Eat less and work more. The 2 sec platitude as patients walk out to be checked out while their obese inflamed body sets them up for the next MACE. I was on the medical board of one meal replacement company and involved with a similar company. These programs work BUT of every 10 patients that very engaged physicians pleaded with to consider trying only 1 started. Of every 10 who started 7 did lose weight and keep it off . But what happened to the 93% of the obese patients who did nothing ? They were the farm of patients funding the practice with never ending imaging and ultimately invasive procedures. The drugs stop the food noise and give patients their life back . The advent of processed sugar and the bait and switch of its " cholesterol " ignore the sugar in the soda - poisoned several generations who are now addicted. The GLPs will result in more people ultimately eating less and walking more if only they are available at a rational price and are prescribed.
If there are physician and cardiologist readers here who are not aware of “this week in cardiology” on Medscape, I suggest adding that to your weekly reading “diet” asap. If there is a way to learn more in 10-15 minutes of reading a week, I haven’t found it.
I think the issue of GLP-1 RA’s is now less of a medical question (the evidence is already solid in a number of cardiac conditions as mentioned, although not for HFpEF), and more of a societal dilemma wrt “access”….both in terms of drug supply, and affordability (both individually, and as a society). To answer the latter question, I hope there will be cost effectiveness analyses moving forward, to allow us to properly slot this drug class in the hierarchy of societal priorities (at least in the realm of drug access).
As for lingering medical questions, we need long term data and data on children (since it’s been noted by Dr. Prasad on Sensible Med that this class is being pushed on kids, absent evidence). And we also need to be mindful of indication creep….SELECT was a secondary prevention population with BMI over 27… but if you think people aren’t going to be clamouring for it in primary prevention, have I got a great deal on a bridge for you! That kind of usage creep occurs on the regular, but in the context of limited drug supply, there is a squishier question of whether people who want it (purely for “vanity” reasons) should be given it when someone else has higher medical need for same, regardless of the ability to pay.
The weight loss drugs clearly look like the next blockbuster, much like statins and ACE-I were in their day. Long term effects remain unknown. I have heard that there is concern about sarcomeric- skeletal muscle loss? If true that could be a very negative long term effect. Does anyone know of any data exploring this issue?
Eat less and work more. The 2 sec platitude as patients walk out to be checked out while their obese inflamed body sets them up for the next MACE. I was on the medical board of one meal replacement company and involved with a similar company. These programs work BUT of every 10 patients that very engaged physicians pleaded with to consider trying only 1 started. Of every 10 who started 7 did lose weight and keep it off . But what happened to the 93% of the obese patients who did nothing ? They were the farm of patients funding the practice with never ending imaging and ultimately invasive procedures. The drugs stop the food noise and give patients their life back . The advent of processed sugar and the bait and switch of its " cholesterol " ignore the sugar in the soda - poisoned several generations who are now addicted. The GLPs will result in more people ultimately eating less and walking more if only they are available at a rational price and are prescribed.
If there are physician and cardiologist readers here who are not aware of “this week in cardiology” on Medscape, I suggest adding that to your weekly reading “diet” asap. If there is a way to learn more in 10-15 minutes of reading a week, I haven’t found it.
I think the issue of GLP-1 RA’s is now less of a medical question (the evidence is already solid in a number of cardiac conditions as mentioned, although not for HFpEF), and more of a societal dilemma wrt “access”….both in terms of drug supply, and affordability (both individually, and as a society). To answer the latter question, I hope there will be cost effectiveness analyses moving forward, to allow us to properly slot this drug class in the hierarchy of societal priorities (at least in the realm of drug access).
As for lingering medical questions, we need long term data and data on children (since it’s been noted by Dr. Prasad on Sensible Med that this class is being pushed on kids, absent evidence). And we also need to be mindful of indication creep….SELECT was a secondary prevention population with BMI over 27… but if you think people aren’t going to be clamouring for it in primary prevention, have I got a great deal on a bridge for you! That kind of usage creep occurs on the regular, but in the context of limited drug supply, there is a squishier question of whether people who want it (purely for “vanity” reasons) should be given it when someone else has higher medical need for same, regardless of the ability to pay.
The weight loss drugs clearly look like the next blockbuster, much like statins and ACE-I were in their day. Long term effects remain unknown. I have heard that there is concern about sarcomeric- skeletal muscle loss? If true that could be a very negative long term effect. Does anyone know of any data exploring this issue?