Podcast Transcription: How Lifestyle Medicine Can Change Your Life: Navigating Fitness, Nutrition, Hormones, and Weight Management with Dr. Charlie Seltzer

Ted Ryce: Dr. Charlie Seltzer, thanks so much for coming on the show today. Really looking forward to chatting with you.  

Charlie Seltzer: Thanks for having me, Ted.  

Ted Ryce: Yeah. And Cliff Wilson, someone who was also also recently introduced to me recommended you. And you're a medical doctor. In fact, you're an obesity medicine and internal medicine. You have dual board certifications in both those specialties.  

You got a certified, strength and conditioning specialist certification, and you're the only physician in the country to hold all three. And on top of that, you have won the men's open overall bodybuilding title in a natural bodybuilding contest. 

So, you're going to have a unique perspective on some of the things that we're going to talk about today.  

Charlie Seltzer: I hope so.  

Ted Ryce: Yeah. And man the thing I wanted to dive into right off the bat is peptides because peptides are super popular right now. In fact, I started asking you about them and you, and you started sharing your perspective with me and I'm like, okay, we got to, we got to click record and get this. 

On record, let's say so peptides super popular, but some people don't know. Can you talk about what peptides are specifically relating to not like what, you know, like what, what people are talking about today? The BCP 1 57 and all those things.  

Charlie Seltzer: So, a peptide is basically just a sequence of amino acids, and the peptides that we're talking about have certain biological actions in the body. 

So, the popular ones now are the growth hormone releasing peptide, peptides, so like cermoralin and ipramoralin, which is supposed to increase your body's production of growth hormone, without the side effects of growth hormone, which I question that statement anyway, BPC 157 is a very, very common recovery peptide. 

It's supposed to find where your body is injured and help it recover. And there's some promising data behind BPC 157. The problem is compounding pharmacies aren't allowed to make it. So, the only place you can get it is through a, I guess, a gray market company on the internet, which makes me really nervous. 

Same thing Ipramoralin and Cermoralin, you can get through reputable compounding pharmacies where you can have a reasonable assurance of purity. But that's not where most people are getting these peptides. Again, they're going on the internet. They're googling stuff. And, you know, this, this site looks legit. Let me get some peptides and inject them into myself, even though it clearly says on the thing, not for human consumption or use. It just, it makes no sense to me.  

Ted Ryce: I know what you mean when you say that based on your knowledge. You're here's the way I look at it because I used to be, I don't know what your history is and I'd love to get into that, but I used to be in the extreme belief category, low carb and insulin makes you fat. Calories don't matter. The big pharma is out to get you and yeah.  

What else did I believe? Oh yeah. Fat doesn't make you fat and people are lying about cholesterol. So, I used to believe that stuff. And so, I think it's really, I think there's that element where it's especially post COVID, there's a lot of people questioning science and they're having trouble differentiating the people who. Uh, and I don't want to get into the vaccines because neither one of us are experts on it, but you know, like the, you know, the COVID vaccine, put it together and, you know, all the, the controversy around that versus, you know, sports science, it's not science. 

It's not the same people doing all the research, but I feel like a lot of people have lost faith in the scientific process and the people who do science, regardless of all the differences between them. And so, it's like people are thinking, ah, the FDA is just trying to keep these peptides for me, but these, but these, these people online, they're trying to make it accessible so I can heal myself without the help of big pharma. Right?  

Charlie Seltzer: Yeah. And maybe like, I personally believe that BPC 157 should be available for people and I'm not smart enough to know or I don't know enough to know whether the FDA is out to get us or to hold. Yeah, it's irrelevant because it is what it is. Like right now you can't get these, you can't get BPC 157, except through a company on the internet. 

Ted Ryce: Why do you think they did that? Cause it was, I don't know anything about peptides because there's so little data and I'm more into, you know, I'd rather get a PRP injection, right? With where there's a lot of data on it. Can, what, what happened there? Can you just talk a little bit about that? 

Charlie Seltzer: I don't know what happened. I know that it was available and then it wasn't available. And like, to your point, there's so many other interventions to treat specific issues that have more research behind them or more well known that I think it makes more sense to go down that route rather than something new, which may or may not help or may be harmful. 

Like, can growth hormone accelerate cancer? Yeah, probably. Do these growth hormone releasing peptides cause cancer indirectly? Maybe. Yeah. I wouldn't be surprised. It's just, I feel like, you know, a lot of guys will come in with specific symptoms then immediately go to peptides when there might be more well researched, safer, more effective options for them. Maybe they're not the sexiest peptides, but they're probably more effective.  

Ted Ryce: Certainly the sexiness aspect is a factor. I shared my view on things because that's, I used to be like that. How do you see the situation where people are turning to these, these things that aren't really proven? Like how do you view that?  

Charlie Seltzer: I think there's a lot of good marketing going on and a lot of like people with a lot of degrees convincing other people to do things. 

It might not be the most responsible thing just because someone has a lot of letters after their name doesn't necessarily mean they know what they're talking about. But people are, they're frustrated by the traditional medical community. They're not getting answers for questions. They're not getting reasons for their symptoms. 

They're being told they're depressed when they might have low testosterone. The doctor just wouldn't bother to check it or will refuse to check it. And that disillusionment leads people to Looking at Reddit forums and going on the internet and I, and I can't say blame those people. I don't think it's the right way to approach things, but I certainly understand the rationale behind it. 

Ted Ryce: Yeah, the Reddit forums, it's like, yeah, oh man, I'm having a problem. Got to, got to go to Reddit to, you know figure out this complicated physiological thing because someone there must know. And there's a lot I would add to that. There's a lot of people who are very charismatic and confident in what they're saying, but it doesn't, they can be sincere, but they can also be sincerely wrong. 

So many people are saying things, yeah, go for it. You had something to say about that?  

Charlie Seltzer: No, I just, I'm just thinking of these, there's a lot of guys on TikTok that I watch a lot in between my fishing videos and cooking videos. And they just, they're very, very convincing and they look very, very official, but they're very, very wrong. And clearly wrong. And yet they have, they have 30, 000 views on this video and a bunch of comments saying, well, I didn't know that I thought the opposite, I'm like, yeah, well, the opposite is true.  

Ted Ryce: Yeah. And I would also say this, it's a weird thing. So, I made this shift away from the extremism into, let's say, an evidence based approach. 

So, if there's, I don't necessarily need research to believe something works. I had stem cell injections and had good results from it. If you're familiar with the literature on that, it's a little all over the place, but at the same time, it's like, why ignore if something like in, in, in terms of PRP, for example, platelet rich plasma, for those of you who don't know, there's metaanalyses on randomized control trials for, for those, depending on the joint being injected. 

So it's just like, Ooh, pretty strong evidence there compared to things that don't have that.  

Charlie Seltzer: And there's like, University of Pennsylvania, for example, the hospital of University of Pennsylvania has a whole PRP program, a regenerative sports medicine program. So, you can look that when a university teaching hospital is embracing this stuff, you know, there's literature behind it because they're not going to do a fly by, you know, they're not going to grasp onto a fly by night study from, you know, a non-PE reviewed journal and then latch onto it and say, this is the end all and be all. So I am, I'm a fan of, of PRP. It, it probably works.  

Ted Ryce: Yeah. Well, I think the takeaway there is like, if you're listening right now, and I always say this, Charlie, it's like the truth is like a, a lot of people look to me and you know, like, oh, Ted really knows what he's talking about. 

And I like to believe that's true because I do my due diligence. I like to clarify like what's backed by research versus my opinion. But the truth is like, I don't think people have the edge, like they have to take a leap of faith if they listen to someone, right? It's always a leap of faith if you don't have expertise. 

Charlie Seltzer: Even the well credentialed people, but it's, it's also not that hard right now to look at data on the Internet, like it's more accessible now than it's eve been. Like, you can go on Google Scholar for free and look at evidence and you don't necessarily need a scientific background to be able to read the abstract of the study and say, okay, this is a review of 30 other studies. 

And this is what they all show.  

Ted Ryce: That's great point.  

Charlie Seltzer: Yeah. And the problem is when individuals are recommending things and they think they're doing a controlled experiment, they're not. So for example, somebody goes on a growth hormone, releasing peptide at the same time, they clean up their nutrition and work on their sleep and stop drinking alcohol. 

And then they feel better. Like, Oh my God, it's the growth hormone. It's a fountain of youth. When in fact, It's not, and that growth hormone might be giving them cancer. So, you know, it's like, there's a lot of misguided stuff out there. And when I make a suggestion, I'm like, this is not me making the suggestion.It's the science making the suggestion. I'm just relaying it to you. 

Ted Ryce: Yeah, that's a really good point. And I want to return to that comment you made. That someone on Twitter the other day, they're like, oh they were arguing with me about protein and because a recent study came out showing that protein causes heart disease, right? 

This link, but it's, you know, just kind of not really. And it was published in nature, which is a prestigious journal, but. There's just a lot, a lot more steps that need to be taken to make that type of leap. And what I, and then what he said was, I was like, listen here, and I shared a video from Lane Norton, who's, you know, someon  I've learned a lot from over the years. 

And what he said was, yeah, well, as if I, yeah, he's great. Right. Yeah. I hope to get them back on the show sometime. And the guy said, well, Dr. Dougal is my guy. And I'm like, I don't even have a guy. I read studies. That's the whole problem is if you have a guy. And even if you're listening to this right now, listen to Charlie's you know, what, what Charlie said about anyone can go and read Google. 

And at least even if you're like, you read it, cause I've been reading a lot of, I've been reading research for years. When I first started, it was so tough because the wording it's not really accessible at first, but you start reading it, you start getting better at reading it. And I think over time, it really helps to make you a more critically thinking person when it comes to evaluating some of this health stuff and the claims. 

Charlie Seltzer: And I think that having somebody you trust that you can go to to bounce ideas off of is really helpful. And like, back in the day, the primary care doctor was that person, but a lot of the people out there no more, you know, a lot of people, they know enough to be dangerous. And oftentimes that's more than what the primary care doctor knows. 

And then they get, again, disillusioned that they're not getting answers from them, and then they're going to other places to get it that's not scientifically back necessarily, or the person who's looking at one particular cherry picked poor study to base a whole platform off of. 

Ted Ryce: Yeah, there's a lot of that, right? Can you talk about what cherry picking is, just if someone's never heard that term before?  

Charlie Seltzer: Yeah, so I think of the China study from the China studies that book that said so basically protein is bad. Protein is bad. Right? So, if there are, if there are 30 studies, which show that protein is neutral to beneficial and one study that says protein is bad, then cherry picking would be only looking at that one study. 

Yeah, the people who wrote the China study or whatever, cherry pick literature, like it was no one's business. They just took out an entire like. Scientific like conclusions that didn't match with their hypothesis. I just disregarded them and we see that a lot, you know, it's why meta-analyses are so helpful. We're not just looking at one study. We're looking at a bulk of studies.  

Ted Ryce: Yeah. And I mean, you don't know the answer to this, but I'm going to ask you anyway, for your opinion. Why do you think people do that? Certainly there's the people who make money from doing that, but I don't think it's just money, right? Not always.  

Charlie Seltzer: No, I mean, I think a lot of people mean well and they want to get their ideas out, but the ideas are wrong.  

Ted Ryce: Like Colin Campbell, you think he'd, I mean, he's a researcher. He must be aware of the studies on a protein that show a neutral to positive benefit.  

Charlie Seltzer: Well, you know, I would even take a step back from that and say, you know what we know gives you cancer and heart disease being overweight. 

So, unless you're really, really lean, don't even worry about whether protein may or may not cause heart disease. You need to get lean first because we know with 100 percent certainty that at your body fat level right now, you're going to die prematurely. So it's a moot point for most people.  

And if somebody is super lean and they want to extend their longevity and they want to talk about like the AMPK pathway versus the mTOR pathway and, you know, aging versus anti-aging, great. 

Then we can have that conversation. But if you're. Body fat is 30%. It's a moot point until you get that down to a healthy range. So, I would say in that sense, it doesn't even matter.  

Ted Ryce: Yeah. And people love having those conversations about the, you know, the toxins in the environment, as an example, like endocrine disrupting chemicals. On the effects of T levels versus like, well, dude, you, you got, it looks like you swallowed a basketball. Okay. Let's probably start there and then seeing whathappens next.  

Can you talk a little bit about what we know with the study show about body fat percentage? What's the healthy place to be for a man and a woman to minimize risk?  

Charlie Seltzer: I don't know what the current recommendations are. Now. I like, I tell my guys that you should be able to see her abs when I work with them, maybe under 15 percent for women, it's going to be higher because they carry more body fat, but I think that being as lean as somebody can be without looking sick or doing things unmaintainable to maintain that level of leanness is going to be beneficial for most people. 

And like for somebody so low body fat is good. Like if a, if a person has to dedicate their entire life and live in a box to achieve 13 percent body fat, then 16 might be their realistic number, even though it's not technically like the best number for them. A lot of it comes down to like practical applications of this stuff. Like you try to be as lean as your lifestyle will allow you to be.  

Ted Ryce: Yeah. That, you know, that's such a good point, Charlie. And it's something that's not talked about enough. I actually, I didn't work with this person, but he can't, he I had a client who just had a, an incredible transformation, right. And people were asking him what he was doing and they're like TRT. No, so you're doing keto. No. And you know, we, we basically had him track macros and I showed him some systems within macro tracking that worked pretty well that we've used with other clients.  

So, he recommended this guy and he got on the call with me and he was telling me how the whole 30, which is, you know, you know, in credit, if go look, if you're listening to this, you don't know what the whole 30 is go look at the, the recommendations. It's basically an eating disorder. It's like, so an orthorexic anyway, just really quick. He said that it worked great, but him and his wife had to stay home all the time and they got really kind of down because of it because they couldn't go out and you can't eat anywhere. 

Charlie Seltzer: Sure. It sounds like it worked really well.  

Ted Ryce: Exactly. Right. Well, it worked well for fat loss, but it didn't work well for their social life, which is also connected with longevity.  

Charlie Seltzer: And I think that, so when you look at like what kills people prematurely, it's stress slash poor sleep and excess body fat. 

And if you're super lean, but you're stressed out 24, seven, because you have to follow the whole 30 diet, then you're just going to die of stress. Right. So, you know, reconciling that being able to be physically fit and mentally happy, that's the key to longevity. And it might not necessarily mean that you have to eat a lot of vegetables to live a long healthy life or to follow Whole30. 

Ted Ryce: Yeah. I think one of the controversial opinions that I have is that you know, there's, there's probably some diet stuff that we'll figure out how to optimize, but a lot of it's just getting that, getting lean, like you said, as lean as you can for your lifestyle. And then just making sure those. The, your blood work is as good as it can get to and whatever diet does, that is kind of like, you know, there's a lot of flexibility there. What are your thoughts? 

Charlie Seltzer:  In my practice, the people who do the best both mentally and physically tend to eat the least clean. Uh, one of the nice parts about being a doctor is I can write for labs. So, in the beginning I order everybody an insulin level as well as the hemoglobin A1c, which gives you the average three months of your blood sugar, a sedimentation rate, which is a nonspecific mark of inflammation. 

A detailed cholesterol panel, a lipoprotein A and a C reactive protein, which are also independent cardiovascular risk markers. And what we see consistently is when people lose body fat, those numbers get better. So, if somebody's insulin level is going to come down, even if their diet is 100 percent sugar, if they are losing body fat while they're preserving their lean muscle mass, you couldn't do that if you're just eating sugar. 

But you could eat a whole bunch of sugar and see a more insulin sensitive picture because what causes insulin resistance, pre diabetes, diabetes is body fat and genetics. It's the body fat that makes people's blood sugar rise. It's not the sugar. If you're exquisitely insulin sensitive and lean with a lot of muscle mass and you eat a bag of Skittles, you're not going to need that much insulin to clear it out. 

Whereas if you're a big overweight insulin resistant guy and you eat a quote good carb end quote, like oatmeal. It could take your blood sugar up pretty significantly and cause a significant amount of insulin release to bring that blood sugar down, which is not the scenario we want, even though that's quote a good carb or skittles or bad carbs, it comes down to the person's body composition I think, not what they eat.  

Ted Ryce: Yeah, I mean, that's what the data shows, right? And it's a really tough. I have I get annoyed as I really get annoyed with people, but I have to remind myself, this is really tough because people say, no, you're wrong. The low carb diets. Cause I went on a low carb diet. I mean, I didn't lose any weight, although most people do, but let's say this person didn't lose weight or even gain weight, right? 

Cause there's people that happens to even on carnivore. There's a guy who I follow on Instagram. He shares all these carnivore stories. So, these are people who don't eat any carbohydrates, all these meat and butter, and they're sharing their, their levels, of course, their cholesterol goes sky high, but more interestingly and less controversially, right? 

Cause there's some people who don't believe in the cholesterol hypothesis. So no, no need to go there. But everyone believes that hemoglobin A1C, like the markers of metabolic dysfunction are important. And these people, their A1Cs are going higher, like into pre diabetic or even diabetic ranges, and they don't know why. 

And it's like, cause it's the calories, especially saturated fat, getting into your organs. And again, you said like the, the genetics, the personal fat threshold is what they, right, is what scientists call it. And it's like, you're giving yourself diabetes. You don't need the carbs. The carbs might if you're, if you are diabetic, lowering the carbs might give you a more even. 

Or fasting glucose or A1C. Right, but it's the underlying, but the PO path, you're still diabetic until you lose the fat. Is that the right  question.  

Charlie Seltzer: Yeah, absolutely. Yeah. That's how I look at it anyway. And, and we see consistently people's A one Cs go down when they lose body fat. It's just, it's just the way it is. 

Ted Ryce: That's a tough one, man. It's like, so I just need to eat fewer calories. And sometimes it doesn't even matter.  

Charlie Seltzer: Yeah. I mean, look, there's a practical scenario and there's an ideal scenario and we live in the real world and trying to apply the same strategy in America that you would apply if you lived on a tropical Island with no grub hub and no door dash, try to apply that strategy to America, you're going to lose. 

You know, based on where you are, you need a different strategy than you might need somewhere else. Like if you live in Greece, follow the Mediterranean diet. Great. You'll probably be great, but trying to follow the Mediterranean diet in America is more challenging because we don't live in the Mediterranean. We live in America.  

Ted Ryce: Yeah. And let's get into that because how do you help your clients? You say some things that go in the face of. What is, let's say, commonly talked about with influencers eating, you say, eat most of your food at night, eat processed food. Minimize meal prep. Can you talk a little bit about how you approach helping people? 

Charlie Seltzer: Sure. We take a minimal change approach here. So, once you can figure out what somebody's doing, the less you change from what they are doing now, the more likely they are to be successful over the long run. Like, obviously, like one little tweak is much easier to follow than overhauling your lifestyle. 

It's also really hard to change habits. So, unless your habits are fundamentally detrimental to your health, like tell people not to change them. Like there's nothing wrong with eating at night. Lane Norton wrote a great article about eating carbohydrates at night. Fat loss killer or imaginary boogeyman. 

I give that to every new patient who comes in my office to read. And even if they don't want to eat their carbs at night, they can if they want to. So, by mirroring most people's natural tendencies, you can increase their likelihood of success. Now, most people want to eat most of their food at night. 

They're busy during the day. They don't particularly care about food during the day. They want the food at night when the kids go to sleep and they're watching TV. And to have to white knuckle that because you force fed yourself a giant breakfast just never made sense to me. In an ideal world, we'd all have personal chefs who make us the whole 30 like food and just follow us around and give us that all day. 

Now, most of us don't have the means to do that. And even if they did have the means, they would probably end up craving food anyway, which is causing an overeating pattern. So, you can, you can be restricted in your eating while still consuming a large number of calories. If you're trying to eat too clean and all you want is pizza. 

Then what happens is that continuing desire overwhelms you and you start to eat that stuff, but you're doing it in the mindset of, well, I shouldn't be doing this. I'm never going to do it again. I'm going to start tomorrow. So I might as well eat as much of this item as I possibly can. Once we shift their mindset and say, look, dude, you can eat a fast break bar every night. 

If you can make it fit in your total calories, then the urge to eat 7 fast break bars goes away. Because it's not forbidden anymore. We have patients who go on vacation and they lose more weight than they're losing at home because like, oh, there are all sorts of fresh fruit and vegetables. And it was really nice. 

As far as minimizing meal prep goes, most people have very little free time. And I would much rather see somebody go for a walk in nature on a Sunday afternoon than cook chicken breasts for four hours. So, you know, again, it's this mental health aspect of it is not looked at enough like these, the influencers, the people who espouse a clean eating plan. 

I don't think that there's nothing wrong with it. If you can do it, aren't taking into account the mental angst that causes and the lack of maintainability over the long run. I see the long run. I'm talking years. Like, anyone can do it for a week or so. But I ask people like, do you really see yourself putting chicken and Tupperware and bringing it to a party for the rest of your life? 

Even if you could, is that something you'd want to do? And the answer is always, no, we don't want to do that. 

Ted Ryce:  Yeah, it's a really good point. I don't do any people ask me like, Oh, you must meal prep. I'm like, I boil chicken and then I keep it in the fridge and then I like heat it up with some mushrooms and put some teriyaki sauce on it. 

And that's the extent of my meal prep. Or I buy Greek yogurt and just, you know, it's like, I don't meal prep at all. And I, anyway, but right. Those tactics you have to ask yourself. Yeah. There's a lot of influencers who let's say there's a lot of people out there who suffer from anxiety about health and about what they do and they have, they're extremely regimented. 

And I think it's really important to recognize some of that stuff that people say, like the crazy meal prepping. I don't do any of that. And I, but I say for clients, if they like to do it, it's fine, experiment with it, but you know, you got to make sure it makes it work for you. 

Charlie Seltzer: I ask everybody, is this going to be a positive impact on your psyche, neutral or negative? 

And if the answer is negative, we have to do something different. Some people find meal prep relaxing. I don't get it. But if they do, you know, I'm all for it, right? You know, it's whatever you need to do to hit your calorie number and consume sufficient protein that you need to do in a way that makes you happy. 

And if that means drinking protein shakes during the day and having ramen noodles with American cheese at night, I'm okay with that. It might not be an ideal scenario, but again, we don't live in the ideal scenario. I thought of this the other day, Ted, when the ideal is not practical, the practical becomes ideal. 

Ted Ryce: Yeah, that's a great quote for sure. And you should, if you just, you should say that you should write that down because that's what, too many people aspire to, and we don't even know what ideal is. That's part of the issue. I've had guys you know, on the show and we talked about like, what, what do we know about people who live a long time and what they're eating? 

And it's very, it's varied, right? There's monkey brains in there, you know? Can I, yeah.  

Charlie Seltzer: Can I comment on that for a minute? Yeah, sure. So like the blue zones, right? Like the five areas in the world where people live. So they do eat differently. The Okinawans do not eat anything like the people in Greece, right? 

Or in the other areas. So, you look at commonalities and they are, they are, they're lean, they're relaxed and they move a lot. So lean and relaxed are the big ones. It's not possible for everybody to move a lot. Cause a lot of us work sedentary jobs, but if you exercise and you're chilled and you're lean, you're going to live a long, healthy life. And that's going to be regardless of your nutrition, I believe.  

Ted Ryce: Yeah. I'm with you on that, but the narrative is in our society. And I've done this on, on social media, I've asked like, what's more important to longevity. Diet or nutrition and everybody who let's say is in the health and fitness field and they're not totally crazy, right? 

They say fitness one because that might be what they believe personally But two that is what is shown by the data right vo2 max Leg strength, upper body strength. So strongest predictors that we have of, of longevity right now. And if I was going to write a book on, let's say in the health and fitness field, and I wanted it to do well, you better believe it would be on nutrition. 

Though people are crazy for it. I don't know why. It's not nearly as exercise. Isn't nearly as provocative. There's something about nutrition that people just go crazy over. And they think that there's some special secret answer when what you're saying is true. It's like, you know, we just don't know. And there's no commonalities diet wise between Okinawans and some of the other, in terms of food choices, like it, but they all eat, you know, they're all lean and they exercise and they, you know, have. 

They're happy and they're happy. They're relaxed.  

Charlie Seltzer: They're, they're, they're chilled. Yeah. And I think that that's a really important thing to know. Like if you're lean, but you're stressed chronically and you're not sleeping well and you're, you're risk of disease is high. Like if you're overweight. 

Ted Ryce: Yeah, let me ask you about that. I'm not sold on the, the sleep and the stress thing, because one, one thing it's like, maybe if someone's really unhealthy and then they're sleeping poorly. I get it. And there's people like Matt Walker, who has talked about that a lot, but there's also some research saying that, you know, it has more to do with exercise. 

So, can you talk about, like, in terms of the data, especially, and of course, your, your perspective, why do you say that, you know, stress, like, how does stress or sleep deprivation lead to disease?  

Charlie Seltzer: I believe it leads to overeating, like cortisol. When you don't sleep well and you're stressed all the time, your cortisol levels are high, which does cause the increase in appetite over time. 

So, then people become overweight. Um, and these people who are people who don't sleep well are less likely to exercise because they're not sleeping well or they're tired all the time. So, it's more of an indirect thing, like, because there are guys who will sleep three hours a night. And live to a thousand if they're relaxed and they're lean and they're exercising. 

Ted Ryce: Yeah. Thanks for clarifying that. Cause you know, I slept, I was in, I was living in Bangkok, Thailand in 2019. And I was sleeping like crap, not because I was stressed out. I was taking calls at weird times. As you can imagine that the times that it was just crazy there, all my clients were the States. So, I was like working in the morning, working at night. 

And doing calls at night and not sleeping that well. And man, I was having the time of my life. My business was just taking off. I was lean as I was super lean. I had just come off of a cut. And yeah, because I think some people believe like, oh, gosh, not only do I have to get into a calorie deficit and lift weights, but I have to like sleep like eight hours or whatever people are saying. 

Charlie Seltzer: No, yeah, I think that's impractical for a lot of people. Like, I'd rather, I'd rather have somebody sleep seven hours and give themselves like an hour of like, like their time to relax or chill because if somebody feels like they're only taking care of their kids and working and sleeping, it just creates a negative like psychiatric like environment or like mental, you don't feel like you're doing anything for yourself. 

And I would tell people you should take, take an hour and do something for yourself rather than just finishing work and taking a sleeping pill and going to sleep, you know, do something, do something creative, read a book or listen to an audio book or go fishing or do something like that.  

Ted Ryce: I was going to bring up the fishing thing, because I read that, you know, we're, we're talking about, you know, sleep and everything. And, and you often go fishing at 3am in the morning. It drives your wife crazy. Can you talk a little bit about that?  

Charlie Seltzer: Well, she thinks it's dangerous. She says some crazy guy is going to go out there and kill me. And I'm like, you don't understand Beth. I'm the crazy guy. I'm the one fishing at 3 o'clock. People are avoiding me. You know, I don't have to worry about avoiding other people. Like, who is this crazy person fishing in the middle of the night? I'm going to stay away from him. Not a big deal.  

And I'm not going to fall in the water. And the water that I'm fishing in is only 3 feet deep anyway. So, yeah, so sleep is sleep is great, but not at the expense of doing something fun for yourself. And yes, I will take a nap when I do fish from 3 to 5 a. m, but there's nothing like reeling in a bass in the middle of the night.  

And I think that it's important to have hobbies and things that are fun to do. Um, and it goes back, you know, don't spend any more time with nutrition, then you absolutely have to to get yourself lean, like do other things that are fun. 

You know, take a minimally like invasive approach for lack of a better phrase when it comes to nutrition.  

Ted Ryce: Yeah, absolutely. People always ask me like what my, they, they get great results in our program because we take them away from strict diets and we show them that calories, you know, we show them. You know, calories are really the key. And then it opens up with this world of flexibility.  

And then they always ask like, well, how do I maintain this? And the answer is what you just said is what, that's what I tell them. It's like, this cannot be your life. You're going to get your lean, you're going to hit your target weight or target body fat percentage, and you're going to have to maintain that. 

And the way to stay in the game to maintain that I've found personally is you live a life that's exciting, which goes back to why most people are probably overeating and over drinking anyway.  

It's like some cheap, cheap entertainment. Is a substitution for doing something amazing, having, getting up off the couch and turning off the Netflix and going you know, I had a client who found himself at the end and I'd love to hear a story from your clients next Charlie, but just to finish this one, I had a client who was finding himself, like you said, people aren't hungry during the day when they're super busy. 

It's when they're home at night after a long day, and then all that stimulation at the office. And now they're at home and his kids were gone. So it was quiet. And he would found himself watching TV and eating handfuls of caramels at night. And he's like. If you tell me to go for a run, I'm going to tell you, and we had a good relationship. 

So, so this, he didn't say this in a real, you know, it was appropriate in the context or a relationship. He's like, I'm going to go tell you to go after yourself. And I said, guess what? I'm not going to tell you what to do. You're going to tell me what you're going to do, because I'm not going to choose what your hobby is. 

And we ended up helping him find what it was. And after trying a few things, he fell in love with pickleball and we got him into pickleball and now he's playing pickleball a few times a week and plays pickleball competitions and sometimes does these pickleball clinics. And it changed everything for him. 

And that's an example of how like people are looking for the answer and they go on these short term diets or even on a program like yours or mine, but without changing like hey, I'm bored In my life without changing those things It's going to be really tough to maintain and Charlie, I'd love to, can you share a story, a success story from the people that you worked with that, you know, how you coach them in the things like, cause we all, you know, it's calories, the protein, it's the weightlifting and then it's the steps and okay, but how do, how do you help them maintain it for life? 

Charlie Seltzer: So, I first tell everybody, whatever you plan on doing for the rest of your life, you need to be doing while you're losing weight. So, I have a guy who's lost like 70 pounds and he's kept it off without medication and without hormone replacement therapy or anything. And when every patient for 2 weeks just uses my fitness pal to track all their food, just so we can get a baseline idea. 

And his food was McDonald's and Wendy's and your frozen, like, I think he had the white frozen White Castle burgers on the first set of data we had, and he was like, okay, so what do I need to do now? I'm like, well, you need to figure out a way to stay around 2000 calories. With a hundred grams of protein while you're still eating that stuff. 

And he's like, wait, what about like, yeah. And not in these words, like, what about the chicken and broccoli? What about the, I'm like, I don't care about chicken and broccoli. We got your blood work here. We, we have a, we have, you know, we got your numbers. Humor me and keep eating like crap, but lose weight. 

And let's see where your numbers are in three months. And like the testosterone went up, the cholesterol, everything, the normal changes that you would say, but he kept eating that stuff and he had tried and failed a million diets before because all diets fail, right? He can't be on a diet. The diet connotes an end point. 

So. When he hit his goal, it wasn't like he had to go reintroduce McDonald's because he's been eating McDonald's the whole time. You just got to eat a little bit more, you know, in a, you know, everyone's got like a metabolic range, right? When you decrease your calories, your metabolism goes down, when you increase it, it goes up, you know, we got him to the top of that range, which was like 24, 2500. 

And he would kind of get lax on his tracking game, five or six pounds close and start to get a little bit tidy, buckle down for a month and go back and then it buy him six more months and not really have to worry about it.  

And that's what happens in the real world, because as much as I like people to track every day and to have a meal plan for themselves laid out for them for that day, it doesn't happen in the real world and a lot of people, it just, it becomes second nature the way they're eating, especially if they're not eating super clean and they were eating the way that they normally eat, it becomes easier to maintain that rather than like the, you know, the diets that require like the diet, the loss phase, then the transition phase and the maintenance phase and that, that kind of stuff only works on paper. Or with robots.  

It's hard to change your behaviors. It's hard to try to change habits and those kinds of plans like Atkins. It makes you do it 3 times once in the last phase, once in the transition phase and to quote normal and quote, whatever that means and then maintenance for the rest of your life. It just doesn't work like that in the real world. 

It's not people do things. If you don't drink wine for 3 months, you're not going to pour 4 ounces of wine on the 4th month on the 1st day. You're going to drink a bottle, you're going to be hung over, you're going to have a bacon, egg and cheese in the morning and I say, screw it. I'll start again on Monday. And then before you know it, you're right back where you were before you started. 

Ted Ryce:  That's what happens. Yeah. I didn't realize I've never been on a, I mean, I say I used to do low carb diets because, but I never followed it so strictly. And also, I wasn't tracking. So, I have no idea what I was, you know, how many carbs I was eating or anything like that. 

To your point, yeah, you really have to you just said it right there. That's why people end up back where they started. So that's you. I read a great quote. I forget the guy's name on Instagram, unfortunately. He said, just like what you said. So the people believe like. I eat this way, the White Castle burgers, the McDonald's, and to be a healthy person, I need to eat this completely different way that I don't like doing, don't want to do, but my health is important to me. 

And so they do that and then they revert back. And so that's what a diet is, or that's what people think a diet is. But this guy on Instagram, he said, you already have a diet. You just need to understand it better.  

And what he meant by that was what you're saying, the calories, the protein, right? Just don't try to change the food so much because you're going to go backwards. You can optimize later if you want, but just use within the context of the foods you're already eating. Just dial it in to lose weight. Such a great message, Charlie.  

Charlie Seltzer: Thank you.  

Ted Ryce: Go for it.  

Charlie Seltzer: No, no, I forget what I was going to say. I'm losing my mind in my old age, Ted.  

Ted Ryce: How old are you, man? 

Charlie Seltzer: 47.  

Ted Ryce: Okay. We're the same age. And speaking of hung over, I had two, two beers. So, I'm not on my, you know, my, my memory isn't so sharp at the moment. 

Charlie Seltzer: I very rarely drink anymore. The, the hangovers have just, they were always bad in my life, but they've become even worse as I've gotten older. It's. Yeah, there's certainly other things out there that do not cause a hangover and they do not have any calories in.  

Ted Ryce: We're going to talk about in a second because you mentioned that I don't drink either as a general thing. Although I do enjoy why, if I'm in, if I'm in Europe, if I'm in Portugal or Italy, I'm definitely having some wine, but I don't drink regularly, but I am single and I'm in Sao Paulo, Brazil.  

And so, I'm just kind of going with the flow at the moment. I'm drinking more than, than I have in a long time. And probably the past, I don't know, maybe decade, but you have, you have, you say use TCH instead of alcohol. Can you talk about what that is? 

Charlie Seltzer: THC. THC. Yeah. So THC, THC is the active ingredient in marijuana. That's what makes people high. Again, in an ideal world, we use relaxation techniques to combat stress that we don't have because it's an ideal world, right? And we don't have to worry about anything. Now, in the real world, people need, people have vices and people will seek an altered state. 

So while it's best to do nothing, if there's a choice between coming home and having two beers or having a couple bourbons versus eating a THC gummy you're better off eating the THC gummy. It's not going to have any calories in it. Um, it's not going to destroy your liver. It's not going to necessarily lower your inhibitions to eat. 

Now, it might make you hungry a little bit, but that tends to be with less chronic use. People who use marijuana regularly have lower waist circumferences and lower body fat percentages, lower risk of diabetes. People who don't use marijuana for reasons that are not 100 percent clear, but that's pretty clear. 

It's a minor effect, but it's there. So, I tell people, you know, you're, and it's also not going to interfere with your sleep the way a traditional, like the way alcohol is going to, and people say, well, I'm going to get the munchies. I'm like, well, you're, we've looked at your data, like you tend to overeat at night anyway. 

So, let's just anticipate the fact that you're going to be hungry and make sure we've built in enough food there for you. So you're not hungry when you go to sleep. So not, you know, you're from a probability standpoint, as far as hitting your calories, If you run out of calories at 7 p. m. and don't go to sleep until 11, it gives you 4 hours to get into trouble. 

If you have 500 calories allotted for the 20 minutes before you go to bed, you're going to go over your calories a lot less often. Additionally, having something delicious to look forward to often will take your mind off of food during the day. Whereas the converse is, if you know you only got chicken and broccoli to look forward to for the rest of the day, noon rolls around and you're looking for snacks, you're looking for chips, you're looking for candy. 

Because you got nothing, nothing. There's a chicken and broccoli that stinks. Let me go, like, you'll get something good versus, oh, I've got whatever I got jelly beans before bed. I got cheese and crackers before bed. Um, I don't need it now.  

Ted Ryce: Yeah, I hear you on that. And if you're exercising and your calories are on point, I mean, yeah, it probably just. Well, at least with what we know now, it just, it doesn't seem to matter all that much.  

So let me ask you this. I didn't, you know, if you don't want to talk about this, this is cool, but since you're a doctor and you mentioned hormones earlier, TRT for men is just, it's just super popular. So many guys ask me about it, I'm not a doctor. I'm not on TRT, even though I've been accused of it.  

But I'm not very big, but people think if you're lean, which has, I've worked with guys on TRT who are fat and nothing that it might help you if you build some muscle, but ultimately if you're eating in a calorie surplus, you're going to be fat regardless of, you know, if your testosterone is 2000 nanograms per deciliter, right? It just doesn't matter. So, can you talk about, you know, do you prescribe it? Do you advocate for it? 

Charlie Seltzer: Yeah, I do a ton of, I do a ton of TRT in my practice, both with testosterone and then inclamaphene as well. The pill that increases the signals from your brain, your testicles to make testosterone. 

Somebody will come in with very nonspecific symptoms. I'm tired. I'm having a hard time recovering from exercise. I'm not losing weight the way I want to. I have excess fat around my belly, very nonspecific things. So when someone comes in like that, I'm like, yes, it could be your testosterone and it doesn't necessarily have to be below the lower end of the normal range in order for this to be your testosterone. 

But before we go down that road, let's just make sure there's nothing else going on that's causing these same symptoms like hypothyroidism. Anemia can cause it. Poor sleep can cause those symptoms. Um, insulin resistance sometimes. You know, so we do that blood work and when we rule out everything else what I like about testosterone is we know what the side effects are. 

We know what it doesn't do. It doesn't raise your risk of prostate cancer. It doesn't raise your risk of a cardiac event. It does lower your risk of diabetes and it does help a lot of people feel better. So, if somebody is borderline low, they're symptomatic. We don't have any more plausible explanation. I think that it's a very reasonable thing to do for a lot of people. 

With the understanding that if it's not working, if it doesn't have the intended consequence, then we can just take it away, no harm, no foul. 

Ted Ryce: Got it. And so what if someone was listening to this right now and they're like, okay, well, you know, I feel like I've, you know, I feel, I read a lot of you know, low T and how to boost T. 

And, you know, I'm, I'm having a hard time getting rid of the gut. What would you tell that person who the guy who is. You know, really bought into this idea of TRT probably being the answer for him?  

Charlie Seltzer: I would say definitely get your levels checked to see where you are, but also understand that testosterone is not going to do the work for you. 

You still have to create a calorie deficit. Now, testosterone does make it easier to recover from exercise. It does make it easier to build muscle, but unless you're controlling the diet, then you're just going to have more muscle underneath your fat. So, I tell people like testosterone is very beneficial for a lot of people, but it's not, you know, it's not the fountain of youth. 

It's not something that's going to be. Those you can inject testosterone every week and expect your gut to vanish like that's not how it works. You still need to be in a calorie deficit. You still need to consume adequate protein. You still need to lift weights. 

Ted Ryce: And you said even if someone's not below the or the cut off, which is different depending on the lab, right? But it's around 300  nanograms per deciliter, right? Uh, for free testosterone. Yeah. What would you say is like, okay, well, you know, even if they're not at that level, if they're around this range, I would still. Recommend it. If we've tried all the other things.  

Charlie Seltzer: Yeah, that's so hard. It's hard because the number is going to change from person to person. You know, I, and then you have to look at whether you're looking at the total testosterone or the bioavailable testosterone. Like, sometimes we'll see people with very, very good total testosterone levels, but because they're on thyroid hormone, for example, their sex hormone bonding globulin is high, which takes down the amount of testosterone that the body's actually able to use. 

Yeah. So, you see the bioavailable testosterone being very low, sometimes you need to treat those people up to a level of 12 or 1500 just to get their bioavailable testosterone somewhere in the normal range or in the reference range. So, everybody's different. You can have somebody with a very, very low testosterone. 

But because their sex hormone bonding globulin is low because they've got diabetes, for example, their free testosterone or their bioavailable might be in the normal range. So oftentimes we'll look at the number that makes the most sense given their symptoms. So if someone's bioavailable is normal, but their total level is 250, we may still go down that treatment path with the very clear understanding that if it doesn't alleviate the symptoms that we were trying to treat in the first place, because it should be about symptoms, not numbers, we would stop it. 

Ted Ryce: Yeah, I've had some clients who tested quite low and I was like, well, do you have any, do you have problems with, you know, their doctor didn't want to do anything about it yet. And I just asked him, well, are you, you having issues with libido? What would be the thing for you as a doctor that would say, okay, well, now I'm thinking low, low T here. 

Charlie Seltzer: Sex drive. Irritability, or low sex drive, irritability, difficult losing body fat when you're doing everything right, which is really like zero. No one does the right thing with that. So, it's, it's more of the libido fatigue on blood work. We'll see elevated hemoglobin A1Cs, elevated blood sugar levels, you know, increased abdominal fat. 

Again, you still have to do the work to lose it, but someone who has that may be better off on testosterone replacement therapy. So it's just things like that. But again, nonspecific things. 

Ted Ryce: And that would be because as we, you already talked about, you still got to get into it. Cowry deficit. So let's say someone's got a belly and just to be clear, right? 

And he has trouble losing body fat. You put them on the T. R. T. Let's say you get his numbers up to wherever you feel like they need to be based on his blood work. And then you know, what you're saying is that it just gives people the motive. It might help them build muscle and feel better, which makes them eat less and have more muscle, but it doesn't change the metabolic rate outside of increased lean mass? 

Charlie Seltzer: Right. Exactly. It's, I would approach a overweight guy with low testosterone the way I would approach an overweight guy without low testosterone, minus the fact that we might replace the testosterone on the low guy, but same approach as far as the weight loss goes, because I do see a lot of people who come in and they're like, I have low testosterone. 

It's why I have all of these problems. And if I get the testosterone on board, all these problems are going to go away. Okay. And I try to be really, really clear that that's very unlikely to happen. It's like someone who's considerably overweight because they're hypothyroid or has low thyroid function who goes on thyroid hormone is unlikely going to be able to still lose all that weight without having to work to get the weight off. It happens sometimes, but it's very, very rare.  

Ted Ryce: Yeah. Thanks for bringing that up. Cause I I've had people reach out to me and inappropriately ask me about like, oh, I have hypothyroidism. It's so hard to lose weight. I'm like, well, are you on are you on, are you taking this synthroid or you're, you know, taking medications to bring it back up like, yes. 

And I was like, look, you know what? There's people who are completely fine. They struggle to lose fat. It, the hard truth here is you're probably not doing something right.  

Charlie Seltzer: You're eating. I asked people, okay, you got hypothyroidism. How many calories are you eating per day? Well, I don't know. I eat healthy. 

How many calories are you eating per day? I barely, so what I find shocking, Ted, is once I disclose to people that I struggle with my weight and I have binge eating tendencies and like the amount of times it will just automatically go from, oh, I don't eat that much to like, you know, sometimes I ate six McDonald's burgers at one time. 

Okay. I'm like, thank you. Like we know it, it's there. It's the elephant in the room. Like you don't become 500 pounds by not eating anything.  

Ted Ryce: Right. And let me ask you, Charlie what type of clients, so if someone's listening to this right now and they're like, maybe Charlie can help me, what is the type of client that you work best with? 

Charlie Seltzer: Anyone who wants to better themselves, either physically or improve their mental health, I work with a lot of specialists to like, I'm an internal medicine doctor with a history of depression and anxiety. So, I feel relatively comfortable treating that stuff. I've been treating thyroid stuff for a really, really long time, but at the same time, I stay in my lane and have a good referral network of people.  

So, I would say anybody who, if you want to lose weight, if you have low testosterone, I work with a lot of guys with low testosterone, we get really good responses or even just like a stressed out executive, or a woman who doesn't need to lose any weight, but doesn't like her relationship with food, or a guy for that matter, I guess, the same thing, or someone non binary, the same thing. 

You know, people who want to better their relationship with food. I think we do that really well. Um, because again, if you're lean and miserable and you're white knuckling life, it's no way to go through life. Like you lose. So, you know, helping somebody, you know, we try to shift the focus away from like, not necessarily shift away, but there's a difference between healthy food and nutritious food. 

I would suggest that nutritious food has nutrients in it. And that's an absolute thing. Healthy food is contextual. And I tell people healthy food is any food that allows you to be lean and happy. So, and if you put it in My Fitness Pal, by definition, it becomes healthy because then it's data that allows us to analyze and fix what we need to fix. 

So, I tell people never ever feel bad about the food choice ever again. You can feel bad about not tracking and I'm okay with that, but never once it's in my fitness pal, I want you to look at that as now the food is healthy by definition and you have to enjoy it. Because eating a pint of Ben and Jerry's while you've got overriding feelings of guilt, then you lose, you got the calories, plus you don't feel good about it. 

Ted Ryce: Such a great perspective there, right? The difference between nutritious food and healthy food. And there's way too much food demonization, demonization out there. Absolutely.  

Well, Charlie, man, it's been a great conversation and really thank you for coming on today and sharing your perspectives and your experience, especially with your, your background with your own struggles with binge eating and anxiety and depression and, you know, the take that you have in helping people with their hormone levels. 

It's just been, it's, it's been a great conversation. I appreciate it. Likewise. And if you're interested in reaching out to Charlie to see if he's right to help you, go to drseltzerlifestylemedicine.com. And we'll have his links on the show notes. For this episode and we'll have his Tiktok, Instagram and Facebook there for you. 

But yeah, Charlie really appreciate it today. Really enjoyed your perspective and that it comes from both personal experience and from being a medical doctor.