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Ania Jastreboff

lines on the record: 50
first: 2025-01-14
most recent: 2025-01-14
sittings or episodes: 1
sources: podcast

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“Yeah, absolutely. I mean, I always say people ask me, well, how did you know that you wanted to do this? The first time that I helped a patient lose a meaningful amount of weight for that person, I was like, I'm never doing anything ever again. This is it. And I'm so grateful that I get to do this. And I'm so grateful that patients trust me. They trust me to care for them. Again, I couldn't imagine doing that.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“That should not happen. Absolutely. Absolutely. Then, you know, look around, see if there's another healthcare provider, somebody who really knows how to treat obesity and understands that it's a disease, that this is not about weight loss, this is about weight reduction and optimizing health, opposed to pair them with the diet, the correct nutrition, the exercise, someone who really knows”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“The main thing that a healthcare provider can do when they're prescribing these medications to help avoid or mitigate those side effects is start low and go slow. Always start with the lowest dose. And then you do not have to go up once a month. You do not have to go up once a month. You go up as is right for that patient. So if a patient is having nausea, I do not go up on the dose. I let them stay on the dose, let their body get used to the medicine.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Well, it depends how much weight someone loses and how quickly because losing weight is a stress. It's a stress on our body, right? So we've actually seen the hair loss with things like bariatric surgery. And now with people who lose a large amount of weight in a short period of time, we're also seeing those types of effects that we saw with bariatric surgery. But let's focus in on the most common side effects, as you were asking about. So the most common side effects are gastrointestinal. So they are things like feeling nauseated, having diarrhea, constipation, and for some people vomiting. But there are ways that we can really combat those side effects. And again, they don't happen in everybody. So number one, what physicians or providers can do is invite their patients to share the side effects with their provider and make sure that the provider says, look, I'm not going to stop the medicine. Let's work through these together.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Yeah, that's a great question. And side effects do occur, right? With any medicine for any disease, is there any medicine for any disease that doesn't have side effects?”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Biology, if you decrease your blood pressure medicine, what's going to happen? Your blood pressure is going to go up. Same thing with your blood sugars for diabetes. It's no different with obesity.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“For some patients, maybe, but right now we don't know how to determine ahead of time, apriori. So basically that's why when patients, if they ask me to go off or some patients ask to go down on the dose, we try that, but then bring them in quickly because the hard part is if you start gaining back weight, that is so, you know, people think again, it's my fault. And it's not their fault. It's not their fault. If you detect out.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Yes, and it takes time. So the more highly effective a medication is, we're seeing it may take longer to see the effects. That's why the trials are getting longer.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Never going to go away. It's like once you have diabetes, you always have diabetes. It can be treated or controlled diabetes. Same thing with obesity. Once you have obesity, you always have obesity. Is it treated and controlled? That's the question.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“I know 20 years. So the earlier ones were a little bit different than the newer ones, and they were shorter acting and they had to be taken more daily rather than weekly. So there are differences there. But the point is that we do have data, all the trials. That's why we do all the trials. That's why I do all the trials, right? To make sure that the FDA has the information that it needs, not only to know that these”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Have been using Years. Yes, the first one was FDA approved in 2005. So it was nearly 20 years ago that these medications were first.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“So that's a great question and another very common question that we get from our patients. And first, you know, I'll start off by saying that as you've identified, there are risks to having obesity in and of itself, right? And when we treat patients for any disease, we say, okay, what are the benefits of treatment? What are the risks of treatment? What are the benefits of not treating or treating, right? We really look at all that very, very carefully. And right now all the data is pointing to the fact that these are very beneficial, but that doesn't mean that we don't have to do our due diligence, be very careful and monitor everything long term because millions of people are taking these medicines and millions more will take them. Having said that, GLP1 receptor agnists have been used for the treatment of diabetes for 20 years. Now, all of these medications also for diabetes.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“It's like Yeah. So those studies are being done. We think that, again, it's similar pathways in the brain that are being targeted. So just as you're craving or your hunger may come down as you're taking these medications in the same way you're craving for other things, other things that may be pleasurable goes down. Now that doesn't mean that makes you unhappy. You can just take it or leave it.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Well, and that is also being looked at. What are the effects in the brain in terms of, again, improving that? And we'll have to see that those studies haven't yet been conducted out as far as these other ones. So the heart disease, what is...”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Yeah, I mean, there are studies coming about heart disease, about heart failure, about improving knee pain, obstructive sleep apnea, and all of these are obesity-related diseases.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“It is the symptom, just like the blood, the high blood sugars are the symptom of diabetes and the high blood pressure is high blood pressure. It is hypertension. So the analogy is perfect with diabetes especially, especially.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“It's the same way with diabetes, hypertension, just because your blood pressure decreases or your blood sugars decrease doesn't mean you no longer have.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Another way to look at it because if you look at it as a weight loss drug. That's right. But the disease doesn't know away. And that is why I think so many patients ask us that for that exact reason. They're like, well, I lost the weight. Aren't I? I'm cured. I'm cured.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“And this is why this is actually critical when we think about the words we use. These are not weight loss drugs. They are medicines that treat obesity. They treat The disease processes in the brain.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Is we see the same thing in clinic. So that is the case with most of my patients. What I usually do when patients say, well, I really like to see what happens when I stop is I decrease the dose. I go down on the dose by just a little bit, by one step. And then I say, come back and see me in two, three months. And they come back and see me and we see how they're doing. If they're maintaining their weight and the food noise isn't back and they're not struggling, then great. We stay on that dose. But if their weight is starting to trend up or if that food noise is coming back and they're having a really hard time, then we go back up on the dose. And I do think that just as there's differences in how much weight people lose, we will see differences in terms of how much people gain back. So we'll see variability in that weight regain. But right now, for most patients on average, what we see and in the studies we've seen this as well, most people, yes.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“I mean, I think that's a great question. It's probably one of the top questions, if not the most commonly asked questions that my patients come to me with. Right now, what we do know is that obesity is a chronic disease. It's a chronic disease. So let's say that you had high blood pressure and you started taking a blood pressure medicine. What would happen if you were to stop taking that blood pressure medicine? Your blood pressure would go back up. Same thing with diabetes if you were taking insulin. If you stop taking the insulin, your blood sugars would go back up. And what we're seeing in not just in clinic, but also in trials, we just conducted a trial. It was three years with one of the medications is that the weight was completely maintained while people were taking the medicine. And then when the medicine was stopped, people started gaining back the weight. Now I can”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“I mean, I can't agree more. You literally can't win. You cannot win. You're shamed if you have obesity. You're shamed if you don't try and lose weight. You're ashamed if you lose weight. You're shamed if you use the master. Sense, there's literally no winning. So, you know, I wholeheartedly agree, you are sharing your story so vulnerably and bravely online. And you're fighting for what's right. And what's right is to stop shaming and blaming people. Do what they do. You're taking care of your health.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“The dose, and then the Let's say to 170 pounds. So with every dose escalation, you're chasing a new lower reset. Defended fat mass or set point.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“And it's different for every person. This is a really because there's more than one type of obesity, there's many different types of obesities. We just haven't defined them yet. But let's say so somebody starts at 200 pounds and let's say they start one of these medicines. Maybe with the first or the second dose. That set point goes down to Say 180 pounds, right? And then Medicine, and after some time.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Yes. And so what happens in obesity is that there's something that is dysregulated or broken in terms of the set point, in terms of how much energy we want to store. And the medicines, what we think that they do is that they re-regulate that set point. They decrease that set point. So as you start taking a medicine during that first phase when you're losing weight, what happens is your body is trying to chase a lower defended fat mass, a lower set point. And so that's why people eat less in that first phase than once they plateau, once their weight plateaus out, then some of the hunger and cravings and things can return, but the weight does not. And we have to reassure our patients that that's exactly what's supposed to happen because once you get to a new weight plateau, you're not chasing a new defended fat mass. So the medicine's lower or reset the defended fat mass or the set point. And then basically they re-regulate it to a new place.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“So, as we talked about hormones, nutrient stimulated hormones, they communicate with our brain to let our brain know how much energy to store, how much fat to store. The medicines they target the same receptors as these nutrient stimulated hormones.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“And if you begin the discussion of this is really about biology and that your body's smart and that the hormones are communicating with your brain and all these organs and your body and your body's doing exactly what it was meant to do, exactly what it was meant to do. And then again, patients start to. Start to let go, and there's something magical that happens in that moment because they become curious, curious about the disease of obesity and open to treatment.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“I mean They cry, I cry. And the thing is, there's something that happens in that moment where people begin that journey of understanding that it's not their fault and it's not something that they chose. And we're here to help them, to treat that biology.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“It's critical. It's absolutely critical. And when I approach this, so when I see a patient, the first thing I do is one, I set the stage and I say, this is a no judgment zone. And the first thing I ask them after that is tell me about your weight journey. Tell me about your struggles. Tell me, just tell me. Tell me, and then I listen, and as I listen to them, I bet you get a lot of”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“That's right. That's exactly right. And with obesity, for whatever reason, we have this different perspective and we need to change that.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“And here are the medicines. And for your mom, if it was insulin, right? And here are the medicines. So we pair them together to help that person's health, whether it's to help prevent all those downstream complications that can develop or whether it's to treat that disease in and of itself.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“When you have diabetes, yes. Things that happen exactly, and so diabetes is another perfect example. We say we recommend a low glycemic index diet, so less sugar.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Lots of Americans have high blood pressure. Exactly. So we say, okay, low salt diet is very helpful, and here are some medications that can treat the disease biology. And we need to do the same for obesity. We need to say yes, healthy diet and exercise are critical and they're very important for optimizing health and to treat the biology, the biology of obesity. Here's a medicine or medicines or surgery or what have you that will help actually treat that biology.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“That's right. That's absolutely right. And to get to your question of, well, is this the easy way out? Is taking medications the easy way out? It's not. Think about it. Think about when we treat someone who has, let's say, high blood pressure.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Yeah. And just like with alcohol, those reward motivation pathways, those regions in the brain really respond in a certain way when someone who has alcohol use disorder is drinking alcohol. In terms of obesity, those are the same brain pathways. Now, obesity is not an addiction. The thoughts of food and the wanting of food, that is something different. And again, that's...”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“And it's absolutely the opposite. It's absolutely the opposite. And none of this is in our control. Somehow in society, we think that how much we weigh is in our control. And it's not. It's not. Our brain is in control.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Now I know they were so wrong. Now I know why they were wrong when you're living it. It is so hard. Yeah, of course you blame yourself. It is so hard.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Colleagues, their families, and also Yeah. I mean, I couldn't agree with you more, and your story is one. First of all, I'm so sorry that you went through all this and in such a public way.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“They knew what they were doing. They had called you. But to your point about the fact that you're eating very healthily and you have for a majority of your life, again, the amount that we eat, and again, our body craves a larger amount of food. The amount that we eat is a lot more than what we actually need. So our body actually burns a lot. It's just that different people may hold on to less of that food than others.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Commercial. Get a bang of ruffles. And that's, and this is the thing. And maybe we'll talk about food noise, but that's what it is. If there is a bowl of brownies on the table, I would not be able to focus on you. I'd be like, I want the ice cream and the brownies. And the thing is, it's”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Other people don't Right, exactly. It's something, and that is actually why I started doing the research that I do. Because I thought to myself, well, why is it that some people crave potato chips and other people want the cheesecake or the Krispy Krems? So why is that? And the answer is right now we don't know. But initially I was doing these brain studies to really try and understand what that was about and what reward regions of the brain were actually responding. Let's say you saw a picture of a potato chip. How would your brain respond differently than somebody else's? And again, that has to do with ruffles.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Your brain. So, for example, for you, it's maybe potato chips. When you consume those foods, when you eat those foods. That signals to your brain something positive. So these hormones, they don't communicate with all sorts of areas of our brain, including reward motivation areas of the brain. So we find these foods highly rewarding. Our brain does. And the thing is, again, we were designed to function this way because let's say that we”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Obesogenic environment, so one that is filled with ultra processed food, lots of stress, lack of sleep, lack of physical activity, all these things are built into our environment right now.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“They may be, or your brain, it's because obesity is a neurometabolic disease or neuroendocrine, hormones inform the brain. So maybe in your body, your body's like, I'm really good at holding on to that energy. I'm really good at holding on to some extra fat just in case I need it later and somebody else's body says, no, I don't need that. But for most people where we started the conversation, for most people, we want to store more. We want to store extra. And that is where our body is happy. And that is what our body defends. And it's because of the environment we live in. And that tells us two things. One is we have to change the obesogenic environment. We have to because if we don't, we're not going to. And what do you mean by obesity?”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“And that's a really great question and one that we're trying to sort out and figure out what we do know is that for most people, maybe, you know, over centuries and millennia, we evolved in this way. We're basically, you wanted to make sure that you didn't starve, right? So you wanted to store enough energy so that if there was a famine, you would not starve. But if you think about this, this is actually very, very tightly regulated. So we all eat. Incredibly, we all eat a lot more than what we actually need. So our body actually figured out how to burn extra. But after a while with this obesogenic environment, it actually says, no, store it. Maybe I need it for later, right? So when we try and lose it, our body fights back and it says, no, no, no, no, no.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Every person's body, every person's body. And so basically it says, okay, this is how much energy you're storing. This is how much fat you're storing. And so you would think, oh, we have this beautiful biology. Wonderful. Then why do so many people have obesity if this is so carefully regulated? Well, it turns out that our obesogenic environment, an environment that is filled with ultra-processed food, lack of sleep, lack of physical activity, all this stress on a population level, that obesogenic environment that developed so much more quickly than the biology, it basically pushes up how much energy or how much fat our body wants to store. So our body ends up defending a higher amount of fat, the defended fat mass or the set point. These are terms that you may have heard, but that's exactly what our body's doing. So our body's doing what it needs to be doing, what it should be doing, but a little bit too much.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Yeah. And so it said, okay, how are we going to do this? Well, there are these hormones, they're stimulated when we eat food. They're called nutrient stimulated nutrient stimulated hormones. And they communicate with our brain, how hungry are we? How full are we? How much energy do we have? And so, this beautiful biology, so hormones inform the brain.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“And that is such an important and critical question. So, as you said, so many people have obesity now. And two-thirds of Americans and half of the world population did not wake up one morning and decide to have obesity. Obesity is not a choice. It is about biology. So what is obesity and why do so many people have it? And why is it so difficult not just to lose weight, but to maintain that weight loss? And so our body is amazing. It has this amazing, beautiful biology. And basically what it was designed to do is to make sure that we stored enough energy or enough fat because we store energy as we by storing fat.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Yes, body mass index. BMI's body mass index. Now we're really starting to rethink what that means. What does it mean to have obesity? And the indications for the medications were based on these initially. And now that's also evolving and changing as well because we're really trying to understand what is obesity, how does it affect our health because ultimately when we're treating obesity, the point is not just weight reduction. It's improving and optimizing overall health. That's the goal.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT
“Okay, so in terms of that first question, right now there aren't really great definitions. So we used to use definitions of BMI. Yeah. But BMI is really a screening tool. It's not something that was actually ever designed to be a diagnostic tool. So technically, overweight was defined as a BMI of greater than 25. And obesity as a BMI of greater than 30.”
2025-01-14 · The Oprah Podcast · Dr. Ania Jastreboff · IDENTIFIED FROM THE TRANSCRIPT