288: Unlocking the Power of Lifestyle Medicine with Dr. Laurie Marbas

Dr. Laurie Marbas is a double board-certified family medicine and lifestyle medicine physician who has been utilizing food as medicine since 2012. She is the co-founder and chief medical officer of Marbas Medical, which offers physician-led medical groups that employ the power of lifestyle medicine to help patients achieve health.

In this episode, you will learn the following:

• How did a small-town doctor transition her family and patients to a plant-based diet?
• What did the patient with lupus experience when transitioning to a plant-based diet?
• How did the doctor's humble beginnings shape her journey to practicing lifestyle medicine?

Visit Dr. Laurie Marbas’ Socials: 

Website: https://www.mora.com/

Podcast: Health and Mora

Transcript

00:00:00 Laurie: Do the things that you want to do. You brush your teeth. You shower. People literally do daily tasks that they need to survive. Why can't you just make these smaller habits that has such a great impact over time? Because I guarantee you, 10 years from now or 20 years from now, that self that's living in that future is going to turn around and say, “Thank you for taking the time and investing in their future.” And think of it as another person because it really is. That person is being molded with your decisions that you're making right now.

00:00:32 Maya: Absolutely. Very true. And for it being your first film, you were great. I loved it.

00:00:39 Laurie: Thank you.

00:00:40 Maya: This is the Healthy Lifestyle Solutions Podcast, and I'm your host, Maya Acosta. If you're willing to go with me, together we can discover how simple lifestyle choices can help improve our quality of life. Let's get started.

00:00:55 Maya: Welcome back to another episode, my friends. This is Maya, your host. And so today, I have the pleasure of speaking with Dr. Laurie Marbas, a double board certified family medicine and lifestyle medicine physician, who has been utilizing food as medicine since 2012. Dr. Marbas is the co-founder and chief medical officer of Mora Medical, which offers physician-led medical groups that employ the power of lifestyle medicine to help patients achieve health. She is the former founder of plant based TeleHealth and the first managing

editor for the Plantrician Projects International Journal of Disease Reversal and Prevention. Dr. Marbas is also the host of the Health And Mora podcast, whose mission is to provide resources that will empower individuals with the knowledge , mindset, and inspiration to  successfully adopt lifestyle interventions and achieve health and wellbeing. As always, the full bio and the links for each of my guests can be found on the website, healthylifestolutions.org. And welcome, Dr. Marbas.

00:02:01 Laurie: Thank you for having me. I'm excited to be here. 

00:02:04 Maya: Well, I'm excited to have you. This is wonderful. Several reasons why I was eager to have you on the show and let the listeners know, first of all, just who you are. I've known of you. I've listened to your podcast for quite a while. So just you have such an exposure in this plant based world. I didn't know that as I was reading your bio that you contributed to the journal.

00:02:31 Laurie: I actually helped create it. There were three of us on a phone call, Scott Stoll, myself, and one other person who helped fund it. And they're like, “Laurie, we're asking you to create.” And that's what we did. And so then we brought on Kim Williams and everybody. And I was there till 2020, October 2020, and then turned it over to some willing and very capable hands of Katie Adair, their newest managing editor.

00:03:01 Maya: Yeah, well, a great job on that. Like I said, I don't know how I did not know that. So that's wonderful. And then you're one of the people that was responsible for creating plant based TeleHealth. And today, you have a new group, which we'll talk about as well. I'm very excited. I think it'll be important for my listeners to know what services you offer via TeleHealth. And then another thing that I wanted to touch on today was your participation in the most recent documentary. It hasn't quite been released yet, but I did have Nelson Campbell on the show. And I saw the documentary and loved what you did with patients. So I was hoping that when we get to that point, we can talk about what jump starts look like and then why sometimes people don't stick around when they've seen results. And there's that whole psychological component and the support that people need. So I’m very excited. Yeah. So tell our listeners a little bit about who you are in terms of your interest in medicine, and also how did you learn about using food as medicine?

00:04:15 Laurie: I'll give you the abridged version. Basically, I wanted to be a physician since I was about the age of 10. My sister was very ill. She was six years younger than me. At age four, she had surgery, and it literally turned her from a sickly child to one that literally was a pain in the neck type little sister. And when I was 10 and I saw this transformation. And we spent time in hospitals, and my parents were speaking to doctors. And I was like, “I want to do that when I grow up. I want to help people get well.” And it was like a burning center that just grew and grew and grew. And then proceeded to finish high school, college. I stayed home, though, for six years and had three kids. And then I went back to medical school when they were five, three and 10 months. And now actually my oldest is a physician finishing up, about to start her third year of family medicine residency. So that's fun. 

00:05:10 Laurie: And then as far as the plant based diet, what was interesting, I was in the military. I was in the Air Force, active duty for four years. And I came back. After we got out, we moved to Colorado. We love the outdoors and just partaking in anything fun and adventurous. And so that's when we ended up on the western side of Colorado in a little town called Rifle. So it's literally the name of a gun. What a wonderful place for a vegan to start their journey, right? But I worked there at a great little place, hospital there, Grand River. And it's a Critical Access Hospital so that means that there's not very many hospitals available in that area. For example, there's no pediatric ICU on the entire west side of Colorado, at least the last that I was aware of. And that's a big deal because the thing that's separating the west side of Colorado and the east side of Colorado, in case you've never heard of these things called the Rocky Mountains. And that's significant for many reasons. 

00:06:11 Laurie: And so also that means a lot of specialists aren't available on the west side, the rural parts of Colorado. So [film] medicine, you're doing a lot of different things, which pertains to the story. But I had a patient come into me one day and say, “Hey, Dr. Marbas, meat and dairy upset my stomach.” I said, “Okay, stop eating meat and dairy.” This was in 2012. And back then, of course, it's still called Rifle. It's a little town. It's 12,000 people. There's not going to be plant based restaurants. And when I suggested her stop eating meat and dairy, I mean, I understood there were foods that she would be able to consume. But it didn't literally sit in my brain that this was a plant based diet or a vegan diet. 

00:06:53 Laurie: And she went on about her way. I made some notations in her chart so that when she came back in 30 days, we would just see how she was doing. And during that visit, she actually brought her daughter with her. So her daughter missed school in order to return to her mother's appointment. In my mind, I'm thinking, “What am I going to speak to a teenage daughter about?” That usually it means mom wants me to do the hard lifting of some difficult conversation, like STDs or sex or something. So those are my mom thoughts go. And so what was fun was instead she turned to her daughter and said, “Tell Dr. Marbas what you did.” And I said, “Uh-oh.” And she goes, “Well, I'll tell you. I wanted to help my mom focus on this healthy diet, so I decided to help her cook. And we went shopping.” And she helped her do all those wonderful things. And she goes, “I felt so good that I stopped my ADD medications. So these are attention deficit disorder medications, two of them, which she had been on since the age of 11, and she was 16 at the time. 

00:08:01 Laurie: And I'm sitting here going, “Wow, that's awesome.” And her mom's looking at me going, “Why was she able to do that?” And I said, “I don't know, but that's the coolest thing I've ever heard.” And we really did a deep dive on what they were doing. So what they were eating was fruits, vegetables, beans, whole grains, nuts and seeds, all plant origin. There was no processed foods, because again, we lived in a place that 11 years ago, there was not a whole lot of vegan processed foods available, much less in a little rural town in western Colorado. And I was astounded. So I took the time, right after her visit, that appointment. And I Googled plant based diet and ADD, the first book that came up, which of course was T. Colin Campbell's book, The China Study, which is so interesting how the world Happens. And anyway, my relationship with the Nelson's has been such a joy in my life. But regardless, Nelson's with the Campbells. 

00:09:01 Laurie: So I read that book. It came. I read it literally in two days. It's 400 pages. And I'm just sitting here reading it going, “They're turning off cancer with food. What is going on? And as I started really diving into understanding the food is medicine paradigm, that was just like, shift, my brain. I really started understanding the inflammation was a key component here, I think, at least for her daughter, and in many chronic diseases. And I'm thinking, “Wow, two things. How am I going to bring this to my practice? But how am I going to do this on my own?” Because I really feel very strongly that you need to be walking the talks. If I'm going to tell patients not to smoke, I shouldn't be a smoker. If I tell them to exercise, I should be

exercising. And if I tell them to eat a plant based diet, I better be eating a plant based diet because I'm not sure how else I can give advice if I'm not living what I'm giving. And I found that to be very helpful as a doctor, as a mom, as just a friend, as a human in general. 

00:10:01 Laurie: So the really fun thing was within about two weeks, as I was trying to just figure this all out, reading more information, how to transition, I hadn't really brought it to the family yet because I understood at that point. Because the kids then were 18, 15, and 13. And I was just like, “Mm-hmm” and my poor husband. And I was like, “How am I going to do this at home, living in Rifle, Colorado? What am I going to cook?” Whatever. And then I'm like, “How do I bring this to patients? How do I transition them? What am I going to say?” All these things. And I found a few articles on McDougall's site which were helpful for physicians. But during these two weeks, I had another patient come to see me and she had lupus. And the interesting about lupus, this is an autoimmune disease. It can be terminal. It's devastating, right? It affects a lot of different organs. And there's no typical case of lupus. It'll affect people differently and at different rates.

00:11:04 Laurie: But this patient was on 12 different medications. She was about 50 pounds overweight. And she had really high inflammation, I mean, just significant. And she was already on methotrexate, which is an immunosuppressant, high doses of steroids, and a variety of other pain medications. And she came to me and she was like, “Dr. Marbas, I'm having headaches daily. I don't think I can continue to work. She was younger than me at the time. She had been diagnosed about two years earlier. And as I'm looking back at her whole lifestyle, it was much more than food, right, that affected people. It was stress. It was other habits. Just a lot of different things. But for me, the one thing that I could make a suggestion for her was focusing, what was on the end of her fork. 

00:11:48 Laurie: And she was telling me all these things. I said, “You know, I can't prescribe any more medications for you, at least as a family medicine doctor.” And there was no rheumatologist on the west side of Colorado. I said, “Why don't we change what you're eating?” And I told her this story about the other patient. And I said, “Let's measure a thing called CRP. It's an inflammatory marker in the blood.” And it was three times high normal. And the cool thing was, when she came back in two weeks, it had dropped almost 300%, so it was just outside of normal. She had lost eight pounds and her headaches were improved. Fast forward five months, she was 50 pounds lighter off 7 to 12 medications. And in about a period of a year and a half to two years later, she actually had negative lupus antibodies off of medications made to suppress the immune system and all these different things. 

00:12:41 Laurie: Anyway, when she came back after and I requested her to follow up in that, two weeks, after two weeks. I went home. It was a Friday. And I told the family, “We're going on a plant based diet as of today.” I literally took a garbage bag and I put the milk, the eggs, the cheese, meat, whatever I had in the house into the garbage. And I had a quarter of a grass fed beef in my freezer in my garage. I wasn't quite sure how to dispose of a large carcass of meat because in western Colorado, there are things that you don't want to attract, like large animals, like mountain lions and such. We lived where you could literally see the Colorado River outside my front door, so you're literally in the mountains. And so that was a Friday. 

00:13:29 Laurie: So Sunday, we went to church. We came back home, and that freezer broke. So this is no less. This is 36 hours later, right? And the stench and just the seeing, yeah, it had been melting for a while. My husband was like, “Laurie, if you hadn't been with me, I could have sworn you would have unplugged the freezer.” I said, “I think that's a big sign from the big man upstairs saying, “You're done.’” And they haven't eaten meat or dairy, at least intentionally. There might have been, in something, unintentionally, but since then. And that's been 11 years. All three children are now plant based. My husband's plant based. And then I just started on a

quest to get it to patients and learned a lot since then. 

00:14:14 Maya: Oh, my God, what a beautiful story. That's incredible. Especially, that you were willing to walk the talk and do what you're preaching. And that's really because you saw that there was science behind it as well. 

00:14:28 Laurie: Well, there's that. And it's just for me, I'm just ingrained that way. I feel like I'm lying to someone. If I tell you to do something and I'm not doing it, how can I in good conscience do that? And I just like to sleep well at night, and the easiest way to do it is to have a clear conscience. So it's just been a principle of life that's done me well.

00:14:54 Maya: Yeah, that's important to me as a patient. I know that it's very hard, and that's why we'll talk about telemedicine. But people often come to  us, asking for PCPs that are plant based, and we don't know any here in Dallas at least. We'll talk about that. And so that's been one of my biggest frustrations. And now there is a physician that will encourage you to eat plants if that's the diet that you choose. But he won't choose it for himself. And it's very difficult for me to refer people to him. I'm very open about it. I'll tell them. He'll agree with you because at the end of the day, it works for his business, but he's not willing to do that for himself. And it's so frustrating because I was having this conversation with another podcaster recently. I just happened to ask him, “How many times have you gone to your physician and asked, ‘Is there anything that you can do to improve your health?’” And they'll just throw out the general terms of nutrition and exercise, but they never really go into detail because they may not know exactly how to help you. So it's important for us to learn about doctors, like yourself, who embrace not only plant based nutrition, but lifestyle medicine. So how did you learn about lifestyle medicine?

00:16:18 Laurie: Well, it was a process, so I was already very active. We had already eaten. And I was unfortunate growing up, that I came from very humble beginnings. There wasn't a lot of money, and it was a difficult childhood in a lot of senses. But the one thing that was to my advantage is that we grew most of our food, like our vegetables and things. They would have meat, but it was expensive. So we had meat a couple, maybe three or four times a week. And then we had a lot of beans and potatoes. I could eat my weight in beans. I've never had trouble. It's funny when people saw they transitioned to a plant based diet and the beans cause them trouble, I was like, “I have never had trouble with beans. Like, never in my life.” My microbiome is ready for beans, which has been good. And so we never eat the processed food, even box cereal. My mom's like, “Yeah, that box of grits and oatmeal are going to feed you a lot longer than just raisin brand or something. And then when we'd go to visit my grandmother, she would indulge us with different things like sodas and box cereals and ice cream, which I ate, but I didn't have the taste for it, right? I didn't crave it. It was not part of my normal life. 

00:17:37 Laurie: So there was that piece. So we had already eaten healthy. We were already active. I was active duty in military, so the kids were always in sports. So we already lived those lifestyles. But when I saw the power of the food and how that also enhanced everything,  right? So it enhanced our activities. It helped with Gabriel, my youngest, when he used to have these horrible abdominal cramps. And it come to find out it was dairy. I mean, this kid would lay it out. I mean, he's a tough kid. I mean, tough kid, like some things I've seen him deal with in sports. I was like, “He would just flat out, just be knocked out.” And so that was quite remarkable for me. 

00:18:18 Laurie: But as I started doing more research, looking for resources to the practice, I came across the American College of Lifestyle Medicine and took their first sports certification offer back in 2017 and passed that, which was great.  So Michael Greger was in the room with me. I was like, “Really? Someone's going to bust the curve there.” But I still passed. It was all good. And so that was really fun. And it's just lovely to connect with the like minded folks. When I go to these conferences, my husband says, “Oh, you're going back to the mothership to plug back in and get rejuvenated?” I'm like, “Yes, that's exactly what I'm doing.”

00:18:54 Maya: That's a great way to put it. I love that. And I did see you at the recent Lifestyle Medicine Conference in Orlando, and that's when I met the rest of your team, or part of your team. You now have Mora Medical. Now, two of the people that you introduced me to lived not far from where I'm at right now. And so we had an event in the fall and I just thought, “Well, why not invite them and see if they want to tell our group what they're about?” And then I want them to be able to come on the podcast as well. And I might have mentioned I also had [Dr. Rock] on the show. And hearing his perspective, for me, it's so refreshing. Again, as a layperson, as a patient, to hear that decisions come back to life, that they were experiencing fatigue and burnout from the same way of practicing medicine, that when you learn and embrace lifestyle medicine, suddenly you're doing it for yourself as well. So you see an improvement in your own health and then in how you speak with your patients.

00:20:00 Laurie: Absolutely. I get, if not daily, definitely three or four times a week, emails from PAs, nurse practitioners, doctors, you name it. Dietitians, coaches who would want to come work for us. And I'm at full capacity at the moment. We're bringing on some doctors later this year. And they're all the same. They're basically saying, “I love what you're doing. I love the idea of practicing lifestyle medicine with every single patient.” And there's plenty of patients to go around, but there's limited opportunities for physicians and other clinicians to actually practice lifestyle medicine. So I think there's plenty of opportunities to learn about lifestyle medicine. The ACLM does a wonderful idea or wonderful job of sharing those resources. But the actual practice of lifestyle medicine on a day to day basis and utilizing insurance, right, like Medicare, Medicaid, and all the commercial payers to actually increase access is there's very few of us. I don't know of any that are national like we are. But yeah, this evolved out of my experience with plant based TeleHealth, which we sold last summer. And then we started more because I really felt strongly that we needed to utilize insurance and increase our access.

00:21:19 Maya: Well, speaking of insurance, so was that different from the model that you had with plant based TeleHealth?

00:21:24 Laurie: Yeah.

00:21:25 Maya: Okay. 

00:21:25 Laurie: Yeah. So plant based TeleHealth was one on one structures where we're doing group medical visits here. We do, do some one on ones. But the point with plant based TeleHealth was that it was strictly cash and we kept it at the lowest possible rate because we understand that that was a significant cost to the patient. But at the same time, it was the fastest way we could actually get into the landscape of offering at least plant based medicine, which basically is lifestyle medicine because we talked about sleep and exercise and all those things to our patients. But we were very fortunate that, I should say fortunate and unfortunate. But we launched March of 2020, plant based TeleHealth. And so it was right when the pandemic hit. So telemedicine was known, but it wasn't known to everyone. So the concern about educating people to what telemedicine was, was done for us. And so the silver lining of COVID was that it made us easy to launch our business and then we got some great doctors involved. And yeah, we helped really shift the health of a lot of patients. So it was really fun. 

00:22:40 Maya: Yeah. And I remember there was another group that I was also trying to highlight their providers because they also offer telemedicine and really wanting to emphasize to my listener the value in all of that. Now, the model that you're talking about also, I want to explain because I've seen it with my husband as well in wanting to implement lifestyle medicine into his practice, and yet he's still doing procedures and his work is keeping him very busy. But insurance companies do not necessarily pay you to talk about nutrition, to talk about  stress management with your patients. You're very limited with time. And then, of course, I guess the models that some of the physicians, that become trained in lifestyle medicine, take is, what is like the DPC. It's called DPC, right? 

00:23:34 Laurie: No. So the direct primary care model is typically cash pay, but I'm assuming there are lots of other ways that people could certainly accept insurance. The problem with that, however, if you accept insurance, they're going to give you limited money. And so it'll be very tight, and it'll be a lot of hard work. The idea behind the group medicine visit, which was, really, helped you, is one. Not only are you seeing multiple patients at a time you can bill appropriately, but the group model builds this community piece where we're really seeing patients are struggling to do this alone. But when they feel like there's a group of individuals who are also cheering them on and they meet weekly, it's a really extraordinary and powerful experience for the patient and the physician. It’s really fun because honestly, I tell them, “You’re not the hero. You’re the guy in this group medical visits. You're literally sitting here helping the patients understand. One, you are managing medications, and you're discussing the diabetes and the obesity and the hypertension. You're certainly doing doctor things, ordering labs, and such.” But what's really fun is patients will maybe discuss a problem, and another patient will pipe up and say, “This worked for me. I'm happy to help.” That’s cool.

00:24:57 Maya: Community.

00:24:57 Laurie: Yeah.

00:24:57 Maya: Community and support in that group setting. So this is done virtually, right?

00:25:02 Laurie: Yes, it's through our EHR, just HIPAA compliant and through Zoom technology, which, if you're not familiar with Zoom, I'm not sure where you've been the last three years. But it really is remarkable that someone can be sitting in Texas and talking to 10 patients from Florida or New York or Ohio or California. It's just really fun.

00:25:26 Maya: Yeah, I can imagine that. I mean, in any kind of setting, whatever issue the individuals are dealing with, whether it's even loss or recovery, whatever it may be, the group setting always is a true support system. Being able to bounce ideas off each other and share struggles that they're going through. This is pretty cool. So how does it work? Because I saw  that you're certified. You're licensed now in all 50 states. 

00:25:55 Laurie: I am personally licensed in all 50 states in DC. However, because I'm a co founder, chief medical officer, I am not seeing patients. I've got my hands full building the business, and I'm hiring wonderful physicians. Sorry if you hear the dog.

00:26:09 Maya: It's okay.

00:26:10 Laurie: She's a little rambunctious at the moment. But basically, we have launched in Texas, Florida, California, Ohio, New York, working on Colorado. And the reason we have to limit our states at the moment at least, is, one, you have to have a physician licensed or a PA licensed in the state that the patient is located at the time of the appointment. So that takes time. So you're literally talking, 50 different licenses, 51 if you count DC. Yeah. So there's that piece. And then there's the actual payer enrollment and what that means is that I have to apply to be enrolled with Blue Cross or Blue Shield. I have to apply to be in the state Medicaid. I have to apply for Aetna, Humana, and then that process. So there's the Licensure, which takes about three to four months. Then you have the payer enrollment, which takes another three to four months. All of that, you have to pay for. And if they deny you, like Humana is denying me in Texas and California because they said there's too many family practice doctors in those states right now. But it's driving me crazy. I've been known to write CEO letters, which I have, and it's worked in the past. But anyway.  

00:27:23 Maya: Yeah, I was going to ask you, is there anything physicians in Texas can do to request you to be licensed here?

00:27:32 Laurie: For physicians?

00:27:33 Maya: Yeah. Can they vouch for you or request? I mean well, this is for Humana, I guess, is what you're saying. Humana was the one that denied you? 

00:27:43 Laurie: Yeah, Humana. Humana.

00:27:44 Maya: Okay. 

00:27:45 Laurie: So, yeah, Humana. I think probably what would have to happen would be, honestly, a network of lifestyle medicine physicians, and we all banded together and created our own group in the sense for “enrollment purposes,” right? So we would have an umbrella network, and then we would utilize each other's group to bring them on. You still have to go through the credentialing, but at least you wouldn't be denied because the group has already been accepted. So, for example, more medical has been accepted in Aetna, right? And then we bring in our individual physicians who go through the credentialing process and then we can bill. So patients like, “Why don't you accept my insurance?” Well, if you know, there are literally thousands, thousands of insurances across the United States and hundreds in each state. So it's expensive and time consuming, and people have no idea when we say, “Can we take your card? And we can accept it.” Literally, the six to eight months it took to get to that point to say, “Yes, I can take your insurance.” I really wish people understood the difficulty. And then you have to go through the process of signing contracts and accepting what they give to you. Yeah, absolutely. It's great. Well, you would know, as your husband's practice.

00:29:10 Maya: Yeah, I know a lot of red tape and politics and everything that happens in medicine because my husband shares all that. But I also pick his brain. I'm always curious, why this? Why not that? Just all these things. But I think it's important to have these conversations for the listener to know. And often, Dr. Marbas, I have these ideas of, I should have someone that represents or can talk about insurance companies and the limitations, for example, so that the listener can understand, why sometimes there is that frustration when we say, “Well, there is a telemedicine practice, but some of them are more out of pocket.” And the person wants to argue about that, but it's more expensive and this and that. And I'm like, “But do you realize that your insurance company only gives you 15 minutes a year of access to your doctor?” I'm exaggerating, but you are so limited for the amount that you're paying every year for your insurance company. You're very limited. And it's really, the doctor is limited, too. They can't spend that kind of time with you. 

00:30:14 Laurie: Right.

00:30:14 Maya:  And this is why it's important for me to have these conversations so that we can know how to refer patients to you. I almost wish, as we're talking, that I've started compiling a list of people that approach us from here locally that say, “Do you know of a plant based physician?” Because the truth of the matter is that we want people to have the physician that really supports what we're preaching. 

00:30:38 Laurie: Right, exactly. No. We call our group visits circles. So we have three primary types. We have those focused on chronic disease and reversal, if not at least improvement, but hopefully reversal. And then the second one is weight loss. So a lot of patients really struggle with just weight loss in general. So we consider ourselves the alternatives to medications. Now, it doesn't mean that we wouldn't use medications if needed on an extraordinary basis. And then we have plant based circles. So the plant based circles is a five week program that typically these are folks who've already been on a plant based diet or maybe struggling to optimize the diet. Maybe their cholesterol remains high. Their hypertension remains high.  They're struggling to lose weight even though they've lost them on a plant based diet. They want to make sure they're optimizing supplementation if need be. And so those are those three primary groups that we have.

00:31:34 Maya: This is wonderful. So whether you have a condition that you want to help improve weight loss, that's a big one for everyone. But I love the idea of supporting people in weight loss because it's not so much about just losing the weight, but reducing your risk for other complications along the way. And then the plant based circles, the people that are wanting to have that support, this is awesome. Now, could you speak directly to my listener right now and tell them how they can get started? Like, if they wanted to work with one of your practitioners, how do they get started? What's the value? I mean, we talked a little bit about it, but what's in it for them via telemedicine, as opposed to the short visits that they get with their physicians? 

00:32:27 Laurie: Right. So the first thing to understand is the value of lifestyle medicine. So what is lifestyle medicine? Which I'm sure someone's listening to you, they already understand.  But I'm going to just reiterate it from the perspective of me treating a patient. I'm going to be looking and focusing in on the things that are really important for you to not only change  behaviors, but sustain behavior changes that are going to help you improve your life. But it's not only your physical health, but your mental, your spiritual, all of those things improve when you start taking better care of yourself and doing the things that our human bodies were meant to do. We live in a very abnormal state, right? We live in houses and have things literally delivered to us from the touch of a button on our phone. It can be processed foods and all these different things. We don't move anymore. We're sitting all the time. So when we think about that, we're going to focus in on a healthy diet. Of course, it's a whole food plant based diet. A focus in on movement. It doesn't have to be prescribed exercise, but just movement that you enjoy. For example, my husband and I are going to be doing West Coast Swing classes starting on Friday, right? So that's fun. And I'm doing kickboxing tonight. I'm training for a half marathon, so I do kettlebell. 

00:33:44 Laurie: So all those different things, you go hiking, you go skiing, whatever it is, just movement in general. It could be running up and downstairs, whatever you enjoy. Playing with your kids. I mean, little kids can definitely take a balloon and blow it up and start dashing. So anyway, movement in general. Got off the sidetrack there. Sleep, really focusing in on sleep. So is it restful sleep? Are you sleeping a full seven to eight hours? How do you feel when you wake up? How's your energy level throughout? Looking at different medications that can affect it. We're really looking at the deprescription piece because there are a lot of medications that will be weight promoting, meaning they cause you to gain weight. They can cause side effects and you're taking another medication for. So we're really big on looking at medications, interactions, side effects. 

00:34:31 Laurie: And in addition to that, we're looking at stress management because we're all going to have stress. I have yet to have a day that there's not some stress provoking event, but it's how you respond, right? So that's that discussion. And then there's community, which we address just by being in a group, but also help you deal with your community that you reside in. And then of course, trying to encourage people to remove any toxins such as smoking and alcohol consumption. We really focus in on that. But there's another piece of this that I think is really important that Mora, we really focus in on, is understanding the behavior change. And we geek out. Geek out. Like geek out is nutty. It's an understatement on behavior change and sustainability. And one of my favorite things about that is really understanding how we speak  to ourselves. Because literally, it's this three pound organ between your ears that is going to make you or break you. And as soon as someone understands that they literally can talk themselves into wellness, the most amazing things start to happen in their life. And it's really fun to see someone have an awakening of sorts, to understand that the self talk, that voice inside your head, that's chattering to you at all days, hours of the night, day, really is important to change your programming. And there's some ways and strategies to do that.  

00:35:52 Laurie: So those are the things that we offer. Those are the things we really focus in on, on the prescription of lifestyle medicine. Then there's the managing of the chronic condition. So it's decreased prescribing insulin, deprescribing oral medications for hypertension, helping people understand their labs, what they need to do to maybe optimize what they're already doing. And coming from a physician, that's really key because they have the training of the body and the biology and the physiology and all the pathology that comes with chronic disease. But as lifestyle medicine physicians, we also understand how to optimize health. So when you put those two together, it's a really powerful platform, so to speak, that you can engage in, to allow yourself an opportunity to ask the questions that you couldn't ask,

maybe another primary care doctor because they haven't taken the time to educate themselves and go deeper, even still beyond the basic pillars of lifestyle medicine. Really, how do you practice this to an individual ? Even though you're in a group, you're still getting personalized attention.

00:36:52 Maya: I love that. And it's the personalized attention with a physician that already knows. I want to say holistic in terms of the whole individual understanding the pillars of lifestyle medicine, whereas most of our physicians are not trained in knowing even how to encourage you to manage your stress. And it's interesting, Dr. Marbas, because as we have gotten into really understanding the pillars and reading about the science behind why we want to improve our lives in these areas, we work hard in applying those into our own lives. So it's a little checklist I go through. Okay. I feel like I've mastered the nutrition part. I've been doing that for quite a while. I have a good system now. I have the foods that work for me. Just the other day I was thinking, “Okay, got to work on my sleep, I know how important. What do I need to do to start going to sleep a little earlier because I am a night owl?”

00:37:53 Laurie: Right. And understanding that each individual is going to have maybe you are. There's three different types of people. There's those night owls. There's the early [PCOS] who wake up. And there's just the in between and how to work optimally the best you can in the modern world to get your best sleep. And as we age, right, an aging woman might be a little different than an aging man or a mom of young children. What can we do to improve their sleep? And given their very specific circumstances.

00:38:21 Maya: Yeah, and actually that brings me to a point now that you're saying like the age, but also specific circumstances. So you take into consideration what the individual is going through. If we're going through menopause, for example, our anxiety might be up a little bit more. We have the hormonal imbalances that are happening. So then you know how to tweak those as well and work with us,

00:38:42 Laurie: Right. Exactly. And it's really interesting. I think there's some really interesting discussions. We certainly don't have all the answers around menopause and things that we could do to optimize it. But I don't think we have to suffer as much as we do in the United States because when you look at other populations, for example, in Japan, where they have a lot of the blue zones. Like in Okinawa, women are significantly lower risk of suffering menopausal symptoms that we consider, “Well, this is just what you go through.” It's the sleep difficulties, the weight gain, the emotional imbalances, the hot flashes, all those things because they live a different lifestyle, they tend to suffer because they're coming into menopause in a healthier state. And for me, that's just getting back to the basics, see what's left over, and then we address those more particular, difficult problems because maybe there's something else that is occurring. 

00:39:34 Laurie: And so some people just say, “Oh, these are your hormonal fluctuations. We need to give you more hormones.” Well, I'm not a big fan of prescribing hormones unless we absolutely have to because I certainly have prescribed hormone replacement therapy. But again, that comes back to the individual. Maybe they've done everything like you said and they're still struggling. Well, then there's genetics they take into consideration, or maybe there's just some things we need to help. And it may be life altering and changing for those folks, but now at least, we're going to be using the least amount of medication to get the highest benefit.

00:40:06 Maya: Absolutely, yes. And I want to make sure that I don't forget to bring up your participation in From Food to Freedom, the second film that Nelson Campbell put together. And I'd love to learn how you got involved and then I like the listeners to know as well because the reason I bring it up is a couple of things. I'm a leader. I'm a Pod leader here in Dallas as a result of the first film, PlantPure Nation. And in the past, we've been known to host local events, to help educate our community about the power of nutrition and now lifestyle medicine, too. So the second film, once it comes out, and I think that Nelson mentioned. It might prerelease on, I think, the Food Revolution through Ocean Robbins. And then he has encouraged us, if possible, to try to screen it at a local theater. And I'm thinking about doing that and see if I can gather a group because it's going to get us really excited. And you're in it. 

00:41:07 Laurie: Yes, I’m in it.

00:41:08 Maya: So tell us. Yeah, I’m so excited.

00:41:11 Laurie: That was my first documentary so that was fun. I'm in it because Nelson called me up and said, “Hey, you want to come do this?” I'm like, “Sign me up.” And so this was October of 2021, and so I actually celebrated my birthday with these 10 people, too, which was really fun. So I turned 51 with a bunch of strangers, except for Kim and Nelson, of course. We're not strangers. We literally spent 10 days in Greensboro, North Carolina, in this beautiful home. And Kim and another chef friend of theirs actually cooked for us for 10 days. I was like, “Do I have to go home? This is delicious.” And if you don't, Nelson and Kim, they're just the most loving individuals, and they're just so moved to serve others and do good things. And so it's really fun to be around people like that. 

00:42:07 Laurie: And so what was really cool was you meet these individuals, and we walk into the homes. We had eight, and six of them were type two diabetics on insulin. Two of the others that were not were spouses of those. And over the course of 10 days, we hooked them up with CGMs. We saw they learned about their blood fluctuations, so we could literally watch them 24/7. We just watched food do their magic. The other thing that we did was we spent a lot of time talking. We did a lot of walks, talking about different things, teaching them how to cook this way, how to, when they get ready to go back, doing the best we could to prepare them. 

00:42:49 Laurie: And we had great results. We pulled off, four of them off the insulin. The two others were dramatically dropped, like 95%. And the cool thing was really seeing their change of attitude in that 10 days. Now, I don't want to give away the ending, but 50% did very well. The other 50% fell off and went back to their old lifestyles. But that gets back to the point of really needing to focus in on community. So the PlantPure Pods, the Pod community is such a wonderful opportunity to do that, but also understanding that the environment that we're living in, right, is so critical to our success, whether it be our health or to our death. And so it really behooves you to think about, “What am I doing in my daily life to set myself up for success? Am I putting foods in front of me that I see that will prompt me to want to eat healthy or am I not? Am I driving by the McDonald?” 

00:43:51 Laurie: I had a patient. It's a good example. They would drive by. Was it Wendy's or McDonald's? I can't remember. It doesn't matter. Anyway, I believe it was McDonald's. Yeah, because I remember saying the golden arches to him. So he would drive by the golden arches on his way to work. And he goes, “Dr. Marbas, I just can't stop myself. I have to go get a Coke. And I have to, of course, by then.” I'm seeing he's like, whatever fast food there. He liked hamburger or whatever. And what was interesting, I was like, “Okay.” He goes, “But I have to drive to work.” I was like, “Can you not go a block out of your way and go a different way?” He goes, “Oh.” I said, “Yeah.” So human behavior is going to have to have that prompt. Something's  going to have to prompt you. And if the golden arches are prompting you, remove the prompt by going, it's one block. And then that really seemed to help significantly. 

00:44:41 Laurie: So just be thinking about you can really design your success or failure. Now, granted, there are times that we are not in control, but then it becomes down to the decision. You get up your children. You get them dressed. You get them out the door. You get yourself dressed. You go to work. You do the things that you want to do. You brush your teeth. You shower. People literally do daily tasks that they need to survive. Why can't you just make these smaller habits that has such a great impact over time? Because I guarantee you, you're 10 years from now or 20 years from now, that self that's living in that future is going to turn around and say, “Thank you for taking the time and investing in their future.” And think of it as another person because it really is. That person is being molded with your decisions that you're making right now.

00:45:28 Maya: Absolutely. Very true. And for it being your first film, you were great. I loved it.

00:45:35 Laurie: Thank you. It was quite a challenge walking out because you didn't leave the bedroom, and so you were like properly because there were cameras watching you. And I was like, “Oh, my goodness gracious.”

00:45:46 Maya: Oh, my God. Yeah. I had the opportunity just to tell the listener to watch it as a  leader, as a plumpier leader. Again, the tiers. I'm always impacted, Dr. Marbas, by the stories that people tell, the hardships that they endure as a result of having health problems or seeing health problems in other people that they love. So it's moving. It's wonderful. And then also, you do. So these are 10 days. They're considered 10 day jump starts. So you do the biometrics.

00:46:19 Laurie: We do blood work. We did blood work there, and we did blood work at the end of the 10 days, and it was amazing. We saw significant improvements in blood sugars, obviously significant improvements in cholesterol and weight loss. Those three things people are always discussing, right? We're discussing weight loss. We're discussing, they want to feel better. They had more energy. They had less pain, all in the span of 10 days. 

00:46:47 Maya: That's the part because I agree with you. We don't want to give it away, but people are going to want to see this movie no matter what, because it's just as encouraging. We need another good film. It feels like every two years, we need something good to watch. But it does impact me when I see that people see an improvement in 10 days. And then a month later, they're like, “Well, I'll have the cookie and I'll have this and that.” And then before you know it, they're back to these things. And I agree with you that the support is so important. I believe. And I could be wrong, but I believe that the average person would eat healthier if they didn't have to cook the food themselves. If the food were to be catered every day, they would eat the food.

00:47:32 Laurie: Yeah, I would say for the majority. And it tastes good, right? But the amazing thing is this food can taste quite delicious. You just have to take the time to invest in the cooking skills that many of us lost or were never taught, right? And so that's the important piece to understand. Again, people who will, do spend hours watching television, which is, why can't you spend an hour prepping food on a weekend? So you can eat better through the week and have more energy to do more of the things that you love. And at the end of your life, look back on and said, “Man, I'm so glad I was able to spend time with my family because I was less sick, because I chose to invest in the foods that were going in my mouth, the environment that I was living in.”

00:48:16 Laurie: And just think about your future in the sense of, ”Where am I going to be at the end of this life? What do I want to look back and be thankful for and glad that I made those choices?” It's not because you're working more. It's not because you spent more time on YouTube or scrolling through media through the death scroll, right? It's literally spending time with your family, spending time with those you love, and doing the things that you enjoy. And that really comes down to investing in those small little habits that have such a huge impact. And what's on the end of your fork movement? Sleep. All those things matter.

00:48:47 Maya: Absolutely. Yes. Wonderful. Okay, so as we're closing, Dr. Marbas, is there anything else that you'd like to say to my listeners? And then again, we'll share websites. 

00:48:58 Laurie: Sure, yes. Thank you. That's mora.com. It's M-O-R-A.com. And like I said, we have intake teams, so if you have any questions, feel free. There's a phone number there you can call. Someone will answer it seven days a week and would be happy to work with you, especially if you're in the states of Texas, Florida, California, New York, Ohio, or Colorado at the moment. I know I can hear the people going, “What about North Dakota?” I'm working on it. So it just takes time. So we've been focusing in on populations in places that we have folks like yourselves who can refer to us, where we have a strong network, like, I have a very strong network in Colorado, for example. And yeah, so those are the main things. And write to your insurance companies and tell them to cover Lifestyle Medicine and to really say, “I want to partake and see these type of individuals. Why aren't you covering it?” We bill as family medicine and internal medicine. But if you belong to Humana in Texas, write them and say, “I wanted to see more covered, but you guys denied them. Why?” Please. Or if you're in Humana California.

00:50:06 Maya: Oh, my goodness. Well, that's a great idea. You just gave me the idea. I don't know if you have a template with the proper, right, but maybe just creating a template that people can personalize and then send over.

00:50:18 Laurie: Send to their insurance company. Yeah, that's a great idea.

00:50:21 Maya: To get the ball going, to cover Lifestyle Medicine because it's becoming well, we're very fortunate that we know these things. Some of us, I take care of my own health now. Not always, but now that I know my Lifestyle Medicine, I know what I need to do now. But individuals need support. And they need well informed physicians like your group. So this has been wonderful. Dr. Marbas, thank you so much for coming on today. 

00:50:49 Laurie: Well, thank you for having me. And it was such a joy to speak to you because, again, these things are dear to my heart and I just hope that we can help some people. 

00:50:57 Maya: Yeah, I'm sure we did. I can't wait to send people over to you as well because people have been knocking on our door and so now we have you. So thank you again.

00:51:06 Laurie: Appreciate it.

00:51:07 Maya: That was such a wonderful conversation. Friends, we would like to thank Dr. Marbas for joining us today and sharing her expertise and experience with us. Her work in utilizing food as medicine and promoting lifestyle interventions to achieve health and well being is truly inspiring. We encourage you, the listener, to check out the podcast Health and Mora podcast and visit Mora Medical's website, mora.com, to learn more about their physician-led medical groups that employ Lifestyle Medicine to help patients achieve optimal health. Thank you for listening and we're going to catch you in the next one. Again, thank you for being a listener. 

00:51:50 Maya: You've been listening to the Healthy Lifestyle Solutions podcast with your host, Maya Acosta. If you've enjoyed this podcast, do us a favor and share with one friend who can benefit from this episode. Feel free to leave an honest review as well at ratethispodcast.com/hls. This helps us to spread our message. And as always, thank you for being a listener.