. And then I started to see all of this research, and the research is brilliant. And then, um, I was just at Metabolic Health Summit and they were showing me how they would take it, eat a candy bar, drop

[00:22:16] Ashley Koff: their

[00:22:16] JJ: blood

[00:22:17] Ashley Koff: sugar. Yeah. What are you talking about?

[00:22:18] Ashley Koff: We aren’t quite sure [00:22:20] how it, um, what it does to the microbiome, and I think that’s really interesting. I think it does some very positive things. One of the reasons I like allulose is it’s 70 percent as sweet, um, versus regular sugar. Yeah. So unlike all of, like, Monkfruit and these others, or Stevia, which are more sweet.

[00:22:35] Ashley Koff: Which I always get worried about. Yeah. It’s like, is it turning you on to go more sweet? That’s right. And so it’s dialing up. [00:22:40] So one of the, like, fun free experiments that I have people do is their sweet taste bud test. So you bite into an apple, like, on a clean palate. Take a couple of bites and see on a scale of 1 to 10, is it a 7 or greater?

[00:22:50] Ashley Koff: And the number of people who are like basically freebasing monk fruit and ZBL, like, or Stevia, like it’s nothing, who are at like 8, 9s and 10s, you know, and we have to do this [00:23:00] full reset for their sweet taste bud, because you’re right, it’s affecting psychology and microbiome. So I think with allelocytes, that part is really interesting, you know, to sort of look in that space.

[00:23:09] Ashley Koff: And all of these are part of those solutions and tools. And agonist is a little bit different. So it is a hormone that you’re injecting. So think about when we inject other hormones. So if you are diabetic and you need insulin and you [00:23:20] inject that, right? So it’s fast acting going into your body on that part.

[00:23:23] Ashley Koff: Maybe if I use testosterone cream or, you know, something else in that way. So it’s overriding. It’s not actually asking your body to produce anything, right? That is why if one, if ever, Anybody is trying to equate endogenous production and exogenous or what the body makes versus this [00:23:40] medication. They’re, they’re having like a, it’s an, it’s not even apples to orange.

[00:23:44] Ashley Koff: I think it’s like an apple to broccoli conversation. Like we’re just not in the same space. Don’t, don’t talk about it. So I think in this space, what we want to understand is that, you know, If we are injecting a hormone, you are going to have implications in your body of a higher amount of a hormone. That is, your [00:24:00] body’s actually only designed for it to, like, go away.

[00:24:02] Ashley Koff: But the upside benefit of it is you have all these receptor sites. And if you, when it, when that light switch goes on, if in your body that light switch doesn’t mean that those, like, 12 lights go on, then you’re Then if it needs more time for those 12 lights to go on, if you take an agonist and it hits all [00:24:20] those 12, then suddenly you get full action, right?

[00:24:22] Ashley Koff: Like you’re, the room is lit on that part. And what we’re seeing is many people on the light switch goes on maybe only two or three of those things, right? And so that’s, that’s the difference. With,

[00:24:30] JJ: uh, when they’re doing things like protein or fiber.

[00:24:33] Ashley Koff: Right.

[00:24:33] JJ: Yeah. And that’s part of the question. So you look at the things that naturally raise it.

[00:24:36] JJ: And as I started to dig into this, I go, And I think this is [00:24:40] something that was, we’ve always had, we’ve just so disrupted our gut microbiome that we’ve messed everything up. Because if you look back ancestrally, what was our diet? It was, you know, we would eat animal protein and lots of fiber. I remember hearing Laura Kodane say that we were eating like a hundred grams of fiber a day.

[00:24:58] JJ: And I consider myself to be [00:25:00] like a fiber hero. But I’m like, no.

[00:25:01] Ashley Koff: Yeah. And you’re not like me where I was, so I grew up with, um, this, unbeknownst to me, this diet, like belly issue. And literally if I would eat any fiber, I would, I just would bloat out, right? Cause I had no good bacteria. So it took me a long time to repair [00:25:20] and to do that.

[00:25:21] Ashley Koff: Um, but there, you know, I think we have to recognize in each individual what is that capability, you know, in that part. And I also want to be really clear, um, financially, like we’ve both worked in Los Angeles, like, you know, we’ve worked with people who have, where access theoretically from a financial standpoint is not an issue.

[00:25:38] Ashley Koff: But for the rest of the population, it’s a [00:25:40] significant issue. And so I think one of the things that I’m loving about the medications is that when used properly, when used strategically in partnership with your practitioner, uh, when you’re evaluating blood work, when you understand who the person is, uh, you can use that and somebody can now have success increasing their fiber or success, you know, [00:26:00] increasing their protein.

[00:26:00] Ashley Koff: And I also don’t want you increasing your protein unless your digestion can handle it. And that means that we’ve Gotta make sure, because if you can’t break it down, if you’re on a proton pump inhibitor, if you are, you know, are somebody where, um, Or you’ve been

[00:26:13] JJ: doing a vegan

[00:26:13] Ashley Koff: diet forever. Or like, so the answer has to be multifactorial, but you’re, like, the, the core part for us to come [00:26:20] back to is these are tools and they’re choices.

[00:26:23] Ashley Koff: Um, a choice. For no one should be, don’t optimize your GLP

[00:26:27] JJ: 1, right? And I love to say diets are tools, choose wisely. So I love, I love all the tools. So when someone’s doing something, assuming we’ve like, we’ve optimized their microbiome, doing [00:26:40] protein, they’ve got fiber, What is the typical, we release GLP 1, some of the other things, what’s the, is it like 30 minutes and it comes back down?

[00:26:49] JJ: What’s, do we know?

[00:26:50] Ashley Koff: Well, I mean, it’s a 30 second, like it literally is 30 seconds. Yeah. So 30 minutes is the medication, 30 seconds. And again, I’m not, like, I’m giving you numbers of what I’ve heard [00:27:00] and what people, you know, from a research standpoint have heard that and whatever, and it is really, because it’s really hard to research it, right?

[00:27:06] Ashley Koff: And even in the research, um, you have people reporting certain things and they’re measuring it, but we’re not, they’re not measuring somebody who’s just out in the wild, like, drinking coffee and eating, you know, and, oh, by the way, coffee. Yes. And for many people, coffee and tea have an [00:27:20] appetite suppressing and it’s like, aha.

[00:27:22] Ashley Koff: So are we, you know, we used to always just attribute that to the antioxidants, you know, in that part. Um, some people were like, Oh, you’re getting in water. I’m like, not really the way I agree.

[00:27:30] JJ: So it’s very quick.

[00:27:31] Ashley Koff: Yeah.

[00:27:31] JJ: Quick. And then the medication though, you’ve taken the medication and doing it once a week.

[00:27:36] JJ: So, It’s just, it’s not [00:27:40] hanging out there, it’s just doing,

[00:27:42] Ashley Koff: um, and so one of the things with the medication is you do, you should. And again, this is why I, the one place I don’t, I understand why it’s available in this way, but I don’t recommend it is taking this as a medication without a practitioner oversight and without sort of.

[00:27:56] Ashley Koff: Nutrition council and coaching. Is it really available that way? It [00:28:00] is. And what, like, you can, it’s kind of the wild west out there. And there are also people that are, um, and I’m not, again, I love compounding pharmacies, so I’m not saying compounding bad. I’m just like, I want somebody to be able to verify for me that the, what’s in the compounding is actually what you’re supposed to get.

[00:28:15] Ashley Koff: There’s just, yeah, there’s just cheats that are out there, right? That they’re selling you, um, something that’s, that’s, that’s, that’s, So don’t [00:28:20] buy this online. Don’t buy this online. Yeah. Or from a practitioner who is just literal, who is willing to do an online script for you to, and selling it from a compounding pharmacy, and you never, you’re not seeing them as a practitioner.

[00:28:31] Ashley Koff: That’s not the way we do medicine anyway, but I think it is important to remind people. So when you do this, um, and you’re taking it, you actually are going to try to get up to the [00:28:40] dose that is going to be better for you in the moment. And that really depends for people. I’ve seen some people who started the lowest dose and they do great in that space.

[00:28:48] Ashley Koff: I’ve seen some people who started the lowest dose and they start off having side effects. Okay, we can almost always address those side effects. So it doesn’t mean you need to go off of it. And we typically [00:29:00] don’t want you going on and off. Um, so that’s also, you know, something we can speak about, but then you’re going to increase your dosage on that part and be able to get to a place where you’re getting your optimal results.

[00:29:11] Ashley Koff: Um, and that optimal level to me is very much about where you are. Still wanting to eat. We’re not trying to shut off the desire to eat. We’re not trying to shut that down. [00:29:20] Um, but where we see appropriate weight loss, so we might say that’s like 1 to 2 pounds. It also depends on who the individual is. Um, where we see nothing else negatively happening.

[00:29:29] Ashley Koff: Maybe where we see more rolling hills than spikes, if appropriate, you know, for your blood sugar. And then we would keep you on that. Um, there are some people that it will stop working. So it [00:29:40] stops working. So in that instance. And clue one? Well, there, there is a sense for some that you’re, that the body is adjusting from a hormonal standpoint.

[00:29:47] Ashley Koff: I don’t know if that’s valid or if it’s, um, basically what I have a suspicion in my head, which is, is this really just the plateau experience? And we should just accept a plateau because we know fundamentally a plateau means your body is [00:30:00] adjusting. So when we say it’s stopped working, you’ve

[00:30:01] JJ: stopped losing weight.

[00:30:02] JJ: They’ve stopped losing weight. See, I just look at this whole thing and, and if I were the benevolent dictator of all things nutrition and health, you know, it would be, Any of these things, you would sign a contract. Yeah. And you only get this if you come in and do an in body or DEXA. So you’re [00:30:20] tracking your, your fat free mass that you would absolutely be tracking your food intake and optimizing, making sure you’re eating that protein first and getting in the amounts that you need.

[00:30:30] JJ: And

[00:30:34] Ashley Koff: if you

[00:30:38] JJ: aren’t, this should [00:30:40] not be a thing to go on, or any diet for that matter, because it is so much worse to go on a diet. Lose weight and then go off the diet and gain it back than to have never done it. Yes. Better off not doing it.

[00:30:57] Ashley Koff: Dr. Shaw and I, um, we were actually just, you know, [00:31:00] presenting on this, um, at Next Health, uh, we have put together a protocol. See, I’ve had the protocol for how to do the endogenous side and also how to support patients who are wanting to have hit their goal and are wanting to either stay or to come off of it.

[00:31:11] Ashley Koff: And he’s been scripting and say, you know, figuring out that part. So he actually, Taught practitioners here that you absolutely need to have a contract. I [00:31:20] love this. So that was Malish right there. So it’s, here’s the contract. Here’s the things I want you to be able to do. And in the event that you’re not able to do some of those, let’s have a conversation about what that means, but you are not going to keep getting the medication, you know, on that part.

[00:31:33] Ashley Koff: And that’s really important. What I do with people though is also make sure that we have a budget conversation. So for many people, they’re [00:31:40] actually going to end up paying out of pocket for this. I’m just kidding. Like, 1, 700. See, that’s where I mean, then, yeah,

[00:31:46] JJ: why wouldn’t we go to a compounding pharmacist?

[00:31:48] Ashley Koff: Right, well, so, oh, even the compounding, like, so the, the cost of these is, depending on where somebody’s getting it at, could be 300 a month, it could, but compounding’s not much less expensive. Like, so there are core ingredients there [00:32:00] that are going to be expensive. The difference is, or, and the question mark is, is how much do you need, right?

[00:32:05] Ashley Koff: So if I’m at a higher dose, it’s going to go away sooner, you know, et cetera. But I will sit down and say, are you prepared for the next six months, for the next four years, to pay X, which also includes seeing me, or working with, you know, one of my coaches, here’s what the blood work, and by the way, we [00:32:20] can get your insurance to cover some of the blood work, I don’t necessarily need fancy labs, I just need to make sure, you know, we’re looking at this, and is also going, and the supplement side of things, And if you’re not willing to do that, then I’m going to talk bariatric surgery and I’m going to talk my, of my endogenous production and my other tools and say, maybe we’re going to take the slow scenic route because I don’t, you know, as much as you wanted that, that faster [00:32:40] acting, I can’t in good conscience start you there and not know that I’m going to be able to take you to success.

[00:32:45] Ashley Koff: That’s tempting. Yeah. And so we have to put that together from a protocol standpoint. And for those of you that are listening that are like, yeah, I’m already on it, or, um, I want to be on it, or my patients are just saying, put me on it. Okay. So if your patient is saying, put me on it, somebody came up after, after our talk and said that, and [00:33:00] I said, I said, turn around.

[00:33:01] Ashley Koff: And I said, Hey, and by the way, I love to shop at Target. I said, turn around and said, go to Target. Like, not that they, to get your GLP one there, but literally I’m not, I’m not here to be that low, that low cost option that isn’t going to deliver long term outcomes. Well,

[00:33:14] JJ: I

[00:33:14] Ashley Koff: mean,

[00:33:14] JJ: would

[00:33:14] Ashley Koff: you

[00:33:14] JJ: go to your manicurist and say, I really need my haircut?

[00:33:18] JJ: I mean, it’s like, it’s, yeah, [00:33:20] you go to the person that knows how to do this correctly. That’s right. And this isn’t, I think people think this is just, and you just did it, but you’re messing with metabolism. Yeah. Yeah. And any diet. Yeah. That’s right. That’s right. Because. Losing, losing weight without tracking it and losing muscle is so devastating.

[00:33:39] JJ: Yeah. And [00:33:40] especially if you’re 40 plus. Yes. We have to be

[00:33:42] Ashley Koff: so careful about this. Yeah. And I think for perimenopausal women, um, one of the physicians that we work with, uh, who helps us nationally, is Dr. She also does, she looks at blood tests and will adjust from a hormone standpoint to make sure, number one, that we’re not missing a hormonal reason that this is [00:34:00] slow or that this is happening.

[00:34:01] Ashley Koff: So there’s that side of it. But number two, that we have a baseline so that we can then, you know, so if you’re 50 and you’re like, where am I? That at 52, we can turn around and we can still optimize. We did have, uh, Um, several, uh, dieticians come up and say, you know, in New York, they’re constantly hearing and seeing friends and patients where the [00:34:20] doctors are scripting for the medications and they’re not suggesting a follow up.

[00:34:23] Ashley Koff: And I find that just really bad medicine. You know, we, we couldn’t do that with bariatric surgery because you actually couldn’t get insurance to cover it if you didn’t have a diet. At least in the beginning, you had to cover a dietician and you had to cover a social worker, which we haven’t even talked about how trauma and all, you know, all of these other factors are in there.[00:34:40]

[00:34:40] Ashley Koff: But I think for, if you’re a practitioner listening to this. You have to make that decision. If you’re not going to provide that support yourself with your resources, you need to partner. And you and I are both very dedicated and you’re extremely skilled at this of making sure the practitioners stay in their zone of genius and then outsource what isn’t theirs, but make sure that it’s delivered.

[00:34:58] Ashley Koff: So their system offers that. [00:35:00] There are things you can do at scale. Make sure that those are being offered though in this space. And

[00:35:05] JJ: here’s the thing. That’s how you create a successful business, right? Why don’t you want to do all the steps that you don’t need to learn all these Yes. Yeah. You know, I was, when I was doing my talk yesterday, I was saying, so they talk about how doctors get an hour of nutrition, but they get [00:35:20] zero of exercise.

[00:35:21] JJ: But the reality is these are complicated. They have, it doesn’t

[00:35:25] Ashley Koff: seem like it. Yeah. And also I feel like, shouldn’t we be saying to doctors, okay, the recognition is you actually are not trained on this. So as a result, what I’d much rather train you on is how to ask or how to support your patient in getting connected to the person that can help them with [00:35:40] nutrition.

[00:35:40] Ashley Koff: Right. That’s actually what the doctor should learn. So the doctor should learn how to be the quarterback or how to be the team player in that space, rather than saying, I need you to be the expert. Cause honestly, I want the doctor to be the expert at diagnosing, right? Like that’s really important to me, but as a dietitian, I’m not coming in and saying, Hey, I’m going to diagnose you.

[00:35:57] Ashley Koff: Some of my colleagues may, but I’m not. And then you turn [00:36:00] around and I’m going to say, but I’m going to be the one that’s going to be here with you to help put together a plan from which we can start seeing if that works for your body. I have 50 coaches that work for me around the country. 50 coaches because I don’t listen well to people.

[00:36:12] Ashley Koff: You and I are talking about this. I like to tell people what to do. Well, guess what? That doesn’t translate into them actually doing it. So I then [00:36:20] gracefully hand them over to my coaches who create smart goals and who work with them and who help them figure out and who also give me feedback. And I can give the doctor feedback and say, Hey, Oh, okay.

[00:36:29] Ashley Koff: This is where we need to adjust. Or the person is actually not doing any of what you discussed, um, or they’re doing what you discussed and we’re not getting better outcomes. So that’s, it needs to be a team experience, um, with you [00:36:40] in the place that is your zone of genius.

[00:36:41] JJ: So, you know, one of the big things you hear about this is people go off and gain all their weight, or they have to be on it for life.

[00:36:49] JJ: What, what, and, and I’m really unpacking these. I got this great research article the other day. Um, showing, showing all the different things GLP 1 agonist can do in the [00:37:00] body. Yeah. I put my son on it for neuro regeneration, you know, we’ve been slow, low cycling him on it where he does it every other week that he does.

[00:37:07] JJ: Um, but the kidney function, cardiovascular is like osteo, osteoporosis, osteoarthritis. I mean, I was like, holy smokes. So Is this something that someone could low [00:37:20] dose for life? And I heard another practitioner talk about how she was basically micro dosing it, doing super low doses of it. And I just wonder if there’s other applications we’re going to start to find, or are you finding that someone kind of goes through the rehab, they use it to help get them going, they can start to taper it as they’re building up gut bacteria, gut microbiome, [00:37:40] and getting these good habits in place.

[00:37:42] JJ: Yeah. Do you think this is something that someone would need to do for life, or do you think they can?

[00:37:45] Ashley Koff: So I think there are a couple of things. I’d love to start at the macro level. I don’t really know of a class of medications that if you just went off of them immediately you wouldn’t have any side effects.

[00:37:54] Ashley Koff: Right. I like, so if I go off of a proton pump inhibitor, I have a backwash of acid. It’s like the worst thing that you can [00:38:00] do. Um, if I’m somebody who takes insulin and I stopped taking insulin, I’m going, yeah. So like if I needed it or if I’m, you know, I’m using it, like, so I think we have to downplay this concept of what if I needed to be on this for life?

[00:38:12] Ashley Koff: So we identify that this is the health enabling tool for you that is going to be supportive for one year, for 10 years. Uh, somebody asked a question in our session, [00:38:20] well, You know, my patient is saying they are going to be on this forever and I, that really bothers me. And I was like, why are you bothered?

[00:38:25] Ashley Koff: Like they’re your patient, you know? So like maybe what they’re actually saying to you is I’m afraid that nothing will ever work and I need this. And so maybe my job, and I said, with respect, I think you’re a physician, as a dietician, my job, not your job, is to help you feel less [00:38:40] codependent on it and to feel empowered and maybe to, at some point in time, decide that it might be the right time that we lower a dose or, you know, that we do something.

[00:38:47] Ashley Koff: Um, because I also want to prepare people for the reality that. Unfortunately, if you had a cancer diagnosis and needed to go through treatment, maybe if you’re, I don’t, I personally wouldn’t want a patient on it while they’re pregnant or trying to get pregnant. I don’t think we have the data [00:39:00] there, you know, some of those things.

[00:39:01] Ashley Koff: So we know life is going to happen and you may need to come off the medication. So I think we should just let go of what if you’re on it for life. I think we’re both saying, so what if you’re on it for life and you actually have a healthy long life or, you know, this, and you’re able to achieve your goals and live how you want to live.

[00:39:16] Ashley Koff: Great. You know, on that part. I think there’s another side of it [00:39:20] that says, look at all of these downstream benefits. It could possibly be upstream of metabolic health and of being able to eat better amounts for yourself and of being able to lose the stress associated with food noise, of being able to be present at your, the dinner table or at the, the meeting.

[00:39:36] Ashley Koff: Somebody that I have that’s on medication said that she can’t [00:39:40] ever be at a business meeting where there’s food because she literally can’t be focused. She’s like, I’m living two brains. I’m so focused on what the food is that’s there. Whether I should have it, whether I shouldn’t, you know, all of that, that I’m actually not hearing the business conversation.

[00:39:52] Ashley Koff: And she’s a high powered executive, and this is actually helping her break through. So that’s interesting to me, right, to be able to say, like, look at all of these wins that [00:40:00] we could have.

[00:40:00] JJ: I wonder too if one should break through with that feedback lube, if that’s just Gone. So,

[00:40:05] Ashley Koff: so this is interesting. So I actually think the only evidence that we have, which is not going to be very positive is from bariatrics because with, I don’t think like me personally, I’ve been working with people about, say about 15 months.

[00:40:18] Ashley Koff: So it hasn’t been a long time. So I don’t want to [00:40:20] overstay and be like, Oh my God. Yeah. I kept him off it for years and you know, whatever. I mean, a lot can happen in 15 months, you know, or in the subsequent time. But with bariatrics, I would find that many people experienced tremendous challenges, year two, year three, you know, et cetera.

[00:40:34] Ashley Koff: Some people had done beautifully and, and, and were able to use their, their surgery as a tool. [00:40:40] Maintain, and other people really had to try other interventions, and now even including, I have a, um, some bariatric patients, history of bariatrics who are on agonists, and we’re seeing a positive, um, you know, a positive play there.

[00:40:51] Ashley Koff: So I think that we have to look at this as a trajectory where we don’t know what is going to happen from your, from a long term health standpoint. This [00:41:00] is a tool that we could use. But what I will say hard and firm is before you decide to go off the medication, before you intentionally go off the medication, you have to have a plan.

[00:41:11] Ashley Koff: You’ve got to make sure that in minimum, you’re at that one shot of espresso, right? And that’s what we have to do now for the end, that you’re going to be able to commit to the lifestyle [00:41:20] behaviors, including your nutrition and these others, where you’ll stay at that one shot of espresso. Otherwise, I don’t have a good sense that you’re going to be able to be successful there.

[00:41:28] Ashley Koff: You’re right. Well, I mean, and here’s the thing, I don’t mess with anything. Like, these arguments around GLP 1 agonists are literally people yelling, like, because they can yell. I had somebody come up, I think she was very well intentioned and maybe just kind of wanted to, [00:41:40] like, show off in front of the doctor.

[00:41:41] Ashley Koff: Definitely not in front of me, but she was like, well, it does this and, you know, downstream interact with this and it would do this other stuff. And I was like, great that you know the mechanism. I was like, you get an A on the test. I’m actually talking about the patient, and the patient over here is a human, and I’m trying to figure it out, and I’m honestly not going to know for you.

[00:41:56] Ashley Koff: I’m not going to know, like, if, if somebody comes in with a severe liver issues, [00:42:00] I’m going to work on their liver, um, but if, like, if they are also, if part of that can be, because we’re seeing great results with fatty liver with agonist. So, I, I don’t want to, like, sound, like, I, I’m dismissive to everyone on that part.

[00:42:12] Ashley Koff: I just think, I think the drama around it is, is, you know, Totally misplaced because it’s deflecting attention from [00:42:20] where we actually should be. If you are coming in and you don’t have, you have, you check the boxes for why I need GLP 1 optimization, um, then that is going to tell me that you, there is intentional work that we need to do in your body for your body to get healthy.

[00:42:34] Ashley Koff: And that tells me that this is where you should be investing, right? And that’s where the focus should be. Um, [00:42:40] the focus should be on us understanding like we do with anything else, where could there be areas of concern? So if somebody’s on a proton pump inhibitor, and they also are, um, Deciding to take a semi glut tide.

[00:42:52] Ashley Koff: I’m gonna wanna look at some things there, right? I’m not gonna go into all of those. If somebody is on biologics for an autoimmune disease and they wanna go on a [00:43:00] glide, I’m gonna look at some things there. If somebody is newly trying to figure out the right hormonal balance for them and they add the semi glut tide, those are the conversations.

[00:43:10] Ashley Koff: And I do also think this is gonna be where I’m gonna take the opportunity to talk about it, is I think it’s really important for us to consider. In a body that is, that is [00:43:20] rapidly doing its cell work to develop in hormones that are newly developing. And I’m talking about a 12, 13, 14 year old child where somebody is so worried about their obesity and their diabetes at that point, which I completely appreciate.

[00:43:32] Ashley Koff: They have zero confidence because of access, because of family history, like all these other things that this kid is going to have a fighting chance to have a [00:43:40] healthy body is the first step with that child bariatrics or a medication. And I think the answer could be yes, but we have to do this other stuff.

[00:43:49] Ashley Koff: Otherwise, we’re compromising their future health. And I think that’s an area where that’s probably the one space where I’d love to try, if possible, to do some of the endogenous work. I just understand what I’m [00:44:00] up against, you know, on that part. Yeah, I

[00:44:01] JJ: remember. We tried on Dr. Phil to, we did the teen weight loss.

[00:44:08] JJ: There were so many issues you would never know. That’s right. There was the school, there was the parent. Yeah. I was like, Oh my God. Yeah, totally. Oh my God. Yeah.

[00:44:18] Ashley Koff: Yeah. And, and, and at [00:44:20] that point too, you, you have to be thinking about, um, where like, I want you to, I want to try to have you have as positive experience around food and things like that.

[00:44:31] Ashley Koff: So maybe intervening with a medication here so that you feel more empowered and not so negative about yourself. So. That’s another area where agonists are [00:44:40] helpful. We are able to take somebody who feels like a serial failure in their life and their health. There’s so much

[00:44:46] JJ: complication around this, too, and what happened with your, you know, all the metabolic dysfunction.

[00:44:51] JJ: And I just, I learned that early on. I go, Oh my gosh, this is not, this is not because someone’s lazy. Right? No. There are so many issues. Yeah. And I remember early on, [00:45:00] I met one of the doctors, the big sluice surgeon. I met. And because they were going to hire me for the teen show and I was finally like, it was like, yeah, no, I’m, I think I can’t do this.

[00:45:08] JJ: But the doctor literally said to me, I’m watching them and they just eat too much and they do exercise. And I’m like, Oh my God.

[00:45:16] Ashley Koff: Yeah.

[00:45:17] JJ: Oh my God.

[00:45:18] Ashley Koff: Yes. You know? Well, I, I did [00:45:20] work on it. I did shedding for the wedding with that same dot with one of the physicians. I don’t know if it was this name. Yeah. And I did, I did celebrity fit club and they told me, they said, Oh, this person is failing.

[00:45:30] Ashley Koff: She’s non compliant with your diet, which by the way, when I hear non compliant, I hear somebody hasn’t actually done their job to figure out what that person needs. And it turned out she had horrible [00:45:40] IBS and the diet was high in fiber, and she was just like all the time feeling badly bloated for her weigh ins.

[00:45:45] Ashley Koff: Like she literally was not losing weight because she’s just, you know, trying to do And they said to me, instead of addressing that on TV, um, this, I got the call, uh, and it was, um, actually sometimes it’s good for us to show that people fail despite having all the help that you could offer. And I was [00:46:00] like, and I worked with her for another five years and she did beautifully.

[00:46:02] Ashley Koff: Um, but I think in that space or in chatting for the wedding where it was like, they just need to exercise more. Exercise is actually not the thing. That’s right. That’s right. And maybe they’re like, you know, some of them actually need to just be able to relax and have some fun in their life. You know what I mean?

[00:46:16] Ashley Koff: I think. If we can’t make this deliciously doable, I don’t [00:46:20] know kind of how we, you know, how we meet somebody where they are. So I think that there’s, there’s so much, I’m just so grateful that you wanted to have this conversation because it’s, um, I think we can take to task kind of everyone here. I think pharma is not doing a great job because they kind of are just in here and are like, look at this miracle drug that’s been created.

[00:46:38] Ashley Koff: I think practitioners who are just [00:46:40] scripting and not sort of, you know, texas. edu. You can even use this recording with your patients where you can say, Hey, I want you to listen to this first to understand what we’re going to do. We have actually done your systems approach work for you by having this conversation, you know, and do that.

[00:46:54] Ashley Koff: And then individuals, if you’re going to just jump in and like, Buy a, take any old car off the lot and [00:47:00] just hope that it runs really well for you for a lot of years. Like that’s your problem, you know? So I think that we’ve got to, we have to accept, you know, accountability across the board. What

[00:47:08] JJ: a reasonable approach.

[00:47:09] JJ: Maybe. That’s right. Now you’ve created a guide that we’re going to be making available to everyone. I’m going to put it at jjvirgin. com forward slash cough. K O F F, not [00:47:20] cough like the cough. That’s right. K O F F. And what is in the guide?

[00:47:24] Ashley Koff: Yeah, so I wanted to share a lot of this information because in case you weren’t like putting us on, you know, point five and taking notes and all of that.

[00:47:30] Ashley Koff: Um, so in the guide, you’ll get this information and it’ll also direct you over, uh, if you want to, to our site where you can do the GLP 1 optimizer quiz. Um, and then we’ll just answer the [00:47:40] question. I mean, I don’t like you heard from us. You everyone should be optimizing, but if you really need to take a quiz for me to tell you whether or not, like the majority of us still need to take this on that.

[00:47:48] Ashley Koff: It’s going to take like this. There you go. Yeah. Yeah,

[00:47:51] JJ: absolutely. Right. That’s perfect. Yeah. jjvirgin. com forward slash cough. Yeah. And I hope this is just the one of many. I hope so too. Yeah.[00:48:00]

[00:48:02] JJ: Be sure to join me next time for more tools, tips, and techniques you can incorporate into everyday life to ensure you look and feel great. And more importantly, that you’re built to last. And check me out on Instagram, Facebook, YouTube, and my website, jjvirgin. com. And make sure to follow my [00:48:20] podcast so you don’t miss a single episode at subscribetojj.

[00:48:24] JJ: com. See you next time.

[00:48:34] JJ: Hey, JJ here. And just a reminder that the Well Beyond 40 podcast offers health, wellness, fitness, and nutritional [00:48:40] information That’s designed for educational and entertainment purposes only. You should not rely on this information as a substitute for, nor does it replace, professional medical advice, diagnosis, or treatment.

[00:48:51] JJ: If you have any concerns or questions about your health, you should always consult with a physician or other health care professional. Make sure that you do not disregard, [00:49:00] avoid, or delay obtaining medical or health related advice from your healthcare professional because of something you may have heard on the show or read in our show notes.

[00:49:08] JJ: The use of any information provided on the show is solely at your own risk.
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