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.

How the STEP-UP trial came to life,  and what made the 7.2mg dose possible

What the data actually says about weight loss and side effects at higher doses

Why trial design, pharmacokinetics, and estimands matter more than you think

What’s coming next in obesity meds: duals, triples, and even antagonists

The real talk on intermittent fasting, access issues, and preaching vs. science

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Takeaways

• The study examines the overlap between clinical and anthropometric obesity.
• Anthropometric measures include waist circumference, waist-to-hip ratio, and BMI.
• Challenges exist in applying the Lancet Commission's definitions in clinical practice.
• Metabolically healthy obesity is a debated topic in obesity research.
• The study highlights the importance of data from the All of Us Research Program.
• There is a significant prevalence of preclinical obesity in individuals with normal BMI.
• The classification of obesity may need to shift focus towards overweight individuals.
• The study's findings suggest a need for more nuanced definitions of obesity-related diseases.
• Future research will explore the transition from preclinical to clinical obesity.
• The conversation emphasizes the importance of real-world data in understanding obesity.

Click here to see the study

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Learn what age-related macular degeneration (AMD) is

What causes AMD

The types of AMD

The update on NAION - listen to last year's podcast all about it

Why we aren't too concerned

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Click to read the JAMA AMD article

Click to read the Ophthalmology journal AMD article

• Menopausal hormonal therapy should not be a blanket recommendation for everyone going through menopause
• Weight management in women is influenced by hormonal changes throughout life stages.
• Retrospective analyses can provide insights but have limitations.
• The wellness industry often oversimplifies complex medical issues.
• Hormonal replacement therapy may have subtle benefits for weight management.
• Confounding factors like SSRIs can complicate weight loss efforts.
• A holistic approach is essential for managing women's health during menopause.
• Education and awareness are crucial for women navigating menopause.
• Future research should focus on randomized controlled trials for better clarity.
• Understanding individual patient experiences is key to effective treatment.

Click here to see her study

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• Dr. Grant Tinsley joins the discussion as the body composition expert.
• Myostatin is a key regulator of muscle growth.
• Wendy Whippete the most jacked muscled up dog
• The concern of GLP-1 receptor agonists and muscle mass loss.
• Overview of Courage trial looking at semaglutide and trevogrumab and lean mass loss
• Upcoming Believe trial coming out (bimagrumab and semaglutide)
• Exercise remains crucial for muscle health and function.
• MRI data from SURPASS MRI provides new insights into muscle volume changes.
• The combination of medications may have varying effects on muscle mass.
• Caution is advised regarding the long-term effects of new drugs.
• Clinical benefits of medications often outweigh concerns about muscle loss.
• Future research will explore the synergy between exercise and medication.

Other docs who lift podcasts with Dr. Grant:

Tirzepatide muscle loss

Lean mass loss and GLP-1 meds

Takeaways:

• The MAHA report aims to address public health issues but lacks actionable policies.
• Historical context is crucial for understanding current dietary guidelines.
• Funding for nutrition research has been inadequate, impacting the quality of data.
• Public perception of nutrition often outpaces scientific evidence.
• The evolution of dietary guidelines reflects political and social influences.
• There is a need for more rigorous nutrition science to inform policy.
• The dietary guidelines have not significantly improved population health metrics.
• Political will is essential for implementing effective nutrition policies.
• Nutrition science faces challenges in funding and research infrastructure.
• The MAHA report's recommendations may be more performative than substantive. Food policy changes are often superficial and ineffective.
• There is a significant disconnect between policy and actual health outcomes.
• Nutrition science is underfunded and lacks high-quality research.
• Misinformation in nutrition can lead to harmful public health outcomes.
• The focus on food additives distracts from more pressing issues like obesity.
• Experts are being sidelined in favor of political agendas.
• Public trust in health recommendations has eroded post-COVID.
• Nutrition policies need to be based on solid scientific evidence.
• The food industry needs clearer guidance on reformulating products.
• Future nutrition policies must prioritize public health over political gain

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Click to read Joy Prescriptions

Drs. Karl and Spencer talk to Dr. Tiffany Moon all about Joy Prescriptions. Learn how to stop chasing perfection and embrace connection. 

00:00Introduction to Dr. Tiffany Moon

02:02Journey to Reality TV: The Real Housewives of Dallas

05:58Life After Reality TV: Finding Joy and Purpose

09:59The Joy Prescription: A New Approach to Life

17:01Work-Life Integration: Balancing Career and Family

22:09Empowering Women: The Lead Her Summit

22:33Tiffany's Journey: From Childhood to Medical Success

24:43The Quest for Joy: Breaking the Hedonic Treadmill

26:42Finding Gratitude and Connection in Life

28:37Coping Mechanisms: Humor and Self-Reflection

29:57The Joy Prescription: A Path for High Achievers

32:29Reconstructing Identity: Beyond External Validation

35:37The Impact of Sports on Identity and Achievement

40:54Closing Thoughts: Embracing Joy and Connection