Exploring GLP-1 Drugs for Weight Loss with Dr. G and Peter Bernard

Exploring GLP-1 Drugs for Weight Loss with Dr. G and Peter Bernard

The latest episode of Open Forum in the Villages, Florida, hosted by Mike Roth, features Dr. Gerard Acloque, Jr., MD, and Peter Bernard discussing the benefits and challenges of GLP-1 drugs for weight loss and diabetes control. Dr. G, a well-known concierge doctor specializing in weight loss medications such as Zepbound and Manjaro, joins Peter Bernard, a retired TV reporter who has lost 36 pounds using Zepbound, to talk about their experiences and insights. They cover topics such as the origins and benefits of GLP-1 drugs, potential side effects, the cost of medications, and the importance of working closely with a healthcare provider. Dr. G also highlights his practice's focus on lifestyle changes alongside medication and offers telehealth consultations. The episode concludes with a short Alzheimer's tip from Dr. Craig Curtis.

00:00 Introduction to the Open Forum
00:32 Meet Dr. Gerard: Weight Loss Specialist
00:56 Peter Bernard's Weight Loss Journey
01:18 Understanding GLP-1 Drugs
03:08 Dr. G Joins the Conversation
03:54 Dr. G's Background and Practice
05:29 The Role of YouTube in Dr. G's Practice
06:22 Clinical Research and GLP-1 Drugs
08:15 Addressing Concerns and Side Effects
15:04 The Cost and Accessibility of GLP-1 Drugs
17:14 Compounding and Big Pharma
20:43 Kidney and Cardiac Benefits
20:50 Exploring Alzheimer's and Other Conditions
21:33 Side Effects and Safety Concerns
23:32 Hydration and Electrolytes
24:25 Effectiveness and Dosage
26:00 Long-Term Use and Lifestyle Changes
28:08 Consultation and Telehealth Services
29:37 Cost and Insurance Considerations
36:08 Final Thoughts and Contact Information
37:17 Alzheimer's Tips and Podcast Information

Contact Info: Dr. Gerard Acloque DR.G@floridaconciergemed.com  954 932 3269

FALL IMPROV - UNSCRIPTED FUN AND GAMES

 If you are a Villager, I wanted to remind you about our great new improv show coming up on September 29th at 6:30 pm at the Rohan Recreation Center.  The show is for Villagers. The funniest show ever.
Reserved seating at tables of eight. Bring your own snacks and favorite adult beverages. Get Your Tickets at My.AllEvents.in/improv92925   but remember  it is only for Villagers who like to laugh!

Have you heard about mature adults with Donna Hoover and Mike Roth? Yes. This is my second podcast and Donna and I are going to be addressing subjects which are significant for seniors, especially seniors living here in the villages.

The easiest way to hear the show is to look it up on Apple Podcasts. Look for mature adults with Donna and Mike. We'll be looking for you there. 

You can also find us on mature adults with Donna and Mike. All spelled out. Dot buzz sprout.com

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Transcript

Exploring GLP-1 Drugs for Weight Loss with Dr. G and Peter Bernard

Welcome to the Open Forum in the Villages, Florida. In this show, we talk to leaders of clubs and interesting folks who live here in the Villages to get perspectives of what is happening here in The Villages Florida. We are a listener supported podcast. There will be shout outs for supporters in episodes.

In today's show, one of our guests will join a few minutes late. His name is Dr. Gerard Acloque, Jr., MD, an internist and primary care physician. He's a well-known  a concierge doctor whose practice is in the Hollywood, Florida area. He has been specializing in weight loss using GLP one drugs for the past several years.

He does not accept insurance and is well known for his YouTube videos. He will be joining the conversation a few minutes late. We start today with Peter Bernard, a retired TV reporter who has lost 36 pounds on Zepbound in the past six months.

[00:01:04] Mike Roth: This is Mike Roth on Open Forum in the Villages, Florida. 

I'm here today with. Peter Bernard, thanks for joining me, Peter. 

[00:01:12] Peter Bernard: Good to be here. Mike, good to see you

again.

[00:01:13] Mike Roth: Good seeing you. And I'm seeing less of you actually.

[00:01:17] Peter Bernard: This is a good thing, 

[00:01:18] Mike Roth: yeah. We're here today to about prescription meds 

for weight loss.

We're actually, they really created by the drug companies for weight loss or was it for. Control of diabetes. 

[00:01:29] Peter Bernard: It was for the control of diabetes, type two diabetes and the whole weight loss thing, it's kinda like serendipity. They stumbled on it and found some of the patients that were getting, Ozempic, which is one of the originals from Novo Nordisk.

People were losing weight, so they did a little more research and decided, hey, this is a good weight loss med. Of course, Eli Lilly not to be outdone, came up with their own version of it. So now they have Manjaro and I'm taking Zepbound and it's working for me. 

[00:01:54] Mike Roth: Okay, so who makes Zepbound? 

[00:01:56] Peter Bernard: Zepbound is Eli Lilly.

Okay. And they also make Manjaro. Manjaro is for patients and for weight loss, it is zepbound. 

[00:02:04] Mike Roth: So is it's a slightly less strong 

[00:02:08] Peter Bernard: Nope. Nope. It's exactly the same. As a matter of fact, the label is exactly the same. I'm gonna hold it up to the camera. That's the Zepbound label. My, a wife at home is taking manjaro.

It's the same exact thing, except it's a different color and it says Manjaro on there. It's Tirzepatide, that's what the drug is. And then this is the that's what they call it, that's their labeled that's what they're that's what they call it when they sell it. 

[00:02:30] Mike Roth: And. How long actually on the market? 

[00:02:33] Peter Bernard: They're called GLP ones Glucco, peptide one Receptor agonists. I know that's a mouthful, but they've been around for a long time. There's other versions of it have been around that diabetics have been taking for years, but the problem is that you have to take them daily. These, they figured out a way to make it so that it doesn't break down and make sure that the half life is such that they last a week. So they've been around for several years now as far as weight goes in the case of Zepbound, it was okayed back in 2024 and is now being widely prescribed for weight loss. So there's millions of people across the country taking it right now.

[00:03:08] Mike Roth: Oh, it looks like we have Dr.

G joining us.

[00:03:11] Peter Bernard: Here we go.

Alright. Oh, now we actually can see you, Dr. G.

[00:03:15] Dr. Gerard Acloque, Jr. MD: How are you guys doing today?

[00:03:16] Peter Bernard: Doing great and yourself.

[00:03:18] Dr. Gerard Acloque, Jr. MD: Doing amazing, man. Just got a little behind on, on a patient I had to squeeze in, but we are here.

[00:03:23] Peter Bernard: All right. I figured that was the reason I was telling Mike. I'll bet he's got a patient that ran over and he says it happens.

[00:03:29] Dr. Gerard Acloque, Jr. MD: Yeah. Here we are. But we're here. Hi. Everything good? Your Mike and your Peter.

[00:03:34] Peter Bernard: Yes. Got nice to meet you. Nice meeting you. Feel like I'm meeting a celebrity. I've been watching your video since I started my zepbound journey.

[00:03:40] Dr. Gerard Acloque, Jr. MD: I appreciate that. I take, I humbly received that. Thank you very much. A celebrity, I don't know about all that. Just a doctor trying to make a difference in, in a space where there seems to be a lot of. Noise. I call it noise. A lot lies and a lot of, 

speculation.

Try to give you facts 

[00:03:54] Mike Roth: Let's back up and say, Dr. G, why don't you introduce yourself and tell our about how long you've been involved with weight loss medications.

[00:04:04] Dr. Gerard Acloque, Jr. MD: I've been a physician for, over 15 years now, training for over 20. If you had training in opened my office here in Hollywood, Florida in 2021, in, in the midst of the pan, like right at, in the tail end of the pandemic. Which was a good idea in a terrible idea at the same time, in hindsight.

But Felt it was time for me to move from the hospital space. Didn't like the way medicine was being forced. I was being forced to practice medicine in the hospital space as , as an employed physician. So I employed myself, took a huge pay cut and, but I got a lot of freedom and in that freedom I, I noticed that one of the biggest things that, we have as a barrier to care for patients is that, the way we practice medicine doesn't allow doctors to, to give, education. And patients are smart. People are smart. We, I'm not treating, I, I have doctors and lawyers and not, people are engineers. They come to me way smarter than I am. And , they don't have the information on the medical side on how to treat themselves.

So then, one of the biggest. Problems in the country, and this country is obesity, hypertension which then begets hypertension and diabetes and metabolic disorders and all that. So I am constantly teaching about, managing your weight, nutrition, sleep, and all the other things.

So when this, these GLP ones took off around the same time when I was opening my practice, I had an influx of patient coming from other places. Hey, doc. I'm on this medication compound or whatever, and I have no idea. Whoever it was, they so I was constantly doing that.

Decided to take it to YouTube. And here we are, 40, 47,000 subscribers later. 

Nice. 

Thanks. Thanks. Humbly, 47,000

[00:05:38] Peter Bernard: You put 'em together yourself or do you have somebody that spices them up? 'cause you have some good 

[00:05:42] Dr. Gerard Acloque, Jr. MD: Kyle's amazing. Kyle's amazing. He's, he is the I am the talent.

I am the, the brain behind the words that we say. But the visual aspect is all Kyle. He taught me the basics of lighting, the basics of, how to get started as a YouTuber, basically. Nice little camera, decent camera, decent lighting. And then making sure the timing is.

Put on it is uploaded correctly. He's the one who's pushing me, Hey, you gotta do three this week, you gotta do two, you gotta, so he's the marketing director behind everything. Kyle kudos to Kyle.

[00:06:07] Mike Roth: Cool. Cool. And that's a good way to do it. You create the content, hand it over to a marketing editor who can turn it into great content. I've seen one or two of your pieces in it. They look very good. Professional 

you. Thank you.

now before you, got involved or as you were getting involved with these GLP one drugs, did you look at any of the medical studies that Li Lily or anyone else had done?

[00:06:34] Dr. Gerard Acloque, Jr. MD: Of course, I am heavily involved in clinical research. I've not, and I'm super, transparent. I've purposefully not involve myself in any of the GLP one research because I don't want to be, I don't want to have any type of accusations of bias. At all because I talk about them so much, so I've, not purpose, but I am in my, in the research company that I work for, two of them, one of 'em is heavily into GLP ones and I like the endocrinologist he takes, he's the principal investigator on those.

But I'm always peeking in. Always peeking in, seeing what's going on, asking them what's in the pipeline, what things, we have all of these, all of the tach tide and of course semaglutide and tirzepatide and wegovy, all of those. We worked on those. Our office did.

I did not personally, I'm not on any of that, but yes, the answer is yes. I actually, one of my two most boring videos. Before I got with Kyle, it was about, when this, it blew up, the surmount and those things. And it's, I thought I was doing great stuff, right?

I had a little camera set up and I, Kyle was like, this is terrible. But it's those, I actually did go, that process didn't get a lot of view traction. People are not looking for that really. Most people wanna know. The basics about the medication, how it works, and you know what to do while on it. Not a lot of people are interested in the studies, but I read all that stuff.

 I think great.

[00:07:51] Mike Roth: So you've been using 'em with your patients for about how many years?

[00:07:55] Dr. Gerard Acloque, Jr. MD: We're going on three years now.

[00:07:57] Mike Roth: Three years. that's how many patient experiences? 

[00:08:01] Dr. Gerard Acloque, Jr. MD: Geez, we're approaching in the office over 475, close to 500 patients. I've come through here through insurance and cash pay combined. I have, about 400 patients that are treated with GLP ones.

[00:08:15] Peter Bernard: Doctor, some of the things that I run into when I post about it or talk about it, is people say to me, oh, you don't know the long-term side effects. You don't know what's gonna happen 10 years from now. What I always tell 'em, and I'd like you to weigh in on this, is. We do know the long-term side effects of being obese, and that is heart attacks, stroke, high blood pressure, and all kinds of other ailments that come along with being fat.

And I tell ' em, I hope to either forestall or eliminate that risk. Do you have an opinion on that?

[00:08:43] Dr. Gerard Acloque, Jr. MD: A hundred percent I. You, Peter. We do know the risk of being obese or, not carrying on a carrying around a healthy amount of weight. Too much fat. We need all of those things you mentioned. I'll add on, renal disease, I'll add on diabetes and its complications in comorbidities that come along with it.

And there are several cancers that are being associated with having a BMI greater than 27. Per 27, of course. Of greater than 30, for sure. So that's, there's just no disputing that. But let me get, lemme put another quiver in your, another arrow in your quiver there Peter, for the next time you get attacked with that craziness.

 True or false? The first GLP one was created and started in two. It was market in 2005. True or false?

[00:09:22] Peter Bernard: I believe so it's, it goes back many years.

[00:09:25] Dr. Gerard Acloque, Jr. MD: True 2005 for first FDA

drugs. They're not,

[00:09:28] Peter Bernard: This is not an experiment.

[00:09:29] Dr. Gerard Acloque, Jr. MD: We have long-term data. The GLP ones we have this idea in our minds. People have this idea in our minds that now because it has a new indication that it's a brand new drug. That's marketing that's research. That's how FDA in our system here works.

So we've taken a medication and we've repurposed it with a new indication, slapped a new label on it, put a new name on it, changed the dosage, marketed it different, and we're presenting the same sandwich. As a hoagie and was like, and people are like, wow, this hoagie is great, right? This place is restaurant's amazing.

It's the same sandwich, right? We just put a name, name on it, right? So we have long-term data of GLP ones. We have it. It's just not in the indication for weight loss. Do we know what the long-term effects are? At the doses That we're much higher? We do not. But data for GLP ones in our hands already.

Already got that.

[00:10:15] Mike Roth: Mike, and there, there have been several reports in the 

media about the negative side effects of GLP one. 

Can you talk about that for a second?

[00:10:24] Dr. Gerard Acloque, Jr. MD: Of course any medication name one any medication that doesn't have a negative side effect. That's what the clinical trials are there for. When I'm doing a clinical trial, we are obligated to report side effects and of course, what's called severe adverse effects. SAEs. And that's how you get these long commercials dah.

If you have this and that. You can't, you came in here, the guy's talking so fast 'cause the list is so long,

There is, there, there is, yeah. Basically no medication out there. Manmade and even, natural that doesn't have something that's adverse to it. We're putting toxins in our body hoping to get effects of GLP ones are related to how the GLP ones work. GLP ones slow down the digestion track. They increase insulin sensitivity.

 And of course one of the side effects that we found, and we now automated a the actual indication for the medication. It goes to the feeding center, the sat satiety center of the brain, and turns off that that's signaling. So the side effects are associated with that.

The worst of them all would be pancreatitis, which thankfully I've never seen here in my office when any of the 475, 500 patients I've treated. And that's because I just said it increases insulin. Where does insulin come from? The beta cells of the pancreas. So it turns it on, and if you get a, you crank up a pancreas and it doesn't turn off, it doesn't wanna turn off.

Then they got a pancreas is auto eating itself. It's just, it's not gonna just make insulin, it's gonna make all of the other. Enzymes that we use to digest, fats and other things, and that's called pancreatitis. So unfortunately there are a small amount of people that do that. But then you have constipation and gastroparesis and all that because of the slowing down the di So we can predict what is going to happen for the most part.

Very low. Very low incidents.

[00:12:01] Mike Roth: Yeah. So is there a treatment for pancreatitis? 

[00:12:05] Dr. Gerard Acloque, Jr. MD: Yes, there is it's called. IV fluids and pain medications 30, 40 years ago. May I say 40 years ago, one of the most deadliest killers of people who have gallstones and, or, people who abuse alcohol is pancreatitis, alcohol induced or gallstone induced pancreatitis. 34 years ago, it was such a bad thing that, we started studying like, how can we save more lives?

This was like 70% fail. A few years that, not too long ago, I'm not that old, but I was a long, I was a young boy at the time. Through the time when I went to going through medical school, there was, a bunch of studies were done in the ICU space and we found out if you control the pain.

And give a ton of fluids early. For the most part, we can save it and we drop that 70% down to 20, 15%. Now, I'm not saying that's a trivial, it's still a high amount of mortality, but we are, that's the treatment basically. And of course, stop the offending agent, whatever it is that's you're doing, stop.

If it's alcohol it's earth's a stone, I remove it. But yeah, not as fatal as it used to be 34 years ago.

[00:13:04] Peter Bernard: Hence the reason that when I talk to people about it, doctor, I say that you should not be going it alone and be aware and and keep track of what's going on in your body if you've got pain in your lower right side. Yeah, maybe that's something you need to talk to g, talk to Dr. G about, or in my case, my physician.

And so I think it's a thing that you don't get just to prescribe the drug and you're on your way. You need some counseling, and I know I'm speaking to the choir here, but you need some counseling. You need to know what you're doing along the way because there are side effects that can be bad.

I know in rats they determine that thyroid cancer, but no human cases as far as I know, have been detected. So that's not, that's a non-starter. Yeah.

 I agree, and these are the type of conversations that need to be had. When we start on the medication or any medication for that matter, speak to a professional, someone who's going to give you the evidence-based. Truth about whatever you're deciding to do, what are other things you need to accompany with it?

We know the medications aren't magic. They're not just gonna magically, seems like magic, but to maintain your weight or, actually get some good, weight loss on it, you've gotta do other things. You gotta get your nutrition together and. These things can be coached and, for instance that the, the scary or the scary thing about the cancer, the medullary thyroid cancer that was seen in in irrelevance was induced because during the rat portion or the animal portion of any clinical trial, we crank up the doses to dosage that you have mega doses.

And then we induce it and then now it sticks. Of course you have to say it right? So if you have a history of medullary thyroid cancer or pancreatitis, you are not. It's does a black box know? No notes? You should not. So again, like you said, talk to your doctor. Hey doc, do I have medullary thyroid cancer?

Some people don't even know. They might have a history back in the day and a family, whatever. No, I don't think you should take this. Or you've had pancreatitis. Did you know that? You shouldn't be honest. My sister gave me a dose. Don't do it.

Something I think we might wanna touch on. 'cause I think here in the villages there's a lot of people that will see this and think to myself, you know what? I wanna try it. I'm overweight and how many of us are not overweight? Raise your hand. I'm, most of us are.

I'm not anymore thank goodness because of this, but I think the cost is something that is a turnoff to a lot of folks. I had to do a song and dance with my Medicare Advantage plan. They had to write a prior authorization. And because I have OSA obstructive sleep apnea and five heart stents and a couple other things they eventually approved it.

So my out the door cost is 93. I'm getting I think that's a pretty good deal. But this little tube right here, four of them cost, like 12 or $1,300 for someone who just walks in off the street and their insurance company says yes. Do you think that Medicare eventually will say, look, being overweight, obese.

Is a hazard. So we need to get people down and maybe this is the way to do it. 

[00:15:43] Dr. Gerard Acloque, Jr. MD: Yeah I agree with you. The cost of these medications have to change. I think that they will naturally, that the market will, speaking in business coming outta the clinical side the market is going to, it's, it is gonna drive it down as more newer generations come in this tirzepatide or tirzepatide, some IDE prices will come down.

Will it come down enough that it makes it affordable for someone who you know, to go through insurance or even cash pay? Not sure. I do the fact that Lily and with and Novo has have decided to who to personally by themselves do their own Pharma Pharm Pharmac which have lower price.

Again, not, I'm not, I'm applauding the fact that they've lowered the prices, but again, those prices are still too high. Three 50 to 500, still too high for many people. I think that. You are right. The way what's going to really drive these prices down is if the government finally decides to do the right thing and treat obesity as a chronic disease that it is.

And if the biggest payer, the biggest insurance payer in the country is Medicare. And if they say, Hey, we're not paying this. We're paying this. That's what gonna push the market down. They're, Hey, we're, you're not paying that. And 

you're not dealing with any of your meds, then, gonna, 

oh okay, we can, we'll cut our margins down

All of a sudden, okay.

To pay less. So we were on that track. Peter, the last administration was on that track, left it for this administration to make a decision. They've punted on that. And, Medicare has not decided yet to make to negotiate prices directly. But at least it looks like they, they are calling, they're calling obesity or chronic condition.

They're just not ready to negotiate prices yet.

[00:17:13] Peter Bernard: Hallelujah. What about compounding? Doctor? I'm gonna, I'm, do you use compounding in your practice?

[00:17:18] Dr. Gerard Acloque, Jr. MD: I absolutely do.

[00:17:19] Peter Bernard: Okay, you are, I'm sure, very aware that there's some bad players out there in the compounding business. There are some good ones like Orderly and Mochi and some of the others that I think are doing the thing.

But I think there's a lot of others out there that are selling snake oil and could possibly be, hazardous.

[00:17:35] Dr. Gerard Acloque, Jr. MD: I agree with you. Full disclosure, I am a, an influencer for mochi. Started, I started this this, the speaking about their platform. We started that. Deal in middle of June, after a very long discussion, and I really got into them about a lot of stuff that I've heard and I, I felt, I was like, Hey, before, if I'm gonna bring this to my subscribers, I built, a trust with them as far as giving them solid information and all that.

And they, they've done the best they can. I think the problem with, not just mochi, but all the platforms is, supply. They're doing a good job. Like you said, they're trying their best, trying their best to give a, good medication from a good compounder.

But sometimes, with everything that's going on with DA, their supply gets cut off and all of a sudden they can't fulfill those those orders, then get frustrated. That's number one, right? You wanna make sure that you're the platform that you use has a steady supply.

That is good Now. You are right. There's a bunch of bad actors out there. I, my, my saying of, don't don't take, don't get your meds from the lady at the dollar store is basically saying that's what that's why I say that is because I'm saying get it from a reputable person.

Get it ordered behind a doctor. I personally went to the compounding pharmacy. Before, I had a relationship with them. I'd never gone there. But before I started selling or delivering compounded, GLP ones, I actually went to the pharmacy. It's local here in Miami.

Thankfully, I've not sourced my compounds from anywhere else. It works. I know it's safe. I know and they've been FDA, visited and passed with flying colors. So I think all doctors should do that due diligence. If you can't go, at least speak to the director, speak to the pharmacist, get some samples, see what's going on, and then you can start putting your patients.

These are our patients. I'm responsible for them and I feel so yes. You gotta use a reputable place, a reputable platform, and ask questions and go through your doctor for suggestions.

[00:19:18] Peter Bernard: But as both Novo Nordisk and Eli Lilly 

have been on the lawsuit war path, trying to shut down. I think mochi was served as cease and desist, if I'm not mistaken. Is it a possibility that these big pharma companies are gonna shut 'em down and cut off the supply of less expensive drugs for those that need it?

[00:19:37] Dr. Gerard Acloque, Jr. MD: I answered this question in a comment section of my one of the videos talking about what's going on with this? How couldn't I be? I was like big Pharma has two things that people are very scared of. Two things, two weapons, one high price lawyers, I two deep

of them.

So they can drag you out to the deep end of the pool and hold you there. And some of these companies you just fold, right? You just don't have enough to go through the, the discovery and, eh, they've got 10 lawyers, you got two, and you're trying to, make, keep your head above water.

So then, these companies are gonna fold. That's what's gonna happen, Peter. Eventually what's going on right now is the, these compound pharmacies are attempting to. Massage the rules. The rules say if the dosing is not available and patients need it, that's where compounding can come in.

Or if there's an additive that needs it. A lot of, you'll see people like, hi, all of a sudden I got my my, my GLP ones. It's pink. That's B12, right? So I, I think that is going to be something that you'll see the big pharma companies come at next. And hopefully if, this is a wonder drug.

I want everybody to have it or access to it. And I think that, as Peter, I'm sure you've deep, you've dug deep into it and you say it looks like they're using this for other stuff. What the heck? This works for the kidneys. Yes. Improves cardio cardiac function.

Yes. Maybe improves 

neuro dimension, all that.

Alzheimer's. What does it do

Are we using it 

for Alzheimer's?

Dr.

Are we gonna use it for addiction for the kidneys? Improves kidney function.

[00:20:56] Peter Bernard: Breast cancer. I something about breast cancer the other day.

[00:20:59] Dr. Gerard Acloque, Jr. MD: And I think that's a, I think that I, I breast cancer and they're now studying it right now for osteoarthritis.

Both of those, if you think about it, take more, take weight off of your knees and all your hips, now you're less on, on these pain meds. So looking. And then and then now the breast cancer I think is connected to actually obesity as well. Both are connected to obesity.

That's crazy how obesity can, it has so many tentacles into so many different things in this country. And just by dropping weight, we can cure and keep people off of, and, prevent.

[00:21:27] Peter Bernard: I'll deal with a little nausea if I can forestall or make sure I don't come down with all that stuff. Mike, you were chime? 

[00:21:33] Mike Roth: Yeah, there, are a couple other questions that come up as a side effect. I've read that people are losing their side completely or partially, as a result of taking the GLP ones and that the loss of sight is irreversible.

[00:21:46] Dr. Gerard Acloque, Jr. MD: That is a finding in the northeast of the United States in a very group of patients. So what happened was and of course, if you're a hammer, if you're a hammer, everything looks like a nail. And this was a group of ophthalmologists, eye doctors, that took a look at this, right?

And this condition n NAIOC believe it is it's basically the blood flow to the retina, to the back of the eye, which is the picture screen where project the initial movie, the blood flow to the eye and the optic nerve and optic artery gets shut down. This is something that we've known in diabetics long time ago. But as I said before, all side effects that come from these medications typically come from known effects of the medication. And one other known effects of the medication that we don't talk about is, GLP ones tend to lower blood pressure.

Don't know if you've noticed that, but your blood pressure is like a few points slower. And how it does that is be it. Yeah. And doctor didn't tell you that. It it has you through the kidneys decrease the amount of sodium a little bit in your body. You, it's a, it's called nature esis.

Resis urinating nature na plus sodium. Sodium urinating, right? So when you drop sodium levels, you drop the urine, you can't. Really urinate salt. You gotta urinate salt water. You, Dr. You. And that's where the dehydration comes from on the GLP ones. You urinate a little bit more than you used to.

That's why we're always saying hydrate. I am going to bet. And I don't have money on this. I don't mean I don't have any study on this. I'm gonna bet that the patients that are on GLP ones that end up having didn't listen to the hydration thing. And these small vessels that had your water in it collapsed down.

And here we go. So preventable, I believe. I've not seen it and I've treated diabetic patients on these medications. Thankfully, I'm gonna knock on wood somewhere, nothing. And that's because I'm on hydration. Hydration. Hydration is part of your process here. Yeah, it a small study.

[00:23:37] Mike Roth: How much water day did you drink? 

[00:23:39] Dr. Gerard Acloque, Jr. MD: You recommendation is your weight in pounds, half of that in ounces. So if you weigh 150 pounds, you should be drinking about 75 ounces of water a day.

[00:23:48] Peter Bernard: And then electrolytes.

[00:23:50] Dr. Gerard Acloque, Jr. MD: If you need to, if you're, if you feel that you're losing electrolytes in your activity levels, but you're not typically losing, you know you're gonna get sodium from your diet unless you're on a no sodium diet, which is, probably have a reason for that. But. If you're eating a nutritious Mediterranean diet with all types of colors and all types, you're gonna get all of the little things.

You probably lick your shoe and get the amount of zinc that you need. And if you don't you're not getting what you need. That's where you would probably get a a supplement with, B12 and everything else just to make sure. But electrolytes, sodium, potassium calcium, all of those things typically are in a very around diet.

[00:24:25] Mike Roth: What about, what percentage of patients that go on GLP get some of the side effects or any of the side effects, or what percentage don't get any side effects based on your

[00:24:36] Dr. Gerard Acloque, Jr. MD: I'd say about 50 to 60% of 'em get some sort of side effect. The question is the side effect so severe? Peter says he's gonna deal with nausea. I picked that up, that he has a little bit of nausea on it and he's okay with it. Is it so severe that it costs you that we have to stop?

Is the constipation so bad that it causes your intestines don't move like gastroparesis is paralyzed. Is the nausea so bad that you can't eat and hold down food and you're throwing up? Is do you have diarrhea that's dehydrating you upon, are this, are the side effects so bad that we can't mitigate them or live with them?

So again, the medications are pretty powerful. Some people need to get up to, for, to zip peptide. Five, seven and a half, some people up to 15. And then on the on the ozempic side, we're talking, on the wavy side we're talking about, up to one milligram. Typically I get them up to you and we got good effects. The key here, Mike, is to get to a level where you get all most of the good and a little of the bad that you can handle. 'cause you're gonna get a little bad somewhere if you go high enough, right? So what is the good. Appetite suppression, food noise is quiet and I'm losing weight appro appropriately.

What are we looking at? Two pounds. One and a half pounds or two pounds. Three pounds is amazing, right? When's the last time you lost 12 pounds? You're like never. Great. Why are you going to 15 milligrams? I want 20. What you want side effects,

That's 

you're looking for.

yeah,

yeah it's, and I was talking to a couple people yesterday and it's just 'cause people wanna go fast and that's you're find, we're gonna run into a problem.

So it easy. Go low, go slow.

[00:26:00] Mike Roth: is this long term and chronic that once you go on to the GLP ones, you have to stay on them unless you had severe side effects. That's the million dollar isn't it?

 All we gotta do in this life, sir, is pay taxes and die. Everything else is not a must, right? So while you're on, while you're on the GLP ones, if you can find a way to get your lifestyle to a point where you're actually steady and we can slowly retract the medications and you can come off the GLP ones.

Hallelujah. You fixed your lifestyle to the point. Your nutrition, my five pillars, nutrition, you got your exercise. Sleep hygiene, stress management and mental health awareness. And emotional intelligence. Knowing why you're eating, why you're not wanting to work out, why don't you wanna manage your blood pressure or your weight or all those, if you can handle those five things every while you're on the medications, of course, 'cause it helps you to quieten food noise so you can make a better, a deep dive into the ear and we can take it off and you can just, like riding a bike, take the trainers wheels off and there you go.

My son drives the rides now. Great. Amazing.

percentage of the patients can get off

I've gotten about 70% of 'em off.

really? In what of time?

Yeah, that's the question. So to get this, these habits down, to six months, typically six months. Six months.

Is that all? I thought you were gonna say three years. I'm surprised at that too.

[00:27:18] Peter Bernard: How long have you been I started March 20th and I've lost 36 pounds.

[00:27:23] Dr. Gerard Acloque, Jr. MD: So it's it but I'm not afraid to leave a patient for life 'cause diabetics are doing it for life and there's nothing wrong with them right now. What we have to do is find the dose that's going to keep you at a weight that you're not gonna continue to drive your weight down to zero.

The body doesn't want that, and that's not what we're looking for, right? ' cause after a while you're gonna start chewing up all your protein and your lean muscle mass, and now you become a sick, skinny person. So we wanna get you down to a maintenance dose that may be lower than what you're taking now for, actively losing weight or increasing the interval from seven days to 10 to 14.

Maybe have patients that come in once a month, and or both lower dose and an increase interval. We'll find that sweet spot for you that'll have you plateaued at your goal weight.

[00:28:08] Peter Bernard: Okay, Dr. GI was thinking it'd be helpful for some folks in the villages watching this if they're thinking about doing this after watching this podcast. How do you start? Do you think I don't want to have people go out and Google, I know you have Florida Concierge Medicine. Would that be a good place to, I.

Go online, 'cause I know you have the videos and you can get a lot of facts and figures. And then if they're interested, they, I guess they can call your office and you can do this on a telehealth basis, can you not?

[00:28:31] Dr. Gerard Acloque, Jr. MD: Yeah. For our, you we're in Florida, it's pretty easy. You can call and get on the telehealth program with me. If they want just a consult like we're talking right now, the, the nuts and bolts, what they should be doing, shouldn't be doing. Look out for how to be successful.

That's a consult or if you wanna get on our program. I have one program right now where I see patients on a monthly basis on a, they have one-to-one with me, 45 minutes, 30 minutes, and 45 minutes where we are talking through all of these things. And I'm coaching the five things that I talk about and my 10 steps on how to get there.

And then to get the one-on-one consults with me as part of the program, I send a hundred percent of those prescriptions either to Lilly direct or to Novo.

Oh, not

It's. N no I don't send, because Mochi is a platform, they can go to mochi and use my code and get 40 bucks off the first fine. Mochi does everything. They'll see a doctor. It won't be me. I don't see patients on Mochis platform. I am doing because the mochi relationship is, it's a little weird. You're like why would you do that? Because I can't see the whole world and I don't wanna see the who.

I want everyone to have access, right? So Mochi picks up the people who can't see me.

[00:29:34] Peter Bernard: What is the I know it goes all over them. What's the cost? I say on a monthly basis. By the way, I'm in a full disclosure. I'm with 9:00 AM Health, if you've heard of them. Man, I pay 1 49 for their services plus the cost of my drugs which is 93 for me. Would it be about in line with that?

[00:29:50] Dr. Gerard Acloque, Jr. MD: Yeah, we're at 397 for three months. We're only doing, we're doing, we do it quarterly. 'cause I want you to have, I want you to know that this is a long-term thing and I wanna see you for three months. My, my program now has gone to a quarterly model. So every three months you pay 397 for the three months.

That includes seeing me. And then you pay for the meds. So it's about in line with what you're paying. But 

[00:30:11] Peter Bernard: you pay less for the

Those 

Those compounded drugs, they're less than going through Lilly Direct or the Novo plan, right?

[00:30:18] Dr. Gerard Acloque, Jr. MD: Yeah. The compounded drugs are less than Lilly direct. I only do the compounds in my office. I don't ship out the compounds because I don't want, I'm doing YouTube. I've got patients waiting. Now I've got, I've got, I'm talking to you. I'm doing a million things. I don't have the wherewithal for it.

Fulfillment. And I don't want to fall short sending it. Hey, compound. Hey, you guys didn't send it? What's got, I got people waiting. So all of these, my GL GLP one program is all through the big pharma and they're doing a great job of fulfilling, especially Lily. Lily does a great, they get it, they send you a text like I'm on the phone, I'm still on the call.

I put it through Lily's already saying a text on their phone. For the meds and all they gotta do is confirm and pay and their meds come in 48 

Nice. Probably using the gift health pharmacy, correct.

No give help. No, it is straight from Lily. Lily direct. Lily Lilly has their own pharmacies based outta Ohio is the send the orders to and they fulfill direct from Lily. Lily not use and is no intermediary. And then so thing, same thing with Novo. Novo does the same.

So for our listeners who are wondering if any of the cost is going to be covered by Medicare or Medicare Advantage plans, that's a dead zero.

Yeah. I'm not going through the insurance of Medicare, like Peter says, and he can attest to, to the fight that he had to do that. I don't have the wherewithal to do that. And plus, I'm not the PCP of record. This will be all cash pay. My pro my, my program is all cash pay, no insurance, because yeah, the, too much red tape, too much back and forth fulfillment PAs and all that good stuff.

It just. Too much. So it's all cash pay. So on a, it'll be the quarterly for me. And then the price is separate from Lilly Direct.

[00:31:53] Peter Bernard: You don't write PA prior authorizations. What's for our

No, not with, not the Lilly direct because it's cash pay. Prior 

[00:32:00] Dr. Gerard Acloque, Jr. MD: authorizations. I'm sorry. I'm using I'm using jargon. I shouldn't use PA's prior authorization.

 Yeah. Transitions assistant, no, pa no, it

Yeah. I'm sorry about that.

describe there. If you have co mobility Mobil morbidities they may approve it, which they did for me because of zep bound is okay to treat OSA, which is obstructive sleep apnea. I think that's the one that got it for me. And by the way, Experiments now to see if I can not use my CP pap at night.

And I'm having my wife come in to see if I'm gasping for air and snoring and she says I'm snoring a little bit, but the gasping has gone away. That's good. You have to wait down. That'll get the, get most of

The weight. It's weight. It's the weight. It's definitely the weight.

[00:32:38] Mike Roth: We live in a society here in America where what? It's too easy to gain too much weight. Too easy. Yeah. We too many processed foods and we have, thankfully we have the economic ability to eat it's pleasurable

so Dr. G, in your practice you rec, you're recommending that people see you face to face or face to teleconference? At least once every three months.

No I see them monthly.

Monthly. Yeah.

Yes, sir. Yes, sir. Monthly. A lot can happen in three months. I prefer seeing 'em monthly.

great.

[00:33:09] Dr. Gerard Acloque, Jr. MD: And besides I, I fancy myself a, a lifestyle modification coach. I think I have the, the wherewithal. And that's where I think the real, the real heavy lifting is we need to find out what happened here.

Many people do have obesity, as a chronic disease, and it's. No matter what they do, they're, a little heavier. Great. I understand that. But other people have bad habits and we need to figure out if that really, are you exercising? Really? Are you really eating whole foods and nutritionally in, in the right proportions?

Are you sleeping the way you should? Are you managing stress and your cortisol levels are coming down? Insulin resistance is caused by that. And, are you, do you have a mental or emotional issue that's causing you to not work out or eat inappropriate? What's going on here? Let's dig into this and see if we can fix it.

So a monthly basis, I'm checking in and seeing what we're doing.

[00:33:52] Mike Roth: And what kind of weight loss are you seeing in a patient in the first month? 

[00:33:56] Dr. Gerard Acloque, Jr. MD: It's average anywhere between seven to. 13 pounds the first month.

I've seen higher 20. But, those are people that are really committed and consistent. But yeah, that's what I expect to see When you when the first month, if you're not doing that, I'm thinking you're not doing what you should be doing.

And I dig into accountability there, but but yeah, that, that's what I expect the first month.

Then it ramps up from there because then we're, I really get you going with resistance training. We dig into nutrition, I expect, consistently 15, 12 to 15 pounds a month.

[00:34:24] Dr. Gerard Acloque, Jr. MD: Now with other prescription meds they talk 

[00:34:27] Mike Roth: about bringing them in from Canada and saving a lot of money. Are people doing the same thing with these GLP ones, bringing 'em in from Canada?

Okay.

No Canada's ordering it from here. Canada has an issue with that. Can Canada's getting 'em from us from here. They're ordering from here.

 Oh, okay. Yeah. I think the future of this is Medicare. Getting on board and realizing that obesity is a chronic disease, and hopefully recognizing that people like me that are on Medicare Advantage plans, this is something you have to have. And if they don't give it to people like me, then they're gonna have to deal with all the other repercussions of being obese in the future, which is gonna cost a lot more.

Then the cost of my little 

[00:35:07] Dr. Gerard Acloque, Jr. MD: zep band bound, pens. 

100% Peter. You've got it. You've got it. So it's gonna take people like you and me to sit in front of the powers that be and, drive this into their heads that these medications are, at this point, the best. Weight loss medications we have ever seen. We've been looking for these meds since 1950.

We found them. We found them. Let's use them appropriately. Let's get the price down. Let's get more people on these medications and let's lead, let's change a little bit of our lifestyle. Let's get back to what we, when we were more active and aid a little bit better, right? I agree with you a hundred percent.

Yep. Thank goodness for the if this is off the wall here, he a monster venom. Wow. That's,

Old, the D, the Gup monster,

yeah.

when they found the sali and the saliva is where we discovered the GLP one. The activity GLP one looked for it in human beings and found out that we actually make the same similar hormone from our intestines. Pretty smart Peter.

A lot of people don't know that. That's good stuff. They, the

Hundred haven't been talking about Helio monsters today.

it's like a, it's like a lizard. It looks like a Komodo dragon almost.

I know what it is. we'll be talking about it. He's probably got a lobby of out ready to go here, I think we, we've held you up for enough time, Dr. G.

I appreciate, I really do. I'm humbled.

thank you for being with us.. Great.

 I love it. I was super humbled and I thank you and your patient and I'll give you my information. If anyone wants to do a telehealth visit with me just for education, I don't want to, I'm not trying to sell and I want to, I want people to get on these and be successful. It's a lot of money to pay for these medications.

Hate for you to be on it for six months and have a bad experience and just swear 'em off. Where, just because you didn't have the right guidance. So I do consults and yeah that, that'd be, it'd be my pleasure to do consults for your community.

Excellent. Excellent, FREE: Tele-Health VisitDr. G. 

[00:36:47] Edward: FREE: Tele-Health Visit

 Florida Concierge Medicine & Wellness

Dr. Gerald Acolque, Jr., MD

(954) 932-3269

Info@floridaconciergemed.com

https://floridaconciergemed.com

it

[00:37:01] Peter Bernard: Super nice meeting you. You're the same here as I see you on your YouTubes. Some people put on app or an error that's not you. Thank you for responding to my email. Great,

absolutely brother. I appreciate you reaching out. Peter. Nice to meet you Mike. You guys have a blessed day, man. Great day today.

too. Thanks. Thanks a lot.

Alright, bye.

Bye.

[00:37:17] Mike Roth: And now let's listen to a short Alzheimer's tip from Dr. Craig Curtis.

[00:37:24] Dr. Craig Curtis: All scientists feel. All doctors Feel that you should definitely engage your brain and get involved in crossword puzzles, Sudoku, whatever types of brain stimulation you enjoy and do it on a regular basis. 

[00:37:37] Warren: With over 20 years of experience studying brain health, Dr. Curtis's goal is to educate the village's community on how to live a longer, healthier life.

To learn more, visit his website, craig curtis md.com, or call 3 5 2 5 0 0 5 2 5 2 to attend a free seminar.

[00:37:53] Mike Roth: This is Mike Roth. Listeners, I'm thrilled to share with you this podcast, which is my passion project, to bring knowledge, inspiration, and things you need to know about the villages and the people living here. Be sure to hit the follow button to get the newest episode each week, or you can hit the purple supporter box.

Even a small donation of three to $10 a month makes a big difference. You can cancel your subscription at any time. Your support means the world to us. Stay curious, stay inspired, and keep those headphones on.

Remember, our next episode will be released next Friday at 9:00 AM Should you wanna become a major supporter of the show or have questions, please contact us at mike@rothvoice.com. This is a shout out for supporters, Tweet Coleman, Ed Williams, Duane Roemmich and Dr. Craig Curtis at K two in The Villages. We will be hearing more from Dr.

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