The Physiology Forum

In this episode, Jake leads us in a discussion of a manuscript entitled Once-Weekly Semaglutide in Adults with Overweight or Obesity (10.1056/NEJMoa2032183). This manuscript is the result of a massive international randomized clinical trial that enrolled 1961 people with overweight and obesity to examine the effect of once-weekly semaglutide on weight loss. These data have the potential to make a big change to how obesity and overweight are treated. Look out for our follow up episode where we look at a similar GLP1 receptor agonist (liraglutide) and the efficacy of adding exercise to the pharmacological treatment. 

TIME STAMPS

00:00:00 – 00:16:31                                        Intro/Catch up

00:16:31 – 00:19:31                                        Background

00:19:31 – 00:33:31                                        Description of Lifestyle Intervention

00:33:31 – 00:46:40                                        Trial Description/Methods

00:46:40 – 01:13:20                                        Data!!

01:13:20 – 01:25:06                                        Adverse Events

01:25:06 – 01:26:37                                        Semaglutide + Exercise?

01:26:37 – 01:33:08                                        Cost?

01:33:08 – 01:39:25                                        Muscle Mass Loss and How to Mitigate

01:39:25 – End                                                Wrap Up and Final Thoughts

 

Reach out to us on Twitter

Edwin Miranda @EdwinRay91

Dr. Jake Mey @CakeNutrition

Dr. Austin Robinson @AusRob_PhD

Dr. Alec Chaves (Yes he is a PhD now) @AbcSience02

On this episode of the podcast our special guest Dr. Chris Wolff, talk about the interactions between exercise, circadian rhythm and exercise by highlighting a paper published in Cell metabolism in 2019 entitled, “Time of Exercise Specifies the Impact on Muscle Metabolic Pathways and Systemic Energy Homeostasis”.

In this episode, Alec continues our Exercise for Health series, by highlighting a recent article published out of the journal of clinical endocrinology and metabolism, entitled “Lipid Metabolism Links Nutrient-Exercise Timing to Insulin Sensitivity in Men Classified as Overweight or Obese,” which investigates the interplay between timing morning exercise and breakfast to optimize exercise-induced increases in insulin sensitivity in males with obesity.

This episode kicks off our series on Exercise for Health. In this series we will highlight several benefits that exercise has on general health as well as the current literature examining the potential mechanisms providing these benefits, if there is an optimal mode/intensity/timing of exercise, and much more! This episode starts by framing everyone’s expectations of exercise, especially when it comes to eliciting weight loss. 

What should the expected weight loss from an exercise regimen be? Is more exercise better? This discussion covers all of these concepts and more as we discuss a recent article that was published in the journal of Medicine and Science in Sport and Exercise entitled, “ Exercise for Weight Loss: Further Evaluating Energy Compensation with Exercise”.

Manuscript DOI: 10.1249/MSS.0000000000002376

Obesity and Energetics Offerings Subscription (it's free!): https://obesityandenergetics.org/subscription

Link to NYT article: https://www.nytimes.com/2020/12/09/well/move/to-lose-weight-with-exercise-aim-for-300-minutes-a-week.html

Link to Opinion Piece in response to NYT article: https://conscienhealth.org/2020/12/exercise-for-weight-loss-the-lie-that-wont-die/

Link to Yoni Freedhoff's twitter thread discussing this paper and NYT article coverage: https://twitter.com/YoniFreedhoff/status/1337040020398600194

Time Stamps

Introduction                                                                                              00:00:00 – 00:03:55

Catch Up (Alec’s delusions about Cleveland Sports)                          00:03:55 – 00:16:52

Manuscript Background                                                                          00:16:52 – 00:27:24

Methods and MATH Models                                                                   00:27:24 – 00:49:45

Results                                                                                                      00:49:45 – 01:00:58

Caloric Intake Regulation in Response to Energy Expenditure           01:00:58 – 01:18:41

Wrap Up and Take Home Message                                                       01:18:41 – End

 

Supporting Article from Kansas Med and Texas Tech DOI: 10.1002/oby.23022

In this episode, Jake leads our discussion to close out our series on the topic of bariatric surgery. Our focus will be on the STAMPEDE trial, which was a randomized clinical trial investigating the impact of bariatric surgery versus medical therapy (lifestyle) in patients with diabetes. Here we discuss 3 papers from the trial, all published in NEJM and discuss their clinical outcome results and metabolic implications at 1, 3 and 5-year time points. 

 

DOI for main articles:

1-year - 10.1056/NEJMoa1200225

3-year - 10.1056/NEJMoa1401329

5-year - 10.1056/NEJMoa1600869

7-year (LABS) - 10.1210/clinem/dgaa849/6006261

 

Time Stamps:

Introduction                                                                                                      00:00:00 – 00:01:37

Catching up                                                                                                      00:01:37 – 00:14:36

Manuscript Background                                                                                  00:14:36 – 00:16:23

Stampede Study Description/Methods                                                         00:16:23 – 00:26:20

STAMPEDE 1 Year Follow Up Results                                                            00:26:20 - 00:42:39

STAMPEDE 3 & 5 Year Follow Up Results                                                     00:42:39 – 01:06:44

LABS 7 Year Follow Up Results                                                                      01:06:44 – 01:16:00

Wrap Up                                                                                                            01:16:00 – End

n this episode Dr. Austin Robinson and I are joined by Dr. Rich Severin to discuss the paper we covered on the last episode of the podcast which examined the effects of obesity and bariatric surgery on cardiovascular health and carotid intima-media thickness at a 3-year follow-up. We also discussed some of the exciting work Rich currently is doing as a part of his dissertation on the effects of obesity and endothelial function as well as his recent review paper entitled, “Endothelial Function in Obesity and Effects of Bariatric and Metabolic Surgery” (DOI below). Rich is a Doctor of Physical Therapy and a PhD candidate at the University of Illinois at Chicago under Dr. Shane Philips.

Review Article DOI: 10.1080/14779072.2020.1767594

In this episode Dr. Austin Robinson is leading our discussion of a paper entitled, “Bariatric Surgery-Induced Changes in Intima-Media Thickness and Cardiovascular Risk Factors in Class 3 Obesity: A 3-Year Follow-Up Study”.

In this companion episode we had the pleasure of talking with metabolism expert Dr. Lynis Dohm about his manuscript that we discussed in the last episode and his Vicious Cori Cycle hypothesis. In this episode we talk a lot about the ability of lactate to provide insight into metabolic health. Lactate, the seemingly inauspicious metabolite wrought with misleading narratives including those that implicate it as a cause of muscle fatigue with exercise, has never been so exciting!

In this episode Alec leads our discussion on research investigating the effects of obesity and bariatric surgery on plasma lactate and skeletal muscle glucose handling

This episode follows up on our discussion of Sam Klein's NEJM manuscript which attempts to compare the effects of diet and bariatric surgery-mediated weight loss on glucose control and diabetes.