In later life, weight loss can be a double‑edged sword. A few pounds off the joints can be both helpful and risky. Shedding a few pounds may ease joint pain, but losing weight without meaning to can be a warning sign. Fast weight loss can also lead to muscle loss, which is key to staying independent.

Experts also point out practical issues: injections need good vision, steady hands, and a regular routine. Stomach and bowel side effects can be tougher for seniors, especially if they’re already losing weight without trying. complicate life for older adults — and how to approach them with a “safety first” mindset.

1) Aging changes the risk–benefit math (even when a drug “works”)

Older adults, especially those who are frail or have several health issues, are often left out of clinical trials. This is important because average trial results may not match the real-life experience of a 75-year-old who takes several medications and needs to manage appetite and hydration.

A 2024 debate paper on GLP-1 drugs in older patients, including those with kidney disease, points out that limited trial data and multiple medications make it harder to judge safety and effectiveness for frailer seniors. Clinicians need to make decisions based on each person, not just on averages. In simple terms, the real question is not whether GLP-1s are good or bad, but whether they help this specific older person with their unique health needs.

There’s another subtle issue: in later life, the goal is often less about chasing an ideal weight and more about protecting function—walking safely, rising from a chair, maintaining balance, staying hydrated, and maintaining enough strength to live independently. So for older adults, the most important question isn’t “How much weight will I lose?” It’s “What will this do to my strength, my nutrition, and my ability to stay steady on my feet?”

2) Common side effects can become serious for older adults.

GLP-1s often cause nausea, vomiting, diarrhea, constipation, and less appetite. Younger people may find these symptoms unpleasant but manageable. For older adults, though, these issues can quickly lead to dehydration, dizziness, and falls, especially if they also take blood pressure medicines or diuretics.

Current FDA labeling for semaglutide products highlights this pathway: stomach and bowel side effects can lead to volume depletion, and acute kidney injury has occurred, including in postmarketing reports. The label advises monitoring kidney function when starting or increasing doses in people who develop severe gastrointestinal reactions, and it notes that dehydration has been part of reported kidney injury cases.

This is how many real-life problems start: a few days of not being able to eat or drink much, then feeling lightheaded, falling, or needing emergency care for dehydration. Older adults may not feel as thirsty and may have less ability to recover. So, it’s important to watch hydration, electrolytes, blood pressure, and kidney function, especially in the first months of treatment and after increasing the dose.

3) Muscle and frailty: losing weight does not always mean better health.

The headline benefits of GLP‑1s often focus on pounds lost. But the body doesn’t lose only fat. Lean mass (including muscle) can drop, too. This matters in older adults because age‑related muscle loss (sarcopenia) is already common — and it’s tightly linked to frailty, falls, and loss of independence.

A 2025 mini-review on older adults warns that starting and stopping GLP-1s repeatedly can change body composition, sometimes leading to ‘sarcopenic obesity’ — having too much fat and too little muscle. The authors are not saying to avoid GLP-1s, but to remember that weight loss does not always mean better health for older people.

More pointedly, a 24‑month retrospective cohort study in older adults with type 2 diabetes reported that semaglutide use was associated with muscle loss and functional decline, particularly at higher doses and in patients who already had sarcopenia. The authors emphasize individualized risk–benefit assessment and the need for monitoring and intervention.

If you’re reading this as an older adult, it may help to translate the research into plain questions to bring to your next appointment: “If I lose weight, how will we protect my muscles?” “How will we check whether I’m getting weaker?” “What would make us stop or change course?” An older adult who becomes “smaller but weaker” has not gained health — only risk.

4) Other complications: gallbladder, pancreas, vision, and low blood sugar

Gallbladder and bile duct problems can be an unexpected issue. Losing weight already increases the risk of gallstones, and GLP-1s seem to increase it even further. A large review found that using GLP-1 drugs increases the chance of gallbladder or bile duct disease, especially at higher doses, for longer periods, or when used for weight loss.

For older adults, this might present as sudden pain in the upper right side of the belly, nausea, fever, or pain spreading to the back or shoulder. These symptoms should be checked by a physician right away.

GLP-1 drug labels also warn about the risk of sudden pancreatitis and say to get medical help for severe, ongoing belly pain. The overall risk is low, but older adults may have additional risk factors, such as gallstones or high triglycerides. Severe belly pain in later life should always be checked quickly.

Then there’s the risk of blood sugar dropping too low. GLP‑1s don’t usually cause hypoglycemia by themselves, but the risk rises when combined with insulin or sulfonylureas. Semaglutide labeling warns that concomitant use with an insulin secretagogue or insulin may increase the risk of hypoglycemia and may require dose reductions of those agents.

In older adults, hypoglycemia can be particularly dangerous: it can cause falls, confusion, fainting, and cardiac stress. It’s also easier to miss, because symptoms may look like “just being tired” or “a little off today,” especially in someone who already has memory or balance problems.

Eyes and vision deserve special attention. Semaglutide labeling includes a warning about diabetic retinopathy complications and recommends monitoring patients with a history of retinopathy. Beyond labeling, post‑marketing safety monitoring continues to explore visual signals.

A 2025 analysis of FDA adverse event reporting data found a potentially elevated risk of vision‑impairment reports with semaglutide use compared with some other diabetes and weight‑loss medications, and it called for vigilant surveillance and further research. That doesn’t prove the drug causes vision loss in an individual patient, but it is enough to justify a cautious posture: new blurring, blind spots, or sudden changes deserve a same‑week medical call, not a “let’s see if it passes.”

5) Surgery and sedation: delayed stomach emptying can cause problems

GLP‑1 medications slow stomach emptying — one reason people feel full sooner. But that same effect can complicate anesthesia and deep sedation if food remains in the stomach despite standard fasting. A 2024 review describes the connection between GLP‑1 medications, delayed gastric emptying (including gastroparesis), and increased risk of aspiration during anesthesia, as well as possible effects on the absorption of other medications.

This issue has become important enough that several medical groups have created guidelines for surgery. The 2024 guidance says many people can continue taking GLP-1s, but doctors should look for higher-risk situations, such as people with stomach problems or other risks of food entering the lungs, and adjust plans as needed.

This is important for older adults because they are more likely to undergo procedures requiring sedation, such as colonoscopies, joint injections, cardiac procedures, dental work, or surgeries. The easiest and most often missed safety step is to tell every physician involved — surgeon, anesthesiologist, endoscopist, dentist — that you are taking a GLP-1 medication and when you last took it. Do not assume it will be clear in your medical chart.

6) A senior‑friendly “yes, with a plan” approach

If you’re an older adult considering a GLP‑1 (or already taking one), a safer approach often looks like “yes, with monitoring.” That means starting with function, not just the scale: tracking energy, steadiness, and strength in everyday life, not only pounds.

It also means treating hydration as a real medical concern. Ongoing nausea, vomiting, or diarrhea is not just part of getting used to the medicine. These symptoms can affect blood pressure and kidney function, especially when changing doses.

Because muscle matters so much in later life, protecting it should be part of the prescription. That can include discussing protein intake, adding a realistic strength plan (even chair‑based work or physical‑therapy guided resistance), and reassessing the medication if weight loss is accompanied by weakness, poor balance, or reduced stamina.

Older adults should also have their medications reviewed with a focus on preventing low blood sugar. If insulin or a sulfonylurea is being used, doses may need to be adjusted as appetite decreases and blood sugar improves.

Finally, it is important to take symptoms seriously. New stomach pain, ongoing vomiting, or sudden vision changes should be checked by a doctor right away. Before any procedure with anesthesia or deep sedation, make sure to tell the medical team about your GLP-1 use — do not assume they already know.

The GLP-1 medications can help some older adults, but there is less room for mistakes. Side effects can quickly lead to dehydration, frailty, falls, or problems during procedures. The safest approach is not just ‘yes’ or ‘no,’ but ‘yes, with a plan’ — one that protects hydration, nutrition, muscle, vision, and safety during medical care.

The post GLP‑1 Medications in Later Life: Why the “Miracle Shot” Needs a Senior‑Specific Safety Lens appeared first on Medika Life.

I was standing in my kitchen at 1:07 a.m., the only illumination a cold rectangle from the refrigerator.

It felt like a reversed Caravaggio scene. Darkness everywhere, a harsh pool of light on a plate of leftovers.

I was not hungry.

The light wired me awake. It felt like an invitation to eat.

I am a radiation oncologist.

I discuss circadian clocks with patients more often than most in my specialty because I’ve seen, over decades, how sleep, light, food timing, stress, and movement influence recovery, inflammation, and weight.

When you sit in a treatment room for a long enough time, you start to notice patterns.

People who live in bright evenings and dim mornings often struggle with appetite, cravings, and maintaining a healthy body composition.

They are swimming upstream against their biology.

This is the essay I wish someone had handed me ten years ago.

Light is not neutral.

It is a metabolic signal.

And the way we dose it each day can quietly nudge our insulin, our melatonin, our leptin and ghrelin, our brown fat, and even the clocks inside our liver and pancreas.

Let me show you how to use that to your advantage.

The Night I Realized Light Exposure Could Make You Fat.

In the clinic, I began asking a new question: not just how many hours you sleep, but how much light hits your eyes after sunset.

Most patients stared. Then came the stories: three glowing screens, bright LEDs in the bedroom, a dog walk under sodium street lamps.

Late light. Fragmented sleep.

Late eating. Creeping weight.

Our fat cells tell time. So do our mitochondria. So does your gut microbiome.

Light at the wrong time scrambles those clocks. Scrambled clocks change how you store energy.

Your Fat Has a Clock: Circadian Rhythm, Metabolism, and Weight Gain.

Every cell in your body keeps time.

Morning light anchors the master clock in your brain, which in turn syncs the clocks in your organs and fat cells.

Weak morning light and strong evening light throw those clocks out of phase.

The result is a subtle metabolic jet lag that never ends.

Quiet jet lag doesn’t show up on your calendar. It shows up on your scale.

Melatonin, insulin, and the late-night snack

Melatonin is not just a sleep hormone.

It cross-talks with insulin.

When melatonin levels are high, your ability to handle glucose decreases.

That is adaptive if you are asleep.

It is not adaptive if you are scrolling with a bowl of cereal near midnight.

Bright light at night suppresses melatonin, delays sleep, and shifts appetite later.

You wake underslept, with more ghrelin, less leptin, and a stronger drive to eat ultraprocessed food.

Rinse. Repeat.

Want to reset your metabolism?
→ Get my Micro-Habits bundle for daily light protocols, circadian checklists, and the exact scripts I give patients.

Morning light is metabolic medicine.

Ten minutes of unfiltered outdoor light soon after waking can move your circadian clock earlier, deepen your sleep that night, and improve next-day insulin sensitivity.

Morning light is rich in wavelengths your brain needs to set the day. Indoors, even bright-looking rooms are often one or two orders of magnitude dimmer than outside.

Your brain can tell the difference. So can your pancreas.

If you do one thing after reading this, step outside within 30 minutes of waking.

If it is cloudy, go anyway. If it is winter, aim longer. Treat it as you would a prescription.

Darkness is a habit

We talk about sleep hygiene.

We rarely talk about darkness hygiene.

Your retina is exquisitely sensitive to blue light, but even dim bulbs can disrupt your sleep cycle.

Swap bedside LEDs for warm, low-lux bulbs.

Set your phone to grayscale and enable a screen sunset. Cover the power lights with black tape.

Close the fridge quickly. Dim your home two hours before bed until it resembles a Rembrandt painting.

Your metabolism prefers Rembrandt over Times Square.

What I tell patients in the clinic

1. See the morning light early and consistently.
2. Eat most of your calories in the daylight zone.
3. Dim the house two hours before you want to sleep.
4. Stop eating at least two to three hours before going to bed.
5. Keep the bedroom dark, cool, and free of screens.
6. Anchor wake time seven days a week.
7. Move your body in the day, not at midnight.
8. Treat shift work like altitude. You need extra recovery, extra discipline, and a plan.

Micro-habits that fix your light diet

• Lux-before-latte rule: no coffee until you have been outside.
• Two-switch protocol: one button that turns off all bright overheads at 8 p.m., one that turns on warm lamps. Make darkness effortless.
• Yellow-card your phone: night shift mode, grayscale, and a screen curfew you respect.
• Front-load protein: bigger breakfast and lunch, smaller dinner. Your insulin sensitivity is higher earlier.
• Walk after dinner: even ten minutes blunts the glucose spike and helps your clock wind down.
• Bedroom audit: cover LEDs, use blackout curtains, move chargers to the hallway.
• Weekend consistency: Social jet lag is a form of metabolic jet lag. Keep your wake time within 60 minutes of weekdays.

The lab evidence in plain English

Animal models demonstrate that mistimed light exposure leads to weight gain, even without consuming extra calories.

Human studies have linked nighttime light exposure to a higher BMI, poorer sleep, and worse glucose control.

Shift workers have higher risks of obesity, diabetes, and some cancers.

These conditions are not destiny. They are signals you can change.

If you still want numbers

Chronobiology papers repeatedly show that eating the same calories at night causes a higher postprandial glucose and insulin response than eating them in the morning.

Timed light therapy can correct delayed sleep phase and improve metabolic markers.

Dim light at night correlates with higher rates of depression and weight gain.

Again, correlation is not causation, but the mechanisms are biologically sound.

A one-week protocol to test on yourself

Day 1 to 2

• Wake at the same time both days.
• Get 15 minutes of outdoor light within 30 minutes of waking.
• Track meals. Eat 80 percent of calories by 4 p.m.
• Dim the house lights at 8 p.m. Aim for minimal screen time.
• Sleep in full darkness.

Day 3 to 7

• Extend morning light to 20 minutes.
• Add a 10-minute post-dinner walk.
• Keep dinner smallest and earliest.
• Keep wake time strict.
• Note morning hunger and energy. By day 4, many people report fewer nighttime cravings.

How this plays out in the real world

A patient with breast cancer told me she could not lose weight despite “doing everything right.”

She tracked calories, lifted weights, and avoided ultraprocessed foods. She also answered emails at midnight under bright LED downlights and ate a second dinner at 10:30 p.m.

We moved her dinner to 6 p.m., instituted a house-wide dim at 8 p.m., added morning light exposure, and asked her to maintain a stable wake time, even on weekends.

Six weeks later, she had lost six pounds without changing her total calorie intake.

Her sleep improved. Her cravings diminished.

The scale finally listened.

The broader stakes of light exposure and weight gain

We are the first species to flood the night with light and the day with dimness.

We built a 24-hour culture and then wondered why our biology pushed back.

Weight gain is not a character flaw.

It is often a circadian mismatch.

Fix the light. Observe the effects on hunger, sleep depth, glycemic control, and weight.

Final Thoughts

Light is a drug.

Dose it wisely.

Morning heals.

Evening disrupts.

Darkness is a habit, not a switch.

If your weight has been creeping up, remember this: your first diet is not on your plate.

It is in your eyes.

→ Want my full circadian reset, daily checklists, and Micro-Habits plan? Get the Micro-Habits bundle today.

→ Follow me here on Medium for more science-backed, story-driven guides to living longer and better.

Author bio: I am a radiation oncologist who writes daily about longevity, cancer prevention, and the small habits that change health trajectories.

The post The Strange Link Between Light Exposure and Weight Gain appeared first on Medika Life.

Many of us may take multiple medications daily, and we depend on our prescriber’s ability to monitor those that are safe for us and exclude those that may be problematic. Anyone who wishes to be safer may do a bit of their research, and that’s fine. It does not mean you are suspicious; you only wish to ensure there’s no problem.

Hundreds of medications are listed, and it’s almost impossible for anyone to know if a medication could cause one of those rare effects for you. It is, therefore, in your best interest to be vigilant for these effects. In addition to being aware of the side effects, most patients would not know that the number of side effects may increase as the number of people taking the medication increases. Not every side effect manifests immediately, and it may require a significant increase in medication usage for it to show up.

How does a side effect enter the PDR? Usually, during clinical trials where drugs are being tested on patients, the principal investigator (PI) and those involved at the clinical sites will note any side effects that subjects report. Occasionally, an ultra-concerned clinical investigator may turn up a problem that isn’t one.

I recall a woman who developed a rash during clinical trials of a medication. Later, researchers determined that her caregiver had caused the rash by applying skin cream to her. The rash, however, continued to appear as a side effect of the drug. Although the rash wasn’t severe wasn’t related to the medication, it suggested that the researcher was very cautious about their protocol records.

Over the past several years, the discovery and prescribing of weight loss drugs (usually GLP-1) have been noted to have some mild side effects, and several studies have indicated what to expect in terms of side effects. Gut bacterial action causes bad breath (Ozempic breath), but it was easily manageable, provided the healthcare prescriber also examined any dental problems.

The Potential Risks

In another study, semaglutide was associated with a prevalence of nausea (44.10%), vomiting (24.58%), and gastroesophageal reflux disease (GERD) (6.28%) in obese individuals.

However, researchers are now expressing additional concerns about side effects that have emerged after tens of thousands of people have used these medications. How do these drugs work, and what are they noting?

By stimulating the body to create more insulin, these drugs decrease blood sugar levels. They also slow food’s passage through the stomach and lessen the sugar released into the bloodstream. When the digestive process is delayed, patients experience prolonged feelings of fullness, which can reduce their caloric intake and lead to weight loss. The action of the drugs would seem beneficial, especially for those who need to control their blood sugar levels and their weight.

But there was an increased risk, however, of gastrointestinal disorders, hypotension, syncope, arthritic disorders, nephrolithiasis, and interstitial nephritis associated with GLP-1RA use compared to usual care.

Researchers also followed more than 200,000 diabetics taking GLP-1 meds and over 1.7 million diabetics using other medications to decrease blood sugar for around 3.5 years. The study did find that using GLP-1 was not without its hazards. They found these medications were associated with an increased risk of pancreatitis of 146% and an increased risk of arthritis of 11%. But most of the study’s participants were white men in their 60s and 70s with US VA ties. Such a sample would not necessarily provide the most robust results, and future studies need to be much more diverse in the population studied.

The Vanity Factor

Aside from any physical effects, there is also something women especially might be concerned about: Ozempic face. A New York dermatologist came up with this term. It means that losing weight can make your face look older because of the tissue that is being lost. The fact that videos describing it have received millions of views indicates the extent of concern.

But when it comes to treating type 2 diabetes, the GLP-1 RA family provides positive benefits. In addition to a favorable impact on weight and a low risk of hypoglycemia, all medicines in the class have shown substantial reductions in A1C.

Despite some noted adverse side effects, the medications have proven beneficial to a significant number of users. However, as with everything, the benefits and risks must be weighed carefully, and Ozempic face should not be a negative when considering questions of health.

The post Skinnier, Sicker? Weight-Loss Meds Raise Concerns appeared first on Medika Life.

“The fault, dear Brutus, is not in our stars, but in ourselves…”
— William Shakespeare, Julius Caesar.

That quote haunted me for years, long before I ever held a linear accelerator’s joystick or delivered radiation to a tumor curled around someone’s spine.

Back then, I didn’t fully grasp its relevance to my work.

Now, after decades in oncology, I see it with stark clarity.

Because here’s the truth:

Up to 42% of cancers are preventable — not through miracle drugs or genetic luck, but through modifiable, everyday choices.

This observation isn’t about blame.

It’s about power.

And it’s time we stopped whispering about it.

Even through the fog of risk, we can walk toward healing. 42% of cancers are preventable, and every step counts.

🔁 Why Cancer Isn’t Just Bad Luck: The Myth of Randomness

When patients hear “cancer,” the next question is often whispered:

Did I cause this?

It’s a painful, complicated moment.

I always remind them: no one deserves this, and no one gets cancer from one bad meal or missed screening.

But I also tell them we know that cancer is not a lightning strike.

Yes, some cancers come from sheer genetic chaos.

But others arise from a slow, silent drift, shaped by inflammation, environment, and habit.

🔁 Inflammation and Obesity: The Hidden Cancer Risks

You don’t see inflammation in the mirror. But it shapes your fate.

Low-grade, chronic inflammation — often fueled by excess fat, poor diet, poor sleep, and stress — is a known contributor to several cancers, including colorectal, breast, and liver.

Chronic inflammation in the etiology of disease across the life span – Nature Medicine

www.nature.com

We once thought of obesity as a cosmetic issue. Now we understand it as a biological amplifier of cancer risk:

• Fat cells release cytokines and estrogen-like compounds
• These can trigger DNA damage and tumor-promoting environments

I’m not judging anyone’s weight. I’m inviting a deeper understanding of how the body works — and how we can gently steer it.

Diseases desperate grown,
By desperate appliance are relieved,
Or not at all.”
— Shakespeare, Hamlet.

Sometimes, small daily shifts are our most potent medicine.

🔁 How Alcohol, Smoking & Diet Tip the Scales

If you asked me what four lifestyle changes would make the biggest impact on global cancer rates, I’d say this:

1. Stop smoking
2. Drink less alcohol
3. Eat more plants and fewer processed foods
4. Move

🥃 Alcohol

Alcohol is a group 1 carcinogen, the same class as tobacco and asbestos.³

It increases the risk for at least seven cancers, including breast and colorectal.

And even “moderate” drinking has risks, especially for those with other risk factors.

No level of alcohol consumption is safe for our health

. www.who.int. int.

🍽️ Diet

Ultra-processed foods cause inflammation, metabolic dysfunction, and now, higher cancer risk.

A 2023 study in The Lancet tied them to a 29% increased risk of colorectal cancer.⁴

It’s not about moral purity. It’s about stacking the odds in your favor.

Prevention Isn’t Perfection. It’s Daily Poetry.

When I talk to patients, I don’t hand them guilt. I hand them a possibility.

• A walk after dinner to quiet insulin spikes
• A decision to swap soda for tea
• A full night of sleep instead of doomscrolling

These things may seem small, but they are acts of devotion, not just to the body, but to the life it still wants.

Though this be madness, yet there is method in’t.”
— Hamlet.

Health is not about perfection. It’s about rhythm.

About small, quiet methods repeated until they shape destiny.

The Truth I Wish More People Knew

When people find out I’m a cancer doctor, they usually ask about treatments.

But the conversation I wish we had more often is this:

What can I do now, before the diagnosis, to change the story?

The answer isn’t sexy. It’s not a pill or a breakthrough headline.

It’s this:

Cancer isn’t always random. And your choices — however small — are not meaningless.

You deserve to know that.

A Gentle Invitation

I don’t write this to scare you.

I write it because knowledge is power, and silence is not protection.

Here’s the truth:

• Cancer is common.
• Up to 42% is preventable.
• That prevention is made of ordinary acts repeated with quiet courage.

What’s one habit you’ve changed for your long-term health? I’d love to hear.

The post Cancer Isn’t Random: What 42% of Diagnoses Have in Common — and How You Can Lower Your Risk. appeared first on Medika Life.

GLP-1 agonists have also shown promise in reducing the risk of major adverse cardiovascular events, such as stroke and heart attack. This adds to their potential benefits in managing obesity and its related health complications.

Clinical Trial of Semaglutide and Bimagrumab

One promising avenue of research involves combining existing GLP-1 receptor agonists with experimental drugs designed to preserve muscle mass. A clinical trial, known as the BELIEVE Phase 2b study, is currently underway to test the combination of semaglutide and bimagrumab. Bimagrumab is a first-in-class, fully humanized monoclonal antibody developed by Versanis Bio, a clinical-stage biopharmaceutical company recently acquired by Eli Lilly. It targets activin type II receptors, which play a role in regulating muscle growth and fat storage. This trial aims to assess the efficacy and safety of bimagrumab in preserving or increasing muscle mass while promoting weight loss with semaglutide in non-diabetic patients with overweight or obesity.

To be eligible for the BELIEVE study, participants must have a body mass index (BMI) greater than or equal to 30, or greater than or equal to 27 with one or more obesity-related comorbidities. Key exclusion criteria include a history of hypersensitivity to monoclonal antibody drugs, treatment with any medication for obesity within 30 days before screening, and a diagnosis of diabetes requiring current use of any antidiabetic drug.

Pre-clinical studies have shown that blocking activin type II receptors with bimagrumab leads to increased lean mass and decreased fat mass in mice. In a Phase 2 study, bimagrumab produced a 22% reduction in fat mass and a 4.5% increase in lean mass in patients with type 2 diabetes and obesity. Notably, no weight regain was observed after stopping bimagrumab treatment, unlike the rebound effect often seen with GLP-1 therapies. This suggests that bimagrumab may offer long-term benefits in maintaining weight loss even after treatment cessation.

The ongoing clinical trial will provide valuable insights into the potential of combining semaglutide and bimagrumab to achieve superior fat loss while preserving muscle mass. This combination therapy could offer a more comprehensive weight management approach, addressing fat loss and muscle preservation.

Semaglutide and Bimagrumab: Mechanisms of Action

Semaglutide and bimagrumab work through distinct mechanisms to achieve their therapeutic effects. Semaglutide, a GLP-1 receptor agonist, mimics the action of GLP-1, a natural gut hormone crucial in regulating blood sugar and appetite. GLP-1 agonists work by

• Triggering insulin release from the pancreas
• Blocking glucagon secretion
• Slowing stomach emptying
• Increasing feelings of fullness

Semaglutide helps lower blood sugar levels, reduce appetite, and promote weight loss by mimicking these effects.

Bimagrumab, on the other hand, is a human monoclonal antibody directed against type II activin receptors (ActRII). Upon administration, bimagrumab binds to ActRII, which prevents binding the natural ligands, myostatin and activin, to activin receptors and blocks ActRII-mediated signalling. This increases protein synthesis, decreases protein degradation, stimulates skeletal muscle cell growth, and increases muscle function and strength10. Overstimulation of the ActRII-mediated signalling pathway is associated with muscle loss and weakness.

Other Anti-Obesity Drugs in Development

The success of semaglutide and tirzepatide has fueled a surge in the development of new anti-obesity drugs. These drugs target various biological pathways and aim to improve upon the limitations of existing therapies. Targeting multiple pathways simultaneously could allow for lower doses that achieve the same weight loss with fewer side effects. Some of the key areas of development include:

GLP-1 and GIP Receptor Agonists

Tirzepatide is a dual GLP-1 and GIP receptor agonist that has shown superior weight loss results compared to semaglutide in a large head-to-head trial by Eli Lilly. Participants who took tirzepatide lost an average of 20% of their body weight, outpacing the 14% reduction achieved with semaglutide. Tirzepatide is already available under the brand names Mounjaro and Zepbound.

There are two main strategies for modulating GIP activity: activation and blocking. While both approaches can lead to weight loss, they have different potential benefits and drawbacks. As seen with tirzepatide, GIP activation can further enhance energy metabolism and promote weight loss. However, some concerns blocking GIP signalling could adversely affect bone health, as GIP also plays a role in bone metabolism.

Amylin Analogues

Amylin is a hormone co-secreted with insulin that regulates blood sugar and appetite. CagriSema, a combination therapy developed by Novo Nordisk that pairs a long-acting analogue of amylin (cagrilintide) with semaglutide, has shown promising results in clinical trials. Participants in a 68-week, phase 3 trial lost an average of nearly 23% of their body weight.

Glucagon and GLP-1 Receptor Co-agonists

Glucagon is a hormone that raises blood sugar levels, while GLP-1 lowers them. Combining these two hormones in a single drug could offer a balanced approach to weight loss by increasing energy expenditure while maintaining blood sugar control. Survodutide, a glucagon and GLP-1 receptor co-agonist developed by Boehringer Ingelheim, is currently in clinical trials.

Triple-Hormone Receptor Agonists

Retatrutide, a triple-hormone receptor agonist developed by Eli Lilly that targets GLP-1, GIP, and glucagon receptors, has shown impressive weight loss results in Phase 2 trials. This drug, dubbed “triple G,” delivered an average weight reduction of 24% after 48 weeks, setting a new benchmark for obesity treatments.

Alternative Delivery Methods for Anti-Obesity Drugs

Companies are also exploring alternative delivery methods to once-weekly injections, which can be challenging to incorporate into people’s routines and come with manufacturing challenges. Once-monthly injectables are in the works, but oral formulations of GLP-1 receptor agonists, such as orforglipron produced by Eli Lilly, could arrive first.

Another potential alternative is oral semaglutide. In a phase 3 study called OASIS 1, people taking oral semaglutide 50 mg once daily lost up to 15% of their initial body weight after about 15 months (68 weeks) of use. This is comparable to the weight loss benefits of Wegovy, the injectable version of semaglutide.

Potential Side Effects of Anti-Obesity Drugs

While anti-obesity drugs offer a promising approach to weight management, they can also cause side effects. Some of the common side effects of GLP-1 receptor agonists include nausea, vomiting, diarrhoea, and constipation. More serious side effects, such as pancreatitis and gallbladder problems, are rare but can occur.

Specific side effects associated with semaglutide include nausea, vomiting, diarrhoea, abdominal pain, constipation, heartburn, and burping. In rare cases, semaglutide can cause more serious side effects such as pancreatitis, kidney problems, and changes in vision.

Tirzepatide can cause similar side effects, including nausea, diarrhoea, decreased appetite, vomiting, constipation, and stomach pain. Serious side effects, such as pancreatitis, gallbladder problems, and low blood sugar, can also occur.

Another concern with GLP-1 and GIP drugs is the potential risk of pulmonary aspiration during anaesthesia. These drugs can cause delayed gastric emptying, which may increase the risk of residual gastric contents despite preoperative fasting. This can lead to aspiration, where food or liquid gets into the lungs during surgery.

The increased demand for GLP-1 receptor agonists and dual GIP/GLP-1 receptor agonists has led to temporary product shortages. This has resulted in the emergence of compounded formulations of these drugs, which produce entities that bypass regulatory measures. The American Diabetes Association recommends against using non-FDA-approved compounded GLP-1 and dual GIP/GLP-1 receptor agonist products due to concerns regarding their safety, quality, and effectiveness. The FDA has also issued an alert on dosing errors associated with compounded semaglutide injectable products, which have led to adverse events and hospitalisations in some cases.

It is important to note that the potential side effects of anti-obesity drugs vary depending on the specific medication and individual factors. Patients should discuss these medications’ possible risks and benefits with their healthcare provider to determine the most appropriate treatment option.

Alternative Treatments for Obesity: Bariatric Surgery

For some individuals, bariatric surgery may be an alternative treatment option for obesity. Bariatric surgery involves making changes to your digestive system to help you lose weight. It is typically considered for people with a BMI of 40 or higher or those with a BMI of 35 or higher who have obesity-related health problems.

There are several types of bariatric surgery, including

• Roux-en-Y gastric bypass: This procedure involves creating a small pouch at the top of the stomach and connecting it directly to the small intestine, bypassing most of the stomach and the first section of the small intestine
• Sleeve gastrectomy: This procedure involves removing about 80% of the stomach, leaving a long, tube-like pouch
• Biliopancreatic diversion with duodenal switch (BPD/DS): This is a two-part surgery that involves performing a sleeve gastrectomy and then connecting the end of the small intestine to the duodenum, bypassing most of the small intestine

Bariatric surgery can be very effective for long-term weight loss and can also improve or reverse obesity-related conditions such as diabetes, high cholesterol, and sleep apnoea. However, it is a major surgical procedure with potential risks and complications, such as bleeding, infection, and leaks in the gastrointestinal system. Patients should carefully consider the risks and benefits of bariatric surgery with their healthcare provider.

Emerging Applications of GLP-1 and GIP Drugs

While GLP-1 and GIP drugs are primarily known for their role in treating obesity and type 2 diabetes, research is exploring their potential applications in other disease areas. These include:

• Neurodegenerative diseases: Conditions such as Parkinson’s and Alzheimer’s disease involve protein misfolding and chronic inflammation. Studies have found that GLP-1 mimetics can cross the blood-brain barrier and have neuroprotective effects, including reducing oxidative stress and chronic inflammatory responses in the brain.
• Liver disease: GLP-1 and GIP receptor agonists have shown potential in improving liver health, particularly in individuals with nonalcoholic fatty liver disease (NAFLD).

These emerging applications highlight the versatility of GLP-1 and GIP drugs and their potential to address a wide range of health challenges beyond obesity and diabetes.

Conclusion

The field of anti-obesity drug development is rapidly evolving, with new therapies emerging that offer the potential for more effective and personalised weight management. While GLP-1 receptor agonists like semaglutide and tirzepatide have revolutionised the field, ongoing research is exploring new targets and combination therapies to address the limitations of existing medications. These advancements, such as the combination of semaglutide and bimagrumab, the development of triple-hormone receptor agonists like retratrutide, and the exploration of alternative delivery methods, hold promise for improving the lives of millions of people struggling with obesity and its related health complications.

However, it is crucial to acknowledge the potential side effects of these therapies, including gastrointestinal issues, pancreatitis, and the risk of pulmonary aspiration during anaesthesia. Patients should carefully consider the risks and benefits of these medications with their healthcare provider to determine the most appropriate treatment option.

Developing new anti-obesity drugs has significant implications for public health and the future of obesity management. These advancements offer hope for a more comprehensive and personalised approach to weight loss, potentially reducing the burden of obesity and its associated health problems.

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Like an endangered species, preventive medicine and chronic disease management—the US primary care system—face extinction. With nearly 30% of American adults lacking a source of care and 28 percent reporting delaying or not getting care due to cost, the consequences are far-reaching.  The focus on chronic disease prevention and addressing its root causes demands greater attention, as the health of the system—and the people it serves—depends on it. If we are frustrated about something, this is worth the outrage.

It has been almost impossible for elected officials, who too often look for singular villains, to grasp the extent of this system-wide dysfunction. This crisis extends beyond consumer comfort with technology or the cost of medicines. Primary care medicine—the basis for health delivery—is marginalized as an honored medical discipline. Somehow, we opt for a national health system prioritizing sick care over healthcare.

Primary care providers are grappling with burnout and inadequate compensation compared to their specialist counterparts, and the system often prioritizes paperwork over quality of care. Economics drives health delivery and access, and it’s simply not working to the advantage of consumers and primary care physicians.  

Finger-pointing and Senate HELP Committee photo ops cannot solve this nation’s care crisis. What’s needed is a fundamental shift in our approach to illness, prevention, and access—one that addresses the root causes of our failing primary care system and ensures that quality healthcare is accessible to all Americans, regardless of zip code or digital literacy. That will reduce our total health costs.

Obesity and Heart Disease: A Multigenerational Threat

America’s waistline is changing—we are adding notches to the nation’s belts. Obesity rates among younger Americans are climbing, creating an abundance of chronic diseases that once seemed confined to older generations. Alarmingly, heart disease, which had been in decline for decades, is creeping back up.

The invention of new weight-loss drugs like GLP-1 receptor agonists helps many struggling with chronic weight issues and mitigates some health risks. Yet, these drugs are not a complete answer to the challenge. They do not adequately address the underlying risks—heart disease, diabetes, and other chronic conditions—that require ongoing, consistent engagement with health professionals. Without this, even those who benefit from these medications – looking trim – may still end up battling old health challenges.

The persistent challenge of obesity across various age groups in the US, which hovers at +/- 40 percent, reinforces worrisome trends that impact people by age, race and region. A rate stable at 40 percent is not something to celebrate – it requires action. It’s a tipping point for illness.

Prediabetes: A Perfect Public Health Storm

Prediabetes is the nation’s silent epidemic. Close to 90 million adults—more than 1 in 3 Americans—have it, and 90% don’t know they do. Left unchecked, some 20 percent of these people “graduate” to Type 2 diabetes and other complications annually. The rise in obesity among younger populations only exacerbates this issue, setting the stage for an earlier onset of chronic diseases that worsen over time.

Prediabetes demands a dedicated behavior-focused treatment plan. Without significant lifestyle changes, individuals are on a fast track to diabetes and its life-altering complications. And yet, the primary care system—our first line of defense—is buckling under pressure, unable to provide the consistent support patients need. It’s not just the use of medications – it’s understanding that obesity is a multi-system condition and a unique disease that transcends more belt notches.

The Limitations of GLP-1 Drugs:

GLP-1 drugs do reduce weight and lower the risk of diabetes and heart disease. But they are not a substitute for comprehensive care. The underlying dangers—poor cardiovascular health, insulin resistance, and other metabolic issues—don’t disappear with weight loss alone. Without engagement with allied health professionals trained to address the complexities of obesity to monitor and address these risks, consumers will face new challenges despite these drugs’ initial success in losing pounds.

We live in what Katherine Saunders, MD, DABOM, a Weill Cornell Medicine’s Comprehensive Weight Control Center and co-founder of FlyteHealth, calls the “Obese-a-genetic” era.  Her efforts at FlyteHealth leverage the latest in science, technology, patient support, and a range of medications to individually tailor weight treatment based on a person’s unique biology alongside the complexity of obesity treatment:

“Overweight and obesity are misunderstood medical conditions that are more complex than calories in and calories out. The advice many patients receive—to eat less and exercise more—often fails to address the problem.”

Saunders and her colleagues are at the cutting edge of results-oriented care, but she is among the handful who have dedicated their careers to this pressing clinical discipline.

Walk-In Clinics are about Convenience

Convenience of care is essential to people’s well-being. Entrepreneurial internists have recognized this, creating “pop-up” vaccination and care centers to bring services closer to those in need and better work/life balance. But convenience alone isn’t enough. Urgent care clinics underscore one of the nation’s most pressing public health threats—the erosion of primary care—has reached a retail-like inflection point.

Walk-in clinics and telehealth check-ins are helpful but do not offer dedicated follow-up. They are geared to address the consumer’s immediate need and are not structured for the longitudinal engagement for the hard-to-tackle considerations that call for comprehensive support.

We are stuck between a system that focuses on its self-preservation and what is in our and national long-term interests – protecting our most important asset – our health.

The Rise of the Make American Health Again Movement

Primary care physicians, the cornerstone of preventive health, are becoming extinct as a medical profession species. The reasons are many: medical school debt driving doctors to higher-paying specialties, they are paid by the number of patients seen daily burnout, and the rise of retail clinics offering quick, transactional care.

While these clinics improve access, their focus is not on a long-term patient-physician relationship. This shift leaves a dangerous gap in the medical safety net, particularly for chronic conditions like obesity, prediabetes, and heart disease. Without a trusted health provider to guide them, patients are left to navigate their health journeys solo—often with devastating consequences.

Many are aghast at Robert F. Kennedy Jr.’s nomination to the Department of Health and Human Services as Secretary of the nation’s key organization setting national health policy. This justified anxiety centers on his stated positions on vaccines and his off-hand comments dismissing the importance of medicines in preventing more serious illnesses. However, his thoughts about America’s poor health report card grades deserve attention regardless of the outcome of the Senate confirmation hearings.

His Make America Healthy Again movement has an approach that deserves consideration: the need to tackle the chronic disease epidemic, which has become the leading cause of death in the US and, later, drives massive costs in hospitalization.

“There are some things that RFK Jr. gets right,” says Resolve to Save Lives CEO Dr. Tom Frieden, who was appointed Director of the Centers for Disease Control and Prevention during the Obama Administration. “We do have a chronic disease crisis in this country, but we need to avoid simplistic solutions and stick with the science.” Frieden made his comments in an NPR interview on the RFK Jr. nomination.

We need (much) more than medications and pop-up clinics to address America’s growing health crises. The health ecosystem must be reimagined to center around people’s health outcomes – not a one-size-fits-all approach to keeping them well. We must foster long-term patient-provider relationships, ensure easy access to understandable health data, emphasize nutrition and physical education in schools, and make care accessible to people across racial and generational lines.

As the ticking time bombs of obesity, prediabetes, and heart disease continue to warn, the urgency for change cannot be overstated. The frustration over the current complexity of access underscores what happens when we prioritize the system over prevention. Access to care isn’t just a convenience—it’s a matter of survival. To prevent the collapse of this fragile house of cards, we must act decisively and collaboratively to build a health system that sustains us all.

The post Conceptually, the “Make America Healthy Again Movement” Needs a Nod appeared first on Medika Life.

Over a thousand epidemiologic papers were examined, including clinical trials of weight-loss or weight-control therapies. These investigations included observational studies on cancer risk and fat excess. Because of this, the assessments focused on the dangers of being overweight rather than the benefits of preventative measures.

Studies varied in their risk assessments; most focused on adults’ body mass index (BMI), while others looked at childhood or adolescent BMI or body shape, weight or BMI changes over time, or other measures of adiposity, such as waist circumference.

The analysis considered relative-risk estimates where sufficient analyses of observational data were accessible. The absence of extra body fat, it was concluded, reduces the risk of cancer at previously described organ sites. In addition, study results point to the fact that being lean reduces the incidence of eight more cancers: gastric, cardiac, liver, gallbladder, pancreatic, ovarian, thyroid, multiple myeloma, and meningioma. Once again, however, we must understand that correlation does not equal causation. But the indicators are of concern and great interest.

If the newly introduced GLP-1 medication can control obesity, which, in turn, may reduce the incidence of cancer, researchers are now questioning whether these drugs may serve other purposes in healthcare. There is a belief that GLP-1 medication use may extend beyond obesity and weight control. What areas are they currently considering for studies with these medications?

GLP-1 for Addiction?

The World Health Organization (WHO) found that 2.6 million people die each year because of alcohol intake (or 4.7% of all deaths), and 0.6 million people die because of the use of psychotropic drugs. Men accounted for 0.4 million drug-related fatalities and 2 million alcohol-related fatalities. But while alcoholism remains a serious health hazard, there are other addictions to street or prescription drugs that are also of concern to healthcare professionals and patients.

Cocaine use disorder affects an estimated 5 million people. Worldwide, the death toll from cocaine overdoses is rising at a faster rate than that from opiate overdoses.

But there is an intriguing relationship between obesity and addiction. Substantial evidence in the literature linking obesity to substance use disorders supports a link of sorts. Studies have shown that when people are exposed to meals that are very tasty, certain hormones in the brain are triggered, which makes consuming unhealthy choices more likely.

This is analogous to what occurs in the brains of those who suffer from substance abuse disorders. Behaviors comparable to addiction to foods high in fat and sugar have led to studies employing animal models of obesity, discovering typical neurobiological features of addiction in the brain systems. The reward system that is engaged, and that perpetuates a preference for specific types of foods, may also be involved in addiction disorders.

The conclusion, currently, is that there is a viable solution for addiction through the use of the GLP-1 medications. Researchers must further investigate these specific connections and detail their interrelationships.

Since the discovery of GLP-1 medications for obesity, several off-label uses have also been shown to be useful. Researchers are actively exploring the growing number of diseases that these medications might treat, which is extremely promising.

The potential utility of GLP-1 disorders of addiction and others include: food addiction (binge eating), alcoholism, Parkinson’s disease, depression, anxiety, heart disease, hypertension, fatty liver, polycystic ovarian syndrome, chronic kidney disease, inflammation, and opiate and narcotic addictions.

Addiction regulation, inflammation reduction, dopamine pathway modulation, and insulin sensitivity are just a few of the many physiological consequences of these receptor agonists. Because of these processes, they are promising candidates for the treatment of diseases outside of their original indications.

Medical and scientific communities are highly intrigued by the prospect of GLP-1 medicines potentially treating this wide array of illnesses, but research into these uses is still in its early phases.

The future, however, appears promising as new indications come to light, and as research reveals the areas where they may be brought into a treatment regime that is successful. At this juncture, however, it is not always apparent which biological pathways are being affected and that is a remaining question for future research efforts.

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In addition to obesity, a growing number of people around the world are struggling with substance use disorders, tobacco use disorders, and alcohol use disorders. Everyone, from the person experiencing the disorder to their loved ones and the community at large, feels the effects of these conditions.

The co-existing disorder data indicate many patients are engaging in multiple substance use, which significantly raises the dangers linked to each substance individually. But there’s also another factor: discrimination. Experiencing both obesity and discrimination can contribute to mental health problems, leading some to rely on substances for relief.

Consider, for a minute, who the primary targets are for advertising substances, such as alcohol and cigarettes. I suspect you will note that it is in communities with lower socioeconomic levels and higher rates of discrimination.

Medication to the Rescue?

Medications for alcohol use disorder, opioid use disorder, cocaine use disorder, and tobacco use disorder may not be as effective as we need. Recent findings suggest targeting GLP-1 receptors as a potential approach for developing new pharmaceutical therapies for many disorders besides obesity. How might they work?

The small intestine produces GLP-1 upon food consumption, and the brain also produces it and releases it as a neurotransmitter in several brain regions. Importantly, GLP-1 can cross the blood-brain barrier (the brain’s biological moat) and reach receptors in areas associated with the neurobiology of addiction.

These new GLP-1 drugs are assuredly affecting something that may drive obesity—junk food. Junk food may play a significant role in obesity, and the new medications meant to curb our taste for it are cutting into junk food profits. But the desire for junk food starts early, and many factors are associated with it.

Three reasons for junk food preferences may be present: lack of money leads to purchasing cheaper foods, one behavioral element, and one lifestyle element. The lifestyle element may have more to do with the demands of work and a lack of time for food preparation. But why do we crave junk food? Some experts believe it’s a learned response from infancy. We have an industrial palate.

The “industrial palate” is a taste preference for processed foods developed from early exposure in infancy and characterized by artificial ingredients. What’s in baby foods, and do you recognize all the ingredients? Oddly, it echoes the expression, “Give me a child before the age of seven, and they are mine for life.”

Some people on GLP-1 medications have found that they no longer crave ultraprocessed foods. What is in these foods? They contain chemicals, such as artificial sweeteners, colors, bleaches, and modified starches, are not normally seen in a home kitchen.

Don’t you want bleach in your food anymore? (Side note: They bleach maraschino cherries before dyeing them red.) There may be several solutions for all of that, and it is problematic for industries built on keeping your palate leaning in their direction.

Food Choice and Obesity Medications

The GLP-1 medications may affect the reward center in our brains, but how do they specifically affect junk foods?

The main point is that the glucagon-like peptide-1 (GLP-1) system in the brain is very important for controlling how much food you eat and your weight. The study focuses on the differences between GLP-1 that comes from the gut and GLP-1 that comes from the brain, and how these differences affect the effects of drugs that bind to GLP-1 receptors and are used to treat obesity. It also shows that targeting the GLP-1 system in the brain could open up new ways to treat obesity.

There is a simpler way to state this interaction and the biology behind why these new drugs work. GLP-1 is secreted in the small intestine and aids in maintaining stable blood glucose levels, decreasing hunger, and delaying stomach emptying. As a possible treatment for addiction, GLP-1 receptor agonists have garnered interest via animal studies.

Preclinical research in mouse models has demonstrated that GLP-1 receptor agonists can reduce the rewarding and reinforcing effects of certain addictive substances, alcohol consumption, and seeking behaviors. We do not yet know how activation of GLP-1 receptors affects alcohol and drug effects, although it might have something to do with regulating the dopamine and stress systems, among other neurotransmitter systems.

Technology Enters the Mix

If our current economy demands workers have little time for shopping and food preparation, how might technological advances in food preparation affect the purchase of ultraprocessed food? Hot pots and countertop devices are gaining popularity with consumers and prices for them are coming down as their intended uses increase with advanced design.

In competing with food technology devices, corporations that are engaged in the production of fast or junk foods have research teams currently producing lines of weight-maintaining or weight-loss meals. These meals are designed to temper upward their attractiveness in a variety of ways, one of which is in the naming of the products. They are now being called products that are “weight conscious” or “high protein” or to be used in conjunction with weight reduction medication.

Consumers must decide whether fast food fits their lifestyle, despite potential health consequences and cost. The research on the GLP-1 receptors, however, offers promise in substance abuse disorders, and, therefore, in life-maintaining methods. The medication’s will not be limited to obesity alone and will find a welcoming field in healthcare providers where addiction has proven to be difficult for many.

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Considering that over 40% of U.S. adults have obesity and there are fewer than ten thousand obesity medicine specialists, PCPs are a critical part of the solution as we tackle this epidemic. While PCPs have extremely limited time to delve into the complexities of obesity and provide support between visits, it’s wonderful when they are knowledgeable about evidence-based obesity treatment so that they can at least initiate the conversation and refer their patients to an obesity specialist.

But the collaboration doesn’t stop there. Obesity is not only a chronic disease in its own right; it is also associated with more than 200 other conditions that can affect all body systems. According to data from IQVIA, people ages 40-64 with obesity have 2.4 comorbidities on average. That figure rises to 4.9 for individuals 65 and over (and 7% of people in the latter age group have 10 or more comorbidities). Effective treatment requires taking these comorbidities — and the medications often prescribed for them — into account and communicating with other members of the patient’s care team throughout treatment.

The following are just a few of the subspecialties that obesity touches.

• Cardiology: The impacts of obesity on cardiovascular health — raising the risk of high blood pressure, heart attack and stroke, among other conditions — are among the best known and most thoroughly studied. In fact, the anti-obesity medication, Wegovy, was recently approved specifically to reduce the risk of adverse cardiovascular events in individuals with obesity and established cardiovascular disease.

• Endocrinology: Adipose tissue is an active endocrine organ that produces more than a hundred different hormones, so it’s no surprise that endocrinologists are frequently involved in treating obesity-related conditions — Type 2 diabetes being the most familiar, but also polycystic ovarian syndrome and infertility, among many others.

• Orthopedics: Obesity is a risk factor for the development of soft tissue damage and osteoarthritis in load-bearing joints, particularly the knees, due to both inflammation and mechanical stress. Joint pain then inhibits physical activity, which worsens obesity, creating a vicious circle — while also increasing the risk of complications associated with orthopedic surgery.

• Oncology: Obesity is a risk factor for the development of many types of cancers, including breast, colon, rectal, pancreatic, kidney, esophagus, ovarian, skin, liver, thyroid, gallbladder, brain (meningioma) and endometrial cancer. Researchers believe that excess body fat leads to hormonal and metabolic changes that trigger inflammation and promote tumor growth.

• Gastroenterology: Obesity is associated with many digestive system diseases, including gastroesophageal reflux disease, esophagitis, gallstones, metabolic dysfunction-associated fatty liver disease and cirrhosis, and various related cancers.

• Pulmonology: Individuals with obesity face a higher risk of asthma, obstructive sleep apnea and other respiratory conditions (including, as we observed with COVID-19, potentially worse outcomes from viral infections).

• Psychiatry: Obesity and depression are closely linked, with a bidirectional association, and it’s worth noting that many antidepressants can promote weight gain, so prescribers should be prepared to consider weight-neutral or weight-loss-promoting alternatives for patients with obesity when possible. Other common mental health comorbidities include anxiety and eating disorders.

For many of these obesity-related health complications, losing weight can be the first line of treatment, and the relationship is often dose-dependent, meaning that these conditions worsen as obesity worsens and improve as obesity improves. This correlation may lead us to instinctively reach for GLP-1 medications as the most effective option, since we want to help our patients lose as much of their excess weight as possible and experience the greatest benefit. But especially considering significant cost, coverage and supply constriants, other anti-obesity medications can still bring measurable health benefits and might even be preferable for many individuals. Losing just 5% to 10% of body weight can lead to clinically significant improvements in markers such as blood glucose, cholesterol and blood pressure.

Improving patient health — not just reaching an arbitrary number on the scale — is the ultimate goal. Obesity touches everything, and treating obesity can have a positive, cascading effect on other conditions. If we can help a patient achieve Type 2 diabetes remission, reversal of sleep apnea or improved fertility, we’ll have made a real difference in their life.

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Dr. Igel’s distinguished career spans both academia and clinical practice. As a Clinical Assistant Professor of Medicine in the Division of Endocrinology, Diabetes, and Metabolism at Weill Cornell Medicine, and an Attending Endocrinologist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, Dr. Igel has demonstrated unparalleled expertise in the management of a wide range of endocrine disorders, with a specific focus on weight management, post-bariatric surgery care, type 2 diabetes, and other related conditions.

His commitment to advancing diabetes care is evident in his innovative approach, particularly in addressing the often-overlooked connection between diabetes and obesity. Dr. Igel emphasizes a weight-centric approach to diabetes treatment, advocating for medications that are either weight-neutral or lead to weight loss. This approach challenges the status quo in healthcare, where the impact of certain diabetes medications on weight gain is often disregarded.

“The link between diabetes and obesity is complex, and addressing it requires a comprehensive approach,” says Dr. Igel. “We know that over 11% of Americans have diabetes, and a large percentage are actually undiagnosed. Many individuals are in a progression towards diabetes, and much of that progression is closely tied to weight gain that occurs throughout someone’s lifetime. This is why we are committed to continuing our work to improve diabetes care and raise awareness of the critical connection between obesity and diabetes.”

“It is a privilege to recognize Dr. Leon Igel as the Medical Honoree of the Year,” said ADA’s Research Dinner Executive Committee Chair Gil Bashe, Finn Partners. “Obesity is a common, chronic, and progressive disease that is linked to a significant number of diabetes cases every year, and Dr. Igel’s dedication to reshaping diabetes care through his groundbreaking work in obesity management will help improve the lives of many people. His innovative approach and unwavering commitment are invaluable contributions to the field.”

As part of the Intellihealth team, Dr. Igel’s contributions extend beyond clinical practice. Intellihealth is at the forefront of leveraging innovative solutions to improve patient outcomes. Dr. Igel’s work with Intellihealth underscores the company’s dedication to advancing healthcare through research, technology, and patient-centered approaches.

For more information, sponsorships, and tickets, please go to www.diabetes.org/researchdinner2024.

About Intellihealth
Intellihealth is changing the perception of obesity and redefining how it is treated. We offer evidence-based medical obesity treatment that is three times more effective than lifestyle intervention alone. Our product, Evolve^™, enables health care providers to offer effective medical obesity treatment both via telehealth and in person. Our clinical services affiliate, Flyte^™ Medical, provides businesses and healthcare systems the services of experienced clinicians who are passionate about obesity medicine, including physicians, nurse practitioners and registered dietitians. More about Intellihealth, Evolve and Flyte Medical may be found at www.intellihealth.co.

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