Michael
Nov 2, 2022 12 tweets 11 min read Read on X
1/DAY 1 of #OW2022 in the books.

My highlight 🧵:
2/The Effect of COVID on Clinical Research by Drs. Laughlin and Evans:
—Significant increase in new onset diabetes
—A lot of COVID specific research for years to come
—COVID19 disproportionately impacted female scientists, parents and caregivers #OW2022
3/Update on the Use of Genetic Information to Tailor Obesity Treatment by Dr. Kaplan:
—People respond uniquely to treatments
—Genetic info can be used to predict treatment response and risk for weight gain over one’s life
—Precision genetic research IS EARLY #OW2022
4/New Developments in Anti-Obesity Pharmacotherapy by @AniaJastreboff:
—We are entering a new era of obesity treatments
—Nutrient-stimulated hormone (NuSH)-based therapies will revolutionize obesity treatment and MEDICINE
**credit to Ania for NuSH. She owns it. 😂 #OW2022
5/ GIP/GLP1-RA changed the game!
- -
>95% lost a clinically significant amount of weight at 15 mg dose!!!🤯

**many more exciting studies investigating the health benefits of this combo! #OW2022
6/Before there was tirzepatide, there was semaglutide.

So many exciting options! #OW2022
7/The future of NuSH-based therapies is bright! An incredible number of NuSH-based molecules in development!!! #OW2022
8/Novel therapeutics treat OBESITY!
- -
They are not weight loss drugs. They treat the underlying pathophysiology‼️ It’s time to move beyond weight-centric conversations and start talking about disease treatment and health benefits! 👏🏻👏🏻#OW2022
9/Reducing Barriers to Treatment: Insurance Coverage by @ConscienHealth:

We’ve created a broken system of care for obesity founded on scientific ignorance and structural racism. #OW2022
10/Biases rationalized care denial…FORTUNATELY, things are changing!! People are noticing and policies are changing. #OW2022
11/Metabolically Healthy Obesity by Dr Klein:
—Metabolically healthy obesity exists
—With strict criteria, it likely represents 7-13% of PwO
—Adiposity-related complications associated with insulin pathophysiology #OW2022
12/Questioning dogma related to obesity complications:
—Adipose expansion or spillover hypothesis is not supported
—Adipocyte size dysfunction hypothesis is not supported
—Inflammatory hypothesis is not supported
👉🏻IS IT ALL ABOUT INSULIN? 🧐🤔 #OW2022

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More from @MichaelAlbertMD

Aug 6, 2023
1/ WHAT YOU NEED TO KNOW ABOUT THE QUALITY OF WEIGHT LOSS. 🧵 Image
2/ When you lose weight, you don’t just lose from fat but also from other body compartments, including lean tissues. Image
3/ Why should you care about where the weight comes from?
Excess loss from specific lean tissues is associated with many adverse health outcomes: reduced QoL, osteoporosis, sarcopenia/frailty, decreased ability to perform ADLs, etc.
Read 19 tweets
Feb 19, 2023
1/ Are lean mass losses a real concern with GLP1 meds?
peterattiamd.com/the-downside-o…
🧵
2/ Simply, yes. And it is a concern any time you lose significant wt. I would remind people that human outcomes are the most informative, as physical functioning scores and QoL improved in STEP trials & SURMOUNT-1. However, the LT health impacts of LM loss need to be monitored.
3/ Fortunately, we have some high-quality data from Lundgren et al., 2021.

👉Structured Exercise + Liraglutide (GLP-1RA) led to FM loss and LM gain.
Read 6 tweets
Dec 22, 2022
1/ Merry 🧵-mas
---
WHY DECADES OF "EAT LESS AND MOVE MORE" WAS TERRIBLE ADVICE

For starters, remember semaglutide? How could you not? Journalists have written 1000+ celebrity weight loss stories on it.
2/ If you're familiar with semaglutide, you may know it is FDA-approved for treating obesity and chronic weight management under the brand name "WE-GOVY."
3/ Our story begins with the STEP Trials, a slate of phase 3 clinical trials that served as clinical validity for a novel drug platform for obesity.
Read 10 tweets
Nov 11, 2022
NASH Treatment Strategies:
1) Reduce Adiposity
2) Improve adipose tissue function (more difficult; PPARg agonists)
Pts w/ F2 or F3 fibrosis, SEMA 0.4 mg SQ Q at 0.4 mg was superior to placebo for resolution of NASH w/o worsening of fibrosis after 72 wks of tx, with 59% of the pts in the 0.4-mg group having a response, as compared with 17%. (OR, 6.87; 95% CI, 2.60 to 17.63; P<0.001)
Read 9 tweets
Nov 10, 2022
Treat-to-target for NAFLD/NASH:
🔑 is ≥ 10% weight loss.
journal-of-hepatology.eu/article/S0168-… Image
Bariatric surgery is exceedingly effective for people with obesity and NASH.
Aminian et al., JAMA. 2021.
jamanetwork.com/journals/jama/… Image
Mediterranean diet adherence is inversely associated with liver steatosis, 10-yr ASCVD risk, and NAFLD-associated incident T2DM.
linkinghub.elsevier.com/retrieve/pii/S…
Read 5 tweets
Oct 17, 2022
My living 🧵 on the highlights from 'Causes of obesity: theories, conjectures and evidence.' #RScausesobesity
@royalsociety

Link: causes-obesity.royalsociety.org
DAY 1 -- From genetics to nutrient-dependent conditioned eating, variable mitochondrial energy efficiency, neuroendocrine feedback systems, and nutrient-sensing food liking, obesity is very clearly more complicated than CICO. Energy balance is a constraint, that is all.
GENETIC SUBTYPING OBESITY by Dr. Loos
👉Genes contribute to genetic susceptibility, but it is hard to say how much.
👉Obesity subtyping will require more than genetic information. #RScausesobesity ImageImageImage
Read 26 tweets

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