Podcasts about victoza

It's In the News.. a look at the top headlines and stories in the diabetes community. This week's top stories: Eli Lilly will start a lcinical trial for tirzepatide for people with type 1 diabetes, more details on Dexcom's 15 day G7 sensor, Ozepmic pill form tested, type 5 diabetes identified and more! Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom   Check out VIVI Cap to protect your insulin from extreme temperatures The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode transcription with links:   Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX Our top story this week.. Eli Lilly takes the first steps toward getting tirzepatide approved for people with type 1 diabetes. Tirzepatide is sold under the brand names Mounjaro for type 2 and Zepbound for obesity. The main purpose of this study is to find out how well and how safely tirzepatide works in adults who have type 1 diabetes and obesity or are overweight. Participation in the study will last about 49 weeks. Official Title A Phase 3, Multicenter, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study Evaluating the Efficacy and Safety of Tirzepatide Once Weekly Compared to Placebo in Adult Participants With Type 1 Diabetes and Obesity or Overweight This is a big deal because, even though many people with type 1 are able to get a prescription for tirzepatide, it's not approved for T1D and so insurers won't usually cover it.   https://clinicaltrials.gov/study/NCT06914895 XX The use of drugs like Ozempic, Wegovy and Zepbound in people with type 1 diabetes has risen sharply over the past decade, a new study finds, even though there's little information on the drugs' safety and effectiveness for the condition. The family of medications called GLP-1 receptor agonists includes drugs like Wegovy, Zepbound, Ozempic, Mounjaro and Victoza. But the clinical trials of these medications specifically excluded people with type 1 diabetes, who are dependent on the hormone insulin to survive because they can't make enough of their own. Drugmakers feared that using the GLP-1 medications with insulin might raise the chance of dangerously low blood sugar events, or hypoglycemia, and were unwilling to take the risk of studying them in people with type 1.   For the study, which was published last month in the journal Diabetes, Obesity, and Metabolism, researchers at Johns Hopkins University reviewed the medical records of more than 200,000 people with type 1 diabetes from 2008 to 2023. They grouped the data in three-year periods, starting with October 2008 to September 2011 and ending with October 2020 to September 2023. GLP-1 medication use spiked, as well. Among adults with the highest category of obesity, about 4% used GLP-1 medications in 2008, and 33% did by 2023 – an 800% increase. But these are anecdotal reports and may not reflect instances in which people have side effects or complications like low blood sugar, which can be life-threatening. But Shin says what's really needed is information from randomized, double-blinded studies, in which participants are followed forward in time and given either a drug or a placebo. https://www.cnn.com/2025/04/09/health/glp-1-type-1-diabetes-study/index.html   XX Later this month the FDA will conduct a final meeting regarding a new, investigational compound (sotagliflozin) soda-GLIFF-a-zin that has been shown to Improve QoL and Reduce Long-term Complications for people with type 1 diabetes (T1D). The patient advocacy group Taking Control of Your Diabetes (TCOYD.org) is working to inform the T1D community about sotagliflozin - and to encourage people to sign a Change.org petition directed towards FDA.  Last fall, the FDA declined to approve sotagliflozin due to concerns about a potential increased risk of diabetic ketoacidosis (DKA), despite this being a condition that people with T1D on insulin face and manage daily. While TCOYD respects FDA's caution, the group stands by T1D patients and their physicians who, as a team, balance risks and benefits every day. https://tcoyd.org/petition/ XX Dexcom receives FDA approval for it's G7 with 15 day wear. We have an interview with Chief Operating Officer Jake Leach coming up on Tuesday – we talk about the planned roll out of this sensor, what else has changed, and the fine print in the press release – it says    “A study was conducted to assess the sensor life where 73.9% of sensors lasted the full 15 days. When using the product per package labeling, approximately 26% of sensors may not last for the full 15 days.   https://investors.dexcom.com/news/news-details/2025/Dexcom-G7-15-Day-Receives-FDA-Clearance-the-Longest-Lasting-Wearable-and-Most-Accurate-CGM-System/default.aspx?utm_source=www.diabetech.info&utm_medium=referral&utm_campaign=dexcom-g7-15-day-sensor-gets-fda-cleared-but-will-it-actually-last-that-long   XX Glucotrack is joining something called  FORGETDIABETES bionic pancreas initiative, - this is an European Union project that aims to develop a long-term automated insulin delivery system for type 1 diabetes patients. Glucotrack's Continuous Blood Glucose Monitor (CBGM) will be integrated into the system to provide real-time glucose readings. The initiative's goal is to create a bionic invisible pancreas that eliminates the need for therapeutic actions and reduces psychological burden.   The architecture of BIP encompasses a ground-breaking, lifelong lasting implanted ip glucose nanosensor; a radically novel ip hormone delivery pump, with unique non-invasive hormone refill with a magnetic docking pill and non-invasive wireless battery recharge; an intelligent closed-loop hormone dosing algorithm, optimized for ip sensing and delivery, individualized, adaptive and equipped with advanced self-diagnostic algorithms.     Pump refilling through a weekly oral recyclable drug pill will free T1D subjects from the burden of pain and awkward daily measurement and treatment actions. Wireless power transfer and data transmission to cloud-based data management system round-up to a revolutionary treatment device for this incurable chronic disease. key feature of BIP is to be fully-implantable and life-long lasting thanks to novel biocompatible and immune-optimized coatings guaranteeing long-term safety and stability https://www.stocktitan.net/news/GCTK/glucotrack-to-participate-in-forgetdiabetes-a-prominent-european-cjjldjb0dq7h.html XX A newly recognised form of diabetes, called Type 5, was announced this week at the World Congress of Diabetes 2025. A global task force will investigate this less-understood condition, which differs from Type 1 and Type 2 diabetes. Type 5 diabetes affects people who are underweight, lack a family history of diabetes and do not show the typical symptoms of Type 1 or Type 2 diabetes. The condition was first observed in the 1960s and referred to as J-type diabetes, after being detected in Jamaica. It was classified by the World Health Organisation in 1985, but removed in 1998 due to lack of physiological evidence. At the time, experts believed it to be a misdiagnosed case of Type 1 or 2 diabetes. New research has since confirmed that Type 5 is different. https://economictimes.indiatimes.com/news/new-updates/a-new-type-of-diabetes-has-been-found-by-scientists-and-it-doesnt-show-the-typical-symptoms-of-type-1-or-type-2/articleshow/120276658.cms?from=mdr   XX Oral semaglutide cuts major heart risks in people with type 2 diabetes by 14%, offering a powerful pill-based option. A new clinical trial, co-led by endocrinologist and diabetes specialist John Buse, MD, PhD, and interventional cardiologist Matthew Cavender, MD, MPH, at the UNC School of Medicine, has demonstrated that the oral form of semaglutide significantly lowers the risk of cardiovascular events in individuals with type 2 diabetes, atherosclerotic cardiovascular disease, and/or chronic kidney disease. Results from the rather large, international trial were published in the New England Journal of Medicine and presented at the American College of Cardiology's Annual Scientific Session & Expo in Chicago, Illinois.     The effect of oral semaglutide on cardiovascular outcomes was consistent with other clinical trials involving injectable semaglutide, but more trials are needed to determine if one method may be more effective than the other at reducing major cardiovascular events. https://scitechdaily.com/new-pill-form-of-semaglutide-shows-major-benefits-for-people-with-diabetes/ XX April 14 (UPI) -- The U.S. Food and Drug Administration on Monday warned consumers and pharmacies that fake versions of Ozempic, a drug to treat Type 2 diabetes, have been found in the United States. Novo Nordisk, the Danish-headquartered manufacturer, informed the FDA on April 3 that counterfeit 1-milligram injections of semaglutide were being distributed outside its authorized supply chain. The FDA and Novo Nordisk are testing the fake products to identify whether they're safe. Patients are asked to obtain Ozempic with a valid prescription through state-licensed pharmacies and check the product for any signs of counterfeiting. People in possession of the fake product are urged to call Novo Nordisk customer care at 800-727-6500 Monday through Friday from 8:30 a.m. to 6 p.m. EDT and report it to the FDA's criminal activity division's website. Side effects can be reported to FDA's MedWatch Safety Information and Adverse Event Reporting Program (800-FDA-1088 or www.fda.gov/medwatch) as well as to Novo Nordisk, at 800-727-6500. https://www.upi.com/Health_News/2025/04/14/FDA-fake-Ozempic-drugs-Novo-Nordisk/6841744666854/ XX Can a digital lifestyle modification program reduce diabetes risk? A new study shows that the lifestyle intervention significantly reduced 10-year diabetes risk among prediabetics by nearly 46% and increased the diabetes remission rate, highlighting the importance of lifestyle changes. However, the study was not a randomized trial, and participation in the lifestyle intervention was voluntary, which may introduce selection bias. The study evaluated 133,764 adults, categorizing them as diabetic (7.5%), prediabetic (36.2%), and healthy (56.3%), based on fasting glucose and HbA1c levels. https://www.news-medical.net/news/20250414/Digital-lifestyle-program-cuts-diabetes-risk-by-4625-in-prediabetics-study-of-130k2b-adults-reveals.aspx XX Chrissy Teigan is speaking out about her son's type 1 diagnosis – teaming up with Sanofi to encourage people to screen early for Type 1 diabetes.   Teigen got a crash course in the risks of undiagnosed Type 1 diabetes when her 6-year-old son, Miles, was hospitalized with complications of the autoimmune disease last year. The family knew nothing about Type 1 diabetes when Miles was diagnosed during an unexpected medical emergency, Teigen said in a Tuesday announcement. “We were confused and scared when Miles was first diagnosed,” she said in a statement. “There is no doubt in my mind that knowing in advance would have made a positive impact for Miles, me, and our entire family. I want everyone to hear me when I say: stay proactive and talk to your doctor about getting yourself or your loved ones screened for type 1 diabetes today!”   Teigen shared her family's story in a two-minute video on ScreenForType1.com, a Sanofi website that discusses how to get screened for the condition. Miles' diagnosis made Teigen feel like she “went from a mom to a doctor overnight,” she said. That experience is why Teigen said she is “begging you: Do this one thing, and screen yourself and your family for Type 1 diabetes.” https://www.fiercepharma.com/marketing/sanofi-signs-chrissy-teigen-diabetes-screening-campaign XX Dr. Richard Bernstein – best known for his advocacy around low carb diets for people with diabetes – died this week at the age of 90. Born in 1934 in Brooklyn, New York, he was diagnosed with type 1 at age 12. In the 1970s he adapted a blood glucose monitor for home use and helped pioneer home glucose monitoring. He published multiple books on Diabetes including the #1 selling Diabetes book on Amazon.Com “Dr. Bernstein's Diabetes Solution: A Complete Guide to Achieving Normal Blood Sugars” and “Diabetes Type II: Living a Long, Healthy Life Through Blood Sugar Normalization”.  He practiced and saw patients right up until his death.

Ozempic, Trulicity and Victoza are decreasing dementia by 45%, so what is going on with Medicare coverage for obesity medicine? The Knapp family was featured in a health.com video! Watch it Here: https://www.health.com/beyond-obesity-glp1-8685599 WAYS TO SUPPORT MY WORK ⬇️

As we work our way through the alphabet from A to Z in my drug pronunciation series, we're on the letter “L.” Disclaimer: we don't cover pharmacology in this series. Just drug names.   In this episode, I'll divide liraglutide, Victoza, and Saxenda into syllables, tell you which syllables to emphasize, and share my sources. Written pronunciations are helpful, so you'll find all three below and in the show notes for episode 324 on thepharmacistsvoice.com. Once you've listened to this episode, practice saying liraglutide, Victoza, and Saxenda. Repetition is the key to mastery.   Thank you for listening to episode 324 of The Pharmacist's Voice ® Podcast. The FULL show notes (including all links) are on https://www.thepharmacistsvoice.com/podcast.  Select episode 324.   Liraglutide = LIR a GLOO tide  LIR, like a Learjet Uh, which is a short “A” sound or a schwa “A” sound.  GLOO, like the sticky substance we use to stick two things together And tide, like the ocean tide Sources: Novo Nordisk Customer Service, MedlinePlus, and drugs.com    Victoza = VIC-tow-za  VIC, like Victor Tow, like a tow truck And za, like pizza Emphasize VIC Sources: Novo Nordisk Customer Service, drugs.com, and the FDA's website    Saxenda = sax en duh Sax, like a saxophone En, like the letter “N” in the alphabet Duh, which is an interjection we use in the US to mean, “Isn't it obvious?!” For example, if someone told you, “Water is wet,” you might say, “Duh! Water IS wet.”

Subscriber-only episodeResources for the Community:___________________________________________________________________https://linktr.ee/theplussidezpodcast Ro - Telehealth for GLP1 weight management https://ro.co/weight-loss/?utm_source=plussidez&utm_medium=partnership&utm_campaign=comms_yt&utm_content=45497&utm_term=55______________________________________________________________________Streamed live on Mar 26, 2025261 views • Streamed live on Mar 26, 2025Unlike traditional media, our live sessions offer raw, real-time discussions on obesity treatments. The community can engage directly in the comments, share their perspectives, and connect with experts and fellow patients. It's a space for honest dialogue, advocacy, and breaking the stigma around obesity, all while staying informed about the latest breakthroughs and understanding Mounjaro, Zepbound, Wegovy, Ozempic, Rybelsus, Saxenda, and Victoza and all the newest GLP1s.______________________________________________________________________⭐️Mounjaro Stanley⭐️griffintumblerco.Etsy.comUse code PODCAST10 for $ OFF______________________________________________________________________Join this channel to get access to perks:   / @theplussidez______________________________________________________________________#Mounjaro #MounjaroJourney #Ozempic #Semaglutide #tirzepatide  #GLP1 #Obesity #zepbound #wegovy  Kim Carlos, Executive Producer TikTok https://www.tiktok.com/@dmfkim?is_from_webapp=1&sender_device=pc Instagram https://www.instagram.com/dmfkimonmounjaro?igsh=aDF6dnlmbHBoYmJn&utm_source=qr Kat Carter, Associate Producer TikTok https://www.tiktok.com/@katcarter7?is_from_webapp=1&sender_device=pc Instagram https://www.instagram.com/mrskatcarter?utm_source=ig_web_button_share_sheet&igsh=ZDNlZDc0MzIxNw==

Subscriber-only episodeResources for the Community:___________________________________________________________________https://linktr.ee/theplussidezpodcast Ro - Telehealth for GLP1 weight management https://ro.co/weight-loss/?utm_source=plussidez&utm_medium=partnership&utm_campaign=comms_yt&utm_content=45497&utm_term=55Sign The Petition for Avoidable Access to GLP-1s https://glp1collective.org/ ______________________________________________________________________We discuss Wegovy, Ozempic, Mounjaro, Zepbound, Rybelsus, Saxenda, and Victoza and the active ingredients Tirzepatide and Semaglutide. Unlike traditional media, our live sessions offer raw, real-time discussions on obesity treatments, where the community can engage directly in the comments, share their perspectives, and connect with experts and fellow patients. It's a space for honest dialogue, advocacy, and breaking the stigma around obesity, all while staying informed about the latest breakthroughs. Tonight, we are joined by @Downsidezed    / @thedownsized  ______________________________________________________________________⭐️Mounjaro Stanley⭐️griffintumblerco.Etsy.comUse code PODCAST10 for $ OFF_____________________________________________________________________Join this channel to get access to perks:   / @theplussidez______________________________________________________________________#Mounjaro #MounjaroJourney #Ozempic #Semaglutide #tirzepatide  #GLP1 #Obesity #zepbound #wegovy  Kim Carlos, Executive Producer TikTok https://www.tiktok.com/@dmfkim?is_from_webapp=1&sender_device=pc Instagram https://www.instagram.com/dmfkimonmounjaro?igsh=aDF6dnlmbHBoYmJn&utm_source=qr Kat Carter, Associate Producer TikTok https://www.tiktok.com/@katcarter7?is_from_webapp=1&sender_device=pc Instagram https://www.instagram.com/mrskatcarter?utm_source=ig_web_button_share_sheet&igsh=ZDNlZDc0MzIxNw==

Hoy en día podemos ver en los medios de comunicación como famosos de la talla de Elon Musk, Oprah Winfrey, Cristina aguilera, Kim kardashian, Luis Miguel, Lady Gaga y decenas de actrices de Hollywood, o ricos de Sillicon Valley… comentan que han perdido mucho peso y sin esfuerzo, gracias a un medicamento Unos hablan de ozempic, otros de wegoby y otros de mounjaro…. Otros comentan sus principios activos, liraglutida, semaglutida o tirzepatida Pero prácticamente nadie se ha parado a explicar los razonamientos fisiológicos que hay detrás de todo esto… Y para ello os traigo a Alfredo Andreu, farmacéutico , nutricionista y autor del libro, Ozempic & Co: Apagando el Ruido de la Comida, Perdiendo Peso y este es su web: https://www.habitonutricion.com/ Hablaremos de: Que es impacto tienen la insulina y el glucagón en la perdida de grasa y sensación de hambre y saciedad Que es el GLP 1 y que son los análogos de GLP 1 ) agonista del receptor del péptido similar al glucagón tipo 1 (GLP-1): Acciones en cerebro; hipotálamo nervio vago / pancreas: aumenta insulina y baja glucagón / tracto gastrointestinal vaciamiento gastrico tipos de medicamentos Agonistas duales GLP-1/GIP) Novo Nordisk: Produce Ozempic, Wegovy, Rybelsus, Victoza y Saxenda. Eli-Lilly: Trulicity y Mounjaro., Mounjaro es el primer agonista dual de GLP-1 y GIP, con potencial superior en la pérdida de pes Elimina grasa vs perder apetito…. Musculo y hueso Mi comparación : sueño y descanso ---- esteroides Efectos secundarios corto plazo (estomacales, Reducción de acetilcolina, lo que puede afectar la motilidad intestinal y la contracción muscular, hipoglucemias) medio plazo (posibilidad pancreatitis, cancer de tiroides…) largo plazo (rebote, perdida de masa muscular) Realmente quien debería ser candidato… ultima bala antes de operación en obesidad mórbida? Recuerda su web: https://www.habitonutricion.com/

In this enlightening episode of Healthy AF, Amy dives into the comprehensive world of GLP-1 RA drugs and their impact on weight loss. Whether you're contemplating starting a GLP-1 RA regimen or already on one and seeking more insight, this episode is packed with all the good information you need. Amy covers everything from the basics of GLP-1 RA drugs to the latest updates and data up to 2024. Discover practical advice on what additional health measures you can take while on these drugs to mitigate adverse effects and sustain weight loss. Tune in to arm yourself with knowledge and make informed decisions about your health journey with GLP-1 RA drugs. Trying to get healthy and stay healthy is f-ing hard! Everybody struggles with some aspect of it, no matter what they look like or what they tell you. There is no magic formula - a healthy lifestyle is a choice we need to make daily. Join Amy as she supports, informs, and entertains you on your journey toward health.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

It's In the News.. a look at the top headlines and stories in the diabetes community. This week's top stories: Sana announces beta cell transplantation without the need for immunosuppresion drugs, Modular Medical teams up with Nudge BG for a brand new completely closed-loop system, the FDA moves forward to crack down on compounded Ozempic and Mounjaro, Dexcom and Abbott bury the legal hatchett for a while, and more.  Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom  Edgepark Medical Supplies Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode transcription with links:     Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX Big news from Sana Biotechnology. Their first in human study of islet cells without any immunosuppression appears to be a success. This is very early and hasn't yet been peer reviewed and published.. but after four weeks, there were no safety issues and the transplanted beta cells were producing insulin. Sana's CEO says  “As far as we are aware, this is the first study showing survival of an allogeneic transplant with no immunosuppression or immune-protective device in a fully immune competent individual. Safe cell transplantation without immunosuppression has the potential to transform the treatment of type 1 diabetes and a number of other diseases.”   I've reached out to Sana to get more on this.. love to talk to them soon.   https://www.bakersfield.com/ap/news/sana-biotechnology-announces-positive-clinical-results-from-type-1-diabetes-study-of-islet-cell/article_d0390fd6-99cb-53bd-b04d-9337121e01bf.html XX FDA says no for sotagliflozin as an adjunct to insulin therapy for glycemic control in adults with type 1 diabetes (T1D) and chronic kidney disease (CKD).  Studies showed a meaningful reduction in A1C but a meaningful increase in DKA. The FDA first rejected this in 2019 and was resubmitted last summer. But The advisory committee voted 11 to 3 against the approval of sotagliflozin stating that the benefits of sotagliflozin do not outweight the risks in adults with T1D and CKD. Sotagliflozin is currently approved under the brand name Inpefa to reduce the risk of cardiovascular death, hospitalization for heart failure, and urgent heart failure visit in adults with 1) heart failure; or 2) type 2 diabetes mellitus, CKD, and other cardiovascular risk factors.  According to Lexicon, Inpefa will continue to be manufactured and made available to patients. https://www.renalandurologynews.com/news/fda-denies-approval-of-zynquista-for-type-1-diabetes-and-ckd/ XX Two companies we've been following are teaming up.. Modular Medical has an FDA clear patch pump and Nudge BG has an adaptive full closed loop. They've announced a new partnership agreement. From the release: Modular Medical's easy-to-use and cost-effective MODD1 insulin pump technology. Our combined system is intended to nudge blood glucose by making small changes to insulin delivery based on estimated glucose inputs from a continuous glucose monitor." Familiar name to some of you, Lane Desborough is the founder of Nudge BG. He says this will be a fully automated system, no mealtime bolusing needed.   https://www.accesswire.com/957703/modular-medical-announces-licensing-and-partnership-agreement-with-nudge-bg XX Beta Bionics filed for an initial public offering on Monday. The company did not disclose the number of shares it will offer or the price range. Beta Bionics plans for shares to be listed on the Nasdaq under the ticker symbol “BBNX.” The Irvine, California-based company makes an insulin pump called the iLet Bionic Pancreas, which was cleared by the Food and Drug Administration in 2023. Beta Bionics plans to use the proceeds to grow its sales and manufacturing infrastructure and develop new features for its device.   https://www.medtechdive.com/news/beta-bionics-insulin-pump-files-ipo/736805/     XX Tandem Diabetes Care, Inc. signed a multi-year collaboration agreement with the University of Virginia Center for Diabetes Technology (UVA) to advance research and development efforts on fully automated closed-loop insulin delivery systems.   There's a long history here – UVA is where the Control IQ algorithm was developed.  This agreement seems to keep the team together for another decade. https://www.businesswire.com/news/home/20250107162995/en/Tandem-Diabetes-Care-Enters-Multi-Year-Research-Collaboration-with-UVA-Center-for-Diabetes-Technology-for-Development-of-Advanced-Insulin-Delivery-Systems XX New study says insulin is still the best treatment for gestational diabetes, compared to oral glucose-lowering medications. Metformin and gluburide are being closely looked at since they're easier to administer, less costly, and have better acceptance among patients. But this study says insulin was a bit better – slight more babies were born larger for the metformin group, and more moms had hypoglycemia. https://www.medpagetoday.com/obgyn/pregnancy/113651 XX In its Citizen Petition to the FDA, Novo Nordisk argued that there is no clinical need to allow compounding for liraglutide, the type 2 diabetes injection it sells as Victoza. Novo Nordisk last month filed a Citizen Petition with the FDA asking the federal agency to exclude its type 2 diabetes injection Victoza (liraglutide) from a proposed list of drugs eligible for compounding. https://www.biospace.com/fda/novo-launches-citizen-petition-to-block-compounded-victoza XX Bit of an update on compounded terzepatide and semaglutide. The FDA is allowing a grace period of 60 days before starting to enforce the end of allowing compounds of Mounjaro. Meanwhile, semaglutide remains on the FDA's shortage list for several dose strengths, though all doses have been reported as “available” since late October 2024. Compounding pharmacies, especially larger 503B “outsourcing facilities,” maintain they provide an essential public service by offering lower-cost versions of medications that can cost over $1,000 per month. Many insurers still refuse to cover brand-name GLP-1 products for weight loss. Yet  the FDA has reported hundreds of adverse event reports allegedly linked to compounded versions of these drugs, which do not undergo the same rigorous manufacturing inspections and clinical testing as approved brands.   https://www.drugdiscoverytrends.com/compounders-and-drugmakers-clash-over-compounded-weight-loss-drugs-with-fda-in-the-middle/ XX Interesting story here.. this study says a fecal transplant can help people with type 1 and severe gastroenteropathy. The researchers say diabetic gastroenteropathy commonly affects individuals with type 1 diabetes, causing debilitating symptoms like nausea, vomiting, bloating, and diarrhea; however, treatment options remain limited. Researchers conducted a novel clinical trial to test the benefits of FMT in adult patients with type 1 diabetes and severe symptoms of gastroenteropathy, who were randomly assigned to receive either FMT or placebo capsules as the first intervention. After four weeks, Compared with placebo, FMT led to significant changes in the diversity of the gut microbiome. https://www.medscape.com/viewarticle/fmt-shows-early-success-type-1-diabetes-bowel-issues-2025a10000bg XX A couple of weeks ago, listeners told me that the Dexcom geofencing issue we reported on seems to be resolved. Dexcom is now confirming this. Previously, if you had an issue with Dexcom G7 outside of your home country, you couldn't reinstall or use the app without customer support. As of last month, the geofencing issue has now been resolved with the latest Dexcom G7 2.6 app update. Can I travel with my Dexcom G7? | Dexcom XX Abbott and Dexcom settled all patent lawsuits related to continuous glucose monitors (CGMs). The two competitors, who lead the U.S. market for CGMs, agreed on Dec. 20 to resolve all outstanding patent disputes and not sue each other over patents for 10 years.   Dexcom and Abbott previously reached a settlement in 2014 related to their diabetes devices, which included a cross-licensing deal and an agreement not to sue each other until 2021. After that agreement expired, the companies filed a volley of patent lawsuits. https://www.medtechdive.com/news/abbott-dexcom-settle-cgm-patent-lawsuits/736300/  

Good morning from Pharma and Biotech Daily: the podcast that gives you only what's important to hear in Pharma and Biotech world.Merck has acquired a Wuxi Biologics facility in Ireland for $500 million, expanding manufacturing operations in the biopharma industry. Analysts predict Viking Therapeutics as a top candidate amid higher M&A activity. Danish biotech Orbis has secured $93 million in funding for developing oral medicines. Evidence is growing on the benefits of GLP-1s in treating heart disease beyond weight loss and blood sugar control. Lilly has opened a new facility to drive innovation in bringing medicines to market, while Novo has filed a citizen petition to block compounded Victoza. Roche has invested $1 billion for another ADC from China. Various job opportunities are available in the industry, with insights on Alzheimer's treatment, Novo vs. Lilly's performance, and updates on FDA decisions and lawsuits related to GLP-1 products.

In this episode of Fat Science, Dr. Emily Cooper, Andrea Taylor and Mark Wright take a comprehensive look at the current FDA-approved medications designed to treat metabolic dysfunction and what may be approved next.  Dr. Cooper discusses the range of factors that determine whether these essential drugs are available for those who need them. Government approval, drug company strategies and insurance company policies all play a role.  Key Takeaways: Pharmaceutical Approval Process: Pharmaceutical companies typically seek FDA approval for one drug indication at a time due to the high costs and extensive trial requirements. Approval for obesity drugs is more stringent than for diabetes, involving costly and rigorous trials. Rebranding Drugs for Accessibility: Drugs like Liraglutide (originally Victoza for diabetes) are rebranded as Saxenda for obesity to bypass insurance coverage issues. However, rebranding can create coverage gaps for weight-loss purposes, leaving some patients without access. Insurance Coverage Challenges: Insurance companies often limit coverage for these medications unless a patient has a diagnosed condition like type 2 diabetes. Preventative benefits of metabolic medications are frequently overlooked by insurers, limiting broader access. Risks with Compounded Medications: Compounding pharmacies are creating untested versions of GLP-1 drugs to address affordability and shortages, raising safety concerns. Future Developments in Metabolic Meds: New potential drugs, such as a dual hormone agonist and high-dose semaglutide as a daily pill, show promise in improving metabolic health and accessibility. Resources: Connect with Dr. Emily Cooper on LinkedIn. Connect with Mark Wright on LinkedIn. Connect with Andrea Taylor on Instagram. Fat Science is a podcast on a mission to explain where our fat really comes from and why it won't go and stay away. We are committed to creating a world where people are empowered with accurate information about metabolism and recognize that fat isn't a failure. This podcast is for informational purposes only and is not intended to replace professional medical advice. If you have a question for Dr. Cooper, a show idea, feedback, or just want to connect, email us at info@diabesityinstitute.org. Fat Science is supported by the non-profit Diabesity Institute which is on a mission to increase access to effective, science-based medical care for those suffering from or at risk for diabesity. https://diabesityresearchfoundation.org/

All over the Internet, you hear about the risks of using GLP-1 agonists like Ozempic, Wegovy, and Victoza—such as muscle loss, depression, pancreatitis, nausea, vomiting, digestive distress, appetite suppression, and headaches. …but it turns out there's a lot more to the story, including potential systemwide benefits that go far beyond appetite control and weight loss, and fewer side effects than the fearmongering suggests (which I myself have been guilty of!). The effects of my experiment with GLP-1 agonist semaglutide, how dosage impacts appetite and metabolism, and the importance of individualized strategies for balancing appetite control, blood sugar, and sleep quality…05:54 The cautious use of GLP-1 agonists, their powerful effects on appetite and cognitive health, and the importance of personalized dosing for cognitive and neuroprotective benefits…12:26 How GLP-1 agonists can help brain health and diabetes by improving metabolism, the importance of careful dosing, and why personalized approaches based on individual health needs are the key…18:13 How GLP-1 drugs can support health beyond just weight loss by mimicking natural GLP-1, the potential to restore L-cell function through lifestyle changes, and the importance of individualized, low-dose strategies to avoid side effects…27:04 GLP-1 agonist side effects, from nausea to more serious concerns like gastroparesis, and how careful, individualized dosing and digestive support can minimize risks while still providing therapeutic benefits…38:12 The nuanced risks of GLP-1 drugs, why appetite suppression may dampen life's pleasures, and the importance of addressing mental health, coping mechanisms, and individualized screening to prevent unintended emotional side effects…45:32 The complex effects of GLP-1 drugs on muscle and tissue health, the risks of improper dosing, and the role of patient compliance with strength training and protein intake to protect muscle mass and maintain metabolic health…50:49 The rising impact of GLP-1 drugs on industries from food to healthcare, the economic shifts as companies adapt to consumer health trends, and the critical need for medical guidance and safe sourcing…57:48 Full show notes: https://bengreenfieldlife.com/glppodcast Episode Sponsors:  Our Place: Go to fromourplace.com and enter my code BEN at checkout to receive 10% off sitewide.  Timeline Nutrition: Go to timelinenutrition.com/BEN and use code BEN to get 10% off your order. Joovv: Go to Joovv.com/ben and apply code BEN for an exclusive discount. Young Goose: Visit younggoose.com and use code BEN10 at checkout to enjoy a 10% discount on your first order.  MOSH: Head to moshlife.com/BEN to save 20% off plus FREE shipping on either the Best Sellers Trial Pack or the new Plant-Based Trial Pack.See omnystudio.com/listener for privacy information.

It's In the News.. a look at the top headlines and stories in the diabetes community. This week's top stories: World Diabetes Day roundup, existing drugs examined for T1D prevention, Blue Circle Health expands its novel T1D care model, Mounjaro studied further, Canada approves a new pumps system, and tragedy in the diabetes community.  Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom  Edgepark Medical Supplies Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode transcription with links:   Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX Of course, World Diabetes Day was yesterday. November 14 marks the birthday of Sir Frederick Banting. who discovered insulin along with Charles Best in 1922. Lots of the tech companies are taking action.. I'm going to link up a great article highlighting what many of them are doing…. from Medtronics Blue Balloon challenge to Dexcom's Nick Jonas video and a lot more. https://www.drugdeliverybusiness.com/world-diabetes-day-2024/ XX A new triple combo therapy could restore insulin production in people with type 1 using existing medications. Levicure's triple-combo oral therapy is already considered very safe, because it involves two drugs approved by the U.S. Food and Drug Administration (FDA) and a well-known supplement. The therapy is a combination of: DPP4-inhibitors, a common type 2 diabetes medication Proton pump inhibitors (PPIs), a drug for severe acid reflux A proprietary version of gamma-aminobutyric acid (GABA), a supplement often used to treat anxiety Levicure says the combined effect can block beta cell destruction, suppress autoimmunity, and restore beta cell function. So far, Levicure's triple therapy has gone through only one retrospective chart review; it has not been put to the test in a randomized controlled trial https://www.diabetesdaily.com/blog/can-this-triple-combo-oral-therapy-restore-insulin-production-733261/   XX Blue Circle Health is expanding it's unique approach to type 1 care. Already active in Florida, Maine & Vermont, it will now be in Delaware and Ohio. Blue Circle Health is free and develops a personalized care plan for each participant, tailored to their unique needs, and offers comprehensive multidisciplinary support over a six-month period. It's paid for by the Helmsley Charitable Trust. The program is available to people 18 years of age and older that speak Spanish or English, regardless of insurance coverage or citizen status. We've got an upcoming podcast episode all about Blue Circle coming up soon. https://www.prnewswire.com/news-releases/blue-circle-health-expands-to-delaware-and-ohio-to-address-health-system-barriers-to-type-1-diabetes-care-and-education-302304170.html XX An international team of experts has created the world's first evidence-based guide for eating lower and low carb. The group says until now, people with type 1 diabetes and their healthcare providers have lacked comprehensive resources to help implement this approach safely and effectively. The guide provides essential information for dietitians and nutritionists and empowers them to work collaboratively with individuals and families who are interested in reducing carbohydrates. It's free and we've got the download link in the show notes. https://www.newswire.ca/news-releases/international-team-launches-first-guide-for-carbohydrate-reduction-in-type-1-diabetes-883729104.html XX A new pump system is available in Canada. mylife YpsoPump insulin pump and CamAPS FX hybrid closed-loop algorithm by Health Canada. mylife Loop consists of the mylife YpsoPump, a lightweight intuitive insulin pump, integrated with the CamAPS FX hybrid closed-loop, a mobile phone-based algorithm, and the Dexcom G6 Continuous Glucose Monitoring (CGM) System. Working together, these components provide an innovative, automated insulin delivery (AID) system designed to simplify insulin therapy and improve glycemic control for Canadians living with diabetes.   "The approval of the mylife YpsoPump and CamAPS FX marks an important milestone as we bring these advanced technologies to the Canadian market," said Sébastien Delarive, Chief Business Officer of Ypsomed Diabetes Care. "Although Ypsomed is relatively new in Canada, our established leadership in diabetes care throughout Europe provides a solid foundation for delivering innovative solutions to Canadians living with type 1 diabetes."   "We are excited to see both mylife YpsoPump and CamAPS FX approved," said Karina Schneider, General Manager at Ypsomed Canada. "This step brings us closer to offering an integrated solution that will help simplify diabetes management for Canadian patients, empowering them to take more control of their health." https://finance.yahoo.com/news/ypsomed-camdiab-receive-health-canada-205500840.html XX The FDA updates the labels for all GLP-1 receptor agonists with a warning about pulmonary aspiration during general anesthesia or deep sedation. The affected drugs are semaglutide (Ozempic, Rybelsus, Wegovy); liraglutide (Saxenda, Victoza); and the dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 tirzepatide (Mounjaro, Zepbound). the Medication Guide section of the label also has new additions. Patients are counseled to tell their healthcare provider if they are scheduled to have surgery or other procedures that use anesthesia or deep sleepiness (deep sedation). They are alerted that the GLP-1 RAs they are taking may cause serious side effects, including food or liquid getting into the lungs during surgery or other procedures that use anesthesia or deep sedation. Patients are advised to tell all their healthcare providers that they are taking a GLP-1 RA before they are scheduled to have surgery or other procedures. https://www.medscape.com/viewarticle/fda-updates-glp-1-label-pulmonary-aspiration-warning-2024a1000k84?form=fpf XX Following an impressive data drop this summer highlighting the potential for Eli Lilly's tirzepatide to stave off progression to Type 2 diabetes in prediabetic patients, the Indianapolis-based drugmaker is laying out full results from its longest completed study of the dual GIP/GLP-1 receptor agonist to date. In the three-year SURMOUNT-1 trial, tirzepatide curbed the risk of disease progression to Type 2 diabetes by 94% versus placebo in adult prediabetes patients who were obese or overweight, Lilly said in a release Wednesday. The number represents a pooled result from three tirzepatide doses (5 mg, 10 mg and 15 mg) studied in the trial.   Putting those results into perspective, one new case of diabetes could be prevented for every nine patients treated with tirzepatide, which is marketed in the U.S. as Mounjaro for Type 2 diabetes and as Zepbound for obesity, Lilly said. https://www.fiercepharma.com/pharma/lilly-unwraps-detailed-data-showing-tirzepatide-kept-nearly-99-pre-diabetic-patients XX Edgparke commeical? XX https://www.bloomberg.com/news/articles/2024-10-25/apple-secretly-tests-blood-sugar-app-in-sign-of-health-ambitions XX XX And finally, many of you have likely already heard but we had some incredibly tragic news in the diabetes community, especially for the Breakthrough T1D ride community. I'm going to read from the Breakthrough T1D website: The leadership, staff, and volunteers of Breakthrough T1D mourn the tragic, sudden loss of five T1D Champions on Friday, Nov. 1, 2024.  Jeff and Michelle Bauer, Josh and Tammy Stahl and Barry Sievers were all killed in a singe car crash. The group included two married couples and one single individual—all very close friends and veteran Breakthrough T1D Ride participants. Of this incredibly impactful group, I knew Michelle Bauer personally, I met her as Michelle Alswager – you may know her as Jesse's mom. Her son, Jesse died from complications of type 1 in 2010. And that year, mile 23 on the JDRF ride was created as a mile of silence in memory of Jesse.  Now all riders are asked to ride in silence for that mile not only in memory of Jesse, but all those lost to type 1 diabetes. Michelle wrote her book, Jesse Was Here and created a program that's part of Beyond Type 1 to this day, all to help other families going through grief. She called me a few years ago when she was thinking of writing her book and I'm so grateful for our conversations and that our conversations may have helped her get it out there into a world where it's so needed. But we need Michelle here to talk about grief. More about talking to Michelle about the book).   Please, write the book, ride the bike, do the ironman, follow your heart and your dreams.  All of these incredible people gone too soon. https://www.breakthrought1d.org/news-and-updates/breakthrough-t1d-mourns-tragic-sudden-loss-of-five-ride-champions/   Thanks for joining me..

This week's health news brings attention to significant topics impacting public health. Fred Bodimer covers the tragic story of an 88-year-old Colorado man who passed away from an E. coli infection, potentially due to cross-contaminated onions from McDonald's and Burger King. In other news, low vaccination rates among U.S. healthcare workers are raising concerns, with fewer than one in six receiving the latest COVID vaccine. As respiratory illnesses surge, California hospitals are re-implementing mask mandates to protect vulnerable patients. The episode also discusses a UK study showing how regular and weekend exercise can reduce the risk of mild dementia and the recent addition of Ozempic and Victoza to the FDA's drug shortage list, signaling potential treatment challenges.

We're seeing a LOT more medications like Ozempic in the emergency department nowadays. In fact, 12% of U.S. adults have used a GLP-1 drug! So, what do we need to know about these drugs? Dr. Megan Boysen Osborn, Professor of Emergency Medicine at the University of California Irvine, discusses these GLP-1 agonists with host Maiya Smith.

Send us a textResources for the Community:____________________________________________________________________________________________https://linktr.ee/theplussidezpodcast Ro - Telehealth for GLP1 weight management https://ro.co/weight-loss/?utm_source=plussidez&utm_medium=partnership&utm_campaign=comms_yt&utm_content=45497&utm_term=55____________________________________________________________________________________________The Provider Spotlight is a new bonus series of shorter episodes featuring doctors and specialists from past sessions—think of it as 'doctor shorts.' With over 25k scripts for Zepbound written weekly, many new subscribers haven't seen our earlier episodes, which helps them catch up quickly. Thanks for your support!On August 8th 2023 Dr Sasha High set down with The Plus Sidez and discussed how mindset and obesity medical treatments such as Ozempic, Wegovy, Saxenda, Victoza, and Mounjaro.Dr. Sasha HighTikTok: @sashahighmdWebsite: https://www.sashahighmd.com/____________________________________________________________________________________________⭐️Mounjaro Stanley⭐️griffintumblerco.Etsy.comUse code PODCAST10 for $ OFF____________________________________________________________________________________________Join this channel to get access to perks:   / @theplussidez____________________________________________________________________________________________#Mounjaro #MounjaroJourney #Ozempic #Semaglutide #tirzepatide  #GLP1 #Obesity #zepbound #wegovy  Support the showKim Carlos, Executive Producer TikTok https://www.tiktok.com/@dmfkim?is_from_webapp=1&sender_device=pc Instagram https://www.instagram.com/dmfkimonmounjaro?igsh=aDF6dnlmbHBoYmJn&utm_source=qr Kat Carter, Associate Producer TikTok https://www.tiktok.com/@katcarter7?is_from_webapp=1&sender_device=pc Instagram https://www.instagram.com/mrskatcarter?utm_source=ig_web_button_share_sheet&igsh=ZDNlZDc0MzIxNw==

Join Dr. Emily Cooper, Andrea Taylor, and Mark Wright on Fat Science as they explore the best GLP-1 drugs for treating Metabolic Syndrome and weight management. Dr. Cooper sheds light on the differences between popular options like Victoza, Ozempic, and Manjaro. Andrea shares her personal journey with these medications, emphasizing their life-changing potential. Mark underscores the importance of consulting knowledgeable doctors and staying informed through science-based education. Key Takeaways: GLP-1 drugs mimic naturally occurring hormones to regulate appetite and metabolism. Victoza and Ozempic are similar in function, while Manjaro targets both GLP-1 and GIP hormones. Medication choice is highly individual and should be tailored to personal health needs and circumstances. Consistent eating patterns and regular check-ups are essential to maintaining balance and a healthy metabolism. Personal stories from Andrea highlight the profound impact these drugs can have on well-being. Resources from the episode: Connect with Dr. Emily Cooper on LinkedIn. Connect with Andrea Taylor on LinkedIn. Connect with Mark Wright on LinkedIn. Fat Science is a podcast on a mission to explain where our fat really comes from and why it won't go (and stay!) away. In each episode, we share little-known facts and personal experiences to dispel misconceptions, reduce stigma, and instill hope. Fat Science is committed to creating a world where people are empowered with accurate information about metabolism and recognize that fat isn't a failure. This podcast is for informational purposes only and is not intended to replace professional medical advice. If you have a show idea, feedback, or just want to connect, email info@diabesityinstitute.org.

It's In the News! A look at the top diabetes stories and headlines happening now. Top stories this week: The Eversense CGM could soon be approved for one year of continuous use, the first generic GLP-1 medication is launched, a new company tauts and all-in-one sensor and pump infusion set, a new diabetes accessory in the Roblox game, and more! Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom  Edgepark Medical Supplies Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode transcription with links: Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX In the news is brought to you by Edgepark simplify your diabetes journey with Edgepark XX The first ever generic GLP-1 medication will soon be available in the US. It's a generic of Victoza, originally approved by the FDA in 2010 for diabetes, is part of the same class of drugs that includes Ozempic and Mounjaro. Liraglutide is Glucagon-like peptide-1 receptor agonists (otherwise known as GLP-1s or GLP-1 RAs) are a class of incretin drugs that mimic the body's natural hormones to help treat diabetes and obesity. However, the popularity of the drugs has spiraled out of control at times, leading to shortages and supply chain issues in the US and abroad.  The arrival of a GLP-1 generic drug provides reasons to be hopeful for doctors and patients alike, but there are also caveats. Couple of caveats - liraglutide is injected once daily (vs. weekly) and many doctors say it doesn't work as well for as many people as semaglutide and terzepatide. No confirmation on the price Two other generic options are being developed and could launch in December 2024. Patents for newer GLP-1 medications like Ozempic and Wegovy won't expire until several years down the road https://www.healthline.com/health-news/victoza-generic-glp1-drug-available XX Senseonics plans to launch a 365-day sensor in the U.S. in the fourth quarter of this year. A one-year Eversense CGM could be a game changer for the company.   In 2024, Senseonics expects to more than double U.S. new patient starts and increase the global installed base by around 50%. The growth is built on the current 180-day version of Senseonics' implantable Eversense CGM. Eversense's 180-day sensor can need calibrating twice a day, something Senseonics CEO Tim Goodnow said “has been a competitive disadvantage.” Users calibrate the 365-day sensor once a week. Senseonics is in talks with insulin pump manufacturers about integrating its Eversense CGM with their devices but has yet to commit to a timeline for finalizing an agreement. https://www.medtechdive.com/news/senseonics-365-day-cgm-2025-sales/719717/ XX People who take Ozempic or Wegovy may have a higher risk of developing a rare form of blindness, a new study suggests. Still, doctors say it shouldn't deter patients from using the medicines to treat diabetes or obesity.   Last summer, doctors at Mass Eye and Ear noticed an unusually high number of patients with non-arteritic anterior ischemic optic neuropathy, or NAION, a type of eye stroke that causes sudden, painless vision loss in one eye.   The condition is relatively rare — up to 10 out of 100,000 people in the general population may experience it — but the doctors noted three cases in one week, and each of those patients was taking semaglutide medications. The risk was found to be greatest within the first year of receiving a prescription for semaglutide.   The study, published Wednesday in the medical journal JAMA Ophthalmology, cannot prove that semaglutide medications cause NAION. And the small number of patients — an average of about 100 cases were identified each year — from one specialized medical center may not apply to a broader population. The ways that semaglutides interact with the eyes are not entirely understood. And the exact cause of NAION is not known either. The condition causes damage to the optic nerve, but there is often no warning before vision loss.   For now, patients who are taking semaglutide or considering treatment should discuss the risks and benefits with their doctors, especially those who have other known optic nerve problems such as glaucoma or preexisting visual loss, experts say https://www.reuters.com/business/healthcare-pharmaceuticals/wegovy-ozempic-linked-with-sight-threatening-eye-disorder-study-2024-07-03/ XX We got some updates at ADA about the over the counter CGMS Dexcom Stelo and Abbot's Libre. Dexom plans a late august launch of stelo, which you'll order from their website – it won't be physically in stores. Abbott also plans to sell its wellness-oriented Lingo device this summer through an e-commerce website. That's a sensor that's been available in other coutnires for a while, but was recently okayed in the US. It's not meant for people with diabetes. The Libre Rio is designed or adulst with type 2 who don't use insulin. No timing yet on that product's launch. Neither Abbott nor Dexcom have disclosed pricing for the upcoming products. https://www.medtechdive.com/news/abbott-dexcom-over-the-counter-cgm-launch/719928/ XX Insulet is looking to expand the label for its Omnipod 5 insulin pump for people with Type 2 diabetes. The company said Friday it recently filed with the Food and Drug Administration. Insulet presented study results at the American Diabetes Association's 84th Scientific Sessions that evaluated Omnipod 5 in people with Type 2 diabetes who were taking basal insulin or multiple daily injections. The results showed “substantial improvements in blood glucose outcomes and overall quality of life,” said study chair Francisco Pasquel, an associate professor of endocrinology at Emory School of Medicine. Omnipod 5 is currently cleared in the U.S. for people with Type 1 diabetes. Insulet hopes to expand the pump to people with Type 2 diabetes, with an expected launch in early 2025. The FDA has not yet cleared any automated insulin delivery systems for people with Type 2 diabetes, Insulet said. The company has a basal-only insulin pump, called Omnipod Go, that was cleared for people with Type 2 diabetes last year, but it does not connect to other devices. Even though Omnipod 5 is not currently indicated for Type 2 diabetes, doctors prescribe it for their patients with full reimbursement since the pharmacy channel doesn't distinguish between Type 1 or Type 2 patients, J.P. Morgan analyst Robbie Marcus wrote in a research note on Sunday. https://www.medtechdive.com/news/insulet-omnipod-5-type-2-diabetes-study/719644/ XX In the keynote address at the American Diabetes Association annual conference, FDA Commissioner Dr. Robert Califf expressed concerns about the rising rates of diabetes in the U.S. Though revolutionary medications and technologies for diabetes and weight loss continue to emerge, these treatments are vastly underused. The silver lining lies with type 1 diabetes therapies, which are showing great promise in clinical trials. “For the larger epidemic of type 2 diabetes, we're failing right now,” Califf said. “I don't say that lightly.” A huge problem, Califf said, is access. While most health insurance plans cover medical devices and medications for diabetes, without insurance, costs add up quickly. Ozempic, for example, costs nearly $1,000 per month without insurance. Studies have found that regardless of insurance status, roughly 26% of Americans skipped or delayed treatment due to cost. https://diatribe.org/diabetes-management/fda-commissioner-says-were-failing-people-type-2-diabetes XX Embecta presented two abstracts at the American Diabetes Association Scientific Sessions last weekend making the case for its insulin patch pump for Type 2 diabetes. The company submitted the device for Food and Drug Administration clearance in late 2023. The diabetes device company developed a patch pump with a larger insulin reservoir that can hold up to 300 units. Embecta, which is better known for making equipment such as pen needles and insulin syringes, has been developing its first patch pump. The company found that a device with a larger insulin reservoir could provide longer wear times and fewer disposable patches. https://www.medtechdive.com/news/embecta-insulin-patch-pump-volume-american-diabetes-association/719779/ XX   Pump/CGM sensor in one The niaa signature patch pump, shown with a watch displaying current blood sugar level The niaa signature patch pump has a manual bolus button and is part of an in-development AID system. Swiss technology maker Pharmasens demonstrated a new semi-reusable tubeless patch pump and glucose sensor in the same compact device, called the niia signature, which the company says can be worn for five days.   The top of the device, which includes Bluetooth connectivity and the electronic and mechanical parts to control the pump, separates from the disposable 300-unit reservoir along with the adhesive used to attach the device to the body via a steel cannula. A small button on the device allows manual bolusing. The company says an AID system will manage the device, controlled by smartphone.   PharmaSens' simpler basal-bolus patch pump, the niia essential, was submitted for FDA approval in late December. Availability of the niia signature AID system has yet to be announced. https://diatribe.org/diabetes-technology/diabetes-technology-display-ada-2024 XX Edgepark Commercial XX New international consensus statement offers guidance on the care and monitoring of people who are at high risk for type 1 diabetes (T1D). This is all about screening and testing for islet autoantibodies. These individuals are classified as: At risk or Stage 0 (single autoantibody or transient single autoantibody), Stage 1 (two or more autoantibodies with normoglycemia), and Stage 2 (two or more autoantibodies with dysglycemia but without symptoms and not yet meeting diagnostic criteria for Stage 3 clinical T1D). The document was presented on June 24, 2024 in a 90-minute symposium at the American Diabetes Association's annual Scientific Sessions and published simultaneously in both Diabetes Care and Diabetologia. "This is not guidance around who to screen or when to screen. This is guidance for the hundreds of thousands of people around the world who have participated in screening, mostly through research programs, and have been identified with positive autoantibodies and need care in the clinical setting," panel co-chair Anastasia Albanese-O'Neill, PhD, APRN, CDCES, of Breakthrough T1D, told Medscape Medical News.   The recommendations also include when to start insulin, and how to provide education and psychosocial support to individuals and family members of those given the early-stage T1D diagnosis. https://www.medscape.com/viewarticle/experts-advise-early-risk-monitoring-type-1-diabetes-2024a1000bpo XX Roblox has added a diabetic option, complete with insuli pen and Dexcom You can find it in the marketplace JDRF – now breakthrough t1d – started a world in roblox a couple of years ago as well Roblox is a super popular online game that a lot of kids play. https://www.roblox.com/games/5823990610/Breakthrough-T1D-World XX FFL next week! 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Send us a Text Message.Get OTP Emails: https://www.onthepen.com/emailsEli LillyEli Lilly sent cease and desist letters to providers of research grade GLP-1sExclusive news from onthepen.com that has not been covered by any other sourcehttps://www.onthepen.com/post/generic-versions-of-zepbound-how-recent-news-affects-their-futureHim & Hers:Him & Hers giving GLP medications without consulting with a doctorhttps://hntrbrk.com/hims/Price for generic liraglutide/Victoza (multiple tiktok videos):Note: podcast last week announced generic liraglutide from Tera PharmaPrices as low as $225 for two penshttps://www.goodrx.com/liraglutide?form=carton&dosage=2-pens-of-18mg-3ml&quantity=1&label_override=liraglutideTROAScaled-back TROA bill is passed out of the US House Ways and Means Committee This version would limit coverage to people who had been taking a weight loss drug for a year prior to enrolling in Medicarehttps://www.nbcnews.com/health/health-news/house-committee-passes-bill-allow-medicare-cover-weight-loss-drugs-rcna159248BI 3034701 (tiktok video):Boehringer Ingelheim and Gubra start phase 1 trial of BI 3034701 which is retatrutide competitor (GLP-1/GIP/glucagon)https://www.boehringer-ingelheim.com/science-innovation/human-health-innovation/phase-1-start-novel-triple-agonist-obesity-treatmentSupport the Show.MY WORK RELIES ON YOUR GENEROSITY, WAYS TO SUPPORT:Venmo: OnThePenCa$h App: ManOnMounjaroBECOME A MEMBER:https://www.youtube.com/channel/UCDocQ-4IhVS3ihy_dW7nSKw/joinSOCIAL LINKShttps://www.tiktok.com/@manonthemounjarohttps://twitter.com/ManOnMounjarohttps://instagram.com/manonthemounjarohttps://facebook.com/manonthemounjaro

New maintenance treatment approved for COPD; Authorized generic version of Victoza launches; Duchenne muscular dystrophy treatment indication expanded; Narcolepsy treatment expanded for certain pediatric patients; FDA clears digital therapeutic for ADHD.  

In an era of popular weight loss drugs, including GLP-1 agonists like Ozempic (semaglutide), Victoza (liraglutide), Wegovy, and Saxenda, many people are looking for safer, natural alternatives. Calocurb (use code BEN10 to save 10%) is a patented natural plant-based supplement clinically proven to reduce hunger by 30%, cravings by 40%, and calorie intake by an average of 18% — in just an hour. It does this by stimulating the body's own "feel full" hunger hormones cholecystokinin (CCK), glucagon-like peptide-1 (GLP-1), and peptide YY (PYY). In this episode, Dr. Edward Walker, a scientist and lecturer who helped develop Calocurb, will introduce you to the concept of the "bitter break" and the powerful plant extract, Amarasate, which has shown remarkable results in stimulating anti-appetite hormones when delivered to the small intestine. You'll also get to explore the science behind how this extract works, its impact on glucose and insulin levels, and much more! Over the last 13 years, Dr. Walker's primary research focus has been the investigation of plant-based appetite suppressants that may reduce hunger and support healthy food choices. This work led to the development of Amarasate, a novel New Zealand hops-based appetite suppressant that shares an overlapping mode of action with a new class of effective GLP-1-based anti-obesity drugs. He is passionate about plant-based nutraceuticals and believes that with the appropriate scientific research, they have the potential to improve health and wellness, and even prevent or delay the development of chronic disease. Whether you're interested in nutrition, weight management, or cutting-edge health science, this episode is packed with insights you won't want to miss. Tune in and discover how you can take control of your cravings and support your journey to better health! Full Show Notes: BenGreenfieldLife.com/hungerpodcast Episode Sponsors: BioStack Labs: Get 15% off your purchase of $100 or more by going to biostack.com/ben15. Kineon: Visit shop.kineon.io/bengreenfield today and receive 10% off your purchase. Organifi Happy Drops: Go to organifi.com/Ben for 20% off your order. Mito Red Light: Go to mitoredlight.com and use code BGLIFE to save 5%. Power Plate: Visit PowerPlate.com/ben and save up to $699 today.See omnystudio.com/listener for privacy information.

A class of medications known as GLP-1 receptor agonists has revolutionized the treatment of type 2 diabetes and obesity. These drugs mimic the action of glucagon-like peptide-1 (GLP-1), a hormone that stimulates insulin secretion and inhibits glucagon release, helping to regulate blood sugar levels and promote weight loss. In this podcast, we'll talk about the differences among some of the most well-known GLP-1 receptor agonists for type 2 diabetes. Ozempic (Semaglutide) Form: Injectable Dosing Frequency: Once weekly Uses: Primarily for type 2 diabetes (lower blood sugar and A1c); also approved for reducing the risk of major cardiovascular events like heart attack and stroke in adults with type 2 diabetes and known heart disease. Keep in mind, Wegovy (semaglutide) is a higher-dose version that's approved for weight loss. When you start taking Wegovy or Ozempic, you'll begin with a low dosage. Your prescriber will increase your dosage every four weeks until you reach the target amount. However, the specific dosage you inject will differ depending on the medication. The maximum dose for Ozempic is 2mg weekly, while the target dose for Wegovy is 2.4mg weekly. Rybelsus (Semaglutide) Form: Oral tablet Dosing Frequency: Once daily Uses: Lower blood sugar and A1c in people with type 2 diabetes. Rybelsus shares the same active ingredient as the injectable medications Ozempic and Wegovy. Ozempic is also approved for Type 2 diabetes, while Wegovy is approved specifically for weight loss. Rybelsus is available in three different strengths: 3 mg, 7 mg, and 14 mg. Similar to Ozempic, the dose is slowly increased every 4 weeks.  Good to know: It's important to take Rybelsus first thing in the morning with 4 oz of water. After taking it, you should wait at least 30 minutes before eating, drinking, or taking other medications. Failing to do so may reduce its effectiveness. Currently, Rybelsus is undergoing clinical trials to evaluate its effectiveness for weight loss. The trials involve higher doses than those approved for diabetes treatment. Results indicate that a 50 mg dose of oral semaglutide (Rybelsus) achieves weight loss comparable to Wegovy.  Trulicity (Dulaglutide) Form: Injectable Dosing Frequency: Once weekly Uses: Type 2 diabetes; and like Ozempic, it's also approved for reducing the risk of major cardiovascular events in adults with type 2 diabetes and established cardiovascular disease. Like Ozempic and Rybelsus, you will start at a low dose to help reduce side effects. Your healthcare provider will then gradually increase the dose, balancing the management of side effects with the benefits of blood sugar control. The maximum dose for Trulicity is 4.5mg weekly. Victoza (Liraglutide) Form: Injectable Dosing Frequency: Once daily Uses: Type 2 diabetes; also approved to reduce the risk of major cardiovascular events in adults with type 2 diabetes and established cardiovascular disease. Victoza is one of three GLP-1 agonists approved for treating Type 2 diabetes in children aged 10 and older. The other options are Trulicity (dulaglutide) and Bydureon BCise (exenatide). More on this later. Ozempic, however, is only approved for use in adults. Saxenda and Victoza are both injectable medications containing liraglutide, but they are approved for different uses. Saxenda is FDA-approved for chronic weight management in people 12 and older, while Victoza is approved for treating Type 2 diabetes in people 10 and older. Victoza also helps lower the risk of major adverse cardiovascular events in adults with diabetes and heart disease. Both medications are injected once a day, starting with a low dose that is gradually increased over time. The target dose for Saxenda is 3 mg once daily, whereas the maximum dose for Victoza is 1.8 mg once daily. Byetta (Exenatide) Form: Injectable Dosing Frequency: Twice daily Uses: Type 2 diabetes. Additional Benefits: It has a shorter duration of action than other GLP-1 agonists, which may be preferable for some patients. Byetta, approved in 2005, was the first GLP-1 medication of its kind for diabetes. Its active ingredient, exenatide, is a synthetic version of a substance found in Gila monster saliva.  The recommended starting dose for Byetta is 5 mcg twice daily, administered within 60 minutes before your morning and evening meals. After one month, your healthcare provider may increase the dose to 10 mcg twice daily. Starting at a lower dose helps reduce stomach-related side effects. Bydureon BCise (Exenatide Extended-Release) Form: Injectable Dosing Frequency: Once weekly Uses: Type 2 diabetes. Additional Benefits: Extended-release formulation provides a more convenient dosing schedule compared to Byetta. Unlike Byetta, Bydureon BCise has a fixed dose of 2 mg administered once weekly, on the same day each week. It can be taken at any time of day, with or without food. Mounjaro (Tirzepatide) Form: Injectable Dosing Frequency: Once weekly Uses: Type 2 diabetes. Additional Benefits: Dual action as it targets both GLP-1 and GIP (glucose-dependent insulinotropic polypeptide) receptors, potentially offering enhanced efficacy in blood sugar control. Mounjaro is not approved for weight loss; however, its active ingredient, tirzepatide, is approved for weight loss under the brand name Zepbound. Typically, Mounjaro's starting dose is 2.5 mg once weekly for four weeks. By week 5, the dosage is often increased to 5 mg once weekly for another four weeks. Following week 9, if necessary for better blood sugar management, the dosage can be escalated to 7.5 mg weekly. It's important not to increase Mounjaro doses by more than 2.5 mg every four weeks. The maximum recommended dosage is 15 mg once weekly. Unlike Ozempic, Trulicity, or Victoza, Mounjaro is currently not approved for any heart-related uses. However, an ongoing clinical trial is assessing its effectiveness in reducing major adverse cardiovascular events in people with Type 2 diabetes. The study is anticipated to conclude in October 2024. Key Differences and Considerations The right GLP-1 agonist for you will likely come down to a few key factors like age, treatment goals, and underlying health conditions. Personal preferences like dosage frequency will also come into play. Dosing Frequency: Once weekly: Ozempic, Trulicity, Bydureon BCise, Mounjaro. Once daily: Rybelsus (oral), Victoza, Saxenda. Twice daily: Byetta. Administration Form: Injectable: All except Rybelsus (oral). Oral: Rybelsus. Indications: Type 2 Diabetes: All medications. Cardiovascular Benefits: Proven cardiovascular benefits: Ozempic, Trulicity, Victoza. Pediatric Use: Approved for children: Victoza (for children 10 years and older). Thanks again for listening to The Peptide Podcast. We love having you as part of our community. If you love this podcast, please share it with your friends and family on social media, and have a happy, healthy week! We're huge advocates of elevating your health game with nutrition, supplements, and vitamins. Whether it's a daily boost or targeted support, we trust and use Momentous products to supercharge our wellness journey.  Momentous only uses the highest-quality ingredients, and every single product is rigorously tested by independent third parties to ensure their products deliver on their promise to bring you the best supplements on the market. 

Nausea is one of the most frequently reported side effects of GLP-1 agonist medications used in obesity treatment, such as Zepbound, Wegovy, Mounjaro, and Victoza. Although not everyone will experience it, the nature of these anti-obesity medications can often lead to nausea, caused by the slowing of gastric emptying.Anyone who has experienced nausea before, especially during pregnancies, will understand just how debilitating it can be, impacting your daily life and work. So, what level of nausea should you expect from weight loss medications? And how can we effectively manage this side effect? In this episode, I'm sharing practical strategies to mitigate nausea, advice on when to seek medical advice, and insights on using medications like Zofran to ease discomfort.Remember: This podcast provides general educational information. Always consult your doctor and medical team for personalized advice and guidance on any symptoms you're experiencing.ReferencesQuest Nutrition Cheese CrackersDevotion Nutrition HydroFLEX PacketsGHOST®Audio Stamps00:58 - Dr. Rentea explains why most anti-obesity medications contribute in some capacity to nausea and describes the nature and impact of this common side effect.06:05 - Dr. Rentea encourages us to be mindful of the types of foods consumed while on anti-obesity medications as certain foods can trigger nausea more than others.08:20 - We hear the importance of hydration in managing nausea and Dr. Rentea explains how cold drinks and electrolyte products can alleviate symptoms.13:05 - Dr. Rentea shares some general tips and changes you can make to your diet to help manage nausea.17:35 - Dr. Rentea stresses that vomiting is not normal and urges consulting a doctor if it occurs, as adjustments to eating habits or medication dosage may be necessary.Quotes“You need to be spacing out your food because most people will not be able to eat these bigger meals at once.” - Matthea Rentea MD“If you are avoiding fried stuff, greasy, or really high sugar foods, it's going to be really helpful.” - Matthea Rentea MD“Vomiting is never normal. You always need to talk to your doctor.” - Matthea Rentea MD“Electrolytes can oftentimes be helpful for nausea and headaches.” - Matthea Rentea MD“Something like Zofran, if you're not allergic, is just nice to have in your toolkit. But you need your physician to walk you through when and how to use it.” - Matthea Rentea MDAll of the information on this podcast is for general informational purposes only. Please talk to your physician and medical team about what is right for you. No medical advice is being on this podcast. If you live in Indiana or Illinois and want to work with doctor Matthea Rentea, you can find out more on www.RenteaClinic.com

Two drugs for type 2 diabetes are being restricted to only those already prescribed them, due to a global shortage. From Wednesday funded access to dulaglutide and liraglutide known as Trulicity and Victoza respectively will be restricted. Between December last year and March about 5000 people started taking these medicines and Pharmac says if the growing trend continued it would start to have difficulty with filling prescriptions. The drugs are used alongside metformin and help to trigger the body's feeling of fullness. General Practice New Zealand chair Dr Bryan Betty says the drugs are a "game changer" for those with type 2 diabetes and he expects Pharmac to work to resolve the situation as soon as possible. Diabetes NZ chief executive Heather Verry says there's no doubt the shortage comes from a global demand to use the drugs for weight loss. Dr Ruth Large, is chair of the New Zealand Telehealth Forum.

Answering questions from X (Twitter). XQ Can you take Mounjaro and Ozempic together?Does Victoza becoming generic matter? (liraglutide generic)Does LDL Particle Size Matter?How does a cardiologist assess CVD risk?When would you order an ECG, Echo, Stress, CAC, CCTA?If I do everything right, does Lp(a) still matter?Why do surgeon medfluencers comment on medical topics?Should we stent asymptomatic 65% lesions in coronary arteries? https://dralo.net/links

On April 13, Dr. Marianne Ritchie and Emily Rubin, RD, LDN, MPH discussed how taking a GLP-1 drug (like Ozempic, Wegovy, Rybelsus, Victoza, Saxenda, Mounjaro, Zepbound) should still include a balanced diet, exercise and behavioral modification.

For Complete Show Notes... and... special links... visit www.StuSchaefer.com  Take the free fat-loss quiz at https://stuschaefer.com/ 

Zwangspause? Freiwellige Pause? Wenn Sie wieder mit einem der Medikamente Victoza, Saxenda, Ozempic, Wegovy beginnen wie machen Sie das am besten? Die Tipps der Zuckertante.

Wichtige Diabetes-Medikamente gibts derzeit einfach nicht oder nur nach langen Wartezeiten. - Was Sie da tun können - Und wie eine Medikamenten -"Familie", die "Gliptine" beim Überbrücken ein wenig helfen können

The first 2024 episode of HR Benecast features Courtney Keefe, Employers Health's resident GLP-1 expert. She'll share utilization, discontinuation and coverage trends for GLP-1s and anti-obesity drugs. Listeners will hear the latest on anti-obesity drug coverage under the pharmacy benefit, new drugs in the pipeline and how the big PBM's are managing drugs like Wegovy, Mounjaro and Zepbound. 

Semaglutdie-containing medications (like Ozempic, Wegovy, Rybelsus) have recently made headlines after some reports of gastroparesis. And experts don't know for sure if this side effect is linked to semaglutide itself.  Keep in mind that several other medications and health conditions can cause gastroparesis. There were no reports of gastroparesis in a 2-year clinical study of semaglutide use in patients with overweight or obesity. And while semaglutide and other GLP-1 agonists like tirzepatide (Mounjaro, Zepbound) and liraglutide (Victoza, Sexenda) cause stomach-related side effects like nausea, vomiting, upset stomach, diarrhea, and constipation, we know these effects happen because the medications slow down how quickly food leaves your stomach (delayed gastric emptying).  The good news is that these side effects are reported to be reduced after about 5 months (20 weeks) of use. In this podcast, we'll discuss gastroparesis, what causes gastroparesis, and how to lower your risk of gastroparesis. What is Gastroparesis? Gastroparesis occurs when the stomach muscles fail to function properly, leading to slowed or incomplete movement of food and liquid from the stomach to the small intestine, even though there isn't a blockage.  This delay can result in digestive issues and discomfort for individuals with gastroparesis. Symptoms include stomach pain, ulcers, and heartburn. You may also experience nausea and vomiting. What Causes Gastroparesis? One of the most common causes of gastroparesis is diabetes (T1DM or T2DM). High blood sugar levels over time can damage the vagus nerve, which controls the stomach muscles. Some individuals may develop gastroparesis as a complication of abdominal surgery, particularly those involving the stomach or intestines. Certain neurological conditions, such as Parkinson's disease and multiple sclerosis, can affect the nerves that control stomach function, leading to gastroparesis. It can also be caused by certain medications, including some opioid pain medications, antidepressants like venlafaxine, and allergy medications like diphenhydramine (Benadryl). It can also be caused by viral infections that can damage the stomach nerves and marijuana use. How can you lower your risk of gastroparesis? If you have diabetes, you can lower your risk by keeping good control of your blood sugar. You can also avoid medications that can cause gastroparesis. But it's important to know that 40% of gastroparesis cases are idiopathic (unknown reason). GLP-1 agonists and gastroparesis Research on semaglutide-induced gastroparesis is limited, but there have been patient reports of gastroparesis with GLP-1 agonists like tirzepatide, liraglutide, and semaglutide. However, the majority of the people who reported gastroparesis symptoms also had diabetes and their gastroparesis resolved after temporarily discontinuing the GLP-1 agonist. In some cases, diet changes (eating small frequent meals that are low in fiber and fat and avoiding carbonated beverages that may bloat the stomach) also helped resolve symptoms. Keep in mind: We mentioned earlier there were no reports of gastroparesis in a 2 year clinical study of semaglutide use in patients with overweight or obesity. The FDA states that they can't confirm if GLP-1 agonists directly cause gastroparesis or an underlying health condition. Remember: Gastroparesis symptoms are very similar to common semaglutide side effects. But just because these symptoms occur, it doesn't mean there's a problem. If your symptoms become severe, aren't going away, or worsen, you should let your healthcare provider know. They can help determine what steps you should take next. Thanks again for listening to The Peptide Podcast. We love having you as part of our community. If you love this podcast, please share it with your friends and family on social media, and have a happy, healthy week! We're huge advocates of elevating your health game with nutrition, supplements, and vitamins. Whether it's a daily boost or targeted support, we trust and use Momentous products to supercharge our wellness journey.  Momentous only uses the highest-quality ingredients, and every single product is rigorously tested by independent third parties to ensure their products deliver on their promise to bring you the best supplements on the market. 

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog That is a strong statement, however I am confident in saying that belly fat can put you at risk for Alzheimer's disease, because it is a fact supported by medical research. These studies reveal that obesity, especially abdominal obesity (Beer belly, Gut, “Dunlap's disease”…..), increases the onset and rate of Alzheimer's dementia! Another reason to change your lifestyle to benefit your longevity. Abdominal obesity can come from fat accumulation right underneath your skin (the fat you can pinch between 2 fingers) OR the fat that grows inside your abdomen like an apron draped over the intestines. It is called “visceral fat”, and this type of fat is what places you in the crosshairs for several diseases of aging including Alzheimer's Disease, heart disease, stroke, diabetes, and rapid aging.  A large belly is more common in men, but it is still a risk for women if they develop an apple shaped body. Below is a picture of visceral fat, and a diagram of what it looks like in an artist's sketch of a normal weight person. When the yellow fat doubles and triples in thickness the abdomen pushes out to look like a “beer belly”.   Visceral fat extends from your stomach over the transverse colon and your small intestines like an apron.  This fat pad thickens with alcohol abuse (beer belly), high carbohydrate diet, overeating, junk food, under exercise and creates a large pad of fat that secretes inflammatory cells.  The resulting inflammation is the vehicle that damages your brain leading to Alzheimer's disease and damages your arteries leading to heart disease and stroke. In my office we use INBODY machines that measure your Visceral fat, BMI, and percent body fat.  Normal visceral fat is below #10 on our machine, BMI less than or equal to 25, and fat % for men < 19% and for women < 26%. The Research: A recent study correlated the size of patient's belly (visceral belly fat), and obesity with the amount of amyloid plaque (the cause of Alzheimer's disease) in their brain. This was measured by MRI in the study subjects' brains.  The age of the patients studied was between 40-60. The study found that the amount of visceral fat (fat inside your abdomen) is directly correlated with the amount of amyloid plaque and inflammation in the brain!  That causes Alzheimer's Disease. If that doesn't motivate you to lose your belly fat, then you are making a choice to eventually suffer from Alzheimer's disease, a heart attack, a stroke or arthritis.  If you are thinking that you will just wait for “something to happen”, then not making a decision to change your lifestyle is making a decision to take on illness in the future. We have new medications to help you lose that belly fat and they really work. You should ask your doctor to help you and if they don't understand the importance of arriving at ideal weight then look for a different doctor who will help you. Even with medication you will have to put in the work and self-control to turn down unhealthy foods when others are being unhealthy.  You will also have to add daily exercise to your schedule if you really want to avoid Alzheimer's Disease, heart attack, stroke and early death. The possible meds and habits that can help you lose your “belly”: ·     Limit calories and or carbohydrates ·     Increase daily exercise ·     Diet pills (amphetamines that older patients usually can't take) ·     Xenical (Orlistat)-Side effect is fatty diarrhea ·     Qsymia (topiramate/Phentermine) can increase BP ·     Contrave for craving (naltrexone/bupropion) can decrease sex-drive ·     Semelanotide (Imcivree-new), darkens the skin, expensive ·     Metformin ER an oral, effective medication to treat insulin resistance, and promote weight-loss ·     Victoza and Saxenda injections are diabetic treatments, that can cause GI reflux, however they work well for patients who have Type II Diabetes who need to lose weight. Even though many patients lost weight with these medications, many could not tolerate the drugs listed above because of the side effects.  These side effects limited our ability to help all patients lose weight…until now! Now, for the first time we have an effective way to help most people lose their dangerous visceral (belly fat). If you have a big belly you are at high risk for inflammatory diseases like Alzheimer's dementia, obesity, heart disease, diabetes, cancer and stroke. The new weight loss drug's generic name is Semaglutide, and has been marketed under several names: Wegovy, Ozempic, and Rybelsus. A second generic drug that is in the same family of drugs is called Tirzepetide, includes Mounjaro (for diabetics) and Zepbound (for weight loss). All of these drug's work for weight loss, pre-diabetes and Type 2 Diabetes.  Most insurance companies do not cover weight loss and they require a precertification for you to get the medication covered by insurance.  This precertification process is time consuming for the doctor and her staff, which costs the doctor an increase in her overhead to employ a nurse to provide this service for the patient. In general people with a BMI under 30 will not be covered for Semaglutide or Tirzapeptide, however if their BMI is over 30, there is a chance insurance will pay for one of these drugs for a period of time. The market price at the pharmacy is between $900/$1200 per month if you pay out of pocket to your pharmacy. Because of this fact and because we have so many patients whose pellets are not paid for by insurance, we provide access to the generic form of these drugs through a compounding pharmacy. The cost is a fraction of the normal out of pocket cost, about $560 for 3 months supply. In this way we have been able to treat many people who cannot afford to pay the exorbitant going rate for this medication. Because it is costly for a patient to receive the medication no matter how they are able to get it, It is very important for weight loss patients to be compliant and follow a low carbohydrate diet, exercise daily and to refrain from alcohol consumption while they are taking weight loss medications.  We require our patients who request these drugs to be seen at least every 2 months by one of our NPs or our weight loss specialist to help them get the best results possible. These drugs work for weight loss and diabetes by multitasking.  The ways the medication actually works are listed below: Semaglutide and Terzapeptide, ·      decrease hunger between meals   ·     you feel full faster than normal so you eat less ·     decrease sugar and alcohol-craving ·     decrease the release of sugar from the liver when you are fasting, which turns into fat ·     Prevent hypoglycemia which causes hunger and fat gain ·     Makes patients more insulin sensitive. Obesity is not just a lifestyle problem; it is a disease that should be treated with medicine PLUS lifestyle changes. These drug actions take place in the brain, stomach hormones, pancreas and liver, as well as in all the cells in your body. At Bio Balance Health® have years of experience in treating patients with bio-identical testosterone pellets and we have observed that weight loss plus testosterone pellets for patients over 40 allows patients to lose fat without losing muscle. Now we add these weight loss medications to T pellets, and we have the perfect combo for safe weight-loss (really fat loss). The biggest worry for patients is that they may not be able to get off this drug after they achieve ideal weight.  I have found that the longer you have been overweight and the more overweight you are, the higher the risk of needing maintenance medications to maintain your ideal weight. We try to wean our patients off injectable meds by switching them to Metformin ER, a drug that insurance will pay for. With these effective meds we finally, we have an effective preventive treatment to add to our testosterone and estradiol pellets for those people who view Alzheimer's as their worst nightmare, and for those patients who are worried about heart disease, diabetes and stroke  we can prevent the diseases that can ruin our “golden years”.   KCM Research: People with large amounts of visceral fat as they age may have higher risk of Alzheimer's disease. NBC News (11/20, Carroll) reports, “People who have large amounts of” visceral fat “as they age may be at higher risk of developing Alzheimer's disease, a new study suggests.” The findings were presented at the Radiological Society of North America's annual meeting. HealthDay (11/20, Thompson) reports that investigators “compared brain scans of 54 people between the ages of 40 and 60 with their levels of belly fat, BMI, obesity and insulin resistance.” The investigators “found that people who had more visceral fat compared with fat found just under their skin tended to have higher amyloid levels in the precuneus cortex.” The “relationship was worse in men than in women, and higher visceral fat measurements also were related to increased inflammation in the brain.”

Today On Medical Grounds, we will be speaking with Dr. Heather Whitley. Dr. Whitley is a clinical professor in the Department of Pharmacy Practice at the Auburn University Harrison College of Pharmacy. She is a board certified pharmacotherapy specialist and a certified diabetes educator. Earlier this year, Dr. Whitley spoke with us about screening for diabetes in high-risk individuals. Today, she is back to talk about some new things going on in the diabetes and pharmacy world. This is part 1 of a two part series. In Part 1, Dr. Whitley will be discussing shortages in GLP-1 agonist drugs for diabetes and what pharmacists can do to address those shortages.Dr. Whitley recently published a paper in Clinical Diabetes about this topic:Special Report: Potential Strategies for Addressing GLP-1 and Dual GLP-1/GIP Receptor Agonist Shortages(00:09) Introduction to Dr. Whitley(01:08) Publication on strategies for GLP-1 and GLP-1/GIP shortages(02:36) GLP-1 and GLP-1/GIP agonists, names, and dosing(04:15) Why are there shortages?(08:52) Alternatives(10:11) What happens if a patient misses a dose?(12:19) Re-initiation of medications(14:51) GLP-1 agonist equivalency(15:31) Substituting SGLT2s(17:16) Self-sourcing or online sourcing problems(21:51) Managing patient expectations and concernsVisit us at OnMedicalGrounds.com for more podcasts! You can subscribe through your podcast platform, our website, or follow us on social media for podcast updates and medical news. Some of our podcasts offer FREE CME/CE credits.LinkTreeTwitterLinkedInInstagram

Etken maddeleri "liraglutide" olan bu iki ilacın kilo verme üzerindeki ve yan etkileri nelerdir?

Weight loss and obesity medicine expert, Dr. Alo, discusses the most recent data on weight loss medications and how to use them properly. Phentermine, Ozempic, Diethylproprion, Wegovy, Semaglutide, Victoza, Saxenda, and more! https://dralo.net/links

GLP-1 agonists are a class of medications that everyone is talking about right now because of their beneficial effects on weight loss. And while they are effective at helping with weight loss, there have been multiple studies that suggest that there is a link between their use and the new onset of thyroid cancer. Let's talk about this connection in more detail to see if it is something you should actually worry about. First off, where does this information come from? Studies like this one (https://pubmed.ncbi.nlm.nih.gov/36356111/) suggest that there is indeed a real risk of thyroid cancer with long term use of GLP-1 agonists in diabetes. This study showed that there were about 2,500 new cases of thyroid cancer in a sample size of over 3.7 million. The incidence of thyroid cancer in these patients was small but still real. It's important to note here that correlation does not equal causation but this is just adding to the pile of studies that suggest a link between these medications and thyroid cancer so it's definitely something that should be thought about prior to using them. Given this information, is it still worth taking medications like Wegovy, semaglutide, saxenda, and victoza? In some situations, it may make sense but my recommendation is to always try to lose weight with diet and exercise first. If you are going to use these medications then do your best to use them in the short term for no more than 1 year. This will minimize the negative side effects while maximizing their benefits. My personal recommendation would still be to try other treatments like bioidentical hormone replacement therapy prior to using GLP-1 agonists. #weightloss #glp1 #weight #weightlosstips #obesity #thyroidcancer #thyroid Download my free thyroid resources here (including hypothyroid symptoms checklist, the complete list of thyroid lab tests + optimal ranges, foods you should avoid if you have thyroid disease, and more): https://www.restartmed.com/start-here/ Recommended thyroid supplements to enhance thyroid function: - Supplements that everyone with hypothyroidism needs: https://bit.ly/3tekPej - Supplement bundle to help reverse Hashimoto's: https://bit.ly/3gSY9eJ - Supplements for those without a thyroid and for those after RAI: https://bit.ly/3tb36nZ - Supplements for active hyperthyroidism: https://bit.ly/3t70yHo See ALL of my specialized supplements including protein powders, thyroid supplements, and weight loss products here: https://www.restartmed.com/shop/ Want more from my blog? I have more than 400+ well-researched blog posts on thyroid management, hormone balancing, weight loss, and more. See all blog posts here: https://www.restartmed.com/blog/ Prefer to listen via podcast? Download all of my podcast episodes here: https://apple.co/3kNYTCS Disclaimer: Dr. Westin Childs received his Doctor of Osteopathic Medicine from Rocky Vista University College of Osteopathic medicine in 2013. His use of “doctor” or “Dr.” in relation to himself solely refers to that degree. Dr. Childs is no longer practicing medicine and does not hold an active medical license so he can focus on helping people through videos, blog posts, research, and supplement formulation. To read more about why he is no longer licensed please see this page: https://www.restartmed.com/what-happened-to-my-medical-license/ This video is for general informational, educational, and entertainment purposes only. It should not be used to self-diagnose and it is not a substitute for a medical exam, treatment, diagnosis, prescription, or recommendation. It does not create a doctor-patient relationship between Dr. Childs and you. You should not make any changes to your medications or health regimens without first consulting a physician. If you have any questions please consult with your current primary care provider. Restart Medical LLC and Dr. Westin Childs are not liable or responsible for any advice, course of treatment, diagnosis, or any other information

Come and join us for our special two-hour, season 1 finale! We will be reminiscing about some of our favorite moments from season 1 and will be joined by Dr. Michael Albert from episode 1 to discuss the future of GLP-1 medications. We'll explore their potential use in treating addiction and sleep apnea and delve into the possibilities of Retatrutide and increased doses of oral Semaglutide. With medications like Ozempic, Wegovy, Mounjaro, Victoza, Saxenda, and Trulicity, the opportunities for improved health are limitless.Dr. Michael Albert, Accomplish Health https://www.accomplish.health/abouthttps://www.tiktok.com/@michaelalbert...https://www.instagram.com/michaelalbe...Explore the podcast on YouTubehttps://www.youtube.com/@theplussidez Support the showKim Carlos @DMFKimonMounjaro on TikTokJernine Trott @TheeJernine on TikTokKat Carter @KatCarter7 on TikTokLydia Roberts @mounjaro_GLP_Help on TikTok

Wegowy er et nyt ord der er landet i vores bevidsthed, sammen med navne som Victoza, Saxenda og Ozempic. Det er den nye klasse af potente appetithæmmende vægttabslægemidler. I dette afsnit tager vært Dr. Muskel og Producer-Jonas os med hele vejen rundt om disse lægemidler. Der besvares spørgsmål som: Hvad gør de, hvad gør de ikke, hvad koster de, hvordan virker de, holder vægttabet og hvad kommer de til at betyde for fremtiden?See omnystudio.com/listener for privacy information.

In a world where fad diets come and go and weight loss supplements flood the market, it's easy to feel overwhelmed and skeptical about what truly works for shedding those extra pounds. But a promising peptide on the weight loss scene is causing quite a buzz: semaglutide (Wegovy).  If you've got questions about this weight loss medication, you're in the right place. In this podcast, we'll answer the top questions about semaglutide for weight loss.   What is semaglutide? Semaglutide is an injectable medication used to help manage weight. It may also lower your blood pressure, improve your cholesterol, and lower your blood sugar. And it must be used in addition to lifestyle changes (healthy diet and increased physical activity). It was originally approved in 2017 (Ozempic) to help with blood sugar control in type 2 diabetes. People taking Ozempic for diabetes also lost weight, so the manufacturer conducted trials to see if people without diabetes had the same benefit. They found this to be the case, and the FDA approved the medication's use to include weight loss in adults (Wegovy) in 2021.  How does semaglutide (Wegovy) work for weight loss? Semaglutide mimics a hormone in your gut that controls hunger (GLP-1). When you eat, GLP-1 is released from the gut and tells your brain you are full. GLP-1 also slows down how fast food leaves your stomach, suppressing your appetite. And GLP-1 tells your pancreas to release insulin after you eat. This lowers your blood sugar. You'll then use the sugar from your food instead of storing this excess sugar as fat. All of these things together lead to weight loss. Is semaglutide (Wegovy) safe? Yes, semaglutide for weight loss is FDA-approved and has undergone rigorous testing to ensure its safety and effectiveness. But this doesn't mean that everyone can take it. You should consult a healthcare provider to determine if it suits your specific health conditions. Who shouldn't take semaglutide? You should not use semaglutide if you have the following: A personal or family history (first-degree relatives such as a parent, sibling, or child) of thyroid cancer or adrenal gland or parathyroid tumors. If you are pregnant or breastfeeding Type 1 diabetes Bariatric surgery (within the past 18 months) Active gallbladder disease Kidney disease or transplant You also shouldn't take semaglutide if you're taking other GLP-1 agonists like semaglutide, which include medications like Trulicity, Victoza, or Saxenda. Who is semaglutide (Wegovy) for? Semaglutide for weight loss is typically prescribed for adults with a body mass index (BMI) of 30 or higher or those with a BMI of 27 or higher with weight-related medical conditions like high blood pressure, high cholesterol, or diabetes. What are the most common side effects of semaglutide? The most common side effects of semaglutide are stomach-related, including: nausea diarrhea vomiting constipation bloating Burping Most of these stomach-related side effects are due to slowing down digestion. People have also reported headaches and tiredness (usually due to fewer calories-feeling full and eating less). How much weight can I lose with semaglutide? Healthy, sustainable weight loss is 0.5 to 2 pounds per week. And some people routinely lose more than this.  But what do the clinical studies say? A 68-week study with almost 2,000 adult participants reported an average weight loss of nearly 15% of their body weight (approximately 35 pounds). The placebo group lost an average of 2.5% of their body weight.  How fast does semaglutide work? The short answer is that many patients will lose weight in the first week of taking semaglutide if they make lifestyle changes. The first 4 doses are small and are primarily used to gently introduce the peptide to the body without risking stomach-related side effects.  You need to remember that it's possible to "out-eat" any weight loss medication. So, you may see little to no weight loss in the early weeks without making lifestyle changes.  But what do the clinical studies say? In clinical trials, people lost about 10% of their body weight during the first 20 weeks. They lost an additional 8% of their body weight through week 68. How and when do I take semaglutide? You can inject semaglutide into the fatty tissue of your upper arms, stomach, or upper thighs. Typically, the dose of semaglutide is increased no faster than once every 4 weeks. For example, you would receive 4 weeks of 0.25mg, then 4 weeks of 0.5mg, and so forth, assuming your side effects are not bothersome.  Most clinics consider three factors when deciding how to increase the dose for their clients. Each month, you should discuss whether you've experienced bothersome side effects, how well semaglutide managed your hunger, and how much weight you lost. How fast your dose increases depends on the needs of each patient.  Do I have to take semaglutide on the same day every week? Yes. It's recommended that you take semaglutide on the same day every week. However, if you need to change the day of the week you take semaglutide (e.g., vacation, illness), you may change the day of the week you take semaglutide as long as your last dose was given 2 or more days before. Will I have to take semaglutide forever? The answer to this is complicated. The short answer is it depends on the person.  Nutrition, physical activity, and good-quality sleep are essential for weight loss. And unfortunately, stress can also impact your ability to maintain a healthy weight. Semaglutide is helpful but may only be necessary for a while if you can adopt lifestyle changes and continue to use them after you stop semaglutide.  Semaglutide is a medication that's meant to be taken long-term. But some people may want to stop taking it or need to because of side effects or other reasons. It is possible to regain some weight you've lost after you stop taking semaglutide. The STEP 4 trial found that people switching from semaglutide (Wegovy) for weight loss to placebo regained about 7% of their body weight in 48 weeks. Why do I regain weight after stopping semaglutide? It's important to know that regaining weight isn't unique to semaglutide. It's possible to regain weight after stopping any weight loss medication. Because semaglutide suppresses your appetite, stopping treatment can cause your appetite to return. Also, keep in mind that semaglutide should be used with lifestyle changes, including a healthy diet and exercise. Getting enough quality sleep is important, too. You'll likely regain weight if you stop incorporating these healthy habits into your routine when you stop semaglutide treatment. Do I need to wean off semaglutide? No, you don't need to wean off semaglutide. Your healthcare provider will provide instructions for stopping treatment based on your individualized needs. Where should I store my semaglutide? Semaglutide should be stored in the refrigerator. Never put your syringes in the freezer. Although there's no one-size-fits-all approach to weight loss, making informed decisions that align with your personal weight loss goals is very important.  Remember, semaglutide for weight loss may not be clinically appropriate for everyone. But it can be life-changing for people where it is appropriate. When you're not hungry all of the time, it's much easier to focus on nutrition, regular exercise, stress management, and getting good, quality sleep.  Thanks again for listening to The Peptide Podcast, we love having you as part of our community. If you love this podcast, please share it with your friends and family on social media, and have a happy, healthy week!

In this episode, we will be focusing on the mental aspect of weight loss. Our medical specialist guest, Dr. Sasha High, will be exploring the connection between mindset and obesity medical treatments such as Ozempic, Wegovy, Saxenda, Victoza, and Mounjaro. We are excited to have Cory as our guest to share his community story! He shares his personal journey of growing up as a larger child and eventually developing obesity and type 2 diabetes. Cory bravely opens up about how emotional eating contributed to his weight gain over the years. He also shares his thoughts on how the medication could have potentially helped his mother battle obesity and possibly extended her life. Follow Cory @midlifecrisison8earthsTo hear some of Cory's music see links below  Lightfoils https://open.spotify.com/artist/25pI4r8Ip65oUonf92oUb3?si=1tn7chEdTVSukeyQJ19gAAPanda Riot https://open.spotify.com/artist/3l65Zubp9XQv2SDSL3DhTi?si=VVgb3FrLSpauqeLeOa1lSQFollow Dr. High on TikTok and YouTube @thepsychdoctormd  Dr. High's BioDr. Sasha High is an Internist and Obesity Medicine Physician, mom of 3, kitesurfer, and entrepreneur. She completed a Bachelor of Science at the University of Ottawa, then medical school and residency at the University of Toronto. Dr. High is board-certified in Obesity Medicine and is a certified Life Coach. She has also received additional training in nutrition, CBT and ACT.Dr. High is the Founder of Best Weight and the High Metabolic Clinic, Canada's leading medical weight loss coaching program for women. Her team consists of Endocrinologists, Internists, Psychiatrists, Psychotherapists, Registered Dietitians and Certified Life Coaches. Their evidence-based approach involves cognitive behavioral coaching, lifestyle counseling and medical treatment to help women lose weight sustainably, stop emotional eating, and learn to love their bodies.Support the showKim Carlos @DMFKimonMounjaro on TikTokJernine Trott @TheeJernine on TikTokKat Carter @KatCarter7 on TikTokLydia Roberts @mounjaro_GLP_Help on TikTok

It's In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: FDA approval for a pancreatic islet cell therapy to treat type 1, stem cell research moves ahead, big news from the ADA Scientific Sessions about what's next for medications like Mounjaro and a pill form of semaglutide. Dexcom announces a sensor for people with type 2 who don't use insulin, Libre moves ahead with Ketone monitoring and more.   Please visit our Sponsors & Partners - they help make the show possible! Take Control with Afrezza  Omnipod - Simplify Life Learn about Dexcom  Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com   Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines happening now XX In the news is brought to you by the T1D Exchange a nonprofit organization dedicated to improving outcomes for the entire T1D population. XX Big week of news following the 2023 ADA Scientific Sessions conference. What follows is just the tip of the information iceberg, so please follow the links in the show notes to much more. -- XX Top story though isn't from ADA – but a new FDA approval.. for a pancreatic islet cell therapy to treat type 1. It's called donislecel, developed from cadaver donors and giving as a single infusion straight into the liver. Immunosuppression is required to maintain cell viability, just as it is required to support a transplanted kidney or other organ. Approval was based on what seems to be a very small study – 30 people with type 1 who had hypoglycemic unawareness and who received between one and three infusions of donislecel. After one year, 11 people did not need to dose insulin.. 10 stayed that way for more than five years. But five people in the study were not able to stop dosing insulin at all. This method is different from what Vertex and Sernova are trying to do with stem cell therapy. https://www.medscape.com/viewarticle/993854 XX Vertex moves forward on their clinical trial of islet stem cell therapy. All six patients treated with VX-880 had undetectable fasting C-peptide (endogenous insulin secretion) at baseline, a history of recurrent SHEs in the year prior to treatment and required an average of 34.0 units of insulin per day. Following treatment, all six patients demonstrated endogenous insulin secretion, improved glycemic control as measured by HbA1c, improved time-in-range on continuous glucose monitoring, and reduction or elimination of exogenous insulin use. Two patient are completely insulin independent after one year – with an A1C of 5.3 compard to 8.6 at baseline.. the other 6.0 with a 7.6 at baseline – again the ”after” number is without taking insulin. As a result of these safety and efficacy data in Parts A and B, the independent data review committee has recommended moving to Part C of the trial, which allows for concurrent dosing of patients at the full target dose of VX-880. https://www.businesswire.com/news/home/20230623446641/en/Vertex-Presents-Positive-VX-880-Results-From-Ongoing-Phase-12-Study-in-Type-1-Diabetes-at-the-American-Diabetes-Association-83rd-Scientific-Sessions XX Sernova also reports good results with their cell pouch system. Five of the six patients who have completed implantation continue to experience insulin independence for periods ranging from six months to more than three years. The sixth patient only recently completed the protocol-defined islet transplants.. so no results yet. There is a second group testing a larger cell pouch. https://www.drugdeliverybusiness.com/sernova-interim-data-cell-pouch-system/ XX Big news from ADA about all of the type 2 and obesity drugs you've likely heard about.. here are some headlines: SURMOUNT-2 clinical trial evaluating tirzepatide – brand name Mounjaro - for weight loss in adults with obesity or overweight and type 2 diabetes. Average weight loss was 15.7% at the highest dose, with many other health benefits such as lower A1C levels; reduction in waist circumference, and body mass index; and improvements in cardiometabolic disease risk factors such as lipid levels, cholesterol, and blood pressure. That 15 percent weight loss was about 34 pounds and the a1c reduction for half of those in the study went down to 5.7 which is considered nondiabetic. Mounjaro is currently approved for type 2 and the FDA could approve Mounjaro regardless of diabetes status later this year. https://diatribe.org/new-lilly-trial-results-show-big-weight-loss-results-positioning-mounjaro-obesity-drug-approval XX A study called PIONEER looks at oral semaglutides – some calling it the Ozempic pill. When compared to other anti-diabetic medications such as Jardiance, Januvia and Victoza, people taking the oral semaglutide say 1% or or more reduction of HbA1c compared to those treated with other anti-diabetic medicines. They also were more like to achieve a 5% or more reduction of body weight. Note: this was not a study comparing a semaglutide pill with the same type of injection. https://www.news-medical.net/news/20230607/Oral-semaglutide-outperforms-other-medications-in-type-2-diabetes-treatment-significantly-reducing-HbA1c-and-body-weight.aspx XX And look for two additional new drugs to treat obesity in the next few years.. orforglipron, is easier to use and to produce, and it will probably be cheaper than existing treatments. The second, retatrutide, has an unprecedented level of efficacy, and could raise the bar for pharmacological obesity treatment. Orforglipron and retatrutide both mimic hormones produced by the lining of the gut in response to certain nutrients. These hormones help to slow the passage of food through the digestive tract and lower appetite by acting on receptors in the brain — both effects that reduce people's desire to eat and help them to lose weight. Orfoglipron is a non-peptide molecule that researchers say is easy to produce and is a pill.. a lower price is anticipated for this one. Retratritude looks like it could help people lose even more weight than Mounjaro. https://www.nature.com/articles/d41586-023-02092-9 XX Dexcom announces a new product in the US – coming in 2024 – designed for people with type 2 who don't use insulin. This will be built on the G7 hardware, but with different software and a 15 day sensor. CEO Kevin Sayer also announced that the G7 will be able to share data direct to the apple watch https://www.businesswire.com/news/home/20230623025076/en/Global-Continuous-Glucose-Monitoring-Pioneer-Dexcom-Reveals-New-Plans-to-Bring-Sensing-Technology-to-Millions-More XX Abbott will partner with Weight Watchers - people who have been prescribed one of Abbott's FreeStyle Libre 14-Day or FreeStyle Libre 2 sensors and who are using the WeightWatchers diet plan to see their CGM data directly in the WeightWatchers app. This is also a study where Abbott will launch two pilot programs directed at using CGM data to help people with Type 2 diabetes adjust and manage their dietary habits, regardless of whether they're on insulin therapy. XX A little bit more news about Abbott's dual glucose and ketone sensor under development. Announced a last year's ADA, the company says it's moving forward through R&D Separately from the Type 2 CGM push, Taub also offered an update on the dual glucose ketone sensor that's currently under development at Abbott and that the company first announced at last year's ADA conference. The sensor will be aimed at catching rising ketone levels as early as possible to help avoid cases of diabetic ketoacidosis. An Abbot executive says – quote - “There's so much that we stand to learn about ketones because there hasn't been a continuous sensor for them before, so there's really very little we know about the evolution of ketones “ https://www.fiercebiotech.com/medtech/ada-abbott-pushes-widespread-cgm-use-type-2-diabetes-weightwatchers-ada-collabs XX Commercial XX Beta Bionics has received FDA 510(k) clearance for the compatibility of the Fiasp Pumpcart prefilled insulin cartridge with the iLet automated insulin-delivery system. The iLet is a bionic pancreas that fully automates 100% of all user insulin doses, providing users with the choice of three insulins, Novolog; Humalog; and Fiasp Pumpcart. The device eases diabetes management in everyday life and almost eliminates the expertise that has been required in the past to set up and manage a traditional insulin pump. In May 2023, Beta Bionics was awarded FDA approval for the iLet device. The iLet manages glucose levels with just a meal announcement and is paired with a Dexcom G6 Continuous Glucose Monitoring System for glucose readings. All that is required for set-up is the user's weight. While there is a need for carbohydrate awareness, no carb counting is necessary. Bolusing, correction factors, insulin-to-carb ratios, and pre-set basal rates are also unnecessary. Beta Bionics president and CEO Sean Saint said: “Beta Bionics has been working tirelessly to create an insulin delivery system that offers less burden and more convenience for the type 1 community. Since launching last month, the iLet bionic pancreas is now available and clinics and users are being trained on its simple design and easy management features. “When Fiasp Pumpcart prefilled cartridges are available, users will save time not having to manually fill cartridges and will have more choice for their diabetes management.” https://www.medicaldevice-network.com/news/beta-bionics-gains-fda-clearance-for-prefilled-insulin-cartridge/ XX Oura – the ring that tracks your sleep – will start sending info to three CGM info companies.. January, Supersapiens and Veri. All three of these companies provide software based off of the Libre CGM. These companies will now be receiving sleep scores and other biometric data from Oura so they can see how these measurements affect users' glucose levels and overall health. https://www.forbes.com/sites/andrewwilliams/2023/06/27/oura-smart-ring-can-be-used-to-help-monitor-blood-sugar/?sh=2520116c2b10 XX Just a fun fact here – there is a Facebook group called type 1 diabetics for 50 plus years. And it looks like this week they passed over 1500 members. XX On the podcast next week.. I sat down with Dexcom's new Chief Commercial officer to talk about their announcements from this week about the type 2 market and other features important to people with type 1. Our last epoisde is all about Kickass Healthy LADA That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

Listen By:Season 7Season 6Season 5Season 4Season 3Season 2Season 1Podcast Categories:Fertility and pregnancyGuest interviewsInfectious diseaseRespiratory healthSkincareSkincare for babiesMy somewhat political views!Listen By:Season 7Season 6Season 5Season 4Season 3Season 2Season 1Podcast Categories:Fertility and pregnancyGuest interviewsInfectious diseaseRespiratory healthSkincareSkincare for babiesMy somewhat political views!Listen By:Season 7Season 6Season 5Season 4Season 3Season 2Season 1Season 7Season 6Season 5Season 4Season 3Season 2Season 1Podcast CategoriesGuest interviewsFertility and pregnancyInfectious diseaseRespiratory healthSkincareSkincare for babiesMy somewhat political views!John Test PageGuest interviewsFertility and pregnancyInfectious diseaseRespiratory healthSkincareSkincare for babiesMy somewhat political views!John Test PageA WonderCare PodcastMedicines Shortages Including Ozempic ExplainedPlay EpisodePause EpisodeMute/Unmute EpisodeRewind 10 Seconds1xFast Forward 30 seconds00:00/00:24:07SubscribeShareAmazonApple PodcastsGoogle PodcastsSpotifyRSS FeedShareLinkEmbedDownload file | Play in new window | Duration: 00:24:07 | Recorded on 21/05/2023Subscribe: Amazon | Apple Podcasts | Google Podcasts | Spotify Amazon Apple Podcasts Google Podcasts Spotify Medicine Shortages Including Ozempic ExplainedMedicine shortages are becoming more and more common. Here I explain why!In This Episode: Supply issues with medicines. What this means on the ground for community Pharmacists. A reflection on the patient impact now and the potential danger for the future. How supply chains work in Ireland. Government policy on medicines from The Health Act. Proactive ways we can address medicine shortages. Wejovy, Saxenda, Ozempic and Victoza supply issues. Statements from Novo-Nordisk, HPRA, and Azure Pharmaceuticals.Listen to the Ozempic Patient's perspective here!Support this PodcastSimply following and reviewing this podcast can make a huge difference!  If you enjoyed this episode ‘Medicines Shortages including Ozempic Explained'  I would be so grateful if you could follow or subscribe to the show!I aim to support family health and appreciate every one of you who take the time from your day to learn something new along with me!  We have episodes where I explain medical conditions and offer lots of tips and advice from my perspective as a Pharmacist mum.  We also chat with experts about a whole range of medical and family challenges. Of course I can't forget our little voices episodes where I chat with kids and hear things from their point of view!  I'm also extremely grateful to everyone who contributes to a real lives episode – I learn so much from these and am privileged to be able to share your story which will help people who find them in a similar situation in life.You can check out all of my previous episodes by clicking right here! Sale!Covid-19 Antigen Lollipop Test€1.95 €5.95Read moreSale!Salin Plus Air Purifier (Salt Therapy) – Respiratory Health€117.45 €160.00Add to basket Hosted on Acast. See acast.com/privacy for more information.

In this episode, we discuss the common misconceptions surrounding prescribing GLP1 medications such as Ozempic, Victoza, and Mounjaro, which were initially designed to treat type 2 diabetes and are now being prescribed to treat the disease of obesity. Dr. Michael Albert, an obesity specialist, joins us to set the record straight. Support the showKim Carlos @DMFKimonMounjaro on TikTokJernine Trott @TheeJernine on TikTokKat Carter @KatCarter7 on TikTokLydia Roberts @mounjaro_GLP_Help on TikTok

Living long and living well are two essential elements for a happy, fulfilled life. But, how can midlife women achieve this? On this episode of The Hormone Prescription Podcast, Dr. Suzanne Turner reveals the secrets to boosting longevity and how it's more than you think.   Dr. Turner is the founder of Vine Medical Associates and the VMA Residency. Double Board Certified, her thriving practice treats executives and athletes from around the world. Practicing Cellular, Longevity, and Performance Medicine, Dr. Turner has special interests and experience in bioidentical hormone therapy, metabolic medicine, neurodegenerative disease, and human performance optimization. She also has earned Advanced Certification in Endocrinology and Peptide Therapy. Dr. Turner is the leading expert in peptide therapy in the Southeast. She is an award-winning teacher of medical students, residents, and physicians while on the Faculty of Emory University. She has also served on the faculty of A4M, IPS, BioTe, SSRP, and ACAM. She has been featured on several podcasts including Super Human Radio Network, TRT Revolution, Relentless Vitality, Younique Medical, and Health Matters. Dr. Turner spends her free time with her husband and family, studying cellular medicine and Christianity, managing her urban farm, and powerlifting.   In this episode, you'll learn:   • How to understand the different approaches to longevity and health • Why bioidentical hormone therapy is important for midlife women • What are the implications of metabolic medicine, neurodegenerative disease, and human performance optimization • Dr Turner's top tips for leading a long and healthy life   Don't miss this enlightening episode with Dr. Suzanne Turner as she reveals the secrets to boosting longevity – it's more than you think! Tune in now and start living your best life today!   Don't forget to subscribe, rate, and review The Hormone Prescription Podcast! We appreciate your support!   (00:00): Muscle is the currency of aging. Carl Lenore, what can you do now to boost the life in your years? Find out next. (00:11): So the big question is, how do women over 40 like us keep weight off, have great energy, balance our hormones and our moods, feel sexy and confident and master midlife? If you're like most of us, you are not getting the answers you need and remain confused and pretty hopeless to ever feel like yourself Again. As an ob gyn, I had to discover for myself the truth about what creates a rock solid metabolism, lasting weight loss, and supercharged energy after 40, in order to lose a hundred pounds and fix my fatigue, now I'm on a mission. This podcast is designed to share the natural tools you need for impactful results and to give you clarity on the answers to your midlife metabolism challenges. Join me for tangible, natural strategies to crush the hormone imbalances you are facing and help you get unstuck from the sidelines of life. My name is Dr. Kyrin Dunston. Welcome to the Hormone Prescription Podcast.  (01:04): Everybody. Welcome back to another episode of the Hormone Prescription with Dr. Kiran. Thank you so much for joining me today. You are gonna love, love, love my guest today because I love her after just talking to her for a few minutes and you're gonna hear our conversation. She, like me as a medical doctor who went from the corporate sector into enlightened medicine, is what I call a functional approach, root cause resolution approach. Her story's a little different about how she got into this, so you're gonna wanna hear that you've heard a lot of my other guests share their stories. I'm always fascinated by how people evolve their viewpoints in the world. And so you'll wanna hear hers. She has a wonderful practice in Atlanta and helps people heal and she loves to focus on longevity and she has a ginormous toolbox of modalities to help you maybe increase the years in your life, but definitely increase the life in your years. (02:10): She's gonna talk to you about the difference between health span and lifespan and most importantly, how do you test to know what your aging status is? Are you older physiologically than you are chronologically? She's gonna tell you how to know and she's gonna share with you some of the best tools and strategies in her toolbox that you can start using today to put more life into your years. I'll tell you a little bit about her and then we'll get started. Dr. Turner is the founder of Vine Medical Associates and the VMA Residency Double Board certified. Her thriving practice treats executives and athletes from around the world practicing cellular longevity and performance medicine. Dr. Turner has special interests and experience in bioidentical hormone therapy, metabolic medicine, neurodegenerative disease, and human performance optimization. She also has earned expert in peptide therapy in the southeast and is an award-winning teacher of medical students, residents, and physicians. While the faculty of Emory University, she's also served on the faculty of a four m i p s, Biot, S S R P and Aamp. She's been featured on several podcasts including Superhuman Radio Network, T R T Revolution, relentless Vitality, unique Medical and Health Matters. Dr. Turner spends her free time with her husband and family studying cellular medicine and Christianity managing her urban farm and power lifting. Please help me welcome Dr. Suzanne Turner. (03:42): Hi Kyrin. Thank you so much for having me on today. I'm really excited to get to talk with you. (03:46): Yes, I'm very excited to talk with you. We both were in Atlanta probably at the same time, but I never had the pleasure of meeting you. We have colleagues and friends in common and I love what you're doing and what you offer women. So let's dive into talking about longevity for women and what's involved with that. But first I wanna start because you are also traditionally trained physician, right? Yes. If you could share with everyone kind of your journey from what I call corporate medicine Yes. To enlightened Medicine. What happened there? (04:24): Well, actually I think it was mostly patient driven. So the practice that I started, I had probably half and half men and women and several of the women came to me and said, Hey, will you write these bio identical hormones? And I said, I don't know what that is, but okay. So I wrote for their hormone therapy and the the compounding pharmacist called me up and said, Hey, we love that you're writing for these but you clearly don't know what you're doing. (04:52): . And they said, well, can we send you to a class? So they sent me to this little quick weekend course on biodentical hormones and it was really just a very skim introductory course called get Out of Line. It was about how do you stop following the person in front of you and really be the leader in what you're doing? So I just got all of a sudden this hunger for learning about hormones and learning other ways. I've heard you talk about your toolbox got bigger or you added things to your toolbox and that really is how I feel about it. I'd gotten a bunch of people better, but there were several that were just hanging on and not quite continuing to do well. And so having this whole new thing where I could help patients with both, with adding in hormones and then as I went on, adding more things, the whole perspective of this not being disease centered, but being cellular or organ centered and how do we manipulate the way that the body responds to its environment? (05:54): It was a completely different way of thinking about medicine. I think I just continued. So then I found the American Academy of the anti-Aging and regenerative medicine like you and spent many years learning layer after layer after layer of complexity, adding things to my toolbox learning from other people. I think we spend a lot of time learning now, speaking with people like you, with other friends that really help us to learn other ways. We've just added ozone therapy and neurotherapy to our practice, which have been huge benefits. So there's so many things we can do for that patient that's just not getting better and oh, okay, well then maybe this is a matter of looking at how your cells process energy, how your cells speak to one another or communicate how your nervous system controls the way that your organs work. So it's been a fun journey. (06:47): Yes, it is. And I love that you learned out from a wanting more place. So many of us learned from disasters and then when we couldn't find answers we had to seek elsewhere. So it's very inspiring to hear your story and I want to talk a little bit about longevity. There have been some experts in the more mainstream medical field who have said, no, you can't really impact longevity except don't smoke, don't drink too much, and kind of the usual party line that everyone hears. You know, eat the sad diet, exercise more, right? All the things we hear, but there really is so much more that you can do to impact longevity. So how did you become interested in (07:38): That? I think it's because the patients, again, it's the patients who came to me and said, how do we make sure it really, the specific patients are the ones who are the entrepreneurs or the head of household or the family member who says, I want to, I've seen my mother much like you. I've seen my mother or my father go through this horrible end of their life that they, I didn't want them to go through. How do I keep myself from getting there And I have, they have a passion about something they're doing. Like maybe they own a coffee company or maybe they own a skincare line and they love what they're doing and they're passionate about helping people in that way and they wanna be able to continue to do that. So when my patients come to me and tell me those stories, it really inspires me to provide them that opportunity to continue to be so, I see myself as one of their team members in helping them to be able to continue to pursue their passion as long as possible. (08:34): I'm not necessarily talking about increasing their number of days or years, although that is something that everyone's rushing to, to, to find the research for and maybe probably has been doing for, has been for years. I'm really talking about changing the shape of your health span from a long oval type shape into a square so that you increase your health, you stay at that lovely, improved health all the way until you're ready to pass and then you go so that there isn't this sort of long drawn out disease state at the end of life that we continue to see. I would hope that you would be able to continue to do things that you're passionate about, speaking in front of audiences and teaching about hormones until right up until the day before you pass and that that you would not have that long drawn out, prolonged ending. So when I'm talking about longevity, I'm really talking about longevity of health span. Although the research is out there and currently being done on improving the length of life, I feel like if my length of life is, if my life is not full of health then I don't really want the extra length of life. (09:46): I totally agree , we don't wanna live in a disease state and currently so many of us once we pass 50 are in a disease state. I think it's over 50% of us are on five or more medications after the age of 50, which represents chronic disease management and all the risks that chronic disease carries. So increasing our health span, and I know some of you listening are thinking, you know, Dr. Kyrin, my health is a mess right now and I'm in midlife metabolic mayhem. Or I, you know, I can't lose the weight and I can't sleep. I'm not worrying about increasing my health span. But actually the same tools that Dr. Suzanne and I are gonna talk about are will also help you get out of midlife metabolic mayhem and correct and reverse disease and improve your overall quality of health. So you definitely wanna listen cuz she's gonna share some tools with you that we haven't talked about on the podcast before and I think you're gonna wanna hear this, I have to ask you first, you have this wonderful quote on your Instagram and I love your Instagram cuz it really shows who you are and your life. (10:58): So everybody, you definitely wanna check it out. We'll give the link at the end that muscle is the currency of aging. Muscle is the currency of aging. Can you talk about what that means? (11:11): I have to confess, I stole that from a friend Carl Leor who's a wonderful podcaster as well. This is about, we have to realize that the exercising muscle, it's not just that your doctor's telling you to exercise. Wow. Wow. That's true. Okay, I know about that. This is actually, we know that the exercising or the contracting muscle secretes signals that tell the rest of your body, this is a young person begin to unfold the D N A unfold, the protein processing that in a way that is much more youthful. So an exercising muscle will communicate to the rest of the body that this is a young person and that youthful things need to be happening. So even if you are unable to exercise, there are other things that we can do to help with that. There's a relatively new device called M sculpt that works on helping people who are unable to exercise. (12:06): Now it's marketed for weight loss, but what's exciting about this device is it's able to help with people who are unable to exercise or have injuries to actually as behave as though they were exercising. So it gives that same release of youthful signals that you get. I think most people are able to do some form of activity and even if you are, you know, walking to your mailbox standing up or sitting down at your desk, I tell my 96 year old patients that one of the things they can do is just standing up and sitting down from their dining room chair. Just getting that kind of activity is going to be beneficial for your overall health because your muscles as they move and contract are sending signals to the rest of your body to be more youthful and to produce proteins in a more youthful manner. (12:54): So then all the things that happen with age where we collect more junk in our more trash in our cells where we damage the cells to the point where they become like zombie cells, all of those things are less likely to happen because of the signals that our cells are getting from the exercising muscle. So there's a reason to exercise this, not just my doctor says I need to exercise or I'm trying to lose weight. Although both of those usually are present. The biggest reason is because of this youthful communication that an exercising muscle will give you. (13:28):Where are women getting it wrong over 40 with maintaining or building muscle mass? How are we getting it wrong with our hormones with the exercises we're doing or not doing? Why do we struggle with losing muscle mass? Cuz that's a huge problem for women. So where do, yeah, (13:47): I love the new, it's one of the hashtags I love. It's it's strong, not skinny. I love that because it's, it moves the focus away from being very, very thin to being very, very healthy. And the idea that one of the things I hear my patients say a lot is, I don't want to do any weight training because I'm afraid I'm going to be too bulky. And that makes me a little bit sad because I think it's one of the easiest, fastest way for women over 40 to lose weight. And so patients that I can finally convince, okay, you don't need to be in the gym, do on the treadmill for 45 minutes every single day. You can do a hit exercise program that's just 15 really probably we can get away with four to five minutes of high intensity interval cardio and the rest of the time you can do some weight training because that's where we get our fat burning. (14:39): Again, that's where we tell ourselves to choose to burn fat as an energy source. If is in that 70% maximum heart rate range, it's not in killing yourself on the treadmill, it's in that lovely 70% max heart rate range, which we usually will get with a good weight training program. Now I definitely recommend people use a trainer, especially if you've just started doing weight training. I have been doing this for several years and I still use a trainer because I wanna make sure I don't injure myself. So injury is a little bit worse of course. So I would rather not have that. I want longevity of my ability to exercise as well. So I have someone who guides me through the things that I do in the gym, the way women are because we don't have a lot of testosterone and particularly as we approach menopause or in that midlife mayhem, we will deplete ourselves of testosterone. (15:33): And so it's actually testosterone and the way you train that will build a bulk of your muscle. It's pretty difficult for women to build bulk. They really have to eat a lot and they have to do exercises in a particular way in order to bulk even at that. Most of the women who you see that are that bulky kind of bodybuilder look, those women usually have, they have given themselves some sort of hormonal treatment, not, not like menopausal hormones but additional hormones that will allow them to be that size. Otherwise women are less likely to grow what we should see to hypertrophy or thicken the muscles. Like you talk about bulky, what we instead will see is more definition of the muscle because you're burning the fat around the muscle, so you're maintaining your muscle mass, you're burning the fat around the muscle to be used for that muscle to contract. So typically I recommend that women over 40 really put the majority of their energy in exercise toward muscle, toward lifting weight, some sort of resistance exercise. (16:39): Okay. Yes. And I find that maybe it's post Jane Fonda aerobic exercise era when people say exercise, like we have in our minds says women over 40, oh Jane Fonda, right? But I think it's time that we changed that visual and I don't have a visual representation of who represents probably Deborah Atkinson , you know, flipping 50. She talks about that all the time. And you don't need more aerobics, you need more resistance training. You mentioned testosterone and that's something that I'm very passionate about because you know, the official corporate medical statement summary on testosterone use in women is basically no. And it's so vital for our brain function neurotransmitters, our bone mass, our muscle. Can you talk about the importance of getting your testosterone tested and treated? (17:37): Yes, over our lifetime, even including in our twenties, testosterone is one of the greatest hormones that's produced and I mean greatest in volume of hormones that's produced by women's bodies, which doesn't seem to be, that doesn't make a lot of sense in our minds, but this is the reason why it's so frustrating. So I just competed in a power lifting competition and I was required to come off of my testosterone in order to com do that competition. I think this is a travesty because this, I'm gonna spend the next several months dealing with my midlife mayhem again as I cover the loss of testosterone and coming back, getting back on it again. And I don't take a huge dose of testosterone. I'm, I'm really just at a moderate appropriate dose because without it, my testosterone, of course I'm 50, my testosterone is very low with testosterone, I sleep better, I'm more calm. Things around me don't bother me. And that's the case with most of my patients. Much like you I'm sure is that they're able to sleep better at night. I tell women things like socks on the floor don't bother you . (18:46): And it's because if you think about it, your husband doesn't, it doesn't bother him. When he sees socks on the floor, he walks right past it. It's because our minds are so diffusely aware. If you're familiar with the work of Allison Armstrong, we have such diffuse awareness when we're in that estrogen cycle and if we are on testosterone, it really helps with bringing some focus to our activities in our day. So I'm a big fan of testosterone and again, not in a, an overdose or super physiologic dosing, but in a necessary for functioning to day-to-day. The dose I take is about one 10th or one 15th. The dose of that I give my husband, it's a way smaller dose, but it's perfect in just what I need in order to function properly in on day-to-day. (19:31): Right. And I love that you brought up Alison Armstrong. I'll just say a little bit about her for everybody listening. She's basically, I guess a woman's dating coach, but she really is very clear about the different psychological profiles that is related to hormones for men and women and how we function differently because of the our hormonal milieu. And so I love that you shared that about our brain because testosterone is super important for that dopamine and the focus and the drive and not only our muscles and our bones, but it's very important. All right, so what else is important when we're looking at increasing our health span? (20:15): I think several things are important. One of the ways that muscle also works. And so this is, it's, I'm gonna tie this into what we just talked about is by increasing the ability of your cells to produce protein and increasing the ability of the cells to produce energy. So I hear a lot of women that are in that midlife mayhem talk about being fatigued. So one of the things that we can use, there's a old drug that was found on Easter Island that is sort of like an old antibiotic, although it functions differently than that. It's F D A approved for use for kidney transplant patients and that's in a fairly high dose. When we use this in a much lower dose, we can find that that we are able to turn off the go, go, go, go, go mi mindset of ourselves and turn on the rest and repair mindset of ourselves. (21:10): Those two aspects of how we see and use energy in ourselves need to be in a really good balance, the calm down, rest and relax as well as the go-go, let's build, let's grow, let's develop. We want that, but we also want the rest and relax. It needs to be in this good balance. Much like we've probably talked about with the sympathetic and parasympathetic nervous system. Those all exist, those dichotomies exist at the cellular level. So one of the things that it's drug is called rapamycin. It's used in much, much smaller doses and there are some really interesting studies about it improving the longevity and the number of years of mice and sea elegance, which is a worm that has very similar D n A to ours as opposed to dogs that don't have similar the for using animals for research rats or mice. (22:03): And the sea elegance has a very similar d n A to us so we can use those to study and rapamycin, because it's been around for a long time, it's been used for many, many years treating kidney transplant patients. We're using this in really, really tiny infrequent doses for every once in a while to give your cells a rep and a chance to recover from all the things we do in a day. So that also sort of, so rapamycin is one option, but we also use that rolls over into the idea of how important sleep is. So one of the things that's the tenant of health for me is going to bed at eight 30. And the reason this is important is because during sleep, this is when your brain opens up what we call the glymphatic drainage system. This is sort of the trash or the sewer system of the brain. (22:52): It's closed during the day and at night while you're sleeping. It opens up as long as the body's not doing anything like digesting food. So this is one of the reasons why your Dr. May say for you to wait at least two hours from eating to going to bed because that gives your body time to handle the food and then it can focus on that recovery and repair. During sleep is when that glymphatic drainage system opens up, all the trash can be cleared away. The immune cells can take the trash, bundle it up, put it out into the glymphatic to be moved away. The systems can be all things can be filed away like where they're supposed to be in the brain and the next morning you can wake up refreshed because all of that was able to happen. So in our patients who aren't sleeping, we need to be really focused and helping them to make that a priority, not only as far as setting aside the amount of time that's necessary, but also in providing them ways to help them with sleep. (23:52): That list is very, very long, but getting adequate number of hours of sleep and the research is around seven to nine hours per night and then also getting enough of the kinds of sleep we need. So the same thing happens during sleep on a nightly basis in the brain. That can happen during the day with using something like rapamycin. The other interesting thing is doing a 12 hour fast overnight. And that's probably the only thing that's been proven in humans to promote longevity is calorie restriction. This is really hard to do long-term, so it's not something that we, that we definitely recommend for everyone, but one of the things I do recommend for everyone is a 12 hour overnight fast. This is, it seems like 12 hours overnight. That seems like it would be easy. Well if you eat dinner at six o'clock at night and don't eat anything again until six o'clock in the morning, that sounds pretty easy. (24:46): But most of my patients have a hard time getting that 12 hours in. What's interesting is if you fast for that 12 hours, we know that the brain will begin to produce a protein or a fat rather called butyrate and butyrate is used by the cells as an alternate fuel source and it triggers that same response as the rapamycin does to help the body with that process of autophagy or rest and relaxation. So an overnight fast of 12 hours is cheaper than getting rapamycin of course, and is a really simple way that everyone at home can be involved in their own longevity is by setting aside that time not only for adequate rest but also for fasting overnight (25:30): Regarding fasting because it's very popular right now all kinds of fast dry, fast wet, fast water, fast juice fast. But intermittent fasting is a huge topic and there's several best selling books on it. What about longer intervals of fasting? What is the research saying about that? (25:50): It's, I think the research is still up in the air and what really works in the research is fasting in the morning and is early, I'm sorry, is is evening fasting, which is much more difficult for most people to do. Most people don't mind fasting in the morning, but they have a really hard time fasting in the evening and as we just talked about, it runs right into your ability of your body to rest and and recuperate and especially the brain to repair the things it needs to overnight if you're bumping that up too close to your sleep time. So I really encourage people if they can, to push that fasting window up against their dinnertime and make that dinnertime be earlier in the evening. Then you get that full 12 hours of overnight sleep, I mean of overnight fasting for the brain to be able to begin producing butyrate so that it can cause all the healing that the cells need through that time when it's produced. (26:46): Okay, alright. I want us continue on tools to improve longevity, but I wanted to ask you about how do people know how old their body thinks they are? I mean sure we have a chronological age, but for some of us, and I've seen some inventories where people can do answer questions about their health and then it spits out kind of what their, and I forget what Eric Braverman calls it, their true age and your, you can find out does your, is your body functioning at an older age or a younger age or your age appropriate? Where are you? But there's some clinical tests that can be used, correct? (27:27): Yes. So I think the simplest way for us to look at that is there's a couple of simple markers that are probably on everyone's last lab test. They're not going to give you a specific age, but it is something for you to monitor over time and it's again, something probably everyone's had done on their most recent lab tests. If you look on your complete metabolic panel, one of the tests that's on there is called an albumin. The goal for albumin is for the level to be four and a half or greater. If you're four and a half or if you're less than four and a half, your risk of aging and your risk of mortality from all causes goes up. So I just encourage people to watch their albumin level. We wanna see that it's either staying the same or improving and that's a general good marker of how well your health overall is. (28:20): The second easy simple marker is in your complete blood cell count and that is a lymphocyte count. We want that lymphocyte count to be greater than 35. When you, as we age, one of the things that causes us aging is that your immune system declines in its ability to function optimally. We know that this has happened with our most recent virus that's gone through and most of the people who were unable to tolerate that were people who were elderly or over 75 80. And part of that is because their immune system is also aging. One of the ways we can look at that is looking at the lymphocyte count, which is look is one of your immune cells and we want that level to be greater than 35. A less than 35 is concerning that you will not be able to fight off viruses or cancer should the two of them come your way. (29:12): And so those are two things you can monitor generally in every lab test. Now a little bit more specific are two different tests and one is called a beta-glucan assay. This can let us know whether or not you also gives you an approximation of what your age is because we accumulate this as we age. There are specific labs that do this. The second one is called true age and it is an epigenetic test, which means you know, you have, you know about people who have genetic variations in their D N A from birth and they have changes that make them more susceptible to things like down syndrome for example. Well those various genes and all of our genes will change the way they are expressed based on what's happening in your environment. So a more appropriate environmentally induced aging marker is this epigenetic test. They're looking for specific changes on specific pieces of D N A that are more common with aging and they can give you both a rate of aging as well as an proposed current age based on all the patients they've had do the test. (30:25): And so there are several companies that do a test like this. I use one called True Age, there are lots of others. And they look at your epigenetics to see whether you are how quickly you are approaching aging. I really am concerned about the rate of aging. So for every one year of age, how many years older are you? And I'd like to see that number be one or less so that you are not continuing aging. And again, one of the ways we can fix that is what we've already talked about with contracting muscle and adequate sleep and overnight fasting. (31:00): All right. Where are we with telomere length at this point clinically? What are your thoughts on that? (31:06): So what's interesting is telomere length, it tends to be associated with aging. We know that again with the most recent virus that people lost a good bit of telomere length. The jury is still out whether extending telomeres will affect your longevity in the long run. So we are still looking at that research to see whether or not there is a benefit. We know that a shorter telomere length is associated with a shorter lifespan, but it's not necessarily correlated with a lengthening of that. Telomere is not necessarily corded with a lengthening of lifespan. So again, the jury is still out. There are several companies that have products that are beneficial in lengthening T telomeres and I am not convinced of the information yet. It's the jury is still out about whether that telomere lengthening will extend lifespan. (32:00): Right. And just for anyone who doesn't know whatt mirrors are, they're kind of like the binding on your end of your shoelaces that you have on all strands of D N A that kind of holds it together and they shorten over your lifespan and like Dr. Suzanne was saying, you're at increased risk for certain diseases when they're shorter. So that's what telomeres are. Alright, so we're working out at the gym doing, getting our muscle mass, we're doing resistance training, we're sleeping, we're doing a 12 hour fast. What other things have been shown or clinically (32:38): Proven to help us improve our health spans? There was a big study that was done called the trim study that's probably the most significant one that's out there. And it was done with growth hormone, growth hormone and the, the study was intended to see whether or not growth hormone would improve lifespan and giving people growth hormone would improve their lifespan. Well one of the side effects of growth hormone is increase in blood sugar. So they also gave those patients metformin to cut counteract the increase in blood sugar from the growth hormone. The other thing that growth hormone is known to do is increase cortisol or stress hormone. Who needs that? So they gave those people D H E A to help counteract this, the ef, the growth hormone side effect of raising cortisol. So the study was done with growth hormone, D H E A and D and metformin. (33:31): So this is one of the places where the hype around metformin began. Metformin has some benefits in, this is what I was getting to. Metformin has some benefits in improving lifespan in animal studies. The concern I have with metformin is its mechanism of action. Number one, its mechanism of action is at the mitochondria or the energy generating level. This interferes with the ability of cytochrome one, which is one of the little things that helps your mitochondria to make energy. It interferes with that function. So I don't want any of my mitochondria to be fun to be messed with. I get concerned when I see that when I hear about mitochondria because mitochondrial dysfunction is one of the causes of aging. So it just doesn't jive in my mind to use metformin, although there's a lot of research out there that's very interesting and ongoing about using metformin for longevity. (34:26): It just makes me nervous because of its mechanism of action. The second thing that metformin does, mechanism of action-wise is affects your microbiome. Which if you have a terrible microbiome might be a good idea if you have a great microbiome. I don't wanna mess with my microbiome. I think our intestines speak volumes to our entire bodies. I think the food that we put in tells the microbiome to be what it is and it will send signals back to our body to be more youthful, to be more energetic, to be more calm. All the things. I listened to your last podcast about anxiety and she was right on about the microbiome really affecting our anxiety. So I get concerned about, about messing with the microbiome if we don't have to. So metformin is a little concerning to me. The study was done with growth hormone and last I understood they were actually looking at using an a peptide called liraglutide, which does not have the glucose raising or the cortisol raising effects of me of growth hormone. So I'm interested to see the research on that. That's still pending lilu most people are probably familiar with it as as Victoza or Saxenda, which are, which is used for weight loss. (35:37): Okay, awesome. All right, so what other tools are available? You mentioned peptides, you are an expert in peptides, you have all book coming out on this topic. What we've covered a little bit of that on the podcast, but can you speak to peptides that might specifically improve health span? (35:57): It's one of the things I think is really interesting and helpful because of how they work. I think there's two in particular that would be beneficial and there's several of them probably that would be helpful. But let's just talk about two, I think thymus and alpha one, which is comes from your thymus thymus gland and can help to rebalance the way your immune system functions. When we get a vaccine, when we have an autoimmune disease, our immune system is really shifted over to one side where it's primarily focused on making antibodies. We don't want our immune system to be focused in that direction because then it's unable to fight things like viruses and cancer. And this is an oversimplification of the way our immune system works. But there, if we're talking about in binary language, that's really what we're looking at. So if it's busy making antibodies, it's not gonna be busy making things, what we call natural killer cells that can fight off bacteria, I'm sorry, viruses and cancer. (36:53): Oh, I'd love for it to be more balanced. And one of the ways we can do that is using this peptide that's naturally occurring in the thymus gland. It's depleted in patients we know that have things like rheumatoid arthritis, MS for example. And so we love having that extra ability to give ourselves depleted thymus and alpha one if we are able to find it. That's a little bit of trouble right now. I like it because it works on that immunosenescence or the aging of the immune system that occurs as we age. The thymus gland, which is where your T-cells come from. Everybody's familiar with this conver you, I couldn't have had this conversation several years ago cuz no one would know what we were talking about, but right. The recent virus we have all this, people are familiar with these terms. You are a thymus gland where your T-cells come from gets replaced with fat as we age. (37:42): And so that's part of the problem with aging is your immune system's unable to fight off things that used to be able to. So if we can give you something like thymus and alpha, we stimulate your baby T-cells to become cells that can fight things off, then we have this better balance. So I think thymus and alpha would definitely fall in my toolbox of anti-aging. The second thing would be to use a growth hormone secretagogue. The reason why I like the instead of growth hormone itself is because they're increasing the ability of your body to produce its own growth hormone. Again, as we age, we know we hit that midlife mayhem and we deplete our bodies not only of testosterone melatonin, estrogen, progesterone, but also growth hormone. And so if we can allow our bodies just to make the amount of growth hormone that it would've made in our twenties and thirties, that it would na you won't overdose on the growth hormone because you're not giving yourself actual growth hormone. (38:40): You're giving yourself an it's, they're usually analogs of growth hormone releasing hormone, which is also naturally produced by the brain. We know that these are associated with improvement in longevity, especially in animal studies. And so this is one of my favorites to help to put people on for improving their longevity. And we can follow that again with a true h test and see how they're chronologically versus biologically improving in their age. So those would probably be my number one. And number two, anti-aging. If we're talking about appearance as aging, one of my favorites is using the copper peptides. And so growth GH HK is the amino acid sequence that it's called. Most of the peptides have a letter and number name on them because they're, they're still in research use. And so G H K has a copper p attached to it, so it's blue when you see it. (39:31): You may see several skincare lines that have a G H K that have a blue coloration to them and these can really help to restore the skin. They have been compared against re A and vitamin C with better than re A and vitamin C outcomes in the research. So very interesting anti-aging for the skin. What's very interesting recently is I've been recommending these topically for people to use for hair loss and we've had several patients lose their hair in this most recent pandemic. And if they use this on their scalp with a derma roller, we do it a couple times a week. Many of these patients will, we're seeing some really amazing results with restoration of hair. And this is not even using p R P, it's just using the, the DRO and the the medical grade J H K C U serum. (40:25): Awesome. Yeah, this is so much good information and I know you could go on probably listing things. I'm thinking, oh, we didn't even talk about oxygen therapies, but I'm gonna tell everyone they just need to read your book , where you're gonna talk about a lot of this. And I thank you so much for joining us. I want everybody listening to really hear that you can improve the quality of your health throughout your life. Juries is not in yet on whether we can actually increase our years, but we can certainly increase the life and the years that we do have. So where can everybody find out more about you? (41:08): My website is Vine as in grapevine medical.com on Instagram at Dr. S Turner, d r s Turner. I'm on Facebook, vine Medical on Facebook. That's the best places. (41:21): And talk a little bit about your book. What are they gonna find there? (41:24): So it's pretty exciting. I'm about halfway through. We're expecting it to be published in November. It is about how to restore your youthful self, recognizing yourself in the mirror again, there I am. And particularly with use the use of peptides. (41:42): Awesome. Well we look forward to that. And thank you for the wisdom and information that you've shared. Thank you for your passion and for your willingness to get out of line. I too started with Dr. Taylor and for everyone listening, Dr. Taylor Eldridge Taylor used to run a program called Get Out of Line for physicians who really recogniz that particularly as women in medical weren't being served properly. And he started by teaching other doctors about natural hormone therapy and then expanded. And then both Dr. Suzanne and I went onto the A four M residency, as she said, or fellowship. So thank you so much for your bravery. A lot of people lay, people don't realize how brave it is for doctors like you to get out of line and say no to the drug and surgery paradigm and walk this path. It's very courageous and I thank you for doing it. I'm so grateful that you just said yes and that you continue on this path. Thank you. (42:46): Thank you Dr. Ki. I appreciate you so much (42:48): And thank you all for listening to another episode of The Hormone Prescription with Dr. Kiran. I know that you loved the information that Dr. Suzanne shared and that you two appreciate her path and are looking forward to her book. So definitely check out her website, check her out on social media, subscribe to her channels so that you can be one of the first to know when her book is available. And I hope that you learn something today that you can implement in your life to change your health and transform your life to what you deserve it to be. I will see you again on next week's episode. Until then, peace, love, and hormones (43:27): Y'all. Thank you so much for listening. I know that incredible vitality occurs for women over 40 when we learn to speak hormone and balance these vital regulators to create the health and the life that we deserve. If you're enjoying this podcast, I'd love it if you'd give me a review and subscribe. It really does help this podcast out so much. You can visit the hormone prescription.com where we have some free gifts for you, and you can sign up to have a hormone evaluation with me on the podcast to gain clarity into your personal situation. Until next time, remember, take small steps each day to balance your hormones and watch the wonderful changes in your health that begin to unfold for you. Talk to you soon.   ► Learn more about Dr. Suzanne Turner - CLICK HERE Follow her on Instagram.   ► Feeling tired? Can't seem to lose weight, no matter how hard you try?   It might be time to check your hormones.   Most people don't even know that their hormones could be the culprit behind their problems. But at Her Hormone Club, we specialize in hormone testing and treatment. We can help you figure out what's going on with your hormones and get you back on track.   We offer advanced hormone testing and treatment from Board Certified Practitioners, so you can feel confident that you're getting the best possible care. Plus, our convenient online consultation process makes it easy to get started.   Try Her Hormone Club for 30 days and see how it can help you feel better than before.   CLICK HERE to sign up.    

In this episode, Dr. Christopher Tookey and Dr. Rose Wolbrink go through some common misconceptions patients may hear about with regards to some of the new weight loss medications everyone is talking about. This episode is focused on the injectable medications called GLP-1 agonists. Examples inculde Saxenda, Ozempic, Wegovy, Trulicity Mounjaro and Byetta  A disclaimer, we're providing general guidance but everyone is different and you should always discuss with your health care professional management of any disease and therapy before trying anything you discover from a source on the internet (including this podcast) 

The FDA is expected to approve Tirzepatide for weight loss sometime this year and we think it could become the best selling drug of ALL TIME. Today on Dumb Money, we'll weigh the data, size-up the opportunity, and give you the skinny on our diet drug investment thesis. Here are the GLP-1 RA drug makers and their drugs: Eli Lilly (ticker LLY) Tirzepatide sold as Mounjaro for diabetes. Weight loss version expected in 2023. Dulaglutide sold as Trulicity. Novo Nordisk (ticker NVO) Semaglutide sold as Ozempic and Rybelsus for diabetes and Wegovy for weight loss. Liraglutide sold as Victoza for diabetes and Saxenda for weight loss. --- Support this podcast: https://anchor.fm/dumbmoney/support

This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing!The American Academy of Pediatrics has put out a new Clinical Guideline for the care of higher-weight children. This document is 100 pages long including references and there are so many things that are concerning and dangerous in it that I had trouble deciding how to divide it up to write about it. I began on Thursday with a piece about the undisclosed conflicts of interest. Ultimately for today, I decided to focus on what I think will do the most harm in the guidelines, which is the recommendations for body size manipulation of toddlers, children, and adolescents through intensive behavioral interventions, drugs, and surgeries.A few things before we dive in. First, this piece is long. Really long. I thought about breaking it up to make it easier to parse, but I also know that people are (rightly) very concerned about these guidelines and I didn't want to trickle information/commentary out over days and weeks in case it might be helpful to someone now. Also, know that this may be emotionally difficult to read, in particular for those who have been harmed by weight loss interventions foisted on them as children. That will likely be exacerbated by the gaslighting these guidelines do to erase the lived experience of harm and trauma from the “interventions” they are recommending, and from their co-option of anti-weight-stigma language to promote weight loss. So please take care of yourself, you can always take a break and come back. Per my usual policy I will not link to studies that are based in weight bias and the weight loss paradigm, but will provide enough information for you to Google if you want to read them. I'll also use an asterisk in “ob*sity” for the reasons I explain in the post footer. Ok, big breath and let's get into this.In later newsletters, I'll address other issues in depth, but for now here are some quick thoughts and links about overarching issues before I dig into the actual recommendation:The claim that “ob*sity is a chronic disease—similar to asthma and diabetes”No, it's really not. And it's this faulty premise (that having a body of a certain size is the same thing as having a health condition with actual identifiable symptomology) that underlies everything in these guidelines. The diagnosis of asthma requires documentation of signs or symptoms of airflow obstruction, reversibility of obstruction (improvement in these signs or symptoms with asthma therapy) and no clinical suspicion of an alternative diagnosis. The diagnosis of diabetes requires a glycated hemoglobin (A1C) level of 6.5% or higher. But to diagnose “ob*sity” you just need a scale and a measuring tape. A group of people with this “diagnosis” don't have to share any symptoms at all, they simply have to exist in their bodies. That is not the same as asthma or diabetes, though the weight loss industry (in particular pharmaceutical companies and weight loss surgery interests) have absolutely poured money into campaigns to try to convince us that it is. (Note that the argument that ob*sity is correlated with other health conditions and thus is a disease actually proves the fallacy since some kids/people who are “diagnosed” with “ob*sity” don't have any of those health conditions and some kids/people who are thin do have them. It's especially disingenuous as it ignores the confounding variables of weight stigma and, in particular, weight cycling both of which these guidelines, if adopted, are very likely to increase.)The myth of “non-stigmatizing ob*sity care” Like so much of these guidelines, this idea and much of the verbiage around it mirrors that of the weight loss industry. In this case, it's attempt to co-opt the language of anti-weight-stigma in order to promote (and profit from) weight loss (there's a guide to telling the difference between true anti-stigma work and diet industry propaganda here!) In truth, there is no such thing as non-stigmatizing care for ob*sity, because the concept of ob*sity is rooted in size and the treatment is changing size (the word was made up to pathologize larger bodies, based on a latin root that literally means to eat until fat so…less science than stereotype there.) There is no shame in having a disease, it's just that existing while fat isn't one. The concept of “ob*sity” as a “disease” pathologizes someone's body size. The concept of ob*sity says that your body itself is wrong, and requires intensive therapy and/or risky drugs and surgeries so that it can be/look right. There is no way to say that without engaging in weight stigma.If someone claims that the treatment is actually about health and not size, then it's not “ob*sity” treatment since both the criteria for the “disease” and the measure of successful “treatment” of ob*sity are based on body size. If the treatment is about health and not size, then the treatment and measures of success should be about actual metabolic health, not body size (which would be ethical, evidence-based, weight-neutral care.)The idea that “It is important to recognize that treatment of ob*sity is integral to the treatment of its comorbidities and overw*ight or ob*sity and comorbidities should be treated concurrently”Again, I think this is demonstrably untrue. Any health issues that are considered “comorbidities” of being higher-weight are also health issues that thin people get, which means that they have independent treatments. We could skip body size manipulation attempts entirely and still treat any health issues that a higher-weight child/adolescent has.The dubious claim that “ob*sity treatment” is compatible with eating disorders preventionI wrote a specific piece about this here. Weight loss as a “solution” to weight stigmaThis is unconscionable. Regardless of what someone believes about weight and health, the message that children (as young as 2!) should solve stigma by undertaking intensive and dangerous interventions that risk quality of life moves beyond inappropriate to disgusting, especially when one is perpetuating weight stigma, as these guidelines (and the weight loss industry talking points that are repeated herein) do.There is so much more to unpack here, but I want to move into a discussion of the recommendations themselves.For this, I will start where I left off on the conflict of interest piece. Which is to say, almost all of the authors of these guidelines are firmly entrenched in the body-size-as-disease paradigm. They have pinned their careers to it. None of the authors are coming from a weight-neutral paradigm.  In fact, in the research evaluation methodology section, they explain that they excluded studies that looked at impacting health, rather than weight. In their own words:The primary aim of the intervention studies had to be examination of an ob*sity prevention (intended for children of any weight status) or treatment (intended for children with overw*ight or ob*sity) intervention. The primary intended outcome had to be ob*sity, broadly defined, and not an ob*sity comorbidity.Note that by “ob*sity comorbidity” they mean a health condition that happens to children of all sizes.I don't know if it was intentional, or just a myopic focus on body size manipulation as a supposed healthcare intervention, but the option to focus on health rather than size was specifically excluded by a group of authors whose careers on based on focusing on size.There are three main areas of their recommendation that I'll talk about today - Intensive Health Behavior and Lifestyle Treatment, Weight Loss Drugs, and Weight Loss Surgeries.RECOMMENDATION:  Intensive Health Behavior and Lifestyle Treatment (IHBLT)This is recommended starting as young as age two. That's right, they are recommending intensive interventions to kids in diapers (and they think that they should look into how to “diagnose” kids who are even younger, yikes!) What these guidelines subtly admit is that these interventions don't actually work. They include this (long-time weight loss industry) talking point “a life course approach to identification and treatment should begin as early as possible and continue longitudinally through childhood, adolescence, and young adulthood, with transition into adult care.”The translation to this is that they have absolutely no idea how to make higher-weight people of any age thin long-term. They are aware (and if not they are negligent) that a century of data shows that the vast majority of people will lose weight short-term and gain it back long-term. What they seem to be trying to do here is rebrand yo-yo dieting (aka weight-cycling) as a successful intervention. If there is a prize for moving the goalpost and declaring victory, they are in the running.Don't just take my word for it, they created a graphic as part of Figure 1 to show it:Pro tip: When they say “relapsing remitting” they mean “yo-yo dieting". I know why the weight loss industry loves this idea - it's how they've built a business that creates exponential growth with a product that doesn't work. What I don't understand is how this group of authors can possibly justify this ethically. The health risks of weight cycling are documented (and very consistent with the health risks that get blamed on higher-weight bodies) so setting people up for weight cycling starting as toddlers does not, to me, have the ring of sound science or ethical, evidence-based medicine.Let's dig into the evidence they are using to support this:The guidelines claim that “IHBLT is the foundational approach to achieve body mass reduction or the attenuation of excessive weight gain in children. It involves visits of sufficient frequency and intensity to facilitate sustained healthier eating and physical activity habits.” The study they cite to back this up (Grossman et al; 2017, Screening for ob*sity in children and adolescents: US Preventive Services Task Force recommendation statement) says “Comprehensive, intensive behavioral interventions (≥26 contact hours) in children and adolescents 6 years and older who have ob*sity can result in improvements in weight status for up to 12 months.”They also include a chart of seven randomized controlled trials (RCTs) from 2005-2017. The combined study population of all seven studies was just 1,153 kids. The largest study (with 549 participants) and the only study to include children from ages 2 to 5 had a duration of 12 months and showed a BMI change of 0.42 that year, and was only “effective” (if you consider a .42 change in a year “effective”) in kids ages 4-8 years old. There was only one study that followed up for more than 12 months, and from 12 months to 24 months, the BMI change decreased (from 3.3 to 2.8,) consistent with the weight regain pattern that we would expect.This will be a running theme in these guidelines - short-term studies will be used to justify life-long recommendations, and weight regain is ignored. In general, sometimes this is based on the idea that if a weight loss intervention works short-term, then it will continue to work forever, other times it's based on the idea that weight cycling is an ethical, evidence-based healthcare intervention. Again, the data on both the long-term failure of weight loss and the danger of weight cycling does not support this.They make a point to mention that IHBLT “involves interaction with pediatricians and other PHCPs who are trained in lifestyle-related fields and requires significantly more time and resources than are typically allocated to routine well-child care.” At this point I'll note that many of the authors of the guidelines run clinics or have practices that provide exactly this type of care.Their criteria for the studies was, I'll just call it lax: “Over a 3-12 month period: The criteria for the evidence review required a weight-specific outcome at least 3 months after the intervention started.” Obviously, this is a very short-term requirement and, again, excludes studies that looked at actual health instead of just body size.Here again they tell on themselvesTreatments with duration longer than 12 months are likely to have additional and sustained treatment benefit. There is limited evidence, however, to evaluate the durability of effectiveness and the ability of long-term treatments to retain family engagement.Note that the idea that longer duration treatment is “likely” to have additional and sustained treatment benefit is not remotely an evidence-based statement, and I would argue that it is biased and should not be included here. Also, they seem to be setting the stage for blaming families for the entirely predictable and almost always inevitable weight regain.Under “referral strategies” they get real about how little weight loss we're actually talking about:Pediatricians and other Primary Healthcare Providers (PHCP's) are encouraged to help to set reasonable expectations for these [BMI-based] outcomes among families, as there is a significant heterogeneity to treatment response and there is currently no evidence to predict how individual children will respond. Many children will not experience BMI improvement, particularly if their participation falls below the treatment threshold.”As described in the Health Behavior and Lifestyle Treatment section, those who do experience BMI improvement will likely note a modest improvement of 1% to 3% BMI percentile decline.So they are recommending an “intensive,” time-consuming, expensive intervention to kids starting as young as age 2 with no prognostics as to which kids might be “successful,” the stated result of which is that “many” (their word) of them won't experience any change in the primary outcome, those who do will see a very small change.They do mention the supposed actual health benefits of these interventions, but fail to mention that the health benefits may have nothing to do with the very small change in size. That's because often when health changes and weight changes (at least temporarily) follow behavior change, those who are invested in the weight loss paradigm (financially, clinically, or both) are quick to credit the weight change, rather than the behavior change, for the health change. Here again, the evidence does not support this. It's very possible that these same health improvements could be achieved with absolutely no focus or attention paid to weight, which would provide more benefits and less risks (including the risks associated with both weight stigma and weight cycling.) It could also allow the children (some, remember, still in diapers) to create healthy relationships with food and movement, rather than seeing choices around food and movement as punishment for their size or a way to manipulate it.As they move into specific recommendations, they start with:Despite the lack of evidence for specific strategies on weight outcomes many of these strategies have clear health benefits and were components in RCTs of intensive behavioral intervention. Many strategies are endorsed by major professional or public health organizations. Therefore, pediatricians and other PHCPs can appropriately encourage families to adopt these strategies. To me this sounds a lot like throwing the concept of “evidence-based” right out the window. None of this means “these strategies are likely to lead to long-term weight loss,” but I'll bet that won't be what is conveyed to the patients and families upon whom these “strategies” are foisted. Before we move on to their recommendations around diet drugs, here is some research to contextualize these recommendations:Neumark-Sztainer et. al, 2012, Dieting and unhealthy weight control behaviors during adolescence: Associations with 10-year changes in body mass indexNone of the behaviors being used by adolescents for weight-control purposes predicted weight lossOf greater concern were the negative outcomes associated with dieting and the use of unhealthful weight-control behaviors…including eating disorders and weight gain [Note: This is not to say that there is anything wrong with higher-weight, but that there is something wrong with a supposed healthcare intervention that has significant risks, almost never works, and has the opposite of the intended effect up to 66% of the time.] Raffoul and Williams, 2021, Integrating Health at Every Size principles into adolescent careCurrent weight-focused interventions have not demonstrated any lasting impact on overall adolescent healthBEAT UK, 2020 Eating Disorders Association, Changes Needed to Government Anti-ob*sity StrategiesGovernment-sanctioned anti-ob*sity campaigns* increase the vulnerability of those at risk of developing an eating disorder* exacerbate eating disorder symptoms in those already diagnosed with an eating disorder* show little success at reducing ob*sityStrategies including changes to menus and food labels, information around ‘healthy/unhealthy' foods, and school-based weight management programs all pose a risk.Pinhas et. al. 2013, Trading health for a healthy weight: the uncharted side of healthy weights initiativesOb*sity-prevention programs that push “healthy eating” are triggering disordered eating in some children, creating sudden neuroses around food in children who never before worried about their weightThey were all affected by the idea of trying to adopt a more healthy lifestyle, in the absence of significant pre-existing notions, beliefs or concerns regarding their own weight, shape or eating habits prior to the interventionFiona Willer, Phd, AdvAPD, FHEA, MAICD, Non-Executive Board Director at Dietitians AustraliaQuoted from: health.usnews.com/health-news/blogs/eat-run/articles/for-healthy-kids-skip-the-kurbo-app“Dieting to a weight goal was found to be related to poorer dietary quality, poorer mental health and poorer quality of life when compared with people who were health conscious but not weight conscious”Ok. Moving on.RECOMMENDATION: Use of Pharmacotherapy (aka Weight Loss Drugs)Their consensus recommendation is that pediatricians and other PCHPs “may offer children ages 8 through 11 years of age with ob*sity weight loss pharmacotherapy, according to medication indications, risks, and benefits as an adjunct to health behavior and lifestyle treatment.”They admit that “For children younger than 12 years, there is insufficient evidence to provide a Key Action Statement (KAS) for use of pharmacotherapy for the sole indication of ob*sity,” but then go on to suggest that if kids 8-11 also have other health conditions, somehow weight loss drugs (which are not indicated for the treatment of the actual health conditions they have) “may be indicated.”Their KAS is that “pediatricians and other PHCPs should offer adolescents 12 y and older with ob*sity weight loss pharmacotherapy, according to medication indications, risks and benefits as and adjunct  to health behavior and lifestyle treatment.”The studies that were actually included in the evidence review predominantly studied metformin (alone and in combination with other drugs,) which is not approved for weight loss, orlistat, exenatide, and one study that looked at phentermine, mixed carotenoids, topiramate, ephedrine, and recombinant human growth hormone.Even though the studies for other drugs did not exist at the time of the evidence review, they made the choice to include them anyway. (This includes Wegovy, the drug that Novo Nordisk, a donor to the AAP, has promised their shareholders will be a blockbuster and that announced its approval in children as young as 12 just days prior to the publication of the guidelines.) Let's look at the efficacy of the drugs they are recommending:MetforminAdverse effects include bloating, nausea, flatulence, and diarrhea and lactic acidosis which they characterize as “serious but very rare.” The guidelines describe the evidence of metformin for weight loss in pediatric populations as “conflicting” They evaluated 16 studies, about two-thirds of which showed a “modest BMI reduction” and one-third showed “no benefit.” Also, this drug is not approved for weight loss. They recommend that due to the “modest and inconsistent effectiveness, metformin may be considered as an adjunct to intensive health behavior and lifestyle treatment (IHBLT) and when other indications for use of metformin are present.”Orlistat:This drug is currently approved for ages 12 and up. Orlistat is sold under the name alli by GlaxoSmithKline and as Xenical by Genentech (both GlaxoSmithKline and Genentech are donors to the AAP.) The guidelines point out that the side effects (including fecal urgency, flatulence and oily stool) “greatly limit tolerability” but do say that “Orlistat is FDA approved for long-term treatment of ob*sity in children 12 years and older.” They cite two studies from 2005. One (Behzat et al., Addition of orlistat to conventional treatment in adolescents with severe ob*sity) started with 22 adolescents, 7 of whom dropped out within the first month due to drug side effects. The remaining 15 subjects were followed for 5-15 months with an average of 11.7 months of follow up. Those 15 patients lost 6.27 +/- 5.4 kg within the study time.The other (Chanoine JP et al, 2005, Effect of orlistat on weight and body composition in ob*se adolescents) was a one-year study with 357 adolescents (age 12-15) in the Orlistat group. They lost weight initially but the weight loss stopped at week 12 and by the end of the study the weight of those in the Orlistat group had increased by .53kg.Glucagon-like peptide-1 receptor agonistsThese are drugs that are type 2 diabetes medications that were found to have a side effect of weight loss. In some cases they have been rebranded specifically for weight loss and, in others, are prescribed off-label.ExenatideThis drug is currently approved in kids ages 10 to 17 years of age. The guidelines point out that a small weight loss was shown in two small studies but with “significant adverse effects.”LiraglutideThe study they cite for liraglutide (Kelly et al, Trial Investigators. A randomized, controlled trial of liraglutide for adolescents with ob*sity.) was a 56 week study with a 26-week follow-up period. Participants lost weight initially, but after 42 weeks began to regain weight (though they were still on the drug) at 56 weeks weight gain became more rapid and at the end of the 26-week follow up they were nearing baseline. The guidelines characterize this as “A recent randomized controlled trial found liraglutide (daily injection) more effective than placebo in weight loss at 1 year among patients 12 years and older with ob*sity who did not respond to lifestyle treatment.” They do not make it clear that participants experienced near total weight regain (see graphic below.) In addition to the near total lack of weight loss (and remember that it's pretty likely that subjects continued to regain weight after the tracking stopped at 82 weeks,) side effects included nausea and vomiting, and among patients with a family history of multiple endocrine neoplasia, a slightly increased risk of medullary thyroid cancer. Liraglutide is sold as Victoza and Saxenda by Novo Nordisk. This study was a clinical trial funded by Novo Nordisk, multiple study authors work for, are employees of, take payments from and/or own stock in Novo Nordisk (see disclosures below) and Novo Nordisk provides funding directly to the American Academy of Pediatrics, and has paid thousands of dollars to authors of these guidelines.Just for funsies I checked the disclosures: Dr. Kelly reports receiving donated drugs from AstraZeneca and travel support from Novo Nordisk and serving as an unpaid consultant for Novo Nordisk, Orexigen Therapeutics, VIVUS, and WW (formerly Weight Watchers); Dr. Auerbach, being employed by and owning stock in Novo Nordisk; Dr. Barrientos-Perez, receiving advisory-board fees from Novo Nordisk; Dr. Gies, receiving advisory-board fees from Novo Nordisk; Dr. Hale, being employed by and owning stock in Novo Nordisk; Dr. Marcus, receiving consulting fees from Itrim and owning stock in Health Support Sweden; Dr. Mastrandrea, receiving grant support from AstraZeneca and Sanofi US and grant support and fees for serving on a writing group from Novo Nordisk; Ms. Prabhu, being employed by and owning stock in Novo Nordisk; and Dr. Arslanian, receiving fees for serving on a data monitoring committee from AstraZeneca, fees for serving on a data and safety monitoring board from Boehringer Ingelheim, grant support, paid to University of Pittsburgh, and advisory-board fees from Eli Lilly and Novo Nordisk, and consulting fees from Rhythm Pharmaceuticals. Melanocortin 4 receptor (MC4R) agonistsThese are specialty drugs that are only FDA approved for patients 6 years and older with proopiomelanocortin deficiency, proprotein subtilisin or kexin type 1 deficiency and leptin receptor deficiency confirmed by genetic testing. They site a small, uncontrolled study in which patients experience weight loss of 12-25% over 1 year. PhenterminePhentermine is a controlled substance chemically similar to amphetamine which carries a risk of dependence as well as side effects including elevated blood pressure, dizziness, and tremor. These are FDA approved for a 3-month course of therapy for adolescents 16 or older. I'm not clear what good could come out of giving a teenager a drug with these kinds of risk for 3 months?TopiramateThis is a drug that is used to treat seizures and migraines that happens to have a side effect of making people not want to eat through what the guidelines admit are “largely unknown mechanisms.” These drugs cause cognitive slowing and can cause embryo malformation. It's approved for children 2 years and older with epilepsy and 6 and older for headaches and I cannot for the life of me imagine how it could possibly be ethical to cause cognitive slowing in a child (who is going to school!) in order to disrupt their bodies hunger signals.Phentermine/TopiramateYou read that right, those last two drugs with the dangerous, quality-of-life impacting side effects? The guidelines discuss the option of prescribing them together. To children. This is based on a 56-week study (Kelly et al, 2022, Phentermine/topiramate for the treatment of adolescent ob*sity.) In the study, 54 subjects were given a mild dose, 15 of them dropped out. 113 were given the “top dose” 44 of them dropped out. As we've seen in other studies, weight loss had leveled off and begun to rise slightly by week 56 and there is no reason to believe it wouldn't go back up, but we'll never know because they didn't do any more follow-up. By the way, like most of the other studies, these subjects were also undergoing a “lifestyle modification program.” Also, like the other drugs, I think it's important to note that this was FDA-approved for “chronic treatment” based on the results of a study that only lasted 56 weeks. That is a common situation with weight loss drugs.Finally, the guidelines don't mention that side effects of this drug include increased heart rate, suicidal behavior and ideation, slowing of linear growth, acute myopia, secondary angle closure glaucoma, visual problems; mood and sleep disorders; cognitive impairment; metabolic acidosis; and decrease in renal function.  As I was looking this up, I noticed that the lead author of this study is the same lead author of the liraglutide study. Phentermine/Topiramate is sold under the brand name Qysmia by Vivus. I had to do some digging to get to the disclosures on this one and what do you know, Dr. Kelly has received grant consideration and consults for Vivus. In fact, with the exception of Megan Oberle, every author of this study either receives funding from/consults for Vivus, or is an employee of Vivus. Megan Oberle lists no conflicts of interest in this 2022 study but, interestingly, in a 2019 study (It is Time to Consider Glucagon-Like Peptide-1 Receptor Agonists for the Treatment of Type 2 Diabetes in Youth) the disclosure states “MO serves as site PI [principal investigator] for study through Vivus Pharmaceuticals” so we know they're not strangers. LisdexamfetamineThis is a stimulant that is approved for kids 6 and older who have ADHD, in those 18 and up for Binge Eating Disorder, and while it is sometimes prescribed off-label for higher-weight kids, the guidelines note that “no evidence available at the time of this review to demonstrate safety or efficacy for the indication of ob*sity in children.”Summing up, there are significant risks of side effects (some life threatending) and not a drug among them has shown anything approaching long-term efficacy. Let's look at the last of the recommendations.RECOMMENDATION: Weight Loss SurgeryThis is the last bit I'll write about today. This section beginsIt is widely accepted that the most severe forms of pediatric ob*sity (ie, class 2 ob*sity; BMI ≥ 35 kg/m2, or 120% of the 95th percentile for age and sex, whichever is lower) represent an “epidemic within an epidemic.”Remember, for a moment, that this phrasing is from authors who swear up and down that they are working to end weight stigma. One wonders what they would have written if they were trying to stigmatize higher-weight children. (Just fyi, if anyone is confused, you can't usefear-mongering language, describing a group of people simply existing in the world at a higher-weight as an “epidemic” without stigmatizing them.)The KAS here (for me the most horrifying of those offered,) isPediatricians and other PHCPs should offer referral for adolescents 13y and older with severe ob*sity (BMI ≥ 120% of the 95th percentile for age and sex) for evaluation for metabolic and bariatric surgery to local or regional comprehensive multidisciplinary pediatric metabolic and bariatric surgery centers. [I'll note here that at least one of the authors of these guidelines runs just such a facility.]Before we get too far into this, let's be clear about what these surgeries do. They take a child's perfectly functioning digestive system, and put it into a (typically irreversible) disease state forcing, restriction and/or malabsorption (for an explanation of the various surgeries, check out this post.) If this state happens to a child because of disease or accident, it is considered a tragedy. If the child is higher-weight, it is considered, at least by the authors of these guidelines, healthcare.They make the claim “Large contemporary and well-designed prospective observational studies have compared adolescent cohorts undergoing bariatric surgical treatment versus intensive ob*sity treatment or nonsurgical controls. These studies suggest that weight loss surgery is safe and effective for pediatric patients in comprehensive metabolic and bariatric surgery settings that have experience working with youth and their families”To support this, they cite a single study. The study (Laparoscopic Roux-en-Y gastric bypass in adolescents with severe ob*sity (AMOS): a prospective, 5-year, Swedish nationwide study) included 81 subjects who underwent Roux-en-Y gastric bypass.The average weight loss was 36·8 kg over five years, but 11% of those who had the surgery lost less than 10% of their body weight.A full 25%  had to have additional abdominal surgery for complications from the original surgery or rapid weight loss and 72% showed some type of nutritional deficiency. And that's just in five years. Remember that the damage done to the digestive system is permanent. They are recommending this as young as 13, so a five year follow-up only gets these kids to 18. Then what?By the look of their own graph, what comes next may well be more weight gain, since the surgery survivors' weight loss leveled off after year one and started to steadily climb after year two. There's also the impact of those nutrient deficiencies. They also claim that these surgeries lead to a “durable reduction of BMI.” Let's take a look at the studies they cite to prove that.Inge et al., 2018 Comparison of Surgical and Medical Therapy for Type 2 Diabetes in Severely Ob*se AdolescentsThis study lasted two years. It looked at data from 30 adolescents who had weight loss surgery. They averaged 29% weight loss over 2 years and 23% of the subjects had to have a second surgery during those two years.Göthberg et al., 2014, Laparoscopic Roux-en-Y gastric bypass in adolescents with morbid ob*sity--surgical aspects and clinical outcomeThis study just rehashes information from the Olbers study above.O'Brien et al. Laparoscopic adjustable gastric banding in severely ob*se adolescents: a randomized trialThis study is about gastric banding and I'm not sure why they included it because in the paragraph above it they point out that these surgeries are “approved by the FDA only for patients 18 years and older, have declined in use in both adults and youth because of worse long-term effects as well as higher-than expected complication rates” (they cite 18 studies to back up this particular claim.)Olbers et al., 2012 Two-year outcome of laparoscopic Roux-en-Y gastric bypass in adolescents with severe ob*sity: results from a Swedish Nationwide Study (AMOS)These are just the two-year outcomes from the five-year Olbers study aboveOlbers et al. Laparoscopic Roux-en-Y gastric bypass in adolescents with severe ob*sity (AMOS): a prospective, 5-year, Swedish nationwide study.This is the exact same 5-year Olbers study from above, just given a different citation number.Ryder et al., 2018 Factors associated with long-term weight-loss maintenance following bariatric surgery in adolescents with severe ob*sityThis study included 50 subjects who had Roux-en-Y gastric bypass and had a follow-up at year one and another follow-up sometime between years 5 and 12. They were then divided into “regainers” and “maintainers” though by their criteria, “maintainer” subjects could regain, they just couldn't regain more than 20% of the weight they lost prior to their follow-up. Though the study is called “Factors associated with long-term weight-loss maintenance” they were not able to identify any factors that were predictors of “regaining” or “maintaining.” You'll note in the graph below that weight was still trending upward when they stopped following up.So let's recap: They cite 7 studies to back up their recommendation of referrals for these surgeries for kids ages 13 and up. Four of the seven are the same study. One is a study for a surgery that they themselves have said is declining in use, so I'm excluding it. Combined, the rest of the studies followed a grand total of 161 people. The longest follow-up is “5+ years” and the studies consistently showed weight regain that was trending up when follow-up ended, as well as high rates of additional surgery and nutrient deficiencies. This, to me, doesn't come close to justifying a blanket recommendation that every kid 13 and older whose BMI ≥ 120% of the 95th percentile for age and sex be referred for evaluation for weight loss surgery.And when it comes to their criteria for these surgeries, they predicate risk on size. Those with “class 2 ob*sity” are required to have “clinically significant disease” which doesn't make the surgery ethical but, in comparison; children with “class 3 ob*sity” simply have to exist in the world to meet the criteria to have their digestive system put into a permanent disease state. One thing they do point out is that recent data showing multiple micronutrient deficiencies following metabolic and bariatric surgery serve to highlight the need for routine and long-term monitoring. Here we see a serious issue with giving this surgery to adolescents. First of all, they are rarely in control of their access to food. If their parents don't buy them what they need, if a parent loses their job and can no longer afford the supplements they require, if they experience hunger and/or homelessness… there are so many things that could impact a 13-year-old's ability to eat in the very specific ways they need to after the surgery for the rest of their life. Also, these surgeries are going to change the ways that these kids eat - at every school lunch, birthday party, family holiday. Anytime food is served, it is going to become clear that they are different, and if they aren't in charge of preparing the food, there is no guarantee that they will be able to get what they need. And that's if they want to do that. Let's not forget, these are humans who are/will be exploring their independence, including through rebellion, they are humans whose prefrontal cortex is not fully developed, meaning that they can literally lack the ability to fully recognize the consequences of their choices. (Of course, given that we only have five years of follow-up data, I would argue that their doctors and surgical teams also lack the ability to fully recognize the consequences of their choices.)The authors end the section with a fairly shameless plug for insurance coverage of these surgeries. This is another long-time goal of the weight loss industry that has made its way into these guidelines.I think this is a good time for a reminder that thin kids get the same health issues for which higher-weight kids are referred to these surgeries and thin kids are NOT asked to take the risks of these surgeries or to have their digestive systems permanently altered. They just get the ethical, evidence-based treatment for the health issue they actually have. Also, remember that the authors' research methodology specifically excluded research about weight-neutral intervention to see if any health benefits that the surgeries might create could be achieved without the significant (and, from a long-term perspective, largely unknown) risks of these surgeries, and perhaps be more lasting?But there is more to this in terms of informed consent. There are many of the same issues that we see with adults (which I wrote about here). With kids, there is another layer. In the state of California, for example, it is illegal to give a tattoo to someone under the age of 18, even with parental permission. But an eighth grader can make the decision to have their digestive system permanently altered, impacting their life and quality of life in myriad ways, many of which are unknown, and with no prognostics? Given all of this, is informed consent even possible for these kids? I would argue that it is not.Even worse, how many kids' parents, in some combination of weight stigma, concern for their child, and acquiescence to a doctor who may be pressuring them, will make this decision for their child?While I'm sure that there are adolescents who had the surgery and are happy with their outcome, I'm equally sure that there are adolescents who had terrible outcomes and would give anything to not have had the surgery (I know because I hear from them). And I know that the research can't tell us why anyone has the outcome they have. When you combine that with the total lack of long-term follow-up (I'm completely unwilling to consider 5 years “long term” for a lifelong intervention,) I think what we have here are, at best, experimental procedures, not procedures that should receive the kind of blanket recommendations that these guidelines provide for kids as young as 13.Ok, there's a lot more to discuss in these guidelines but I will save that for another newsletter. I hope that the outcry against these guidelines is loud, sustained, and successful in getting them rescinded. Kids deserve far better than this.Finally, I just want to give a quick shout-out to my paid subscribers (I know not everyone can/wants to have a paid subscription and that's totally fine - absolutely no shame at all if you are reading this for free as a subscriber or randomly!) those who are able to pay are allowed me to spend HOURS this week going through these guidelines and creating Thursday's post and this post, I'm just super grateful for the support.I'll be posting additional deep-dives into the research they cite and I'll keep a list here:“New insights about how to make an intervention in children and adolescents with metabolic syndrome” Pérez et al.Did you find this post helpful? You can subscribe for free to get future posts delivered direct to your inbox, or choose a paid subscription to support the newsletter and get special benefits! Click the Subscribe button below for details:Liked this piece? Share this piece:More research and resources:https://haeshealthsheets.com/resources/*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight” to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings Fearing the Black Body – the Racial Origins of Fat Phobia and Da'Shaun Harrison Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

Novas estratégias para o emagracimento. Falamos sobre os análogos de GLP 1, os famosos Saxenda, Ozempic e Victoza, entre vários outros temas relacionados tratamento da obesidade.

This week we are continuing our mini-series on semaglutide. Today we'll cover how semaglutide compares to other weight-loss peptides that are on the market and promising weight-loss peptides in the pipeline.  What weight loss peptides are available? Besides semaglutide (Wegovy), another injectable glucagon-like peptide-1 (GLP-1) agonist available is liraglutide (Saxenda). Saxenda was the first medication in its class to be approved for weight loss. Unlike semaglutide, it's short-acting and needs to be given daily. A couple of weeks ago, we mentioned that one reason there's a lot of buzz around semaglutide is the amount of weight people lost during clinical trials. A 68-week study with almost 2,000 adult participants reported an average weight loss of nearly 15% on semaglutide compared to 2.5% on placebo. Liraglutide, on the other hand, has been shown to provide an average weight loss of 8% from baseline body weight.  Unlike semaglutide, Saxenda is approved for use in children at least 12 years old. Semaglutide is only approved for use in people at least 18 years old.  It's important to know that Victoza, an FDA-approved medication used to treat Type 2 diabetes, has the same active ingredient as Saxenda. However, Saxenda is approved at a higher dose (3 mg) than Victoza (0.6, 1.2, and 1.8 mg). The 3 mg dose has been shown to be more effective at helping people lose weight. This is why Victoza is not approved for weight loss.  What peptide weight loss medications are in the pipeline? Tirzepatide (Mounjaro), also a GLP-1 agonist, is a newer medication recently approved for Type 2 diabetes. Like semaglutide, Mounjaro was studied in people without Type 2 diabetes to treat obesity. Based on their weight loss findings, the highest dose of the medication reduced body weight by about 21% of the total body weight compared to the placebo group, who lost an average of 3%. These results are an important step forward for potentially expanding more therapeutic peptide weight loss options. In fact, on October 6 the FDA granted tirzepatide a “fast track” review to be designated as a treatment for obesity. To receive this label, Eli Lilly, the manufacturer of Mounjaro, will be using data from the SURMOUNT-1 clinical trial and the ongoing SURMOUNT-2 trial, which is investigating the medications use in people with type 2 diabetes who have excess weight or obesity. Although the SURMOUNT-2 trial won't' be completed until April 2023, the FDA's fast-track designation allows for the rolling submission of trial data. This means the FDA can review data as it comes in, instead of waiting for the entire trial to wrap up. This helps speed up the review process, resulting in a faster approval date. As always, speak with your healthcare provider or pharmacist to see what medication is right for you. You'll also want to keep in mind that most of these peptides are quite popular and difficult to get your hands on right now through retail pharmacies. If the medication you need is not in stock, you may be able to get your medication from a compounding pharmacy.  Always check that the compounding pharmacy you are using is credible. The pharmacy should follow USP 797 guidelines to help protect you from getting contaminated products.  Thanks again for listening to The Peptide Podcast. You can find more information at pepties.com. We love having you as part of our community. If you love this podcast, please share it with your friends and family on social media. Have a happy, healthy week! Pro Tips We're huge advocates of using daily collagen peptide supplements in your routine to help with skin, nail, bone, and joint health. But what do you know about peptides for health and wellness? Giving yourself a peptide injection can be scary or confusing. But we've got you covered. Check out 6 tips to make peptide injections easier. And, make sure you have the supplies you'll need. This may include syringes, needles, alcohol pads, and a sharps container.

It's “In the News…” a look at the top diabetes stories and headlines of the past seven days. This week: Michigan joins California in exploring producing and distributing insulin made in-state, new study looks at why girls have a harder time with T1D than boys, weekly basal insulin moves forward, Dexcom puts G7 in wider release (but not yet in the US) and more! Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here Episode Transcription Below (or coming soon!) Please visit our Sponsors & Partners - they help make the show possible! *Click here to learn more about OMNIPOD* *Click here to learn more about AFREZZA* *Click here to learn more about DEXCOM* Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days. XX In the news is brought to you by T1D Exchange! T1D Exchange is a nonprofit organization dedicated to improving outcomes for the entire T1D population. https://t1dexchange.org/stacey/ XX Michigan following California when it comes to exploring making and distributing insulin. Governor Gretchen Whitmer signed an executive directive this week to establish a Michigan-based insulin manufacturing facility, and facilitate the development, in conjunction with a partner or partners, of a low-cost insulin product for distribution in Michigan. Whitmer already announced a plan to cap insulin costs in her State of the State address in January. https://michiganadvance.com/blog/whitmer-signs-directive-seeking-to-lower-insulin-costs-wins-bipartisan-praise/ XX Novo Nordisk plans to move forward with its once a week insulin icodec. Recent studies show it worked as well or better than daily basal insulin, reducing A1C after 52 weeks. Novo Nordisk's ONWARDS program for once-weekly insulin icodec comprises six phase 3a global clinical trials, including a trial with RWE involving more than 4,000 adults with type 1 or type 2 diabetes. It is expected that Novo Nordisk will file for regulatory approval of the once-weekly insulin icodec in the first half of 2023 in the US, the EU, and in China. There is a separate and additional study for people with type 1 – looking at weekly insulin icodec wth mealtime insulin. That's expected to conclude in about six months. https://pharmaphorum.com/news/novo-nordisk-achieve-headline-results-with-icodec-insulin/ XX Big new study shows that girls tend to have more serious issues with type 1 diabetes than boys. This is physical, quantifiable stuff, including higher blood sugar levels, weight issues, and higher cholesterol. This was a review of 90 previous studies at Amsterdam University Medical Centers. that women and girls have typically not received as much attention as study subjects as men. These researchers say more study is needed including finding ways to help doctors treat girls with type I diabetes differently than boys https://www.healthline.com/health-news/why-type-1-diabetes-can-be-tougher-on-girls-than-boys XX Alarming new study says that cases of type 1 worldwide could double by 2040. Tracking has improved in recent years, but Type 1 diabetes is underrepresented. In addition, because many countries don't collect Type 1 diabetes data, the numbers have historically skewed toward North America and Europe. About 175,000 people worldwide died because of Type 1 diabetes in 2021, they believe, and 63 to 70 percent of the deaths in those under age 25 occurred because the disease wasn't diagnosed. This study is in the Lancet Diabetes and Endocrinology https://www.washingtonpost.com/health/2022/10/03/diabetes-type-one-surge/ XX Big new study looking at which drugs paired with Metformin work the best for type 2. The trial was conducted at 36 study centers nationwide with more than 5000 people. Three groups took metformin plus a medicine that increased insulin levels: sitagliptin or Januvia, liraglutide or Victoza, or glimepiride or Amaryl. The fourth group took metformin and a long acting insulin. After about five years of follow-up, the researchers found that all four drugs improved blood glucose levels when added to metformin. But those taking metformin plus liraglutide or the long-acting insulin achieved and maintained their target blood levels for the longest time. The effects of treatment did not differ with age, sex, race, or ethnicity. However, none of the combinations overwhelmingly outperformed the others. https://www.nih.gov/news-events/nih-research-matters/popular-diabetes-drugs-compared-large-trial XX Dexcom's G7 is getting a wider rollout: the United Kingdom, Ireland, Germany, Austria and Hong Kong, with launches in New Zealand and South Africa in the coming weeks. I'll link up the promotional video.. no news yet from the US FDA on when the G7 will be approved in the US. I am talking to Dexcom's Senior Director of Global Product Design for Tuesday's podcast episode. https://www.youtube.com/watch?v=dYqNUf0paAU XX Tandem's t:connect mobile app is now compatible with the latest iOS operating system on version 2.3 of the t:connect mobile app. Until this update, you could lose the mobile bolus if you updated your phone. Tandem also added a new iPhone and nine new android devices to their compatibility list. We'll link that up in the show notes. : https://www.tandemdiabetes.com/.../device-compatibility XX Back to the news in a moment but first.. The T1D Exchange Registry is a research study conducted online over time, designed to foster innovation and improve the lives of people with T1D. The platform is open to both adults and children with T1D living in the U.S. Personal information remains confidential and participation is fully voluntary. Once enrolled, participants will complete annual surveys and have the opportunity to sign up for other studies on specific topics related to T1D. The registry aims to improve knowledge of T1D, accelerate the discovery and development of new treatments and technologies, and generate evidence to support policy or insurance changes that help the T1D community. By sharing opinions, experiences and data, patients can help advance meaningful T1D treatment, care and policy. The registry is now available on the T1D Exchange website and is simple to navigate, mobile and user-friendly. For more information or to register, go to www.t1dregistry.org/stacey XX The College Diabetes Network announces a name change – they'll now be known as the Diabetes Link. The groups says this new name reflects a commitment to expand support to the larger young adult diabetes community, whatever the type of diabetes they live with and whether they're in school or in the workforce. Currently, there are 3 million young adults (ages 17-30) living with diabetes in the U.S. and that number continues to increase every day. The Diabetes Link is the only national organization that focuses specifically on people in their teens and twenties, in recognition that this time of their lives is full of enough change and challenges without a chronic disease added to the mix. XX And finally, another zoo animal with a CGM. Tiana is a lemur in New Zeleand. The zoo's education officer, has diabetes and recommended the Dexcom for the lemur. Interestingly, they aren't using insulin here, but rather a hypoglycemia medication and are altering the lemur's diet. Apparently lemurs are prone to something more like type 2 diabetes due to some iron issues or if they eat too much sugar, but Tiana's case more resembles type 1. https://www.stuff.co.nz/national/130016440/meet-tiana-the-diabetic-lemur-with-a-glucose-monitor-stuck-to-her-back#:~:text=Hamilton%20Zoo%20resident%20lemur%2C%20Tiana,with%20diabetes%20in%20the%20zoo.&text=Zoo%20vet%20Tori%20Turner%20says,Hamilton%20has%20joined%20the%20club. XX On the podcast next week.. Dexcom's Senior Director of Global Product Design – Very We'll talk about what goes into designing a comletley new product like the G7. He lives with type 1 himself. This past episode is all about how diabetes communities around the world stayed connected during the early days of the pandemic, Listen wherever you get your podcasts Hey for you parents, we've got a webinar on Halloween, link in the show notes and on my social media. That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

What do humans and cars have in common? No this is not the start of a lame joke, but it is an introduction to the Diabetes Warranty Program. Similar to your car, which comes with a warranty manual explaining when to take the car in for regular maintenance checks, Dr. E created the Diabetes Warranty Program to prevent, detect, and treat the complications related to diabetes as soon as possible. Learn when you should see your healthcare provider to keep your eyes, kidneys, feet, heart, and mouth running as smooth as your car—or at least as smooth as you'd like your car to run.  Questions We'll Cover in This Episode:·       What is the Diabetes Warranty Program?·       What are the goals of the Diabetes Warranty Program?·       What are the medical recommendations for eye care for people with diabetes?·       What are the medical recommendations for kidney care for people with diabetes?·       What is the recommended blood pressure level for people with diabetes?·       What are the medical recommendations for foot care for people with diabetes?·       What are the medical recommendations for heart care for people with diabetes?·       What are the medical recommendations for oral care for people with diabetes?Show notesTCOYD live kidney care: https://youtu.be/F--YwkaJlToSGLT2 inhibitors: Jardiance, Invokana, Farxiga, SteglatroGLP-1 receptor agonists: Bydureon, Trulicity, Ozempic, Victoza, Adlyxin, Rybelsus Nutrition Videos for Type 1s: https://tcoyd.org/vv-t1d-nutrition/Nutrition Videos for Type 2s: https://tcoyd.org/vv-t2d-nutrition/Exercise Videos for Type 1s: https://tcoyd.org/vv-t1d-exercise/Exercise Videos for Type 2s: https://tcoyd.org/vv-t2d-exercise/ ★ Support this podcast ★

What's a GLP-1 agonist? Let's comprehensively compare all the common GLP-1 agonists (Wegovy vs Ozempic vs Rybelsus vs Saxenda vs Victoza vs Trulicity vs Byetta vs Bydureon vs Adlyxin vs Tanzeum) for weight loss.

Trulicity Ozempic Saxenda Victoza- co powinieneś wiedzieć o tych lekach. Otyłość, insulinooporność, odchudzanie. Popularne zastrzyki stosowane w cukrzycy, otyłości, odchudzaniu, czy insulinooporności. Wasze pytania i wątpliwości. Jak przewozić? Co robić w przypadku działań niepożądanych? Czy mogą powodować nowotwory? Dlaczego u niektórych osób nie zadziałają? Te i inne pytania i wątpliwości omawiam w moim nagraniu.

For an upcoming documentary, Dennis Hadac took part in a 10-day plant-based health immersion run by Plant Pure. Before going plant-based, Dennis took four oral meds for Diabetes, two injectables [Victoza and Tresiba], two high blood pressure meds, two high cholesterol meds, and a gout med. He was off all, but the cholesterol meds and had lost 9 pounds in the ten-day health immersion. Since that time, he has lost an additional 35 pounds. He's been able to have his doctor cut the remaining meds [reluctantly] in half doses while she monitors his cholesterol levels. Dennis has remained on the plant-based eating plan since November. He is sleeping better, his energy levels have been maintained, and he has been able to get his wife to eat what he cooks for dinner and on weekends! To learn more visit: https://www.blueberry.health/

How does Ozempic / Rybelsus (semaglutide) vs Victoza / Saxenda (liraglutide) compare for weight loss? What are the differences and similarities? Here's how these four drugs compare in terms of effectiveness, side effects, cost, dosing, and what you should know before using any of them.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ Last week we reviewed the traditional weight loss medications that were used commonly before this very effective new class of weight loss drugs. Like most medications, drug companies', researchers and doctors find amazing new drugs for a use that the drug was never intended for.  An example of this is the drug Viagra.  It was initially being presented to the FDA as a blood pressure and cardiac drug.  It increased nitric oxide and that dilates arteries, which lowers blood pressure and eases the work on the heart.  On the pathway to approval, they found that Viagra was the first drug discovered that could create an erection in men who were important. In 2010 a drug-group called GLP-1 receptor agonists was introduced as a treatment for diabetes.  This class of drug, much like Viagra, was found to induce loss of fat, while preserving muscle mass resulting in weight loss.  The first drug name was Victoza (liguride), and after the weight loss aspect of this drug was confirmed, the weight loss drug was named Saxenda. These drugs are injectable only but are subcutaneous delivered with a “pen” and are extremely effective for weight loss. If a patient doesn't have a problem with injecting a subcutaneous medication every day, then this drug has it all!  GLP-1 RAs causes weight loss 3 ways: 1) They decrease hunger, 2) they cause patients to feel full when they eat half as much as usual, and they 3) speed up their overall metabolism so they burn more calories at the same level of activity.  These drugs can also be continued for life if necessary to maintain a healthy weight. These drugs are perfect for pre-diabetics, and Adult-Onset Diabetics (AODM), because not only is weight loss successful but insulin resistance is treated with this medication.  As usual, with any excellent answer to a problem, we are limited in its use by the cost of this medication.   For those people who need to lose weight and can go on it for 6 months or less to achieve their goal, it is still unaffordable.  There is no way to write a script for this medication and expect a patient to pay $667-928/month, and unless they have diabetes insurance will not generally pay for this drug.  The side effects from Liguride may also be a reason it can't be used by everyone.  Patients who have GI reflux, Barret's esophogus, or GI ulcers can't take this drug because it slows the emptying of the stomach and makes these conditions worse. Prior to 2010, Metformin ER had been used for the treatment of pre-diabetes, AODM, and Insulin resistance for years, and has been effective for weight loss in many patients who have these conditions as the reason for their obesity.  Metformin ER is inexpensive and is paid for by insurance, unlike all the other weight loss drugs, because it is also used for diabetes. In my practice, for patients with IR, AODM, hypertension, and heart disease who need to lose weight This is a very safe and effective way to lose weight, but it only works when a patient follows a low carb diet, and daily exercise to be truly effective.  Metformin literally makes my patients healthier and is considered one of the most effective anti-aging medicine available. Another rather new combination of drugs used for weight loss is Naltrexone/Bupropion is not one that I have used in the office because of the high risk of side effects. I suspect in other medical hands it can be effective. The newest drug, Semaglutide, sold under the name of Ozempic and Rybelus, is extremely effective  and is given as a subcutaneous shot that can be self-administered once a week so compliance is not a factor. Rybelus must be taken daily but is a pill and not an injection, so is good for those with needle phobia.   Semaglutide in either form stops hunger, makes my patients feel full, and increases the speed of metabolism so they burn more calories than other people at the same level of exercise.  Ozempic/Rybelus can be given to patients who are not candidates for amphetamines and who have reflux side effects from Victoza/Saxenda. Ozempic/Rybelus is well tolerated and can be given to anyone who will give themselves a shot once a week.  The only problem with this medication is the cost, 4-6 weeks costs $900-$1200. We have found a way around this for those patients who can't afford this price and have gotten it down to about $500/2 months.  If you think about it, you can be very compliant and not use it very long to get to your ideal weight, then you would only have to use the drug for a short period of time.  We have achieved a great weight loss for our patients when we manage their diet, exercise, and replace testosterone with pellets if they are over 40, by seeing them in the office every month until they achieve their ideal weight. We always recommend a low carb diet, keeping a diary of food, water and daily exercise in My Fitness Pal app, which makes all of these treatment methods more successful than the experts claim. There is no weight loss that lasts without dieting and exercise, even with medication. Taking a drug to lose weight is your chance to change your lifestyle so that you can keep the weight off after you stop the medication. You have to be completely on board to actually succeed at achieving your ideal weight….and staying there. Talk to your doctor about these drugs …but only if you are ready to change your lifestyle for the better..you must be all in to get healthy for life!

Have you seen the commercials for diabetic drugs where the patient says the drug “unlocks the insulin inside of me”, and then you see people dancing and having a great time? Sadly, that's not the reality. Today we're talking about drugs like Victoza, Adlyxin, Trulicity, Ozempic which are weekly injections which sound wonderful that you only have to take a shot once a week!  – keep in mind this is not insulin... and other drugs such as  Rybelsus, Januvia, Tradjenta, Glipizide, and Glimepiride.  Many of these actually do more than just work on your pancreas. They can also work on other organs. Don't worry, there's always more in the works.  It seems like there is a steady stream of diabetes drugs coming out on the market.  You'll know when you see another new diabetes drug commercial with people dancing around.HIGHLIGHTSMarketing vs Reality - on your pancreasHow most doctors approach diabetics' weight problems, relying on these drugsDiet and Exercise: the eternal (and natural) companions to drugs in order to see real positive changes Deconstructing Trulicity's functionality and side effects based on their own information and dataInconsistencies between what's "promised" and the impact of taking some of these drugsBeta cell burnout and insulin dependencyImportance of the C-Peptide testWARNING: if you are taking Trulicity or any other similar drug, DO NOT make any changes before consulting with your health care professional. GOLD MEDAL QUOTES"The newer drugs that keep coming out have more and more of these terrible possible side effects"."Using a drug of this nature, one that works on the pancreas to produce more insulin can worn over work your pancreas"."Losing weight should be a slow process so you retain as much muscle as possible".LINKS OF INTERESTCheck out Trulicity's site to verify the information given on this episode https://www.trulicity.com/Visit My Diabetes Concierge ProgramNeed someone to talk to about your Diabetes? Book a free consultation with Denise today https://reversemydiabetes.net/  Sign up to the Email list  to get notified when webinars and trainings come up.Follow  The Virgin Diabetic on Instagram and TikTok @thevirgindiabetic Get diabetes-friendly recipes and find some useful articles about diabetes at https://reversemydiabetes.net/blogGet The Virgin Diabetic Book https://amzn.to/3auCJl6Join us on Facebook for more info, discussions and articles https://www.facebook.com/reversemydiabetes/ 

This episode deals with the question of weight gain from antipsychotic medication: I'm on 20 milligrams of olanzapine. It's helping me and I don't want to change it. The only thing is that I've gained a lot of weight that makes me feel very unattractive. I've spoken to my psychiatrist about it, but I haven't gotten any guidance on the matter. Are there any solutions to weight gain from this kind of medicine? Modern antipsychotic medications can be very helpful for some people. And they are less likely to cause neurological side effects, compared to their first-generation predecessors. However, many of these newer medicines can cause someone to gain significant amounts of weight. This is a serious problem that the psychiatric profession (in my view) has been very slow to address. In this episode, Dr. Erik Messamore describes several strategies that can reduce the risk of medication-related weight gain or that can reverse weight gain once it has started.   Strategy 1. Choose antipsychotic medications with low weight gain risk Different antipsychotic medications come with different degrees of weight gain risk. Table 1 in this open-access medical journal article lists medications with higher or lower risk of weight gain. The graph in this article also illustrates the differences in weight gain risk among the various antipsychotic medications.   Strategy 2. Switch to an antipsychotic medication with lower weight gain risk People who have gained weight from higher-risk medications – like quetiapine (Seroquel) or olanzapine (Zyprexa), for example – may lose weight after switching to a lower-risk medication. On the other hand, some people (like the person who sent in today's question) might mostly like their current medication, or may not want to take the risks involved in medication switching (e.g., the switched-to medication might not work as well, or might have other side effects). In situations like these, there are several weight loss options worth considering.   Strategy 3. Diet and exercise to reduce weight from antipsychotic medication Many studies show that antipsychotic-induced weight gain does respond to standard diet or exercise interventions. A relatively small reduction of 150 calories per day can lead to about 16 pounds of weight loss over a year. For many people, that can be achieved by sticking to natural, whole foods and avoiding processed foods with a lot of carbohydrates or added sugars. Exercise and physical activity can enhance weight loss. And numerous studies show that exercise can improve mood, reduce anxiety, increase cognitive performance, and reduce symptoms of psychosis. Very low carbohydrate diets like the ketogenic diet are popular these days. These diets are designed to reduce insulin levels, which can make it easier to lose weight (because insulin is a fat-storage signal). Many people who undertake these diets can maintain calorie deficits without feeling hungry. Several case reports and a small clinical study suggest that the low-carb/ketogenic diet might help some people with schizophrenia, psychosis, or bipolar disorder to experience fewer symptoms.   Strategy 4. Metformin to reduce weight from antipsychotic medication Metformin is a widely-used treatment for type-2 diabetes. It improves the body's insulin signals and reduces spikes in blood sugar. Metformin can also help people without diabetes to lose weight. And there are many studies showing the metformin can reduce weight in people who have gained weight from antipsychotic medications.   Strategy 5. GLP-1 Agonists to reduce weight from antipsychotic medication GLP-1 is an abbreviation for glucagon-like peptide 1. The GLP-1 agonist drugs mimic the action of natural GLP-1. They optimize the body's insulin responses and reduce appetite. Some of these medications – liraglutide (Victoza, Saxenda); semaglutide (Ozempic, Rybelsus, Wegovy) – even have FDA approval for treating obesity. Lirgalutide has been studied in weight gain from antipsychotic medication and appears to produce more weight loss than metformin.   Strategy 6. Melatonin might reduce weight gain from antipsychotic medications This episode mentions that some studies show that melatonin might reduce the amount of weight gained from antipsychotic medication, while at the same time helping to further reduce symptoms of psychosis. The studies referred to are: Romo-Nava F et al. (2014) Melatonin attenuates antipsychotic metabolic effects: an eight-week randomized, double-blind, parallel-group, placebo-controlled clinical trial Modabbernia A et al. (2014) Melatonin for prevention of metabolic side-effects of olanzapine in patients with first-episode schizophrenia: randomized double-blind placebo-controlled study. Mostafavi A et al. (2014) Melatonin decreases olanzapine induced metabolic side-effects in adolescents with bipolar disorder: a randomized double-blind placebo-controlled trial.   Summary and suggestions Although the psychiatric profession has been slow to respond to the problem of antipsychotic-related weight gain, there are several options that can reduce the risk of weight gain or that can help someone lose weight. Many psychiatrists are aware of these options and are willing to help. But in cases where the psychiatrist does not know about these options or does not have experience with prescribing medications to assist with weight loss, it's likely that a general practice doctor or an endocrinologist does. The goal of treatment is always to maximize improvement and to avoid side effects whenever possible. And in cases where side effects are unavoidable, the goal should be to minimize them as much as possible. If you're concerned about weight gain, there are options and solutions. Your health care provider should be able to address them, or refer you to someone who can.   Topics 0:44 This episode's question is about weight gain from antipsychotic medication 1:20 – How common is the weight gain problem? 5:49 – Which medications are more likely (or less likely) to cause weight gain? 12:38 – How to these medications lead to weight gain? 15:27 – What are some strategies to prevent or reduce weight gain from antipsychotic medications? 20:56 – How effective is diet and exercise for antipsychotic-related weight gain? 26:28 – Suggestions for someone who is concerned about weight gain from antipsychotic medications.   About the Podcast: Dr. Erik Messamore is a board-certified psychiatric physician and PhD-level pharmacologist. He's a consultant psychiatrist, researcher, lecturer, teacher, and solution-focused scholar currently affiliated with the Northeast Ohio Medical University in Rootstown, Ohio. He is joined on this podcast by Melissa Xenophontos, a journalist, radio producer and longtime mental health advocate. Send us a question   Useful Links Dr. Erik's website and blog Podcast website Ask A Psychiatrist YouTube Channel

"Dagáll læknanemans" er hlaðvarp fyrir læknanema og annað áhugasamt fólk um hvaðeina sem viðkemur klínik og læknisfræði. Stjórnendur eru Sólveig Bjarnadóttir og Teitur Ari Theodórsson. Í þessum þætti er fjallað um lyfjameðferð við sykursýki 2. Mörgum lyfjum er hægt að beita og sífellt bætast fleiri lyf við. Arna Guðmundsdóttir, sérfræðingur í innkirtlalækningum, segir frá hvernig lyfin verka og hvernig hægt er að velja rétta lyfið fyrir hvern og einn sjúkling. Þessi þáttur er sá fyrsti af þremur sem unnir eru í samstarfi við læknadeild. Munu þeir nýtast í kennslu í lyfjafræði á 3. ári við Háskóla Íslands. Magnús Karl Magnússon, prófessor í lyfjafræði og sérfræðingur í blóðlækningum, heldur utan um verkefnið og er jafnframt viðmælandi í þáttunum þremur.  Hér má finna meðferðarskemað sem vísað er í í þættinum:https://drive.google.com/file/d/1w82td61yO6GvW-dnqn_on0CxAow8IaPR/view?usp=sharing Dagáll læknanemans er sjálfstæð þáttasyrpa innan Hlaðvarps Landspítala. Þættirnir eru aðgengilegir á helstu samfélagsmiðlum Landspítala og einnig í streymisveitunum Spotify og Apple iTunes, ásamt hlaðvarpsveitum á borð við Simplecast, Pocket Casts og Podcast Addict.(Tónlist: "Garden Party" með Mezzoforte. Notað með leyfi frá hljómsveitinni.)SIMPLECAST:https://landspitalihladvarp.simplecast.com/episodes/dagall-19

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ The most frequent question asked by my patients, both women and men, the first time they see me is, “Why is my belly getting bigger? I never had a big belly before, and I can't get rid of it!”. My answer is individualized to the patient, but there is one change that occurs as the first trigger of aging and ends in a distended and obese abdomen—Low free testosterone, and high estrone blood levels.   The cause is loss of the production of the “all important hormone” testosterone, from the ovary or testes, and the result is a slower metabolism and gain of fat in the abdomen. But why do we crave a thin waistline?  Having a thin waist is indicative of a youthful body, and youth in general.  It is one of the biggest reasons that we crave, desire, even demand that our bodies revert to a thinner waist to bring back our youth! The aging process takes the thin waist away and deposits fat where we once had a narrow middle! When we turn 40-50, our body changes from a highly metabolic body that was fertile, into a lower, more efficient metabolism that is slowed even more by carbohydrates in the diet. We can bring our metabolism back to normal by one medical intervention and a healthy lifestyle specifically created for postmenopausal women and aging men. No one escapes the aging process and the deposition of belly fat, without replacing testosterone in a non-oral and bio-identical manner. I explain this to every patient and since I know each of my patient's medical histories, family histories, medications, diet and exercise programs, I can target my advice to their individual need. At my office at BioBalance Health® we make a plan to get rid of that belly fat for each of our patients and we measure the about of belly fat that they have by measuring their body composition with an INBODY® machine.   What IS Belly Fat, Really? Let me specify exactly what belly fat really is made of: A portion of an individual's belly fat is from the accumulation of fat inside the abdomen around the intestines, in an organ called the omentum.  This belly form of belly fat is called Visceral fat, which increases a person's risk of diabetes and heart disease, and takes a long time to dissolve this form of belly fat, requiring low carb diet and daily aerobic exercise. This is usually a long-term project (a year). The second type of belly fat, subcutaneous fat, is deposited between your skin and your muscles, most often seen in women who have had pregnancies that stretched their skin and caused the collection of fat under their skin. To lose this type of fat, this fat requires specific abdominal exercises, and or radio wave treatment to melt fat and tighten skin, and sometimes surgery to remove excess skin and liposuction of fat deposits. Generally, this type of fat is the first to respond and decrease when testosterone pellets and lifestyle changes are instituted. The last type of” belly fat” is really intestinal distention from gas collection in the intestines or from constipation, food allergies or intolerances,  diseases like intermittent bowel obstruction after abdominal surgery, or a variety of GI diseases that must be diagnosed and treated by a board certified gastroenterologist. Many people confuse abdominal distention with one of the first two types of fat accumulation.  Bowel distension (or abdominal distention sometimes called bloating is generally a GI mobility problem, or an anatomic defect like an abdominal hernia and may require probiotics, fiber, diet changes like avoiding gluten and milk products, getting a low thyroid treated, treating diabetes or prediabetes, or repair of abdominal wall abnormalities surgically. Abdominal distention can also come from very lax abdominal muscles which require dedicated exercises if they are not severe, and sometimes require surgery if they are greatly lengthened and lax. What causes belly fat to occur as we age?  First it is low testosterone that lowers the metabolism in everyone as they age so you burn fewer calories. Second it is lack of exercise and poor diet. You just get more “efficient” and save your calories and make fat out of them instead of energy. Last is the metabolic changes of aging including Insulin resistance or Pre-diabetes that occur at or right before menopause, and the production of more estrone which is made in belly fat from conversion of testosterone into estrone, which both lowers free testosterone levels and makes more belly fat to make more estrone.  A viscous cycle ensues! The triggers that stimulate the production of belly fat: Pick the ones you have working against you and determine your individual issues that make losing belly fat more difficult. Menopause Low T in men and women Aging causing higher estrone levels Inactivity History of multiple pregnancies with excessive weight gain which left extra skin hanging Poor diet Lack of abdominal wall strength No abdominal exercises Lifestyle, Diet and Habits that cause belly fat. You can assess your personal causes of belly fat on your own, but then you should take the initiative to change your lifestyle to decrease belly fat. The following list include the things you can change to lose belly fat.   Diet High in carbs Diet High in Lectin foods which interfere with carbohydrate metabolism Lack of any exercise Lack of daily targeted abdominal exercise Lack of aerobic exercise Poor posture Sitting all day Over-eating poor quality food (junk or fast food) Intestinal issues like constipation, and irritable bowel from lack of good bowel bacteria. Alcohol consumption Smoking Type 2 Diabetes without medication, or following a low carb diet Alcoholism with liver disease Fatty liver Eating foods that are not compatible with your genetics (blood type). To achieve your goal of a narrow waist and a flat belly, look at the list above and eliminate as many bad habits as possible and foods that you can, and begin an exercise program specifically aimed at working out your abdominal muscles, (Pilates?). A word about Lectins are proteins in most foods and some are harmless but others many interfere with your health and are  considered anti-nutrients that bind to carbs in foods which can cause malnutrition, abdominal pain, GI disease, autoimmune disorders and are in every food. We teach our patients to avoid certain foods with lectins by their blood type. Dr Da Damo MD spent his life researching the foods containing lectins and how they genetically affected people in each blood type. In the future we list foods by blood type that should be eaten and those that should not be based on your genetics. We will dedicate an entire Healthcast to the lectins that are dangerous to your health individualized by your blood type, so you will know what to avoid and what is beneficial for you to eat. Luckily, Lectins can be inactivated by cooking the vegetables, fruits, grains that have lectins! To find the Blood type diets for each blood type look in the back of my book, The Secret Female Hormone®. Sometimes my patients adjust everything they can on their own and still need medical help. All of my patients have their testosterone replaced if they are over 40 and if their thyroid is low, I replace their thyroid back to normal levels. Both of these treatments will make getting a younger smaller abdomen possible. The following list will provide the possible medical imbalances that can stimulate belly fat growth, and that can only be treated by a doctor. Factors that can only be treated by your doctor that have a great impact on the loss of belly fat: Low testosterone—replace T with pellets Low thyroid hormone—replace women with Armour Thyroid and men with Levothyroxin High cortisol—suppress with relaxation and or Endodren supplements Low growth hormone –stimulate production with aerobic exercise and weight training exercise, replace testosterone, and or stimulate GH with a peptide. Insulin resistance/ Pre-diabetes-treat with Metformin ER, Victoza, Trulicity, or Ozempic Overall Inflammation throughout the body-Treat with anti-inflammatory drugs Elevated triglycerides—treat with metformin ER Low protein intake and low protein in the blood: increase, meat, cheese, milk products as well as eggs and ultra-filtered whey protein shakes Inadequate vitamin D intake—take 5,000 MIU per day Inadequate vitamin B intake—increase Methyl B12 + Methyl Folate Decrease Intake of lectins that (not eating right for your blood type) For Severe overwhelming hunger-treat with stimulants to suppress hunger   There are some things that will make your journey harder, but we all have genetic challenges. Our past sometimes makes our current work harder such as genetics for adult-onset diabetes, family history of obesity, a history of childhood inactivity and overeating.  Unchangeable things in our past can cause roadblocks to losing belly fat, but you can still succeed. The following are examples of situations that you may have to overcome to lose your belly fat.  It is not a race with other people, it is a race with yourself! An endomorphic body type (pear-shaped build) which is genetic Obesity as a child Lack of exercise as a child Genetically low testosterone Family history of obesity Genetics that cause you to be hungry all the time Genetics that cause you to never feel full no matter how much you eat Bowel disease that must be treated before your nutrition can be made normal Inherently bad gut biome you are born with limited gut bacteria that causes us to gain weight from early on. Lack of a good sleep cycle because of your normal rhythms, or your job or disturbances throughout the night like kids coming in to sleep with you or getting up multiple times because of a very small bladder or a large prostate. If possible, increase your hours of sleep to at the minimum of 7 hours a night. Follow your progress by measuring your waistline once a week with a tape measure to keep track of your progress. By taking care of our patients and eliminating all the high-risk factors, changing lifestyle and bringing all hormones back to normal young healthy levels, we are very successful at helping our patients lose their belly fat.

Hello and welcome to another audio version of Burnt Toast! This is a newsletter where we explore questions, and some answers, about fatphobia, diet culture, parenting and health. I’m Virginia Sole-Smith. I’m a journalist who covers weight stigma and diet culture, and the author of The Eating Instinct and the forthcoming Fat Kid Phobia. I’m so excited today to introduce my guest, Marquisele Mercedes, or Mikey. She is a writer and doctoral student from the Bronx who is completing her PhD at Brown University School of Public Health, specializing in weight stigma, racism and critical public health studies. And oh my goodness, we need her work so much. I’m putting Mikey’s Patreon right here at the top of the transcript, because I hope everyone reading/listening will check it out and support her work. Welcome, Mikey. Thank you for being here.Mikey Thank you for having me!VirginiaThe first thing we have to talk about is the piece you did a couple weeks ago, a brilliant, searing takedown of Wegovy, the newest FDA-approved weight loss drug. Honestly, anyone who hasn’t read it yet, go read Mikey’s piece. One of the things that really jumped out to me is how the diet industry finances these drugs, because whenever we see these headlines, it’s presented as unequivocally good news. People may sort of know that scientists are required to disclose whether they have a financial stake in the research they’re doing, but—I have been reporting on this stuff for a really long time and I don’t even totally understand all the ways that the financial disclosure on a study does not tell the whole story. So why don’t you walk us through that a little bit.What does a financial disclosure do? And what does it tell us? What does it not tell us? And why, in the case of Wegovy, is there just so much more money at stake?Mikey The first thing to know is that to publish in most journals—especially those that have biomedical research—any journal that you try to publish in, if it’s peer reviewed, will ask if you have any financial conflicts of interest. But people who aren’t familiar with that process usually don’t understand that there isn’t a point at which the journal editors will say, “Oh, you have too much of a vested interest. We’re not going to take this article.” That doesn’t really happen. So, for example, there are three different authors on that Wegovy study that are employees of Novo Nordisk and then there’s also two that additionally hold stock, and that was not enough to not have this paper published.VirginiaSo it’s like: We’ll disclose it, but we’ll go right ahead and report this as unbiased science.Mikey Honestly, with a lot of areas of research, especially pharma or biomedical tech or whatever, having corporate ties is not a thing people really question. It’s definitely not a thing that journal editors question because it’s normal. So people are like, oh, okay, you’re a stock-owning employee of this of this pharmaceutical company. And you also receive fees from whatever and you invest actively in these companies, okay, we’ll note it at the bottom of this article. But it’s not like we’re not going to take your research, especially when it’s something like this. So there’s a lot of publication bias at work here too where, the medication had such distinct results, you know, an average of 15% loss of weight from participants’ initial weights, and a lot of people lost a third of their initial weight. When you have a result like that, it’s almost impossible for that to not get published, even in a journal like the New England Journal of Medicine, which is one of the most prestigious journals in the world.So you have publication bias on your side, because you got positive results, and no one in this area is really going to question whether or not to publish this on the basis of your financial conflicts of interest, they’re just going to note the conflicts of interest, and then go on and publish it anyway. On top of that, you have this culture within medicine, especially in biomedical sciences, where, you know, there are just certain forms of research where corporate influence is seen as okay. And a lot of the time, pharmaceutical companies are part of that culture. And definitely when it comes to weight loss.I’ve said this before: In science, there are some things that we get outraged about in terms of corporate influence, and others not. Like with tobacco. If a tobacco company tries to start an organization or a research foundation and do studies on the health outcomes related to smoking that may portray cigarettes in a less negative light, then people in public health especially are going to be pissed off about that. And they’re going to raise the alarm. But when it comes to Nestle funding research foundations, everyone’s like, oh, cool, private-public partnership, when it’s really private influence over what should be public work.VirginiaWhy that double standard? Why are we outraged that a tobacco company would do science to try to make their products seem safer, but not outraged that a pharmaceutical company will do science to make a drug they can sell and profit off of?Mikey Fatphobia. It’s literally just fatphobia. Public health is very proud of how it’s solved tobacco. It’s weird. They’re like, yeah, like, we managed to cut the smoking rate and blah, blah, blah. It’s one of the main examples that people use in health communication classes or science communication classes, when we’re talking about how to encourage or discourage people from doing certain things. Tobacco is the main example, as well as that health communication campaign, “Verb: It’s what you do.” Which actually wasn’t that effective, but that’s a whole other conversation.It mostly boils down to fatphobia. And I’ve found that’s amplified by the way that corporations have always been part of, the “obesity prevention” area. So it’s less jarring when something like this happens because it’s like, oh well, this is the way it’s always been done.VirginiaRight, you don’t question this whole system. It feels very radical to say pharmaceutical research should only be government-sponsored or that there shouldn’t be a capitalist stake in this. When I say it out loud, it seems quite logical yet also anathema to the way we are programmed.Mikey If you were to say that in a room full of like, researchers, I think people would be like, whoa, hold up. That’s a bit much.Virginia These corporations do have huge amounts of money, they do directly impact people’s health. If we could get them to put that money towards useful things like that could be a good thing. The problem is, they’re only putting it towards—Mikey Profit-making.VirginiaRight profit-making, and in this case, creating a drug that you and I both feel strongly is going to be more harmful than it could ever be good.Mikey Exactly. This is all aside from the fact that these corporations should not have the money they have anyway. So that’s a whole other thing, that we might not have enough time to get into.VirginiaYeah, that’s a whole separate conversation. But definitely worth noting.So let’s talk a little bit more about the drug itself. I mean, as you said, it’s had these “positive results” and people are reporting more weight loss while on the drug then you usually see in these studies, but you also talked in your piece about our short-term memory when it comes to this industry, and specifically weight loss drugs. So tell us a little bit about what we’ve forgotten about this drug’s predecessors that’s clouding our ability to assess this drug?Mikey If the diet industry was held accountable for all of its past failures, and not-delivered products, then it wouldn’t exist. Let’s be clear about that. The diet industry—and when I say the diet industry, obviously, I’m talking about manufacturers of weight loss drugs, but also like, companies like Weight Watchers, or individuals who actively profit off of selling weight loss, not necessarily as a thing that happens, but as a dream.VirginiaRight, a very important distinction.Mikey And that’s the distinction that I think is really core to this cycle. Somehow we are so drawn to the promise of weight loss, that we choose to forget that if you’re a fat person living in this country, you have probably tried more than one, more than multiple forms of weight loss, dieting, some kind of weird cleansing program. You’ve probably tried some of those things, if you haven’t, I think you would be in the minority of fat people.VirginiaMinority of all people but especially fat people.Mikey And I think the normalization of that activity, engaging in this collective fat hate, paired with the fact that like, there are tangible benefits to being smaller—and then also the fact that this industry has so many resources to make sure that we never forget that weight loss is a good idea—obviously, we’re sort of slowly seduced into forgetting the fact that most of us have definitely tried to lose weight and it hasn’t happened or it’s sent us off into spirals of disordered eating, or has had other kinds of negative implications on our lives. I think it’s really hard to remember that these things don’t usually work the way that we’re told they work because all those other things are happening.We’re constantly being reminded that fat is bad, constantly reminded that weight loss is good. And then we see that reified by all of this media explosion when something like this comes out. It’s being talked about as a game changer: “This is gonna change people’s lives.” There’s always, always, always, always a steady supply of people waiting in the wings to advocate for something like this on a large scale. Which, honestly, the application of a weight-loss recommendation or technique for community-level or population-level health, that’s f*****g unethical. That’s unethical as hell.We know that encouraging weight loss, encouraging body comparison, encouraging body dissatisfaction, does all kinds of messed up things to our health. And we also know that it’s incredibly rare that people lose weight and then sustain that weight. And we also know that the consequences of putting people into a cycle of weight gain and weight loss has serious implications on our metabolic health. And yet, it is completely acceptable to recommend those things on a community level, on a population level. And there are people in the medical community who will absolutely advocate for that. And there are lots of reasons why. And sometimes those reasons boil down to dollars, and it’s a really uncomfortable thing to sit with. Regardless of how much we complain about how bad healthcare is in this country, I think that a lot of us still hold on to the hope that the people who give us healthcare services have our best interests in mind. And being confronted with information that suggests the opposite, or suggests that the story might be a little bit more complicated, is incredibly uncomfortable.I strongly believe that people are the best experts of their own bodies. We live in these bodies every every damn day. We know when things don’t feel right. We know when we’re content. And when we’re at ease. The fact is that most doctors don’t know what to do with fat bodies. There are plenty of studies that suggest that doctors do not feel equipped to deal with patients that are “obese.” [Virginia Note: I summarized a lot of that research in this article.]They don’t know how to do nutrition education, they spend less time giving health education to people who are fat. A lot of the restrictions that fat people face, especially when they’re looking to get life-saving surgical procedures or transplants—there’s this idea that at a certain weight you are less able to get through that procedure. That is also something that I’m very sure is born from doctors just straight up not knowing how to deal with fat bodies. In medical school, a lot of cadavers when they’re fat, people are just like, “Oh, I have to, like, cut through all of this. Oh, my God.”Virginia So dehumanizing.Mikey And it also just turns treating fat patients into a burden from the get go. So, yes, people are absolutely, probably the best experts on their own bodies. But also, a lot of doctors don’t know what the f**k they’re doing when it comes to fat patients.VirginiaIt’s so important to highlight that. With this drug in particular, it had this initial 15 percent weight loss or up to a third weight loss, which sounds like some brand new achievement. But let’s talk briefly about what are the concerns about Wegovy?Mikey Someone who engaged in the study and was receiving Wegovy, is quoted in multiple articles about the medication, saying that she ended up gaining back most of the weight that she lost while she was on the medication, and then also lost some of it and then also gained some of it back. That’s the textbook definition of weight cycling. The fact that this medication is being heralded as this game changing diet drug—there’s nothing game changing about it. When you’re on it, it f***s with your pancreas enough that you are sent into a process of losing weight that probably is not healthy or organic or makes sense for your body. And then once you’re off the drug, you gain it back.Novo Nordisk has sort of perfected the playbook of taking one drug and finding that it has a side effect of weight loss and then just like, selling it in bigger dosages so that weight loss happens more quickly.They did this with another drug, Saxenda is just Victoza at a higher dosage. The only difference between them is the dosage and Saxenda is also specifically marketed as a weight loss drug whereas Victoza is not.VirginiaRight, it’s a diabetes medication.Mikey Right, it’s a type two diabetes medication, and it is very effective at doing that. But it’s not meant for weight loss. And then you have Ozempic which is the drug that they amplified the dosage of, to get Wegovy.So Victoza was the subject of a major 2017 federal case against Novo Nordisk. Novo Nordisk was ordered to pay $58.65 million to the federal government and state Medicaid programs for intentionally minimizing the risks of developing a rare form of cancer to physicians who would be prescribing this medication to their patients.I’m not saying that what happened with Victoza is what’s going to happen with Wegovy, that doesn’t even need to be the case for this to be just a failure and hazard to everybody’s health. The point is that if a company has a history of doing things for profit that intentionally did endanger people’s lives, maybe that company should not still be making things that people will ingest. Moving on from that, if we know that a medication has risks, like serious risks, even in small doses, and then you rebrand that medication into a weight loss medication…like, why, how was that allowed to happen?It’s really hard to find out if people from the FDA have taken corporate money. I’ve tried to figure that out, because I really didn’t see any other way for Wegovy to have been approved. It’s been a few years since a drug has been approved for weight loss by the FDA. So this is a big deal and I don’t know. I’m not sure if the FDA has ever approved a potentially risky medication, especially after a corporation has been found to have intentionally mislead physicians. I don’t know if that’s something that has happened before in history. But clearly, this is something that we should be worried about.VirginiaThere’s so many red flags, except none of them were being reported in any of the mainstream media.Mikey I’m sure you saw how the American Academy of Pediatrics like came out supporting bariatric surgery for tweens, and it’s the same thing. I was like, damn, NPR should be ashamed of itself, because—VirginiaThat story was a travesty.Mikey Like, how is it that the only risks focused on in that piece were like, trisks of promiscuity following weight loss? They were like, she’ll be socially relevant. Are you f*****g kidding me? VirginiaThe girl’s mom was against her getting it, but not because she was worried about the risks of the surgery, but because she thought she hadn’t tried hard enough to lose weight. And that was completely unexamined.Mikey Portraying that doctor that helped her get the surgery as a kind of savior, especially since that particular doctor is like, honestly, I want to I want to start like, I don’t know, I want to gamble basically on the chance that this specific doctor shows up in an article about weight stigma, because she’s always always always around. And she’s heralded by medicine as this crusader for dismantling weight sigma. And I’m like, what the f**k is so different about her from the people who are just more obvious about hating my body? I honestly find it more dangerous, that someone would hide their disgust for fatness in like, not genuine concern for my well being.VirginiaThe tell is always when they come around and say we’re helping these kids lose weight to avoid weight stigma. It’s like, that’s not how you fight stigma. You don’t fight stigma by taking the marginalized person and making them assimilate. That’s the opposite of fighting the stigma, that’s reinforcing the stigma.Mikey And then we can’t really rely on most journalists, at least to give us the the real on what is happening with these. I mean, a colleague of mine tried to write something about Wegovy, they really tried to get something published. And they were told that it was just too controversial. And I’ve pitched this to no less than 15 places and no one will get back to me. It’s ridiculous. I think that with how pervasive weight stigma is, it makes it seem like there’s no one that gives a s**t about it at all. But there are people like you, like me, like my colleagues, like fat activists, people that really do this every single day. They’re constantly thinking about weight stigma, how to dismantle it, constantly working to do that, but they get shut down at every single angle. And, it’s exhausting. VirginiaI often run into this attitude of “yes, we’re very worried about weight stigma, I guess it’s this terrible problem, but oh my God, ob*sity equals death. And that’s the real danger.” It’s almost like we have to sacrifice people’s mental health to fight this public health war. And I think that discourse comes out of the public health world. And it really is about how the diet industry has infiltrated public health discourse. So talk a little bit about that, how you see diet culture and fatphobia showing up in public health and how these two things got so enmeshed?MikeyIn terms of public health, I mean, I don’t see an area of research that is not impacted in some way by diet culture, by the diet industry. I’m doing my PhD in a behavioral science department. I’m surrounded by people who do behavioral interventions on obesity, and it’s just the most whacked s**t ever. A lot of people are completely disconnected from how certain areas of science really come to be, how certain areas of public health really come to be. And so when you try to say like, “Oh, hey, maybe what we’re doing in public health is shitty. Like to a lot of people.” When you bring that up, they’re just like, what are you talking about?This is research that I’m currently doing now for my own book proposal. Like, how deep do obesity prevention initiatives really go? A year ago I was reading Fit to Be Citizens? by Natalia Molina, who talks about Mexican Chinese and Japanese immigrants in the 19th century, late 19th century, early 20th century, and their experiences being actively marginalized by the Los Angeles county and city public health departments. And it’s a really good read, I recommend that people pick it up. It’s very accessible language. Molina is a really, really good writer. But even in those health interventions that they would target towards Mexican moms in the early 1900s, late 1800s, a lot of that was critiquing their diet, and the way they ate. So even that falls into the parameters of an obesity prevention initiative. And that’s something wouldn’t necessarily be classified as one because it falls into the realm of maternal and child health, which is honestly one of the most fatphobic areas of research I’ve ever seen in my life. But I mean, it’s the same reason why that survey returned that ob-gyn is one of the most fatphobic areas of medicine. These things are not a coincidence. VirginiaWe like to police women’s bodies, mothers’ bodies, mothers of color’s bodies. It all needs to be policed and controlled as much as possible.Mikey We have to understand that critiquing people’s diets—especially people from other cultures—critiquing people’s diets, critiquing the way they feed their kids, critiquing their cultural foods, really became bolstered by public health initiatives justified by the faulty science that they put out to justify their bigotry. And now it’s a whole area of research. Now, that’s not just critiquing immigrant mothers, that’s obesity prevention research. Like that’s a thing like that has journals, that has grants, that has clout. So it goes really, really deep. And it's not just relegated to the areas of research that look at eating, it’s also about physical activity research. And also people who do research on racial health disparities often fall back on like fatphobic racist logic for why some people are healthy and why others are not.Virginia Say more about that. Mikey I mean, so first of all, there's the enduring, long-lived fallacy that race is biological, which it is not. But when you make race biological, and you essentially make culture something inherent to an individual, then you can make the case that their way of eating and their way of cooking is an inherent pathology. And some people don’t even bring race into the picture, they’re just like, oh, you know, some cultures are just so unhealthy, and we need to help them. And all of its b******t, because of how malleable and subjective it is, like, now quinoa and avocado are seen as super foods like, now it's okay that people of color were the ones who like, really eat them.VirginiaAnd collard greens..Mikey And kale and collard greens. Yeah, like, f**k off, like, whenever I see something like that, I'm just like, this is how I know that none of this is really rooted in anything but our internal hatred for certain kinds of people. When you start to look at things through that lens, it’s a really depressing lens. I don’t recommend doing it all the time. But it’s often the perspective that I use when I’m thinking of things like Wegovy, because I’m like, who is benefiting from this drug being approved? Who is benefiting from what it does in the meantime, and also, who was benefiting from what happens afterwards? Because I remember, someone made such a wonderful comment when I first put out my article, and they were just like, this is going to lead to a whole generation of diabetics, the way that this messes with people’s insulin production. That’s a consequence that I think will happen. Even if a few years from now the FDA is like, this is not a thing that should have ever been approved, by that point, the damage is already done. And since it’s fat people that are going to be prescribed this drug, right, that just feeds into the idea that fatness is inherently inherently pathological. Thus the cycle begins again.VirginiaThe last thing I want to talk to you about is the how all of this stuff plays out in food culture. A lot of my listeners are parents, so I get a lot of questions around kids and processed foods, and there’s a lot of fears around processed foods. I want to hold space for the fact that parents are under a huge amount of pressure to feed our kids perfectly. But I think it’s very useful to unpack how much the anti-processed food argument is rooted in fatphobia and racism and classism. There are a bunch of new studies that came out this week looking at processed food and kids’ diets and then immediately linking them to health problems. There’s this never ending onslaught of research in that area, much like with the weight loss drugs, and we see these headlines and we think, Okay, well, there it is, salt, sugar and fat is so bad for us. You know, processed foods, the ultra processed foods are so bad for us...Mikey This is more of a new thought, but I wonder about the utility of making certain kinds of foods that are more widely available to people of color, especially Black people, low-income black people, I think about the utility of marketing those foods as something health conscious, respectable people shouldn’t be eating. Who benefits from that? A lot of the discourse that demonizes certain foods over others is honestly some form of marketing ploy to push some kind of new form of eating, whether that's clean eating or, or being like, oh, we all have to be vegan, or we all have to eat clean, or we all have to buy organic foods, you know, whatever that means. The way I see it, the more we impose hierarchies on food, there will always be certain foods that we have a fixation on, because those are the foods that we shouldn’t be eating. In terms of parenting, I feel like that is so relevant.When I was younger, my fixation on eating more and more, first originally stemmed from hunger, because like, I was restricted, you know, in terms of my diet. I have always lived in a fat body at any age. And so when it came to the point where restriction was an enforceable thing, that was when I became most fixated with food. I didn’t become fixated with, you know, ultra processed food, or like, that wasn’t the thing that I really even gave a s**t about. When I was a kid, I was like, I want to eat more of the food that I had for dinner, because I was still hungry. And I live in this body, and my body is telling me that it needs food. And eventually, that fixation moved away from being something that I physically felt was necessary, and more a compulsion that I had to fulfill. Because if I didn’t have it, it meant that I had let some kind of need go unfulfilled. And that caused me a lot of distress. So when we talk about ultra processed foods, I feel like especially in areas of parenting, we’re just like, how do we make kids less fixated on these foods? How do we make kids like these foods less, you know, like, marketing for these foods is all bright and colorful and draws people in. And kids are always told not to eat them. So you know, they might like them more, but I honestly tell people to start with their relationship with the food they eat on a regular basis. The idea that food abuse starts with foods that are, you know, “unhealthy” I feel is misinformed and incorrect. But it’s something that so many of us feed into. And it’s extremely prominent in literature that is targeted towards parents, because just because of the way that a lot of these foods are age-coded. Is there a reason why Lunchables and other forms of prepackaged ultra-processed foods are so bad? I think that’s a conversation worth having. But I also think that a lot of the time, it’s a distraction.VirginiaI think you’re articulating a key tension I think about a lot which is: The processed food industry, much like the diet industry, could certainly use more oversight, could certainly stand to have someone coming in and saying hey, stop with the predatory marketing tactics, stop disproportionately marketing communities of color, stop disproportionally marketing to kids. All of that would be super, and is really important. But we often lose that nuance, and it becomes: these foods are bad. You are bad if you feed them to your child. And it’s so much more complicated than that, these foods in and of themselves are not terrible, it’s the excessive marketing and the way that’s done in this disproportionate way that is the problem. Mikey It’s the way that these foods give in to the fixation we already have about eating. Like, if I'm a child, and I am already thinking about food, and then I am suddenly bombarded by food marketing, those are things that feed into each other. It’s not like food marketing started my issues with food.VirginiaBecause if you hadn’t been restricted, you could have navigated the marketing much easier.Mikey Do not restrict kids. I hear things like, Oh, well, if I don’t restrict my kid, then they’ll eat whatever they want, until they’re sick. And, you know, sometimes we need to have that experience. You need to have that outcome in order to be able to learn from that experience.VirginiaIt’s part of learning how to navigate these foods. And if you restrict your kid around them, they will have that experience at a friend’s house on a play date or something, you know, they will, it’ll happen one way or the other. Mikey And we have to think about how the fixation that we have on ultra processed foods in general, and the insistence that we eat a certain way that’s cleaner, healthier, blah, blah, blah. All of those things just demonize other people.VirginiaRight.Mikey That’s where a lot of that comes from, it comes from the inherent distaste that we have for poor people, for fat people, for Black people, who are often more often than not forced into a position to buy foods that fall into the category of processed or ultra processed, because of the fact that they have restricted access to resources to buy other kinds of foods.This is literally just another way to push bigotry and enforce hierarchies. And the more we think about it like that, then the next time, you know, it’s easier for us to be like, well, this thing is telling me that unless I have this prepackaged meal, that will help me lose weight, then I’m a bad person, it becomes easier to unpack that and point out why that’s b******t when we understand that these are not fueled by health promoting goals. They’re promoted, they’re fueled by profit seeking goals that are also amplified by division and bigotry.VirginiaSomething I often think about when parents are articulating these anxieties to me is: How much of this is honestly about your concern for your child’s health, and how much of this is about your concern for your perception as a parent? I’m thinking about kids lunches, and the standards for kids lunches have gotten just, you know, there’s supposed to be like four types of produce and a rainbow and you know, it’s insane. And it’s all white ladies on Instagram, performing their parenting in this way and performing their white savior lady thing, right?MikeyPerformance is a crucial social tool, right? But it’s not a thing to base your lifestyle on. Like, it’s okay to be like, oh my god, I made this really cute lunch for my kids. This sandwich looks like a face and it’s smiling. And I can’t wait to talk about this with like, the other parents that I know. That’s totally cool. The thing that’s not okay is taking those values that you have around that sandwich and applying it to how you’re treating your human child.VirginiaAnd that you’re then judging the other parents such as myself who are packing Uncrustables for our kids lunch, right?MikeyI have Uncrustables because as a semi-functioning adult, If I don’t have them, I might not eat anything. They’re amazing. I also want to say that just because you’re a parent doesn’t mean that you’ve resolved your own issues with food, so unpack that s**t. Figure out your hangups around food and how you might be projecting those onto your child. Because, you know, a lot of the times, we’re guided by these conventional nuggets of wisdom, but those conventional nuggets of wisdom are just trauma that we’re still holding onto.VirginiaSuch a good point. Mikey, thank you so much. This was an amazing conversation.Mikey Thank you for having me. I don’t usually talk about this kind of stuff.VirginiaTell us all of the ways that people can follow you and support your work. MikeyOn Twitter, which I spend way too much time on, I’m @marquisele. On Instagram I’m @fatmarquisele. I'm also on Patreon: patreon.com/marquisele. I’m currently working on a fat studies public health syllabus. So if that’s of interest to anyone, I break down a lot of what we’re talking about right now, in terms of how fatphobia became a thing, especially in the sciences. And if there are some concerns or questions that you have around fatphobia, I’m always always always taking questions through my website. And those are the subject of my semi bi-weekly newsletter I put out through Patreon as well. This is a public episode. If you’d like to discuss this with other subscribers or get access to bonus episodes, visit virginiasolesmith.substack.com/subscribe

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ Saxenda®: is a GLP-1 agonist that normalizes blood sugar and causes decrease in appetite as well as slower emptying of the stomach and which makes people feel full longer. was used for treating Type II Diabetics under the name Victoza® for years. It is now offered in a higher dosage in a larger pen specifically for weight loss.  It also reverses the insulin resistance both diabetics and obese people develop by eating too many carbohydrates in their diet.   People who have a significant weight problem, Insulin Resistance, or Type 2 Diabetes responds well to this medication because it works on relieving insulin resistance, normalizing blood sugar and controlling hunger, in addition to helping people get to their ideal weight!   For those people who genetically are never full, this is the drug for them to make them feel full, maybe for the first time in their lives!   My experience with never feeling full: I never understood those kids and adults who had to eat constantly or who could eat 2-3 plates of food at a time. I just had never walked in their shoes…. until I was pregnant. At that time in my life, I was 118 lbs. when I got pregnant, I never could catch up by eating enough in a day to feed both of us, while I was pregnant.  I felt full at the beginning of a meal but was really hungry, so I had to eat every 30 or 40 minutes during my waking hours.  I was hungry all the time!  Eating literally ruled my life and it made me think about food all the time.  I felt like I was in the prison of my body, but it was a good experience for me to have because now I understand how terrible a genetic albatross always being hungry or never being full is!  If you feel like that it is an inherited trait so there are probably other family members who feel the same way. As people lose weight on Saxenda, they feel less and less hungry and are more satiated by eating.   Back to my experience with feeling hungry all the time, and never full.  When I delivered my daughter, I was thrilled to not be manipulated all day and night by my hunger.  It was the happiest day of my life to see the beautiful baby that she was, and also to be in control of my eating again.  I think those patients who have this problem for a lifetime will be just as grateful to find Saxenda®.   This medication is one of those that you have to slowly increase over 4 weeks to the maximum dose. The biggest side effect is reflux esophagitis and that means two things…that the patient ate too much out of habit, instead of hunger, or they already have the problem of reflux, and this drug makes it worse.   The second most common side effect of Saxenda® is diarrhea.  If a patient doesn't follow a low carb diet this medication causes the carbs to dump into the intestines and that causes diarrhea.    The application of this medication is that you take a subcutaneous shot (very small needle) every day in the abdomen like insulin, but it is not an insulin replacement.      The Saxenda® dosing schedule Patients should follow a 4-week dose escalation to reach the clinically efficacious 3-mg dose.   • The Saxenda® starting dose is 0.6 mg per day for 1 week1   • Patients increase the dose by 0.6 mg each week until the full maintenance dose of 3 mg is reached1   • If patients cannot tolerate an increased dose during dose escalation, consider delaying escalation for approximately 1 week1   • If a patient cannot tolerate the 3-mg dose, discontinue treatment1   There are people who can't take either of these drugs (Contraindications): Patients with MEN I and II, Medullary Thyroid Cancer, History of Pancreatitis, and or Pregnancy. There are so many people who could benefit from Saxenda®. I believe it is the key to normal weight and normal appetite.  I regret that the pharmaceutical company finds it necessary to charge a price that only a few people can afford. If you have obesity as a diagnosis and have high fasting blood sugars or have failed Metformin ER treatment then your insurance company may pay for your Saxenda®, but it will take a precertification by your doctor or Nurse practitioner.  OZEMPIC® is another drug used for weight loss.  In many ways Ozempic® is a lot like Saxenda®, however it is only one shot a week.  The side effects are not as severe with Ozempic®, and the price is lower.  Your insurance may very well pay for Ozempic®, as it has for many of our patients at BioBalance Health®.     Ozempic dosage for obese diabetics is gradually increased as follows:   1st and 2nd  injection is 0.25 mg/week x 2 weeks 3rd and 4th   injection is 0.5 mg/week x 2 weeks 5th week and thereafter 0.1 mg/week   Dosage for weight loss patients on Ozempic: 1st and second injection is 0.25 mg/week x 2 weeks Thereafter injection is 0.5 mg/week Only in resistant cases do nondiabetics have to increase to 1.0 mg/week     Side Effects of both drugs include:   Symptoms of hypoglycemia like headache, fatigue, and insomnia. Reflux esophagitis and the cough associated with it when you lie down. Distention of the abdomen from slow bowel peristalsis. How to put it all together for Weight Loss:   Exercise daily for 45 minutes or more—normal life activity is not enough to be considered exercise! If you walk for exercise, you must walk briskly, and walking briskly means you can't talk and walk at the same time.   Diet: Eat a low carbohydrate diet (know what that means) which means no sugar and no alcohol while you are working toward your ideal weight. Replace carbohydrates with a high protein diet including meat, cheese, eggs and protein shakes, Whey protein is preferable and tastes the best. You must eat Vegetables and fruits of every color 3 times a day. Snacks can be veggies, nuts, cheese, yogurt, eggs, and or fresh fruit. No baked goods, no crackers, bread, junk food or fast food. A High protein diet means eating as many grams of protein as your weight in lbs. if you are active. Eat ½ of that in protein if you are not exercising that day. A delicious protein powder that actually tastes good is Phormula #1 –I like the “mint ice cream sandwich” flavor….I can eat that as a meal substitute alone or blended with frozen fruit 3 meals a day.   Drink filtered water and lots of it! At least 80 fl oz a day.   No alcohol   If you want to lose weight in certain spots like your waist or your thighs, I recommend the Juvashape Ultrasound fat destroyer with Skin Tightening combination. It helps you lose fat where you want to when you have lost enough to be concerned about getting your shape back.   Medications assist in this process and speed weight loss along. Saxenda® and Oxempic® can be prescribed by BioBalance Health in our weight loss program.   If you are interested in coming in for a weight loss program, please go to our website biobalancehealth.com and fill out the history forms and have your blood drawn and we will make an appointment for you as soon as possible.

In this episode, we discuss: What is the non-medication treatment of diabetes? 2:05What are some of the common medications used to treat diabetes? 3:48Does everyone with diabetes need to be on medications? 4:45How do you know if your diabetes is well-controlled? 5:34What is metformin and what are the side effects? 6:11What is Hemoglobin A1C? 7:09What if my blood sugars are still high after starting metformin? 7:26What is emagliflozin (Jardiance), canagliflozin (Invokana), or dapagliflozin (Forxiga)? 8:18What are the side effects of SGLT2 inhibitors? 9:24What is gliclazide (Diamicron)? 9:48What is sitagliptin (Januvia), linagliptin (Trajenta), or saxagliptin (Onglyza)? 10:20What should I do if I'm not feeling well? 11:08What is liraglutide (Victoza), dulaglutide (Trulicity), or semaglutide (Ozempic)? 11:49When do we use insulin? 12:38Are there different kinds of insulin? 13:17What are some examples of different insulin regimens? 14:01What other resources do you recommend? 14:53Diabetes Canada: https://www.diabetes.caAmerican Diabetes Association: https://www.diabetes.orgEmail: thedoctordictionary@gmail.comTwitter: @TheDrDictionaryPeer reviewed by Dr. Rob Silver, Endocrinologist at University Health Network (UHN) in Toronto, CanadaOriginal music by Nicholas and John BragagnoloDISCLAIMER: This podcast isnt meant to be a replacement for a traditional doctor's appointment, nor is it meant to be providing medical advice. Rather, it is meant to supplement your doctor's visit and explain why your doctor asked what they asked, and help explain the diagnosis and common treatment plans.Doctors often have very different styles and approaches to a patient and their diagnosis. If we discuss a question or treatment plan that your doctor didnt mention, that doesn't mean that they are a bad doctor. This could represent a difference in practice style, or the fact that your doctor knows you better than we do, and has created a treatment plan that better fits your lifestyle. In case of emergency, please go to your local emergency department. 

Entenda a utilização da Liraglutida no tratamento da obesidade

Saxenda is the new name given to diabetes drug Victoza in 2014, when manufacturer Novo Nordisk discovered that Victoza can also cause weight loss. Both brands are under the generic drug liraglutide. Liraglutide belongs to a larger class of drugs called incretins. These were discovered by Dr. Eng from the saliva of the lizard called the Gila monster. These have become blockbuster drugs with revenue rising to $3.5 billion in 2015. In terms of advantages, these meds appeared to save the beta cells of the pancreas and prevent the hypoglycemic episodes seen with insulin. (However, the impact on the beta cells may have turned out to be the source of biggest risk--pancreatitis.) The LEADER trial showed improved cardiovascular outcomes for diabetics taking liraglutide. So, there are clearly opportunities, but risks as well.For more information, contact us at 859-721-1414 or myhealth@prevmedheartrisk.com. Also, check out the following resources: PrevMed's article on liraglutide/Victoza/SaxendaPrevMed's websitePrevMed's YouTube channelPrevMed's Facebook page

Diet and exercise are obviously critical to weight loss. But is there a place for medications outside of weight loss clinics?  Yes. Overweight and obesity are major (and growing) causes of heart attack, stroke, and cancer. The easy assumption is that we get fat because we eat too much. But why is there so much weight gain as we get over 50 years old? Understanding this, most of us realize there are endocrine reasons for weight gain. But we often think only of behavior (lifestyle) in relation to treatment of weight gain. As far as medications are concerned, metformin is usually the best first option for the majority of baby boomers with prediabetes or insulin resistance. Saxenda is simply one of the new diabetes drugs; it's used to be Victoza (liraglutide) but renamed for weight loss. Naltrexone is most often given for alcohol and opiate addiction, but genetics do not favor naltrexone in many patients. However, naltrexone combined with buproprion (Wellbutrin) may be as successful in the form of Contrave.For more information, contact us at 859-721-1414 or myhealth@prevmedheartrisk.com. Also, check out the following resources: PrevMed's blogsPrevMed's websitePrevMed's YouTube channelPrevMed's Facebook page

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ Three recent studies have shown a new light on treatments for diabetes. This group of research discoveries teaches us how to improve the severity of diabetes through several changes in diet and medication choices. One study discovered that a simple food addition to your diet can lower the risk of complicating illnesses and death from diabetes. The second study reveals the fact that statins increase the risk of getting Type II Diabetes just by taking a particular cholesterol lowering medication.  The third study found that select diabetic medications are effective at preventing heart disease in diabetics.  Join us to learn what you can do to help you, or someone you love, avoid diabetes and the complications from diabetes. Diabetes is a disease that is rapidly becoming the most common and dangerous disease of aging Americans.  The increase in obesity, the switch from whole food to junk food and fast-food and lack of active lifestyles, has contributed to the development of Adult-Onset Diabetes in almost half of all Americans.  Now that our society is flooded with citizens who have high blood sugars that cause heart disease, stroke, infections and increase the risk of cancer, what are we to do?  The first medical study recommends a simple diet change to those MEN (and possibly women) who already have diabetes, to prevent Adult-Onset Diabetes.  A study done at Stratton Veterans Affairs (VA) Medical Center in Albany, NY revealed that just one cup of blueberries daily, fresh, frozen or freeze-dried, significantly decreased triglycerides in the men tested who followed this recommendation.  It is widely known that elevated triglycerides increase the risk of cardiovascular disease in diabetic men, and one cup of blueberries daily lowered triglycerides and the risk of cardiovascular disease.  I believe that this diet recommendation can work for women as well, but they only tested men. The previous research gave Diabetics a simple way to lower their risk of getting heart disease by eating one readily available food!   Our next study reveals how doctors can prevent their patients from developing diabetes in the first place, beyond the strategies of achieving ideal weight, exercise, and eating a low carbohydrate diet?  A study done recently revealed the fact that taking statins for high cholesterol increased the risk for elevated blood sugars, HBA1C and triglycerides in patients who weren't diabetic and could cause Type II Diabetes!  As with most meds, all statins are not the same. The cholesterol medication, Crestor ®, is the least likely to have this side effect, however it is better to take an alternate drug that lowers cholesterol called Zetia® if it is strong enough to lower these blood fats enough. Zetia® is not a statin, and It doesn't cause any of the side effects that statins do, including raising your blood sugar, because it works in a completely different way than statins. If you have gotten diabetes since starting your statin then ask your doctor to switch your medication to Crestor®, Zetia®, or try normalizing your sex hormones and triglycerides through diet or by taking diabetic medications like Metformin®., which will lower your LDL cholesterol as well, without a statin! At BioBalance Health® we are able to get patients off statins all the time by replacing testosterone with pellets, lowering body fat, treating patient's AODM with Metformin, and normalizing thyroid hormones.  This is Dr. Maupin's secret weapon for treating patients with a high risk for vascular disease, who have high LDL cholesterol and or Triglycerides…Testosterone pellet therapy! Last but not least is a study from the June 2020 Endocrine News that gives us hope for a new classification of diabetic drug that lowers cardiac risk and all vascular causes of morbidity!  This class of drug is called SGLT2 Inhibitors, specifically Invocana® and Farxiga®.  These two drugs lower glucose by increasing sugar in the urine to get it out of your system.  This is how it works to treat the intended disease of Adult-onset Diabetes, but recently it has been found to prevent a common outcome of diabetes, cardiovascular disease!  Specifically, it lowered the rate of heart failure by 35% in diabetics.   Dr. Maupin has always started AODM patients on Metformin® for the past 18 years to lower blood sugar, sensitize diabetics to insulin which helps them lose weight and lower their blood sugar, and to make the other diabetic drugs they are taking, more effective.  It is inexpensive, generic, very effective, and has few side effects if a patient follows a low carbohydrate diet. The Endocrine Society guidelines, that rule the actions of Endocrinologists, changed this year: Pre-diabetes and early noncomplicated diabetes first with Metformin®. Patients with established AODM and atherosclerotic heart disease and kidney disease should be placed on SGLT2 Inhibitor like Invokana®, or the drugs like Victoza®, a GLP-1 receptor agonist. The experts in treating Adult-Onset Diabetes, Endocrinologists, are considering the use of Metformin ® for diabetic and non-diabetic patients alike, who have kidney disease, and heart disease without diabetes to improve these diseases as well.  If you have these complications to diabetes, or have these diseases but do not have AODM, ask your doctor about these new uses for this old drug. The most important part of this message is for individuals to prevent diabetes if at all possible, with lifestyle changes low carbohydrate diet and daily exercise, however some people get diabetes anyway because of their genetic makeup.  You can easily have a cup of blueberries every day to prevent heart disease if you do have diabetes, and then change your statin to Crestor® or Zetia®, and yes to the appropriate diabetic medications plus Metformin® to save you from having a heart attack, heart failure or stroke.   All of these recommendations for medications should be discussed with your doctor, who knows you best.  If they have not read these new studies or find that this research is not going to help you then always follow the advice of your diabetes doctor.

در این اپیزود گفتگو می کنیم با دکتر سعیده فارس پور، متخصص پزشکی خانواده، در مورد بیماری دیابت، انواع و درمان های آن --- « سوالات مطرح شده » علت بروز بیماری دیابت چیست علائم بالینی تیپ ۲ دیابت چیست علاوه بر تست قند خون، چه تست دیگری برای تشخیص و پیگیری دیابت وجود دارد چه درمانهایی برای بیماری دیابت وجود دارد چرا سولفونیل اوره ها در درمان دیابت تیپ ۲ دیگر جایگاهی ندارند داروهای جدید در زمینه درمان دارویی دیابت نقش انسولین در درمان دیابت چیست --- « کلمات کلیدی » HbA1C, Metformin, Glimepirid, SGL2, Jardiance, GLP-1, Victoza, Ozempic, DPP-4 inhibitors, Januvia, DPP4. --- مجری: میترا نادعلی تدوین: امیر ختایی انتخاب موسیقی: کتایون صابری ---

Topic: The Nitty Gritty on GLP-1 MedicationsCurious about one of the newer classes of T2D medications? You may have seen or read about some of them, including: Ozempic, Rybelsus, Trulicity, Victoza, Byetta, Bydureon. Learn how these medications work, tips for combating side effects, and the positive impact many of these medications have on protecting your heart.Need a visual of GLP-1 benefits and risks? Check out my GLP-1 Medication Sheet!Dietitian/Certified Diabetes Care and Education Specialists Resources for Today's Diabetes Dilemma:Bonnie R. Giller, MS, RDN, CDN, CDE, BRG Dietetics & Nutrition, P.C.www.brghealth.comhttps://brghealth.com/healthy-living-diabetes/Bonnie's free eBook: https://brghealth.com/5keysebookErin Phillips, MPH, RD, CDE, Erin Phillips Nutrition, LLC.www.erinphillipsnutrition.comDiabetes Dilemmas (Q&A):I answer a Diabetes Dilemma question on how to combat feeling guilty around food choices.Have a Diabetes Dilemma? Ask Me HERE!Or, find me on:Facebook: https://www.facebook.com/Type2andYouwithMeg/Instagram: https://www.instagram.com/type2andyou_by_a_cde/Twitter: https://twitter.com/Type2andYouCDETake Away of The Day:I give recommendations on how to turn today's topic into action. Find additional resources and supportive tools on Type2andYou.Org.

See all the Healthcast at https://www.biobalancehealth.com/healthcast-blog/ Women who have genetic predispositions to develop cancers and are under the age of 50 are more at risk if their BMI is over 24.5. In fact, the risk is twice as high for them to develop colorectal cancer if they are obese. (a BMI of 30 or more). It is so important to try to keep your weight regulated in order to reduce the inflammation within your body. The more inflamed your body is the more likely you are to develop heart disease, breast cancer, colorectal cancer, diabetes and many other illnesses that can shorten your life. You may feel that you are really healthy now, even if you are overweight. What you don't know and what you can't know, is how at risk you are for deadly diseases down the road. You do not know where you are on that journey. What you do know is that if you can find a way to reduce your weight you can increase the likelihood of avoiding those illnesses and living longer and healthier lives. There are diet programs that can help you, there are exercise programs that will improve your ability to control your eating and teach you how to eat healthily. There are even better medicines that can help fight that fight. At BioBalance Health their doctors and nurses who can help you learn what you need to do to put you on the path to weight control and healthy living. Research shows that roughly 22% of early onset colorectal cancer could be avoided if the women had managed to keep their weight below 18.5-24.9. New guidelines recommend screening beginning at age 45. If you need medical assistance there are drugs like metformin and Victoza which can help if you also participate in a diet and exercise program that encourages you and provides a support system for you to encourage you in your determination and strength.  At the offices of BioBalance Health we have such programs. Dr. Rachel Sullivan can help you determine what you need to do in terms of your food consumption, your exercise and she can prescribe the appropriate helpful medicines and will provide the support system to encourage you and direct you towards success. If your BMI is higher than 24 please contact Dr. Sullivan and ask for help, you will be glad you did.

Melissa's story: I have always struggled with my weight. I can remember being slightly chubby from around the age of 5, but everything got worse when at the age of 8 we moved from the city to another local suburb. I struggled to make new friends, and began to be picked on. Like so many others, I found comfort in food. This lead to my highest weight of about 225 pounds by the time I was 20. On my small 5’1″ frame it looked worse. Shortly after getting married to my ex-husband I was diagnosed with Type 2 Diabetes! I went to the doctor for a checkup after having a miscarriage, and I walked out of the office with 6 prescriptions for pills, meter, strips, and not really knowing what Diabetes even was. While I realize now my low/no carb approach was unsustainable for me, I did lower my A1c, lose 50 pounds and get pregnant with my son! But after my first pregnancy I struggled. I would yo-yo with both my weight, losing the same 20 pounds over and over again, but also with my diabetes. My A1c was all over the place, anywhere from 11 to 5.1! I tried so many different diets, shakes, extreme workouts, pink drinks, pills, etc, and nothing worked longer that a few weeks or months. I went from Metformin, to insulin, to Victoza-until I got a lump in my neck from it. Around the same time I also experienced knee inflammation. I have an old knee injury and some arthritis from it, but now my knee was the size of a grapefruit, for no reason! I couldn’t walk for a month. I was stuck on the couch, peeing in a garbage can! My husband was transitioning from his day job to a higher paying evening job, so he would get the kids on the bus, leave all day, come home for an hour, feed and bath our daughter, and then leave all night. My butt went numb from sitting and laying. I had tennis elbow from lifting myself, and then carpal tunnel in both wrists from switching to them. I was at ROCK BOTTOM! This was when I knew I had to make a complete change. This just wasn’t working. Everyday I felt like I was slowly dying instead of living and thriving. We had watched Forks Over Knives, Hungry For Change, Fat, Sick & Nearly Dead 1 & 2, Food Matters, and so many other documentaries before but just never did anything. Now we were ready! We tried one day, a Saturday, eating a 100% WFPB diet. This was rebirth! Immediately I noticed changes. I had to start lowering my insulin because I was having lows and waking up in the 50’s. I was sleeping better. I had energy. I was losing weight. And my knee was straight and normal after just 2 weeks. After 4 weeks I was completely OFF insulin! For the first time in my life I felt like I was living instead of dying. This is why I don’t cheat or why I haven’t “fallen off the wagon” Because no junk food is better than how I feel everyday! I have since lost a total of 82 pounds since switching to a WFPB lifestyle (or 107 pounds if you go off my highest weight of 225)! From the start I made videos on my YouTube Channel and created my Facebook page: Plant Based Melissa. I’ve been reading book after book and just recently received my Certification in Holistic Nutrition. Food is powerful and can truly help so many ailments and diseases. It’s about embracing your “why,” educating yourself on this lifestyle and never looking back.

Are you having difficulty losing weight? This case study walk through shows you an example of a hypothyroid patient who was found to have multiple hormone imbalances that were leading to weight loss resistance. After treating her multiple hormone imbalances like thyroid resistance, insulin resistance and low testosterone she was finally able to lose almost 40 pounds over 3 months. This is her story: By the time she came to see me she was already on natural desiccated thyroid but still having symptoms. Despite that her TSH was still elevated. She was unable to lose weight, she had lots of fatigue and she was dealing with insomnia. She had tried everything to lose weight including a lap band surgery and was able to lose some weight initially but gained it all back over time. After evaluating her lab work she was found to have: 1. Hypothyroidism with hashimoto's 2. Insulin resistance 3. Active inflammation with a component of autoimmunity 4. Low testosterone After undergoing treatment with Victoza, Testosterone, WP thyroid hormone and LDN she was able to lose a significant amount of weight over 3 months. Victoza is a powerful medication that can help patients who have leptin resistance, PCOS, insulin resistance (even those who are not diabetic) and metabolic damage from recurrent dieting. Victoza and other GLP-1 agonists work by sensitizing the body to insulin, lowering glucagon levels, sensitizing the body to leptin levels. Studies have shown patients with PCOS, insulin resistance, and leptin resistance may benefit by using it. In this video I talk about all of the various patient populations who can benefit from using Victoza and how to use it appropriately for the weight loss that you see in this case study. Using Victoza by itself generally will NOT lead to significant weight loss, but if used in conjunction with hormones, thyroid, and nutrients it can be very powerful. I also go over a list of common side effects and how to use Victoza appropriately. Including injection sites and dosages required. More information in the video and the full blog post can be found here: https://www.restartmed.com/victoza-weight-loss/ You can read more on my website here: http://www.restartmed.com/ Dr. Westin Childs is the Thyroid and Weight Loss Doctor This video is not intended to be used as medical advice. If you have questions about your health please consult your physician or primary care provider. Dr. Westin Childs goes to great lengths to produce high quality content but this is NOT a substitute for medical care.

I discuss the dangers of the infamous bone deteriorating osteoporosis drug, Fosamax. I also dust the dangers of the pancreatitis/cancer causing Type-2 Diabetes medications Januvia, Janumet, Byetta, and Victoza.

I discuss the dangers of the infamous bone deteriorating osteoporosis drug, Fosamax. I also dust the dangers of the pancreatitis/cancer causing Type-2 Diabetes medications Januvia, Janumet, Byetta, and Victoza.

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Today in FirstWord:

 Joining us today in studio, C. R. Kannan, M. D.                   Dr. Kannan is presently Director of Endocrinology and Metabolism at Red Rock Medical Center in Las Vegas.  He served as Professor of Internal Medicine at the University of Nevada School of Medicine in Las Vegas from 2009 to 2013, with teaching and patient responsibilities. He was also Consultant in Endocrinology at Southwest Medical Associates in Las Vegas, from 2003 to 2010.  He moved to Nevada in 2003, following many years of academic and clinical practice in Chicago.      He is the former Chairman of Endocrinology at Cook County Hospital in Chicago, and Associate Chairman of Endocrinology at Rush Presbyterian St. Luke’s Medical Center.  He was responsible for the combined Endocrinology Fellowship Program of Rush Presbyterian and Cook County Hospitals.  He is a tenured Professor of Medicine at Rush University, Chicago.   During his tenure at Cook County and Rush Presbyterian, he won the Teacher of the Year Award ten (10) times.   He has single-authored four (4) medical textbooks, and has served as an editor of the Year Book of Endocrinology for 15 years.  He has also co-authored several original articles in peer-reviewed journals.

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Today in FirstWord:

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