Skinny Shot Update: Dr. Basu’s Own Weight Loss Experience, Tirzepatide, Compounding Pharmacy Misconceptions & More

Dr. Basu (00:08):
Welcome back to Behind the Double Doors. I'm Dr. Bob Basu. Today we're talking about all things Skinny Shot and weight loss, and we're back to share some updates. So it's a new year and I know that just like me, many others that are listening have had their New Year's resolutions or weight loss resolutions, and most of the time those weight loss resolutions don't work out. What I'm trying to share is that it's time to abandon the weight loss resolution and it's time to join the weight loss revolution. And that brings us to the Skinny Shot and the Skinny Shot Pro. So we're offering two options for medical weight loss. I had mentioned before the Skinny Shot, which is Semaglutide, who we're now excited to also offer Skinny Shot Pro, which is also known as Tirzepatide. Now, tirzepatide was already approved for type two diabetes management, but most recently tirzepatide is the active ingredient in a brand name medication called Zepbound that was recently approved by the FDA for the indication of weight loss.

(01:19):
So what's the difference between Semaglutide and Tirzepatide? Are they similar? Are they different? Is one better than the other? Let's go over some of the differences. First, semaglutide very effective. It focuses on a receptor called the GLP one receptor. It's called a GLP one agonist. Now, I'm not going to get into the basic science and get everyone confused, but what that means is that the medication binds to a receptor that impacts how full you feel satiety. It slows down your gastric output, meaning it makes you feel full quickly, and it helps to balance your insulin and glucose so you don't get those insulin surges that makes you binge eat. Now, tirzepatide is different in that it also binds to that GLP one receptor, but it also hits another receptor called the GIP receptor. So think of it as a double whammy, a double attack plan. So tirzepatide in long-term studies has been a little bit more effective in losing more weight over time.

(02:25):
Now, I think both are effective options and we evaluate individual patients, their goals, their baseline physical health or baseline body mass index to guide patients what may be better for them. So how do I guide patients to the Skinny Shot versus Skinny Shot Pro? Well, if you're not sure I start patients out on the Skinny Shot, I think it's effective semaglutide. We've seen some amazing results with semaglutide, but if you've tried a weight loss medication before you plateaued, it didn't work as well, and you have a higher body mass index, meaning your height and weight ratio, your body mass index is in the high thirties or forties, or you're trying to be more aggressive with your weight loss, then I think at that point, Skinny Shot Pro may be a better option. So in summary, both are really good options for medical weight loss, and that's where you come in and visit with us with a consultation.

(03:21):
So we can guide you based on your specific needs and health status. So sometimes we get a question about why Tirzepatide or the Skinny Shot Pro costs more. Well, it's a newer medication and it binds to receptors, whereas the skinny shot binds one receptor. Does that mean it's doubly more effective? I think that's not necessarily an accurate way to describe the differences, although the studies do show that patients tend to lose a little bit more weight on tirzepatide compared to semaglutide. So simply put, it costs more because Tirzepatide impacts two receptors, perhaps being a little bit more effective with weight loss versus semaglutide, which attacks one receptor. I wanted to take this opportunity to try to clear up some misconceptions about compounding pharmacies. Sometimes there's a real misunderstanding and misinformation that compounding medicines aren't good or they're not the same where they're not safe, and that's simply not true.

(04:19):
And I'm here to clarify and educate you about what compounding medications are. So we source these medications from a compounding pharmacy based in Texas, actually in Houston. So we know the head pharmacists, we know this processes, they meet FDA guidelines and standards for sterility and safety. So these are high quality establishments that we source our medications from. And so this ensures the effectiveness of these medications that they're safe and they'll do what they're supposed to do. So why are we allowed to provide these compounding medicines? Well, the active ingredients such as semaglutide, tirzepatide are actually in some of the brand name medications that are out there that cost significantly more. So why are compounding pharmacies able to produce this for physician practices? Well, the FDA recognizes that there's a huge nationwide shortage of the brand name medications. So because of the shortage compounding pharmacies can provide these medications to physician practices so we can improve access to these treatments.

(05:23):
The reality is obesity is a nationwide epidemic and it's having significant implications to our health system skyrocketing healthcare costs. So these medications are made available so that we can help patients lose weight and lead a healthier lifestyle. Look, the downstream effects of weight loss, not just you look better, you fit better in the clothing. Of course, those are huge positives, but it's also losing weight helps to stave off and prevent diabetes. It helps with sleep apnea, it helps manage blood pressure and the medical positives of weight loss. The list goes on and on and on. And so we're really excited to provide the Skinny Shot and Skinny Shot Pro to really help people live better lives. You may be asking why is an aesthetic plastic surgery practice offering medical weight loss treatments? Well, if you remember, one of the reasons why I went into aesthetic plastic surgery is I want to help people live better lives, live more confidently, live their best life.

(06:25):
Aesthetics and wellness go hand in hand, and living a healthy lifestyle is all part of wellness and aesthetics. It goes together. And we see so many patients that struggle with their weight. Sometimes they're not candidates for surgeries or sometimes they're not getting the results they're wanting because of the weight they carry. They're just stuck. And so medical weight loss treatment options, I think is an integral part of what we offer as an aesthetic plastic surgery practice. Now we see all the ads out there. There are no shortage of strip mall clinics, online sources that are offering medical weight loss treatment options. And I can't really comment on the quality of their products or services. But I think what makes our practice very different for a patient who wants to lose more weight is that number one, a physician like myself and my team will evaluate you to make sure you're a good candidate.

(07:17):
We take the time to educate you about how this medication works. Now we also educate you that this is not a magic pill. We want you to be successful. We're invested in your success to lose weight, and that also means we want to make sure you're educated about what to eat, what not to eat. So nutritional counseling and how to eat portion control is critical. And last but not least, we want you to lose fat, but we don't want you to lose muscle. Every time I go to gym, I see someone that I haven't seen in a long, long time. They come back and they're pencil thin, and that's not necessarily a compliment. They look cachectic, they look wasted away. And my gut tells me they've probably been on these medical weight loss programs, but they weren't counsel correctly. They lost weight. But the problem is they lost fat, but they also lost muscle mass.

(08:09):
So one of the things that we try to do is to educate our patients that if you're doing portion control, it's really important for you to take protein and it's important for you to engage in an active lifestyle. Exercise is key. So you want to be able to maintain your muscle mass and if possible, build your muscle mass gain strength. So the goal is simple burn and lose your fat, but preserve and build muscle, and that's the way you get a healthier you, and that's the way you look healthier and not looking cachectic. So it's important we help our patients to lose weight the right way. Last but not least, look, weight loss has its impact. You can get loose skin, you can lose volume. With a board certified plastic surgery practice like ours, we have an gamut of non-invasive non-surgical med spot treatments that help tighten skin and restore and prevent volume loss.

(09:03):
And for cases that have more loose skin or more volume loss, we have an entire gamut of surgical options that may be the right thing for the patient to make themselves look and feel their best. So we've helped people lose weight for almost a year. So what have we learned? So we've learned a lot over the years. I've had patients that have lost 10 pounds. I've had patients that have lost 200 pounds and weight loss, and the experience is very different for every single patient, and that's why it's really important for you to follow up with us every four weeks so we can check in on you, see how you're doing. Some patients have barriers, they start out and they're not losing weight. But when we follow up with them, we dive deep on why they're not losing weight. I'll give you an example. One patient I'm thinking of, she was taking medical weight loss at the lowest doses.

(09:52):
Again, we start at the lowest doses because we want to find the least amount of medicine to get the desired effect. However, what we found out when we dove deep in her follow-up appointments was that she actually was not eating enough. She was actually not getting enough calories. She was not getting enough hydration. And so without getting too complex medically, what she was doing is putting her metabolism into a freeze that she prevented herself from losing weight. So when she started eating with our counseling and started increasing her protein intake, magically the weight started coming off and then she got back on track. So this is why it's so important for you to follow up with us every four weeks so that we can see how you're doing. So we can modify and adjust. Sometimes in some cases we have to go up on higher doses.

(10:39):
Sometimes it's about nutrition and diet counseling. Sometimes we have to get a patient to decrease their alcohol intake. Sometimes they have to hydrate more. Sometimes we've got to get them to go to the gym or work with a personal trainer. Every situation is unique, but that's why it requires a physician follow-up to make sure you're on the right track. And I really mean it. We're vested in your success. We want you to be successful and that's why you're coming to us. So we were talking about compounding pharmacies and to show you that I'm confident in their safety and effectiveness, I took some glide, the same medication that we offer to our patients. So I'm a Skinny Shot patient myself, I exercised. But to be frank, when I started my practice 20 years ago, I ate at the hospital all the time, working late hours. We're talking 14, 16 hour days.

(11:29):
I wasn't exercising and I gained a lot of weight and I exercise and try to lose the weight, but I hit a plateau. I was stuck, and most of my weight was inside the belly. Like most guys, right? Intra-abdominal fat, which is the hardest fat to remove, that's the fat that increases risk for diabetes and high blood pressure, joint pain, and the list of medical problems goes on and on. So I was stuck. I tried modifying my diet, but to be honest, I'm a foodie. I like to eat out. I like my food. So that's my guilty pleasure I guess. So I put myself on the semaglutide at the lowest dose and I added in portion control, which semaglutide forced me to do, and I slowly started losing one to two pounds a week, and I've lost about 15 pounds and I was able to wean myself off of semaglutide and I've kept the weight off.

(12:17):
Now, during the holidays, I gained a little bit of weight, so I did a short course of Tirzepatide, the Skinny Shop Pro, just to shed a few pounds to get me back to my happy place, and you can do that. So my experience with Semaglutide has been that I think it's quite effective, but if you overeat, you will get nauseous. And one way I knew that I was misbehaving with my portion control and eating too much carbs is I felt really nauseous the next morning. And you've got to listen to your body. You don't want to mask or cover up the nausea with taking anti-nausea medicines. You want to listen to your body and it forces you to adjust so you do the right thing for portion control. The other thing that I did that I think helped me effectively lose weight fairly quickly is I kept my protein intake up.

(13:06):
I was trying to do about 80 to a hundred grams of protein a day, and I just took an over the counter high protein, lower carb shake of your choice. I like Muscle Milk, I got it from Amazon. You can get anywhere. And I also work with my personal trainer about two to three times a week. I made a commitment to go to the gym, and it's hard with my work schedule. I love plastic surgery, I love taking care of patients, but I made a commitment at least two times on the weekends and try to squeeze in one workout during the week to do resistance training, to help maintain and build muscle so that I'm losing fat content, I'm getting leaner, but I'm not losing muscle mass. That was really important to me. So I guess I'm a success story. My goals were to lose about 15 to 20 pounds.

(13:46):
I'm at about 15, I'm happy there, and that's my experience. But I also experienced some of the nausea that can occur if you misbehave, if you eat too much, and being a foodie, that was my learning curve. That was where I had to adjust. And I'll give you an example. I like my steaks and I love my filets, and I learned that when I was ordering an eight ounce filet. When I'm on Skinny Shot or the Skinny Shot Pro, I'm going to have about four ounces, and the way I would describe it is the middle of the dinner, I would feel that someone flipped a switch in me that I'm full instantaneously. It would come out of nowhere. I'm full. And you have to listen to that inner voice because if you push beyond that and you have more, you're going to get nauseous the next morning.

(14:32):
And trust me, I learned the hard way. And so I don't want you to learn the hard way. When you feel that you're full, it's time to stop, right? You got to listen to your body and then you won't get that nausea in the morning the next morning because it's forcing you to do portion control. Long term, I feel that if we're on Semaglutide or terzapitide for several months, for some people that'll be three months. So some people, it'll be a year, some people will be two years. Everybody's different in how much weight they want to lose and how fast they lose the weight. But if you listen to your body and you adjust to portion control, you see the success of weight loss. You like your new, healthier you, you're going to learn a new pattern of behavior so that in the future we can wean you off this medication and you'll be just fine without it because you've learned a new behavior pattern and you like what you see and you don't want to go back.

(15:22):
Now we're all human. Sometimes you can have setbacks. And so if you do have a setback and you're just trying to gain weight, we have a solution for you. But my goal for my patients is I want them to adopt a new pattern of behavior, installing a new lifestyle forever, so that they don't need to be on these medicine lifelong. So what I'm trying to share with my experience is that the Skinny Shot and Skinny Shot Pro can be for someone that wants to lose eight to 10 pounds, or it can be for someone that wants to lose 80 pounds. It can be someone that wants to lose up to a hundred to 200 pounds. It depends on what your goals are. This is not just for someone who has a high body mass index above 35 or 40. It can be for someone that, like me was a mildly overweight, but I just wanted to focus on my intra-abdominal fat to be healthier.

(16:15):
And for me, that was about 10 to 15 pounds. And so it can be for someone that has some focal trouble spots that they cannot lose fat, and this is part of their healthier repertoire of exercise and better nutrition. So this is why everyone's different. Everyone has different goals, and so that's why it's important for you to visit with a board certified plastic surgeon on my team so that we can figure out what your goals are and create a customized treatment plan for you and follow you closely so that if there are setbacks, we're going to get you over them. So we're in this together. We want you to be successful and we're going to help you as long as you're committed to it and you're ready to do the Porsche control, ready to listen to the nutritional counseling and try to lead a more active lifestyle together.

(17:00):
We're going to get you over the finish line. And if you do encounter loose skin and laxity and volume loss, one of also the advantages of coming to us is that even if you can get a prescription from your primary care physician or another doctor, oftentimes this medication is actually not covered by your insurance or requires what's called a prior authorization, which takes a lot of time with no guarantee of success. So your first appointment will be a consultation where you fill out some paperwork so we understand what your goals are, what your challenges are. We get your height and weight. We will review your health status. We want to make sure that medically you are the right candidate. You're safe to proceed with one of our medical weight loss treatment plans. Then we educate about what the Skinny Shot is and what Skinny Shot Pro is.

(17:52):
We do some nutritional counseling. If indeed you are a good candidate for the Skinny Shot of Skinny Shot Pro, we can actually start your treatment on that visit, and then we give you all the supplies, the medications for the next four weeks, and we schedule your four week follow-up for you to check in with us to make sure you're doing okay and moving in the right direction. The nice thing about the Skinny Shot and Skinny Shot Pro is this requires no insurance. The costs are a lot lower even compared to insurance copays, and there's true price transparency. You know exactly what everything costs upfront. There are no surprises or hidden costs. Our hope is that we build a lasting relationship with you as you go through this and you trust us enough to ask for help with anything else that comes up. So how do you get started with the Skinny Shot or Skinny Shot Pro? First, give our office a call 7 1 3 - 7 9 9 - 2 2 7 8 or visit our website at basuplasticsurgery.com. That's B as in boy, A S U plastic surgery.com. Or follow us on Instagram at Basu Plastic Surgery.

Announcer (19:05):
Basu Aesthetics and Plastic Surgery is located in Northwest Houston in the Towne Lake area of Cypress. If you'd like to be a guest or ask a question for Dr. Basu to answer on the podcast, go to basu plastic surgery.com/podcast on Instagram. Follow Dr. Basu and the team at Basu Plastic Surgery. That's B A S U Plastic Surgery. Behind the Double Doors is a production of The Axis, THE AXIS.io.