Eating a nutritious diet is essential to staying healthy and active. Gladys Lopez, DO, from WellMed at Hampton in Dallas, Texas, discusses the importance of eating well and questions to ask your primary care provider.
July 10, 2024
Docs in a Pod focuses on health issues affecting adults. Providers and partners discuss stories, topics and tips to help you live healthier with hosts Ron Aaron, Dr. Audrey Baria and Dr. Tamika Perry.
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Show transcript
Podcast transcript
INTRO
Welcome to Docs in a Pod, presented by WellMed. Over the next half-hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-hosts, Dr. Tamika Perry and award winning veteran broadcaster Ron Aaron, will share information to improve your health and well being. And now, here are Ron Aaron and Dr. Tamika Perry.
RON AARON
Well, hello everybody and welcome to the award winning Docs in a Pod. I'm Ron Aaron. Delighted to be here along with our co-host today, filling in for Dr. Tamika Perry. We have Desarae Murray, nurse practitioner. I want to remind folks, if you want to listen to our podcasts, Docs in a Pod is available wherever you get your podcasts and we encourage you to check it out. Desarae is a nurse practitioner for WellMed at Live Oak in Dallas. She has been with WellMed for quite a while, and she says she always knew she wanted to help people and provide her patients with the care they needed. Desarae, on her journey to becoming a nurse practitioner, became the first African American Miss Southlake in the 12th year of the Miss America pageant in 2015. She's a singer, as you can hear from the quality of her voice and loves working with patients. She's committed to education, and that's one of the reasons we love having her as a nurse. Hey, Desarae, it's great to see you again.
DESAREA MURRAY, NP
Oh, so good to see you too, Ron. I'm happy to be here. Thanks for having me again.
RON AARON
Now for those who are listening, we see each other here on Zoom and you get to see us over the radio. At some point were hoping to make this show available on YouTube so that you can check us out both voice and faces, but we're not quite there yet. Desarae, we're going to be talking about diet today and I gather in your work as a nurse practitioner, that's something that comes up a lot.
DESAREA MURRAY, NP
Oh, very, very important. Unique to each individual person and their needs. So I'm excited about this topic today, Ron. I think we all need a refresher.
RON AARON
Well, we're going to welcome our guest. Gladys Lopez is a doctor of osteopathy. She's at the WellMed at Hampton, located in Dallas. She earned her medical degree from the University of North Texas Health Science Center. Texas College of Osteopathic Medicine in Fort Worth. Completed a residency at Methodist Health System Family Medicine Residency in Dallas. Dr. Lopez is board certified by the American Board of Obesity Medicine, the American Board of Family Medicine, and the American Osteopathic Board of Family Physicians as well. She specializes in obesity medicine. Today also is a special day, it turns out to be her birthday. So welcome, Gladys Lopez. Happy to have you with us.
GLADYS LOPEZ, DO
Hi, thank you for having me again. It's good to be back.
RON AARON
It's great to have you back. What is it that attracted you to looking at obesity medicine? Because as I look to you on Zoom, you look to be not an ounce overweight.
GLADYS LOPEZ, DO
Well, thank you. Its just so prevalent and people are often asking about how to go about weight management, especially as we start to age and sometimes, were just predisposed to gaining weight over time. To answer our patients' questions, I went out of my way to obtain additional training in obesity in weight management in order to help our patients and kind of cater towards their health goals.
RON AARON
Well, we know in Texas, for example, obesity is a huge problem, and it also has a direct correlation to type two diabetes and other issues. So, there is a purely health factor involved in being overweight, is there not?
GLADYS LOPEZ, DO
There absolutely is. It's tied to what we call the metabolic syndrome. So, that can incorporate diabetes, changes in cholesterol levels, we can gain weight or extra fat in places that we're not really supposed to be gaining like our waistline. So, it's a comprehensive type of disease that can impact really any organ system, your liver, kidneys, your eyes. It can be quite detrimental with time.
RON AARON
Somebody once explained to me that you know, if you gain a pound or two in a month, no big deal. But if you gain a pound or two every month, suddenly you're 24, 25 pounds overweight.
GLADYS LOPEZ, DO
That's the red flag. We always try to look at the causes, you know, changes in lifestyle, sometimes different stressors or life events can definitely contribute to play a part. Even people's medications, or if they've suddenly changed the way they eat or are becoming less active, that can definitely play a role.
RON AARON
Well, talk to me in just a moment. I want to let folks know who've just joined us, you're listening to the award winning Docs in a Pod. We're available on podcasts wherever you get your podcasts. We're also on the radio in several Texas and Florida cities as well. I'm Ron Aaron. Our special co-host today is Desarae Lopez. Excuse me, Desarae Murray. I'm confusing both of your names. Our guest is Gladys Lopez, and our co-host is Desarae Murray, nurse practitioner. Dr. Lopez, talk to me about the ideal diet that you would recommend for folks who say, you know, what should I eat?
GLADYS LOPEZ, DO
In general, there is no magic-bullet type of diet. The best one is one that you can stick to for a lifetime. We don't use diets as a temporary fix. It should provide one with a good source of fuel or energy. It should be well balanced and incorporate macro nutrients like protein and carbohydrate. It should allow us to grow and repair our tissues and our cells. There are a variety of different diets, but they can definitely be tailored to meet one's health goals or modified for certain medical conditions. In general, a healthy diet should incorporate leaner proteins, which are the building blocks of life. Complex carbohydrates like those found in vegetables and unsaturated fats, such as olive oils, and we want to minimize heavily processed foods like pastries or chips.
RON AARON
Or hot dogs.
GLADYS LOPEZ, DO
Yes, or hot dogs.
RON AARON
Or salami or sausage.
DESAREA MURRAY, NP
Or donuts.
RON AARON
It's all the good stuff, Dr. Lopez. It's not fair.
GLADYS LOPEZ, DO
Yeah, it all tastes good because it has so many things that have been added on. For example, hot dogs or the salami will have additional salt to preserve it. So that's where we start to say, that's where it's heavily processed. It also comes along with unhealthy fats, like saturated fats. You really want to minimize, especially if we're looking out for your heart health. A lot of these foods are also very high in calories. So, if we're counting calories or wanting to minimize our caloric intake, those are things that can be easily removed or minimized in one's diet.
RON AARON
And Desarae, when I mentioned, it's all the stuff that tastes good, I saw you chuckle. You must get that from patients all the time. Hey, look, I only have three carne asada tacos a day. What's the big deal?
DESAREA MURRAY, NP
Oh, my goodness. I had a patient once tell me that every morning he ate six tacos. And I said, well, can you cut it back a little bit? He said, no, ma'am, no, ma'am. I got a high-demand job that requires a lot of physical activity. Dr. Lopez, something that comes to mind that a lot of patients ask me about when it, when it comes to diet is intermittent fasting, that specific diet. What are your thoughts on that?
GLADYS LOPEZ, DO
It's just one type of diet. The focus is more so on when you eat and eating only at a certain time of day. There's different forms of it, such as time restricted fasting, when individuals may skip breakfast and they allow themselves to eat lunch and dinner. There's also alternate day fasting when one eats normally for one day but may faster have a low-calorie meal the next. It may work well for some individuals. The idea is to limit your total caloric consumption by only eating during a time restricted period, but it's also not for everyone, such as individuals who are pregnant, breastfeeding, individuals with type one diabetes who are taking insulin, eating disorders and children who are growing. Some individuals may even need to eat breakfast due to their demanding work schedule. If they don't eat breakfast, they may predispose themselves to having a foggy brain, but overall, the best diet that you can really stick to is the one that works with your lifestyle and with your health goals. Intermittent fasting is more so tailored for individuals who want to reduce their culinary consumption during a certain time frame. So, that's the idea behind that.
RON AARON
Do you recommend that your patients talk to a nutritionist about helping to design the most effective meals for themselves?
GLADYS LOPEZ, DO
Yes, I often refer them to registered dieticians. Now there is a difference between the two, but we do like working with dieticians because a lot of our patients actually have very specific questions and dieticians have that additional training that can help answer a lot of patient questions when they get into specifics. For example, how many carbohydrates do I need? Or how much protein do I need to be eating? Or how can I count calories? So, they can actually take dedicated time to answer patient questions.
RON AARON
As you think about some of the new-fangled medications like Ozempic and Wegovy and Gizepatide that are out there that apparently every other celebrity in the world is now taking. What's your reaction to somebody who says, Doc, just put me on Ozempic, I'll be fine.
GLADYS LOPEZ, DO
We use those medications often in my practice, but it's not without supervision and in the right person, too. Without any surveillance, those medications could actually be disastrous and can actually cause harm. So, we're very selective about the individuals who would qualify and do well. Without any sort of supervision, there's many risks that one can take. For example, we could break down one's muscle tissue. We could even crash one's metabolism. But they work more so by reducing one's appetite and not in everyone, but that's why we always want to consider the patient's entire profile and how they're going to approach their weight management or goal. We try to work with the patient. It's a comprehensive effort, it's not sort of like a quick, easy fix. It's meant for long-term use and with the adjustment of our eating habits and our lifestyle and incorporating exercise as well.
RON AARON
I'm going to come right back to you and to our co-host, Desarae Murray, who is with us. We're talking with Dr. Gladys Lopez, a doctor of osteopathy. She's with the WellMed clinic up near Dallas in Hampton. I'm Ron Aaron. You're listening to the award winning Docs in a Pod.
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RON AARON
We are so pleased you are sticking with us right here on the award winning Docs in a Pod. Our podcasts are available wherever you get your podcast, and we encourage you to download them and listen and share them with a friend, a neighbor, a relative. I'm Ron Aaron on Docs in a Pod with our co-host nurse practitioner Desarae Murray and Dr. of Osteopathy, Gladys Lopez. She's with the WellMed at Hampton in Dallas, Texas Clinic. And we were talking just a moment ago, Dr. Lopez, about medications that are so much in the news like Ozempic, which is the name everybody uses generically, although it covers a lot of different preparations. You go on it, you lose weight, you're feeling great and time to come off it, or you think it's enough, you get off it, and then the old yo-yo effect comes in and you gain all that weight back. How do you handle that?
GLADYS LOPEZ, DO
We let our patients know and educate them that once we start these medications, you're very much likely going to have to stick with them for the rest of your life. Otherwise, you'll get that rebound effect you're referring to where, in several weeks, we can see some regain, if not all of it. So that's why we often continue to follow our patients for months, years, to make sure they're doing well. Now, these medications; we've known about them. They've been on the market for many years now, but we have seen studies where there is significant regain. So, that's something that we need to continue to monitor with frequent weight checks and checking regular laboratory values just to make sure the patient is doing well.
RON AARON
Now, those medications are so expensive. Are they covered by insurance?
GLADYS LOPEZ, DO
Yeah, they are very expensive. They cost over a thousand dollars a pen. If one's insurance does cover it, we do let the patient know, you're very fortunate to get it because not everybody can get their hands on it. It's very expensive out of pocket so we just let them know we stick with the same insurance plan. Now, Ozempic is more so for individuals with diabetes so that's what we'll prescribe it for. We just happen to know that it helps with weight management as well. So, that's where we're getting the newer branded medication. So Wegovy, for example, that one is marketed as for weight management. Now, not all insurance programs will cover weight loss or anti-obesity medications necessarily. It all just depends on plan to plan. There are other options out there to besides just injections. Some patients, rather than wanting to go through the pharmaceutical options or medications, there's also other ways we can work with them. Some people prefer a more conservative approach by just wanting to learn more about what they can eat or what they can minimize. Or maybe they need just a little bit of help figuring out what kind of exercise routine they need to start.
DESAREA MURRAY, NP
I agree with that because there can be an insurance coverage issue at any time in the treatment process. I still try to encourage the patient to focus on a dietary plan that works for them and that physical activity plan because you still need to have the lifestyle change with the medication. Would you agree with that, Dr. Lopez?
GLADYS LOPEZ, DO
Yeah, absolutely. In fact, we go over some of the side effects if they don't follow through. For example, if someone overeats while on these medications, that can provoke a lot of nausea, a lot of vomiting. Hopefully, whoever is prescribing these medications to someone provides that education and warns them. We also go through other medical conditions just to make sure that they would qualify because there are some that may make their symptoms worse, or maybe trigger some sort of illness or some sort of attack. And we also want to make sure that they're having adequate nutrition, too. We don't want them to stop eating altogether. That doesnt help at all.
DESAREA MURRAY, NP
Right, right, because that can happen.
GLADYS LOPEZ, DO
Yeah. You've probably heard about the Ozempic face as well, where a lot of individuals have this really shrunken face. We've seen studies now that without a good diet that's rich in protein and without some sort of resistance training, like weightlifting, we can lose a lot of muscle mass. That's what we don't want. We want to preserve our weight and muscle, but we want to lose the fat and in order to do so, you need to have that comprehensive approach. It's really sad to see whenever we've gotten patients that have gotten these medications inappropriately prescribed, but now their metabolism is down the drain because your muscle is what naturally burns calories as you sit there. The example that I often use is a bodybuilder, they have so much bulk, they have so much muscle. They could sit there all day, eat whatever they want, and they're not going to gain any weight because they have so much muscle. They can burn just so many calories without really moving.
RON AARON
Interesting. Desarae, are patients asking you about Ozempic and other drugs?
DESAREA MURRAY, NP
Oh, 100%. I mean, who doesn't want to lose weight, Ron?
RON AARON
Well, you spent a lot of years in the beauty pageant industry. Quite successful, by the way, was there pressure there to keep that weight off if it was a risk?
DESAREA MURRAY, NP
Oh, absolutely. My platform at that time was to love being healthy with a focus on prevention of childhood obesity because of the impact it can have on adults when you become an adult. So, I am happy about the availability of these drugs now, Ron, to help people lose weight because it can help with their overall health. However, like Dr. Lopez is saying, you need to have monitoring with that by your health care provider consistently because everything is not for everyone. You may need a different drug.
RON AARON
We haven't talked about some of the surgical procedures that used to get a lot more attention in the news. It's been really overtaken by medications like Ozempic. Folks who would get their stomachs tied off by bypass surgery. Are those still being used, Dr. Lopez?
GLADYS LOPEZ, DO
Yes, those are still being utilized and there's been different advancements and there's different kinds of procedures. Some are more aggressive than others. Some are more effective than others. It just depends on the individual but usually you would have to consult with a bariatric surgeon. It can worsen certain medical conditions like acid reflux. They do require regular monitoring as well. So, you can't just have bariatric surgery and then disappear forever because you'll run into the risk of having things like vitamin deficiencies or maybe an upset stomach. That's where you want to continue following up with your doctor, bariatric surgeon or maybe your weight wellness clinic. Your diet will very much likely have to be modified as well because you're not going to be able to process foods in the same way. We do require specialized testing over time because the last thing we want for you is to be malnourished.
RON AARON
It's interesting when you think back, Desarae and Gladys, to the ancient civilizations, did cave people worry about weight? They were so active, so busy and eating so much protein, they probably never had a weight problem.
DESAREA MURRAY, NP
Of course you would bring up cave people, Ron. I don't think they were worried about it. I mean, they were extremely active. Now we've got vehicles and transit that takes us everywhere so we're not walking as much, depending on where you live, of course. But yeah, there's definitely a different level of societal physicality at that time, in my opinion.
RON AARON
Somebody said to me, Dr. Lopez, the worst invention for us in terms of weight management and exercise was a TV remote.
GLADYS LOPEZ, DO
Oh gosh. We're in Texas, so it doesn't help that to get from one place to the other, you need a car.
DESAREA MURRAY, NP
Yes.
GLADYS LOPEZ, DO
You need a license to drive to get around here. It's unfortunate. We're not like New York where you have to walk everywhere. Here, its more like you need a car.
RON AARON
Well, with the heat as well, and we haven't talked about it, but the heat load is such that it's dangerous for people to be out there walking if they have to walk a long way.
GLADYS LOPEZ, DO
That's absolutely correct. We actually just had someone this morning say they had an episode of dizziness yesterday. With this 90-plus degree heat that they were active in their backyard, so we have to be very mindful of that. Of course, we can continue to be active even when we're indoors. Even just doing some housekeeping can help you stay active. There's a lot of indoor activities or exercises that you could do. Nowadays there's things like YouTube. There's a lot of different applications you can download or subscriptions you can purchase that can provide exercise regimens for you.
RON AARON
We've got about 30 seconds. Dr. Lopez, last question should you talk to your PCP if you're worried about weight, is that the place to start?
GLADYS LOPEZ, DO
That is an excellent place to start. If you'd like, we have some openings within a month or so. Youre always welcome to come on in and discuss, but that would be a great place to start. Your PCP can help you tailor an approach for you based on your needs or goals.
RON AARON
Perfect. Desiree, do you agree?
DESAREA MURRAY, NP
I absolutely agree 100%.
RON AARON
Well, thank you. Appreciate both of you being here and our co-host, Desarae Murray. Thank you very much to our guest, Dr. Gladys Lopez. Appreciate all the information on diet and exercise. A lot of important information on some of the medications. Probably folks don't realize the downside that's involved. Thanks to all of you for joining us today on the award winning Docs in a Pod.
OUTRO
Executive producers for Docs in a Pod are Dan Calderon and Lia Medrano. Associate producer is Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. We welcome your emails with suggestions and comments on this program at radio@wellmed.net. Be sure to listen next week to Docs in a Pod presented by WellMed.
DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.
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