Transcript 

 

Weight Loss Resistance: The Interplay of Stress, Gut Health, Circadian Rhythms, and Nutrition on Our Overall Health with Dr. Alexis Cowan

 

Michelle Shapiro [00:05:23]:

Doctor Alexis, who is just I can't even speak to how bright her light is. She is all pure light and knowledge. She has a personal weight loss of 100 pounds as well on a really similar timeline to mine. We have so much in common and what we don't have in common is how brilliant she is. She is truly, truly incredible and I will just say also about this episode that Doctor Alexis uncovers these really hidden lifestyle deficiencies that might be holding us back from weight loss. And they're the very lifestyle deficiencies that she corrected to have lasting weight loss. I'm so excited for you to hear this episode and learn more about some of these mechanisms of what may be holding you back or holding a love button back from losing weight. If it's something you want to do in a safe, effective, and while minimizing any disorder relationship with food way.

 

Michelle Shapiro [00:06:20]:

Can't wait to see you in there. We have the amazing Doctor Alexis Cowan on the podcast today. You are, you know, littered with letters after your name that we're going to hear about too, and just one of the most academic, but more importantly, soulful and spirited practitioners ever met. So I'm elated to have you here today.

 

Dr Alexis [00:06:48]:

Well, thank you so much for having me. I feel the same way about you. I feel like we're literally soul sisters. I'm so glad we connected from the amazing Gabrielle Lyon. So I'm really excited to be here.

 

What is your personal weight loss story and how did that impact your career path?

Michelle Shapiro [00:06:58]:

We're like soul sisters. So, Alexis, also tell us, I want to hear your personal weight loss story, and I want to hear your kind of how you moved through your career, what made you choose the exact path you did, how those two might tie in or might not. We just want to hear your story and I want to hear both your personal and professional story.

 

Dr Alexis [00:07:16]:

Oh, wow. Well, this could be a three hour long tale, but I'll do my best to make it succinct. So I would say it really goes back to my time in first grade where I kept getting recurring strep throat. And I'll just sidebar briefly that I've done a lot of reflecting on my earlier life, and I really think that I was in mold my entire childhood. So just a little aside, but back to the story. Got recurring strep throat in first grade. My mom ended up pulling me out of school because I just kept missing so much school. And I ended up getting homeschooled.

 

Dr Alexis [00:07:50]:

And then during like the year and a half that I was homeschooled, it was just like the latter half of first grade and second grade, when I went back to third grade, I weighed like double my classmates. So my weight just ballooned during that period of time. I was also on antibiotics for months at a time because of this strep. It just kept coming back. And now I think there's quite a bit of research showing that early childhood antibiotic exposure can lead to obesity, usually later in life but for me, it was really immediate. And so with regards to, like, the mold playing into this, I really think that I was basically just having impaired immunofunction because I was in this kind of. I mean, we lived in the countryside. I wouldn't say that it was, like, the cleanest house.

 

 

Dr Alexis [00:08:35]:

I never really thought of any issue with it when it was happening. But now that I'm thinking back on it, it was certainly an older home, and there was definitely some water damage, smells going on in different places. So it's, like, really sketchy in that way. But between the impaired immune function and then the antibiotics and then just being in the house all day, every day, essentially, for that year and a half when I was being homeschooled, I think that was really, like, the death knell for my metabolism. And it just kind of. I ballooned. And so that weight journey kept spiraling, essentially up through. I was, like, sophomore or junior year of high school, I guess, and I maxed out somewhere around 275 pounds, something like that.

 

Dr Alexis [00:09:17]:

And at that point, I was just kind of miserable because I was also getting, like, lots of upper respiratory infections, lots of skin issues, terrible acne, things like MRSA infections on my skin that I was just, like, having to deal with because I was already, I should mention I was already kind of very wary and suspicious of the mainstream medicine just because it had failed me already so many times as a kid. So I was somebody who, like, would hide if I had health issues and just try to deal with it myself because I didn't want to go to the doctor.

 

Michelle Shapiro [00:09:48]:

You're probably scared of the doctor, too, because you would be judged for your weight. Kids are always judged for their weight and at the same time, not getting any help. And those.

 

Dr Alexis [00:09:55]:

Well, yeah, that was the weird thing. It was like nobody ever told me, like, you're obese. You need to lose weight. It was just like the elephant in the room, almost literally. And, like, you know, as. As a kid, having to navigate that. Like, I didn't actually have the wherewithal or the tools to actually do anything about it until I was, like, around junior year of high school, I want to say. And that's when I just, like, committed to changing my life because I was just sick of being sick and tired and not being able to fit into the clothes I like not being able to, like, fit in at school.

 

Dr Alexis [00:10:25]:

Just feeling like an outsider, which was already exacerbated by the fact that I grew up in a very rural part of New Jersey that was like the caucasity of it. Like, I was one of the darkest people I knew, and I'm barely dark, so, like, that just already added to me feeling kind of estranged from my community. And so I ended up joining a gym with my friend, and we went, like, every day for a year straight. I started counting calories, 1500 calories a day, strictly lots of processed foods, because they're easy to count calories. I know we've talked about this before.

 

Michelle Shapiro [00:10:56]:

But there's a label.

 

Dr Alexis [00:10:57]:

Exactly. So there's a label. It's easy to very much tally up what you're eating. And so I was very much doing, like, a higher carb, higher protein, low fat diet. I think that's really, that was really at the forefront in the nineties and early two thousands, just like, kind of a fat phobia, so to speak. And so that was the approach I used. And over the course of a year, I lost about 90 pounds. And then after that year, I continued to lose maybe an additional 15 pounds, for a total of around, like, between 100 and 110 pounds over the course of, like, a year and a half.

 

Dr Alexis [00:11:28]:

And it was life changing, and people treated me different, and I felt more confident. And I had also picked up weightlifting during that period of time, so I was doing like, an hour of cardio a day at the gym, but I was also lifting for about 45 minutes to an hour as well. And that really changed the game for me, too, because I think, especially after I lost the weight, I got into crossfit and more like a heavy style of lifting, and I saw my body being sculpted, and that really helped with my confidence and stuff because I had a lot of loose skin after the weight loss, of course, which is something that a lot of people don't talk about. And I wish I had known, yeah, I wish I had known how to prepare my skin better or prepare my mentality, at least, to manage my expectations, because I think a big part of the body dysmorphia that comes after major weight loss is like you were expecting to look like the person in the magazine, but now you're actually left with this memory of how you used to look with all of this extra skin, which is also a badge of honor in some ways, but it can also feel like a burden, depending on your perspective around it. Anyways, lost the weight, got into weightlifting, but also had a very strained relationship with food. Good. Obviously, I'd been counting calories strictly for that year, year and a half. And at that point, after you lose the weight, there's this terror of, I cannot gain this weight back.

 

Dr Alexis [00:12:46]:

That's the worst fear imaginable. And so I just kept wanting to restrict more and more and I developed a very disordered eating habits around not only restriction, but also develop bulimia after I lost the weight. And that lasted for like six years after that. So, you know, I think that's all too common with, like, diet, culture. And just trying to have a healthy relationship with food in the post weight loss period can be very challenging without the proper support and the proper, like, information and guidance in that area. But. So anyway, bulimia also developed IB's during this post weight loss period. I had like blood and mucus in my stool every day for like over a year.

 

Dr Alexis [00:13:27]:

Went to the doctor, they basically said, you're pretty young, it'll probably go away, but if you want to use some immunotherapies, that's probably the best we can do for you. And it's like, okay, I don't know, or something.

 

Michelle Shapiro [00:13:38]:

Like an IBD treatment or something.

 

Dr Alexis [00:13:40]:

Yeah, exactly. And it's like, so there's no discussion about anything I'm doing in my life that could be attributing to this. So I just decided that was kind of the death knell for my reliance in any way, shape or form on the mainstream medical model. I'm like, I'm just taking care of myself. I'm going to figure this out. So I ended up doing some research myself online and finding that elimination diets were super helpful for people if they're having any sort of digestive issues. So I ended up doing that and I found out that dairy was a major trigger for me and I removed dairy completely from my diet and all of my symptoms went away. Like, literally all of I suffered for.

 

Dr Alexis [00:14:17]:

I literally couldn't eat anything prior to that without feeling intense, bloating, gas, like my gut was just going to burst. And also, interestingly, but kind of disgusting, my gas literally smelled like gasoline. Like, my microbiome was messed up.

 

Michelle Shapiro [00:14:31]:

Yeah, it was trying to send you whatever signal it possibly could that, like, this. This ain't right, basically.

 

Dr Alexis [00:14:37]:

Yeah, exactly. And message heard loud and clear. Because, you know, this was just like just the worst thing I wouldn't wish on anybody. Just not being able to enjoy food, especially me being a tourist. Elliott, I'm a major foodie. Like, I love my fine dining, I love experimenting with food, eating all different types of things. And this was just like off the table during this period of time. So anyway, I identified dairy as a trigger, removed it, had complete symptom remission, and realized that like, wow.

 

Dr Alexis [00:15:07]:

Like, what I'm doing really has an impact on the way that my body is feeling and the way that it's responding. And so that was really like an introduction into thinking more about food quality instead of quantity, because prior to that, I'd been very calorie focused. But now I was thinking, okay, well, if dairy is causing this, what other aspects of my diet could be optimized, let's say? And what can I do to actually be my best, healthiest self? And that's when I really started my journey onto thinking about the quality of the food, like eating more organic whole foods, like eliminating processed foods, and just really trying to simplify my diet and just basically getting the best, best food that I could into my body. And that, I will say, was really, really helpful from the eating disorder perspective, because as it turns out, when you stop eating a lot of the processed foods that are hijacking your reward center, it becomes much easier to regulate your appetite because there's these signals that are in place to respond to whole foods that send signals to your brain to saying you're full. Obviously, nutrient density as well is contributing to satiety and just how good you're feeling in your body. And so this was like a big aha moment for me around, you know, just not feeling guilty around eating food because I was no longer eating, like, the franken foods or like, the processed foods that actually were making me feel guilty to begin with. So when I started eating, like, a whole Foods based diet, I was now feeling really good about what I was eating. And I didn't feel the need to, like, restrict and purge like I had been doing before.

 

Dr Alexis [00:16:39]:

During my time at Princeton, I discovered the microbiome. And so keep in mind, up to this point, I had still been restricting dairy. I hadn't eaten a single bit of dairy, not even butter, in, like, five years. And I discovered microbiome research, and I discovered Joel Green's book, the immunity Code and optimizing for bifidobacteria and Ackermansia to help reshape the microbiome to receive health outcomes. And I started implementing some of the things he was talking about regarding polyphenols and human milk oligosaccharides to help breed specific strains of bacteria in the gut. And the results I saw were, like, unimaginable. So after six months on that protocol, I reintroduced dairy with zero issues.

 

Michelle Shapiro [00:17:20]:

I'm glad you said that, too. And I was, like, waiting for that because I didn't want people to think elimination diets cure thing, and you're still not like that. So I was like, all right, there's the part of the story we need, Alexis.

 

Dr Alexis [00:17:28]:

Okay, good.

 

Michelle Shapiro [00:17:29]:

Yes.

 

Dr Alexis [00:17:30]:

Yes. So moral of that part of the story is that, you know, restrictive diets or elimination diets have a time and place in the short to medium term. But the goal should always be to be able to have flexibility in your food and be able to eat whatever you want without having issues like that would be the ultimate goal.

 

Explain how an altered gut bacteria mold can cause long term weight loss resistance, and why some people might gain weight in the long term and others in the short term?

Michelle Shapiro [00:17:46]:

Right. That's what health is, having. Metabolic flexibility, which, of course, we're going to talk about digestive flexibility. It's about making the body more adaptable. But while the body is not adaptable, you need to adapt to it so that you're not symptomatic, essentially. Okay, the first thing I want to talk about is you mentioned in that piece of the story that I think we hear a lot. Oh, you know, an altered gut bacteria, mold, these things can cause long term weight loss resistance, but no one literally believes it. For you, it was this very direct relationship.

 

Michelle Shapiro [00:18:19]:

You had exposure to these toxins and immediately gained a rapid amount of weight. Take us through a little bit about the mechanism behind that, and also why some people might gain weight in the long term, but some people in the short term. Why for you, if we can speculate, I don't know if we have an answer. Do you feel that it was such a sudden and extreme onset of weight gain for you?

 

Dr Alexis [00:18:38]:

Yeah. So I think part of it is certainly a dose response. So for me, I was taking antibiotics, which are already toxic to mitochondria at a certain extent. Many people may not know, but the whole endosymbiont theory around mitochondria is that millions or billions of years ago, these bacteria fused with single cell organisms to create the first eukaryotic cell, or like the first cell that had its own mitochondria in it as well. And that mitochondria is derived from a bacterial cell. And so mitochondria and bacteria share a lot in common with regards to their function, with regards to their structure. And so in that way, antibiotics to differing extents, especially like the fluoroquinolones and like cipro, they're very mitochondrially toxic. But, you know, all the antibiotics, like.

 

Michelle Shapiro [00:19:27]:

Some of the most that are prescribed because they're for utis, by the way, so they're like candy prescribed.

 

Dr Alexis [00:19:31]:

Yeah, it's insane. It's insane. And I know so many people have been damaged long term from them, especially like tendinitis that can cause Achilles tendon tears. Like, there's nobody's business. My approach for like, optimizing the microbiome is kind of twofold. We can do prebiotics which make a way bigger impact on the microbiome composition compared to probiotics. You can think about taking probiotics as putting a drop of water into an ocean with regards to the number of organisms in a probiotic compared to the gut. But on top of that, if the proper substrates, the proper food sources aren't coming through, those bacteria that you're taking via supplementation aren't actually going to stay and colonize the gut and provide a benefit.

 

Dr Alexis [00:20:09]:

My approach is typically always a prebiotic based approach, but also some postbiotics as well. Postbiotics are molecules made by probiotic bacteria when they eat prebiotics. Yes.

 

Michelle Shapiro [00:20:22]:

How about that?

 

Dr Alexis [00:20:23]:

Yes. As an example, there's a strain of bifidobacteria that when it digests or metabolizes this pigment molecule from pomegranate, and it makes a compound called urolithin a. So in this context, urolithin a is the postbiotic, the bifidobacteria strain is the probiotic, and the prebiotic is that pigment molecule from pomegranate. That's just one example. Another example is all your fermented foods. So the Sonnenberg lab has shown really nicely that the benefit from fermented foods actually comes from the postbiotics, not the probiotics. So people assume that, oh, the bacteria in the fermented food are actually, you know, they're colonized in the gut and they're giving me benefits. What's actually happening is those bacteria that are used to ferment the food, make postbiotic molecules from digesting the cabbage or whatever it is that's being fermented and makes those postbiotics that then can go in, into the bloodstream, into the gut and feed beneficial bacteria and help to increase gut microbiome diversity.

 

 

Dr Alexis [00:21:19]:

So that's the postbiotic story. And I think they can be very beneficial, especially in the context of like, whole foods, like fermented foods in combination with prebiotics. Then you're really starting to shape the microbiome in a very impactful way that will also be more lasting or durable compared to taking a probiotic supplement, let's say 100%.

 

Michelle Shapiro [00:21:40]:

I also, I'm loving butyrate these days, by the way, for clients, I feel like they're tolerating it super well. I just also have to say the way you're talking is so in the heart and spirit of functional medicine, to me, because when I think of functional medicine or I think of functional nutrition, I really think of it as being not okay. We take bacteria, bacteria goes into stomach. It's like, well, what's the benefit of taking the bacteria? The benefit is the byproducts that it's.

 

Dr Alexis [00:22:03]:

Producing as a result.

 

Michelle Shapiro [00:22:04]:

So I love the hack of just going to the actual thing that we're looking to do and at the same time going about it, like you're saying in the most human way, right? Go outside, get dirty, do these things, like, and actually have the body do the thing as opposed to trying to put a supplement in to make that thing happen. I don't know. So I feel for you always look at the body in a very mechanistic way like that, which I think is very powerful.

 

Dr Alexis [00:22:30]:

Yeah, I like to. And I like to always reflect it back to nature and what nature intended for our species, because that's how we evolved, and we're shaped over millions and millions of years, and that's the way that our bodies are designed to work best. So the more we can get back to the laws of nature and the way that nature interacts with our bodies and at least mimicking that, at the very least, if not, like, actually getting out and doing the things like outside in nature or, you know, getting as much sun as you can or getting your feet on the ground, there's ways that we can kind of mimic that indoors as well. But I think nature can never be replaced. But as long as we're kind of leading our lives with nature in mind, then at least we're going to be way better off than being just very disconnected and, you know, like, mechanistic in, like, a cold and reductionist way versus, like, we're looking at the mechanism, but then we're considering it in the context.

 

Michelle Shapiro [00:23:19]:

Of the whole existence to. Exactly. Yeah. It's not just, you know, again, going, I did this, like, little visual on Instagram recently that was like, you know, allopathic dietitians will look at an apple and be like, this apple has quercetin and fiber. They might not even say quercetin. They might say, this apple has fiber in it. And that's why it's good for your blood sugar. What I'm always considering and thinking about is what happens when that apple goes inside of this particular person's body, and then what is the downstream effect of what that apple does? Right.

 

Michelle Shapiro [00:23:46]:

And then if you zoom it out even more, it's like, what happens in that downstream effect of that apple while this person's also talking to someone they love, and you kind of zoom out and think everything in context of something else. And I think that is the heart of functional medicine that people are missing when they're like, I'll take a gut test and take some supplements. I'm like, the context of environment and the context of humanness, I guess you could say, is always missing in those. Just, how do I take this supplement? And I get this question. You get this question, I'm sure all the time, too, when people say, what do you think about this supplement? And I'm like, I don't really think about supplements independently. It's not something that I go to sleep thinking about at night, you know, this supplement, I'm thinking about what is going on within your body, within your community, within your relationship with earth, and then how do the things that we want fit into that or support that or take us towards that. And I know you do that, probably the best of anyone I know. So thank you.

 

Dr Alexis [00:24:38]:

Oh, my gosh. Like, this is really resonating to a conversation I had yesterday with a new friend about how, you know, in the modern day, we're really always looking under the hood, and we're looking at the metabolites and the gene expression and the microbes, and we're looking at things that we're not really intended to see, so to speak. And it's fun from, like, an intellectual standpoint, it's fun to be able to understand this stuff, but at the end of the day, is knowing these very specific biomarkers and microbial composition, is that important? I mean, it can be, as long as it's informing us to get back to the way that we're supposed to be living versus, like, I'm gonna biohack this one thing, not considering it in the context of the whole, oh, I.

 

Michelle Shapiro [00:25:21]:

Didn'T know we were using trigger words during this. Oh, we're using biohack. Trigger warning for biohacking. A trigger warning as a term is not an Alexis term, by the way. It's major or not. Oh, my God. I have six more hours of content I need for you. Okay.

 

Why do people kind of feel okay when the exposure is happening, or feel crummy but not horrible, and then when they leave the environment of the long term exposure, the symptoms suddenly come to the surface?

 

Michelle Shapiro [00:25:38]:

So in going back to childhood, I just want to bring something up, too that I have never talked about in a podcast. But it's me I think about quite a bit. It is something I stay up not sleeping about at night, which is that I grew up in the New York City public school system. I know when you were talking about growing up, it's so funny, the countryside.

 

Dr Alexis [00:25:52]:

I'm like, I thought you grew up in New Jersey.

 

Michelle Shapiro [00:25:54]:

But there are really rural areas. Super rural area. Yeah. There's a lot of farmland in New Jersey. Yeah, absolutely.

 

Dr Alexis [00:26:00]:

Garden state.

 

Michelle Shapiro [00:26:01]:

Exactly. The garden state. Full of gardens. You know, like, it's full. We got all of it. So I really think about this. So this is a terrible and honest and real thing that happens. But my sister is in the public school.

 

Michelle Shapiro [00:26:15]:

I mean, in public school system. She's a school psychologist in the department of Education. I call it the DOE. If people hear me saying this. My mom is a payroll secretary in the DOE. My aunt was a, you know, ESL teacher. My. Most of my friends and family work in the department of Education.

 

Michelle Shapiro [00:26:31]:

And what happens is a lot of them work in these schools. They retire and the second they retire, they get cancer or something. It's the rates. I've seen studies on this too, that the rates of cancer and these conditions are so much higher. And I have to just be thinking about what the heck is in those walls. I mean, I would assume also, besides the stress of these jobs, which is extremely intense I grew up in the public school system. None of us were feeling that great, to be honest with you. I definitely know there was something going on.

 

Michelle Shapiro [00:26:59]:

We know there was asbestos. These are extremely old buildings. They had no air conditioning. So we were in 90 degree weather in June in the schools. We were sweating. I remember when I had Spanish on the third floor, I would have anxiety about it all the time. And there was, you know, I went to a high school with 5000 students. So it's a combination of these things.

 

Michelle Shapiro [00:27:17]:

But my thought process and concern and question that I have for you that's completely unrelated to what we're talking about is why do people kind of feel okay when it's happening or feel kind of crummy but not horrible and then suddenly get pounded with some either immune condition or otherwise or immediate conditions that we don't consider to be inflammation related, but probably are. Do you have an explanation for that? Of why it's like when. It's almost like when the storm is over, then the symptoms kind of surface?

 

Dr Alexis [00:27:45]:

Yeah, I have some ideas. So I think maybe an example of like the microcosm of that would be whenever you get any sort of infection, you tend to feel fine during the day or more fine. And then at night you start to really feel symptomatic. And in that case, that's related to cortisol rhythm. So when cortisol is at its highest during the daylight hours, especially level towards the morning cortisol will impair or inhibit immune function. Then at nighttime, the cortisol levels go down, and now immune function really ramps up and it starts to do its job. Now, I'm thinking you talked about the stress scenario of the psychological stress aspect of working in these environments. But we also have the physiological stress aspect of working indoors all the time.

 

Dr Alexis [00:28:29]:

Being under fluorescent lights, not getting fresh air, not being exposed to nature, essentially. And combine that with the stress of actually working one of these jobs and maybe working long hours for potentially little pay, and then over time, you're getting this kind of buildup of a stress response that when they actually do retire or do take a break now, the body is, like, immediately going to try to address the longstanding issues that have been going on that it hadn't been able to deal with.

 

Michelle Shapiro [00:28:57]:

Cleanup. Right. Like, actually get in there and do the detox, actually get in there and fight the battle that it was not able to fight. Which is why I'm assuming also people get sick when they're on vacation.

 

Dr Alexis [00:29:08]:

Yeah, totally. And also, not to mention, like, if there is asbestos or mold or whatever toxic exposures are in those environments, once you get out of them, then the body is better able to deal with that burden. Like you said, start to detoxify whatever toxins or molecules it was exposed to in those environments, because if you're actively in it, your immune function's impaired, your body's processes aren't working to the level that they should. And so you're kind of just cruising along, feeling like kind of baseline crummy, but maybe nothing catastrophic. But then once you're finally removed from that environment, now everything is starting to basically pick up the slack of all the shit you are encountering prior to that. So I think that's what tends to happen. It's like it's a sudden crisis. It's not typically like a slow burn or like a slow build.

 

Dr Alexis [00:29:57]:

It's usually like you're kind of fine, but not great. Probably ignoring signals from your body for a long period of time that kind of accumulate, and then, boom, you get a terrible diagnosis or something like this that you kind of knew was happening just based on the way that you were feeling. But maybe you're using painkillers or over the counter drugs to numb things out or alcohol or whatever vices that you use to ignore problems in your body that are coming up. And then ultimately, you can only ignore things for so long before the pain teacher comes along with an even louder message that you can't ignore.

 

How is stress so potent as it affects our immune system, gut microbiome, and all these other aspects of our health? Even in the context of weight, how real from a physiological mechanism is stress as it pertains to weight?

 

Michelle Shapiro [00:30:32]:

Yeah, it makes me extremely emotional, obviously, because it's afflicted also, so many of the people I love, I just don't think we ever believe that stress, mental stress, or physiological stress is actually causing us problem. And what we're not insinuating is that cancer comes from being stressed alone. Deeply contextual, deeply nuanced. And certainly we're not saying that, but I just don't think we believe that we are operating at a level of stress that is abnormal. I don't think people internalize that at all. I don't think we get it, that stress is so potent as it affects our immune system, gut microbiome, and all these other aspects of our health. Can you give us a little context around that, too? And how potent stresses outside of suppressing immune function, obviously, and that way, tell us about that, even in the context of weight, how real from a physiological mechanism is stress as it pertains to weight?

 

Dr Alexis [00:31:32]:

So, stress is really interesting because the body kind of not kind of. It does interpret stress kind of as this blanket term. It's not like physiological and psychological or chemical stress are, like separated. They're summative. And so, especially in the modern world, there's just so much stress in all the different ways that it's become normalized. But at the same time, if you look what else is normalized? It's autoimmune diseases, cancer, diabetes, obesity. So if you're living a normal life, you're going to get the normal diseases as well. So when it comes to stress, there's lots of different ways or different modalities that feed into this.

 

Dr Alexis [00:32:15]:

I would say so. Common ones would be, of course, psychological stress, which also will impact other areas of stress, or stress resilience in the body. For example, if you're super stressed psychologically, that's going to impair your sleep, which impairs your ability to actually deal with stress and impairs your ability for your body to respond to stress in a healthy way. And then that creates a snowball effect. Typically, any form of stress can create this kind of feed forward mechanism that's impairing your ability to deal with additional stress in other areas. Which is also why people, depending on the state they're in, they may not tolerate exercise very well. They may just be better served to just go on some short walks outside or something.

 

Michelle Shapiro [00:32:58]:

So I need to even further substantiate this idea that you're saying, which is that I always tell clients, your HPA axis has a bidirectional relationship with stress, which means that literally, like you're saying, Alexis, the more stressed we are, the less equipped our body is to deal with stress. It actually hurts the tool of being able to deal with stress. Which is, by the way, something I would change the design of, if remotely possible, in the body. This was something I would love to turn a switch on for. Because I would like to say that we become more resilient as stress wears on us. But it does literally wear on us. And in some ways, we do become more resilient and or medic stress. And we'll talk about that too.

 

Michelle Shapiro [00:33:37]:

But overall, too much stress is just too much stress. And it really does impact our ability to process it in the first place.

 

Dr Alexis [00:33:44]:

Yeah, so this is actually a really interesting point with regards to the dose of stress is very, very important. So there's a dose response for basically everything that our body interacts with. But with stress, if we're getting just the right amount of stress, we can actually mount this hormetic response, this adaptive response that makes our bodies more resilient. But if we get too much stress, that's over that threshold now we're getting that wearing effect that's actually impairing our ability to further deal with stress in any department. And so that's where it becomes really important to be conscientious of the types of stressors we're exposed to and the amounts. And also just checking in with our bodies. Because our bodies are always communicating with us about what's going on, whether or not we're cognizant or not. And I think the modern solution has been to kind of check out and just numb things versus, like, getting curious about what's going on and why you're feeling, the ways you're feeling.

 

Dr Alexis [00:34:35]:

And ultimately, we can't do that if we want to be healthy long term because of this exact reason where we're getting the summative effect of stress that's wearing us down, that's impairing our ability to actually become more resilient. And at the same time, if we're engaging voluntarily in stress, that engages a different response in the body versus involuntary stress, which I think is important to note as well. For example, if you're picking up a weight voluntarily and doing this hard thing, you can get your muscle growth, you can become stronger. Versus stress is being thrust upon you involuntarily. And you're cowering from it or you're avoiding it. That creates a fight or flight response that's, in a way, it's not adaptive because you're not engaging it actively. Versus if you're assaulted with something stressful. And you take it head on.

 

Dr Alexis [00:35:24]:

That's when you can actually potentially gain a benefit from it. So the mentality around stress is also super important. But that also relates to our neurochemistry and our dopamine reward system. And our ability to actually tolerate stress. And approach our life with a certain lens. And I think this also ties it really back nicely to the light environments and being in nature and getting enough sun. Because our circadian rhythms are so intricately tied with our neurochemistry. And the.

 

Dr Alexis [00:35:52]:

The ability of our bodies to make neurochemicals and secrete them at the right times. And so if we're very disconnected from nature and we're getting all these stressors now. We don't really have the chemical tools on board to be able to deal with them. And actually approach the situation with the right mindset to be able to grow from that. And so that's why I really like, in my own practice, to focus on getting the low hanging fruit first with regards to the light environment. Just because it's pretty easy, actionable stuff that people can incorporate with little effort. And you can get pretty big payoff. That can create a forward momentum.

 

Dr Alexis [00:36:27]:

And then we can incorporate more exercise and other aspects. When we have the dopamine reward system kind of primed to be able to get you building momentum in a positive direction.

 

Michelle Shapiro [00:36:37]:

Absolutely. We are definitely going to talk about circadian rhythms and light and everything like that too. I think if we're bringing home this adaptive stress kind of piece. That if in the most simplistic ways, no stress is bad. Because then you don't build your adaptive response. Some stress and recovery is optimal, and a lot of stress is bad. And that's kind of it. Even if you are a person who's in, let's say, the military or something, where your stress levels are constantly high, you may be able to engage in those environments with precision.

 

Michelle Shapiro [00:37:08]:

But the question is always, well, what's it doing to the rest of you? Right? You're able to focus on that at what cost, right? And like they are more aware than anyone that there is a cost, right. It's the same thing as being an ER doctor or something like that. I'm sure too, is that there's. It's, yes, you might be able to do the things, but the question is, what is the cost? And there is always a cost with too much stress. But having some stress and then kicking its butt and coming back from it is probably the most important thing we can do for our health. And resiliency is a muscle that we can build and flex, but it can't come from being completely smashed with stress. It's just not. It's not the way to do it.

 

What is the impact of circadian rhythm and light on our health?

 

Michelle Shapiro [00:37:45]:

Tell me also, when you speak about circadian rhythm and light, why do we care, Alexis? Tell me, why do we care about that?

 

Dr Alexis [00:37:52]:

Yeah. So I love talking about this because I think there's a lot of just preconceptions and assumptions to be addressed here, because in the modern lifestyle, we're just so accustomed to having a well lit environment, basically twenty four seven, and we're basically accustomed to living at, like, 70 degrees every day, all day, indoors. And we're no longer exposed to the natural exposures or stressors in the, you know, in nature that we were designed to get in order to function optimally. So, in the case of light, light is the primary regulator of the circadian rhythm. What happens is when light enters your eyes. Well, let's talk specifically about sunlight right now. Obviously, the sun is only out during a certain time of day. When it's not out, it's dark.

 

Dr Alexis [00:38:39]:

So light from the sun is the primary source of light in the environment. When it interacts with your eye, there's a cascade that sends a signal to a part of the brain called the suprachiasmatic nucleus, or the SCN, that is the master clock of the entire body, that sets the clocks of every cell in the body and tells every cell in the body what time of day it is. And this is important because depending on the time of day, cells have different types of functions. So, for example, hormone production, sex hormone production, neurochemical production, neurochemical secretion, melatonin production and release, digestive function, digestive enzyme production, hydrochloric acid production. In the stomach, there's lots of different functions that are moving in accordance with the time of day. Now, imagine we're living in a modern environment and we're getting exposed to light. In particular, blue light is the signal that sends the. Is the signal that's sent to the SCN to tell it what time of day it is.

 

Dr Alexis [00:39:33]:

Because we're getting the most blue light during, like, the noon hours, kind of around now. Between 10:00 a.m. And 02:00 p.m. We're getting the most blue light from the sun. In the sunrise and sunset regions, we're getting mostly red and infrared light, very little blue light. And those are the signals that we evolved to have in order for our biology to be regulated in a circadian fashion or in accordance to time. So now we're getting exposed to fluorescent lighting, led lighting, all the energy efficient lighting is very enriched in blue wavelengths of light. And now that blue light is sending our bodies the signal that it's the middle of day, even if it's 10:00 p.m.

 

Dr Alexis [00:40:08]:

Or whatever time it is. And so what that means is that at a very basic level, we're not releasing melatonin when we should be releasing it. What a lot of people don't know is that melatonin is a primary antioxidant in the mitochondria of many different cells of the body. It's not just released in the brain and into the bloodstream, but it's actually within cells. And it serves a very important role for mitigating inflammation in those cells. But with regards to our neurochemistry, just the release of melatonin is going to be impaired. If we're exposed to lots of bright light at night, obviously that impacts sleep latency. So your ability to fall asleep as well as your ability to stay asleep and getting good quality sleep.

 

Dr Alexis [00:40:46]:

And so that's just one obvious thing that's really important because we know that sleep is just, we spend a third of our life sleeping. We need to, for a reason. Like, we need that to be able to function. And when we're not getting that, things start deteriorating rapidly. I mean, just think about it. If you go two days without sleep, like, you're done, you're toast. I think the world record is only like just over a week maybe. So just imagine, like, it seems wild that we need to be unconscious for this certain period of time per day in order for our bodies to function, but that's how we evolve.

 

Dr Alexis [00:41:16]:

Our bodies are so weird for that, by the way.

 

Michelle Shapiro [00:41:18]:

Yeah, I know. Like, I, like, I wish that it wasn't kind of like that, you know.

 

Dr Alexis [00:41:22]:

What I mean, was.

 

Michelle Shapiro [00:41:22]:

But it's really, uh, there's really no biohack your way out of that. That's just, that's the reality. We just need it. We just need it.

 

Dr Alexis [00:41:28]:

We do. I actually like to think about this, too, for, like, sleep requirements across species. Like, cats can sleep up to 20 hours a day. And I'm like, that's really interesting. Why do you need to be unconscious for like, 20 hours a day in order to perform your basic functions of, like, licking your butt and eating?

 

Michelle Shapiro [00:41:44]:

You know what I mean? Get off your pushy.

 

Dr Alexis [00:41:45]:

Okay.

 

Michelle Shapiro [00:41:46]:

You know, it's really interesting. My cousin, who is both a social worker and has herself openly talks about her incredible story through drug addiction and being in recovery. And part of her, she's also diagnosed bipolar. And part of her story that she tells and the experience that she has is, she always said to me, she's like, you know why bipolar medications work? And I'm like, why? She's like, they knock you out. She's like, because literally, like, we are in such an impaired state, state when we are not, you know, sleep deprived even a little bit. And I don't want this, anyone listening to this to be like, oh, my God, I haven't gotten sleep. I'm in trouble. Don't worry.

 

Michelle Shapiro [00:42:23]:

You'll always be able to catch up. Don't stress out about it. But she really believes that the reason that bipolar medications are so effective is purely, I mean, there's a bunch of different mechanisms, of course, but the main reason is because they just help you sleep, because that's something that obviously, when you're in episodes of mania, can really produce tremendous symptoms and can put us into different mental and physical states, too.

 

Dr Alexis [00:42:46]:

That's a really good point. And another thing about those medications that's, I think, interesting and important is that, you know, if you're getting these big swings, like the high highs and the low lows, and now you're taking these meds, that they don't only reduce the low lows, but by their very nature, they also reduce the high highs so that you become like this very flattened person. And many people on these medications will just say they don't feel like themselves or they feel like zombies, lethargic and just like, depersonalized. And so that's also a fact of life. And obviously, there's some extremes of this when people need certain medications in order to function, but also function in society, quote unquote, which is like, I would argue that you have to be dysfunctional in order to function in modern society.

 

Michelle Shapiro [00:43:31]:

But anyways, I completely understand that, too.

 

Dr Alexis [00:43:33]:

Yeah, it's a trade off.

 

Michelle Shapiro [00:43:35]:

Yeah, of course. Exactly. And it's a trade off that people who need to exist in society are willing to take or if they feel they're harm to themselves or others. Of course, it's not even a question.

 

Michelle Shapiro [00:45:23]:

**But like you're saying again, as always, there's nuance, there's context, there's, there's really important pieces to discuss, but it just really highlights again what even small amounts of sleep deprivation can do or large amounts of sleep deprivation can do. And that also, you know, what, like you're saying what amount we sleep and how we sleep governs what the next day looks like, and when we mean what it governs what the next day looks like, it literally governs what hormones are released at what time, and what your body's going to do with those hormones. So as it relates to weight loss, which hilariously was the initial function of this conversation, but you and I are so awesome.

  

What is your definition of metabolism, and how you view it?

 

Michelle Shapiro [00:46:52]:

But as it relates to that too. Again, if we want our metabolisms to run efficiently, let's also just define what you believe metabolism means, by the way, because I think of, I'll tell you my silly definition, and then you can tell people a better definition in Alexis terms. But when I think of metabolism, I think of, you know, let's say our bodies like a car. A lot of people are focused on the fuel tank, right? Calories in, calories out, how much fuel goes in the car, how much fuel comes out of the car. And that's what they believe the metabolism is. What I want to know is, is the car turned on? Does it have the right parts? Does it need an oil change? That, for me, is what I picture as being metabolism is it's all the different components that would relate to, sure, not only digest and absorption and all these things, but, yes, how many calories you efficiently use and how quickly those get to the right tasks and how we utilize energy. Right. But I think people are so hyper focused on the amount of fuel, and I'm like, there's so much more than that as it comes to metabolism, which is why it's so frustrating when people push just calories onto other people.

 

Michelle Shapiro [00:47:56]:

So I want to hear your definition of metabolism, how you view it.

 

Dr Alexis [00:47:59]:

Sure. So, I mean, at a very basic level, metabolism is just the chemical interconversion of molecules that are in the body, and there's lots of different functions that can come out of that. It can be for energy production, it can be for biomolecule production, it can be for, you know, a whole host of things, lipids, carbohydrates, proteins, fats. But there actually is one really important thing that I want to mention here that you have sparked in my mind, that I want to make sure I don't forget to mention. And that's the story of this molecule called propio melanocortin, or p, that's produced in a wide range of cells, but it's of major importance in the brain. It's produced in response to uv light exposure from the sun. With regards to weight loss, Pom C is this pro hormone that's cleaved ultimately into ten different products. A couple of those products are the melanocortin stimulating hormones, or alpha MsH and beta MsH, which play very important roles in regulating energy expenditure, fat like burning lipolysis, energy intake, and desire for food satiety.

 

Dr Alexis [00:49:07]:

And so if we're thinking about if our hormonal system is properly regulated and we're getting enough production of the precursor molecule palm C, but then also the alpha MSH, which is the most highly associated gene product with obesity. So mutations in this alpha MSH gene are highly associated with obesity. But just in general, in the modern environment, we're not getting the proper signals to even produce this molecule to begin with, because we're living indoor lives and you're not getting uv light if you're living indoors, windows filter out all of uv light, unless they're made of quartz glass, which the vast majority are not. And so we're not getting the impetus to even produce these, which means that our appetite's dysregulated, our energy expenditure is dysregulated, we're not getting proper liberation. And oxidation of fat or mitochondria are impaired because there's a whole host of other molecules produced in response to pom c. But then we're also getting the red and infrared light from sun, which directly stimulate mitochondrial energy production and metabolism in the mitochondria. And so we're also very much deficient in red and infrared light in our modern environments, because all of the energy efficient bulbs are. They don't have red and infrared because infrared is heat.

 

Dr Alexis [00:50:17]:

And these companies or the EPA, they consider heat as, like an energy waste product.

 

Michelle Shapiro [00:50:22]:

It's not efficient.

 

Dr Alexis [00:50:24]:

Exactly. So. But meanwhile, red and infrared light are. I consider them as essential nutrients. I also consider uv light as an essential nutrient. I think it's important to think about light frequencies, different light frequencies, as nutrients in and of themselves, because of the very specific impacts they have on the body. And so if we're living an indoor lifestyle and we're eating a lot of processed foods, we're already going to be dysregulating our reward system and our satiety in response to foods. But then we're also not going to get the proper upticks in energy expenditure, lipolysis, and proper hormonal regulation of appetite to be able to properly manage our weight.

 

Dr Alexis [00:51:04]:

And so it's literally zero surprise that we're having these issues as a society, because we're basically doing everything wrong to a certain extent with regards to how we're living our lifestyles. So I wanted to make sure I mention that because it really ties into the weight loss story.

 

Do you believe that calorie counting could not work for someone who's in a state of metabolic syndrome, and that something like light therapy could actually move the needle for them?

Michelle Shapiro [00:51:18]:

It really does. So, all right, in regards to weight loss, could you literally say that someone could be counting calories and not losing weight? And it's going to come down to something like light exposure? Something like light exposure or something as foundational as the way we're interacting with our environment. Do you believe that calorie counting could not work for someone who's metabolic in a state of metabolic syndrome and that something like light therapy could actually move the needle for them, so to speak.

 

Dr Alexis [00:51:50]:

Absolutely. I mean, I consider the light environment to be the base of the pyramid upon which everything else is built because it's regulating our movement, our desire to move the reward system around, moving our appetites and what foods we want to intake and how much we're intaking. And just the fact that so many people aren't nailing this piece down, even though it is fairly easy to kind of dial in the circadian stuff and the light environments to a certain extent, it doesn't have to be perfect, but you're going to get benefits from even just, you know, changing 10% of the way you're living your life. And a lot of times with the weight loss resistance too. These people are often in like long term or like chronic calorie restrictions. So a lot of times in those cases we need like a reverse diet too, where we're just getting baseline calories up to like a healthy level. Because if you restrict calories for. So, yeah, I also really worry about like the Ozempics and the, and also the gastric bypass in these ways because you're only able to eat such a small amount of food before you get full that there's no way you're needing meeting your micronutrient needs or your protein needs.

 

Michelle Shapiro [00:52:54]:

Well, it's, and it's, you know, I have a client, she got bypassed recently and I have been hounding her for electrolytes and really all minerals. I have been so aggressive with her about it. And it's really just something that is so not told to people, especially because something that I want to discuss also with you is during the weight loss process, we're pouring toxins out of our fat cells, right during this process. So what's it going to take to move those toxins out of the bloodstream is a lot of minerals and a lot of nutrients that our liver requires for detoxification. Let's touch on that for a little bit too. And I do, I do want to go back to the GLP one medications also. But touch on that for me, just the toxicity of weight loss too.

 

Dr Alexis [00:53:40]:

Yeah, I mean, depending on the state the person was in while they were gaining the weight, I mean, fat is just a major reservoir for any sort of lipid soluble molecules, which would include things like mold, toxins, antibiotics, also hormones to a certain extent as well. Vitamin D is stored in fat and whatever any molecule that can be dissolved into a lipid is going to get stuck in fat tissue to a certain extent, just by probability's sake. If it's in the blood circulation, it's going to be partitioned in the body to wherever it's most soluble. That fat tissue can serve as a huge depot of these types of molecules that when we start to lose the fat or lose the weight, that, again, they will be dumping into your circulation and they need someplace to go. So lymphatic support is so important in this context. There's herbs that can support that, but we can do dry brushing, lymphatic massage, sauna, like I love infrared sauna, or just sweating in general, getting yourself sweating. Obviously, the skin is a major route of detoxification via sweat. Make sure people are pooping properly.

 

Dr Alexis [00:54:40]:

That's a major issue too. Also super related to lymphatic function and lymphatic health as well, because there's a lot of lymphoid tissue around the gut. And if things are kind of stagnant and not moving, then that's just kind of setting things up for a whole host of issues with regards to, basically weight loss resistance and feeling very sick in response to weight loss. So there's lots of ways that you can prepare the body to have a more successful weight loss before you even start to think about reducing your food intake and moving your body more. Lots of low hanging fruit that we can reach for to prepare you for the best long term success, which would include optimizing your microbiome, reducing your inflammatory status, making sure your lymphatic system is moving, make sure you're sweating and pooping, making sure that you're sleeping. These would all be like basic things, and obviously the light environment, too. Huge one. So all of these things, if you can nail those down before you endeavor to lose weight, most people will actually start to lose weight without even trying during that period just because things are getting regulated.

 

Michelle Shapiro [00:55:41]:

Yeah. So, you know, there's always these statistics in the kind of more aggressive body positivity practitioners minds where they say, you know, 98% of diets fail. So why would you diet if it's just going to cause more harm? And don't smile, Lexus. Okay. You're smiling out. You're like, okay. I think it's very fascinating for people, honestly, that we're two people who have successfully lost over 100 pounds and kept it off. For.

 

Michelle Shapiro [00:56:05]:

How many years have you kept it off for?

 

Dr Alexis [00:56:07]:

It's been like 13.

 

Michelle Shapiro [00:56:09]:

It's been 13 years from. I think it's exactly like the exact same age. What year are you?

 

Dr Alexis [00:56:13]:

I'm 31. I was born in 92.

 

Michelle Shapiro [00:56:16]:

92. You're 92? I'm 91. So we both lost weight basically our junior year of high school. Also, we are just. We are just telling. When you were saying the story, I'm like, she talking about me? What is she doing? Not to center myself in your very important story, but I was just so deeply resonating. But, wow, you know, I think people are. Are always asking me, how did you do it? And I'm like, well, I starved myself to do it, and then I paid the consequences for ten years after essentially very much for you.

 

Michelle Shapiro [00:56:43]:

Also, you then ended up with these digestive issues. You ended up with an eating disorder. Post losing weight. There truly is a right way to lose weight and a wrong way to lose weight. I need to just vent to you for a second, by the way, on this podcast. I don't know why this week, but all of. I don't know, not all of my clients, let's say I saw like 25 clients this week, seven of them. That's a lot for what I'm about to say, have had intervention from their family members on, you really just need to restrict calories.

 

Michelle Shapiro [00:57:10]:

Or I have another client who has pots, and her family was like, I don't think you should get iv's or. Or take electrolytes for the pots because of the. This was a real thing because of the risk of contamination from the iv. And I was like, I've never met. I'm like, it's a. That's like a standard of care thing, you know, and, like her. Yeah. So anyway, for pots, anyway.

 

 

If someone in someone's family is saying, you just have to count calories and you'll lose weight, you just have to eat less to lose weight, what do you recommend them to say to respond to their family members with, scientifically or otherwise?

 

Michelle Shapiro [00:57:29]:

But this week has been a lot of, like, family interventions on my clients with these very untrue tropes about our health. So I just want you, Alexis, if someone in someone's family is saying, you just have to count calories and you'll lose weight, you just have to eat less to lose weight. What can you. What sentence or two can you say to these people to respond to their family members with, scientifically or otherwise?

 

Dr Alexis [00:57:56]:

Yeah, this is a really great question and point, and I'll try to be as succinct as possible. I mean, what I would probably start by saying is weight gain and fat isn't just in response to eating excess calories. That's like, the most important thing that we need to just dispel. First of all, because I think there's an assumption underlying people who are gaining weight, and it's that they're necessarily overeating calories. But in reference to what? So what is their baseline energy expenditure? What is their baseline calorie intake like? What are they consuming? What are they expending? Obviously, the energy balance piece comes into play, but it's such a complicated piece that it goes way beyond calories in, calories out. In the actual way it's implemented. It's not just as easy as counting your calories and moving your body more.

 

Michelle Shapiro [00:58:48]:

Because for people it's really not, by the way, because the system is not systeming. The system's not doing with those calories what you need it to. To convert them.

 

Dr Alexis [00:58:58]:

Yeah, exactly. And there is such this like a strong, centrally controlled by the brain role for energy expenditure that is just completely not discussed. And so if your energy expenditure is out of whack and you also don't feel like you have the energy to move your body and you don't feel like you just have the resources on board to be able to do this, to lose weight, then there's something deeper going on. It's not just a matter of willpower. Willpower can only take you so far in this conversation because ultimately, if your body is struggling to lose weight, it's probably because it doesn't have the resources it needs to actually do so successfully and maintain that weight loss in the long term. And that's why the diets fail, is because we're really just looking at it through this very myopic lens of calories in, calories out without considering the context of, like, why the body is holding onto this weight to begin with. What's going on there? I think that's the most important thing to consider because that's when we can deal with and manage and optimize all of these other areas before we even have to worry about losing the weight. And then things just tend to move so easily once we do that without just kind of bare knuckling it through this, this just struggle to lose 510 pounds, that maybe somebody needs to lose 50 pounds, but can barely lose five to ten pounds.

 

Dr Alexis [01:00:17]:

Like something else is going on. Even if they're eating like 1000 calories a day and barely losing weight, like something is going on here that is real.

 

Michelle Shapiro [01:00:24]:

Like, can you just say that for a second? It is real. There are people who can be in a calorie deficit and not lose weight. I have many clients who are, you know, people are like, well, maybe, you know, as a dietitian in school, there was this obsession with like 24 hours recalls and you would ask the police person what they ate for 24 hours. And we were trained to basically accuse people of lying. So it's like, well, you know, you don't remember about 30% of the calories you ate. Are you sure you wrote it down? And it's like, it's not. That should not be the relationship we have with people. We're here to help people.

 

Losing weight is not based on willpower alone.

 

Michelle Shapiro [01:00:52]:

And I was so repulsed by that. By the way, even in undergrad, when I was so young, I was like, there's something so weird about detective work against the client. I'm wanting to do detective work to validate the experience they're having and understand what their body's trying to communicate with us that isn't matching up with what they're eating. So it is entirely possible. Let me say this again. It is entirely possible that you could be eating a low calorie diet and actually have weight loss resistance and not be able to lose weight. It's not based on willpower alone. It's not based on just calories.

 

Michelle Shapiro [01:01:21]:

And people truly do not believe it. They will not believe it in the same way we will not believe that stress causes health ails. And again, the compounding nature of stress causes them, but we just refuse to believe it because of these extremely false societal beliefs, which is the name of Alexis's game. Undoctrinate yourself is her podcast. This is your talk. This is the language that you speak. But we so deeply refuse to believe the most obvious truth, which is that we need to be in nature and look at the sun in the morning and be in favor of. We need to starve ourselves.

 

Michelle Shapiro [01:01:58]:

It's just that we. I've been saying it for ten years. It doesn't. It's just not getting through to people. And that's why I'm glad that you're substantiating it through science, because it's just not getting there with people.

 

Dr Alexis [01:02:09]:

Totally. And I mean, even if you think about it, let's say you overeat ten calories a day for a year. So that would be like, I don't know, 3600 calories or something like that. And then you're not going to necessarily gain weight during that period of time because the body has adaptive mechanisms to be able to upregulate its energy expenditure or upregulate your drive to move, and so it ends up equaling out. So just by overeating, you don't necessarily need to gain weight because of these adaptive mechanisms that can counterbalance that effect to help maintain equilibrium, maintain homeostasis at a certain body weight set point. Let's say, but if that set point is messed up, if that feedback loop is messed up, then weight starts to spiral out of control because those hormonal and other contributors to that system aren't working as they're supposed to.

 

Michelle Shapiro [01:03:02]:

You know what was so fun? Did you ever see the show fat to fit to fat, I think it was called. It was about these. It was about these personal trainers who wanted to prove to their clients that weight loss. I do remember that, but they wanted to prove, for people who haven't seen it, they wanted to prove to their clients that weight loss is a willpower issue. They were like, if I gain your weight to be your weight, and I lose it, and they're obviously starting off at a better metabolic picture to begin with. Right? And then I lose it, you know, I want to prove to you that it's your fault, essentially. I want to prove to you this power thing. My goodness.

 

Michelle Shapiro [01:03:46]:

Were they surprised at the results? They had extreme trouble losing weight. They were not responding to calorie restriction. All the lack of empathy that they had, they gained during the process. And some of them I actually know someone knows one of the trainers. Her body, many years later, has still not recovered its metabolic capacity. And so, like, that experiment of just being so condescending and so willpower so failed on them, because it really is like, as you gain weight, the interchemical like process and the immune interactions in your body all changes, too. So you have to really rewire that in addition to, yeah, changing what you're eating. I'm sure that's a piece of the puzzle for everyone, but no one really understands what it's like to be living in a body with metabolic syndrome and truly be throwing every ounce of willpower you have at it and truly doing everything from a calorie perspective and truly not making a difference.

 

Michelle Shapiro [01:04:42]:

So I just want people listening to understand, we believe you. We know that really happened. I want to validate people's experience who are listening to this. If you're a person who feels like you calorie restricted for a long time and you truly did not lose weight, I believe every single word that you say, and I believe your experience.

 

Dr Alexis [01:04:59]:

Absolutely. And it's especially common in, like, the perimenopausal women and post menopause with the hormonal changes, and, like, the fat being put on in specific areas, like, around the belly, and just, like, really restricting calories and not seeing results. It's all too common. And we know that the sex hormones play very important roles and also in energy expenditure and where fat is partitioned in the body and whether you're gaining fat versus muscle weight isn't just all made the same weight. It can be water, it can be fat, it can be muscle. And how that shows up, depending on the way you're living your life and what you're exposed to and your environment, that can all change depending on those exposures, and it's super important. Another thing I wanted to mention before I forgot is that there's a big difference also between growing your fat cells versus making more fat cells. So there's pretty good research showing that once fat cells reach a certain size, then you make more of them.

 

Dr Alexis [01:05:57]:

And once you make more fat cells, you can't necessarily get rid of a fat cell that's made, but you can shrink it. And so something I think a lot about is the increase in the omega six fat consumption over the course of the past, like, 20 years, because, and especially the ratio of omega six to omega three. And maybe we can talk about why that's important, but please. The omega six fats are polyunsaturated fats, which means that they have multiple double bonds in their structure. Every time you add a double bond to a fatty acid structure, it creates a kink in the structure that changes the shape of it. So a saturated fatty acid has a straight chain, and it can stack on top of other saturated fatty acids to, basically, it's packaged very easily, it's more compact. Compare that to something like an omega six fatty acid. If you, like, Google like, linoleic acid structure, you can see it has this big kink in the structure, which means that it doesn't sit nicely next to other fats.

 

Dr Alexis [01:06:52]:

It creates a bigger, like on a triglyceride, where you have three fatty acids bound to a glycerol backbone, it creates a more spread out structure that takes up more space. So I can't help but think about this, because in my research at it, Princeton, we showed really nicely that body fat composition mimics dietary fat composition. So if you're eating a lot of, you know, polyunsaturated fats in the form of omega six s from canola, peanuts, you know, sunflower. Yeah, corn, sunflower is all of that, then I feel that it's very likely, like, somebody could easily do this research, that fat cells are becoming bloated and they're getting bigger, and that's causing new fat cells to be made, more often than not, because of the dietary fat composition and the fats being stored in those cells. So somebody needs to do that. Research. It's very, very EASy experiment.

 

What is the optimal ratio for omega three to omega six fats?

 

Michelle Shapiro [01:07:45]:

The optimal ratio for omega three to omega six fats is what? What would you say the optimal ratio is versus the ratio that we have today?

 

Dr Alexis [01:07:52]:

So the ancestral ratio was about a three to one omega six to omega three. TodaY's ratio, it's about 20 to one omega six to omega three. Importantly, omega six and omega three fatty acids share the same enzymatic machinery that converts them into longer chain fats that have really important functions in the body. So specifically, if you're taking in a lot of, like, linoleic acid relative to alpha linolenic acid, so ALA is the plant based form of omega three. And ALA by itself isn't really that important. It needs to get converted into EPA and then ultimately to DHA, which are the longer chain fats, omega three fats that are really important for inflammatory status, lipid health, like lowering triglycerides, having very important immune functions to help reduce inflammatory state and improve anti inflammatory status, brain health, eye health, all these important functions at the same time. If you're eating a lot of linolenic acid or linoleic acid, rather, the la, which is the omega six fat that you find in all these seed oils that can out compete the machinery that the ALA needs to actually get converted to the EPA and DHA. So not only are people not getting enough EPA and DHA in their diets, but then they're also over consuming the omega six fats, which are out competing the very little ala you're already getting.

 

Dr Alexis [01:09:14]:

So you're basically just completely deficient in EPA and DHA versus at least getting some of a conversion from AlA to the longer chains, because around 10% of ALA can get converted into EPA, and then about 5% or less makes it to DHA. And that's like being generous. Like, it can be much lower than that. So if we're not getting any of the animal based forms of omega three s from seafood, or you could also get them from, like, algal oils as well, and you're consuming seed oils to boot, then you're really going to be super deficient in these longer chain omega three s that have these very crucial functions in inflammatory status, just overall brain health and many aspects of health.

 

Michelle Shapiro [01:09:53]:

Yeah, I mean, we think of our. I think of our body as being primarily composed of fatty acid structures. I mean, this is like, they line the most important parts of our spinal cord. I mean, really, really essential. You know, there's, I don't know if you know this, lux, not all omega six fats are bad I guess you could say. But given the ratio being already so disproportionate, you're very likely to lean into a poor omega three to omega six ratio, which some people would argue is the root cause of many forms of chronic inflammation, which then lead to forms of chronic illness. There are people who believe that omega six intake versus omega three is the most important piece of weight loss resistance or the most important piece of our health puzzle. There's truly an argument for that as well.

 

Dr Alexis [01:10:42]:

Yeah, I think it's really important. And, yeah, I mean, we already know that the, like, the linoleic acid gets converted, you know, down the omega six pipeline. The. One of the final products is arachidonic acid, which is an inflammatory mediator.

 

Michelle Shapiro [01:10:55]:

Yeah. How confident is that? How?

 

Dr Alexis [01:10:57]:

I mean, it's important for immune responses and it serves a role, but if you're over consuming, you're not only going to make yourself more omega three deficient, but you're going to be over producing arachidonic acid. And that's, you know, not ultimately, you.

 

Michelle Shapiro [01:11:10]:

Eat in a restaurant with 100% certainty they're using omega six fats to cook your food. So. Omega six heavy fats to cook your food. So we all eat in restaurants. Most of us, unlike you, eat in restaurants only when you're going your foodie tours, because normally you cook beautiful meals for yourself that people follow on Instagram. But. So I just want to wrap us around, too. When it comes to weight loss resistance, a lot of people will be talking about cortisol.

 

When it comes to weight loss resistance, you're thinking in the context of light, you're thinking in the context of omega six fats. What is the next thing you are really thinking of when it comes to weight loss resistance?

 

Michelle Shapiro [01:11:33]:

A lot of people will be talking about this. What I heard from you is actually, when it comes to weight loss resistance, you're thinking in the context of light, you're thinking in the context of omega six fats, you're thinking in the context of. Tell me the next thing. What are you really thinking of when it comes to weight loss resistance?

 

Dr Alexis [01:11:47]:

Well, I really like to think about the microbiome in this context because there's a couple microbes that I mentioned earlier, bifidobacteria and Ackermansia, that play a really important role in this conversation. Ackermansia lives in the mucus lining of the gut, and it's actually responsible for helping to maintain the tight junctions between cells within the colonial. What that means, in effect, is that you're going to absorb more calories from food the less acromancy you have. And we can see very clearly in human studies that people who are obese or have diabetes have lower levels of Ackermansia, and people who are lean and healthy have higher levels of Ackermansia. And if you give Ackermansia back via like a fecal matter transplant to people who are obese, they will lose weight and they will improve their glycemia, their ability to tolerate glucose. There's a very striking effect in that department, though I do want to say, like, I think some people might interpret that as, like, more acromance is always good.

 

Michelle Shapiro [01:12:41]:

Well, yeah, please say that. Yeah, please say that.

 

Dr Alexis [01:12:44]:

That's also not at all.

 

Michelle Shapiro [01:12:45]:

Yeah, exactly.

 

Dr Alexis [01:12:46]:

Yeah, exactly. That's also not the case because, like, Parkinson's disease, for example, is associated with elevated levels of acromansia. So we don't necessarily just want to, like, we don't really know the whole story yet. But if you're taking like, the lifestyle and the dietary approaches to optimizing acromancia, that's going to be the best way to go compared to, say, taking a probiotic. Because the actionable lifestyle stuff that you would do to optimize acrobatic, do things like eat polyphenols or red, dark red pigments from fruits and vegetables, human milk, oligosaccharides can also feed ackermansia to a certain extent, which is a really nice prebiotic that also feeds bifidobacteria very potently. Also, doing things like cold exposure and exercise also increases ackermansia. So basically, by optimizing ackermansia through our lifestyle approaches and our dietary approaches, that would be a way that's consistent evolutionarily with the way we're supposed to be living our lives. But we can also get the added benefit of supporting our microbiome.

 

Dr Alexis [01:13:38]:

I would also be remiss if I didn't mention in this conversation that there's this very important gut skin axis that exists that has really important implications. There's really cool studies done to show that uvb exposure, which you'll get from the sun, which is what also stimulates the production of vitamin D in the skin. Uvb exposure modulates the microbiome and increases gut microbiome diversity directly, like independent of food. So we often think about food as being the major modulator of the microbiome. My opinion, or my perspective on this is that food is the major regulator of the microbiome only because we're living indoor lifestyles. And that's the major way that our microbiome is being shaped via nutrient availability. But if we're actually living outdoors and getting under the sun more, that that would actually be the major route by which our microbiome is shaped. And there was really cool research done with, like, the Hadza tribe showing that if you give them a bunch of processed foods and keep them in their normal environment, that their microbiomes actually didn't change much at all.

 

Dr Alexis [01:14:40]:

And that's because they're still in the same environment, which is more so having.

 

Michelle Shapiro [01:14:43]:

An effect, unyielding microbiome in a good way. They're strong and resilient and not infected. Yeah, it's powerful.

 

Dr Alexis [01:14:50]:

Exactly. So I think the focus on diet and microbiome, it's important, but it's definitely not the only feature that's shaping the way that our microbial communities are growing and the diversity of these communities in the gut. So that's a really important part of the story that I wanted to mention. Also, you can get more benefit from sun exposure if you're directly exposing your abdomen to the sun. There's neurons under the skin of the abdomen that are very reactive to uv light to produce palm C. So you can make more palm C in response to sunlight if you're exposing your gut to the sun, just an aside. And you can get a lot of the benefits from that with regards to appetite regulation, energy expenditure. I also, you can use things like spurty lamps, like they make uvb and uva lights.

 

Dr Alexis [01:15:33]:

I like to combine that with a red and infrared light device, too. I do that almost every day, especially during this time of year. During the summer, I'm, like, strictly outside and getting sun that way. But this time of year, I like to use the photo therapy devices to just get that impetus for the production of these important molecules and the modulation of the microbiome and all of these beneficial things. And I will say, ever since I started using the spurty lamp and, like, sunning my gut all summer long, I literally get zero digestive discomfort, zero gas, zero bloating. Like, I have no issues. It is incredible. And you can see results right away.

 

Michelle Shapiro [01:16:07]:

I don't know about this lamp. Explain this lamp to me.

 

Dr Alexis [01:16:09]:

Oh, so Spurdi is a brand. They make uvb lights, which are like vitamin D lights. They make uva lights. It's like their Fiji sun lamp is Uva. UVB. So you put it right on your.

 

Michelle Shapiro [01:16:19]:

Gut during winter, since you can't get the sunlight in winter.

 

Dr Alexis [01:16:22]:

Yep. So what I do is I sit in front of it with I. For me, I have a little bit darker skin, so I keep it about ten inches away from my stomach, and I do it for about eight minutes on my stomach, and I do about eight minutes on my back. And I do that at the same time as the red and infrared panel. I have, like, the mito red panel. Because there's really great research showing that you kind of need red and infrared with uv light in order to get all the benefits of uv light without some of the potential drawbacks or harms or damage to the skin, et cetera. So both of them are very important. I do them at the same time.

 

Dr Alexis [01:16:53]:

I do it during, like, the middle ish of the day. Because you want to kind of be consistent with the light you would encounter outside. Just to avoid any circadian disruption. And it's extremely helpful for anybody who's trying to maintain their vitamin D levels. So you really need to get vitamin D from UVB light and not from supplementation. Because if you look at the research, the vitamin D research is very striking. And that vitamin D is, vitamin D deficiency is highly correlated with a whole host of diseases. But providing supplemental vitamin D has very little effect.

 

Michelle Shapiro [01:17:23]:

Yeah, exactly.

 

Dr Alexis [01:17:25]:

And so the way I think about vitamin D is really a biomarker for sun exposure. Instead of thinking about it as just something to modulate in and of itself. And so if we're using something like the lamps inside, then we're actually getting the uv light that we need to make vitamin D. But in addition to that, there's like 13 other vitamin D like species that are created in response to uv light exposure. It's not just vitamin D. Right. And we're getting the pom C and everything else.

 

Michelle Shapiro [01:17:47]:

Vitamin D is the reflection of the bigger picture, which is that you are light deficient, you are sun deficient, as opposed to the other way around, which is that we have no vitamin D. So, yes, we might need more sun, but we just need to supplement with it. It's not a root cause solution, essentially, which is what we want to do. So really, if we're kind of bringing together these incredible vision of yours, of course, there's a food component to everything. But when it comes to weight loss resistance, particularly what you're having people start off on your foundations is really light exposure. It's really the right types of stress exposure that could be cold, that could be exercise, that could be those kind of things. And also, you know, reducing that other stress when needed. We're focused on the quality of fats within our diets.

 

How you are helping people and practitioners, or people with their weight loss goals in a way that's not just calorie counting?

Michelle Shapiro [01:18:38]:

And we are focused just on literally being outside and literally being a person who's existing in nature. That's really your metabolic mastery, which we're going to talk about. So, Alexis, now bring us to doctor Alexis. Bring us to how you are helping people with their weight loss goals in a way that's not just calorie counting and things like that.

 

Dr Alexis [01:18:59]:

Yeah, yeah. I love working with people. I love teaching in particular. So right now I'm finishing up a live course. It's called metabolic mastery mentorship that initially started as a four module course, but it ends up being a nine module course and I didn't finish it yet.

 

Michelle Shapiro [01:19:12]:

So obviously it ends up being a nine module course.

 

Dr Alexis [01:19:15]:

I know, yeah. So I ended up just like having so much more I wanted to share, so I extended it. And so that's still going on for the next couple of weeks. I also just today launched a monthly membership program that's going to have, it's called like, journal club, and it's going to be a monthly Q and A and then also a journal club session where we're going through some interesting research papers together and unpacking them and going through why it's important. Potential pitfalls and follow up studies that could be good. I also do have some limited one on one spaces for either highly motivated individuals who have had a lot of struggles and want a different approach, or also practitioners who want to learn what about what I'm doing and be able to implement that in their own practice. So I'm really very much interested moving forward in working with practitioners, but I do also still really have a joy and it brings me a lot of joy and fulfillment to work directly with people who need my help as well. So I'm probably always going to keep some portion of both of those open.

 

Dr Alexis [01:20:14]:

And yeah, other than that, I have my podcast. Indoctrinate yourself, which I started in October. That's been going great. I had you on and it was amazing. We should have you back on at some point.

 

Michelle Shapiro [01:20:24]:

Same. But you here, we are so blessed to have you as a practitioner. And if you guys are not following Alexis already, please, I'm going to put her information. If you want to work with her one on one, and she only has a couple of slots, get that slot. Even before you work with me, work with Alexis. And I seriously mean that with Doctor Alexis and then otherwise follow her content. Maybe considering metabolic mastery or the journaling club, I could not recommend a human being more to have in your life. It's not even about how you work with Alexis, about having Alexis near you, in my opinion.

 

Dr Alexis [01:20:56]:

Thank you so much. Can I share one more really fun study with you that I think you find interesting?

 

Michelle Shapiro [01:21:01]:

Yes, please.

 

Dr Alexis [01:21:02]:

Okay, so I just recently finished up a postdoc at Penn in Christophe Tice's lab, and it's a microbiome lab. My project wasn't related to microbiome, but there was a really cool project out of the lab that I want to share with you and your audience. So this was conducted a couple years ago. It came out in 2022. Basically, what this study looked at was the reward response to exercise. And as it turns out, the punchline of the study was that there's a microbe that lives in the gut, or a group of microbes, rather, that create these molecules called endocannabinoids, which mimic cannabinoids that you find in, let's say, cannabis, but they're produced by the body. In particular, there's a group of endocannabinoids called lipid amides. That's just the technical name for them.

 

Dr Alexis [01:21:45]:

And these lipid amides are produced by these microbes in the gut. They travel to the brain, where they release. They facilitate the release of dopamine in response to exercise. And if you remove these microbes from the gut, then if you have, this was done in rodents. So if you have the rodents do wheel running, for example, they stop exercising voluntarily. They won't do it. They're not getting the dopamine reward to actually engage in the exercise in a repetitive fashion. And then if you give them back the lipid amides as a supplement, they will begin exercising again voluntarily.

 

Dr Alexis [01:22:22]:

And so the punchline to the study was that the microbiome is shaping the dopamine reward responses we get from things like exercise. But there's lots of different ways that we receive micro rewards in our environment that allow us to keep moving forward and gain momentum in a positive direction towards reaching our goals. And so I think this is a really important testament to the way that our guts and our brains are interacting with each other and how it can literally shape your ability to be motivated. So, again, it comes back to things aren't just about willpower. It's really about neurochemistry. And if we're not optimizing that, if there's any issues with motivation and reaching goals, that we really need to think about the light, the microbiome, your neurochemistry, your sleep, and all of the things in order to create a balanced body that's able to meet its goals. And beyond that, absolutely.

 

Michelle Shapiro [01:23:10]:

And I think, again, we think of motivation as an input, but if you walk it a step back, it's actually something that's presented to you as an input, but it's coming from your, like, neurobiology. Neurochemistry 100%. We're much more ancestral than we ever want to believe. We think we're more and more cerebral than our bodies are. And our cerebral selves just cannot beat out our ancestral selves. We just. We just. We didn't do it.

 

Michelle Shapiro [01:23:41]:

It's just not possible to do. And I. And I love that you always bring it back to that. Thank you so much for the best episode I think I've ever recorded.