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Ep. 521 Metabolism Masterclass: Weight Loss Resistance Explained

  • Cynthia Thurlow
  • 5 hours ago
  • 44 min read

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Today, we have the first episode in a two-part mashup series focused on metabolism and weight loss resistance. 


I am delighted to be joined today by Dr. William Li, Michelle Shapiro, and Lara Adler. Dr. Li and I explore how our metabolism shifts throughout our lifetime, the role of excess body fat, the influence of lifestyle choices, and the distinction between different types of fat. Michelle and I discuss the complex relationship between weight, shame, and self-perception, including how internal dialogue, orthorexia, and adverse childhood events shape our health journey. Lara and I examine how metabolic health and insulin resistance are affected by the endocrine-disrupting chemicals found in everyday products, food, and the environment. 


You will love this invaluable compilation, packed with insights and practical knowledge from our expert guests.


IN THIS EPISODE, YOU WILL LEARN:

  • How metabolism changes as we age

  • The difference between brown (biologically active) and white fat 

  • Excess body fat drives inflammation and hormonal changes.

  • How our internal dialogue influences our lifestyle choices 

  • Impact of adverse childhood experiences on long-term health and stress responses

  • Dietary strategies can fail when driven by fear or perfectionism.

  • Endocrine-disrupting chemicals block or mimic hormones 

  • Early-life chemical exposures set the stage for lifelong metabolic challenges

  • Reducing toxic exposure can support weight management and metabolic resilience. 

  • How reducing your exposure to endocrine-disrupting chemicals present in everyday products can support your metabolic health and help you manage your weight 

“Shame will not produce positive health results in any situation.”


–Michelle Shapiro

Connect with Cynthia Thurlow  


Connect with Dr. William Li


Connect with Michelle Shapiro


Connect with Lara Adler


Transcript:

Cynthia Thurlow: [00:00:02] Welcome to Everyday Wellness Podcast. I'm your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.


[00:00:34] This is the first in a series of mashup podcast episodes devoted to metabolism and weight loss resistance. I am joined in this episode by Drs. William Li, Michelle Shapiro, and Lara Adler. Dr. Li and I discussed how metabolism changes throughout our lifetime, the role of excess body fat, the impact of lifestyle and choices governing our health, as well as what differentiates biologically active fat.


[00:00:59] Michelle and I dove into the impact of weight gain, loss, and shame, and our internal dialogues are critically important for not only our perception of self but how we view lifestyle changes, the impact of orthorexia, as well as adverse childhood events.


[00:01:17] And lastly, Lara Adler and I dive into the impact of metabolic health and insulin resistance and how endocrine-disrupting chemicals in our personal care products, food, and environment can impact our ability to lose weight or to shift our body composition. I know you will find this to be an invaluable compilation of three guest experts on the podcast.


Dr. William Li: [00:01:42] But I love the fact we're still discovering things. There's a researcher at Duke University named Herman Pontzer who worked with 90 other colleagues from 20 countries and they wanted to ask a question. They said, "What does human metabolism look like over the course of a lifetime?" They got 6,000 people from 20 countries, men and women, young and old. When I say young, I'm talking about a one-week-old baby, newborn to old age, 90-plus years old. I think for most people that's to be considered sort of the end, the final chapter of life.


[00:02:12] They studied their metabolism and everything in between. They studied the metabolism all in the same way. How do they do this? They gave everybody a drink of water. Whoa. What do you mean they give them a drink of water? Well, in the lab, we can actually take water, which everyone knows is H2O. H is hydrogen, O is oxygen and you can actually tweak it. You can tweak it so you can measure it.


[00:02:32] If everybody drinks the tweaked water, you can then measure how your metabolism influences the hydrogen, the H, and O, the oxygen of H2O in the breath, in the bloodstream, and in your pee, in the urine. That's how they measured this for 6,000 people across 20 countries in exactly the same way. Never been done before. Now, I want to give you the context for something. Think about this 20 countries, 6,000 people across the ages. Some people, they are different races, different foods, different lifestyle practices, different genetics. You're really talking about the alphabet soup of humanity here. That's what also makes this study really profound is that it really did a real-world study, meaning the entire world.


[00:03:13] I think they got most of the continents. I can't remember exactly-- I can’t name them offhand, but it was quite a profound study. When they looked at metabolism from one week old to 90 years old, what do you think they found? The first results that they came out was that the human metabolism over the course of a lifespan was all over the map. Everyone had a different one. There was no rhyme or reason. It was just like somebody threw paint against the wall. Just like you'd expect, right? Just like, “Oh, there are some lucky ones and some unlucky ones.”


[00:03:40] Actually, we now live in the age of supercomputing. What these researchers did very cleverly is they said, "Let's do an analysis of this." What we want to do is to-- We know every individual's gender, we know their height, we know their age, we know how much they weigh. So we can calculate how much extra body fat every person had and how much they're supposed to have. So what they did is they created an algorithm to subtract from their results the effect of excess body fat on metabolism. So, every person just had the effect of excess body fat removed. And you know what that did? It gave a result of what human metabolism was like by removing the effect of excess body fat and it turned out to be like removing the cloth from the statue of David for the first time.


[00:04:27] We suddenly saw exactly how human metabolism is hardwired from birth to the end of life. There are only four phases we go through. Everyone's the same at the beginning. From zero to one year old, our metabolism skyrockets like one of those SpaceX rockets blasts off. In fact, at one year old, a baby's metabolism-- one year old’s metabolism is 50% higher than what their metabolism is going to be as an adult. It's absorbing everything, moving really quickly.


[00:04:56] By the way, this gives us pause to think about what we are exposing our babies to. Should we be giving them the microplastics in the sippy cup? What about the stuffed animals that are shedding all those little polyester microplastics? What about when we drive them around and they're breathing in fumes, or the new carpet they're rolling around on? All these kinds of things are-- this is what research does is it makes us rethink what we always assumed.


[00:05:18] One year old, 50% higher than adults. Now, from one year old to 20 years old, adolescents, right? Bouncing off the walls, eating two or three dinners. Guess what's happening with metabolism when you remove the effect of excess body fat. Human metabolism is going down, down, down, down, down to adult levels. All right? They're getting bigger, but their metabolism is getting faster. In fact, it's actually slowing down. That's the second phase of human metabolism.


[00:05:42] The third phase of human metabolism is from 20 to 60, and get ready for the mic drop because what they found was from 20 to 60, human metabolism is rock stable. Let me repeat that. The way we are hardwired for our adult lives, 20 to 60 years old, our metabolism is hardwired to be rock stable. This is a laptop that hasn't been dropped, hasn't had coffee or tea or water spilled on it. It hasn't been banged on. It's supposed to be rock stable.


[00:06:09] Then at the age of 60 to 90, there's about a 17% drop. But listen, what this means is that the way our body is designed, Okay? When we come out of the factory ready to roll, is that 60 can be the new 20 if you take good care of your metabolism.


[00:06:25] Now, for those who've been listening carefully, you'll know that one of the ways that they got to the statue of David picture of human metabolism is by removing the effect of excess body fat. So you know what happened once they threw the excess body fat back into the equation? You crush the metabolism. Now, why is that surprising? Because we've always assumed that a slow metabolism causes you to gain extra body fat. Now we know it's the opposite. Excess body fat, which is actually how our body stores fuel from the food that we eat, crushes our metabolism. Completely the opposite.


[00:06:55] This is research that's less than four years old. It's about three years old and it is changing everything that we know about human metabolism. Old metabolism textbooks are being ripped up and thrown away, and the new chapters are still being written today. This actually gives us power. The reason it gives us power is that our metabolism is not dictated by fate. We have the agency, we have the power to be able to use our diet and lifestyle to be able to control how much fuel we're putting into our body and the quality of fuel we're putting in our body so we don't grow that excess body fat and for those of us who have excess body fat, we can do things that can actually burn it down. When we burn down the excess body fat, guess what happens?


[00:07:35] I mean for anybody who's listening, who is in that middle age and wondering, "Oh my gosh, there's nothing I can do wrong," the new science tells us you can burn down your excess body fat and that starts immediately to unleash your inner metabolism to raise it back towards the level where it wants to be. It might take a while to do it, but the agency and the power is in our hands. That's what I wrote about in my second book, Eat to Beat Your Diet. The whole point is that you don't need to be on a diet. It's an anti-diet book.


[00:08:02] Here are the different ways. With a little bit of intermittent fasting, with choosing the right type of plant-based foods, by cooking with healthy fats, and by not overeating quantities of foods. And of course, by exercising, by protecting your gut health, which helps your metabolism, by sleeping properly to reboot our gut bacteria and also to burn down body fat. Did you know that when you sleep-- this is actually really interesting. When we're sleeping and not eating, meaning fasting, we're always intermittently fasting when we fall asleep. Okay?


[00:08:33] But when we are actually not eating, when we're sleeping, our metabolism shifts gears like the gearbox of a Ferrari. That's how I want you to think about your body. You're shifting gears like a Ferrari when you're sleeping and your metabolism shifts from storing energy into body fat to burning energy away from body fat. So, when you're sleeping, you're burning fat, which is pretty cool.


[00:08:51] For those people who are thinking, "I don't ever need sleep," or "I have difficulty sleeping," now's the time to actually rethink that because when we sleep, we're actually helping to right-size our metabolism.


Cynthia Thurlow: [00:09:02] I think that's such an important distinction. When we're sleeping, we are burning fat. We're tapping into fat stores for energy and perhaps describing that there are different types of fat. For people that are listening, a lot of the pesky fat that we don't love generally is white fat which is not metabolically active and you're alluding to the fact that with targeted lifestyle changes including nutrition, you can take the white fat, beige it to make it brown and then that is a metabolically rich type of fat that we can use to our advantage.


Dr. William Li: [00:09:34] Yeah. I'm glad you brought up-- in the last sentence you just said, Cynthia, you actually packed a lot of stuff in there [Cynthia chuckles] that I want to-- Maybe you've talked about this before, but let me unpack it for the listeners in a way that I have found useful when I'm explaining white fat and brown fat to people..


[00:09:49] Have you ever had a project in your house where you got to paint the walls, repaint a room? What do you got to do? Right? You're going to go to the paint store, the hardware store, and you're going to go to one of those whatever sections-- the paint sections. They have got a million colors there. You have to pick up the little swatch and make sure you pick the right swatches. Something that's really nice for the house is if you don't paint all your walls the same color. Even in one room, you paint it one color, and then you pick a matching color or a complimentary color on the other wall, it really lights up the room. Really, this is how Mother Nature designed body fat. Because our fat isn't something to be feared. Our fat is something that we should really love.


[00:10:24] For people who are confused about that, like, "No, I don't love my fat. I hate my fat." Wrong. When your mom's egg met your dad's sperm and you became a ball of cells, the first organ that formed in your body was your circulation because everything needs a blood supply. Then nerves started forming because we need an electrical system to be able to power up our organs. And then, soon after that, body fat formed.


[00:10:48] So fat is one of the first organs, yes, organ to form in our body. And you know where the first organs form of fat? They form around your blood vessels. You didn't even have a belly yet. Okay? You had no chin to double up. All right? You only had blood vessels of circulation. So, fat forms like bubble wrap around our blood vessels and the reason it formed that way is because our body fat formed before birth are the fuel tanks for the energy, the fuel that we'll eventually eat, which is our food. The same way that you have a gas tank in your car, in our body, the fuel tank is our adipose tissue or fat cells. So, don't fear your fat. It is why you're able to move around, all right? Elementally.


[00:11:24] By the way, people always go, "No, no, I can't get over that. I don't buy that." I would say, “First of all, look, I'm like you. I totally get it.” If you go shopping in the grocery store and you go by the butcher section and you see that T-bone or ribeye, and you see that big, thick rind of fat around it, immediately I go, "Ugh. I hope nobody eats that." Right? Like, that's the visceral effect we see we think of body fat, but there is a situation that we smile when we see fat. That's when we see a newborn. Who doesn't smile when they see a baby chubby, you know, big tummy, big fat arms, and big cheeks? It always makes us-- In fact, if you saw a baby that had fashion model chiseled cheekbones, long, thin arms, and long, thin thighs, it would freak you out. You would say, "There's something seriously wrong with that child." You'd be right.


[00:12:12] That's why body fat is part of our health. It's an organ in our body, and it comes in two different colors. Mother Nature designed body fat just like if you're going to the hardware store to get colors to paint your house or your room. One color is white and one color is brown. The white fat is packed into two places in your body. The first place is under your skin. We call that subcutaneous, under the cutin, under the skin. That's the stuff you can see. Subcutaneous fat is the wiggly jiggly under the arm, the double chin, the muffin top. It's the stuff on your thighs. It's the booty. All right? That is the white fat, the subcutaneous fat. Yeah. Okay. Admittedly, we might not want to see that. We might want to have less of it or none of it. But I will tell you, that's not the most harmful, dangerous kind of fat.


[00:12:56] The fat you should fear, the fat you should be repulsed by, is inside visceral fat. Because when you have too much visceral fat, it's inflammatory and that inflammatory fat increases your risk for cancer, diabetes, cardiovascular disease, and dementia. All right?


[00:13:09] So, what am I talking about, visceral fat? Look, if you are any body size, you can have too much visceral fat. If you are a large person, you've got a big frame, you can have too much visceral fat. It's all packed inside; you can't see it. But if you're skinny as a stick, all right? and you have a thin tube for your body, you can still have excess body fat. That kind of visceral fat-- you need some of it. But when you grow extra, when you overfeed and put too much fuel in your body, the fat that grows first, most aggressively, is this visceral fat.


[00:13:37] By the way, visceral fat is like a baseball glove of fat wrapped around your organs. It is really nefarious and inflammatory to everything in your body. It leaks the fat and the inflammation to the rest of your body. That's why it increases the risk of all these chronic diseases. Okay. So, that's white fat. It's all good until you've got too much of it, especially the visceral fat and its really bad. If you got too much of the subcutaneous, you get bummed out when you stare at the mirror. Okay? All right.  Now-- But some of it's important. It's a fuel tank. Then Mother Nature created brown fat because you mentioned brown fat or beige. Beige is sort of mixing white and brown, you get beige.


[00:14:10] But let's talk about the other side of brown fat. Now, brown fat is actually not wiggly, jiggly, it's not lumpy, bumpy, it's not around your waist. Brown fat is in fact not even close to the skin, not subcutaneous. Brown fat is close to the bone, and it's wafer-thin. Brown fat is on our neck, it's under our breastbone, a little bit under our arms, like a girdle or a bra, a little bit in our belly, and a little bit between our shoulder blades. What brown fat does is, I think you use the word energetic. Brown fat actually is like a space heater that ignites heat, it burns fuel. It's called thermogenesis because it makes heat, thermo heat, genesis, making heat. Brown fat does that. By making heat, it actually burns fuel from the harmful body fat. Good fat can-- brown fat can burn down harmful fat, like visceral white fat. How do you understand? Like, "Oh, man, you just said a mouthful, I can't understand it all."


[00:15:03] Think of your brown fat like the gas range in your kitchen. If you've got a gas range, Okay? You know you're going to boil some water or heat up some soup. You're going to put it on a gas range. What happens when you have a gas range? You go to the range and you turn the knob. It goes, turn it up and it goes click, click, click, click, whoosh. That's what brown fat does. It's energetic. It actually-- When you activate brown fat, you actually turn on the clicker. There are specific molecules that can do that, the beta-3 adrenergic receptor.


[00:15:33] For anybody who's like, "Oh, you're too basic. Don't go there with me." I'll take you down to the UCP1 [Cynthia giggles] and the mitochondrial energetics. But I will tell you like-- for a simple explanation, click, click, click, whoosh, brown fat lights up like the burner on your stovetop. On your stovetop, it's getting the gas, the fuel from your gas line from your town or a tank outside of your house. Your brown fat is getting its fuel to burn from your white fat. Good fat burns down bad fat. Brown fat burns down white fat.


[00:15:58] You talked about beigeing. Beigeing is like, "Come on, white fat, let's be the good guy this time. Let's learn how to--" But one thing I wanted to tell you and I think people will always remember this, do you know why brown fat is brown, Cynthia?


Cynthia Thurlow: [00:16:11] No.


Dr. William Li: [00:16:11] Okay.


Cynthia Thurlow: [00:16:12] Oh, mitochondria. That was, I guess, what I knew of it.


Dr. William Li: [00:16:16] Yeah, exactly. In order to actually burn fuel and create heat, brown fat has a lot of this little tiny organ of cells called mitochondria. Now, mitochondria are like your nuclear-powered batteries, like for a pacemaker. Okay? Lasts forever, works a long time, and it can get superhot. That's basically what the mitochondria are. All right? Now, mitochondria happen to have a lot of iron in them. What happens when you take a pile of nails and stick them outside for a couple of days?


Cynthia Thurlow: [00:16:43] They rust.


Dr. William Li: [00:16:44] They turn brown, they rust. So, what happens-- And why brown fat is brown is because it's got so much mitochondria and mitochondria has so much iron that when the iron oxidizes, it turns the fat brown. That's why brown fat is brown. People like to know why. Now you know the reason why. So, you can eat certain foods to activate brown fat. Tomatoes activate brown fat. Dark chocolate activates brown fat. Brassica, like broccoli, activates brown fat. Green tea, black tea, and fermented teas activate brown fat. It's amazing the amount of things that activate brown fat. I came up with a whole bunch of foods, probably close to a hundred in my second book, Eat to Beat Your Diet, that activate brown fat.


[00:17:25] Some foods also cooks your white fat to be browner, okay? And to beige. As a white fat turns to be brown fat, it's kind of like the reverse of Star Wars. You're getting the bad guys, the evil empire, to become the good guys, to be the rebellion. They wind up becoming the good guys. This is also really cool because it means that our body is resilient. It's capable of shape-shifting. Again, back to the listeners who are like, "Man, I'm so bummed out. There's nothing I can do now?" Absolutely not. We now know when you're middle-aged, okay? regardless of where you are in your health journey, it's never too late to take these steps to be able to revert your health, fight your excess harmful fat, activate your brown fat, get your gut microbiome healthier.


[00:18:11] We have that agency. That's the good news. That's wonderful news. The even better news is that we can do it by eating foods that taste great. This isn't about elimination. This is about addition. But you have to watch the volume that you eat because like any fuel tank, it only can hold so much. If you overflow the fuel tank in your car, what's going to happen? The gas will run down the side of the car, around the tires, and pool around your feet, and what are you going to be doing? You're going to be standing-- you're going to be embarrassed for one thing. But then you're going to be standing in the middle of a dangerous, toxic, flammable mess. All right? It's going to be very dangerous.


[00:18:46] In the body, we don't have a clicker of the gas station nozzle. We can eat, we can eat, we can eat. Even good quality food, if we overeat it, okay? The fuel that we overstuff into our fuel tanks, i.e., our fat cells, will just get bigger and bigger and bigger and bigger, and now we are filled with visceral fat, too much of it, dangerous and inflammatory. So, volume and quality make a big difference.


Cynthia Thurlow: [00:19:14] I think as a clinician, I know that discussing patient’s weight, in for many instances, makes people uncomfortable. It makes the clinician uncomfortable, it makes the patient uncomfortable. Yet there needs to be conversations around this in a safe space. Like I actually said many times, “You can say just about anything to a patient or client if it's said in a sensitive, compassionate, kind way.” Kindness wins.


[00:19:39] I would have colleagues that would walk into a patient's room and, like, drop a bomb and walk away. I'd say to myself, “If you had handled that totally differently, the information would have been received. The concern that you have for them would have been well received. But instead, now you've left this patient feeling ashamed and really uncomfortable, and they're less likely to seek out support in the future.” How is shame interwoven with weight?


Dr. Michelle Shapiro: [00:20:07] Oh, wow. That's the question of the hour. It's interwoven in about every way, it's interwoven on a cellular matter, it's interwoven in the decisions and food behaviors we have. Shame will not produce positive health results in any situation and because again we've had this really specific feedback from society that being in a larger body is bad, it is going to be the inherent value system of society that gaining weight is bad and makes you bad internally.


[00:20:36] I think when we can separate the science of eating from the morality of eating, we can get really positive health results and I just have to also talk about the physician-patient relationship when it comes to weight. I think where things get really messy is when a physician proposes that weight is a root cause or even a disease.


[00:20:59] I really view weight as its own symptom set. I think weight is just one symptom that we experience whereby a lot of doctors will say, "You are larger because you are larger." So it doesn't explain why that happened in the first place and most physicians do not have any tools to help patients with weight loss. For someone to bring something up to you and say, "Hey, you need to do this," without providing a tool for it is in and of itself shaming. Right?


[00:21:26] Because you're just saying, "I'm just telling you this for the sake of telling you this, but I have no way of helping you with this. I'm actually going to condescend to you a little bit and say you really should get this under wraps when I myself don't even know how to help you with this." I think that's where the shame comes in and that doctor relationship too and when doctors or even dietitians, any type of practitioner, start viewing weight as more of a disease than just a symptom that someone's experiencing, it's a vital-- it's like taking someone's vital signs, right? These are signs and symptoms that the body is letting us know what's going on under the hood. It doesn't tell you what's going on under the hood. It just tells you that something may be going on under the hood.


Cynthia Thurlow: [00:22:02] Oh, I love that perspective. I think much like a woman's menstrual cycle is a sign of whether your body is receiving healthy inputs, whether it's external, internal, etc. And there’s been a movement-- and as you were talking, I started creating more notes for myself about characterizing obesity as a disease. I know that there are some well-meaning practitioners that are doing so, so that we're getting insurance buy-in, a lot of these GLP-1 drugs-- and this is not a con about those drugs. It is really just this paradigm shift that I'm starting to see within medicine that is objectifying obesity as a disease process, not as a symptom. Again, what are your thoughts around this? Because I think that it seems like that's the direction things are going in right now.


Dr. Michelle Shapiro: [00:22:54] [sighs] Yeah, I literally had to sigh when you asked that question. Recently, since the Oprah documentary about this and that conversation she had, I've really noticed this shift in the conversation so much more because I've been posting about those in larger bodies. I don't even use the term obesity generally because I just really view it as a person who has this one specific symptom of excess weight that they may be carrying on them. I think as you're gaining weight, there are many inflammatory weight in excess or with lack of muscle, there are inflammatory things that happen as our adipose tissue and our muscle tissue is endocrine facing. Right? It is going to create downstream effects.


[00:23:31] But the actual act of gaining weight doesn't necessarily mean and correlate with exact health outcomes. However, yes, as you're gaining weight, you can get a metabolic picture that starts happening. That metabolic picture we might talk about and say “You have metabolic syndrome.” That might be something we would classify as a disease, but it is not something that is genetically brought on, happens immediately. And then there is this point of no return as we think of disease where it's like, "Well, now you have a disease and you need a medication to fix the disease."


[00:24:06] I think that's where we get confused. Now, is obesity literally classified as a disease? Yes, there's a diagnostic feature to it, but it's pretty symptom based, right? It's just based on kilograms over meters. It's your height and your weight. I don't believe that that tells you enough about metabolic syndrome or anything like that and what's really missed is what is the actual disease AKA what is the disease process like you're saying over time and what's happening as a result of you carrying that weight? Because people at different weights have completely different metabolisms and different pictures. You still have to find out what's going on under the hood. I also resent, and I use that word specifically, I resent the idea that's been perpetuated that obesity, now as we call it a disease, has this very strongly genetic feature.


[00:24:55] It like “What did we think was going to happen when we put the food system in the place it is and we put all of these different environmental toxicants and pollutants into our bodies? Did we think that we were going to magically start having genetic diseases?” No, these are lifestyle-driven diseases.


Cynthia Thurlow: [00:25:12] Yeah, such a good point. It's interesting. I just interviewed-- she's a New York-based endocrinologist, Dr. Rocio Salas-Whalen and she was talking about how the terminology when you're speaking about your patients is even starting to shift. You don't say “This 50-year-old female who's obese.” Now you're saying “This female patient who has BMI of X.” She was kind of identifying that we need to start talking about our patients and not associating the patient with the disease process.


[00:25:44] So she was saying that for her, over the last several years, she's been making a concerted effort to be very conscientious about the terminology that she's using so that patients don't get labeled. Just like we say patients are noncompliant. For listeners, that just means we tell patients to do X, Y, or Z, and for a variety of reasons, they may not do X, Y, or Z. Then they get labeled as noncompliant. Those kinds of labels can be harmful is what I'm trying to say. Really looking at patients as individuals as opposed to just labeling them and then stamping something on them and walking away.


Dr. Michelle Shapiro: [00:26:18] As you know, if you have obesity in your medical chart, it lives there permanently. And to me, it's so silly because weight is a vacillating symptom, right? It's a vacillating part of our bodies that changes. It's like having a fever and fever being in your medical chart forever. Weight changes all the time. For it to be that you are now obese person--yes, I think there is A, moral implications of that and B, physically it seems silly and irrelevant to me because it doesn't tell anything really juicy or informative about that patient anyway.


Cynthia Thurlow: [00:26:49] Yeah, it's so true. It's like you go to a new doctor and now there are all these electronic medical record systems sometimes that merge when you go to a new doctor. It's like, in 2012 you had a urinary tract infection. They're like, "Have you had any more symptoms?" You're like, "No, that was 12 years ago." But you're right, it does follow you wherever you go. It just becomes part of your differential diagnoses or problem list, which for many of us, it's like “You have a problem once, it goes away”, but then it follows you everywhere like a trained puppy.


[00:27:19] Now, when we're talking about weight and talking about shame and talking about things like self-empathy, how do you help your patients develop the skills to be able to view themselves with grace and compassion as they're navigating these conversations with you, their work with you? Because I think that internal dialogue is incredibly impactful and powerful and I always say whatever the patient says to me, it's a hundred times worse what they're saying internally.


Dr. Michelle Shapiro: [00:27:50] Absolutely, yeah. A lot of the work that I've done with clients really centers around that internal dialogue. You nailed it. Using a little bit of a within-scope version of internal family systems, we'll get to know the different voices that we have around our weight and especially around food decisions. By the time someone is binge eating, they've probably had a conversation in their head between 10 different voices for hours without realizing.


[00:28:18] So, a lot of it is focused around having people re-center within their bodies and understand what is their experience on a daily basis? How does it feel to be inside of our bodies? The amount of urgency that my clients feel to, whether from a chronic illness perspective or a weight loss perspective, leap out of their bodies. They do not want to be inside of their bodies is how uncomfortable it is. So, how do we create safety within our bodies in the short term? And how do we then, when we feel safety, create that kind of dialogue and understand it better? That's when you can change it, is when you actually can accept and acknowledge that dialogue that happens. A lot of times we'll hear voices from mom. We'll hear voices from an old partner, an old boss. Those will be the dialogues and the voices that are actually making most of the decisions in their head instead of their real, authentic, honest voice.


[00:29:06] Our protection mechanisms often steer the ships and when our protection mechanisms are in charge, we end up making decisions that we don't want to and it can just be so exhausting, Cynthia, to be inside of your head and feeling really unsafe and threatened. I think of people who want to lose weight desperately as feeling very unsafe. So, a lot of it is just, how do we find that safety within our body? It could be again through a little bit of just the somatic embodiment, like, “How do you feel in your body?” Then on the same level, kind of focusing on their identity. “What is your identity outside of your weight?”


[00:29:40] For myself and clients who've experienced major weight loss especially, people treat you completely differently in society when you lose weight, it's like day and night. It's honestly frightening because the same people that you've loved or known forever might even treat you differently in that way too and perceive you differently. How do we stay so stable and strong in our identity that we almost feel like a tree that's rooted in the ground and not like a tumbleweed blowing in the wind? That's a lot of the work is that safety and that grounding and really just understanding ourselves, I think, is the first place to start for many people.


Cynthia Thurlow: [00:30:11] And when you are doing-- I'm sure you do extensive histories with your patients and clients. What are some of the risk factors that put a woman-- we'll just say women right now-- put women at greater risk for developing an unhealthy perspective around themselves? Is it the environment in which they grow up? Is it the friends they choose to associate with? I know that I had several girlfriends growing up who-- they were on the eating disorder spectrum. One was anorexic, one was bulimic.


[00:30:42] I know based on my background, during my psych training, it was all in eating disorder behavior just by pure happenstance. I always say those things have stayed with me because they made such an indelible impression. But when you're working with women, are there risk factors? What are some of the things that make us more susceptible to disordered relationships with food or poor body image issues?


Dr. Michelle Shapiro: [00:31:03] Absolutely, yeah. I would say adverse childhood events would definitely be a risk factor. I would say if you have any concurrent mental diagnoses, like let's call it anxiety or depression or OCD, those are going to leave people more open. I would also say, yeah, socially, being in high-expectation, high-pressure environments certainly can lend to eating disorders or disordered eating. I've really seen people who have different kinds of chronic illness too, or people who felt different than other people in whatever way if it was a disability or if it was any sort of invisible chronic illness even, we end up eating in a certain way to prevent illness, right?


[00:31:45] We end up becoming more and more afraid of certain foods that we think are going to make us sick which is kind of something that I'm seeing online a lot, which is these-- even again are amazing functional people who we love so much, these functional medicine or nutrition practitioners who are really saying, "If you eat this, you're going to be sick." This creates this new fear set for people and just anything that has taken a knock at your confidence or your identity growing up can make a huge impact too. I think food allergies also can influence food behaviors again because of that fear. Any sort of anxiety, any sort of behaviors that would influence your food behaviors or mindsets are going to influence the way you feel around food and your safety as well.


Cynthia Thurlow: [00:32:29] It makes so much sense and it's interesting. I was on a podcast last week in LA and the conversation around orthorexia came up. For listeners, this is people that develop a disordered relationship around something that's healthy, but to the point where they won't eat outside the house. If there's any concern that food's been contaminated with a seed oil or high fructose corn syrup, they can't enjoy living their lives because they're so worried about exposure to potentially unhealthy things and I've certainly seen a lot of this spectrum of eating disorders.


[00:33:07] I would kind of tack in orthorexia. That's an overt preoccupation with not just eating healthy, but like fearing eating anything that isn't designated as sacrament, like so important that it be pure and unadulterated and unprocessed. I think that makes navigating our daily lives very challenging. And certainly under the context of this conversation on orthorexia, I was saying I see a lot of disordered relationships with food around intermittent fasting.


[00:33:36] I know this is poking a big bear, but I think it goes without saying, the longer that I've been in this space talking about the value of this strategy, the more I see disordered relationships with not just fasting, but also orthorexia, overt eating disordered behaviors. The message should never be not to nourish your body. That's never what the message is. But everyone has a different filter, everyone has a different lens. Sometimes people probably don't even realize that they are heading down a very narrow path for themselves.


[00:34:07] You add in, as an example, most of my platform are women in perimenopause and menopause and maybe they've never had trouble with weight loss resistance. Now they do. So, if a little bit of fasting is good, more is better. If being more restrictive with their carbohydrate intake, as an example, over-exercising, losing their menstrual cycles. I'm curious, as kind of an objective outside person, what are your thoughts around these disordered relationships? Whether it's about when you eat, what you eat. How do you make sense of all of that?


Dr. Michelle Shapiro: [00:34:45] Absolutely. I think the tool itself isn't the problem. It's the way that we interpret the tool. Are you using intermittent fasting as a way to gain control of your entire life and to feel better about everything and hanging on it making you happy and losing weight and doing all these things? If we make those decisions from a place of desperation or fear, the tool itself can become unhealthy. So, I don't believe that intermittent fasting as a tool is dangerous or unhealthy when applied to the right person at the right time.


[00:35:19] So, we have to ask ourselves, “Is this for me? Is this for someone else? Is this meant for me in the short term or the long term?” So if we can separate again that data from the actual tools that we're using and put the tools and the data together and separate it from the morality, that's where it becomes really important. But if something feels even a little too exciting, Cynthia, if it's like “Intermittent fasting will do everything for me.” I think that's where we might be in a place where we're like, “Why do we need something to do everything for us?”


[00:35:50] If it's just like, "You know what? I'm going to do intermittent fasting, let me see how it works. Let's see if it works. Let me track the data and understand if it’s happening-- if the results are happening for me," that's a totally different story. You have to feel into yourself. “Is this coming from a place of love, acceptance, honest data research for self? Or is this coming from a place of desperation or fear?”


[00:36:07] And I know people listening are probably saying, "But Michelle, if I'm in a place of desperation or fear, wouldn't I want the tool more?" And the question is that’s when the-- The answer is yes, but that's when the tool can turn against you. So, if you are in that place of desperation or fear, I would have people look first at “What do I need to do to bring my safety level up inside of my body and in my environment before I can start playing around and having fun with some of these different tools.” But it has to come from the right place or it will become disordered and concerning, I think, but no tool is bad. That's what I've been seeing a lot on social media is people clumping the tools in together with orthorexia. So, intermittent fasting does not equal orthorexia. It doesn't mean if you're doing intermittent fasting that you have an eating disorder. The intention behind why you're doing something is what would make it disordered or not.


Cynthia Thurlow: [00:36:56] No, it's such an important distinction and one that I completely agree with. You've brought up the concept of safety multiple times in our conversation already. Help listeners understand what that means because at the root of safety is allowing your body to be in a state where it can receive, where your hormones are going to be better-- I hate to use the word balanced-- but where your hormones are going to be properly regulated. If your body is feeling safe, there are many down toward effects that come from that. So, let's talk around safety because I do think this is a very important concept not just about weight but just about overall health and feeling good in our bodies.


Dr. Michelle Shapiro: [00:37:41] I would even say and agree with you double that the root cause of autoimmunity in most cases is a lack of safety in the body. It's just our body when it doesn't feel like it can rest and like it has to defend or preserve, it acts in a completely different way than it would when a body does feel safe and at rest. If our body is constantly thinking about threats that it needs to defend upon or any-- again, it could be a perceived threat or a realized threat, it is going to act in a weird way hormonally, immune system-wise.


[00:38:15] Our body has all these built-in defense systems to basically help keep us alive. I know we all talk about cortisol all the time and these different-- the nervous system. There are all these like tricky words, but in reality-- and these words that I think have been co-opted to be something that they're not-- in reality, your body has to feel like if it's doing something that your body has its own back and that you're going to be okay if you do something basically and that could be making a food change, that could be existing on a daily basis.


[00:38:41] I think when it comes to our nervous systems and safety, our nervous systems only learn through example. If we have been consistently unsafe our whole lives, our nervous systems are going to act and send out hormonal signals and neurotransmitters and other signals throughout the body to behave in a certain way.


[00:38:59] If we can create safety and security within our bodies, then our nervous system can say, "Oh my gosh, I can calm down now. I don't have to act in a certain way. I don't have to constantly activate that sympathetic nervous system." And that's where we can bring our body into really robust health, but you have to show your nervous system it's safe. You can't say, "Oh, I'm going to do ice on my neck, like a vagus nerve thing." It has to be like, “We're in this together and rebuild that bond with your body and show your body we're going to be safe and okay.”


Cynthia Thurlow: [00:39:29] Yeah and it's interesting to me as someone who until fairly recently did not know that I had a high ACE score. I have a very high ACE score. I've shared this with the community and it helps explain why I have had three autoimmune conditions throughout my lifetime, all of which are in remission, thankfully, because I'm doing the work. But when I was going through my training, trauma was really focusing on big T trauma, and I trained in inner city Baltimore, so we saw it all. Gunshot victims, murders, homicides, rape, etc., like the worst of the worst, never realizing that little t trauma, emotional abuse, etc., the trauma of your parents' divorce, getting teased-- I think everyone gets teased as a child, but some of us are more sensitive to those kinds of stressors. Helping understand that that primes our autonomic nervous system to be leaning more in the sympathetic. So, fight, flight, flee, or fawn. Existing under those circumstances as a child, I leaned into being the perfect child because if I was perfect, everyone left me alone.


[00:40:34] You don't lose those things until you're actively working against them and this is where for me personally, I'd love to hear what you think has been super helpful for your patient population. Things like Reiki, energy work, meditation, breath work, grounding, yoga, and nonashtanga, like doing yin or doing yoga slow flow. Things that slow me down when I'm someone that tends to rev pretty high. Although everyone is oftentimes surprised to hear that I'm a pretty intense person because I look very calm from the outside, but it just shows you that you're working very hard for your body to appear to be one thing, when internally it is not.


[00:41:17] I think there are many many women listening. Although we all have different circumstances growing up, I'm in no way saying, "Poor me," that's not the point of the conversation. But just understanding, you can go online and you can look for adverse childhood events scoring. We've had many women reach out. They're like, "I had a one." I'm like, "That's fantastic." I've had many other people that are five, seven, nine, 10, even higher and so just from the perspective of work that you have found to be beneficial for women who tend to be more sympathetic dominant, what do you think are the low-lying fruit? What are the things that women can do fairly easily without having to buy a gadget? I'm not saying to go buy an Apollo Neuro, although I absolutely love the work that they do. But what are some of the low-lying fruit things that have been very influential in helping your patients navigate making their bodies feel safe?


Dr. Michelle Shapiro: [00:42:11] Oh, I love this question. I will tell you a funny story that I have a-- one of my practitioner partners who I've worked on a lot of projects with. He's a naturopathic physician, Dr. Robert Kachko and he was my doctor at first. Then I was like, "Oh, no, we're best friends and business partners. You think you're my doctor? We're done." [Cynthia chuckles] I went to his office for acupuncture for the first time. This was probably like 10 years ago.


[00:42:32] As he was putting the needles in, I was really nervous and I was shaking. I was like, "Am I going to feel high from this? Am I going to feel loopy? What am I going to feel like?" He looked at me and he said, "Would the worst thing in the world be for you to feel good?" I was like, "Kinda.” That would be really scary. I don't think I've ever felt good before. Yeah, that would be really scary. I think for a lot of people, it's much more about being okay with being happy and feeling okay Cynthia. If you're not used to feeling okay, your nervous system is going to defend against that. When I'm working with clients, oftentimes after like a month or two of working together, they might report to me, "My anxiety is so much better. But I'm really tired. I'm really exhausted." That scares them because they're like, "Where's the anxiety? First of all, where's that anxiety protecting me? Also, I hate feeling tired."


[00:43:23] I'm like-- basically, with a lot of these measures, what's going to happen is you've been on a high of anxiety. Underneath that anxiety for years has been true-blue exhaustion that you haven't felt. In this process, you might be feeling things that you haven't felt in a long time and they might be good, some of them, or there might be this real feeling of exhaustion. But for most people who have experienced to these high ACE scores, and mine's through the roof, of course.


[00:43:47] But for many people like that, they haven't experienced safety and health and happiness inside of their body and they're not even chasing it when they're trying to lose weight or do these other things. They're chasing the uncomfortable feelings that are comfortable for them because they're used to them. My goal with anyone is if you're doing-- I love these tools that you mentioned, like grounding, Reiki, acupuncture. I do them all the time.


[00:44:05] With practitioners at home, it's just to go really slow and titrate your way in and be so constantly just checking in with yourself. I like to laugh at myself too, where I'm like, "Really, Michelle, you were scared of feeling okay?" I was scared. I really was. I was not used to it. The reason we have these autoimmune diseases is to, again, defend and protect us. So, when we start feeling better and we start losing weight, our defenses come down. We're actually forcing ourselves to be more vulnerable.


[00:44:39] With weight loss specifically, you're going to have people looking at you potentially differently who looked at you before. You might be having-- I don't know, it could be any sort of interest. Even people are like, "Oh, you're losing weight. I want to hear more about that." We open ourselves up to the world when we change things in our health and that's not often talked about. And I think so the goal is, if you're making yourself feel better, it's okay if you're scared of feeling better and don't realize it, and go really slow and do things that start out by feeling familiar and then kind of move your way outwards from that point. If it feels really threatening and it feels really scary, maybe save that for later down the road and if it's just like going outside and putting your feet in the grass for five minutes and you're like, “Oh, this feels okay, and I feel okay that it feels okay." That's a good starting point.


Dr. Lara Adler: [00:45:24] When I started learning about this topic, which really happened accidentally because I was working as a health coach and I had clients. I didn't really have a very clear niche in my health coaching business. I was just kind of working with people casually, typically around weight loss. That was kind of an easy area. Most of my clients who sought me out for that, they had results. They did all the things. Then I had a couple of clients who also did all the things, but their weight didn't really budge. They were frustrated and I was frustrated.


[00:45:53] I started looking at “What am I missing? There's got to be something I'm missing.” Because they cleaned up their diet, they're drinking the water, they're sleeping, they're doing yoga, they're minimizing their stress, whatever it was. They did all the things that worked for everybody else. That was really where I kind of cracked the door open into this whole area of environmental health, and it was like “Wait a minute, there are things that we're unknowingly exposed to. They're not things that we're doing, right? It's not choices that we're making that I'm going to eat this versus that or I'm going to exercise or not exercise or whatever.” They were just things that we're passively being exposed to. Some people, certainly more than others, in that case of that sort of deep dive into the literature, was linked to metabolic issues that led to insulin resistance, diabetes, weight gain, and resistant weight loss. I was like, “Wait a second.” At that point, I'd already been researching and reading about nutrition and wellness superficially just for myself, but at that point for like a decade.


[00:46:56] I was like, “Wait a minute, why is this kind of the first time I'm hearing about this? I'd gone to a health coaching school and for a year-long program, it was not mentioned. None of the practitioners that I spoke to knew anything about this.” That kind of was unfolding. At the same time, my sister-in-law was pregnant with my niece, she's now 12. So, that's always my yardstick for-- my measuring stick for how long I've been in this space.


[00:47:24] And I started researching what are the products that-- like a baby's crib mattress. Let's start looking at what are the issues, and I was horrified. I was horrified at the chemicals that were being used in products for babies. The more that I started digging into just products for everybody, it was really this feeling of, “This is not okay. It's not okay that people don't know about this and not okay that people aren't actively talking about it.” Because the secrecy around it is what keeps it being perpetuated. It's what allows companies to get away with knowingly putting carcinogenic chemicals in products, putting chemicals that are known or even suspected to be reproductive toxins and toxic to our most vulnerable, which are infants and babies still in the womb.


[00:48:17] I just kept thinking, “How do these people sleep at night? What is wrong with people that they're so willing to put profits over people?” It was that outrage, honestly, that really was the steam that moved this engine along. I quickly realized that, like I said-- all of the health professionals that I spoke to were like, "I don't know anything about this and I feel like I probably should." I spent two years really making sure that I understood, doing all the research, going to all the conferences and lectures and symposiums, talking to scientists, and doing all the things that I knew that was in my skillset at the time to really understand this topic so that I could spread the word to health professionals and that's been happening since 2012. What's great is that this dialogue has expanded so much in that time.


Cynthia Thurlow: [00:49:11] I'm so glad that you had the circumstances that developed this passion and this interest. I think there's a lot in what you stated that I want to unpack. There's a degree of cognitive dissonance. For people that listen to this podcast or other podcasts that I've done, or other people's podcasts or read things, sometimes it's very hard to understand that there are individuals in this country, other countries, it's not unique to the United States, that are more interested in profitability over safety. That's number one.


[00:49:44] I think number two, sometimes it's really hard to wrap your head around. We're not suggesting anyone that's listening that you have to change everything you're doing right away. It could just be one thing. If you take one little nugget from this podcast that you're ready to do one little thing has a huge impact.


[00:50:01] And then number three, I too left clinical medicine five years ago and developed this business. Almost instantaneously, I started attracting women about the same age that I was that were really struggling with weight loss resistance. So, I always refer to the analogy of it's like peeling an onion. Sometimes for people-- if they remove inflammatory foods, they sleep better, they manage their stress, and boom, the weight comes off. Other people have to do five other things. Then there are people who really still are doing all the right things and I believe everything they're telling me fervently. We've checked all the labs and we've done stool studies. We've done all the tests. It's this type of nuance, it's these exposure to toxins that are oftentimes what most people are not having an honest conversation about.


[00:50:49] That's why I'm so very grateful that you're here today. What I was thinking might be most helpful for listeners would-- let's focus on because there are so many things, I could bring Lara back and talk to her for hours, and we will definitely make that happen. What I thought would be most useful today would be to talk about endocrine-disrupting chemicals. I'd love for you to explain a little bit about what these are because there are probably some people saying, "I've heard of that," or "I might recognize it." But other people are saying, "I've never heard of this before. What are those?"


[00:51:12] Even if you are really careful and conscientious, you are exposed to these things on a daily basis. So, let's unpack what they are and identify examples, and then we can talk about what they actually do. You were already starting to allude to some of what they do with the hormone disruption.


Dr. Lara Adler: [00:51:29] Yeah.


Cynthia Thurlow: [00:51:30] I think it's particularly important for women who are struggling with weight loss resistance in particular, people who are trying to get pregnant, are pregnant, have young children, people that are at my stage of life where I'm done having kiddos who are now teenagers. We're focusing on different things. We've got all these hormonal fluctuations. But let's talk about these groups of toxins because I think this is particularly important for the listeners.


Dr. Lara Adler: [00:51:55] Yeah. I think it's probably, I would say, one of the biggest and most important areas and there's so much research on endocrine disruption at this point. There's still lots we have to learn, but there's a lot that we know. The endocrine system is our hormonal system. It's not just sex and reproduction. It's everything from digestion and whether you're hungry or full. It's your mood, it's your energy, it's development, it's reproduction, body temperature. Your endocrine system regulates all the things basically.


[00:52:25] Interference in that system, as you can logically assume, is that it would cause some downstream problems there. So, this class of chemicals that is known as endocrine-disrupting chemicals, there are about a thousand of them that are identified as known or suspected to be endocrine disruptors. My hunch is that number will balloon exponentially as we do more research. As I mentioned, we've only really started to examine a tiny fraction of the chemicals that are in commerce.


[00:53:02] In the United States we like to say there are like 84,000 chemicals. In commerce, we don't actually know the accuracy of that number. We used to say that there were about 150,000 chemicals worldwide. A new analysis, I think that was published just this year, discovered that we're actually closer to 350,000 chemicals worldwide. So, there is a lot. Because we've only looked at a small pocket of them, like I said, we have about a thousand of these endocrine disruptors.


[00:53:32] Then there are subclasses. Chemicals can be endocrine disruptors and also be obesogens, diabetogens like that. Those obesogens is-- origin of what I started looking at. But these endocrine-disrupting chemicals can block or mimic our natural hormones in our body or can interfere with their synthesis or their metabolism. They're kind of like masquerading as our natural hormones and they can turn on or turn off things in that body that maybe shouldn't have been turned on or shouldn't have been turned off and then cause all these downstream effects. What's really challenging is a single endocrine disruptor like BPA, which is one of the ones that people tend to be most familiar with. As I like to say, it has the most street cred because people see it, labels BPA-free all the time. We can talk about that in a minute.


[00:54:29] These chemicals are ubiquitous, one, so we're all being exposed. But two, a single chemical like BPA has so many different endpoints of potential impact. We can't say for a given person, "Ah, you were exposed to BPA, you are going to end up with this symptom or that symptom." We don't know yet what the outcome is going to be. We can see, here's the menu of things that we think might likely result from exposure to BPA or that BPA is linked to or associated with, but we can't say, "Oh, you were exposed to BPA, therefore you're going to have this outcome."


[00:55:06] That area of research is still in the dark. We don't know that yet. I think that uncertainty is part of what industry frankly relies on. Right? They're like, "Prove it." We're like, "No, we can't prove it exactly." But again, we can look at those rodent studies, we can look at epidemiological data and make strong cases for. But I think that part is challenging.


[00:55:30] But going back to the general topic of endocrine disruption is that we have these low levels of exposures day in day out to these chemicals that are bioactive in the body, meaning that they're doing things. They're turning things on, they're docking in our estrogen receptors or what have you-- They're bumping iodine out of our thyroid, which we need for optimal health on all levels. Most people will come and say, "Oh, but the amount of this exposure that we're getting is so small, it doesn't really matter."


[00:56:11] That's the sort of the company line of industries that use endocrine-disrupting chemicals. "Oh, the amount in our product is so small it doesn't matter." If that was the only exposure that somebody was getting, right? If they only got that one exposure from that one product one time, sure, not a problem at all. No big deal. But that's not the reality of human exposure. The reality of human exposure, to your point earlier, is that some guy might be using five products, some woman might be using 10 products, a teenager might be using 20 products. They use more products than anyone. Those are just personal care products. Right? We're not looking at laundry detergent and household cleaners and home fragrances and whether or not you're driving with one of those Christmas tree air fresheners in your car. Right? We're not exposed to one single product. We are exposed to hundreds of products all day, every day. That's one point to keep in mind.


[00:57:12] The other point is that our body is naturally designed to be responsive to really minute levels of hormones in the human body. That's how the human body works. The hormones that course through our veins are doing so at extraordinarily low levels, like parts-per-trillion levels. Really, really tiny. The way that I like to say it is that our hormones are communicators, they're messengers and that they communicate in whispers.


Cynthia Thurlow: [00:57:41] Yes.


Dr. Lara Adler: [00:57:41] Really quiet. Really little amount. Really, really, really little. And you have ever either-- For people that have gone through puberty or have had children that have gone through puberty or gone through menopause, they don't feel insignificant. Those are not giant fluctuations. Those are relatively small fluctuations in hormones that cause these major fluctuations in how we experience life during those times. We know that the body is extraordinarily receptive and responsive to these really tiny levels of hormones because that's how our physiology has evolved.


[00:58:18] When we have similarly low levels of exposure to these chemicals that interfere with hormones, it logically makes sense, and we see this out in animal studies, that the low levels of exposure that we're getting, these parts-per-billion, parts-per-trillion levels of some chemical in your drinking water or some chemical in your shampoo, day in day out, those chemicals are bioactive in the human body at those levels. The body can't tell the difference in a lot of cases between a molecule of, say, estradiol and a molecule of BPA because they're almost the same.


[00:59:02] This is where this idea that endocrine-disrupting chemicals are really concerning at all levels of the human lifespan. They are most damaging, they are most concerning during fetal development. I would even say back up before that when it comes to conception and the ability to conceive, right? Because a lot of these chemicals interfere with the health of sperm or sperm counts, of egg health, of all of these different factors in human fertility and then this most vulnerable which is the developing fetus, that's like building a Lego set.


[00:59:39] Imagine somebody coming in and taking out a bunch of Legos or throwing in some other Lego pieces that are faulty. You can't undo that structure once it's built, faulty as it might be because of this endocrine disruption. So, this really is the most vulnerable population. What I think is fascinating and makes sense given disease rates that are happening in children right now. Childhood obesity has tripled since the 1970s. We're seeing all kinds of-- whether it's learning disabilities, behavioral problems, all of these different things that are kind of ticking up in children.


[01:00:15] There is this concept called-- it's got a couple of different names, FeBAD is one of them. This fetal basis for adult disease or fetal origins of adult disease, which states that it is what's happening in the womb during fetal development that can actually set you up for increased risk of disease in adulthood. You were talking earlier about how there are some people that just struggle with losing weight.


[01:00:41] It's entirely possible, and we've seen this in rodent studies, that they were exposed unknowingly by their parents while they were in utero to these obesogenic chemicals that can alter their fat cell production or alter their bodies in ways that predispose them to gain weight, even given the same caloric intake as somebody who maybe was not exposed. So that might explain some of those differences why somebody can eat whatever they want and never gain a pound and then you've got somebody who looks at something wrong and then they just put on five or 10 pounds. The gist with endocrine disruption is that these small doses really matter, more so even than some of these large doses, which our toxicology field really looks at those high-dose exposures.


Cynthia Thurlow: [01:01:35] If you love this podcast episode, please leave a rating and review. Subscribe and tell a friend.



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