 Dr. Will Cole, thanks for coming on the show. Thanks guys. I appreciate it. Yeah, no problem. I wanted to start out by talking about just disordered eating in general. I know you work a lot in the kind of celebrity space. We all did most of our work and I guess general pop, but we saw a lot of this ourselves and realize as trainers that this is, this was like the root of kind of everything that we had, we wanted to accomplish with people. Let's start there. It's a fine disordered eating because it could look a lot of different ways and then maybe your experience with working with people and how to kind of tackle that. Sure. As you guys probably know how this works, it's like the celebrities that I see, that's the what gets all the attention, but like 99% of my patients for the past 13 years running this telehealth center are just like regular, my top patient base are actually profession-wise school teachers, engineers and nurses, but they don't get the attention that the celebrities do. Sure. And I found that they all have a love of spreadsheets and getting to the root cause and I just love getting to the root cause, but you're right, there's a lot of food is a double edged sword. It's very much a nuanced, there's a lot of context that I think we need to have about this. There are conversations that I have with patients every single day, but I think that there's a lot of toxic tribalism when it comes to food in our culture, right? We have toxic diet culture on one end, which none of us within wellness legitimately are going to say that's a good thing, eat less, work out more. It's all about thinness and basically shame your way into wellness. They'll never overtly say that, but that's sort of the underlying message. But then I really have a problem with this polar opposite, this toxic anti-diet culture where they sort of remove all basic logic about nutrition that there's quote-unquote no such thing as a bad food. And I have a problem with that as well because I think it's creating a lot of food confusion because I talk to people for a living talking about these things and there's a lot of disillusionment and they don't know what to believe. The fact of the matter is that there are some foods that are going to mess up your blood sugar and going to raise inflammation, impact your digestion, feed chronic health problems. And the point that I'm making in gut feelings is that avoiding those foods isn't restrictive, it's self-respect. And I think that this either or toxic tribalism within wellness, just like toxic tribalism within any sphere, really misses a lot of people in the middle. And a concept that I talk to my patients about that I talk about in the book is this food piece path. This path where, yes, we can recognize that some foods aren't good for us, but ultimately this is coming from a place of self-empowerment and having agency over our health and wanting to feel good. And so I mean, disordered eating is a big topic, but I really have an issue with both polar opposites within this conversation. And ultimately I find that sustainable wellness has to be born out of self-respect and eating foods that love us back. And we're all different. That's really a major facet of functional medicine, its bio-individuality. So it's really about being your own end of one experiment and really exploring food as medicine. And this practice that I tell my patients to do, to learn the art of using food as a meditation as well. And really saying, okay, you're not a bad person if you choose to have that food, whatever food you choose that maybe doesn't love you back, but did it make you, maybe it was you hanging out with your friends and socializing, okay, then don't shame yourself, eat the food and move on. Like shame is worse than any food, but ultimately you may use that food as a meditation and mindfully eat and say, wow, this really wasn't worth it. And you'll remember and grow in awareness for the next time. That's food piece where it's a logical, evidence-based approach to food, a rational approach to food. We talk about this as helping clients become more aware of how these foods affect their body. Now, when you get a client, I would imagine like us, many people are completely numb to how foods affect them. So are there steps, are there certain things that you take with your clients to get them to become more aware of how these things they're consuming are affecting their body? Yeah, I think that initially, I think I start as simple as I can and then from there get as granular as I need to. But starting off with just more mindful eating, are you eating on the go? Are you running around? Or are you stressed when you're eating? There's a lot of distraction and numbing going on in our culture that many people you're right are absolutely divorced between what they eat and how they feel. So it could be as simple for many people as just sit down, breathe, chew slowly and be mindful of how you feel after you eat. And then from there, we can get more granular. I mean, if we will start with food tracking apps to really track foods and we can go back and correlate symptoms and find patterns between what they eat and how they feel if we need to go there. And we get granular as far as continuous glucose monitors and really looking at data and then bigger objective data snapshots like blood labs to correlate like a baseline and how does some positive nutrient dense bioavailable foods, how does that influence your physiology? It's also a massive awareness tool or lab. So it's not this sort of like doctor pontificating about some thing, you know, some idea that he's seen work. But it's no, they know for themselves, whoa, I saw my blood sugar here. Now I'm seeing it here. I see my inflammation here. Now I'm seeing it here. And people get encouraged by that. They want to keep doing the things that love them back and people want to feel good. And it's kind of, I think distills a lot of that food confusion that can really happen in our culture because of all this Dr. Google and all these people with well intent good intentions on social media and on podcast creating a lot of disillusionment around food. Well, I had an experience when I had to years ago become more aware of how food affected my body besides the body fat muscle gain, which I was very well aware of. I was just completely, you know, disconnected from all the other things that how, or how foods affected me. And when I became more aware and started making connections to other positive outcomes like digestion, inflammation, sleep, mood, I actually started to find that I started to crave different foods because I had made those positive connections. And that was extremely effective because one of the challenges that I found with clients and myself was well, if I know that's good for me, but I don't want to eat it. I want to eat this thing over here. But then I found I actually wanted to eat certain foods because I started to become aware of how they affected me. Is this common? Do you see this as part of this process of becoming more aware or doing these food meditations? Absolutely. People want to feel good. And when you start to, like all the noise around the conversations around food, the sort of supercharged conversations and blanket statements and your broad sweeping generalities around food really fall into the background when people know, okay, these are the tools, these are the food tools for my breakfast, lunch and dinner and snacks that make me feel the best. And they really there's, they have a center, they've created a center for themselves and a confidence about themselves and intuition about themselves that it is like it's the center that this is how I see it for my patients that they create this sort of resilient center and they can pivot from that center, but they know their center and they know their wiggle room and we all have different wiggle rooms as far as like quote unquote what we can get away with. But there's this, I think confidence when you find out what foods work for you. But then also realizing what works for you today isn't necessarily what you're always going to have to do. So I do a lot with people with autoimmune problems and different inflammatory problems and as the body's healing and improving function over time and I'm always trying to remind my patients is that your body is going to gain resilience. So you don't have to be so stuck on one ideology and say like this is my identity in food that is going to evolve and change. And for anyone, no matter who you are, I think it's important to remember that it's okay to pivot, it's okay to learn new things and try new things and evolve over time. And I find that there's so much tribalism within food, whether you're talking about like the keto movement or the carnivore or vegan, vegetarian, whatever, like that's their identity. And I feel like that is really sticking your body in a box that when you find out, okay, maybe it worked for you for a time and you get super excited. What happens when things evolve? Our microbiome is always changing. Our life is always changing. Our body is always changing. So I think it's important for people to realize that to be flexible with yourself. All right. Today's giveaway maps anabolic advanced the newest maps program. In fact, we're getting a lot of reviews right now. Uh, it seems to be one of the most effective programs we've ever put out for milk, building muscle and strength. Anyway, one of you will get it for free, but here's how you can win. Leave a comment below this video in the first 24 hours that we dropped this episode, subscribe to this channel and turn on notifications. Uh, if you win, we'll let you know in the comment section. We're also running a sale on some workout programs. We put together a bunch of programs and call it a, and we called it a time crunch bundle and we discounted it. Here's what's included in this new bundle. Maps 15 minutes, maps anywhere, maps prime and the ebook eat for performance. The total price for all that is $99.99. If you're interested, just click on the link at the top of the description below. All right. Here comes the show. Well, how many years have you been doing this now? I've been, I started one of the first functional medicine telehealth centers about 13 plus years ago at this point. So I've basically been in this room for the past 13 years, 10 hours a day, uh, looking at labs and, and talking to people. What do you see, uh, today that is different than when you started? Are there, are there trends that are, that are new now that are different than when you first started? Like what come, tell me a little bit about the evolution of, of coaching these people and what you see today that's different than when you started? I think I see a lot of positives. I think that the democratization of health information, the decentralization of health information is overall a massively positive thing. Before it was these, these gatekeepers that were in white coats and the media that would say, this is what it was. And this was sort of the orthodoxy around nutrition. And I feel like I remember 13 years ago when I would be talking about the idea of reversing diabetes and how the idea of food, it could impact things like diabetes and autoimmune conditions. I would get phone calls from people and say, how could, how dare you say that food influences type two diabetes and you could reverse it. It's genetic. You can do nothing about type two diabetes. And same with autoimmune conditions. How dare you say food can influence inflammation levels and decrease flair ups. And today I don't get any of those phone calls and we're reaching a lot more people. So I think that there's, that's a good sign in my, in my mind that there's a growing amount of people that are aware, the influence that food and mind body practices, how does that impact human physiology? At the same time, I think that this sort of, I go back to this anti-diet culture, I feel like they are this malignant voice, I think within wellness that taking a lot of people back and a lot of confusion around food, because then people are starting to, anytime you talk about any positive food changes, it's automatically labeled as toxic diet culture. And I think that's just very, it can be potentially hurting a lot of people. Yeah, it seems like it's become, at least in my experience, it feels like the diet culture has become more polarizing than it ever was before. Do you feel the same way? Yeah, I do. I do. I don't know why that is exactly. I think social media probably plays a part of that. And I think I'm a massive advocate for freedom of speech. So I never want to silence or cancel anybody. Like the person I disagree with the most, I want them to have a platform to say what they want to say. But when there's a lot of keyboard warrior on the other end of the world saying things that they would never say to your face, I think that there can be a lot of toxicity amongst this conversation, right? You can't just be civil. You can't just be kind, but give your opinion and be strong in your opinion. There's this sort of really malignancy, I think, within the conversation that doesn't have to go there. We're talking about food and we should be able to realize that this is something that we could have a robust debate about, but we don't have to really get to such a dark place that I think social media can breed. Well, Will, you know, I have some commentary on that. I love your opinion on what I'm about to say, because I've been doing this for a long time, over two and a half decades. And all the way back when I first started as a, you know, 18 year old trainer, diets have always been tribal. There's always been tribalism among diets. Everybody in the fitness space knows this. This guy over here will say, eat a lot of carbs. It does this. This person over here will say, avoid these types of foods. This person will say that. And there's always been some tribalism, but something new that I've noticed over the last maybe 10, but especially over the last five years that didn't exist before was that diets became, for lack of a better term, a political. And what I mean by that is before the argument was you're wrong, your diet's unhealthy. The arguments today are starting to sound like this. The way you're eating, it makes you a bad person. Not that your diet's wrong, but you're hurting the environment. You're killing the environment, or it's unethical, or you're a bad person, or he's toss, taught whatever, you know, label however you are, your fat shaming or toxic masculinity on either end. It's, it's like you're getting attacked. We'll take political strategies. Is this, have you noticed this as well? Yeah, that's a very astute observation. I think that's exactly what it is. It's, it's not just about food anymore. It's an indictment on your very character and your sort of moral, moral compass. So I think that that is, again, it's, it's taking something that is probably at some point started with good intentions or good enough intentions, right? It's like, alright, we see a lot of disordered eating out there. We know that toxic diet culture is not good, but then they're all context and all nuance is lost. And when you're sort of swinging the pendulum to the completely other side where it is, whether it's, you're right, the toxic anti diet culture, where everything's in the name of body positivity. And there's so much virtue signaling about that, because it's like, of course, I would say I want everybody to love themselves no matter who or what they look like. But ultimately loving yourself doesn't necessarily mean accepting where you're at right now. And the idea that you could evolve and grow and level up your health is, is like seen as a negative thing. It's upside down. It's completely backwards. So I think you're absolutely right. And then that's not even talking about the, I think the vegan militants, vegans amongst that social media, like back corners of social media, which again, it's a whole other level of morality and political. We are literally seen as murderers if we are omnivore. Yeah, you know what's interesting about this because it definitely is political because if you look at the political space, you'll have one movement that is extreme and it almost always spurs a equally extreme on the other end movement. And so veganism has always been around. It's been around for a long time, but it got real extreme relatively recently and I 100% believe it's the reason why carnivore now is a thing. I feel like it's like the extreme reaction. I mean, how do you feel about what I'm saying? Does that resonate? Yeah, I think that's your right on track there. I think that's part of the issue. It's really they're both sides of becoming more emboldened because of this growing tribalism. And it's like, what's the end of all of this? Right? You know, I've talked to patients for a living. I look at labs for a living. I, and there's a science and art to all of this. Like if somebody, like for example, if somebody really identifies as vegan, right? And they have a lot of stress and anxiety about ever being not vegan, that stress and anxiety and shame around food is going to even if practically it makes the most sense for them to bring like, let's say wild caught fish in and they land on sort of a nutrient dense, bioavailable pescetarian diet. I know clinically we can really move the needle in certain areas based on their goals, but that stress and anxiety and that sort of mental relationship, emotional relationship with foods going to completely sabotage any good results around that food. And that's kind of what I'm talking about and got feelings is like, what's the, what are you not just feeding your body, but what are you feeding your head and your heart? And ultimately, what's your relationship with food? And we have to really start for some of these people really start retraining the limbic system to not have such a supercharged anxiety and stress around healthy foods. Like stressing about healthy foods isn't good for your health. And again, these the carnivore versus vegan, high car versus low carb, like fasters versus not fasters, diet culture versus anti diet culture is only confusing the people more. Yeah, well, you know, you're reminding me of a study I read a long time ago. I'd love your reaction to this, but there was a study that compared obese individuals who worked with a therapist versus obese individuals who worked with a traditional dietitian. Long term success was greater with the people who worked with a therapist, which the, and the goal wasn't necessarily diet, it was just therapy versus the ones that actually worked on the diet in terms of long term success in terms of weight loss. What's your opinion on that? Why do you think that is? I think because in part of this, it's that mind body connection, right? There's a study that I referenced and got feelings of around self compassion. I think a lot of this, when you're looking at shame or what I call shame, inflammation around food or your body or whatever, you know, it is life itself. There's can be a lot of dysregulation of the immune system in the form of chronic inflammation. A lot of dysregulation when it comes to the autonomic nervous system, the body stuck in more of that fight or flight stress state. And there's a lot of sources of what are contributing to these things. It's not just food, it can be environmental toxins. Of course, it could be stress, it could be unresolved trauma as well. But the study looked at the people that had the highest self compassion scores, had the lowest interleukin six levels, they had the lowest inflammation levels. So I think working with a therapist to the, I don't know the study that you're referencing per se, but it makes sense to me when you're set, talking about someone really working on cultivating tools to regulate their nervous system will not only heal their relationship with food, but also influence their physiology in the form of a more regulated nervous system and lower inflammation levels. Yeah, well, that's interesting because I think one of the mistakes that Western medicine has made with diet is that they have separated the psychological from the physiological and you're talking about how they're both, you know, equally important. You mentioned that study, which made me think, you know, the immune system is designed to regulate and attack, it'll attack invaders and sometimes it can attack your own body. If it thinks your own body is a problem, well, if you're psychologically hating yourself, could that perhaps trigger an immune response against yourself? Yeah, I mean, these are sort of the things I spent probably too much thinking about because then it's just, there's so many levels to this, right? I mean, researchers refer to autoimmunity as the immune system, quote, losing recognition of self. And I think, okay, that's happening on a physiological level, right? So molecular mimicry, the immune system is tagging whether the thyroid and Hashimoto's disease or the myelin sheath of MS or the gut with, you know, ulcerative colitis or Crohn's or celiac. That's happening physiologically. But then you look at the research around stress and trauma and these sort of mind body studies are really looking at, okay, what's happening? People losing recognition of self is a lot of shame, a lot of stress. This sort of perpetual, sympathetic, like activation is triggering things for people just as much as food, just as much as environmental toxins, or, you know, virus or pathogen, something like that. So yeah, it's a huge, a huge component that that's why I wrote the book, because I think we, a lot of people know about food. I think I don't necessarily think we need another food book out there in the world. But I think that this sort of mind food, like what are your thoughts for food? How does this influence our physiology? Yeah, this is probably why the process takes so long. What did you say? Like, it's not as easy as just giving somebody, you know, when I first became a trainer, well, we were taught to give people meal plans. And I remember thinking like, just follow what I gave you and you'll totally get in great. Nobody would follow it. Nobody could follow it or stick to it. But of course, you know, 10 years later, doing this for a long time, I started to realize, oh, it's way more complicated than just following instructions like a robot. So do you think that's why one of the reasons why this takes so long is you're not just giving people information. They have to kind of change themselves, change how they view themselves and how they view food and how they use it to self-medicate, for example. Yeah, 100%. So there's a lot to unpack with these conversations. You're absolutely right, like exploring both gut and feelings in my job, like the physiological and the psychological, the physical and the mental, emotional, spiritual, the physical stuff. It's not that it's easy. It's just more straightforward. It's more kind of dry. It's more prescriptive, right? It's like, yeah, I put it in the book. I deal with it. I address it with every single one of my patients. But it is and people with especially a certain personality, like my patient base, we're talking about like type A driven, proficient, high performing people that are want that just tell me what to do, doc. Like I'll do it. I'll execute it. But I need to know what to do. I want that protocol. Okay, let's do it. But for many people, it is just one side of the coin. And the feeling stuff of gut feelings is not so prescriptive because you can't really tell somebody to just not stress or you don't have that shame or like just drop that trauma because it's stock doesn't work like that. So you're really going to have to retrain the nervous system and retrain how they do life. Like what are their coping mechanisms even? Because there's a lot of coping mechanisms around food and things like alcohol that you really need to unpack, which takes time. So in many ways, I find that my job in functional medicine, just as much as it is around nutrition, it's very therapy on the therapy side, it's probably just as important, if not more for many people. How much of a role does the microbiome play in all of this in terms of like your state of well-being mentally in terms of like what drives you towards cravings and food selection and choices? Like how concerned do we need to be? It's massive. And I think that that is that part when we're looking at, let's just say microbiome labs or blood labs that look at different inflammation markers that has a gut centric component. Like the gut is modulating some inflammatory process in the body. There can be a lot of grace, I think, around that when people see, oh, it's just, it's not my lack of willpower. I'm not just like a bad person or a weak person because I keep like going for the fridge late at night. There's just as much as there is a mental emotional component. There's a physiological component. It has to be a both and not either or approach when you're talking about people's health. So the research is clear. I mean that certain bacteria influence like opportunistic and pathogenic bacteria that we can quantify on labs modulate our cravings. This crosstalk between our gut, our second brain influences the how our brain and hormones and blood sugar are expressed. So yeah, it's a huge, I think, weight off of many people's shoulder to know, okay, I can fix this and I can get some metabolic flexibility. I can improve my gut brain access. I can create some resilience here. So I'm not bound by the the hangriness. I'm not bound by these insatiable cravings that seem to consume me. So yeah, it is, it's a huge deal and that's a massive part of what my message to my patients in the book is for us to really give people this freedom from this either or dichotomy between mental health and physical health. I think that I love that there's a growing normalizing destigmatizing around mental health. That's good. But I think in many ways it's an incomplete conversation because in the West we still will separate mental health from physical health as it's sort as if it's some sort of abstract quote unquote chemical imbalance, which is I'm sure you guys agree that it's flimsy science at best even taking that model, but really looking at, for example, the microbiome's influence on the brain or the cytokine model of cognitive function. I mean cytokines are pro-inflammatory cells. How does inflammation impact how our brain works? So it's really dealing with these physiological things which gives people a lot of reprieve. Like when they can get their head above that proverbial water, they could start making decisions that love them back instead of these self-sabotaging ones. Well, let's talk a little bit about the immune system's role in how our bodies react to foods. I remember years ago when CGMs, when people in the fitness and health space started first using CGMs to see how they reacted to different foods. I knew someone whose reaction to an avocado was worse than when they ate a cookie and everybody was so confused. And then we considered the fact that they might have an immune reaction to that avocado and, you know, as immune reactions as an inflammatory response the liver dumps out a bunch of sugar and that's what showed up on the CGM. So how does that happen? How does it happen where I can eat a particular food or way and not even talking about food allergy, right? Just talking about how my immune system reacts to different foods and how that those reactions can influence my behaviors. Yeah, yeah, it's a great point. I think honestly that's probably part of the reason why I'm not super, I'm not ideological one way or the other because I'm reminded on an hourly basis for the past 13 years, if I hung my hat in one way to do thing for everybody, I'd be proven wrong all day long because I can think of a great food that works great for one person and the next person it causes a flare up. So I just I have to be intellectually flexible when you're looking at labs for a living and looking at bio individuality. So I see this a lot that like the healthiest food you can ever think of where you know all the exciting science around it like avocados or like the epitomization and it like makes the vegans happy and the keto people happy. It is like it is like the most inclusive foods. Yeah, right. It is come one, come all to the avocado. Everybody can get behind it. But it it's high in FODMAPs or it's so people that with SIBO can have a reaction to it, which raises inflammation because it pisses off the microbiome and influences blood sugar, for example, or like that you said there's many people that there's some people that can have an allergy to avocados as well, but then beyond allergies there's this continuum of intolerances like a FODMAP intolerance these people that have dysbiosis and things like small intestinal bacterial overgrowth, they don't have the proper ability to break down these fibers. The bacteria actually love to over consume these fermentable sugars that are in things like avocados and they're things like onions and garlic as well. Or you know people can have reactions to all different types of plant compounds. So there's a lot of variables to consider here. It doesn't mean avocado is bad. It just means, okay, look, it's bio individuality. And again, back to my earlier point, just because avocados don't work for you now doesn't mean it's necessarily always going to be the case. So let's use the CGM. Let's use microbiome test and blood test to look at what foods love you back and which foods don't. But then as we're fixing, let's say to use this example, let's fix the SIBO, let's get some microbiome resilience here so you can reintroduce these foods over time. And to use the cookie, sometimes he's like easy to digest quote unquote simple carbs for a very irritated gastrointestinal system. It doesn't mean they're healthy. But I hear that all the time like when I eat junk food, my digestion is better than they're using that. I mean, that's all they need to like go double down on some fast food. It doesn't mean their blood sugar is probably hating though, but ultimately on a digestive standpoint, I see that actually a lot because it's less of a whole food. So it's like requires less to break down sometimes. It doesn't make a healthy though. Let's stay on this avocado metaphor. So you have a client and they've ate avocado their entire life and then we find out that it's, you know, an insult to them now. How do you communicate to somebody how this healthy food they've ate their entire life is now affecting them in this way that they just assume couldn't be possible because they never thought just uprooted their belief system. Right. So how do you how do you communicate that and also how often is that common that it's a food that they've had in their entire life and that you've got to communicate in that this food is no longer agreeing with you. I see a lot of people that have these underlying gut issues right. They have SIBO, dysbiosis, CFO like small intestinal fungal overgrowth. So a lot of these higher FODMAP plant foods higher histamine. I mean, avocado can be higher histamine too. I see a lot of mast cell activation and histamine intolerance too. So these sort of complex things that are beyond the basics. So all like anything's fair game as far as what's irritating their immune system. So normally when we create a baseline some calm calm the reactions down and then do reintroduction they can see for themselves. Oh wow. I never thought that was an issue for me until I removed it for a time and reintroduced it. There's a lot of like feedback I think for people to realize. But then it's I always want to bring the context around this like don't fear that food and we have to work on these limbic system retraining the brain so you don't if you have a trauma like I'm using that word just from the sense of there's a lot of fear and anxiety around food when food causes you flare up sometimes and especially if it's healthy food because then you're like so disillusioned on what even is good for you. So and people I'm oftentimes will meet them and they're eating five different foods because they don't even know what to believe anymore. So there's a lot of unpacking both on a physiological and a mental emotional level that has to come come about. So I think that to use that avocado example and if it is a an intolerance or a reaction some sort of immune system reactivity that's for example we have to show them clearly this is cause and effect. But look it is such a feedback loop because people stress and anxiety around foods does play a part into the reaction. For example for some people when we work on regulating the nervous system getting their nervous system more into a parasympathetic state and retraining their limbic system they reactions they used to have they don't have anymore. So it is back just this overarching idea of a both and approach but the physical and mental emotional and sometimes spiritual component of it. It's huge when you're talking about food reactions and reintroduction of foods over time. That doesn't mean they should be having a food that's causing them a reaction in the short term. Let's say we have to heal their gut and deal with their SIBO. But part of healing that dysbiosis and that what's happening on a mechanistic standpoint is a lack of the migrating motor complex. It's the gut brain communication the crosstalk between the gut and the brain. Trauma and stress will decrease migrating motor complex. So you really have to really work on training that vagus nerve to be strong enough to be able to regulate that gut brain access appropriately. So it is it's definitely can be tough for people when you're talking about healthy foods causing reactions how do you navigate that. So it's very much being proverbially on the ground with these people to let them know this isn't going to be forever. Let's work on repairing these both sides of this coin. So you can start reintroducing foods and healing your relationship with food just as much as you're healing your body. Yeah I have personal experience with that years ago. I had to do some serious gut health work and I couldn't eat peanuts, egg whites, cruciferous vegetables. But then after I healed my gut I mean those are now a regular part of my diet but at the time I was hyper reactive to them. So I have personal experience. Now along those lines I had the luxury of working with someone who was somewhat privy to functional medicine about 18 years ago. And this is back when finding a functional medicine practitioner was like it was impossible. I mean you couldn't find one there were just one around. But I do remember terms and terminology being thrown around in that space that the medical community scoffed at and laughed at because I also at the time trained a lot of traditional doctors. I had clients that were surgeons and doctors and if I brought up the word like leaky gut syndrome I'd get eye rolls and scoffing. If I said something like adrenal fatigue everybody oh my god that doesn't exist. Now to me what's funny to me now is now traditional medicine will say intestinal wall hyper permeability which is leaky gut syndrome or they'll say something like HPA axis dysfunction which is adrenal fatigue. Do you see more inroads because that's a positive change. Do you see that this is accelerating that now we're starting to get more functional medicine into traditional medicine. Yeah I love that you brought this up because I think that's part of the reason why when I go I mentioned those earlier phone calls 13 plus years ago I'm like how could you say this. One of my top referral basis at the telehealth center are conventional doctors. Oh wow. That is shocking to me. I never thought the day would happen when I'm on a zoom call with my common our common patient and the gastroenterologist or the rheumatologist or the PCP. Wow I don't take that for granted at all because I think that our world has changed in that way for the better very dramatically in 13 plus years just that small chunk of time relatively. So yeah I think it's huge and most of my colleagues within functional medicine are conventionally trained. I mean and they will be the first to tell you that they didn't learn any of this stuff in medical school and they had to that's why they had to be trained post-doctorate training in functional medicine and the Cleveland Clinic has a functional medicine center many mainstream institutions medical institutions have functional medicine center. So I mean these hospitals these medical groups are not spending millions of dollars on functional medicine and integrative medicine schools and centers based on quackery based on woo woo. They are doing it because the results speak for themselves. So I think the archaic person out there that's still like deep trying to shame and delegitimize us in functional medicine they're on the wrong side of history and I think the statistics speak for themselves right. I mean the United States spends more on health care than the next 10 top spending countries combined yet we're the sickest with the shortest lifespan of all industrialized nations. So it's very the height of hubris to still have a God God complex with that type of data. So we have to do something different to see something different and I think there are many I mean look most doctors conventional doctors got into health care because they wanted to help people and they're starting to realize wow these complex health issues are largely lifestyle driven. So meaning the best tool within the toolbox for most of these people is going to be some sort of lifestyle approach. But again it doesn't have to be either or some people need to be on medications and we have amazing advancements and diagnostic and acute trauma care emergency care. We need that. Let's have the best of both worlds and that's really what I'm trying to teach people is not having tribalism in medicine just as like we shouldn't have tribalism within wellness and food culture. So here's what's interesting what you're saying. I remember there was a study that came out I want to say five or six years ago that compared herbal treatments to pharmaceutical treatments for SIBO. Now SIBO even a while ago was not accepted by the medical community. Now it is right. You can get tested by a traditional gastro doctor and they'll test you for SIBO. And so it's well accepted. But I remember the study that came out that compared herbals to pharmaceuticals. Pharmaceuticals being antibiotics herbals being antimicrobials and the results were actually the same. They actually did just as well. I thought that was so groundbreaking that we saw that they showed in the study. Hey these are plants that you could buy and use to treat SIBO that work just as good as these super powerful nuclear bomb antibiotics that many people couldn't found too expensive. Are we seeing anything like that with SIFO? You mentioned SIFO earlier. It's a small intestinal fungal overgrowth. First off, is it accepted like SIBO is or is that still kind of considered on the fringe? And if it is what are the treatments for that and how different are they than how you would treat SIBO? It is not as widely. I don't know of any patient that I've heard and I see a lot of when I'm on their initial telehealth consult I'll see labs that are ran in the conventional setting. I don't see really, I see Candida ran the blood test typically to look at Candida antibodies. I do see that. So I think that there's an awareness but oftentimes those type of labs are ran because the patient asked for them. Right? So the patient says like can you please run that and if they have a doctor that's maybe just willing enough to run it for them or open and minded enough to run it for them, they'll run it. There's really not, I think, a wide approach to something they may give them an anti, you know, a diaphragm or some sort of anti-fungal if they push hard enough or think it's warranted certainly. But it's, I think SIBO, a lot of hope when I look at people that are struggled with SIBO and are getting lab access to SIBO breath tests within their conventional doctor to look at these things. But I agree that the refactamine is a vaccine antibiotics they are needed sometimes. They can be a great tool for many people but it really can do a lot of damage to the good microbes as well that I find that many of these dysbiotic cases that don't necessarily need the big atomic bomb antibiotics, some people need them. Not everybody does. So to have more tools within your toolbox versus just that one antibiotic is really an appropriate thing because a lot of these people do really well with herbal antimicrobials it's more sustainable. The chance of reoccurrence is a lot less than my experience versus the conventional antibiotics. So it's similar to people that have SIBO that are these herbal antimicrobials oftentimes many of them do have anti-fungal properties as well. I was just going to say that. So let's get into that for a second Will because antibiotics can actually set an environment that increases the potential for fungal overgrowth. Antimicrobials which are plants like things like oregano, peppermint oil and so on. They tend to possess both anti-bacterial or antimicrobial effects and also anti-fungal effects. So they don't create the environment for fungal overgrowth like antibiotics. Is that am I being correct here? Is that accurate? Absolutely. So the studies that are out there oftentimes you will see within the plant medicine, natural medicine, support, research, you will see that is that they have antibiotic capabilities as well as anti-fungal capabilities. So cat's claw, oregano, powder arco, uverersi, caprylic acid, these type of things can really be helpful for people that have bacterial dysbiosis and SIBO as well as fungal overgrowth as well. And look, people can have both of those many of our patients do that there's because the problem is a lack of regulation of the microbiome. There's a lack of migrating motor complex with the nervous system and these opportunistic and pathogenic bacteria can really be like weeds overgrowing in this gut garden causing a lot of imbalance. So many people have both but they're just tested for SIBO so they are just looking at that one thing but it's way more like SIBO doesn't happen in a vacuum. There's a larger dysbiotic problem oftentimes and we know SIBO is associated with many autoimmune problems too. So normally there's some other inflammatory component beyond just SIBO itself. What, okay. So the reoccurrence of SIBO is quite high. When I look at the data and my own personal experience I probably have to treat myself for some dysbiosis a lot less these days probably like maybe once a year or less. But in the past it would just keep coming back and there's a lot of there's a lot of information I had to treat SIBO now but there's very little information on what to do after to prevent reoccurrence. Can we talk about what that looks like because I guarantee people some people listening right now are like yeah I keep getting it like I had it I fixed it came back like what's the deal? Yeah I think it can come back from any different reasons right I think if sometimes people don't give the protocol long enough time and I see this a lot where they've got the pruning down of the microbiome they improve some migrating motor complex from a nervous system standpoint but the gut can take upwards in my experience and there's some studies to show this as well 18 to 24 months to really heal so if some people on protocols like the herbal antimicrobial protocols and adjunctive nervous system regulation support for a year and a half two years cycling not always on it but cycling through these protocols to really give it the chance that it needs I see very low rate of reoccurrence when we do that and our patients our average patients are with us for about year and a half to two years because of that so it's not really sexy to say that because they want like two weeks of that like seven it doesn't work like that for most people that have these chronic GI issues again it's cycling it's intermittent it's not always taking all the supplements or all the things but at least cyclically over the course of that time so I think that's part of it and the other thing is from a food standpoint people get kind of like not in a bad way but they get kind of cocky around foods like oh I can eat this and I can eat that I can eat that and it's like they because they have more resilience the distance between cause and effect is greater so they don't realize oh like yeah I didn't have a problem with just that but like that and that and time really is breeding these despotic problems I see that all the time too which is fine again they build a center for themselves like let's like get back let's refresh and kind of really not get too cocky too soon would you would you base the cycling of these treatments because this is this is blowing me away because I think that's me would you base the cycling based off of symptoms or more of a regular thing like okay for 30 days you're doing this antimicrobial protocol and then we'll start it again in 60 days or is it let's get back on it when you start to notice certain symptoms like what does that look like normally it's a combination of well I'll say this for most people it is not just based off of digestive symptoms I'm looking at labs as well okay and I think that's the buy-in I think for many people because when they see okay yeah my digestion improved relatively quickly and by that I mean like months of healing but we know we have to create some stability after we got out of the woods and I think at that point if you see the inflammatory markers that are still off or you see these immune markers that are still off 75% of the immune system is in the gut so the overt obvious noticeable digestive symptoms may be in remission fantastic that's a blessing but ultimately the ripple effects of the immune system being kind of fragile is still you can see it on labs for months and months after the digestive issues have calmed down so at that point my approach has always been to create immune system resilience over the course the analogy that I use for patients in this instance is like a cast like you can't like take the cast off with a broken bone and like go do yard work go do some push ups and like put the cast back on that's going to re-endure it and slow down that healing time well okay so the initial intervention protocol a few months right take we can take the cast off we can reintroduce some food to go off of some supplements but still keep that support ongoing cyclically put that sling on do some rehab to use that analogy but don't like take the sling off and go like hog wild you have to really rehab the gut over the course of in my opinion for most people years not weeks and months God that has to be one of the most common things that you see because I'm thinking back now to my experience great analogy right yeah yeah I think that a lot of people get excited and I'm also guilty of this like you've eliminated something for a while healed it feel better you go have it you go have a serving of it one time and you're like oh shit I didn't get any symptoms I'm cool now I'm good and then you introduce it again three days later and then you introduce it again the next day and then before you know it you're doing it every day again and then all the symptoms come back and then you probably go like oh that functional medicine guy he didn't help me and you chalk it up as like you didn't you didn't care me you didn't fix me because it all came back anyway so wow I mean how how often it does that happen is that more often than not that this happens were they revert more oftentimes than not but I don't know I just think doing this as long as I have and really this being my main focus for my patients I they're in it for the long haul I let them know you communicated yeah you communicate I let them know from the beginning so they know the first time I'm meeting them and I'm looking at their labs and looking at their health history looking at all things they've done both conventionally and with other great functional medicine doctors it's like part of this is it's not always more more or more it's just staying consistent with the tools that are the most effective for you and me reminding and like coaching you to stay on this path and not like wavering from this because I know if they put in the time they're going to see the sustainable results they they're looking for so yeah they know what they're getting when the first time I'm meeting me that this is like the time frame that we're looking at and look and I always say this too like if I don't want to limit what your body can do like maybe you're a really rapid amazing demigod of a human being that will heal super fast but like I at the same time like let's just take it step by step and and give the body the time that it needs how how quick within a consult can you tell whether you can help this person or not meaning because I know you talk a lot of we have already talked about the physiological side and the psychological side I'm betting that there are some psychological indicators or maybe my mindsets that people have coming into their console with you how quickly can you tell like oh I'm going to be able to help this person oh this ain't we're probably not we're probably going to fail can you tell yeah I I can and not always right I think you're meeting someone for an hour and a half online I've been doing it long enough like reading between the lines that science and art duality of of what I do in functional medicine so I get a good read but you really there's an unfolding that happens after that but yeah a lot of the obvious signs you can get earlier on but you know I'm up for a challenge I really it's just a matter of like how hard are you going to make this for me but I will see this through and look the overwhelming majority of our patients they've already came to the point by the time they get to me to know I have to do something different to see something different and they have a certain level of teachableness and they are willing to collaborate on their health and they want answers so I maybe in some ways even though I have complex cases kind of have it easy because they're they know that I'm for them and not against them and they're desperate probably a little bit right because yeah because you're not the first person so that was this leads me to the question I wanted to ask you too is and have you seen this change what percentage of your patients would you say that you are actually the first line of defense and how many of them of like western medicines failed them and that's the only reason why they're coming to you and has that percentage shifted since the beginning when you first started today it's that's a great question the overwhelming majority of them have done a lot they they have kind of gone they've either gone through conventional medicine and known that that's all there is to offer maybe they maybe they aren't even that sick they don't even have that many health problems but they know enough to know if they want to optimize their health they're gonna have to look something somewhere different and that doesn't mean that we're replacing their primary care physician like we're still telehealth like they still need their physical exams we're still working in conjunction with their local doctor but they know ultimately to deal and optimize your health improve their labs they're gonna have to go to us but look a big percentage of the people are struggling with some complex health issue that it's stubborn it's just not the needle's not moving for them and yeah I'm normally not people's first rodeo let's just say that normally I'm like down on they've kind of gone through the conventional doctors they've gone through many alternative doctors and I would say this they are better off than they would be if they weren't doing those good things most of them are eating better than most people they're taking well-intentioned supplements they have some labs that they had ran they are better off but they're all kind of stuck at this like sucky plateau that they're looking to move past yeah will what was the primary motivation for for gut feelings what drove you to write that book and write about what you're talking about to me being in the health space professionally I keep saying 13 years but like I was a weird health nerd kid at like 15 years old I worked at the finish line and selling shoes in high school and I'd use my paycheck to go and to the health food store and like by the latest superfood I read about the latest like supplement I saw I was such a weird kid and I think now I have a teenage son and I'm thinking I was so weird I'd pack my brown paperback lunch with like whole bell peppers and like just chew on a whole bell pepper as a teenager in western Pennsylvania it was really weird but the where there's just everybody at McDonald's and Wendy's KFC so that was I've been a part of this sort of community for a long time since the 90s and I really wanted to have a conversation to my community where I find that there's a lot of tribalism amongst us and there's a lot of disillusionment amongst us and it's born out of endless conversations I've had with my patients so I really wanted to have a sane conversation between toxic diet culture and anti-diet culture between conventional medicine and functional medicine and I also wanted to talk about the patients that I see people with autoimmunity people with mental health issues like anxiety and depression fatigue and dealing with both the gut and the feeling side of human health the physical and the mental emotional spiritual and how a both and approach really falls short and a lot of people fall through the cracks of that so I find that that this dual approach of dealing with the physiological stuff like we keep talking about the SIBO protocols and the food protocols like that's all in the book but just as much are these somatic practices and breath work and meditation practices and and things like forest bathing and these sort of that maybe seem kind of out there but there's so much exciting research of how can we modulate our nervous system in a positive way that supports this gut brain access access and lowers inflammation for my people with autoimmune inflammation Excellent Now I I would be remiss if I didn't ask this I'm sure you get this question all the time or it's annoying to have to answer but what uh what led you into the celebrities how did that happen how did you get into helping celebrities so I that's not annoying I you know I'm happy to answer it I really I honestly don't even know because I guys I live in West Pittsburgh, Pennsylvania yeah that's why that's why that's why it's interesting to me because it's like if you were the heart of LA I okay I get it you know what I'm saying but you're I no I live in farm country I live in the middle of nowhere I really haven't changed what I've done in 13 years I don't know other than us I think just being resolute and focused in our lane and provide great results and people that hear about it it's just word of mouth I by no means is western Pennsylvania like the Venice beach of the east coast that is not Abbott Kinney out here it's like farm country but you know I just love what I do I'm passionate about what I do and when I think there's something to be said about just staying in your lane being laser focused and I don't want to call maybe it's going to irritate some people but the law of attraction I think does there's something there of like just being a great at your craft and I'm not being arrogant I'm just saying I just live and breathe this stuff and I look at labs and get people better so when people that the world would know hear about this they're going through the same crap that everybody else is going through but the only difference is that the world pays attention when they talk about gut health and so I think it's good because it's raises awareness to other choices that people have in their healthcare that otherwise like the random like a lot of our patients actually are based in the Midwest where they don't have access to functional medicine I had a group call yesterday and like 70% of the patients were in the Midwest like in Minnesota in Illinois in Iowa not coastal cities that they just want access to this and many of them wouldn't have ever heard about functional medicine if it wasn't for these people that the world would know so I think it's it can be used for a lot of good excellent well this has been great Will thanks for coming on the show this has been awesome man yeah yeah for sure so and in your gut your book can be found pretty much anywhere books are sold so yeah gut gut feelings you can get on Amazon Barnes and Noble Target all the places and I'm really excited to have you guys on The Art of Being Well my podcast as well thank you appreciate it Will thank you very much thanks guys today we're going to teach you everything you need to know to build a strong well developed chest when I think of weak points and in areas that I struggled with developing for a really long time chest was up there with the yeah it was for me it was for me for sure I got more caught up in the weight I could lift versus how I was developing my body I think it's one of the most challenging muscles to develop for most people because the form and technique