Docs Who Lift

Key Episode Takeaways
Oral Wegovy is real, but it’s not “just a pill version of the shot.” Absorption rules, dosing schedules, and patient selection matter a lot more than most headlines suggest.
Switching from injections to oral GLP-1s requires a plan. The transition isn’t one-size-fits-all, and dose timing, GI tolerance, and expectations need to be managed carefully.
Weight regain after stopping GLP-1s is common, but not universal. SURMOUNT-4 data shows large variability, reinforcing that biology, not willpower, drives outcomes.
Maintenance matters as much as weight loss. Some patients need continued therapy at lower doses, while others may maintain with lifestyle plus strategic medication use.
Stopping abruptly is usually the worst approach. Gradual transitions and realistic long-term strategies reduce rebound weight gain.
GLP-1s are chronic disease tools, not short-term fixes. Treating obesity like hypertension or diabetes leads to better outcomes and fewer surprises.

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Takeaways:
Dietary guidelines have evolved since the 1980s.
The food pyramid was introduced in 1992 and has influenced public perception.
New dietary guidelines emphasize healthy fats but retain some old recommendations.
There are contradictions in the new guidelines regarding saturated fat and protein intake.
The definition of processed foods remains vague and controversial.
The guidelines are intended for healthcare professionals, not consumers.
Public policy needs to align with dietary guidelines for effective implementation.
The emphasis on real food is not a new concept in dietary guidelines.
There is skepticism about whether the new guidelines will lead to meaningful changes in public health.
The conversation around dietary guidelines is often politically charged.
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Takeaways:
Cortisol is essential for various bodily functions, especially during stress.
Adrenal glands have a circadian rhythm that affects cortisol production.
Cushing's syndrome can result from excess cortisol and has specific symptoms.
Diagnosis of adrenal disorders requires careful testing and consideration of symptoms.
Mild autonomous cortisol secretion can complicate diabetes management.
The Catalyst trial explored the effects of cortisol antagonism on diabetes.
Future research may focus on selective glucocorticoid receptor modulators.
Woolly mammoth studies provide insights into historical testosterone levels.
Understanding adrenal health is crucial for effective patient care.
Endocrinologists must navigate the complexities of hormone testing and treatment.
 
 

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Takeaways:
Slimmer's Paralysis is a recognized condition.
Ethical boundaries are crucial in patient relationships.
Medical professionals must maintain professionalism at all times.
Humor can sometimes arise in serious discussions.
Patient stories should always be handled with care.
The importance of clear communication in medical settings.
Understanding patient experiences is vital for effective care.
Ethics in medicine is a complex and nuanced topic.
Medical discussions can lead to unexpected topics.
Maintaining a professional demeanor is essential.
 
 

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Takeaways:
Drug transfer during lactation is complex and challenging.
Semaglutide was not detected in women taking any dose.
Low amounts of tears epitide were found in milk.
Tissue damage can affect drug absorption.
Mastitis and engorgement complicate the lactation process.
Injections are necessary for effective drug delivery.
The analogy of an elephant illustrates the difficulty of drug transfer.
Detection of drugs in milk is a critical concern for breastfeeding mothers.
Understanding turnover is essential in lactation studies.
The implications of drug transfer on women's health are significant.

Infant Risk Center Link
 

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