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!
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>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.
7/The future of NuSH-based therapies is bright! An incredible number of NuSH-based molecules in development!!! #OW2022
8/Novel therapeutics treat OBESITY!
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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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1⃣ Insurance navigation
Most clinics lack the workflows and staff necessary to obtain prior authorizations efficiently.
Even though >50% of their patients (modest estimate) could qualify for these medications, they can only push through a handful of approvals because:
🔹Prior auth processes are slow and fragmented
🔹There’s little reimbursement to justify hiring dedicated support pmc.ncbi.nlm.nih.gov/articles/PMC11…
2⃣ Clinical infrastructure
These aren’t “set-and-forget” drugs. Patients often need:
🔹Slower titration schedules
🔹Dose adjustments
🔹Ongoing counseling & support
🔹Side-effect management (remember: >50% of users experience side effects)
1/ WHAT YOU NEED TO KNOW ABOUT THE QUALITY OF WEIGHT LOSS. 🧵
2/ When you lose weight, you don’t just lose from fat but also from other body compartments, including lean tissues.
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.
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.
1/ Merry 🧵-mas
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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.
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)