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How to Lose Weight with Dr. Tim Church

George Grombacher October 6, 2023

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How to Lose Weight with Dr. Tim Church

LifeBlood: We talked about how to lose weight, why we struggle to do it, the impact of new weight loss medications, the role incretins play in the process, and how to position yourself for long-term health and success with Dr. Tim Church, Chief Medical Officer of Wondr Health.       

Listen to learn about the necessary elements of an effective behavioral change program!

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Our Guests

George Grombacher

Dr. Tim Church

Episode Transcript

george grombacher 0:02
Dr. Tim church is the Chief Medical Officer of Wonder health, their leading digital behavior change company that prevents and reduces the cost and impact of chronic health conditions. Welcome, Tim.

Dr. Tim Church 0:14
Thank you, sir. It’s a real pleasure to be here.

george grombacher 0:16
excited to have you on. Tell us a bit about your personal lives more butcher work, why you do what you do.

Dr. Tim Church 0:23
Tim church, obviously, physician, you know, it’s all kind of comes together as one, you know, people ask, Why do you as a physician not carry around the stethoscope and see patients every day. And I do what I do, because we have the ability to impact hundreds of 1000s of people at a time. And I love that. I love the fact when you combine that to that we work with people who often don’t have access to things like this access to things to a modern behavioral program, access to things to moderate weight loss program, access to things like how to sleep better, how to feel better, how to build resilience. You know, I was in clinical research for years and years and years, and it’s kind of the same thing. I love the idea of helping mass groups of people once. And then when I transitioned into more of a direct interaction intervention with with the weight loss program. I mean, that really sums it up. You know, one of the things we love to say at Wonder is most good for the most people. And that’s really what our foundation is.

george grombacher 1:30
I appreciate that very much. What is what is a modern, behavioral or weight loss program?

Dr. Tim Church 1:37
Uh, not modern. Let me tell you, is, Hey, eat less and run more.

george grombacher 1:45
Just do it. And people

Dr. Tim Church 1:46
still say that we will still fit, we got a behavioral program like, yeah, we tell people eat carrots. That’s not a behavioral program. You know, a behavioral program, I think really is about at its core. Helping people help themselves helping people identify what do they struggle with? I’m an emotional eater. I’m a stress eater. I’m a rigid eater. Alright, okay, well, first, we’ll stop putting the like judgment around any of that. Second of all, let’s identify what your challenges are. And then let’s give you very specific interventions, very specific strategies, and tools for those things. If you’re not an emotional eater, you don’t want to hear about emotional eating in your program. It’s not relevant to you. If you are an emotional eater, somebody explains to you what an emotional eater is, you’re like, oh, my gosh, that’s me. And they say, well, here’s some tools to deal with. Here’s some signs of knowing when you’re heading down that path. And here’s some ways to avoid going down that path. That That, to me is a modern behavioral program, taking really complicated skills, making them really simple, and making them usable for people so they can really impact their daily life.

george grombacher 3:01
Is that come natural to you know, the reason I asked just because I think some people would rather be brilliant, that would be useful. And I’d rather be useful to brilliant than it sounds like that’s you as well.

Dr. Tim Church 3:12
Yeah, no, I overshare here, I think we spend a lot of time making medicine more complicated than it is. There are some times it’s really complicated. There’s some times it’s not. And if you can’t help people, what’s the point of even having it in a way, you know, I’m saying, so. You know, that that, that, to me is more important is I like what you said, and for that, and that resonates with me. Yeah, being able to take what in the background is really complicated, make it not complicated and make make make people be able to use it everyday to help people that’s that matters to me. I love like to me, the victory lap is when you help the truck driver. The victory lap is when you help the Teach teacher in the deep south and doesn’t have access to this stuff. The victory lap is when you help the janitor in the hospital system that that to me is a victory lap. Other people who have resources and have access to this stuff. That’s awesome. It’s a great privilege bill to help them be able to help people who otherwise wouldn’t have access to these things. That’s the victory lap.

george grombacher 4:27
Yeah, I certainly appreciate that. That’s what are what are the big challenges that the that wanders working on? Sounds like certainly, obesity being overweight is a big one.

Dr. Tim Church 4:40
medications. I mean, you know, you’ve we’re all surrounded by every day ozempic way govi mon Jarrow? They’re phenomenally powerful. medications that can really really help people. It’s an odd thing for me to have NIST, because they brought so much awareness to the field of weight loss, but it happened through Tik Tok and Instagram and Facebook and celebrities. So with it, a lot of baggage came with it in terms of misinformation, in terms of being used the wrong way. And so now as we come in to help companies to get this under control, you have to undo a lot of stuff before you start doing good stuff.

george grombacher 5:29
So it’s a good thing, to a degree that we have new excitement about a new medium or method of losing weight, but that’s not necessarily it carries with it a lot of other challenges.

Dr. Tim Church 5:43
Yeah, it’s a great thing that we have these tools can help hundreds of millions of people. But there’s a caveat that come with these things. They have to be used, right? Right medication, right person, right reason, better outcomes, better price. And I’ll go back to that emotional eating, because we’re already on that emotional eating trend. If you have a true emotional eater, some of these medications might produce a lot of weight loss, but you’re actually not helping the person. You’re not helping them, they’re emotionally. At the end at the core, you got to get it, what their struggle is. So a you got to bring in the behavioral program that helps with emotionally, there’s actually medications that specifically help emotional eating. So if you don’t have the right program, the right prescriber, you give someone the wrong medication, kind of everybody loses the patient doesn’t lose the weight, they’re emotional enough to get addressed. Somebody paid for that they didn’t get their money’s worth. And the end of the day, everybody’s unhappy. It sets the whole industry back. So right medication. Right, right, right. Patient Rights support, good things.

george grombacher 6:53
Which certainly makes sense. Think we must be must be just part of the human condition of I want the quickest answer the easiest way possible. And then I want to go and do other stuff. But this is not, from my perspective, that’s just not the case. That’s not how things work. I’ve been tracking the weight loss drugs pretty closely. And I’m really bothered by them. I’m really concerned about a lot of it. And then I saw Wall Street Journal article, big headlines saying the verb comes in, it’s all about your genetics. That’s why you’re overweight, it has nothing to do with your behaviors in my head almost exploded.

Dr. Tim Church 7:35
Yeah, it’s not. It’s kind of genetics. It’s more just how we’re wired. And I’ll give you a great example. This whole thing, so wild, because it all comes back to these little molecules called incretins. What actually goes back to a lot of things, we’re going to talk about incretins incretins, your your your intestines, your guts, It’s so wild. They have more nerves and more neurons than your spinal cord. Think about that you’ve yet you have just as many neurons or nerves in your intestines as you do in your brain. So your your test is actually really smart. And they’re great communicators. And the way they communicate, it’s these little chemicals called incretins, which didn’t even exist. When I went to med school, they existed, we didn’t know they existed. And so So we’ve come to figure out these incretins are constantly talking to the brain and constantly talking to the rest of the body. And that’s what these new medications are they mimic the incretins they mimic GLP one they mimic Annalen they mimic other things which aren’t necessarily participant hormones, like glucagon. And, and you know, where we started to really figure out that the weight is more than just willpower was studying these incretins and I’ll give you a great example. So there was a study where they help people lose a lot of weight through through exercise and diet. And then they left them on their own. And every month for a year, they looked at their incretins and what they saw was the chemicals that Pinkertons in your body that promote hunger went up the increased tension in your body that suppressed hunger went down. So it was an example of your own body was sabotaging to your own body wanted to get back to some previous weight, which makes sense if you think about from an evolution perspective, why would we be designed to lose weight and keep it off? In times of when there’s not a lot of food? That’s that’s how we evolved but now there’s excess food everywhere. So our biology, our genetics, our makeup, it’s not designed necessarily to be in an environment where a we eat a lot and B we make our living sitting down you know can’t for Forget about that we make our living sitting down, not, not many of us are physically making our livings anymore. So that all of that’s the underpinnings of why obesity is, in fact a disease. It’s not just willpower. And that’s hard to get your mind around. Even as a professional target each in mind around this, this here we are, we’re in a sense, sabotage by own bodies for losing weight and keeping it off particularly large amounts of weight, little amounts, what you bought it, you lose, you know, 510 15 pounds, the body doesn’t really care, you start losing 3040 5060 pounds, the body wants to put that weight back on.

george grombacher 10:43
Like something must be wrong, there’s there’s something George’s life or Tim’s life is at risk, we must make sure he puts the weight back on because something is happening out there that we can’t see,

Dr. Tim Church 10:53
the greatest example I saw was the idea of a spring II tie a spring to a wall, you pull a little bit, it doesn’t really pull back that hard, you pull it way out here, the spring really pulls back. So yeah, they exactly you perturb the spring, the body perceives it as something’s wrong and the body wants to go back to where it was.

george grombacher 11:16
Fascinating. So incretins, so these incretins that that are hanging out in our guts and doing wonderful things for us. Normally, normally, these these brilliant pharmaceutical companies figured out how to mimic them. And then I give myself this met this medicine, and now it’s telling my body, like the inker, 10, that you’re not hungry anymore, so then I don’t eat as much

Dr. Tim Church 11:48
as I want to screw this up. I’m gonna try anyway. So the first incretin not the first, but the most important one so far, actually came out of the spirit of Gila monster in and they did it in Phoenix, so it’s in your backyard. So that they looked at the spirit of this Gila monster, I don’t know why they looked at it, they realized, oh, my gosh, it had these these molecules in it, which mimicked the human GLP, one incretin. And that was it. Now you had nicotine, you could actually work with, you could actually replicate and work with.

george grombacher 12:30
So, okay, I think that that’s amazing. So they figured that out, and made it into a medicine, and now it’s helping people to lose weight. But it’s not necessarily that simple. Because when I get off the medicine, what, what what will happen to me?

Dr. Tim Church 12:49
You know, what I’m supposed to say here is you’re gonna put your weight. And I think that’s going to be true most the time. But not all the time. You know, I think it depends on how much weight you lost. I think it depends on was this your first time ever losing weight? I think it depends on a lot of things. And the weird thing about you don’t put it on overnight, and it takes about a year, put it back on. So I also think what what matters there is is is is is did you learn any behavioral skills, I mean, if you didn’t learn any behavioral skills, you’re putting the weight on immediately. If you learn some behavioral skills, at least you got a fighting chance of potentially keeping the weight off. So you, but the way to think about this, it was like, oh, I want to be on this medication for the rest of my life. You might be, but you know what, you’re not on a blood pressure medication. You know, I’m on a diabetes medication, you’re not on medication to treat that back pain or knee pain. So the way I think about it is you’re trading out one medication for potentially multiple other medications.

george grombacher 14:04
That is, that is a interesting bargain that that we’re making there. And that’s that, that very married, that may very well be a very compelling case for it. I would obviously rather see people just to get healthy and use methods like y’all are working on to do that. So I’m introducing synthetic anchor tents into my body through medicine. Do they help? And we probably don’t know how long that they hang out for they Yeah.

Dr. Tim Church 14:37
Yeah. So I hear you loud and clear. So what are the long term side effects of these things? Here’s the great news. Is is the current ones we have. The current ones have been around for over a decade used to treat diabetes. The odd thing about these molecules, they’re good for your heart muscle. They’re good for your brain. And they’re good for your blood vessels. They’re good for blood sugar control, oh, by the way, they help you lose weight, they actually do a lot of things, we just happen to focus on the blood sugar control. And, and, and the weight loss part. So the current ones, I can look at you and tell you, they’re safe. There’s there’s been used by 10s of millions of people, there’s no new, weird side effect that’s going to come up. Okay, that does not, that statement does not cover the things in the pipeline, there’s a whole bunch of the pipeline, they’re going to come out that are even more powerful, that even have more impacted blood sugar and blood pressure, but they don’t have the track record the current ones do. So I think we can feel pretty good about the current ones, the one in the pipeline, I think it’d be tells you they know the long term effects will of course, we don’t, they haven’t been used by 10s of millions of people. So So you really bring up a really important point, in a point, I bring up a lot. But with these, you gotta feel pretty good about they’ve been used by people touch your diabetes for going on 15 years now.

george grombacher 16:14
Fair enough. It was. So if I use it for for a year or two years, and I lose a substantial amount of weight, let’s say that I lose 100 pounds of weight. That’s obviously a really, really positive thing. And I get off of these, is my body now going to say? Well, we’re going to this is our new normal, or is it going to say we need to bring George back to that, to that 100 pound that he was at before? Have I pulled the spring or is now that spring, has as the wall gotten closer?

Dr. Tim Church 16:45
You know, again, it’s gonna vary from individual to individual. But in general, yeah, the body’s wanting, we’re going to want to go back, it’s going to be a very slow process, but the body is going to want to go back, especially if you’ve been on it two years. But the great thing about this, George is now you as a human, you’ve learned what your portion sizes should look like, you’ve learned about when you should eat through the day, you’ve learned that you don’t need to snack throughout the day. So you’ve learned a lot of things. Hopefully, if you had a good behavioral program, you also learned your triggers, you learned that when you don’t sleep, you have a challenge with your eating. So let’s work on your sleep, you learn to stress drives your eating what let’s double down on the stress. So if you have that good behavior program who went with this, the odds of reducing the meds or maybe going to a cheaper, less powerful men, or coming off of the odds of success are higher. We don’t have enough mass data on big populations to know what percent of people are going to be we have the pharmaceutical trials. But those are so artificial, because people don’t leave them. You know, it’s different, you get a very motivated group, and it’ll come pharmaceutical trials. But in terms of using this in the general public, I don’t think we know just yet how many those people are going to put all their weight and how quickly they’re going to put it on, especially people who did it for two years, like you described. You didn’t for four months, and then you quit, you’re putting that way right back on, you know, but if it’s two years, and you really stepped into the program, you really stepped into this new life. We’re going to find out over time, hear what happens.

george grombacher 18:21
Yeah. I appreciate that. And I, I, I am such an advocate for getting down to the root cause of problems. And I think probably everybody is, but then, you know, our plan has its collision with reality, I get punched in the face. And I just want to take the pill because my kids need dinner and everything else. I’ve got a lot going on. So how do how do you make this fit? How does how does wonder health make these programs fit into everybody’s life and make it so people actually use it? You’re not going

Dr. Tim Church 18:50
to weave this answer. You start with Greeks. You start with you know, what is the full context, sports isn’t easy. So let’s stop beating yourself up. You know, you can’t, you can’t move forward, you can’t learn skills, you can’t. You can’t step into the process until you first acknowledge this is not about being perfect. You’re gonna make mistakes, you’re gonna have bad days, you have bad weeks, bad months, and some days the kids got to have dinner and some days you’re gonna eat what you got to eat. That’s just how it is. But try not to make that every day. Here’s some strategies to do that. And a lot of what we do is first about reflection. I mean, that sounds weird, but like what are you what do you struggle with? You can’t help people help themselves until they understand what their own challenges are, again, is it sleep stress? Is it I just don’t know anything about nutrition? That’s men. Generally, men generally have never done this before. This don’t even realize that snacking throughout the day sabotaging them doesn’t matter how good they are at their meals, the snacking throughout the day to sabotage them. Yep. So a lot of it’s just about almost inventory, what the person’s challenge is, and then giving them the appropriate skills to that challenge. That’s a week we have a screening on the front end, where you take this questionnaire, figure out, are you a stress eater and emotionally or you’re originator? What are your challenges, and you’re gonna get tailored material for those challenges? Because I couldn’t agree more George, I mean, I want to start with behavior. And no matter what you do, behaviors got to be a huge role. You know, we got to be talking about better sleep, we got to be talking about hydration guide, we thought about physical activity that fits your lifestyle. All those things are the building blocks.

george grombacher 20:40
Yeah, I appreciate that. And I love how you talked about it starts with grace, because we do need to give ourselves the space and the grace to make mistakes because we’ve not necessarily mastered our habits and our lifestyle if we find ourselves overweight, or drinking too much, or stressed out whatever it might be. So we need to be kind to ourselves. And then I love how you tailor the program and make it specific to what they need. Because to your point when we started if I’m not an emotional eater, I don’t need to hear about that. So and then make sure that it fits. I love it. Well, Dr. Tim’s thank you so much for coming on. Where can people learn more about you? How can you engage with wonder health

Dr. Tim Church 21:22
wonder And there’s no E in there wonder supposed to be Dr. For Dr. Wonder

george grombacher 21:31
Excellent. Well, if you enjoyed as much as I did, show Tim your appreciation and share it today. share with a friend who also appreciates good ideas go to wander That’s W O and Dr. And check out everything we’ve been talking about. I think whenever we’re trying to make substantive changes in our lives, it is not an easy thing. So the more resources and support we can get the better. And I love how Tim and the rest of the team have structured this. So thanks again, Tim. Thanks, George.

Dr. Tim Church 22:03
Real, real pleasure.

george grombacher 22:05
Till next time remember, do your part, like doing your best

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