Dr. Bob Gabbay - The Future of GLP-1s

Hey friends, welcome to the Future of Fitness, a top-rated fitness and wellness industry podcast for over five years and running. I'm your host, Eric Malzone, and I have the honor of talking to entrepreneurs, innovators, and cutting-edge technology experts within the extremely fast-paced industries of fitness, wellness, and health sciences. If you like the show, we'd love it if you took three minutes of your day to leave us a nice supporter review wherever you consume your podcast. If you're interested in staying up to date with the future of fitness, go to future of fitness.co to subscribe and get weekly summaries dropped into your inbox. Now onto the show. Hey friends, this episode of the Future of Fitness is proudly brought to you by T-MUP. Since launching in 2012, they've consistently had one mission: facilitate the best customer experiences with the most cutting-edge solution for franchises, studios, gyms, and boxes. Whether it's AI, new features, new partnerships, and new markets, T-MUP's sites are set on raising the bar of the industry to enable their customers to perform and operate at the highest level locally, nationally, and overseas. Out by the most reliable APIs in the market, you can deliver premium customer experiences and scale your fitness enterprise with the strongest technological infrastructure our industry has to offer. Empower your staff, engage your members, and unlock your next chapter of growth with software design for you. For a limited time, get a very generous 50% off your first month. To redeem the offer, simply contact the TeamUp sales team and use the promo code the Future of Fitness. Head to goteeup.com. That is G-O-T-E-A-M-U-P dot com. Hey friends, this is Eric Malzone, and this episode of The Future of Fitness is brought to you by the Podcast Collective. Since our inception in 2023, we have emerged as the fitness, health, and wellness industry's premier podcast placement agency. We're honored to work with many of the industry's most prominent technologists, thought leaders, startup founders, and business executives. Why? Because they recognize that being on podcasts is the most effective way to authentically connect with their specific target audiences and rapidly grow a lucrative professional network. From podcast placements to speaking engagements, go-to-market strategies to investor relations, and media kits to press releases, the podcast collective brings a level of professionalism and deep industry expertise that can only be achieved by spending decades in the trenches. If you are a startup founder, business executive, emerging thought leader, or simply a savvy operator that understands the power of authentic media, learn more at podcastcollective.io and feel free to book a 30-minute strategy session with yours truly. Traditional media is dying on the vine. Podcasts are rising quickly to fill the void. Do not miss the boat. That's podcastcollective.io. All right, we are live. Dr. Bob Gabay, this is quite a treat. Thank you for joining me on the future of fitness.

Thanks. Uh excited to be here.

Yeah. So I'm going to give a little bit of background. There's so much to talk about. This is uh I want to make sure that every minute I have with you is is valuable for our audience. You know, I I first uh got introduced to you while you're on stage. Actually, you were doing uh a panel at the Connected Health and Fitness Summit back in February in Los Angeles of 2025. February of 2025 in Los Angeles. Uh the panel is moderated with Jeff Sweefle from Lifetime and Mura. You also had John Canarak, I believe, who a longtime private equity guy and investor within the industry. It was the most attended, I think, of all the panels that I saw there. And it was focused on GLP1s. And our industry, like most of America and globally now, is somewhat infatuated with the topic of this magic pill that we can take to lose weight. And there's very few people in our industry that do not have a very strong opinion about GLP one. And as we were joking, like we love strong opinions with little education. That's just how we we tend to roll. So don't let the facts get in the way. Anyway, when I saw the opportunity to maybe grab you and get you on a podcast and really start to decipher what's going on within this really emerging, fast emerging sector of our industry. It was great. So I'm gonna shut up now. Doctor, thank you for joining me. Maybe give a quick introduction to who you are, your background, and then we'll take it from there.

Sure. Thank you. Really pleased to have the opportunity to speak with you and and your audience because the fitness world is so critically important to the health of people. So I'm uh I'm an endocrinologist by training, and I've held a number of leadership roles over the years. Most recently, I was chief scientific and medical officer of the American Diabetes Association, and before that, chief medical officer of uh Harvard Medical School's Jocelyn Diabetes Center. And I continue to see patients uh with diabetes, and of course, many of them uh live with obesity and been following this world of GLP1s for quite some time. So uh glad to be here and uh look forward to our conversation.

Awesome. Let's start with this. Can you give us a summary of the history of GLP ones? Like where are these things come from? How long have they been around? Um, what has been the typical use cases for them? All of those things.

Yeah, it's it's a pretty remarkable story that uh it actually is a medication, a class of medications. It's been around for 20 years. And and I'm I'm hard-pressed to think of any example of something that's been around for 20 years and then all of a sudden explodes. And that and that's what happened here, you know, over the last two or three years, where the number of people on these medications has just skyrocketed. It's become part of popular culture in so many ways. So it actually started way back from um the saliva of a uh ghila monster, this gnarly looking lizard, and they isolated something in that that essentially was the first GLP. And GLP1 is also a natural hormone that the body makes, typically when you eat, uh and it's secreted by the intestines. So the challenge to use it as a medication is that GLP1 in the blood lives only a couple of minutes, and so its effect is very short. And so the work that's happened over the last 20 years has been to create longer-acting GLP1s that can then have all of the benefits, and using GLP1, that natural hormone, at even higher levels, that can have all sorts of effects that we'll talk about.

Awesome. Excuse my ignorance on any of this, but GLP1 is a peptide. Is that correct?

Yes, it is, yeah. And uh uh it's a naturally occurring, again, it's something that the body secretes, it's glucagon-like peptide one, not shortened as GLP1. And because it is a peptide, like most proteins, if you were to just take it as a tablet or just take it orally, it gets destroyed by the stomach, and so by the acid in the stomach. And that's why typically it's an ejected treatment. But again, there's lots of work to get beyond that.

So when we talk about the difference between like a a pharmaceutical and a peptide, I think that's something that confuses a lot of people, including myself. Like, what are those differences and then how how does regulations affect one versus the other?

Yeah, that's a good question. So so typically most of the medications that we're familiar with, uh, you know, from aspirin and, you know, all of that to, you know, you name, you know, the vast majority of medications, they're they're a single molecule. They can be synthesized in the laboratory, and uh uh and because of that, you can, you know, ensure purity and all of the important things that come with that. Over the last several years, there've been uh the ability to make uh proteins or peptides, which are groups of amino acids strung together, either shorter, and that's usually a peptide, or longer a protein. And those have to generally be formed by bacteria or something like that and synthesized in that way. And because uh proteins are destroyed in the stomach to break them down for digestion. When you eat a protein, you break it down with the acid of the stomach and you absorb the amino acids, they're generally not available orally. You can't take them as tablets. If you think of a peptide or protein that's been around for a while, um ins insulin is an example of that. And insulin for many years had to be isolated from the pancreases of pigs or cows until the 1980s into the 90s, where bacteria could be developed to make these proteins, and that's what we use today is human insulin that's produced by bacteria.

Gotcha. So over the past few years and the recent history here of GLP1s, what has been the technological breakthrough that it's allowed it to really hit the mass market? Like what has changed?

They've been able to do um, you know, it started as a twice-a-day injection, then you know, in the evolution again, this is over the last 20 years, it became a once-a-day injection, and then ultimately a once-a-week injection. As they kept tweaking with the the protein, they were able to make it not only longer acting, but also more potent. Uh, and particularly the potency has been around weight loss. So the the early GLP ones probably gave about a 7% weight loss. And now the newer ones uh are anywhere from 15 to 22 percent weight loss, so much more uh uh effective, and more effective than honestly any any treatment we've ever had for obesity, with the exception of surgery. And that's what's that's when things really exploded. Starting with with Ozempic and uh as an example, giving 15% weight loss, we never had anything that was as effective as that. And then and then the other thing that that um uh sort of fueled this uh excitement is that these uh medications that were again developed for uh for the treatment of diabetes, not for the treatment of obesity, but discovered to have great effects on obesity, also had lots of other benefits. And first amongst those was that it reduced cardiovascular disease, almost an accidental discovery.

With what we have now in the market, where what is the current state of GLP ones? I mean, I like it's mostly injections. When when uh I heard you guys talk a few months ago, I think someone said there's certain statistics that stuck in my head, over 120 different variations currently in development of GLP ones. I mean, the the market's absolutely exploding. This is gonna be, you know, a trillion dollar industry by without a doubt, right? So we're where are we at right now? And this is, you know, we're recording right now uh in 2025.

Well, there is a huge type of uh newer treatments, and the newer treatments are again this evolution of making even better therapies. The two main ones that are the most effective right now are semiglutide, also marketed as uh Wigovi or uh ozempic, just the hormone GLP1, and then there's a second medication called trazepitide, and that's a combination of two hormones, not only the GLP1, but a second hormone, GIP, gastric inhibitory polypeptide. And that combination of GLP1 and GIP has even more weight loss effect, it's even more potent. And that's available as uh, for example, Monjaro or Zeppao. So those are the two, and the pipeline of new therapies are either making it easier to take, so oral versions that you could take as a tablet. There is a tablet form of semaglutide available now, but it's much, much weaker. It doesn't have the same effect rebella, uh rebelsis is the is the medication. It doesn't have the same sort of potency. So it's either making it easier to take by making it oral or once a month, or there's a a patch that's being developed that you just put the patch on and you absorb it. So that's one class making it easier to take. The other sort of pipeline efforts are to get around some of the side effects, uh, and and we can talk more about that in a moment, particularly about muscle wasting. And then another sort of type of innovation in the GLP ones is well, if two hormones are good, the GLP1 and GIP, what if you do three hormones? Or what if you do a combination of two others or three others? And so they're mixing and matching different hormones that are known to be involved in in uh food intake and seeing if they can get even more potency. Uh, can we get even beyond 22% weight loss, for example, or less side effects? There's a really a lot of activity here. And and to your point, you know, the the market for these has been astronomical. You know, because of their their high cost, it is a highly profitable business to be in. And so, yeah, there's lots of companies that are working on this.

Yeah, it's uh I'm not the only one who has this kind of I guess realization of why it irks us, right? Within the fitness industry, we've always said, you know, healthy lifestyle, exercise, right, nutrition, all these things. That's how that's how you get to your goals. The fact that this problem is a lot largely attributed to the quality of food that we've been sold, you know, uh the addictive nature of foods in the Western diet. And, you know, please at any point disagree with me. I would love to hear your opinion on this. So that that irks me that the problem was largely attributed to marketing and food. And now the pharmaceutical companies are coming along to solve the problem and they're making a ton of money. So the food companies made a ton of money, pharmaceutical men are making a ton of money when a problem that maybe uh shouldn't have really existed ever, right? Is this large obesity issue that we have. So uh yeah, I mean that that's fundamentally I think what a lot of people have a problem with, whether they they've articulated it or not. That that seems to be the issue that people have. So I guess the question I'm leaning to is like, how does that sit with you, Dr. Bob? I mean, is that is that true? I mean, you're the one at the forefront of the research.

You know, I look I first of all, I I don't think it's uh either or uh meaning either lifestyle or medication. I think lifestyle is incredibly important and important for people on these medications as well. Doesn't mean that they don't need to be thinking about eating right and exercising. In fact, it in some ways for the eating side of things, it makes it easier for them to adhere to a healthier diet. So it's not either or, would be the first thing I would say. Um yes, the availability and the promotion uh of essentially unhealthy foods has been a big part of where we are today. And at the same time, there's physiology that makes it difficult for people to have long-term sustained weight loss. Certainly some people do, but if you look nationally, that really hasn't been as successful as we'd like it to be. So there are going to be people that get to their goals through lifestyle alone, and they're gonna be people that get to their goals with lifestyle plus medication. And so it's it's not a battle between those two. They're really complementary. You you can almost think of um, you know, in a in a milder form, there are people that have high blood pressure, uh, and we know that diet uh and exercise can can improve blood pressure. But um some people need that plus medication, which doesn't negate that eating a healthy diet is important, it just means they can't get there through that alone.

Gotcha, gotcha. Uh so the statistics around this and the usage and well, there's a lot. I mean, there there is on the panel you had, there was a very a lot of very interesting statistics. I believe one in eight Americans are currently on some version. Um the reduction in food spending, I think it was like four to six dollars per person per week, something along those lines. And now I've heard other varying statistics that are different than that. So they're all over the place. Everyone's quoting stuff. So what give us from what you know, Dr. Bob, like what what are some of the real statistics on the usage or any other interesting things that that would be uh valuable to our audience?

Yeah, I mean, you know, part of the reason that the statistics are in a lot of different places is this is just happening very quickly. And so, you know, it's hard to stay up to date and measure these things. What we do know, uh, uh, and this was the Kaiser Health Foundation, um, did a study that said one out of eight people in the adults in the US have tried a GLP one. So many people have tried it, but here's an interesting thing: more than half of the people who take a GLP1 stop it within a year. Um, and and that is a real issue because that's much more so than most any other therapy. And sort of understanding that, cost and and access are certainly part of that, but side effects, expectations, you know, I think is an important one. You know, it takes time for these medicines to work because you start at a at a very low dose and gradually go up to minimize the side effects. And so to really see the kind of weight loss that I described, 15 to 22 percent, takes months to get there. And there are people that, you know, will take it for a few weeks and go, I didn't really lose anyway. This stuff doesn't work, and they stop it. So I think there's an educational component here that can help as well. But it's estimated, uh, you know, this is a wild uh uh sort of thing that I saw. The airline industry has started to think about what the implications over the next decade are in terms of people on these medications weighing less, planes are going to carry, you know, less weight, and it's it's a hundred million liters of jet fuel that they'll be able to save as a result of this. It's having implications in so many different areas. Restaurants are struggling with this to try to people are splitting meals more, but we're just beginning to understand the full implications.

Yeah, that's that's interesting, right? Uh so that's there you have it, people. If you want to you know save the environment, get on GLP ones. Side effects. You you mentioned, let's get into it. But what are the uh what are some of the side effects that that you guys are seeing with with the uh with the medications?

Well, the the most common is is nausea and GI upset, uh constipation, diarrhea, those types of things. That that is reasonably common. You went off camera if that's I'll continue anyway.

Yeah, please do.

The the the the nausea issue is is very common. The way to get around that, or the way to reduce that is to start at a very low dose. And so typically these medicines are started at the lowest dose for a month of weekly injections, and then going to the next dose. And the side effects get better over time, and so some people are able to tolerate that, some cannot. So that that's the most common side effect. I think the the side effect that is particularly important for this audience is muscle wasting. So turns out that that almost any kind of weight loss results in loss of fat, but also loss of muscle. And so these medications similarly do the same thing. And this is where interventions can happen to reduce that weight loss, and strength training and protein intake are two biggies.

How uh what have you seen so far as far as how the fitness industry has partnered with with GLP ones? Is there any shining examples across the country where you've seen, okay, like this program is doing exceptionally well of taking GLP? LP1 patients offering them the support they need through exercise, strength training, nutrition, lifestyle. Like, yeah, what can we emulate?

I I think there are examples out there. I think it's evolving quickly because, again, this whole phenomenon, everything we've been talking about, has really only been over the course of two or three years, and the skyrocketed use has really increased significantly. I I think the message that I would give to your audience is you know, A, this is a great opportunity to uh to jump into uh in terms of helping people live healthy on these medications, because again, probably one out of eight of your clients are using these medications, perhaps even more, to a strength training program and explaining to them why strength training is that much more important on these medications than before, I think is another important message, and ensuring that they get enough protein intake. Because people eat a lot less on these medications, and that's part of why they lose weight, it's easy for them not to get enough protein. And the general sort of minimal recommendations are 0.8 grams of protein per kilogram body weight per day. And if you're over 65, 1.5 grams per kilogram uh per day. And people may need even more, but we know that those are at least the minimum. And and so doing some kind of nutritional intake and being able to sort that out uh can be helpful. I I think another area that they can play an important role, and I think you see examples of this, uh, are providing the education uh and information to people on these medications. Because typically, you know, clinicians are busy, you know, primary care providers have less than 10 minutes, they have to cover lots of different areas. They don't get a chance to really talk through all of what we're talking about in terms of these medications and how to use them appropriately, how to matter side effects and you know, all of that opportunity. Again, trainers are are, you know, day by day interacting with these individuals, and they can really motivate them, engage them, and educate them. I think there's a huge opportunity there. And I think some are moving into that space, but honestly, I think everybody should.

And this brings up uh something that you and I are just talking about prior to recording, which is keenly interesting to me and something I've been talking about for a long time, is like, can the fitness industry and the healthcare industry work together? Is there a convergence happening at this point? And in order for some, and this is a great kind of focal point for something like that to take place. Um, you know, the setting's perfect, like the combined effects of both exercise, nutrition, and the pharmaceutical are undeniable when done correctly. So it's it the table seems to be set for this to happen. What what in your mind needs to take place? What needs to change for us to fully have a great partnership between the fitness professionals, the gyms and the health clubs, and the healthcare ministry as it exists now?

First, I would say I I I think this is an opportunity for that to happen. You know, I think uh clinicians are thinking more and more about the muscle loss issue and and how to deal with that. Um, from the the the clinician, the healthcare professional side, I can speak to, uh again, time is uh very hectic. They can make a suggestion, and this is an educational thing that has to happen for them, to say you should do some strength training. Are you a member of a fitness center? Have you thought about doing that, etc.? I think that's one step. The next step would be to know the right uh fitness providers to refer to. And that involves connecting. You know, the way that happens amongst physicians in general is through social interactions and other, you know, sort of ways. Like that's how we we often decide who to refer to. We know we get to know people and we go, oh yeah. Or or a patient comes and said they had a great experience with X, and the provider goes, Okay, well, maybe I'll I'll mention that, you know. I think targeting primary care providers with that kind of thing because they tend to have people local. And so uh uh knowing who the fitness, you know, uh providers are locally can be really helpful. So I I think patients can be their own advocates and educators of clinicians. I think the fitness professionals can reach out in in even sort of simple social ways, believe it or not.

Yeah, we're all people.

We're all people, right? Exactly. You're you know, uh you're at the you know, yeah, exactly. So I I think there's opportunities there. And this is this is a nice place for that conversation to happen because strength training and muscle loss is on the radar for clinicians in a way that it wasn't as much before.

What about education for the fitness professional? Like do you see ways in which that needs to evolve as well?

Yeah, I I I do. I think you know, this kind of podcast is a great way uh to get people up to speed because as as you started out by saying, everybody has you know strong opinions, but often don't have all the facts. And so understanding more of the facts and and getting them from reputable sources, because again, you can see anything and everything out there, I think it's really important. So going to trusted sources for this kind of information, and then as they become more educated, they can share that information with their clients in a really uh helpful way.

Okay. Dr. Bob, if you were going to open a health club gym, right? And you're going to have the perfect synchronicity between the health club and the trainer and the gym, and I know you're not a gym operator, so we'll take that into credit, but what would you create? How would this look in a perfect world to you? What would that uh look like?

Wow, that's an interesting thought experiment. Well, I you know, you know, it seems like the key here is engagement. You know, from what I understand and some of the statistics I heard at the Connected Fitness Conference, you know, people join, but it doesn't always stick and and they don't go regularly. And again, any any treatment, and I I I would consider fitness and exercise as a treatment is only as effective as whether people are adherent to it. The models that I thought were were particularly exciting were where where a sense of community is established andor relationship either with a trainer. That's I I think that's part of the magic of trainers is that they they develop a relationship and then people want to continue because of that relationship. The examples of fitness centers that create uh an environment where you want them just sort of hang out and socialize a little bit and talk to other people, and you know, that also helps things to stick. So I think one big piece is addressing that. And I think digital tools can help, digital wraparound tools can help in that. I think the more you know, creating this sense of uh we are the experts and we know about fitness and nutrition, and uh to the degree that one can um, you know, certification programs or other, you know, sort of validated ways to be able to say, no, it's it's not just me saying that. We have a program everybody's trained in a certain way, I think, can can really help to develop the trust that you need. You know, so I think community and trust are two big pieces of this to ensure engagement.

Yeah, it's it's really interesting that the there's been some emergence of specific educational programs for fitness professionals around GLP ones. I know Eric Durac created one, and there's there's been a couple other ones as well. So I think that's something that people should really start to pay attention to because this is emerging, it's not going anywhere. You said something um about a digital wraparound tools to help the engagement of of the consumer and the patient. What is that what does that look like in in your mind?

Well, you know, there there are a number of things out there, and I think this is also evolving in exciting ways. The simplest are are sort of reminders, which are somewhat effective. The more that it can be personalized and contextualized, the better, and the more effective. Again, it's it's again, once again, about engagement. You know, most of these digital tools, if they're not super engaging, people use them and then stop and they ignore all their reminders. But but we know a fair amount about that uh sort of field, and you know, the giants like you know, Facebook and you know, etc. etc., have figured out how to sort of get you coming back. So using that type of knowledge, personalizing it, uh, and again, AI can be really effective here to to give you the right nudges at the right time to eat healthy, to ensure that you're getting enough protein intake if you're on these medications, to, you know, we missed you, a personal note or something that feels personal, even if it's uh AI generated. I think all those things can be effective.

Are there any specific tools out there that exist now that you would refer people to or anything you've seen that that's uh there there are a number of them.

I I think the you know, from from the large companies that are doing this, you know, like uh Noom and others, to smaller startups that are using lots of contextual data. There's an Israeli company, Swech, that has created a great tool. There's uh LARC that it is all AI-driven coaching in a fun and friendly way. I think I think there's a lot of these out there. And and you know, where fitness centers can partner with them, they can certainly develop their own, uh, and or they could partner with something that's already out there. Uh I also what we do know about behavior change in general is that tracking and feedback are effective tools. And so people that are, you know, I have been wearing an aura ring for, you know, for ages. I I just like to get that. I'm just like that kind of data kind of guy, where you can get people to track things and review. That is a powerful tool to keep engagement going.

As far as like uh diagnostics for these patients, like you you mentioned, you know, um, aura ring, I have mine, I love it, I love Garmin too, I love all of them. Today's episode of The Future of Fitness is proudly brought to you by EGym, a vertically integrated market leader in the fitness and health industry with an incredible vision, transforming healthcare from repair to prevention. I've been a huge fan of EGM's team and technology for years now, and I can tell you that their commitment to innovation is unparalleled within our industry. Here's what makes EGM so special. They partner with companies to improve employee health by providing access to fitness and health facilities. Then they equip those facilities with cutting-edge smart gym equipment and digital solutions. The benefits are clear. Companies see reduced healthcare costs and increased productivity, while fitness facilities benefit from a growing engaged membership base. What really excites me is eGym's smart fitness ecosystem. By combining their strength equipment with AI-powered software and their corporate wellness platform Wellpass, they are leading the shift to proactive preventative health. This isn't just AI for show. This is the real deal. If you're interested in learning more about EGM and how they're transforming healthcare through exercise, visit eGym.com. That is EGYM.com.

Yeah, there's a bunch of good ones out there, yeah.

But what about like regular diet? Like are these patients getting blood work on a or should they be getting blood work on a regular basis? Are we doing any stuff with like, you know, any kind of genomics? Are we doing any kind of yeah, what what other technologies are being integrated?

So there's standard of care kind of stuff, which is, you know, sort of general monitoring of lab tests. And then there's sort of the the frontier things that, you know, sort of the bleeding edge of what else could be looked at. And I think we're in the early days of understanding that, but I am sure that in the near future we will understand more and more. I I went to a great conference, and you can uh uh see information about this on the web called Nex Med Health. Uh, and it's sort of the future of healthcare. And this year it was really dominated, as you might imagine, by AI. And so one of the exciting uh things that are in the near term is creating a digital twin of yourself that would have all of your data and then be able to simulate different uh uh things to see what the impact would be on your health. And again, the more data it has to use to determine that, the more it's gonna be able to personalize it for you. Like, what's the biggest bang for the buck for you? We're living in crazy time. It's pretty wild stuff. We're living in crazy time. And it's it's near term. I mean, this is not 10 years from now. This is you know, uh a couple of years. Uh and then yeah, I mean, even less. Yeah. The the pace of that world is just moving so quickly.

And I want to I want to get back to to your vision of where the future is. But you know, it it's just it's so fascinating to me. Right now, I'm reading this book about Kit Carson and the mountain men of the West, and you know, back in like the 1830s and 1850s, and I I sit there and I'm reading and I'm like, they would find our world now completely unrecognizable, right? None of it would make sense. And with the rate of technological evolution that we're seeing right now, I think in 20, 15, 20 years, we're gonna say, like, we were in the stone ages back in in 2024, right? It's it's it's ridiculous at how fast it's going.

In less time than that. I think in less time than that, because it it's accelerating.

Yeah, I completely believe that to be true. Yes. Yeah. Well, we're we're gonna touch on that before we close out here. But the uh one of the things I want to get on, because you mentioned in notes as we were we were preparing for this, is exercise memetics, which I never heard of before. So educate me. What do you mean by that?

Well, you know, this is also part of that pipeline of medications. Uh so the concern that uh there's muscle loss associated uh with these medications and weight loss in general, can you stimulate muscle growth in the way that in the way that strength training does? And as they're understanding more and more of what controls muscle muscle growth, there are some agents that are being tested to see if they can, in essence, mimic the effects of exercise. I personally don't think that it's going to do everything that exercise does, but it could, it could increase muscle mass. And uh that would be one step. That said, uh, you know, one thing I I often you know will say to patients and others is if you know, if you look at all of the benefits of exercise, if this was a if this was a pill, and I'm not suggesting it should be a pill, but but to how effective it is on so many different parts of the body and the brain and everything, I mean, there there's nothing like it. And so firm believer that exercise will always be important, but could there be medications that help individuals on on uh the GLP ones to sort of build some muscle mass?

The uh some of the things I've been hearing and reading about too is it's not just about weight loss with GLP ones and and some of it, it's it's talking about effects on addiction, right? And things like that. So, what other uh opportunities do you see for this particular classification of drugs in other areas?

Well, I I think that that really is what's made this such an exciting area. So the things we already have proof of is that they uh lower the risk of heart disease, uh, that they help with sleep apnea. And these are based on randomized control trials where these are based on randomized controlled trials where half the people get the medicine, half the people don't, they don't know, and the investigators don't know, so they're really like the gold standard to see what works. So heart disease, kidney disease, liver disease, sleep apnea, osteoarthritis, all of those have evidence from these large trials to show that they're beneficial. And then there's a slew of new possibilities that are being best investigated, and one is around substance abuse and addiction disorders, and there is some evidence to suggest that it's beneficial there. Other exciting area is around dementia and Alzheimer's, where there's some evidence to suggest it may be beneficial there as well. And psoriasis, of all things, seems to be beneficial there. So the list keeps growing. There was just a study released that showed benefit for people with peripheral arterial disease that get pain on walking and are limited by how far they can walk. A year of treatment with these medications improved that significantly. So stay tuned. These medicines seem to do uh a variety of things beyond what they were developed for originally, was really just to lower blood glucose for people with diabetes. And now we've gotten to you know all of these other benefits.

Wow. The the big thing I think that the industry wants to know, excuse me, is the uh is this actually driving people to work out more, right? And I've been um very opinionated. And uh, as one of my my friends Brandon Cullen said, I says, unfortunately, one of the side effects is not exercise, right? Uh, you know, people have to do that on their own. And yeah, I know it's very anecdotal now that we're seeing some people go in, but my my my base thought on what I've seen on human behavior and my time in the trenches as a coach and a gym owner is like it's very difficult for people, and you know, if there's an easy pill for people to take to lose weight and they don't have to do the hard stuff, they're probably gonna lean towards towards the pill alone, right? But a percentage of them will definitely do both, right? Well, they'll do the lifestyle, they'll do the exercise, they'll do the nutrition alongside. So, I mean, are we seeing any early indications now that this is actually driving people to to work with trainers in health clubs?

The date is mixed so far. I do think there are people that, you know, are, you know, and I and I see these individuals as patients that have been so demoralized by their weight um and and the shame and stigma associated with it, they they just can't even imagine going to a fitness club. And now with treatment and and losing some weight and having some success, they're more empowered to want to go do something to be healthy. People unfortunately can get into this sort of rut of it's just not even worth doing anything because nothing works. And I think you've got a lot of people with obesity that have fallen into that sort of rut and continue to eat unhealthy and not exercise. For many people, this has helped them to move in the right direction. And so, yes, there'll be some people that say, Well, you know, I don't need to exercise, which of course is wrong. And the side effect of strength training, you know, the importance of strength training is something they need to understand. But there'll be others where this jump starts them to want to take care of themselves a bit more because they see some success.

Uh, so here's here's a fun question I have for you. So we're in 2025. Uh, let's paint the picture for the turn of the decade 2030. Where do you think you'll be? Where do you think our our our country, our communities will be when it comes to our health, how healthcare has changed, you know, but paint paint the big picture, the science fiction picture, right? Where where do you think we're gonna be?

Wow. Yeah, I I think there are a lot of things that will change and disrupt things. I I think that uh there'll be a number of new GLP1-like medications available. The hope is that as uh they're more on the market, the cost will go down, access will increase, coverage will be better, and more individuals will have the benefits of these medications and the newer versions that'll be available by then. That is likely to lead to some bending of the curve of obesity. And doing that has so many other different implications for health, uh, because obesity is sort of the central problem leading to so many other things. I'm hopeful that that happens, that society becomes more comfortable with the idea of uh uh treating obesity as a disease in the same way we treat hypertension and high cholesterol, and there's no shame in saying I'm on a on a statin for my cholesterol. Uh uh, you know, uh that it's just a normal, like, sure, yeah. Is it everybody at a certain age, you know? Uh I I I I hope that there'll be a better understanding around sort of the roles of exercise, weight training. I think there'll be AI tools that will make it easier to have all the information at the right time, both for the individual themselves and for the clinician that's seeing them. And you know, one thing I'm excited just as a clinician is to spend much too long uh Of my visit with my patients staring into a computer screen instead of looking at them. Because I have to make sure I check all these boxes and do all that stuff. Well, AI, you know, can and already is to some degree solving that problem. And so the relationship between provide healthcare provider and patient becomes stronger because that I do think is the magic that that medicine has always had. And I hope that this will enable that human connection to be even stronger. And I hope that, and we were talking about this a little earlier. Uh, you know, if you if you think about, you know, I thought of the analogy of like chiropractors, you know, 20 years ago, they were sort of on the fringe a bit, and and particularly from the healthcare professional sort of side, they were not really part of the club, so to speak, and they gradually became part of the club, reimbursed by insurance, and now it's a standard form of treatment. Well, I'd love to see the same thing happen for fitness professionals, that they become an important part of the ecosystem, not only recognized by healthcare professionals, covered by uh payers. And I hope that we can get there because there's no medicine better than exercise out there right now. And so we just have to find the ways to make that happen for more people.

Yeah. Well, that's a whole nother conversation for a whole nother podcast and how that would happen, Dr. Bob Gay. That's uh that's something I I would love to see. I think there's uh a lot of people within our industry that are advocating for that, but also there's there's a lot of people who have just kind of lost faith that it's ever gonna happen. So we'll see. I mean, uh, you know, who knows? Tomorrow brings a new day, and things right now are pretty exciting. And really appreciate you spending your time with me. This has been super informative, and I hope a lot of people listen to this once, but maybe twice, and and get a firmer understanding of what the opportunities are here, what the real realities of are of the drug and its applications, um, and go from there. Doctor, uh, if people want to get a hold of you, or if you'd like people to find out more about what you do, is there any place you'd like them to go on?

Yeah, probably the the best is LinkedIn. I post a lot of uh new things around GLP1s and lots of other things. That probably is the easiest place to do that. And I really want to thank you for the opportunity to to join you and also for your forward thinking to cover this topic in depth uh for your audience. And so uh thank you.

Yeah, ladies and gentlemen, Dr. Bob Gebet. Hey, wait, don't leave yet. This is your host, Eric Malzone, and I hope you enjoyed this episode of Future of Minute. If you did, I'm gonna ask you to do three simple things. It takes under five minutes and it goes such a long way. We really appreciate it. Number one, please subscribe to our show wherever you listen to it, iTunes, Spotify, Castbox, whatever it may be. Number two, please leave us a favorable review. Number three, share. Put it on social media, talk about it to your friends, send it in a text message, whatever it may be. Please share this episode because we put a lot of work into it. We want to make sure that as many people are getting value out of it as possible. Lastly, if you'd like to learn more, get in touch with me, simply go to the futurofitness.co. You can subscribe to our newsletter there, or you can simply get in touch with me as I love to hear from our listeners. So thank you so much. This is Eric Malzone, and this is the future of fitness. Have a great day.