Harsh Thakkar (00:01)
All right, welcome to another episode of Life Sciences 360. Today we're gonna be talking about GLP-1 medications, weight loss management, and all the buzz that's around this topic. We're gonna understand how these medications work. We're gonna get some insights on pricing, you know, how can you get access to these medications. I'm really excited to have this guest today here, because he knows a lot about this topic. So let's dive in and have a chat with Dr. Jonathan Kaplan. Welcome to the show.

Jonathan Kaplan (00:31)
Thanks so much for having me.

Harsh Thakkar (00:33)
Yeah, I want to start off by asking you, know you've looked at your work, you've done some work in plastic surgery, but what really drew you to this area of weight management and GLP-1 medications?

Jonathan Kaplan (00:47)
It's very much tied to my background as a plastic surgeon. I'm a practicing plastic surgeon in San Francisco, originally from Louisiana. My wife and I moved here 11 years ago. But about three years ago now, we noticed patients that were coming in for tummy tucks and body contouring procedures that their BMI was too high. They weren't good candidates for surgery. So rather than turning them away, our nurse nurse practitioners suggest we start a weight management program. So we started with coaching and Fentermine and the other medications that were available.

Even before everybody, all the buzz was going on about Ozempic and Wigovia, Mojaro and ZetBound. And so we started with the coaching and all that. But then once Ozempic and Wigovia went on the FDA shortage list, that meant that, and that was around 2022, that meant that compounding pharmacies here in America could start to make a duplicate of the active ingredient in Ozempic and Wigovia, which is semiglutide. And the whole idea is the FDA

wants Americans to be able to get medication even if there's a shortage and it's not just weight loss meds, could be know lidocaine with epinephrine, it could be Tylenol. And if there's a shortage, even if there's a patent, they give compounding pharmacies the permission to make a duplicate just so that Americans can have access to those meds. And so that's why we're able to get semaglutide and then ultimately tear zeppitide, the active ingredient mojaro and zepban. We got them from a compounding pharmacy.

and our weight management program exploded. And then I have a separate company called Dr. Well by Build My Health, where we were able to help all of those practices get set up their own weight management and wellness programs. And we're able to get help them get access to these medications for their patients as well.

Harsh Thakkar (02:33)
Okay. And I have been seeing this trend just on internet, know, all different social media, Reddit threads. It seems like the GLP-1 medications have become really a focal point, you know, in weight management. So for somebody that's maybe not... Yeah.

Jonathan Kaplan (02:50)
Now there.

Harsh Thakkar (02:55)
Go ahead.

Jonathan Kaplan (02:57)
You cut you cut out for a second. So I don't know what the last part of the question was, we can just edit this part out. You cut out for a second.

Harsh Thakkar (03:02)
Yeah, sure, sure.

So I was saying that, you know, as I've been looking online and going through certain, you know, Reddit threads and other social media stuff, I see that GLP-1 is being talked about a lot as a focal point for, you know, weight management. But for our listeners, maybe who are not from a life sciences industry background, who are not from a scientific background, how can you explain to them what's like a unique mechanism as to why

these medications are effective for people.

Jonathan Kaplan (03:35)
So we'll go back a couple steps and first talk about, you know, the human body and when it eats, your body naturally releases these hormones. And one of the hormones is called a glucagon-like peptide, GLP. Your body naturally releases that, it suppresses your appetite. There's another hormone that the body releases when you eat called GIP. And depending on who you talk to, that either stands for glucose-dependent insulinotropic polypeptide, or it stands for gastric inhibitory peptide. But either way, these are naturally occurring hormones.

Harsh Thakkar (03:44)
Hmm.

Jonathan Kaplan (04:05)
the body releases after you eat and they tend to suppress appetite. Maybe they don't work as well on as in everybody. But what these medications were what they came to find out what these medications is they can also control your sugars. And so that's why this whole class of medications, even if people are just learning about ozempic and will go be now this class of medications, collectively called in Crete memetics or GLP ones, this class of medications actually been around for over 20 years. So they're really not new.

Harsh Thakkar (04:33)
Mm.

Jonathan Kaplan (04:35)
And they were originally for type two diabetes, as I mentioned, they stimulate the pancreas to release insulin, so that controls your sugars. But they also cause delayed gastric emptying, meaning food moves more slowly from the stomach to the intestines, you feel more full, you eat less and you lose weight. So they originally indicated for type two diabetes as far back as 2005, the first drug that came on the market was Bieta. But again, in all these studies, all these human studies, they were noticing people were losing weight. So

they eventually got it approved and indicated for weight loss back in 2014 under the name Zaxenda. And then that, but the problem, the reason that didn't take off as much as, you're thinking about, there was weight loss drugs back in 2014. Why didn't that take off then? It was because it was a daily injection. It wasn't a pill. It was a daily injection. But the reason Ozempic really started to take off in 2017 when it was first approved still for type two diabetes,

is that was the first GLP-1 medication that was a weekly injection. And that's when people started to recognize that, okay, this is type two diabetes, but it also helps for weight loss. And the active ingredient in Ozempic is semaglutide and Nova Nordisk, the makers of it, again, realized that people are losing weight on this medication. So they got it reapproved or another indication for it in 2021 under the name Wegovy. Same active ingredient, semaglutide.

Harsh Thakkar (05:35)
Hmm.

Jonathan Kaplan (05:56)
but it was an indicator for weight loss and again, still a weekly injection. And so then that's when things really took off. So even though Wegovy is the one that's technically for weight loss, everybody just collectively refers to it as ozempic. But that's the background of these medications. Then Eli Lilly came out with Mujaro for type two diabetes and then followed that with ZetBound, same active ingredient to your Zapotide, but Mujaro is for type two diabetes and ZetBound is for weight loss. So you can see this.

Harsh Thakkar (06:01)
Mm.

Jonathan Kaplan (06:24)
recurring pattern where they come out indicated for type two diabetes, and then they follow that same active ingredient for weight loss. But then they're finding all these other uses for the GLP ones, that it basically just suppresses your appetite, sure. But it also suppresses your cravings for other things like alcohol, maybe smoking, vaping, a really incredible medication. But back to your original question, how does it work?

Harsh Thakkar (06:42)
Hmm.

Jonathan Kaplan (06:49)
For the most part, they understand that it lowers the body set weight in your hypothalamus, they believe, that makes you feel full sooner, so you eat less. But again, as I mentioned, they stimulate the pancreas to release insulin, which makes you feel full, and the delayed gastric emptying, the slowing of the intestinal, of the stomach contents into the intestines, that also makes you feel full, which is also the cause of most of the side effect, most common side effects that people see with these medications.

Harsh Thakkar (07:15)
Yeah, that's very interesting how there, you know, it looks like there was three or four different paths of research or, you know, work going on from different companies. And I don't want to say accidentally they landed on this for weight management, but it appears as if it wasn't intentional, but somewhere as they were doing the research, they started finding these therapeutic benefits.

Jonathan Kaplan (07:41)
Right. Well, there's definitely,

you're really right because there's other hormones that are involved like ghrelin, things like that, that affect satiety or feeling full. And they've tried different experimental pathways with those other hormones, trying to mimic those hormones. And they were not as successful as the GLP-1. So I don't want anybody to think that, they found the one hormone that does this. No, there's a lot of hormones that deal with appetite suppression, but making it a medication that you can take that's effective.

Harsh Thakkar (07:50)
Mm.

Jonathan Kaplan (08:09)
has not really worked for these other medications. It seems like they would logically work and they just didn't. But GLP-1s, which originally for type 2 diabetes was really an amazing discovery. it really is the biggest thing since penicillin. And I don't say that lightly. I'm not joking. I mean, penicillin was the first antibiotic to fight bacterial infections. But these medications do more than just one thing. Whereas penicillin only fights infection.

Harsh Thakkar (08:24)
Hmm.

Jonathan Kaplan (08:37)
These medications, as I mentioned, are helping people lose weight, but it's also reversing chronic kidney disease, reversing fatty liver. And the FDA is gonna approve these medications for those additional indications. Right now you can get them off label, which doesn't mean it's illegal for you to get it for those other purposes, but they're eventually gonna get those additional indications.

Harsh Thakkar (09:00)
Yeah, and I think this scenario probably you come across a lot when somebody wants to start on these GLP-1 medications. You mentioned early on that when you started in this field, when you were doing surgeries, you would do tummy tucks and other types of weight loss things. So emotionally, when someone comes to you or a person that's heading on this path of weight loss, they have really high expectations, right?

And the reality is different. Not everybody acts in the same way. Somebody might drop a lot of weight in the first four weeks and then stay plateaued or vice. Somebody might not drop anything for the first four weeks and then they suddenly start seeing the benefit. So what's one common misconception that patients have who are starting on this journey and how do you sort of level set that to help them understand?

that hey, this is not a magic pill, there's pros and cons or there is different scenarios.

Jonathan Kaplan (10:07)
It's a great question because yes, especially with social media and I'm really active on Tik TOK and on Instagram and patients are always talking about how they're losing 50, 60 pounds and you know, and really quickly. And so everybody starts to think that's going to happen to them. And it does happen to a lot of patients. I'm not going to lie. It's really amazing, but there are one misconception. I think it works for everybody, but the data shows that it really only works really works well for about 90 % of people, which is a lot of people.

Harsh Thakkar (10:17)
Hmm.

Jonathan Kaplan (10:35)
There is one study that showed if you take tear zepatide, the active ingredient Mojaro and ZetBound that based on their studies, that if you during the clinical trials they did, it was for one year and five months. And they found that over the course of one year and five months that 97 % of people lost at least 5 % of their body weight. So that's pretty good numbers, 97%. The thing is, though, you start to wonder, you know, because of the cost of the medication that

if I'm only going to lose 5 % over a whole year and five months, is it really going to feel like it's worth it to you? Now, maybe you would have gained 5 % if you hadn't been taking the medication. So losing 5 % is great. But yes, unfortunately, people come into this thinking they're going to lose 20 30 % of their body weight. So you definitely have to recognize, let people know that it's not going to work as well for them as maybe what they saw on social media, but it's going to work to some extent for most patients. They

They just have to remember that they probably would not have lost any weight and certainly would have gained weight if they hadn't have been on the medication. So even if you don't lose 20%, then 5%, 10%, that's great. But also it's, you know, if you're type two diabetic, it's lowering your hemoglobin A1C. Even if you're not seeing weight loss, the other things to look forward to are craving other addictive behaviors, but also, and it's a little bit more nebulous, is that it has this anti-inflammatory effect that they don't exactly understand.

Harsh Thakkar (11:36)
Mm.

Jonathan Kaplan (12:01)
So people that even if they're not losing weight, they're showing data that it's reducing cardiac disease, it's reducing joint pain, even without weight loss. So there are other benefits outside of weight loss. And again, most people are probably just want weight loss, but there are other benefits even if they don't see those numbers that people are seeing or that people are talking about on social media. So you definitely have to have a realistic conversation and realize that even if they don't lose 30 pounds,

they're gonna see other benefits. They're gonna probably feel better about themselves. They're going to maybe fit in an airplane seat a little bit better. Maybe they might not get down to a size zero, but there's gonna be typically statistically improvements.

Harsh Thakkar (12:45)
Yep, Yeah, I mean, you know, weight loss is one of those areas that's so different from anything else because there's so much psychological stuff attached to it. There's so much emotion, there's social status. know, if your friends are skinny, you want to fit, like there's, it's very simple, but at the same time, it's one of the most complex things that, you know, every human being at some point in their life, either they're trying to gain weight or they're

too anorexic or skinny or the other side where they're obese and they've been told like they've tried a of diets and gyms and whatnot. And they might suddenly feel like this is a solution to everything they've tried and that's failed, right?

Jonathan Kaplan (13:32)
It really may be the solution. Statistically speaking, it's probably is going to be the solution to help them get to where they want to be. And certainly, know, diet and exercise, while that's always been told to us is that's the best way to lose weight is diet and exercise. We're realizing that's probably not the best. That's not the easiest way to lose weight. And it's probably not that effective because even if you lose weight with diet and exercise, your body set weight, that thermostat is pulling you back up and you eventually regain that weight. Whereas with these medications that can help you keep the weight off.

Harsh Thakkar (13:35)
Yes, yeah.

Jonathan Kaplan (13:59)
but it's still important to continue with diet and exercise because you're eating less. You also may be drinking less. And so that's, you're drinking less fluid. So you might get dehydrated, but because you're eating less, you need to make sure you're still getting in the protein every day that you need. So the diet is important as far as, high protein diet to get those same caloric needs. But also the exercise is important because any type of weight loss, not just with the weight loss meds, but any type of weight loss,

Harsh Thakkar (14:13)
Hmm.

Jonathan Kaplan (14:25)
can lead to lean body mass loss, which is like a reduction in muscle and bone. People think that it only happens with these meds. It happens with all type of weight loss. So exercising is the best way to mitigate or minimize that lean body mass loss. So diet and exercise are still extraordinarily important, maybe more important, but not for the reasons you think. It's not to help you lose weight or keep the weight off. It's really to make sure you're getting in the nutrients you need and to help minimize or mitigate that lean body mass loss.

that everybody is so worried about.

Harsh Thakkar (14:54)
Yeah.

Yeah, I wanna switch gears and I wanna talk a little bit about, because probably whoever is listening to this, they're wondering, if they wanna start taking these medications, what is, you mentioned some, and I know that you are offering these through Build My Health, is that correct? This.

Jonathan Kaplan (15:19)
So that's the name of my company. It used to be Build My Health. Now it's Dr. Well by Build My Health. And so if people go to drwell.com, they can find our providers across the country. We cover all 50 states, but you can find providers there that are able to do a virtual or in-person consult with you, depending on where you live, and then allow you to sign up online for these medications. And you're charged each month like a subscription.

And then each month the medications are shipped to you and you can choose between semiglutide to your Zepetide. There's all other sorts of peptides available, know, NAD, some morelin, there's a lot of things that people B12 vitamins that you can sign up for as subscriptions, but we make it very easy and it's, and it's, out of pocket insurance doesn't cover it, but it's significantly less expensive than the name brand drug, which statistically speaking, your insurance is not going to cover this or they're going to put up so many barriers and hurdles that you're not going to be able to get the name brand drug.

Harsh Thakkar (15:49)
Hmm.

Jonathan Kaplan (16:17)
So by getting it through us, through a compounding pharmacy, much less expensive, but also the convenience of it being shipped to you rather than having to drive around town or to other states, what I've heard from some patients, where they're trying to find the pharmacy that has the name brand drug in stock, because there is such a significant shortage.

Harsh Thakkar (16:34)
And what's, you mentioned about subscription and being charged like per month. I've also read that you talk a lot about how you were so excited in building this unique pricing, know, transparent pricing model. So can you walk us through like, what were your thoughts when you were building this out and thinking of how the patients are gonna pay for these?

Jonathan Kaplan (16:49)
Right.

Well, so each provider in our Dr. Dr. Well network, they can choose what they want to charge. but in my practice, what we do is, the semiglutide, the active ingredient in ozempic and wegovy is $500 a month. And that includes not only the medication, which is, know, it's a once per week injection, four times a month. So it's enough for four injections, but also that $500 in my practice includes a virtual coaching. you can meet with our nurse practitioner for coaching on diet and exercise at least once a week.

It also includes all the medications for any of the most common side effects. So if you're having nausea, we can mail you some Zofran. If you're having constipation, we can mail you some magnesium tablets. If you're sulfur burps, we can mail you ginger chews. so we're including the cost of that in there as well. And I know that you can go to the pharmacy and get Zofran, but you still have to have the prescription called in. You got to go wait in line at the pharmacy. So we make it easier for the patient. That $500 for the semiglutide includes the Zofran and those other treatments.

for tear zapotide, the active ingredient, Mojaro and Zep-bound that is $600 a month. And that includes the 2.5 up to 10 milligram dose. So that's what, that's the pricing that we offer. Now it gets a little bit better that, you know, if you're in our program for at least six months, you're not locked in by any means. These are month to month subscriptions. You can cancel any time. But one of the things that we offer is that if you happen to be in for more than six months,

Well, after six months, we're probably not providing you as much coaching as you once were. You probably got all the coaching tidbits you got in the first six months. You're also probably not having side effects anymore because in general, the side effects are mild, treatable and time limit to eventually go away. So after six months, there's a little less involvement on our part, not because we're telling you can't call us, obviously you can, but there's just less involvement of the patient needs is less. So after six months, we reduce those prices. So the $500 semaglutide goes to $400.

$600 Cheers of a Ted goes to $500. Then that's to continue getting the four shots a month. The other thing is that when patients get to their goal weight, they can stop these medications. But statistically speaking, they'll regain some of their weight. Studies show that they'll regain about two thirds of their weight over the course of the year. So not all of their weight back. So that's good. But if they are worried about regaining, then they can switch to a maintenance subscription, which means that you don't necessarily need

Harsh Thakkar (18:52)
Hmm.

Yeah.

Jonathan Kaplan (19:21)
four shots a month to lose weight, maybe you can get away with fewer shots a month to maintain your weight. so patients know what will work for them. And so in a little bit of trial and error too, that they can switch to a less expensive subscription where they're maybe getting only three shots a month or two shots a month or one shot a month. And then they can do that for as long as they want at a lower price point. And that can get down as low as $299 a month if we're talking about pricing and everything. So.

Harsh Thakkar (19:47)
Yeah.

Jonathan Kaplan (19:48)
I'm not saying any of this is cheap, but it's certainly less expensive than trying to pay for the name brand drug out of pocket because that's all over $1,000 a month. And you have the added hassle of trying to find the medication you can't you just can't get your hands on

Harsh Thakkar (20:01)
Right, right, right. And so for you and the people, like the other providers in your network, when you're operating a practice that's, you you don't take insurance, it's cash, you pay per month, and you stop it when you don't, what are the challenges running a practice like that versus somebody that's, you know, billing to the insurance companies?

Jonathan Kaplan (20:28)
wow. How much time do you have? So billing to the insurance company is really it's such a hassle. We do support that in our practice. We're piloting a program right now where if somebody meets certain criteria, like we're not just going to try to get your insurance to cover it just, you know, if you're trying to lose 10 pounds, that's not we just know that's not going to get covered. So when it comes to insurance, things that you absolutely bare minimum parameters that you have to meet to make it even possible or feasible or like

Harsh Thakkar (20:30)
Ha

Jonathan Kaplan (20:58)
like it's worth trying is that you at least have to have a BMI of 27 with an obesity related condition like sleep apnea or high blood pressure diabetes. So BMI of greater than 27 or BMI of greater than 30 with no obesity related conditions. The other thing is that you have to have private insurance, you know, something like Blue Cross Blue Shield or Aetna. It can't be Medicare.

Harsh Thakkar (21:06)
Man.

Jonathan Kaplan (21:22)
And what we have found, at least in California, it can't be Kaiser. Kaiser does not cover these medications. They actually just had like over $500 million. I think it might have been a $608 million shortfall in their budget from the last quarter. And it was mostly because of the expenses of covering Ozempic and other medications for type two diabetes. So they're even there, they don't want to cover these medications, especially for weight loss.

So we, so for insurance, yes, if you meet those certain parameters, be much greater than 27 or 30, private insurance, then we can try it. We can fill out the paperwork for you, the preauthorization, the benefits assessment. The problem with it is that it's going to maybe take either days, weeks, or months to find out whether they're going to cover it. But then what's even crazier is they'll say they cover it. But when you go to get the name brand drug at the pharmacy, they'll say, your copay is a thousand dollars. Like, well,

How are you covering it if it's still about a thousand dollars? So for those patients, since we're still charging them monthly just to do the process of the pre-authorization and everything, that if they still can't get the name brand drug, even if insurance claims they covered it, they can't find it or the copay is too high, because they're still paying us the monthly fee, they just fall back to the compounded medication. So we still can get it from them. The point is that if they're going through us, whether they're trying to do insurance or not,

Harsh Thakkar (22:18)
Yep.

Mmm.

Jonathan Kaplan (22:46)
We're guaranteeing them access, either the name brand through insurance or the compounded version. So they won't walk away empty handed. but the other problem with insurance is that just because they might approve it and let's say the copay is really low and it's a great deal and you're getting it, they may require preauthorization again in three months. And at which time, they're, not going to probably cover it again. So those are all the pitfalls with insurance. and, and all that time you were struggling to get insurance to cover it.

And maybe it's been like a few months trying to get them to cover it. Your friend who was on the car who just decided to pay less and out of pocket for the compounded version has been losing weight for the last three months while you were waiting to try and get this covered by insurance. So it's pretty frustrating.

Harsh Thakkar (23:30)
Yeah, definitely. the timing and the speed of getting access to the medication, it's common for anything, right? Like if you can get it. And there's also not for GLP-1, but like even other medications and different countries. Like I know I'm originally from India and there are a lot of medicines in US where you need a prescription, but in India, you don't.

Like you just need to go to a doctor and they don't give you a prescription, but it's very different, right? I don't know how other countries work, but in India, I've observed, I'm like, wow, this is just an allergy medicine. And here in US, I have to go get an appointment, then wait for the medication. In India, I could have got that just by walking to a pharmacy and telling them, hey, I need an allergic medication. So I wanna talk about

ethics, right? Because with the popularity of GLP-1s and all the buzz that's going around and the demand or the people who want to have access to these therapies so that they can reach their weight loss goals, I'm sure there are ethical ways of approaching this and unethical ways. And how do you maintain that?

line to say, this is something that we won't do and because it doesn't fit our brand or it doesn't fit our moral values.

Jonathan Kaplan (25:09)
We definitely would not prescribe this or offer this medication to anybody that has any of the black box label warnings like medullary thyroid cancer or history of medullary thyroid cancer. But more to your point, if they have a history of an eating disorder, we would not offer this medication to them. If they have a history of pancreatitis specifically due to these medications, we would not offer it to them. But getting into the patients that are just trying to lose 10 pounds or they're trying to lose weight before their wedding or they're trying to...

Harsh Thakkar (25:15)
Yeah.

Jonathan Kaplan (25:37)
lose weight before a vacation. That is not what the medications were intended for. But we will prescribe it for that and people may find that that's unethical. But the truth is that they can either get it for me, a real doctor that's going to prescribe this to them, and we're going to follow them and make sure they're doing all right and make sure that they're not dropping too much weight. Or if I refuse to work with them, they're going to go online and get the medication

from a pharmacy that sells research grade medication, which is not intended for human use. And they can actually get that without a prescription. So it's not illegal for the pharmacy to sell it to somebody if they're claiming they're using it for research use. It's just, it's not meant for human use. And so there's no, there's fewer quality controls. You don't know how many impurities are in there. So if we have patients who are using this to lose a little bit of weight that, you know, people might shame them on social media.

Harsh Thakkar (26:12)
Mmm.

Jonathan Kaplan (26:33)
My feeling is that they're much safer getting it for me from a legitimate compounding pharmacy that's getting it from an FDA registered manufacturer that our whole supply chain is legitimate, that they're safer getting it for me for those reasons than me turning them away and them going and getting it online when it might be unsafe for them to take. So that's how I feel about that. And sure, it doesn't meet their BMI criteria for it. But again, that's considered off label prescribing. That's again, not illegal.

And I'm feel very comfortable with doing that. I know that we're trying to help them in it. Also a little bit of human nature that there's something out there that works as well as this and to tell a person, no, you can't have it though. That's not going to go very far. Again, they're going to find a way to get it online in a more unsafe situation. So we do prescribe it for patients regardless of their BMI.

We still get their baseline lab work. We still do a virtual or in-person consultation. We're still showing them how to do the injections. So we're doing everything appropriately to make sure they're doing this as safely as possible. again, the main thing is if they had a history of an eating disorder, that would be very concerned. I would not prescribe it to them for weight loss.

Harsh Thakkar (27:47)
Interesting. Yeah.

Yeah, that's interesting. And when you, as an expert in this field, everything you've shared so far, it's evident that you've been in this space for a long time and you've come across all types of cases. But when you look at the broader impact of public health or obesity-related conditions and statistics around that, what do you think GLP-1...

Are they going to make those statistics look better in the next five or 10 years? Or do you think there's any other developments in cosmetic medicine or weight loss that's going to happen, that's going to sort of move that needle?

Jonathan Kaplan (28:31)
These are certainly changing the face of the country, the world, economics. mean, there's one study out there that shows that if all United Airlines passengers lost 10 pounds on these medications, they'd save $80 million in jet fuel costs over the course of a year. I mean, this is really changing everything. It's already changing healthcare because the thing is, if you think about healthcare in America, all of the different providers out there, all the different doctors out there, they're treating something, they're treating...

Harsh Thakkar (28:48)
Wow.

Jonathan Kaplan (29:00)
which is they're treating essentially the symptom of the underlying cause, which is obesity. So take, for example, as a plastic surgeon, we treat obesity, patients are gonna have better results from their cosmetic surgery. But if you look at an ear, nose and throat doctor, instead of treating sleep apnea with a CPAP machine, they're gonna treat their underlying obesity and they're gonna get rid of their sleep apnea. If you take a urologist even who is...

been treating erectile dysfunction, they're going to treat the obesity, it'll get rid of their erectile dysfunction. Even a dermatologist, instead of just treating everybody for acne, they'll treat their underlying obesity and that's going to clear up a lot of acne. So many things in America, you know, OB-GYN is treating infertility. So many things that we're treating are really just treating the symptoms. And if we get to the underlying cause, which is in so many cases is obesity, it's going to totally transform healthcare.

Harsh Thakkar (29:48)
Hmm.

Jonathan Kaplan (29:54)
And that's why we're all obesity doctors now. And that is really the bottom line. Every doctor in America, around the world, especially in America, we're obesity doctors now because we have in our armamentarium now, we have these great medications, which yes, there are some potential very serious but rare side effects. For the most part, they have incredible great safety profile, very effective, very safe. And so even if you're not an obesity medicine specialist, you still

First of all, there's not enough obesity medicine specialists to go around, but that's why it's so relatively safe for all providers to offer these medications because it's really going to treat and improve the quality of life and the health of Americans while we're in a parallel path, also trying to improve the food chain and trying to get rid of processed foods. So there's other things that we can definitely be doing at the same time.

Harsh Thakkar (30:44)
Hmm.

Jonathan Kaplan (30:53)
But those are sort of generational changes to improve the food supply in America. But in the meantime, we have these medications to help people lose weight, hopefully live longer, reduce their risk of major cardiac events, potentially stave off Alzheimer's disease, slow Parkinson's disease. I mean, it's it's unbelievable the amount of data and studies that keep coming out showing what the benefits of these medications are.

Harsh Thakkar (31:19)
Yeah, you mentioned about the food chain and going towards less processed foods. So I'm just curious, do these GLP-1 medications, when people take them, do those patients see any improvements in their gut microbiome or those kind of things?

Jonathan Kaplan (31:39)
Well, one thing that they certainly are doing is that it's helping people crave their, their, their cra- reduce their craving for sugars. And that's why a lot of companies are losing market valuation, whether they really are seeing a decrease in sales, that remains to be seen, but, but it's, definitely curbing people's, appetite for sugary foods. And so I think that's going to also prompt these companies to change what they're offering because the consumer appetite is going to decrease for that. No pun intended.

Harsh Thakkar (31:48)
Hmm.

Jonathan Kaplan (32:09)
I mean, just another way that this is total, the medications have changed certain businesses or business models is that bariatric surgery, know, stomach stapling, gastric bypass, the rates of that operation have plummeted because people are taking these medications and losing weight now. And there's additional medications that are in the pipeline that are going to lead to a bariatric surgery type of weight loss without the surgery. So it's already changing a lot of business models in the economics.

across the entire spectrum in the US. So it's very exciting to see how it's changing.

Harsh Thakkar (32:43)
Yeah.

Yeah, and even as a consumer, remember, I moved to US in 2007 from India and when I go to the grocery store today and reflect how it was when I went to a grocery store in 2007 when I was staying in the dorms with three other roommates, you're seeing a lot of labels with big statements or big letters that say no added sugars.

Because it's the added sugar that's actually killing us, right? Like 20, 30 grams of added sugar in like a small drink or a protein bar or some kind of stuff. If you have those every day, you five days a week, that's 150 grams of sugar. And you don't realize how much that is. I actually waited one time and I saw it in a cup. I'm like, wow, that's a lot of sugar.

Jonathan Kaplan (33:33)
Right.

And people wonder why they're insulin resistant now, which is these medications also help with your insulin sensitivity. But as you mentioned, the grocery store, there's, you're going to see more and more of this where you walk in and instead of like necessarily the ethnic food section or that food section, there's going to be a GLP one section that's going to be high protein foods. You're going to start to see that you're going to see that I'm already seeing that, but you're going to start to see it all across America. And there's companies that are already promoting their, their products.

Harsh Thakkar (33:42)
Yeah.

Mmm.

Wow, interesting.

Jonathan Kaplan (34:08)
that are high in protein, low in sugar. And maybe those were foods that were available before, but they're just relabeling or rebranding them as being GLP friendly. But it's already changing everything. For the better, it's very exciting.

Harsh Thakkar (34:17)
Yeah.

Yeah,

yeah. When you look back at your career, like everything you've done, the work you've done in plastic surgery and then weight management to now what you're doing with GLP-1 medications, going on podcasts and interviews and spreading the knowledge, what's one thing that you're most proud of when you reflect on your career?

Jonathan Kaplan (34:46)
I think one thing I'm proud of is recognizing the change in the direction of what was available out there to recognize when it was timed, not necessarily pivot, because I'm still a plastic surgeon. I still enjoy operating on patients, but recognizing those changing currents, those changing winds of like recognizing those opportunities. And, and, and, and as a surgeon, it's really fun to operate on a patient and then they wake up and then they have

perkier breast or a flatter tummy and it's there, they're happy, even though they might be in pain right after surgery, they're happy because they can see the improvement already. And that's very gratifying for me as a surgeon, but there's only a certain number of operations you can do in a week for that gratification, that instant gratification. Whereas now that we're also offering these weight loss medications in our practice, now we're treating hundreds of patients a month that are losing weight and that are happy and that are writing nice reviews and that are calling us and when we see them in person to tell us how happy they are.

and how successful their weight loss has been. And so that's been great for me, that instant gratification of only several operations per week. Now it's hundreds of patients a month that I'm seeing, I'm getting that instant gratification of seeing how they've done better. So I'm really happy that I was able to recognize that changing, that changing course, that changing opportunity and take full advantage of

Harsh Thakkar (35:54)
Mmm.

Yeah, yeah. And for listeners, know, and viewers, if you enjoyed this conversation today, be sure to, you know, click the like and subscribe button or, you know, follow us on the podcast platform so we can constantly bring you amazing guests like Dr. Jonathan and go on these trending topics because that's what this podcast is about. So I look forward to, you know, hearing your thoughts and comments and what you would like us to cover in the next episode.

Dr. Jonathan, it's been amazing. I know we had some hiccups starting this session. was like, please, I don't want this to be canceled because I really want to talk to you. So we finally got it going. And before we drop off, how can people get access to you? Can they follow you on social media? Can they learn about your companies? Do you want to share those details?

Jonathan Kaplan (36:57)
Absolutely. So they can certainly reach out to our website, drwell.com, drwell.com, like it sounds. And then they could also find us on TikTok and Instagram at drwellrx. They can also just email me if they have any questions. They certainly easiest way is to DM us on TikTok or Instagram, drwellrx, but also they can email me at drkaplin at drwell.com. That's drkaplin at drwell.com. And I'll be happy to answer any questions.

there's any providers out there that want to be part of our platform, our provider to consumer platform will be happy to help on board them as well so they can serve more patients.

Harsh Thakkar (37:35)
Yeah.

So before we drop off and anyone that's, know, whoever is listening to this episode, whether they've already taken these medications or are currently taking these medications or maybe after learning from all the insights that you've shared in this episode, maybe they are interested in going and pursuing to take these medications for weight management, whichever category they are in, what's kind of one takeaway that you want to leave them with before we drop?

Jonathan Kaplan (38:06)
Well, so obviously that they need to be concerned about the different online platforms out there that where you can sign up for these medications and you don't really have a provider like the direct to consumer platforms like Rowe or Hems. And I understand that it's easy to sign up for the med medications, but the problem is you, your, your relationship is with a website, not with a provider. And so that's why that's kind of our alternative that we offer is instead of a direct to consumer platform or a provider to consumer platform. that you

Harsh Thakkar (38:17)
Yeah.

Hmm.

Jonathan Kaplan (38:34)
still have the same ease of signing up online, but you have a provider, a healthcare provider might even be the provider you already have that can help continue to watch you and follow you through your journey, be available for you if you have any side effects, you know, rather than calling some 800 number and somebody telling you go to the ER for everything. This way you actually have healthcare provider to follow you and take care you. And so it's a, it's a much more, it's a much more honest and sustainable way to

Harsh Thakkar (38:51)
Yeah.

Jonathan Kaplan (39:04)
take these medications because you have that continuity of care with a healthcare provider rather than just a website.

Harsh Thakkar (39:10)
Absolutely, yeah. It's kind of like the happy medium. You're not like going to a doctor, waiting for a prescription, paying extra to insurance to cover all the cost of the insurance and the pharmaceutical companies. But you're also not just going to a website where you don't have any supervisory role or you can't call a person, like you said. So what you're doing seems like to be the happy medium in between that ultimately gives them access to the medication.

faster and at a cheaper price.

Jonathan Kaplan (39:43)
Exactly. You get it. I mean, you get what you're looking for. We make it easy for you to get it. But we have that connection with the provider ongoing. And again, it's not like some like independent contractor that you may talk to a different provider each time. This is your doctor.

Harsh Thakkar (40:00)
Okay, interesting. Thanks again. This has been amazing. I have learned a lot. There was a lot of noise in my head about this topic by consuming stuff online, but after this episode, I think I know what's the real stuff and what's noise. So thank you for being forthcoming and sharing everything. All right. Thank you.

Jonathan Kaplan (40:19)
My pleasure. Thanks so much for having me. I really enjoyed it.