• Testosterone therapy can improve libido in postmenopausal women.
• Sexual dysfunction in women is complex and multifactorial.
• Low sexual desire is only considered a disorder if it causes distress.
• Psychosocial factors play a significant role in sexual health.
• Testosterone levels do not change significantly at menopause.
• The placebo effect can significantly influence treatment outcomes.
• Individualized care is crucial in managing sexual dysfunction.
• Dosing for testosterone therapy should be carefully monitored.
• Current medications for low libido have modest benefits.
• Evidence for testosterone therapy in premenopausal women is still emerging.
  
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Show Notes:
In this episode of Docs Who Lift, the Nadolsky brothers welcome back Dr. Sean Wharton, clinical trialist and one of the leading researchers behind the next generation of oral GLP-1 medications. Together, they break down:

The OASIS-4 trial results on 25mg oral semaglutide and how it stacks up to injectable Wegovy

How orforglipron, Eli Lilly’s new small-molecule GLP-1, differs from peptide-based drugs

Why these new therapies could make weight management more accessible and affordable

The fascinating pharmacology behind “snack molecules” and small-molecule receptor agonists

Common misconceptions about bioavailability, dosing, and side effects

The potential role of oral GLP-1s for patients with mild obesity or cardiometabolic disease

Whether you’re a clinician, researcher, or patient curious about the future of obesity medicine, this conversation offers a clear look at how science is shifting toward needle-free solutions.

Oasis 1 Trial Link

Oasis 4 Trial Link

Attain 1 Trial Link

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In this episode of Docs Who Lift, the Nadolsky brothers dive deep into the newly released American Association of Clinical Endocrinology (ACE) Algorithm for Obesity Care led by Dr. Karl himself. They explore:

Why ACE moved away from a BMI-only approach to a person-centered, complication-centric model

The new staging framework (ABCD) that helps individualize treatment intensity

How to interpret “clinical” vs “preclinical” obesity under the new model

Updated targets for clinically meaningful weight loss (5%, 10%, 15% tiers)

The emphasis on resistance training, sleep, and behavioral health alongside nutrition

Practical guidance for selecting anti-obesity medications and identifying the right therapy for each patient

Whether you’re a clinician, health professional, or patient trying to understand modern obesity care, this episode breaks it all down in a practical, real-world way without the jargon.

Youtube Video to follow along the graphic mentioned

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Takeaways

• The book aims to dispel myths surrounding the Biggest Loser study.
• Miscommunication in media has led to public confusion about metabolism.
• Metabolic adaptation is a response to weight loss, not a determinant of it.
• Cultural factors significantly influence eating habits and food choices.
• The food environment plays a crucial role in dietary behaviors.
• Bipartisan support is necessary for effective food policy changes.
• Understanding metabolism requires a nuanced approach beyond just calories.
• The relationship between exercise and metabolism is complex and not fully understood.
• Appetite signals are a major factor in weight regain after dieting.
• Education about nutrition science is essential for public understanding.
  
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Takeaways

Menopausal women often prioritize weight gain concerns over other symptoms.

The study observed an association between hormone therapy and weight loss with GLP-1 medications.

Retrospective studies have limitations but can provide valuable insights.

Future research should focus on randomized controlled trials to confirm findings.

The relationship between estrogen and GLP-1 signaling needs further exploration.

Funding for research can be challenging, especially for early career investigators.

Collaboration between different specialties is crucial for comprehensive patient care.

The media often misrepresents research findings, leading to misconceptions.

Individualized treatment plans are essential for menopausal women.

There is a need for more awareness about the effects of menopause on health.

Research Links:
Weight loss response to semaglutide in postmenopausal women with and without hormone therapy use
Combination of obesity medication tirzepatide and menopause hormone therapy fuels weight loss



 

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We covered:

Fasted training

Protein timing

and many more fitness topics!

Hear Dr. Lauren Colenso-Semple and Dr. Stacy Sims discuss outcomes versus mechanisms and much more

Tap Here for Dr Stacy Sims References
Tap Here for Dr. Colenso-Semples References

Dr. LCS Instagram
Dr. SS Instagram

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Takeaways

• The podcast features Dr. Grant Tinsley, a body composition expert.
• The discussion revolves around a case series on body composition effects.
• GLP-1 receptor agonists are a focus of the research.
• The importance of resistance training in weight loss is emphasized.
• Patient case studies provide insights into individual experiences.
• The first patient lost a significant amount of fat mass while preserving lean mass.
• The second patient achieved remarkable body composition changes in a short time.
• The third patient showed positive changes over a longer duration.
• The need for more randomized trials is highlighted.
• The conversation underscores the role of exercise and nutrition in weight management.
  
  Tap or Click here to see more from Dr. Grant
  Tap here for scientific references in this episode.

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Takeaways

Direct-to-consumer lab testing is on the rise, with significant marketing efforts behind it.

Many patients feel brushed off by traditional healthcare providers, leading them to seek alternative testing options.

Communication between patients and healthcare providers is often inadequate, contributing to misunderstandings about health.

Over-testing can lead to unnecessary anxiety and misinterpretation of results.

Fitness influencers often promote lab testing without proper medical training, which can be harmful.

There is a need for ethical practices in lab testing and patient care.

Patients should be cautious of companies that upsell supplements based on lab results.

The healthcare system often fails to provide adequate time for patient concerns to be addressed.

Understanding lab results requires skilled interpretation, which is often lacking in direct-to-consumer models.

A collaborative approach among healthcare professionals is necessary to improve patient outcomes.

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In this episode of the Dr. Lift podcast, hosts Dr. Spencer Nadolsky and Dr. Karl discuss the recent changes in obesity medication coverage, particularly focusing on the CVS Caremark decision to drop ZEPBound from their formulary in favor of Wegovi. They explore the implications of this decision for patients and providers, the role of pharmacy benefit managers (PBMs) in healthcare, and the ongoing advocacy efforts to ensure access to effective obesity treatments. The conversation highlights the complexities of insurance coverage, the need for patient-centered care, and the importance of making medications more affordable.

- The recent changes in obesity medication coverage have raised concerns among providers and patients.

- CVS Caremark's decision to drop ZEPBound has sparked a petition advocating for better access to medications.

- Pharmacy Benefit Managers (PBMs) play a significant role in determining medication coverage and costs.

- There is a need for more nuanced insurance policies that consider patient needs and clinical severity.

- Advocacy efforts are crucial in reversing negative trends in medication coverage.

- Patients often face challenges with prior authorization processes when switching medications.

- The cost of obesity medications is a significant barrier to access for many patients.

- Insurance companies are increasingly dropping coverage for anti-obesity medications, impacting patient care.

- The conversation emphasizes the importance of patient-centered care in obesity treatment.

- There is a call for making obesity medications more affordable and accessible to patients.

https://www.change.org/p/stop-cvs-caremark-s-zepbound-ban-restore-coverage-of-the-superior-obesity-medication

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In this episode of the Dr. Lift podcast, hosts Dr. Spencer Nadolsky and Dr. Karl discuss the Surpass CVOT trial, which evaluates the cardiovascular outcomes of Monjaro compared to Dulaglutide (Trulicity). They delve into the significance of the trial, the implications of the results, and the potential benefits of Monjaro for patients with type 2 diabetes and cardiovascular risks. The conversation highlights the importance of understanding cardiovascular outcome trials and the evolving landscape of diabetes medications.

Takeaways: 

The Surpass CVOT trial compares Mounjaro to Dulaglutide.

Dulaglutide has shown cardiovascular benefits in previous trials.

The trial results indicate Monjaro is at least not inferior to Dulaglutide.

There is a trend towards better cardiovascular outcomes with Mounjaro.

Weight loss and glycemic control are significant benefits of Mounjaro.

The trial did not include a placebo, but used a putative analysis.

The results are reassuring for patients at high cardiovascular risk.

The conversation emphasizes the importance of comprehensive treatment for metabolic diseases.

The hosts express enthusiasm for the potential of Mounjaro.

Future discussions will delve deeper into the trial's findings.

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