Your Checkup: Health Conversations for Motivated Patients
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Your Checkup: Health Conversations for Motivated Patients
74: Why Your Body Fights Weight Loss: Metabolic Adaptation Explained
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Metabolic adaptation is a powerful physiological process that explains why weight loss is so challenging and why keeping it off can feel like your body is working against you.
• Your body burns fewer calories than expected after weight loss, creating an "energy gap"
• For every kilogram lost, metabolism slows by approximately 25 calories
• Weight loss affects hormones like leptin (satiety) and ghrelin (hunger) that control appetite
• Metabolic adaptation is a survival mechanism, not a personal failure or lack of willpower
• Research suggests metabolic adaptation is strongest during weight loss and the first few months after
• Evidence from "The Biggest Loser" contestants suggests extreme weight loss may cause longer-lasting metabolic changes
• Exercise (200-300 minutes weekly) helps counteract metabolic adaptation
• High-protein, high-fiber diets with low glycemic loads help manage increased hunger
• Even modest weight loss (5-10%) significantly improves health markers like blood pressure and blood sugar
• Medical interventions like GLP-1 medications and bariatric surgery can help address the hormonal drivers of weight regain
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Production and Content: Edward Delesky, MD & Nicole Aruffo, RN
Artwork: Olivia Pawlowski
Hi, welcome to your checkup. We are the Patient Education Podcast, where we bring conversations from the doctor's office to your ears. On this podcast, we try to bring medicine closer to its patients. I'm Ed Dolesky, a family medicine doctor in the Philadelphia area, and I'm Nicole.
Speaker 2:Rufo, I'm a nurse and we are family medicine doctor in the Philadelphia area, and I'm Nicola.
Speaker 1:Rufo, I'm a nurse and we are so excited you were able to join us here again today. So I was thinking well, last week we didn't talk about Trent and our experience at State and Liberty.
Speaker 2:We need to talk about Trent.
Speaker 1:We got to talk about Trent. Tell us about Trent.
Speaker 2:Trentrent. Well, we went to go get eddie's suit for our wedding at state and liberty in rittenhouse. Highly recommend it was so much fun, even for me and like I wasn't even getting anything yeah but trent was. How would you describe trent?
Speaker 1:how would I describe Trent?
Speaker 2:Yeah.
Speaker 1:He was an excited, stylish man who loved what he did and took great pride in helping people look their best. He was a calming presence, but also reassuring and discerning, because he also knew when something didn't look good and he wasn't afraid to tell you he was doing his job. He immediately told you when something was good and I appreciated that. Um, it was like you said, it was really fun. We were the first appointment of the day to take about an hour. Um, he asked us this disarming first question so what fabrics are you thinking of? And tweedweedledee and Tweedledum over here didn't know anything about fabrics and we're just like uh, and he's like uh, I want a black suit.
Speaker 1:Make it black please. And like I had no idea what to do, and so he just, I think he just took, like I knew I wanted a vest, that was like the thing I knew I wanted. But then, like these suits are great, right in the ballpark of other places I've gotten to get suits too, and it looks way better than anything else.
Speaker 2:Oh my gosh, it looks so good. I can't wait. I'm excited To get it.
Speaker 1:And I'm excited to go back. I'm a state and liberty guy. Well, it's an athletic fit store. It is For men with that V-shaped body. You know this is an audio show but you can't see me. But I'm going to state and liberty.
Speaker 2:It's got the athletic build.
Speaker 1:Some might say it's a place to shop for people with an athletic build. I like the store. It was fun, though. Did you have an athletic build? I liked the store, it was fun, though. Did you have any other takeaway? They were so nice. They were just really kind to us yeah.
Speaker 2:They really took care of us. Yeah, and we're probably going to go back and get some work clothes. Well, the thing is the secret button under the collar of their dress shirts, which is the thing that is the bane of your existence with collared shirts for work, because the collar is up or doesn't lay right, blah, blah, blah, blah, blah. But they have this hidden button like under the collar, so that it everything just lays right and looks nice yeah, look at now we need to buy like 17 shirts for them.
Speaker 1:Oh yeah, well, it bothers me because when the even if it's not so much a problem when you're wearing a tie, like it all gets bunched up and tucked in with the tie, but when you're not, and then you get what someone called the jersey flare, where I guess you look like you're like a club owner sloppy. And it looks a little sloppy and like the. The collar flares out a little bit there, looks a little sloppy and like the the the collar kind of flares out a little bit.
Speaker 1:There's like too much chest showing that like second button is like too far down, but the first button is like choking you and it's like what do you do? And then the collar is flared out. It's just a mess. So the hidden button yeah, huge hidden button guy, didn't even know it. Now I am you didn't even know you were looking for it no, and now I'm like I'm locked in and I I can't wait do you think trent will listen to our podcast?
Speaker 1:I think if we told trent that there was a a rave review of his services that he's the best and we wish we could hang out with him.
Speaker 2:I can't wait until your suit comes in so we can go get it and see him again.
Speaker 1:That's. I mentioned that. They were like emailing us too Like they were like letting us know and giving us updates, and.
Speaker 1:I was like this is so nice, it was great. Even that person who was on the phone call with us, who was like in the beginning, was nice, a little shocked that I was like only getting a suit for myself for a wedding and I was like I don't think that's such a big deal, but that's neither here nor there. Any last thoughts about trent I don't think so. Yeah, so what we also watched, or kind of snooze through um most recently, is this storm area 51. It seems like it's been out for a little while on netflix. It's part of this train wreck series, same thing as the poop cruise. This like film team. I guess it's like production company finds like unique stories and then like interviews people and gotta say, the guy who put this together, who got all of this like notoriety, only made 1700 from like selling shirts and not very entrepreneurial.
Speaker 2:No, not at all Missed opportunity Totally. I mean, he also was only like 20.
Speaker 1:Was he? Yeah, hmm, cause a lot of hoopla. Did you know this live when it was happening?
Speaker 2:Um, like very minimally Okay.
Speaker 1:Yeah, and then through this I learned well, I still have to look it up a little bit more about what fire fest was? Um, like very minimally, Okay, yeah, and then through this I learned well, I still have to look it up a little bit more about what fire fest was.
Speaker 2:Oh yeah, there are a couple of documentaries about that. We can watch them.
Speaker 1:Yeah, I I'm into a documentary recently. I'm liking learning about real things that happened in the world and having it spoon fed to me on the TV. I'm liking that. All right, we can watch some more. Yeah, we'll see. Tell us about the rest of our viewing experience.
Speaker 2:Oh, I think there was a new also, not to cut you off.
Speaker 1:That's okay.
Speaker 2:And then we can talk about that, because it'll be a good segue. Yeah, I think there's a new Hurricane Katrina one.
Speaker 1:Oh, that did just pop up. Yeah oh, that did just pop up. Yeah, yeah, saw that. Can add that to the list. We can add that to the list. Maybe we could talk about that next week. A very real thing for a lot of people.
Speaker 2:Sorry if you were affected by hurricane katrina um, okay, and then we watched the biggest loser documentary oh yes it was three episodes. I don't know what I was expecting Me neither. I feel like I don't know Because like they had a couple contestants, like previous contestants that were on, I guess they were supposed to offer like background information and like behind the scenes stuff, but I don't really feel like we got a lot of that.
Speaker 1:No, it was interesting to see like the producers come out and talk about their views, like they were making television first and foremost, and I think, like that's a yes, it was a very inspiring show. Yes, it was flawed, but like I think they own that, like they were, like we were out to make a TV show.
Speaker 2:Yeah, I think the public outrage that the biggest loser wasn't quote unquote ethical or healthy or safe. Yeah, you don't make a reality TV show about losing weight and it's not crazy losing weight and it's not like crazy.
Speaker 1:Well, I guess you know we were a big bob harper stands and there was a flavor of the show that like yeah, I mean cast him in a unfavorable light. Um, I found the dr hyzenga stuff really interesting, like how he like really advocated for the contestants like through and through, and that was met with, uh, countenance from the trainers and the producers who were really trying to steamroll him, and it does like get into a little bit of the power dynamic between the two. And I mean, growing up I always thought, like the even before I realized that I wanted to be a doctor, like I thought the dr haizanga stuff on the show was so fun and I was like, whoa, are you kidding, that's so cool. So I thought it was cool to have him on the show, like the documentary inspiration to be get certified in obesity medicine not really um, but it was cool to see.
Speaker 1:I didn't realize that he was like the team doctor for the raiders oh, I, know me neither no, I like charlie sheen randomly.
Speaker 2:Yeah, I mean, I guess you don't get the role of a doctor on any sort of reality television show by like just being like a random doctor.
Speaker 1:Yeah, that's a good point. You know that's a good point. Yeah, Julia Michaels was not in the documentary.
Speaker 2:Yeah, a lot of people don't like her.
Speaker 1:I think she has some weird views on the world that I've been seeing on threads.
Speaker 2:Yeah, I mean she's also like come out and basically said the show would like them like yelling during workouts and like being all like extreme and stuff was like all an act that the producers told them to do and stuff.
Speaker 1:Yeah.
Speaker 2:But she, yeah, yeah, that's all I'll say about that, yeah but bob harper was on traders.
Speaker 1:So like we love bob circulating in the the zeitgeist in the last year or two, like every year, like bob harper's got something else going on and good for him. I think I was left a little crestfallen.
Speaker 2:I was left wanting more. I was I don't know what that more is, but it didn't give me what I thought it was going to.
Speaker 1:No, I was. I'm glad we watched it Me too. Yeah, I'm glad we watched it. I was hoping for more Fredo.
Speaker 2:Our King Fredo.
Speaker 1:Yeah, I was hoping for more of him. I forget what season that's from, but he was a dastardly fellow that I wish there was more of on the TV, isn't he like from New Jersey or New York maybe?
Speaker 1:The area and you can just tell this guy had a whole following of like dudes on the show. It was funny. I wish they had more of him and I said like 400 contestants. They're probably like could have pulled a few more people to talk. The one thing that was crazy was like that first they had this um, spoiler alert, if you're gonna watch, okay, now we're gonna go. Um, the lady who was like running a running a mile legitimately almost passed away. She had rhabdomyolysis from running the mile. That's crazy.
Speaker 2:Is it rhabdomyolysis?
Speaker 1:You can just stop at rhabdo.
Speaker 2:Is that how you say it?
Speaker 1:Yeah, oh really, how do you think it should be said?
Speaker 2:Not like that.
Speaker 1:Rhabdomyolysis.
Speaker 2:Maybe Wait say it again Rhabdomyolysis. I've never heard anyone say it like that.
Speaker 1:Not just truncated to rhabdo. Yeah, no, she nearly passed away.
Speaker 2:Okay, but the interesting part, which is a great segue into today's episode, is that they talked about I guess, like the very small, limited study that they did, which was still interesting of essentially the people that lost a bunch of weight and then gained it back.
Speaker 1:Yes.
Speaker 2:And so what was that about?
Speaker 1:Yeah, so that, um, I've been meaning to talk about this for a while. So, like, as you mentioned, I'm like studying for the obesity boards, so I was like looking into this stuff and have been talking and thinking about these subjects more again. And it's a subject, it's a, it is a physiological phenomenon called metabolic adaptation or adaptive thermogenesis. Before we really get into too much of it, I want to let you know that the information from this episode comes from published research in obesity medicine, including guidelines from the Obesity Society and American Diabetes Association, as well as recent scientific reviews in journals like JAMA, the American Journal of Clinical Nutrition and Obesity. And, while we keep things conversational, all the details are drawn from peer-reviewed studies and expert guidelines.
Speaker 1:So the simple idea behind metabolic adaptation is it gets at the concept of why weight loss is so hard and why it is so hard to keep off. Specifically, it's not the only thing, but it comes up in a situation like this have you really ever worked so hard to lose 10 or 20 pounds only to feel like your body was fighting you the whole way? And then, when you do that, that it's pulling you back to the weight that it was before, whether it's by appetite or just making you feel like blah and you can't do more. It turns out that this isn't about a lack of discipline. What it is, at least in part, is that your body has built in defenses against weight loss because it is seen as a survival disadvantage Okay and it's known as metabolic adaptation. So the simple definition is that your body burns fewer calories than expected after weight loss, and I'll give a couple different examples here to try to illustrate this point. So let's say that someone weighed 250 pounds. Then let's suppose that they lose 25 pounds. Now they weigh 225 pounds, but if you compare their baseline metabolism to someone else who weighs 225 pounds but didn't just lose 25 pounds, their metabolism the person who lost the weight is proposed to be lower.
Speaker 1:This has been researched, this has been studied in different facets. It's been looked at in individual small cohorts. It was looked at in people in the biggest loser study and we can talk a little bit more about why that was so unique. But it's the idea that there is an energy gap.
Speaker 1:Another way to think about this is that there is a study done by this physician called Dr Kevin Hall, and another way to illustrate it is that it was suggested that every kilogram lost slows the metabolism your resting metabolism, by 25 calories and that it makes you 95 calories hungrier every kilogram you lose. People often get to a point when they're losing weight and they say like, oh, I've been losing my weight, I've been losing weight. And then they get to a plateau and you suggest that maybe someone has been in a calorie deficit. They've been eating less calories than they bring in. Energy out is greater than energy in helping them to lose weight. But this theory suggests that the body slows the metabolism where that calorie deficit may not be a calorie deficit anymore at all. Did you know about this?
Speaker 2:Well, no, not until you told me about it. Well, we mentioned it in our one obesity episode, I think too. Or like weight loss or something Like the general idea that you lose weight and then your body tries to gain it back, essentially, it turns on you, yes, which is really frustrating, but I also understand it lose weight and then your body tries to like, gain it back, essentially, and it turns on you, yes which is really frustrating, but I also understand it and there's a certain degree of now that we kind of understand what this is, um, and illustrate this a couple different ways.
Speaker 1:Uh, it's one thing to explain why it happens and there are this is complex thing Like your body doesn't like change. It's called homeostasis and your body likes things to stay the same and there are sounds dramatic. Yeah, there are like levers that the body pulls and there are hormones and like I'm going to give them names. I think a lot of people like there are a lot of things online when people just quote unquote hormones, but there are hormones that have names and functions. What are you grumbling about over?
Speaker 2:there. That drives me crazy.
Speaker 1:It drives me crazy too. But what I want to get at is that there are specific hormones that cause some of these things to happen. So there are two that I want to name and define. They're called leptin and ghrelin. Ghrelin is the easier one to define. It is a hunger hormone, and so when you lose weight or you're ready to eat, ghrelin goes up, and that's kind of the simplest way to do it and to think about it is that ghrelin is a hunger hormone and when you're hungry it goes up.
Speaker 1:Leptin is the other one. Leptin is a hormone that helps you think that you are satiated. So when it is up, it is making your body think that you are energy neutral or energy positive, like you've had enough to eat. Your leptin is high and you're not going to feel like you need to go out and get food anymore. And one place that leptin comes from is adipose tissue, which is also fat tissue, so adipose tissue is hormonally active. There are a lot of different hormones being sent out by adipose tissue and only one of them is leptin, and this is also kind of the base of where estrogen, testosterone, gets converted essentially into estrogen in fat tissue, which kind of supposes sort of the reason of why different cancers, like endometrial cancer, has increased risk for people who live with obesity because of this underlying feature. But let's say that when someone loses weight, leptin decreases and so when leptin is decreased, your body thinks it's in a starvation mode and that drives forward appetite, which makes you hungrier and makes you want to eat more. So in that little section there we defined two different hormones, leptin and ghrelin, but there are so many more of them. There are also implications of thyroid hormones sex hormones involved in this. There are also implications of thyroid hormones sex hormones involved in this, and these may implicate a slower metabolism and dictate fat storage throughout the body, whether fat is stored internally as visceral fat around the internal organs, which is the more dangerous type, or elsewhere in the body. There are other features that happen, other things that change to help this the shrinking fat cells themselves.
Speaker 1:When someone loses weight, the fat cells shrink and what eventually happens and this is a really interesting point when I was listening to these lectures is that the mitochondria become more efficient at burning calories or essentially creating energy and using it. They become more efficient, which is actually maybe better for you in the course of a lifetime. There was a whole lecture that I watched about aging and aging and the calorie deficit and calorie restriction and because they looked at people in Okinawa and they were like why do these people live longer than people who live on mainland Japan, like right over there? And one theory was that they just had so many, they had a huge calorie restriction compared to the people who live on Japan. So then there was this whole like aging lecture that I watched that supposed that if the mitochondria became more efficient or your body's cellular processes themselves became more efficient and used less calories throughout the day to accomplish the same tasks, there would be less iterations of the cells needed in the body as a whole and less aging. Because, like, none of this is like a limitless thing. Like you can, your cells can only divide so many times before it's like curtains, so Curtains Before it's curtains. So the idea is that if they can more efficiently do this, then they would be able to go and do it longer.
Speaker 1:So it's possible that metabolic adaptation might not be a bad thing in the grand scheme of things. It might just be something that is frustrating for people who are trying to lose weight because the body's being more efficient at doing what it does in living. There's also suggestion that there's inflammation that drops and that, like adipose tissue, is inflammatory in itself. There's. I mean, we looked at a lot of literature and research before this to collate this episode and the big take home point is that there are some immune cells that are still involved. There is some baseline inflammation that might still be there that may make someone more susceptible to weight regain as well. So that was like the meatiest, nerdiest part of the episode that I could possibly give you. Is there any like thought or further explanation you think I could give?
Speaker 2:No, I think that was great.
Speaker 1:But yeah, and before we get too far away from those hormones yeah, there's leptin, there's ghrelin. Everyone knows what GLP-1 is. Now, because of the medications, that's another one of these hormones. They're called incretins Not all of them, but like a GLP-1 or a hormone, pyy or cholecystokinin. These are hormones that are released after someone eats and communicates to the brain to say I'm full, you don't need to eat anymore, please stop eating, because if you do, I'll be too full and I'll feel uncomfy, and that's how that happens. So when someone's injecting a GLP-1, they're essentially telling their brain GLP-1, they're essentially telling their brain hey, relax, stop doing this. Like back in the day they tried to look at leptin. And can you inject leptin into someone and increase those levels and make people less hungry? It didn't bear out. I think it wasn't safe. Something happened, but they did look at this.
Speaker 2:Darn Right Could use a good leptin shot. But they're looking like you know, go to a med spa, get a B12 shot and a leptin shot, get a leptin shot.
Speaker 1:But there's, I mean, I think, now in the pipeline. They're probably looking at like PYY, or they're looking at I mean you have GLP, gip they're looking at. They may look at leptin again, who knows, but it's a complicated process that they're looking at to try to make safe and effective options for medications for the management of obesity. So just know there are a lot of these hormones. They do have names, they have functions. Let me try to keep it as simple as possible here without overwhelming you.
Speaker 2:So how long does this metabolic adaptation last? If someone loses weight, are they fighting this forever?
Speaker 1:Maybe Probably not, though it's an area of active investigation but what we could glean was it's most active during weight loss and within the first few months of weight maintenance. But there is a decent amount of suggestion in the literature that the metabolic adaptation may fade around 6 to 12 months if the weight stays steady. In episode 20, we talked about the obesity set point theory and there's some suggestion in that school of thought that if you stick around at the weight for long enough in a new environment it might stick, and so this metabolic adaptation piece may attenuate or get smaller. The thing we saw yesterday in the show and they even brought this up and I'm curious to hear your thoughts on the show here was in the Biggest Loser competition and it and I'm curious to hear your thoughts on the show here was in the Biggest Loser competition and it was a very small study.
Speaker 1:I think there were some 30 people, 30 contestants from the show, and they had some suggestion that between the start time and six years later that the metabolic adaptation which is a reminder is like your basal metabolic rate if you're sitting doing nothing and the amount of calories you burn decreases lower than it should with weight loss. That that persisted over the course of six years, which was unexpected, and that kind of still bears out in the literature with a big question mark. And they even talked about this on the documentary. They were like did we like hurt these people, did we ruin their metabolisms by doing this? And I still think the answer is I don't know. And I don't think they know either, because I think it has to do with how you measure this stuff too and it's reliable. But I think the theory behind it is that they were I mean, they said it on the show they were burning like 6,000 calories a day.
Speaker 2:Yeah, that was insane.
Speaker 1:And maybe eating 800. And so what the body was maybe doing was lowering the resting metabolic rate to accommodate the total energy expenditure, which is resting metabolic rate plus active energy expenditure. These people were doing 6,000 calories of active energy expenditure. The body's like please relax for a second, bro, and so it just kind of turns a couple knobs down, which as a compensatory mechanism makes sense to me. But then that it they suggest that it lasts for six years is a little confusing and I was surprised.
Speaker 2:Yeah, I mean also not everyone loses weight as extremely as they did on the biggest loser, but six years still feels like a long time. I think it is an extreme body to still be like ah yeah.
Speaker 1:I think it was an extreme use case the medical term.
Speaker 1:Ah yeah, and I don't think I mean I don't think many people listening to this show will have a very similar experience to them and perhaps it's not the most relatable case to think of, but maybe it illustrates the point to some degree that in extreme cases this is what metabolic adaptation is, whether this actually bears itself out or not. It does seem that they looked at in the study that it didn't necessarily correlate with the amount of weight someone lost but with the amount of exercise that they did, and that the people who exercised more may have had a more significant change to their baseline metabolism, to that theory, like that supposition I made before about trying to compensate for the energy deficit. All right, well, that was a fun little detour back to the biggest loser.
Speaker 2:So if someone is listening and struggling with, or thinks they are, what can help to counteract the metabolic adaptation?
Speaker 1:bring it up in conversation when someone's like struggling to lose weight upfront anyway and maybe they really have a great grasp of how many calories are going in and going out, or if they hit a weight loss plateau. I think it invites a conversation about recalculating a calorie deficit based off of, like where you were to where you aren't I don't know this like if this 25 calories per kilogram is something that like works for everyone all the time, but at least helps to illustrate that, like, if you lose two pounds, your metabolism slows down a little bit. If you lose 10 pounds, it slows down a little bit more and maybe you have to rethink. If you need to keep losing weight, you need to rethink where your calorie deficit is. I also think it invites a conversation that you're not crazy and if you're doing everything that you can to lose weight, that, like this is just it's your body, it's not you, it's not your fault. This is a really decent theory and science that this happens to people and it is not an indictment on your character or who you are like. This is very clearly something that happens to people, not something that people do, which I think is like huge. I think weight loss itself like a five to 10% total body.
Speaker 1:Weight loss can improve things like way more than just aesthetics when it comes to weight. Like that kind of weight loss improves diabetes. It improves cholesterol figures. Blood pressure Greater than 10 or 15% can put diabetes into remission, and so, like when we talk about this, that's where we're coming from, like these underlying things, these metabolic abnormalities and cardiovascular abnormalities that can be fixed with some lifestyle changes that are so important. And what else can you do about it?
Speaker 1:We talk a lot about 150 minutes of exercise per week, of a moderate intensity cardiovascular exercise. We talk about that in episode 10 in the power of exercise. The suggestion of some of the literature I was reading is that bumping that up can help maintain muscle and burn the calories in excess, and so moving that to 200 to 300 minutes per week of whereas diet and calorie deficits in weight loss are paramount, and so the scale for lack of a better word flips when it comes to weight maintenance. So increasing that number may be something to think about, maybe something to think about, and then staying attuned to basic foundational nutritional components like high protein, high fiber diets, low glycemic loads, to help kind of neutralize or at least curb your appetite so you're not feeling like oh, I ate this bag of like sour cream and onion chips all at once and I still feel hungry, but now I'm like a thousand calories down from where I should be.
Speaker 2:This sounds very specific and personal and familiar.
Speaker 1:It is very specific, personal and familiar. Hi, I'm Ed and.
Speaker 1:I love sour cream and onion chips more than I should. What's more is that the breakthrough in the science has been so important, especially when it comes to pharmaceuticals. I mentioned them earlier in the show, but medications like GLP-1s, which go by the names of Ozempic Wagovi, and the terzepatide component ones, zepbound and Moonjaro, help. They help with the appetite. So much of obesity is appetite dysregulation, and that's where these medicines step in, and so they themselves may blunt the hormonal signals that help drive weight regain. So that's an important thing.
Speaker 1:There are also other options, like bariatric surgery is still reasonable and on the table, and a fascinating thing is that after bariatric surgery there are significant changes to gut hormone signaling and anatomy that change the way people burn calories and the way that they process food, and it changes all of that hormone profile that we talked about before, and we're talking about people with durable weight loss of 25 to 30% after a year after a bariatric surgery. That's a whole different conversation that we've never introduced before, so I'm aware of that. So I hope this was helpful. It's a little bit of a winding road to discuss metabolic adaptation. It's a little bit of a vague, tough concept to explain. I hope I did it justice today. What do you think?
Speaker 2:I think it was great.
Speaker 1:Thank you. One core message that I really want to get is that if you've struggled, this is biology. It's not your behavior. It's not a failure of willpower. This is something that happens to you. So relax a little bit and take that burden off your shoulders. If you're listening to this, doing whatever, it's not your fault. We all can do better and it's okay. Just take the step forward and get that exercise in and make some better food choices. That's all we ask. All right, so thank you for coming back to another episode of your Checkup. Hopefully you were able to learn something for yourself, a loved one or a neighbor. Check out our website. You can find us on threads. We're very active there. You can send us an email yourcheckuppod at gmailcom. You can also send us some fan mail if you wish. We are very interested in everything you have to say. When you reach out to us, it's like rocket fuel. We love that sort of interaction.
Speaker 2:Yeah, we got a really nice message from someone the other day.
Speaker 1:We did. It was really really nice and we really appreciated that.
Speaker 2:Someone who we didn't know.
Speaker 1:Right. We had never met this person before. It was so encouraging.
Speaker 2:Usually it's like my mom, it is usually.
Speaker 1:So that was awesome and we look forward to having you back for our next episode. But, most importantly, until next time, stay healthy, my friends. I'm Ed Dolesky. I'm Nicola Rufo. Thank you, goodbye, bye. This information may provide a brief overview of diagnosis, treatment and medications. It's not exhaustive and is a tool to help you understand potential options about your health. It doesn't cover all details about conditions, treatments or medications for a specific person. This is not medical advice or an attempt to substitute medical advice. You should contact a healthcare provider for personalized guidance based on your unique circumstances. We explicitly disclaim any liability relating to the information given or its use. This content doesn't endorse any treatments or medications for a specific patient. Always talk to your healthcare provider for complete information tailored to you. In short, I'm not your doctor, I am not your nurse, and make sure you go get your own checkup with your own personal doctor.
