Join us for a rapid-fire review of a groundbreaking study published in The Lancet by McMaster University. Explore the latest insights on weight loss treatments alongside esteemed scholars like Gordon Guyatt and Per Van Vick. With Dr. Goldenberg guiding us through the study's complexities, we quickly unpack findings from 143 trials involving nearly 50,000 participants. Witness the clash of heavyweight medications like the fentermine-topiramate combo, GLP-1 agonists, and naltrexone-bupropion duo, as they vie for supremacy in the battle against obesity. Don't miss out on this fast-paced discussion shedding light on the efficacy and safety of these interventions, offering clarity in the realm of weight loss treatments.
Join us for a rapid-fire review of a groundbreaking study published in The Lancet by McMaster University. Explore the latest insights on weight loss treatments alongside esteemed scholars like Gordon Guyatt and Per Van Vick. With Dr. Goldenberg guiding us through the study's complexities, we quickly unpack findings from 143 trials involving nearly 50,000 participants. Witness the clash of heavyweight medications like the fentermine-topiramate combo, GLP-1 agonists, and naltrexone-bupropion duo, as they vie for supremacy in the battle against obesity. Don't miss out on this fast-paced discussion shedding light on the efficacy and safety of these interventions, offering clarity in the realm of weight loss treatments.
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Introducer:
Welcome to the Dr Journal Club podcast, the show that goes under the hood of evidence-based integrative medicine. We review recent research articles, interview evidence-based medicine thought leaders and discuss the challenges and opportunities of integrating evidence-based and integrative medicine. Continue your learning after the show at www. drjournalclub. com.
Dr. Joshua Goldenberg:
Please bear in mind that this is for educational and entertainment purposes. Only Talk to your doctor before making any medical decisions, changes etc. Everything we're talking about that's to teach you guys stuff and have fun. We are not your doctors. Also, we would love to answer your specific questions on drjournalclub. com. You can post questions and comments for specific videos, but go ahead and email us directly at josh@ drjournalclub. com. That's josh at drjournalclub. com. Send us your listener questions and we will discuss it on our pod. Hello and welcome to another super speedy summary.
Dr. Joshua Goldenberg:
Today we're going to talk about medications for overweight and obesity. Impressive network meta-analysis coming out of McMaster University, with Gordon Guyot and Per Van Vick and sort of like all my heroes of the evidence-based medicine world literally designed the method, like literally wrote the methods for how to do high quality systematic reviews and meta-analyses, and this is really really, really cutting edge. In fact, it was published in the Lancet not too shabby, and so, of course, as everybody knows, overweight and obesity are major problems in the US and increasingly worldwide, and while diet and lifestyle is always the first choice for everybody, clearly it's not sufficient for many, and so the question is what about these weight-lowering medications, these weight loss medications, what are. The question is what about these weight-lowering medications, these weight-loss medications? What are the overall effects and safety of these drugs if used in addition to diet and lifestyle, and their impact on the body weight of adults who are overweight and obese? So this was, like I said, a network meta-analysis. It only included randomized, controlled trials, so really high quality evidence. They found 143 randomized trials with just about just shy of 50,000 participants. This is a huge data set. And all these studies looked at weight loss medications with lifestyle recommendations compared to lifestyle recommendations, either with or without a placebo, looking at different outcomes around weight loss minimal important difference with weight loss and some secondary outcomes as well. And so what did they find? So they found that they were indeed quite helpful large, minimally clinically important differences in weight, and the nice thing about a network meta-analysis is it can rank what the best intervention is for.
Dr. Joshua Goldenberg:
So if you're less familiar with network meta-analyses, go ahead and watch our videos in the EBM skills section of the website. But essentially, a network meta-analysis allows you to compare the value of one drug compared to another, instead of just one drug versus placebo. So it's much more clinically relevant, and so the outcome of this was that three medications sort of scored the best. One is this combination of fentermine and topiramate, the other is GLP-1 agonist and then the third is naltrexone pupropion combination as well. Now, if you took medications, you were twice as likely to experience side effects leading to discontinuation of the medication than if you took a placebo or just lifestyle, and there were only minimal changes, interestingly, actually, in A1c, systolic blood pressure and LDL, but there were differences that were above the minimal clinically important difference in weight loss. So this is just a super speedy summary If you'd like to get a really, really good analysis of this. Dr Sadowski did an excellent job in our basic level video and then he goes into more depth in the in-depth version as well.
Dr. Joshua Goldenberg:
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Dr. Joshua Goldenberg:
We talked about some really interesting stuff today. I think one of the things we're going to do that's relevant. There is a course we have on Dr Journal Club called the EBM Boot Camp. That's really meant for clinicians to sort of help them understand how to critically evaluate the literature, etc. Etc. Some of the things that we've been talking about today. Go ahead and check out the show notes link. We're going to link to it directly. I think it might be of interest. Don't forget to follow us on social and interact with us on social media at DrJournalClub DrJournalClub on Twitter, we're on Facebook, we're on LinkedIn, et cetera, et cetera. So please reach out to us. We always love to talk to our fans and our listeners. If you have any specific questions you'd like to ask us about research, evidence, being a clinician, et cetera, don't hesitate to ask. And then, of course, if you have any topics that you'd like us to cover on the pod, please let us know as well.
Introducer:
Any topics that you'd like us to cover on the pod, please let us know as well. Thank you for listening to the Doctor Journal Club podcast, the show that goes under the hood of evidence-based integrative medicine. We review recent research articles, interview evidence-based medicine thought leaders and discuss the challenges and opportunities of integrating evidence-based and integrative medicine. Be sure to visit wwwdoctorjournalclubcom to learn more.