The Skinny on GLPs in Dermatology with Dr. Jennifer Soung

In this episode of the Skincredible podcast, you'll be able to discover the surprising links between GLP medications, inflammation, and skin health. This eye-opening episode features a very experienced dermatologist: Dr. Jennifer Soung. Dr. Soung practices at Southern California Dermatology in California, specializing in medical dermatology and clinical research. She and Dr. Lisa Swanson discuss how these drugs, originally designed for weight management and diabetes, are showing promising anti-inflammatory effects that could revolutionize treatments for psoriasis and hidradenitis suppurativa. You’ll learn how systemic inflammation fuels autoimmune skin conditions, and why addressing the whole body (beyond just the skin) is essential for effective long-term control. Dr. Soung shares her firsthand insights from clinical trials and her unique perspective on the connection between obesity, inflammation, and skin disease, revealing how GLPs may be revolutionary in dermatology.

This episode breaks down the science into practical approaches for safe medication use, side effect management, and strategies to incorporate behavioral health and lifestyle changes. Whether you’re a dermatologist, researcher, patient, or curious listener, you’ll gain knowledge about the future of inflammation-focused treatments and how they might help you, or your patients, feel healthier and more confident. Perfectly crafted for healthcare professionals and health-conscious individuals eager to stay ahead in medical innovation, don’t miss this essential conversation that blends science with real-world impact. You are sure to be inspired by the multidimensional approach to health!

Keywords

Dermatology, GLP, peptides, Ozempic, Semiglutide, Retatrutide, tirzepatide, Mounjaro, Wegovy, Zepbound, HS, Hidradenitis suppurativa, psoriasis, psoriatic arthritis, inflammation, weight loss, weight management, weight control, appetite suppression, ozempic blues, depression, Dulaglutide, Liraglutide, Saxenda, Victoza, Rybelsus, Diabetes, Hypertension, High blood pressure, insulin resistance, Trulicity, Exenatide, Bydureon BCise, Byetta, Adlyxin, Lixisenatide

Links, Attachments

More on Dr. Soung: http://www.jennifersoungmd.com

More information regarding Taltz/Zepbound discount program (no affiliation): https://taltz.lilly.com/savings-support#zepbound-savings-for-taltz-patients

Chapters

00:00 Intro and Welcome

01:00 Dr. Jennifer Soung: Dermatologist and Clinical Researcher

04:00 Everyone is on GLPs 

06:00 Having Cake For Breakfast Isn’t Healthy

07:30 Teaching Teenage Girls Healthy Body Image

09:08 It Takes 20 Mins for Natural GLP to Tell us We Are Full

11:00 Food is More than Nourishment, Food Counseling

12:00 Using GLPs For Skin: Psoriasis, Hidradenitis Suprativa

14:40 Fat Cells and Inflammation

15:30 Asking Permission to Talk Weight Management

17:00 Direct and Indirect Benefits of GLPs

18:30 Comorbidities of Disease

20:30 Zepbound and Taltz in Conjunction

22:50 Most Common Side Effects of GLPs

24:30 1 Pound 1 Week, Lifestyle Changes

25:30 Psychology: 66 Days to Become a Habit

27:00 Contraindications with GLPs

29:00 Ozempic Blues, Mood Changes

31:45 Rapid Fire Questions for Dr. Soung

36:40 Thank you and Goodbye 

The information shared on this podcast is for educational purposes only and is not a substitute for personalized medical advice. Always consult your  physician regarding your health.

Transcript

SPEAKER_00 0:04

Welcome to Skin Credible, where we tell you what you should know about your skin and how to glow. Because your skin's incredible.

SPEAKER_03 0:16

Hello, everybody, and welcome to another amazing episode of the Skin Incredible Podcast. I'm your host, Dr. Lisa Swanson, and I'm here today with a very special guest, a guest that inspired me to wear pink. I don't know why. I can't explain it. But when I was thinking about having Jennifer Song on the pod, I was like, I feel like I need to wear pink. So here she is, you guys, Dr. Jennifer Song. And Jen, I know you, but tell the audience who you are.

SPEAKER_02 0:50

Hi everyone. I'm Dr. Jennifer Song. I'm a dermatologist and clinical researcher. And I'm wondering why I inspired you to wear pink. Because it was not my favorite color growing up. Actually, growing up as a kid, I kind of wanted to defy being the typical girl. So I said I was not going to like pink. And I like navy blue. When I started to do a lot more speaking, one of my mentors told me, When you go on stage, you need to wear bright colors because it's really boring looking at someone wearing navy blue, black, and gray. And I thought, oh my goodness, that's probably true. So that's when I started wearing solid bright colors because it's a lot more interesting and pleasant to look at something and memorable. So maybe that's why instinctively you think of pink or bright color when you see me, because sometimes when we run into each other at conferences, I am wearing that bright color. But honestly, deep inside, I just like the simple colors, like even white, black, gray, and blue. And so I've really embraced pink at this stage in my life. And one of my favorite flowers is a peony. And that comes in all different shades of pink.

SPEAKER_03 2:11

I love it. I love it. Yeah, I mean, I don't know. I just think of you and I'm like, I should wear pink. I think it's bright and happy. And color affects our mood in a very quick way. And so I think it is kind of a trick for our brains to like make other people happy and you know cheerful and joyful. Um, and also I had a similar experience as a kid. So, Jen, have you ever seen me not in a dress? Oh my gosh, you're right. No. No. I am always in a dress. I do not like to wear pants. I like to be in a dress. But when I was a kid, I was super tomboy, never wanted to be in a dress. Never, ever, ever. And my younger sister was always in a dress and wanted to have like the twirly skirt and the ribbons and the bows and the fluff and everything like that. And then as we became adults, we completely flip-flopped. And now I'm the one that wants to be in the pretty dress and the pink colors and the bright colors, and she and she enjoys wearing pants.

SPEAKER_02 3:22

You know what? I kind of see it as like we don't have just one side of ourselves. Right. We can be and, right? You can like blue and not be a tomboy, and you can like pink and not be the total girly girl. Totally, totally.

SPEAKER_03 3:40

Yes. We're multi-dimensional. We're multi-dimensional. Well, wanted to have you on the pod to talk about a very important and evolving topic. So we know that GLP1 use is exploding. It seems like everybody is on them. And I'm saying that as somebody who lives in Idaho, and I can only imagine you living in Southern California. I mean, is there anybody in Southern California that's not on one of these medicines?

SPEAKER_02 4:12

Great question and observation. So one is I was a very early adopter because in my clinical research center, my research partner is an internist and an obesity specialist. And we've been studying these medications and clinical trials for more than five years. I love second component that I want to mention. So I was recently at a party. These are a close group of friends that we enjoy getting together and cooking together, and we're all foodies.

SPEAKER_03 4:44

Yeah.

SPEAKER_02 4:44

So at the last get together, I was really excited. I brought my like roast lamb.

SPEAKER_01 4:49

Yeah.

SPEAKER_02 4:49

And as we were sitting down eating and chatting, I noticed, why am I the only one eating? And I looked around the room and I go, you guys, like no one barely touched the lamb. And normally we'll consume the entire thing. Yeah. And they all looked at me and they're like, oh, we're sorry, we're all on GLPs. How come no one's sharing? I mean, that's how common it is now.

SPEAKER_03 5:19

I've heard even like restaurants are noticing like businesses down because people aren't like eating out and stuff like that. Which is crazy. I love I love an evening out, Jen. I like to go out to dinner. That's like my favorite thing in the whole wide world.

SPEAKER_02 5:34

Me too. Me too. And I think that one, there's definitely a balance. So that's what we'll be getting into today. Is it's not meant to take away your pleasure of everything in life. And GLPs are really useful in cutting out that craving.

SPEAKER_03 5:52

Yes.

SPEAKER_02 5:52

And sometimes I call it it's your relationship with food and understanding that because there's definitely an emotional aspect of eating for some people as well. Like, don't get me wrong, when I'm stressed, I'm like, oh, I want some chocolate. Yeah. Or I've been known to eat cake for breakfast and it's not healthy.

SPEAKER_03 6:13

What kind of cake? Are we talking like vanilla cake, white frosting, or like chocolate on chocolate, or like what are we talking? All of it. I all of it.

SPEAKER_02 6:23

Yes, Lisa. So uh I like all sorts of cakes and I like baking them too. And so that is my guilty pleasure, is is different kinds of cake. And so whenever you come into town, you'll definitely have to come over. You have to tell me what your favorite flavor is. So I like making interesting combinations of flavors. My favorite is a rendition of a peanut butter and jelly sandwich. So it's actually vanilla cake with jelly in the middle and a peanut butter buttercream frosting.

SPEAKER_03 6:55

See, that sounds nutritious. You got some protein in there with the peanut butter. Like I think that sounds like a balanced breakfast. It's basically like toast with peanut butter on top. That's and you know, talking about this has actually made me think of a bit of a tangential question. I know that you have you have three kids and you have two teenage daughters, right? Correct. And so how do you manage living in Southern California in general? Everybody's on GLP1s, body image issues, raising two teenage girls. Wow, that is a really good question.

SPEAKER_02 7:32

And I am figuring it out as we go. So my two daughters are 14 and 15. They're they're active. That's something that's been really important. One, it's healthy mentally to have exercise in your daily life and physically.

SPEAKER_03 7:48

Yeah.

SPEAKER_02 7:49

So so I role model it. They know they know that when I'm stressed out, I need a good workout, and they'll tell me, Mom, it's time for you to go get a workout. Yeah. And it's also a daily practice that I encourage playing a sport or having some sort of physical activity. For example, during the pandemic, I got a trampoline in our backyard because that was an easy way when they were younger to get physical activity. Now my girls are tennis players, so they play almost daily. So again, it becomes a habit. And then going along with that body image, I think is huge at this age. And on top of the fact that they're getting into makeup, deciding on what clothes to wear. We do talk a little bit about what is what is appropriate for wearing to school, how much makeup. Again, I think a lot of teaching happens indirectly and allowing them a place to explore too. Uh as a mom, I'm I feel like I'm always experimenting. My oldest is a boy, and so he's 19 and off to college. So very different from what girls are experiencing. And also understanding your own body's natural cues. And this is gonna tie back to when we talk about GLPs, is that it takes about 20 minutes once you start eating for the natural GLP to be made and secreted in the gut to make it to your brain to tell you that you're full. Yeah. And so this is why instant food is not so good because if you eat fast, you're not gonna sense being full. Yeah. And what you sense is that pleasure, which is the sweetness, the saltiness, this tastes so good. And then suddenly you've been eating fast and you're like, oh my god, I'm too full now.

SPEAKER_03 9:47

Yeah.

SPEAKER_02 9:48

Yeah. So slowing down and in eating is helpful. So then we can we can listen to our body's natural cues that tell us that we're full.

SPEAKER_03 9:58

I had this happen to me recently. I was getting ready to do a dinner program, and I actually now like to have dinner before I go rather than eating after I deliver the talk because it just ends up being too late in the evening. Anywho, I ran over to Starbucks. I was kind of crunched for time, and they have these packages with two hard-boiled eggs, and they have this stuff called mush. Have you heard of mush? No, I've not seen mush. Uh-uh. It's this overnight oat thing, and it's high in protein, 15 grams of protein. So I'm like, oh, perfect. I'm making good decisions. And so I get my two hard-boiled eggs and I get my mush and I eat it pretty quickly. Oh my gosh, and I was so full. Here, I thought I was making good decisions, but now I'm about to explode in front of a live audience.

SPEAKER_02 10:50

Oh my goodness. Uh, good learning lesson, right? Uh, we need to listen to our bodies. Same here. Now I learn as I age is that eating cake in the morning doesn't make me feel good anymore. Too much sugar and caffeine way too early. And I get these palpitations. While it tastes good at the moment, later, no, it doesn't feel good. It's not worth it. It's not worth it. Exactly. And so when we talk about GLPs, part of it is that behavioral therapy or counseling is understanding what habit is triggering us to reach for food. Right. Because food isn't just about nourishment and calories. It's also a very social activity too. And in certain situations, a coping mechanism. When we feel stressed, it's like stress eating because that temporarily makes us feel better. Yeah.

SPEAKER_03 11:45

Yeah. Well, we know that the GLP1s are being used extensively just in general for weight loss, for type 2 diabetes, for high blood pressure, to reduce the risk of heart disease, for all of these things. And we have even started dabbling in the world of dermatology, specifically in it seems like two primary disease states, psoriasis and hydrogenitis separativa. And you've done a lot of your work and research in the psoriasis realm utilizing these GLP1s. And so is this a treatment that you actively offer to your psoriasis patients? Is it something you talk about right away as you're going through options with them?

SPEAKER_02 12:23

It may not be the first treatment I'm talking about. However, I do address systemic inflammation when I'm talking to a patient who is new to me and coming to me and asking me about their treatments for psoriasis. So usually it's in conjunction with a psoriasis treatment. And the frame ship for me is really thinking, okay, I am a dermatologist. However, for a condition like psoriasis that is truly systemic. And so I call it psoriatic disease because it really infers not only affecting skin, but most importantly are the joints, and then possibly other areas of the body. And so when we look at our psoriasis patients, we have to look at them as a whole. You can't just treat one component. And while we have amazing medications now in psoriasis that can treat the skin 90 plus percent of the time, what I start to see is that you can get a patient clear or almost clear initially with your systemic treatment or topical treatment, perhaps. But this I'm talking when I talk about systemic inflammation, I'm really talking about the patients who have more extensive disease. Yeah. So, or they're in that 30% category who potentially who have arthritis related to their psoriasis, which we call psoriatic arthritis. These patients do well in their systemic, and then after maybe a period of time, maybe they have a couple recurrent flacks, or they notice, you know what? My joint pain was really well controlled and I had really great energy, and now suddenly I'm getting a relapse. Did the medicine stop working? Right. I'm looking for other sources of inflammation. It's kind of like the old days. I used to say, Oh my gosh, my clothes don't fit anymore. It's the clothes problem. They're changing the sizes.

SPEAKER_03 14:08

This brand has decided to alter these sizes on me. Or oops, did I dry this? Did the dry cleaner do this to me? I've gone through that myself.

unknown 14:19

Yeah.

SPEAKER_02 14:20

So these days I'm really exploring. Okay, this patient cleared their skin and was doing well, and then suddenly having a relapse. And now I try to identify other sources of inflammation. And we know that. We've known actually dating 20, 25 years ago, there's research looking at obesity not simply as a storage molecule, but another source of inflammation. So adipocytes or fat cells aren't just simply storage molecules. They release many inflammatory proteins called cytokines. So now I explore, okay, well, what else is going on in your life? Are there any unusual stressors? Have you had a recent illness? And how's your weight doing? You know, there's this gradual, and this is really common, whether it's post-holidays, you've done some extra eating or gone on a cruise and you have this all-you-can-eat buffet, or just over the years, as our metabolism changes as we age, this weight creep. And that is going to contribute to more inflammation. So how I frame it to patients is one, I'm worried that your weight is starting to impact your health. And that's how I open up the conversation. Or sometimes I patients know, right? And they're like, I've been told I need to lose weight. So rather than saying the same thing again, is like, hey, have you ever thought about weight management? And asking permission to talk about it. When they're ready, they're really excited and they're like, I'm so happy you brought it up. And in other situations, maybe there's some other life circumstances going, you know what, Dr. Sign, that's really hard. Can we save that for next time? Right. Right. Yeah.

SPEAKER_03 15:54

Yeah. I think that's a good way to kind of open up the conversation. And you bring up really a really a good point because a lot of patients with psoriasis have a tendency to be overweight or obese. We see the same trends with hydrogenitis separativa. So at first, when we were thinking about these GLP1s in this space, we were like, oh, well, it helps them to lose weight. And that lost weight is what is helping the psoriasis or the HS. But now we're learning that there's more to this story that GLP1s can actually have anti-inflammatory benefits too. So it's not just the weight loss, but it's also decreasing inflammation in the body. I think we're all learning inflammation is what breeds disease in our bodies. And so anything that's anti-inflammatory is going to help us significantly with our general health.

SPEAKER_02 16:37

Right, right. I don't want to overly simplify as just inflammation. There's certain types of inflammation that we're referring to. And in these, in these patients who have a chronic autoimmune skin condition or systemic condition, it's a very unique type of inflammation. What you're speaking to are the direct and indirect benefits. So indirect benefits of these GLPs not only include the weight loss, the improved metabolic health, like wow, we're able to reverse high blood pressure, diabetes, high cholesterol. And don't forget about the body image. My patients come in and they say they feel like a new person and they are so alive. Then we are now delving into the direct benefits. So, in fact, the observation that there is a potential direct benefit of GLPs was observed actually 20 years ago with the initial discovery of GLPs. It was actually at the University of Toronto, and it was an endocrinologist who discovered GLPs and a dermatologist who noticed this relate, yeah, this relationship. And there's a publication on this. There's GLP receptors not only in our brain, our gut, but also in immune cells. And this is where there is that potential direct benefit, possibly, that GLPs are directly inhibiting these inflammatory cells that are key in psoriasis.

SPEAKER_03 18:07

And you've been a trialist in a lot of these psoriasis studies, utilizing GLP1s andor utilizing GLP1s in combination with a psoriasis biologic. What would you share with the audience about what you've learned through that experience?

SPEAKER_02 18:23

To me, it was okay, our psoriasis patients have all these other comorbidities, specifically diabetes, high blood pressure, and high cholesterol. So it just made sense. Like I have them on my psoriasis treatment, but let's address their other health conditions. My goal was always to make the patient healthy as a whole. And that's when we started to notice wow, if their diabetes was not well controlled, that would somehow influence the ability to control the psoriasis well. And when the psoriasis was inflamed, it seemed like, oh my gosh, their diabetes, their other health conditions were really hard to treat. And how can you just treat your one organ by itself? Right.

SPEAKER_03 19:03

Yeah.

SPEAKER_02 19:03

So a lot of times it was really my patients who came back to me and and started asking me because of our long-term relationship and treating oxterasis, that they asked me, hey Dr. Song, what do you think about these GLPs? I didn't start off by by telling patients, oh, you need to be on a GLP. It was like, hey, Dr. Song, you do a lot of research. I'm curious, can I go on a GLP or is there a drug interaction, or what do you think about these GLPs? And that's when I started to see a demand from my patients asking me, because really the demand from our community is interest in using these medications, and the healthcare community can't keep up. That's why you see so many different sources of getting these medications, right? Literally, you can just place an order through an email, and I feel like you can get a GLP. And thankfully, in general, these medicines can be pretty safe when dosed correctly and in the right patients. However, I tell my patients, I want you to get it from a credible source, a pharmacy. I'm not sure what some of these compounding pharmacies are putting in it, and that makes me worried. I started prescribing them about two years ago because it was my patients who wanted them. I'm not always going through insurance because insurance, especially in California, is really complicated. And the criteria for going on a GLP that is covered by insurance is getting more and more strict. The company that makes ZEP bound has a program that allows you to take TALTS. If you're officially approved for your psoriasis treatment with TOLTS, then you can also get ZEPBON at a really reasonable cost because this year in March, the first study studying both a biologic medication for treatment of plaxporiasis and psoriatic arthritis used in conjunction with ZEPBON in particular for patients who are overweight with one comorbidity, meaning like high blood pressure or high cholesterol diabetes, went on these medications and really showed the synergistic effect. So for plax psoriasis, you got 40% more improvement with ZEPBON compared to the psoriasis medication alone, TOLTS. And in psoriatic arthritis, the improvement was even more. And that makes sense because in psoriatic arthritis, the inflammation is truly systemic. This is when the inflammation has gone beyond the skin and involved the joints. 60% improvement in the arthritis when you add Zetbound to the TOLTS treatment.

SPEAKER_03 21:35

I think that's so cool. And yes, for those of you out there that are less familiar, so Zetbound and TALT are both made by a company called Lily. And so they have this program where you get approved for the TOLTS for your psoriasis and you actually get a great deal on ZEPBound to use them in conjunction. Speaking of kind of sourcing these medicines, I feel like there are so many legitimate programs in place, either through drug companies or Through reputable pharmacies to help get patients these drugs in a safe way at a good price. I don't want people to go to the black market to get these medications. Talk to your doctor, whether it's your primary care doctor or your dermatologist or whoever you see, talk to them because there are ways to navigate this in a cost-effective way and keep safety in mind.

unknown 22:22

Right.

SPEAKER_02 22:23

The manufacturers of these GLP medications have worked really hard in conjunction with the government and the FDA to make these medications affordable.

SPEAKER_03 22:31

Now, I think we all have our, I call them our spiels when we're talking to patients about a particular medicine. Like I have my Accutane spiel and my have I have my dupixin spiel. What is your spiel when talking to patients and families about a GLP one?

SPEAKER_02 22:47

Well, first I tell them about the most common side effects being all GI related. So nausea, vomiting, diarrhea, and constipation. As a physician scientist, I go back to how the medicine works. Remember, this mimics the natural Gukagon-like peptide hormone that is meant to help you feel full and it slows digestion. That's why you get constipation. Some people can get diarrhea. And so what that means is that we are going to start low and go slow and then titrate slowly up. Also, it means drinking plenty of water and getting fiber. So if a patient has a tendency to get constipation, I'm telling them, you know what? I want you to start off with metamucle and muralux daily to minimize the chance that you're getting that constipation. Generally, it's really well tolerated. In the clinical trials, we pushed patients to the highest dose to see what would happen. And this is how we learned about the range of side effects. So definitely at higher doses, you're going to get more of the nausea, more of the constipation. And in those situations, you can temporarily use prescription medications. However, the great thing is most of these side effects are really dose related and can be mitigated with the right counseling.

SPEAKER_03 24:03

I love that. In your practice, if somebody comes in and says, I'm dealing with this and that and the other thing, what are your management strategies? You meant you mentioned fiber, maybe some mirror, drinking plenty of water, any other tips, maybe lowering the dose? Exactly. Just don't uptitrate so quickly.

SPEAKER_02 24:20

I know the temptation because patients have heard how much weight you lose, they just want to lose the weight fast. I like to check in with patients after the first month, see how they're doing, and then decide. In my personal practice, working with my obesity specialist, about no more than a pound a week. That's a lot of weight. Yeah. And losing that weight is already really fast. Along with that is all the other education I think is so important to maintain the weight loss. So I look at GLPs as an additional tool and an integrative approach to treating the patient. So along with their GLP, I want the patient to start incorporating exercise if that hasn't been the case in their lifestyle. Start learning about what is a nutritious diet. It's not simply just losing the weight. And then that third counseling component, in order to maintain weight loss in the long run, unless you're just always going to be on your GLP, that might that might be that patient's decision, is you're gonna have to change a habit. And as we all know, changing habits is really hard. Really hard. It takes 66 days to do the same thing over and over to become a habit.

SPEAKER_03 25:33

I read that same study. I read that all the time. To my patients when like they they're not they're having trouble using their acne medicines. I say, you know, that's okay. It takes time. It takes 66 days. We must have read the same study years ago.

SPEAKER_02 25:46

Yes, yes. And so, and it also requires you to be intentional, right? To pause instead of being reactive and going back to the same habit. Uh, a real a trick that my my research partner taught me is instead of reaching for that food, because like, oh, I feel like having a cookie or chocolate is pausing for a second and counting to 10. Do I really want this right now? How much do I want it and why? It helps you develop a habit of being intentional with food instead of being reactive. And I also tell the patients I'm only one in your team of doctors who's going to help you. I can't do, I don't do all the counseling. And I'm the last person to tell you about exercise. When you lose weight, you're gonna lose muscle and fat at the same time. You need to build muscle while your loot is it losing weight or maintain that muscle mass as well. So, so it does require a team of doctors.

SPEAKER_03 26:40

And are there any pre-existing conditions a patient might have that makes you think, oh, maybe a GLP one isn't right for them? Like I deal with horrible reflux and take medicine for it and all that. And and because of that, I feel like GLP1s are just not really a great option for me because I think I need I need everything to keep going through. I need that acid to keep going down. Great question.

SPEAKER_02 27:04

So, some important things that we saw in the clinical trials. One is any sort of gallbladder related pre pre-existing condition. So you if you've had a history of gallstones or um just gallbladder inflammation or history of right upper quadrant pain and it hasn't been or right upper abdominal pain and it hasn't been looked into, then you definitely want to figure that out before starting a med a new medication. And so GLP1s have been shown to have an association with any sort of like gallbladder conditions. The other situation where it is considered what we call a contraindication, so would not be ideal, is if you've had any history of pancreatitis. So that's inflammation of the pancreas. Large clinical studies have not confirmed an increased risk, and they're mainly case reports at this time. However, any patient who has a suspicion of pancreatic inflammation, one, the medication should be stopped right away, probably not ideal for the patient at this time. And the great thing is there are so many newer options that are being studied for weight loss. I think some other and those, and and then one more is really thyroid concerns. So in animal studies, they saw possible increased risk of medullary thyroid carcinoma, which is a very specific type of endocrine kind of tumor. Studies have not confirmed the risk, however, it is listed on the package insert as a warning. So that means that any patient with a history of thyroid cancer and specifically a syndrome called MEN, which is a very rare disorder caused by a mutation that results in multiple tumors in the endocrine glands, would be that unique situation where GLP is not indicated in that situation.

SPEAKER_03 28:55

I'm glad you mentioned that because I always hear that on the commercials. Like, tell your tell your doctor if you have a history of medullary thyroid cancer or M E N type 2. And I'm like, you know, nobody has ever explained to me why that's in there. So it was animal studies, and so we're being cautious and avoiding that and and at risk humans. Gotcha, gotcha. I've seen on the news things like, you know, they call like Ozempic Blues or patients who are on these GLP ones who aren't kind of experiencing joy as much. Have you observed that in your patients? Yes, I have.

SPEAKER_02 29:27

I think that there's no doubt that these medications are acting in our brains. One, we know that it reduces the craving of food. And that is definitely related to our pleasure centers, right? So what makes us happy? We also see that these medicines are being studied for certain addictions. So for smoking, drinking, people who are on a GLP will tell you, like, I don't feel like drinking as much anymore. And so for those people, I can see if this is something you found joy in that was really important to you. Imagine, like, I'm a foodie, and if you're gonna tell me like I don't enjoy food, that would kind of like make me sad. Yeah. That's a pleasure. Yeah, yeah. Yeah. And so I can see why some people may start to feel like, you know, it's making me feel down. And this has actually been studied. This goes back to kind of my core, and is that part of how I treat patients is very much rooted in the science. And this is why I do clinical trials to help answer these questions. And when you look at large systematic reviews of the studies that have been just done so far, the most recent one looked at over a hundred thousand patients in over 80 randomized controlled trials. And what we saw is significant improvement in mental health related quality of life. And so I'm not surprised, right? You're you're happier, you feel healthier too. What I say is that in patients with pre-existing depression or on an antidepressant, is that this may mean we watch them more closely when we first start them on a GLP. In that first three months is kind of the recommended time frame, is to check in with the patient. How are you feeling? My mom is on a GLP, and I will tell you, she is happier. Not because of just losing weight, I can tell. Like her overall mood is just happy.

SPEAKER_03 31:15

Ah, I love that. I love that. You know, I think some of these medicines, we're all unique human beings. We're unique snowflakes. And some people might experience one thing one way, and others a completely different way. And so we all react differently to these things. Well, I think this has been really, really useful. I've learned a lot. I know the audience has too. And I wanted to conclude our podcast episode today with a rapid fire speed round designed to kind of have some fun and allow the audience to get to know you better. Are you ready? Ready. Question number one What's your favorite Taylor Swift song?

SPEAKER_02 31:54

My goodness, that one's a hard one. I'm gonna be honest, I'm not good at the names of songs, but like I know so many of them. And what I love about Taylor Swiss is that like she's not afraid to tell what's on her mind. And so, like, some of her like most emotional songs or her angry songs are the ones I like the most.

SPEAKER_03 32:15

Yes, yes. They're great to work out too. Like down bad. I mean, is there a better workout song than down bad? I don't think so. Like maybe shake it off. I could get that, you know, I could feel how that could get you going in the gym. Um, and when we did a talk together one time, you I had everybody on the docket tell me uh their favorite Taylor Swift song. And this was a few years ago, but yours was 22 at the time. Which is a great memory. Yeah, that's now anything Taylor Swift, you know, like it's hard for me to remember, you know, the names of all the GLP ones out there, but I've got all her lyrics memorized, like right up here.

SPEAKER_02 32:55

It just depends on what stage in my life I'm in, Lisa.

SPEAKER_03 32:58

Right? Yeah. Yes, yes. It's constantly evolving. It's constantly evolving. Um, question number two your favorite potato product. Do you, you know, because I'm here in Idaho. Do you like French fries, potato chips, sweet potatoes?

SPEAKER_02 33:14

No question, French fries. French fries. Okay, okay. Yep. Double fried French fries. Oh, so are those like because they're extra crispy? It doesn't matter. It could be I do, I don't like shoestring fries, but they have to have some substance. But the twice fried fries are the best. I don't like a soggy french fry.

SPEAKER_03 33:34

Right? If you were gonna have a binge watching sesh, would you choose comedy, drama, or reality?

SPEAKER_02 33:41

Okay, the one category you didn't cover was romantic comedy.

SPEAKER_03 33:47

Yes, I love it. So you're a rom-com girl. Yes, yes. Do you have a favorite rom-com?

SPEAKER_02 33:54

So probably the the rom com the most recent one I watched was uh Nobody Wants This. Oh, yeah, that's a great one. Yeah, it's a great one. Do you know which one I really want to watch? I haven't started yet. Is Jennifer Lopez has a new one on Netflix called Office? Yes Romance.

SPEAKER_03 34:16

Yes, yes, yeah. Seen it, seen it. Um, yep, it's good. It's good. It's a good rom-com. You know what is another really great rom-com? Oh my gosh. Seth Rogan, Charlie Saren, long shot. Okay. It's a few years old. I love the recommendations. It's so funny. Okay, a couple more. Worst nightmare, snakes or spiders.

SPEAKER_02 34:37

Ooh, spiders, for sure.

SPEAKER_03 34:39

Spider. Yeah, yeah. And then what are you more curious about? Space or the ocean? Maybe the ocean. It seems scary. Ocean. I know, right? It's so interesting. And then last one that I made specifically for you heels or cowboy boots? Oh my gosh, that's too hard. You know I love both, and I love my shoes. I've seen you rock both, but they you they both work for you, but I wondered if you had a preference.

SPEAKER_02 35:08

I love the cowboy boots because one, it's unexpected in this like Asian girl, and I love line dancing. I never even oh yeah, because I love line dancing. That's why I like that's why I have my boots.

SPEAKER_03 35:21

Oh my gosh, where do you go for line dancing in Orange County, California?

SPEAKER_02 35:26

Can you believe it? We do have line dancing places, and I try to go as often as I can. Anytime you're in town, Lisa, we will go.

SPEAKER_03 35:34

Okay, okay. I will do that. This is one situation where we do need to put that on social media because uh it'll be ridiculous and awful. I'm so poorly coordinated. And so I think that's something that will need to be documented. We'll do that together.

SPEAKER_02 35:48

That's why I like lane dancing, because as an Asian in our culture, there is really not any sort of dancing, but it's something I love and I feel like it's like it makes you feel alive and is learning how to move your body. So line dancing is like a sequence, it's a pattern. And so you learn the pattern, and you don't have to be naturally good at it as long as you learn the pattern.

SPEAKER_03 36:14

Okay, I think I can do that. I think I do, although I do have, you know, perimenopausal brain fog. So I'll have to work through, I'll have to work through that, all of these challenges and opportunities for me in my current my current state.

SPEAKER_02 36:30

We will be sharing with each other the same tricks and challenges.

SPEAKER_03 36:36

Well, thank you so much for agreeing to come on the podcast, Jen. I know you're so busy and I really appreciate you taking the time to be a part of this with us. My pleasure. Thank you. Thank you, audience, for listening. Thank you for watching. Please like and subscribe and stay tuned for more wonderful episodes of Skin Credible. Thanks, everybody.