Podcast appearances and mentions of Robert F Kushner

In this episode, Dr. Jaime Almandoz, Associate Professor of Medicine at UT Southwestern, is joined by Dr. Robert F. Kushner, Professor of Medicine at Northwestern University and a leading authority in obesity medicine, to discuss the recent Lancet Diabetes & Endocrinology Commission report, “Definition and Diagnostic Criteria of Clinical Obesity.” The report introduces a new framework for defining clinical and preclinical obesity, aiming to move beyond the limitations of BMI. Dr. Kushner shares insights into the Commission's global consensus process and how the updated definitions can transform care, reduce weight stigma, and support more targeted treatment. Don't miss this timely conversation on the evolving future of obesity diagnosis and management.

New weight-loss drugs have transformed care for people with obesity. In this Clinical Reviews podcast, Robert F. Kushner, MD, MS, of Northwestern University Feinberg School of Medicine joins JAMA Deputy Editor Mary McGrae McDermott, MD, to discuss prescribing these drugs to improve health outcomes and minimize adverse effects in people with obesity. Related Content: Medications for Obesity

Sanjiv J. Shah, MD, and Robert F. Kushner, MD, join a thought-leader panel to share their insights on the connection between diabetes and heart disease, as well as using semaglutide medication for prevention. They discuss the outcomes of their recent clinical trial studies published in the New England Journal of Medicine, SELECT and STEP-HFpEF. These studies aimed to measure the effects of semaglutide in patients with obesity and pre-existing cardiovascular disease, and Dr. Kushner and Dr. Shah explain how the studies' results complement each other and inform patient care.Dr. Shah is director of Research at Northwestern Medicine Bluhm Cardiovascular Institute and Dr. Kushner is professor of Endocrinology at Northwestern Medicine.

WE APPRECIATE OUR PARTNERS. CHECK THEM OUT!NAD+ for Brain Health: https://innovativemedicine.com/DAVE and save 20%Apple Cider Vinegar Benefits: https://paleovalley.com/DAVE, use code DAVE to get 15% off your first orderNon-Tobacco Nicotine Alternative: https://lucy.co, use code DAVE20 to get 20% off your first order of pouches, gums, or lozengesIN THIS EPISODE OF THE HUMAN UPGRADE™...…you'll learn about semaglutide, a new weight loss drug that's been getting a lot of attention. Highly respected obesity expert Dr. Robert F. Kushner joins the show to talk about new research findings. He was part of a team that published semaglutide study results in the New England Journal of Medicine this past year. Looking into semaglutide, typically used for Type 2 Diabetes, showed that it also reduced body weight.We talk about how you might use semaglutide, both from an aging perspective and from a weight loss perspective. You look at risk reward for everything you can do, and then you decide what's going to work best for you. There's some interesting knowledge to be gained from the research on semaglutide.Here's the short version of how it works: “Semaglutide mimics our naturally occurring hormone called GLP-1,” explains Dr. Kushner. “When you give it back to a person in pharmacologic doses or high doses, but it mimics what we normally have, it augments or highlights this feeling of, "You know what, I am really not as hungry as I was before. I'm more full than I was before, so I don't need as much food." It's actually the change in appetite that causes a weight loss that we see with this kind of a drug.”A clinician, educator and researcher, Dr. Kushner has spent his decades-long career on adult weight management for adults. Board certified in both internal medicine and nutrition, he maintains a medical practice, teaches students and medical professionals, and presents around the world. He's written more than 250 original articles, as well as reviews, books and medical book chapters.He's Medical Director of the Center for Lifestyle Medicine at Northwestern Medicine in Chicago; a professor of Medicine in the Division of Endocrinology and a professor of Medical Education at Northwestern University Feinberg School of Medicine.This episode's conversation includes the role of lifestyle in weight management. It's shortsighted to view semaglutide as a wonder drug isolated from diet, exercise and even mental health. It's all related. And new understanding of obesity as a disease and its biological drivers helps the search for lasting solutions, including training for healthcare professionals.Listen on to find out more about semaglutide and six factors that might be causing your weight gain or making it difficult for you to lose weight.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Episode 61: Semaglutide for Obesity.  Dr Arreaza discusses with Dr Carranza the results of the STEP trials: Semaglutide Treatment Effect in People with obesity, which allowed semaglutide gain FDA approval as a treatment for obesity.By Hector Arreaza, MD, and Claudia Carranza, MDThis is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. One of the major challenges of modern medicine is to find an effective treatment for obesity.Obesity was considered a disease in 1998 by the National Institutes of Health[1].In 2002, the Internal Revenue Service, AKA the feared IRS, issued a statement to make obesity treatment a deductible medical expense. Who would have known that obesity was tax deductible?Later, in 2013 obesity was accepted as a complex, chronic disease by the American Medical Association[2]. Many other organizations have made statements in favor or against the definition of obesity as a disease.We recently announced the exciting news of semaglutide as a new FDA-approved medication for the chronic treatment of obesity. Today we want to give you a very brief summary (brief-ísimo) of the trials that allowed semaglutide to gain that FDA-approval. Semaglutide was tested at different levels with the STEP trials. STEP stands for Semaglutide Treatment Effect in People with obesity (STEP). All these trials were done in 68 weeks, all patients received counseling about lifestyle modifications, 70-80% were women, ages averaging 40-50 years old.STEP 1: Does semaglutide cause weight loss in patients without diabetes?The focal point of this trial was weight management with semaglutide in patients without diabetes. This was a double-blind trial. There were 1961 participants enrolled. A group was assigned to placebo and another group was assigned to weekly injection of semaglutide. For the semaglutide group, the goal dose of semaglutide was 2.4 mg, starting with 0.25 mg, increasing every 4 weeks: 0.5 -> 1.0 -> 1.7 -> 2.4 (reaching the goal dose in 4 months), 3 out of 4 participants were Caucasians. Outcomes: after 68 weeks weight reduction was -16.9% in patients on semaglutide, more than 86% of participants had a weight loss >5%, 69% lost >10% of their weight, and 50% percent lost >15% of their body weight, and about 32% lost >20% of their weight. This may be comparable to bariatric surgery in some patients; however, the weight loss is not as dramatic. Other parameters improved were waist circumference, blood pressure, triglycerides. LDL and total cholesterol were not significantly affected. There was a clinical meaningful change in 40% of patients. 7 out of 100 could not complete trial for GI adverse effects, most commonly nausea, diarrhea, vomiting, constipation. Acute pancreatitis presented in 0.2% of the semaglutide group (all recovered during study) vs 0% in the placebo group[3]. STEP 2: Does semaglutide cause weight loss in patients with diabetes? The focal point of this study was weight management with semaglutide in type 2 diabetes mellitus. 1210 patients participated in 12 different countries across Europe, North America, South America, the Middle East, South Africa, and Asia. Patients were randomly assigned to semaglutide 2.4 mg weekly, Semaglutide 1 mg weekly, or placebo. Weight loss was superior with semaglutide 2.4 mg, -9.6% of body weight with semaglutide vs -3.4% weight loss with placebo. As you can see, weight loss in individuals with diabetes is more difficult. The effect on diabetes control was about the same with semaglutide 1 mg vs 2.4 mg. The 1 mg dose reduced A1C -1.5%, and the reduction was -1.6% with semaglutide 2.4 mg. A1C reduction was about the same regardless of weight loss. STEP 3: Does Intensive Behavioral Therapy increases weight loss in patients using semaglutide?Intensive behavioral therapy was put to the test. 611 participants were enrolled. Each patient in this study received IBT: 30 brief sessions, 19 in the first 24 weeks, monthly thereafter provided by a registered dietitian. Participants had obesity and overweight, lived in 41 states in the US, had >1 related comorbidity, no diabetes. They all were put on a low-calorie diet for 8 weeks and were randomized to receive either semaglutide or placebo. Weight loss was accelerated by the low-calorie diet and IBT earlier in the study, but at the end there was only 1% difference between the two groups, 17.6% weight loss with IBT vs 16.9% weight loss without IBT. Further research is needed to determine the potential benefits of including a low-carb diet to semaglutide to increase long term weight loss. STEP 4: What happens to weight loss if we stop semaglutide?The focal point of this study was sustained weight management. Patients were randomized to placebo or semaglutide after 20 weeks, but continued lifestyle modificationsThose who remained in semaglutide, continued to lose weight up to 18% (lost 8% additional weight). The placebo arm gained half of their weight back. If you stop the medication weight is likely to come back. Weight loss comparison: Contrave® (bupropion-naltrexone) and Saxenda (liraglutide) ~5% weight loss, Qysimia® (phentermine-topiromate ~9%), semaglutide (Wegovy®) is about 15%. The average weight loss with semaglutide is higher than other meds, including liraglutide, after 1 year of use. Medullary thyroid cancer: Not shown to be increased risk.Newer medications that act on the GLP-1 receptors are showing increased rates of weight loss.• IBT is less important in weight management if a highly effective medication is used to curb appetite•Improved glucose control and CVD risk reduction is achieved when patients have ≥10% weight reduction•Obesity is a complex chronic disease that requires long-term managementCredit: This summary was inspired by Dr Robert F. Kushner, Professor of Medicine, Northwestern University Feinber School of Medicine. Conclusion: Now we conclude our episode number 62 “Semaglutide for Obesity”. After listening to this episode, we hope you understand the role of semaglutide in the treatment of obesity. Semaglutide has shown to cause weight loss in patient with and without diabetes, and the benefits go beyond weight reduction to include lower blood pressure and triglycerides, among other health markers. Semaglutide is not for everyone, but it can surely be the answer to many of your patients with obesity. Even without trying, every night you go to bed being a little wiser.Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza and Claudia Carranza. Audio edition: Suraj Amrutia. See you next week! _____________________References:Kyle TK, Dhurandhar EJ, Allison DB. Regarding Obesity as a Disease: Evolving Policies and Their Implications. Endocrinol Metab Clin North Am. 2016;45(3):511-520. doi:10.1016/j.ecl.2016.04.004, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4988332/ AMA House of Delegates Adopts Policy to Recognize Obesity as a Disease, Obesity Medicine Association, June 19, 2013, https://obesitymedicine.org/ama-adopts-policy-recognize-obesity-disease/ Wildings, John P.H. et al., Once-Weekly Semaglutide in Adults with Overweight or Obesity, N Engl J Med 2021; 384:989-1002, DOI: 10.1056/NEJMoa2032183. https://www.nejm.org/doi/full/10.1056/NEJMoa2032183 (STEP1) Davies, Melanie et. al, Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial, The Lancet, March 02, 2021, DOI: https://doi.org/10.1016/S0140-6736(21)00213-0   (STEP 2) Wadden TA, Bailey TS, Billings LK, Davies M, et. al. Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults With Overweight or Obesity: The STEP 3 Randomized Clinical Trial. JAMA. 2021 Apr 13;325(14):1403-1413. doi: 10.1001/jama.2021.1831. PMID: 33625476; PMCID: PMC7905697. https://jamanetwork.com/journals/jama/article-abstract/2777025 (STEP 3) Rubino D, Abrahamsson N, Davies M, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA. 2021;325(14):1414–1425. doi:10.1001/jama.2021.3224. https://jamanetwork.com/journals/jama/article-abstract/2777886 (STEP 4) 

Credits: 0.50 AMA PRA Category 1 Credits™ Claim CME/CE credit: http://www.pri-med.com/online-education/podcast/south-2020-kushner-obesity-ask-the-expert  Overview: Get your questions answered by expert faculty in Endocrinology. You ask: we listen. You will learn practical solutions to common clinical challenges and tips to apply the latest knowledge in practice. Please note that any data, indications, and guidelines presented in this activity are current as of the recording/release on February 8, 2020 and they are subject to change as new information is published. Guest: Robert F. Kushner, MD, FACP

Obesity has reached epidemic levels in the U.S., and it is a contributor to the development of diabetes, cardiovascular disease, obstructive sleep apnea, some forms of cancer, and many other diseases. It is imperative that primary care clinicians incorporate obesity care into their medical practice. This presentation will address a practical and time efficient approach for the assessment of patients with obesity and help to formulate a treatment plan. The medical paradigm of lifestyle management, pharmacotherapy, and bariatric surgery will be reviewed along with guidance on how to intensify therapy when indicated.    Guest: Robert F. Kushner, MD, FACP