Obesity Health Policy Update

In this episode, Rick and Greg discuss a groundbreaking 2026 policy statement from leading obesity organizations that redefines how obesity should be treated in modern medicine.

The key takeaway: Obesity is a chronic, biologically driven disease—and it’s being significantly underdiagnosed and undertreated.  

The new guidelines emphasize:

• Earlier and more aggressive intervention
• Combining lifestyle changes with medication, not delaying treatment
• Strong evidence supporting the safety and effectiveness of long-term obesity medications
• A shift away from focusing solely on weight toward broader health outcomes like cardiovascular risk, diabetes prevention, and overall quality of life

Rick and Greg also highlight a critical reality: stopping treatment often leads to weight regain, reinforcing the need to view obesity like other chronic diseases that require ongoing management.

This episode underscores a major shift in healthcare—from treating complications to addressing obesity at its root, earlier and more effectively.

Transcript

SPEAKER_02 0:24

Hey, welcome back, everybody. Hey everyone, or welcome. First time here. We are uh Rick Sorten, Greg Camp. We are Healthier Ever After, and we're here to discuss. You know, we spend a lot of time just discussing uh weight loss and uh lifestyle changes, healthy lifestyle changes, really with the uh the intent of of being able to achieve and maintain uh a healthy, sustainable lifestyle.

SPEAKER_03 0:48

Yeah, right. Healthy weight, healthy, uh, healthy, just being generally more healthy. And uh we talk about all topics, you know, we'll anything in this realm, medications, um supplements, uh exercise, all the things, protein. Yep. So yeah, if uh if you want to view some of our previous episodes, if this is your first one, uh you can get a more of a basis on the kind of things we talk about. Um, but it's gonna be different every time. Every time.

SPEAKER_02 1:17

Uh it is for informational educational purposes. We um are not intending anything we say here to replace your relationship with your medical provider before starting any weight loss program, medication, exercise regimen or other thing we do recommend you meet with and discuss with your primary care or other medical provider. Absolutely. Um that being said, what we want to talk about tonight is um the some some new guidelines. Like, yeah, let's talk about medical guidelines. It doesn't sound very exciting. This is exciting to me. It's exciting, I think, because because we are we are really witnessing probably what I would say is maybe one of the biggest shifts in in healthcare um policy and practice that that has occurred in decades. Decades. Yeah. Um you know, the the just because so what we're gonna talk about, the basis of what our discussion tonight is is an article, an original article in um the obesity uh journal, obesity, it's a research journal. Um, and this was this is only recently, it's it's uh dated March 5th, 2026. But this was a very recent article. Um and essentially it talks about there's this whole thing, and it talks about a new uh 2026 guidance statement from uh three organizations: the Obesity Society, the Obesity Medicine Association, and the Obesity Action Coalition. So these are three uh big organizations that that uh really are I think you mentioned they're they would be like the equivalent of the American Heart Association or the American Obesity or American Um Diabetes Association. So, you know, they're they're the kind of the leading organizations that that um produce and analyze and look at all of the data. And they have uh come up with some evidence-based recommendations for medication usage and treatments of obesity in the United States and adults um and using a greater approach. So, so really that and this this new policy statement like talks about how we treat obesity. Yeah, we talked a little bit last week about the about about kind of the stigma of weight loss and how it affects healthcare, but we really want to just talk about this this policy like the the kind of the governing informational body of treating obesity with this brand new policy statement that really does or ought to change the entire uh landscape of how we address obesity as healthcare providers. Yeah.

SPEAKER_03 3:43

And I think it's I think what uh Rick and I are excited about this is that in a world of medicine that is oftentimes viewed as reactive, we wait until disease happens, we wait until there's an issue. This really seems like it's it's pushing more towards that proactive uh wellness. Uh, you know, let's get on top of this problem, let's not wait until it's a horrible, you know, where you do have the cardiovascular disease and the diabetes and everything else that comes along with oftentimes obesity. This is a more proactive approach. And I think that's exciting for us because we in this realm and talking about this, we are proactive. We want people to be on top of this. And so, yeah, even if you're coming to us and you're overweight and you're just getting started than this, we want to be more aggressive about let's get on top of treatment for this. Let's not wait until there's more issues or more problems and or until you're 50 pounds heavier than you are now to get on top of this. So I think that's why it's exciting for healthcare in general and not just for medical providers, but for patients. I hear it from patients all the time. Like the healthcare system is designed to only treat problems, not uh not you know, prevent them. Yeah. This is literally saying, let's be aggressive about our treatment plan with this. Let's change the way that we view uh the treatment for this. If it's a little problem or a big problem, let's get after it. Let's not sit around and wait for it to become a bigger problem.

SPEAKER_02 5:07

Yeah. So so let me just uh get into this. This is a this is a long article. So these these three organizations looked at a ton of research and data and information and came up with with like multiple recommendations. Um so let me just give you the background. It says obesity affects over 40% of U.S. adults. Unreal. Uh with severe obesity on the rise. Despite recognition of obesity as a chronic disease, it remains underdiagnosed and under-treated. Uh access to evidence-based obesity treatment is limited, leading to increased obesity, severity, and related complications. Um barriers to obesity treatment include socioeconomic disparities, limited clinician training, stigma, we talked about that, and restrictive or absent reimbursement policies. So FDA-approved uh obesity medications offer significant health benefits, prompting the need for updated and evidence-based guidelines. So that's kind of the background for what they did. And they went through this whole, I mean, pages and pages. We could talk hours about this. We're gonna not talk about hours, but but a little bit, we're gonna talk about so the big picture takeaways on this is obesity is a chronic disease, not a lifestyle failure. Sure. Uh, and when we talked about a little bit of that last time, it's common. 40% of US adults are technically obese by the definition.

SPEAKER_03 6:29

What other disease, and I I don't, I'm legitimately asking, what other disease, especially one that we know has such big social and and medical impacts on a patient's life, what other disease is that prominent? I don't I can't think of anything that's so prominent throughout America.

SPEAKER_02 6:48

Yeah, yeah. So so knowing 40% of adults, only 1.6 percent of eligible patients receive treatment. Uh-huh. Specific treatment for obesity as a disease.

SPEAKER_00 6:58

Yeah.

SPEAKER_02 6:59

1.6%. Uh there's there's insurance things, there's stigma, there's there's clinical clinical training that is lacking, and and we're gonna try and address that at some point as well. Um, so uh one of the key clinical messages then, so when we talk about like that's the big picture, is is this is new. And we talked, I think a couple weeks ago, we talked about um kind of obesity medications and the GLP one specifically, and there's a tool and things, and and and I think we mentioned recently about how you know long-term, you'll hear that there's no long-term evidence. Well, so this is the key thing by these three organizations, they have strong recommendations that obesity medications are a effective, b, safe for long-term use, and C underutilized. 100%. Like, like that they that's the to me, that's the big takeaway here. It cannot be stated more clearly that that these medications need to be used more, they are safe for for long-term use and they are effective. And that's that's like I I so I mean you don't you don't often get like a big huge policy statement like that that is so strongly worded.

SPEAKER_03 8:09

You don't. And and yeah, because it's like I think before that it was always skirted around, right? And and it was like, well, may cause this, or may, you know, you may see some, you know, now they're not they're not mincing their words. They are they are very direct in that, like, hey, we are seeing the evidence of what uh using these medications, how it can affect people, how much significantly more effective it is with than than just uh lifestyle changes alone. And so they're just the the the impact is huge. And I I think once again, it comes back to what we already talked about. There's lack of training for medical providers, that's why people are undertreated. There's a stigma, right? Providers that still stick to the old, hey, you know, eat less, exercise more, and then then send you on your way. And you feel like that's all the help I get. Like that's all the help I get from my medical provider that went to all those years of school to help me, and I'm asking for help with my obesity, and it's like exercise more and eat less. That can't possibly be the solution, so solution to such a complex problem.

SPEAKER_02 9:11

Yeah. So, so um, I'm just gonna go down some of my some of the notes I took on this. The the recommendation talking about medications, they recommend that, and they specifically mention semaglute dietures epitide. They actually mentioned uh fentramine topyramate combination. We talked about that a little bit.

SPEAKER_03 9:26

Cusema is kind of the brand name there. Uh beautiful combination. Uh, use it all the time in clinic.

SPEAKER_02 9:31

Yeah. Uh also another combination, the bupropion and altrexone.

SPEAKER_03 9:35

Yeah, yeah, yeah. So Contrave is the brand name for that. And uh, once again, great combination. Not for everyone. Uh, still not these are great. They're they're not for everyone. And I I still, you know, I favor and the evidence of favor still GLP ones as far as the most effective, but these are all really everyone, some a lot of people think, not to get off track, but a lot of people think that the only treatment options are GLP ones. I will tell you that there are other good treatment options. Now, once again, GLP ones are kind of the latest, greatest, newest. Uh, we have a lot of evidence that supports that they're and also the most effective.

SPEAKER_02 10:08

Does state those are should be first line in many people because they are so effective and they're safe long term.

SPEAKER_03 10:14

And I mean it it's and I agree with that, but I don't want someone to get in their mind that okay, there's no other option. I can't be on a GLP one. What what are my options here? There are options. There are options, and they've been shown to be safe and effective. Yep, yep, absolutely.

SPEAKER_02 10:28

Okay, so so there are those tools available, and I think their recommendation is that the clinicians need to be not only aware of those options, but adept in in using them and prescribing them and helping people understand how to use them best. So, so that's important.

SPEAKER_03 10:45

Well, and I think uh on that point, it's something that I've thought about often is like we refer patients, so if primary care can't take care of this, right? They're just overwhelmed with primary care patients. What do they do if they have a patient that has uncontrolled hypertension? They send them to cardiology or you know, the hypertension place. If they have uh issue with diabetes, they go to the diabetic educator. If they have an issue with uh or really bad problem, they go to the endocrinologist. Um, we have all these specialists, specialists that deal with certain types of medicine. Uh, why are primary care providers, they'll refer you out on a whim to anyone else. Why are they not referring out to obesity providers that that have the time and want to focus solely on this? And the training and the and the knowledge. So if they don't want to do it, that's fine. If they want to get educated in it and and be comfortable with these medications and prescribing them, absolutely. If they don't, there are people available. And I think that this resource is just being underutilized.

SPEAKER_02 11:42

Yeah, yeah, absolutely. And that's one of the points on this key policy statement. So so they they then talk about not just about the medicine, so they talk about um other critical outcomes, right? And it the guidelines recommend um outcomes uh equally or more important than weight. I mean, we talk about you know obesity, and really that's defined by your weight, yeah what your weight versus BMI. Yeah, um, but but it's math based on what the scale tells you and your height. Um but but there are other things. So it talks about quality of life, cardiovascular events, mortality, diabetes risk, other complications, obstructive sleep apnea, um, heart failure with preserved ejection fraction, liver disease, osteoarthritis. I mean, these are all kind of other outcomes affected by this disease of obesity. And so weight loss is not the only goal. And that's one of the other shifts that this policy statement talks about is that we need to shift that focus that this is not just about a number on a scale. This is not just about a BMI lower, this is about decreasing like all these other risks of multiple debilitating other diseases that that are affected by, caused by, worsened by obesity. Yeah, absolutely.

SPEAKER_03 12:58

It's yeah, it's it's just so it's one of those things that it's just almost like we're just treating the outcome of a lot of times the, you know, if the assuming obesity causes or at least is contributing to these, it's like once again, we've been dancing around this for so long. We're we're treating your blood pressure and we're doing this. When a lot of times, if we could just treat some of the root cause, and I I use that word lightly because I you sometimes hear that in puns on TikTok and Facebook, and it sometimes it's like, okay, um, yeah, like let's not have you take this weird uh vitamin they found in the jungle of Antarctica, and that's gonna be the cure all for things. So I I use that that uh root cause cautiously. Um, but yeah, obesity is a root cause for a lot of these things, um, given your genetic profile and just overall history. And so why are we dancing around that? And I love that this is saying, let's attack this head on, let's not just treat all the diseases it's causing around it.

SPEAKER_02 14:04

Yeah, yeah, let's treat this. And and and our end goal is all these other things improving as well. Um, okay, so the other thing they talk about is is length of treatment. We've we've mentioned this before, we've talked about long-term treatment. Um, they actually came out and said stopping the medication can cause significant weight regain, and subsequently, then these other measures that we're talking about, these other outcomes, other health issues, can you know show their head and re-reappear. Um, so they make a strong recommendation that continuing these medications is not only safe, but it improves weight maintenance, it improves quality of life, and it may reduce mortality. Um, strong recommendation to continue long-term therapy, just like you would in, and they mentioned hypertension and diabetes. So, so that I mean the thought on this that comes to me is like diabetes. Okay, what what uh type one diabetic patient have you ever met in your life that thinks, when am I going to get off this insulin? Yeah, none. Like it is literally a life-saving medication that you have to administer sometimes multiple times a day. Um, and that's just how it is. Like your pancreas doesn't do it for you, you have to do it. But but there's there's never a discussion about, well, you know, what do I, what's the long-term effect of using insulin? Yeah, like right, it's the same. And and they they've actually come out on this now and strongly said this this is long term, this is going to be beneficial. Yes.

SPEAKER_03 15:28

And and and it is because of weight regain. Like you stop medications, you stop doing what you were doing to lose the weight, and we talked about this before. If that was diet and exercise, if you stop dieting and exercising, that weight will come back. If you used medications as an assist to be able to get you to that point, which we think the combination that obviously is the best lifestyle and and uh uh and medications in conjunction with that, well, then yes, there's a good chance that if you stop doing some of those things, that there is going to be some weight regain. We're hopeful and optimistic. I always tell patients that if they want to come off of the medication, then yes, they definitely, definitely can, and I will support that, but also to know that it is it is the data shows that the chances that them are regaining at least a lot of that, or if not all of that weight is high.

SPEAKER_02 16:17

Which is which is why we kind of emphasize you know, when when if that's your goal, if you're going, I want to be on us for a year, two years, and then I want to see if I can get off and maintain, and once I reach my goal, that and that's great. Um, but I think that's why we really emphasize during that time, during that one or two years that you're on this and you're losing weight and you're reaching your goals, that you work on all these other little things, these lifestyle changes, these sustainable things, these you know, how much I eat, what's the timing of my food, how much I sleep, watch my protein intake, stay hydrated, like all the little things that we've talked about, um that that then become kind of your your habits. Yeah. Uh and and and even without the medication, as you as you're able to maintain those little lifestyle changes, there is uh, I think a good effect that you may still be able to maintain that. Yeah.

SPEAKER_03 17:06

And if nothing else, you're not going to be, I mean, look, if you if you start eating less, you start working out and moving more. We talked about NEAT, non-exertional activity thermogenesis, which I love that acronym because it's just talking about because who says non-activity? The NEET acronym is just really saying, hey, move, move, move, move, move a little more. Yes, move a little more. Walk, you know, take the stairs instead of the elevator, those kinds of things. And so I think when it really comes down to that, so let's just pretend that you're on a medication and you use all those lifestyle things, and the only thing you stop is the medication, but you keep on doing all those other things. I can assure you that your life, you're still gonna have better health outcomes had you just quit everything. Yeah. So, yes, we want you to do it as a combination approach. But this is also saying that let's stop looking at these medications as the short-term answer to a long-term problem. Right. It's just not, yeah, that's not a good effective thing.

SPEAKER_02 18:01

And and and in that, you know, same kind of mindset. It if if you're one of these people that, you know, I do know some people that like they they don't really give much thought to any lifestyle changes because the GLP1 medication is so effective. Yes, right. So they you know, they lose 50 pounds just by taking it. They don't really change anything. I think people that use that medication as a bigger crutch, as their sole thing that they do, yeah, get that those are the people that are going to gain most back most quickly when they stop. Because that's that's the only thing they've changed. Sure. They haven't they haven't done these other things. Absolutely.

SPEAKER_03 18:35

Yeah, we we love the combination approach. We there's there's a lot of evidence that would support the combination approach. Most of these trials uh and the things that we reference are with that combination approach. But the stigma behind weight loss medications and the problem with the accessibility to these medications right now, especially with insurance companies saying, yeah, we recognize this these are effective and helpful and will prevent um or reduce the risk significantly of all these chronic diseases. We still just don't want to pay for them. It's it's the culture statements like this, research is gonna have to be more research is gonna have to be done, and more people are gonna have to get behind demanding that these these problems.

SPEAKER_02 19:19

And hopefully, this I mean this is only a month old, but this this these policy this statement is is hopefully going to do a lot to shift that narrative. Absolutely. Um so so one of the so the other thing we talk about is um they call it the clinical philosophy shift. So so that's that's how um medical providers view and treat obesity, right? So so kind of our old mindset, the current way we we think about this is um you you change your life, do the lifestyle first and then medications. Yeah. So and that's what you've talked about before. Like, hey, you know, you don't go to your doctor, like, hey, you're overweight, you need to, you know, eat eat less, work, move more, yeah, work on lifestyle changes and things, and that's kind of where we start. And then as that fails, they're like, okay, well, maybe we need to think about maybe some medications, something like that. And that's kind of our old mindset. The new mindset they recommend is you treat obesity like any chronic disease, like I mentioned. You use medication early and alongside lifestyle. Um, so so those things go hand in hand, but the medications need to be early, you know, you don't like just like several other things we use medication for early. So, bottom line, then they say, is obedience obesity is a chronic, progressive, and biologically driven disease. Yeah, uh, medications are central, not optional therapy. And GLP1 and GIP agonists, so like semaglutide, trzezepatide, um are now first line for many patients. Uh and then they talk about how long-term comprehensive care is essential. So, so I mean that those are that's that is, I think, for me, looking at that, that's a big shift in in how to view this, and and really um is gonna take some time. And and you know, medical providers out there, like like that it's worth looking into this a little bit because these recommendations are very strong about how we do this, and and really it's just changing how we view obesity and how we how we treat it, like any other chronic disease, not just as as well, like they mentioned, like a lifestyle failure.

unknown 21:28

Yeah.

SPEAKER_03 21:28

Yeah, and I I think it's just I I'm glad to see this shift. I think it's gonna be so important, and and it's uh it really just comes back to um getting getting providers on board with how we uh address this. I think that it I think that your amount of overweight is somewhat so this is not this article, this is kind of my approach is that like if you're five pounds overweight, I think we can have a lifestyle discussion. Yeah, if you're a hundred pounds overweight. I think what it's saying is, why are we like we're going to try lifestyle things for six months, a year in hopes that the patient even returns to your clinic? And like it's saying, get more aggressive on this because they're 100 pounds overweight. We got to do something about this. If I have someone's cholesterol just very mildly high in family practice, yes, I think that we could probably cut out some of the, you know, more higher fatty foods and move a little bit more and let's check, recheck your cholesterol. And like I said, just like if you're five pounds overweight, we could probably talk lifestyle changes. This is talking about obesity. This is talking about when you already have the disease. If your blood pressure's 160 over 100 in clinic, we're probably not going to just try to, you know, eat a little less salt. Um, we're most likely going to be prescribing medicine. Yes. And and and sure, if if you're, you know, one of the rare circumstances where, look, everything hits, you start doing all the lifestyle things and everything works out in your favor, uh, great. Uh, if the if your goal is to get off the medications, I think that's possible. And I've seen it with uh patients in my weight loss clinic where they've been able to do it, but they don't just get off of them and do nothing. These are people that are like, hey, I took up running and I run five miles a day and I do all these things. These are the exceptions, not the norms. So, yes, making the lifestyle changes are important, but in conjunction with the medication, not separate of it.

SPEAKER_02 23:25

Yeah. Well, and I think I think so, uh as you're talking, I'm I'm remembering, you know, how many, how many interactions have you had like this in a clinic in my case in the emergency department? Like you um you have someone and you say, Hey, how um thing to zoom out like that? No, let's see. No, we're a little too close, aren't we? All right, so so um I'll ask the question like, do you uh do you have any chronic medical conditions?

unknown 23:51

Right?

SPEAKER_02 23:52

No, no, I don't. Do you take any medicine? Um, yeah. What do you think? Well, I take metoprololol and low sartan and carbatolol. And resuvacatin. And returnsatin. Like, okay, so so so you you have high blood pressure because you're on three medicines for blood pressure. And and in their mind, they're like, well, no, I don't. My blood pressure is fine. Yeah. I take medicine. Right. Your blood pressure is fine because you're on three blood pressure medicines and your cardiologist follows up with you and makes sure that your blood pressure stays fine. Like, like, but but you know, so I'm sometimes I'm I'm just surprised that you know it that that uh I guess the the perception is some people are like, well, I don't have high blood pressure anymore. Yeah. Um, what you have is controlled high blood pressure, treated high blood pressure. And I think that may be the the shift that we need to make on obesity. This is a disease. We're treating a disease, or or I'm I'm trying to maintain these lifestyle changes. I move a little bit more, I I watch, you know, all the things we've talked about. I make these lifestyle changes uh because I'm treating a disease. I am or preventing a disease, right? Like, like the same the you use the same thing to prevent as you do to treat in many cases. And so these that's what we're talking about. And it's a different thing than I just want to be skinny, I want to weigh less, I want to fit my clothes. Those are great benefits. But but as the shift on here, at least from a clinician side, is is the recommendation is we treat this like a disease. And and so if we think about that, like the things I'm doing really are it's not like oh, I don't have this disease. Like I have, I I have I'm I'm treating myself for obesity because I don't want to get it again.

SPEAKER_03 25:29

Yes, right, and and you're maintaining it. It's like you go off to that blood pressure medication, the chances of your blood pressure going back up are very high. You go off your weight loss medication, their chances of that weight coming back are very high. This is not a personal attack on you. Uh, there's a number of reasons why that happens. All it's saying is that, hey, look, the chances of this returning, this disease, if you've got it under control, right? Because if you're now to a normal BMI, uh it's saying, hey, stop saying that, like, stop ignoring the fact that you maybe were once obese. Like this is a thing that you're gonna be dealing with. And uh we just know that success rates are significantly higher when you maintain on a medication. That may be a lower dose of that medication. If you the more lifestyle changes you make, probably that you can get down to a very reasonable um dose. And and um, so I I really think it just comes down to a a shift in the way that we approach this, and it's going to have to happen. 40% of adults overweight, 40%, almost half the country of adults. Um, something has got to change. Yeah.

SPEAKER_02 26:38

I you know, and I I as you say that I I'm I I don't have in front of me, I guess we could just we could look it up. The internet has all the, but wonder what the the percentage of uh adolescents and children is compared to 20, 30, 50 years ago. No more. Um because because that's the other, you know, that's a whole nother discussion of overweight children become overweight adults. Absolutely. Um with the same problems earlier.

SPEAKER_03 27:04

Yep. And they're taking the aggressive uh stance too. The American Pediatric Association is taking a very similar stance of saying, we're not waiting anymore.

SPEAKER_00 27:13

Yeah, treat this.

SPEAKER_03 27:14

Like treat this, get on top of this. Kids from the age 12 up, they're they're recommending providers take an aggressive approach, a very proactive, let's call it aggressive, might be over the top. Um, a very proactive approach in these kids, including medications. Yeah, they're not saying sit around and wait for these bigger children to be bigger adults, because that just means that they were bigger that much longer. So they're gonna have osteoarthritis of the knees longer, back bone, knee replacements when they're 35.

SPEAKER_02 27:44

Yeah.

SPEAKER_03 27:44

I mean, this is not where if we're trying to not only extend people's lives, but extend the quality or improve the quality of life, we need to get on this stuff sooner. The longer you are in that disease state, whether it be high blood pressure, high blood sugar, or in this case obesity, the longer you're in that state, um, the more wear and tear it is on your body. Uh Rick had brought up one time he did the math on how much weight he's lost and for how many steps a day he takes. If you take 8,000 steps in a day. Yeah.

SPEAKER_01 28:11

And it was like it was like a million pounds or something a day. I mean, it's just an incredible amount of weight on your back and your knees. I don't know. It was a lot, it was a lot of weight. It's every day on each knee.

unknown 28:22

Yep.

SPEAKER_03 28:23

So it's at the end of the day, we're we're really just promoting that we agree with this stance, we're on board with it, and we really hope that this starts getting treated appropriately. And it takes time, just like anything in medicine. These shifts happen, and it takes time for for it to catch up.

SPEAKER_02 28:38

Yeah, no, and this and we welcome this. This is this is really uh I can't overemploys the groundbreaking to have this joint policy statement. Um, recent is just a month old. And so, so hopefully we can see some some shift and some change in the upcoming uh months, years. Uh, it'll take some time to disseminate this, but this is this is this is a big deal. Uh so anyway, we hope that works. Helps you understand a little bit of kind of the how we how we need to view this as clinicians and as individuals and uh even as family members to support people for those who have this. I mean, it's the same kind of thing. We're all in this together. Uh, hoping everyone stays healthier ever after. Uh, catch us on supportmyweightloss.com. And if you need some supplements, getweightwise.com. Getweightwise.com. Um, we will see you next time. Thanks so much for being here and take care. Be healthy.