You Should Be MAD at What They Told You About Ozempic

Dr. Boz argues that GLP-1 drugs like Ozempic have been wrongly marketed as weight loss medications when their true potential lies in brain health. She explains how combining these hormones with a ketogenic diet can dramatically enhance brain cleanup processes and potentially prevent Alzheimer's disease. The video walks through the science, a patient case study, and practical guidance for using these medications effectively.

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1. Introduction: Rethinking GLP-1 Drugs 🧠

Dr. Boz opens by acknowledging that she herself has been among those who dismissed GLP-1 medications like Ozempic in the past. She used to tell patients they simply needed a strong ketogenic diet and didn't need these drugs. But her perspective has dramatically shifted.

"It becomes more and more obvious when you follow the science that this should have never been sold to you as a weight loss drug. It should be sold as a brain drug, especially if you use it in the way we're going to talk about tonight."

As someone who has been caring for "broken brains" for over 25 years, Dr. Boz expresses genuine excitement about this class of drugs. She describes them as offering hope for patients who previously had no real treatment options for certain brain conditions.

"There is hardly a drug, a class of drugs, that has me more excited about how to really help patients back away from the edge from things that, well, frankly, we've never had a chance of helping them with before."

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2. History Lesson: The Evolution of GLP-1/GIP Drugs 📚

Dr. Boz emphasizes that understanding the history of these medications is crucial. She reminds viewers that every cell in the body has at least 40 hormones telling it what to do at any given time, and GLP-1 drugs are essentially hormones we use to change signals deep inside our system.

The Timeline of Development

• 2013: The first GLP-1 medication, Byetta, entered the market. Dr. Boz wrote prescriptions for it as a diabetes medication. While there were whispers about potential weight loss, only about 1 in 18-20 patients actually lost weight. It was overpriced and rarely used.

• 2019: Ozempic hit the market and eventually dominated headlines.

• 2025 (Present): Over a decade of safety data now exists, with millions of patients having taken these medications.

"If there was a safety concern, we would have seen it in the millions of patients that have taken these medications by now."

The Generations of Medications

First Generation (Ozempic): Contains only GLP-1, a hormone naturally found in our bodies that becomes less effective the longer someone remains obese or insulin resistant.

Second Generation (Tirzepatide/Zepbound/Mounjaro): Combines GLP-1 plus GIP, another hormone that helps regulate metabolism. Think of it as "GIP replacement" or "GLP-1 replacement" for bodies that can't find the right rhythm.

Third Generation (Coming Soon): Will combine GLP-1 + GIP + a glucagon agonist - three hormones in one.

"If you think this generation of medications is good for the brain, that one I think will be written mostly by a psychiatrist."

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3. GLP-1 vs. Gastric Bypass: A Better Path Forward 🏥

Dr. Boz draws a stark comparison between using GLP-1 medications and gastric bypass surgery for patients needing to lose 100+ pounds.

She explains that when patients need to lose significant weight, gastric bypass has traditionally been the last resort option. However, removing stomach cells from a patient's body permanently limits their options for living their best life.

"Do I have patients who do gastric bypass even in this day and age? Sadly yes. They give up. They say I can't do it any other way. I just need you to cut out my stomach."

The consequences of gastric bypass include:

• A lifetime of nutritional problems
• Compromised brain health
• Loss of hope for restoration to a healthy version of themselves

"Ozempic and its class of drugs are a way better brain drug than they were ever a weight loss drug. And the weight loss is what has been touting the headlines. That's why you should be angry that you haven't read about this more."

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4. Ketones as Brain Fuel: The Foundation of Healing ⚡

The Standard American Diet Problem

Dr. Boz describes patients who've eaten the standard American diet for 40+ years as being like "grumpy old men" - irritable, stuck, and struggling to even communicate their symptoms clearly.

"I contend it's not their fault. They are stuck in this spot where they are reaching to a medical provider to say, 'Help me. Help me get out of this stuck place.'"

The solution sounds counterintuitive:

"Eat fat. Do it for 10 days. Watch what happens."

The Brain Transformation Study

Dr. Boz references a 2016 study showing how glucose and ketones enter the human brain differently:

• Day 1 on Standard American Diet: The brain shows heavy glucose usage (red zones), but virtually zero ketone presence (all blue/purple).

• Day 4 on Ketogenic Diet: Glucose usage dramatically decreases, while ketones flood the brain, activating regions that were previously "offline."

"About two-thirds of their brain has been using just glucose. There's a third of it that kind of went offline."

When patients switch to ketones, they experience:

• Cleaner fuel with less waste
• Improved concentration
• Relief from that "grumpy version" of themselves
• Better anti-inflammatory effects
• Mitophagy - the replacement of broken, "leaky" mitochondria with fresh ones

"The first place that I hear folks talking is not that their waistline is better, although they can lose a little weight in that first week. It's that their brain, their concentration, that grumpier version of themselves is not what they wanted to be, but it's what they were stuck with."

The Challenge: Metabolic Adaptation

Here's where things get difficult. After the initial "honeymoon phase" where ketones spike high, the body adapts. Ketone levels settle down, and insulin - which has been abnormal for decades - remains dominant.

"Insulin that's been abnormal for 40 years is not going back to normal in a week and a half."

Patients often write in frustrated:

"Dr. Boz, I can't get ketones above 0.4. What's wrong with me? Why did the diet stop working?"

The diet didn't stop working - the metabolism is simply more broken than they realized. High insulin not only stops ketone production but also stimulates amyloid production, which is the foundation of Alzheimer's disease, multiple sclerosis, Parkinson's disease, and other chronic conditions.

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5. Ian's Case: A Real-World Example 👤

Dr. Boz introduces Ian, one of her favorite patients from her local support group, as the perfect example of what 60 years of insulin resistance looks like.

Ian's Background

• Over 72 years old
• Insulin resistance started in his 20s with hypoglycemic episodes
• Spent 40+ years eating the Standard American Diet
• Actually exercised and kept his hemoglobin A1C just below diabetic diagnosis
• Still accumulated 65-75 pounds of excess fat
• Health-conscious and willing to learn

Ian's Ketogenic Journey

Ian discovered Dr. Boz on YouTube, started attending her free Tampa support group at a bowling alley on Tuesday mornings, and eventually took her 21-day metabolic kick class.

Looking at his numbers from January 2024 to present:

Before the 21-day class: Ketones fluctuating around 0.5-1.7, glucose staying stubbornly high in the mornings, confusion about what he was doing wrong.

After the class: A dramatic shift occurred - ketones shot up to 5.8, glucose dropped to 76.

"That is when he got all of his questions answered... That's freedom, right? When you know what to do and you know what you did wrong."

Dr. Boz emphasizes that Ian's education reached the point where:

"If I was still teaching residents, I could send them to Ian and Ian would teach them what's missing in most of those exam rooms across the country."

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6. GLP-1's Effect on the Brain and Amyloid Plaque 🔬

The Critical Combination: Ketones + GLP-1

Dr. Boz makes a crucial point: adding GLP-1 medications without ketones is like taking testosterone replacement therapy without exercising.

"Adding ketones, having a bed of ketones when you add this GLP-1 hormone is a similar process... to having a 60-year-old man want testosterone and he doesn't do any activity with that testosterone."

Without proper foundation, hormones get stored in fat cells instead of reaching muscles, brain, and sex organs where they're needed.

Three Key Benefits of GLP-1 + GIP (Tirzepatide)

1. Supercharged Autophagy When you combine ketones with GLP-1, autophagy (cellular cleanup) is dramatically enhanced. The microglia - cleanup cells of the brain - work faster at removing debris.

2. Enhanced Lipolysis (Fat Release) GIP specifically helps fat cells that have been "locked down" by years of high insulin become responsive again. Fat mobilizes and becomes available as fuel.

"If you're looking for fuel, sure, I could have you swallow ketones... but how do I get Ian's fat cells to empty from fat as fast as he puts it in there?"

3. Decreased Amyloid Production GLP-1 directly reduces the production of amyloid plaque in the brain.

The Research Evidence

Dr. Boz cites a 2025 study examining both mice and human brains:

• 120,000 patients with diabetes showed an 11% reduction in tagged amyloid production when put on GLP-1 medications.
• People with mild cognitive impairment who took GLP-1 showed 11% reduction in dementia rates.
• Those who naturally produce higher GLP-1 levels have lower Alzheimer's risk.

"Do not do that to your brain. That is a severe injustice that you aren't increasing the autophagy... with a minor adjustment, you can have the kind of results that Ian gets to brag about."

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7. Micro-dosing GLP-1: Ian's Protocol and Results 📊

Ian's GLP-1 Experiment

Ian was at ideal body weight after following the ketogenic diet but still had concerns about potential brain debris accumulated over 60+ years of insulin resistance.

"He has debris that I know needs to be cleaned up just based on his history... Ian can't wait for the trials of double-blinded placebo-controlled people of his age to be on this medication for 20 years."

Dr. Boz recommended he add tirzepatide (the GLP-1 + GIP combination) to his already strong ketogenic foundation.

The Subtle Brain Changes

This is where Dr. Boz's expertise as a physician shines. She shares a story about listening to patients' subtle complaints:

"I've been reading recently about how important it is as a physician to listen to your patient... when you do some of the subtle nuances that only a patient can assess."

She recounts a story about the former Governor of South Dakota, Bill, who told her:

"Something's wrong with my mind. Something's wrong with my brain... Nobody else can notice this but I noticed this."

Dr. Boz recognized the pattern and immediately recommended a brain scan. A tumor had spread throughout his brain, and he died weeks later.

With Ian, a similar subtle change occurred:

"I just have a difficult time speaking out loud in front of people. So I usually stay quiet. But there's times where I'm feeling very confident... and I find myself quite elegant in the verbal speaking."

On GLP-1: That public speaking anxiety disappeared.

Off GLP-1 (6 weeks): The anxiety returned, cravings roared back for a few days, and ketones dropped slightly (though still decent at 1.1-1.8).

Back on GLP-1: Ketones jumped back up to 2.9-4.0, and that mental clarity returned.

The Math Problem

Ian is 72 years old with 60+ years of accumulated brain debris. Even with perfect ketogenic adherence:

"It's going to take us 30 years to clean up the trash if he's perfect in the ketogenic space."

By adding GLP-1 and GIP:

"We improve autophagy. We improve that cleanup rate."

Dr. Boz's goal is ambitious:

"I want him to never have that diagnosis on his chart. I want him to be the grandpa at 92 that's as healthy as he is at 72. And that means the cleanup needs to start and stay."

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8. Q&A Highlights 💬

On Prolonged Fasting vs. GLP-1

Question: Would prolonged fasting render better results than using Ozempic as a crutch?

Answer: Even with prolonged fasting and ketosis, most metabolically unwell people don't produce enough natural GLP-1 for the "superpowers" these medications provide. However, you cannot start GLP-1 before achieving ketosis.

"When people come in and say, 'My ketones are 0.1. I want to go on Ozempic.' I'm like, 'Cart ahead of the horse, buddy. Cannot do that.'"

On Micro-dosing Duration

Question: How long does one micro-dose for long-term brain healing?

Answer: It depends on the individual patient. Long-term healing is... long-term.

"Long-term healing is long term, so that's where it's usually longer than people think it will be."

On Lipedema

Question: Would this help someone with lipedema?

Answer: Lipedema involves chronically frozen, stiff fat cells with receptor dysfunction. These patients absolutely need ketones first.

"Start with ketosis. Quit worrying about a microbiome. The first thing you need are ketones in the morning, not ketones at 3:00 in the afternoon where you get a 0.7. I don't care. I need ketones in the morning."

Dr. Boz contends that lipedema patients will eventually need hormone help, but ketones must come first.

On Atrial Fibrillation (AFib)

Question: Can someone with AFib take a GLP-1?

Answer: AFib will do better without excess weight. However, reversal isn't guaranteed.

"I've had some of them reverse and I'm just so happy for them. But I never promise that. It's kind of like ringing of the ears... Sometimes with AFib, the map of what you send electricity through your heart has been practiced for so long, I don't know if we can reverse it."

On Keto vs. Carnivore for Type 2 Diabetes

Question: Do you recommend keto or carnivore for type 2 diabetes?

Answer: The diet name matters less than the results.

"I recommend ketones in circulation. How you get there is a choice of a menu... I'm looking at reversing the problem and changing your metabolism by having ketones in circulation."

On Gut Microbiome Rebuilding

Question: What does rebuilding a gut microbiome look like?

Answer: Gut microbiomes are remade from scratch regularly, but you need:

• Ketogenic state to remove inflammation
• DBR (Dr. Boz Ratio) under 20 first thing in the morning for about six weeks
• Extended fasting windows - stop eating at least 16 hours before your gut "wakes up" with sunrise (around 2 PM if sunrise is at 6 AM)

"What I see patients do is they waste money on repopulating a gut that doesn't have a soil. It doesn't have the foundation to build that microbiome upon."

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9. Conclusion: The Path Forward

Dr. Boz closes with her core message: GLP-1 medications have been mismarketed as weight loss drugs when their true potential lies in brain health. The key principles are:

1. Ketones must come first - You cannot add GLP-1 effectively without a ketogenic foundation
2. Education is essential - Patients need to understand their metabolism deeply enough to teach their own doctors
3. Combination therapy is powerful - GLP-1 + GIP + ketones creates a supercharged cleanup effect
4. Prevention beats treatment - Don't wait for cognitive symptoms to appear before taking action
5. Time is the enemy - Decades of insulin resistance create debris that takes years to clear, even with optimal protocols

"I want him to be the grandpa at 92 that's as healthy as he is at 72."

The future looks even more promising, with third-generation triple-hormone medications on the horizon and continuous ketone monitoring technology in development. For now, Dr. Boz emphasizes that the tools already exist to dramatically improve brain health - patients just need the knowledge to use them correctly. 🧠✨